Reticulocyte count

1. Include an introductory paragraph that includes the following:

 The author’s name(s): Alireza Moradabadi MSc1, Morteza Khaleghi MSc2, Maryam Shahdoost
PhD3, Alireza Farsinejad PhD4,

 The title of the article: Optimized Method for Reticulocyte Counting: Simple, Accurate, and
Comparable to Flow Cytometry

 The author’s main point: To achieve improved counting by using the modification in the manual
staining method

 A statement that previews your analysis: Interferences related to dye deposits and Heinz
bodies was minimized due to an additional step of bleaching; hence, the accuracy of this
method remained high and comparable to that of flow cytometry methods.

2. SUMMARY

After your introduction, discuss the following in your own words:

 The main points of the article: According to their research study, reticulocyte counts are
currently conducted manually or automatically in clinical laboratories. The difficulties and
limitations of such methods, including imprecision, low reproducibility and laboriousness, are
clear. Researchers used modification in the manual staining method to achieve better counting.

 The arguments presented in the article: Before performing the analysis, normality of data and
also sphericity assumption were checked by Kolmogorov-Smirnov and Mouchley analyses,
respectively. Contrary to normality test results, Mouchly test could not confirm the
compound symmetry assumption (p<0.001). Therefore, the repeated measure analysis was
performed using Greenhouse-Geisser correction (epsilon=0.552).

 The findings of the article: In another study conducted by Pappas et al to compare these
methods, it was found that 10,000 or more cells (now 30,000 cells in our laboratory) could be
counted using flow cytometric method; however, 1,000 could be counted by conventional
method, revealing the higher statistical accuracy of the flow cytometry method.

3. CRITIQUE

After summarizing the article, critique the article and answer the following guide questions:

 Strengths: The proposed optimized method was simple method, highly reliable, and comparable
to flow cytometry. Due to the ease of implementation, this method did not need specialized
training or the use of complex devices so it is affordable.
  Weaknesses: Reticulocyte counting using fluorescent dyes such as Acridine Orange which stains
only RNA in red blood cells, was reported by KOZENOW and MAI in 1950 using fluorescence
microscopy. This method was not generally adopted because of the unavailability of appropriate
equipment and the lack of clear advantages as compared to the microscopic method

 State your informed opinions about the clarity, relevancy, and accuracy of the article about
the topic of interest? Today, the proper diagnosis of blood diseases is dependent on accurate
measurement of blood parameters, including the counting of blood cells. Among these,
reticulocyte count is very important in the diagnosis and determination of the effectiveness of
anemia treatment. The reticulocyte count and the measurement of its related parameters are
very useful in the differential diagnosis of common types of anemia such as iron deficiency and
beta thalassemia minor.

Notes:

1. Type in the link/website URL of the journal article:

https://www.researchgate.net/publication/330268978_Optimized_Method_for_Reticulocyte_Counting
_Simple_Accurate_and_Comparable_to_Flow_Cytometry

ESR
1. Include an introductory paragraph that includes the following:

 The author’s name(s): Reza Hashemi,1 Alireza Majidi,2,* Hassan Motamed,3 Afshin Amini,4 Fares

Najari,5 and Ali Tabatabaey2

 The title of the article: Erythrocyte Sedimentation Rate Measurement Using as a Rapid
Alternative to the Westergren Method

 The author’s main point: To test a faster and more accurate ESR estimation method.

 A statement that previews your analysis: The study results showed that micro ESR at 20
minutes had the earliest significant correlation with conventional ESR, which means that micro
ESR results can be successfully interpreted after this time; thus, it can reduce the report time to
a third of that in conventional ESR method. Furthermore, it was shown that accurate
estimations of the conventional ESR could be made through correcting micro ESR measurements
at 20 minutes by a simple formula presented in their research study.
 

2. SUMMARY

After your introduction, discuss the following in your own words:

 The main points of the article: According to the researcher's study, Newer versions of ESR
estimation have been proposed throughout the years and aimed to reduce its shortcomings
while keeping its benefits. One such flaw, particularly in emergency situations, is that the test
would take at least 60 minutes before it can be reported. So, the purpose of the present study
was to determine the validity of this old form of implementation in emergency situations.

 The arguments presented in the article: the new method of micro ESR is carried out only once
on each patient and therefore the reproducibility of the results is not clear. Nevertheless, the
impressive correlation and agreement of micro ESR with conventional ESR in a wide range of
patients paves the way for assessment of its reproducibility and validity in extreme outcome of
future studies.

 The findings of the article: It seems that performing ESR using capillary tubes and capillary
blood may be a reliable substitute for conventional ESR measurement. Furthermore, alongside
its time saving and diagnostic accuracy, the method described here does not require
venipuncture, requires less blood, less sophisticated equipment, and is more economical. All of
these features in different parts such as screening, diagnosis, and follow up of the disease turn it
to a more desirable and cost-effective alternative to the conventional method proposed by
Westergren. Larger studies with wider range of patients will be required in the future to reaffirm
the finding of this study.

3. CRITIQUE

After summarizing the article, critique the article and answer the following guide questions:

 Strengths: Using capillary tube and capillary blood sample (micro ESR) appears to be a faster,
cheaper, more reliable, and precise tool for ESR measurement in the ED. The results have
acceptable correlation with conventional ESR, especially at 20 minutes of measurement.

 Weaknesses: The conventional method of Westergren, suggested by the International

Committee for Standardization in Hematology as the standard procedure, is time consuming and
requires a relatively large volume of patient’s blood. This is especially cumbersome for critically
ill patients requiring multiple samplings, infants, and neonates. It has been suggested that
removal of 1 milliliter of blood from a 1,000gram infant is estimated to be equivalent to
removing 70milliliter from the average adult. Therefore, a faster but reliable test can greatly
help in timely clinical decision making, while a simpler method of sample collection will be
welcomed by both patients and clinicians.

 State your informed opinions about the clarity, relevancy, and accuracy of the article about
the topic of interest? ESR determination is one of the most basic tests performed in diagnostic
laboratories. Its result has great importance for some critical diagnoses such as giant cell
 arteritis in the ED. It also takes as an important index in the management and disposition of
patients with rheumatologic conditions as well as integral part of clinical decision-making for a
wide range of medical conditions.

Notes:

1. Type in the link/website URL of the journal article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614602/