Pattern of Blood Transfusion Request and Utilization at a Nigerian University Teaching Hospital

Introduction: Provision of adequate safe blood is challenging in developing countries due to paucity of voluntary blood donors; poor facilities for storage and blood component preparation as well as inappropriate blood ordering and utilization. Appraisal of pattern of blood transfusion requests and utilization helps highlight shortcomings that could be addressed toward judicious use of blood. Aims: To determine the pattern of blood transfusion requests and utilization at a Nigerian Teaching Hospital. Materials and Methods: Blood request forms and cross-match worksheets at the blood bank of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto were analyzed over a 3-month period. Number of blood units requested; cross-matched; or transfused and the cross-match to transfusion ratio (CTR) for clinical units were computed. Results: Of the 1703 units of blood requested for 986 patients; 94.42 (1608) were cross-matched but only 34.51 (555) were transfused giving a CTR of 2.90 for the hospital. The CTR for the various clinical units were: O and G - 3.40; Surgery - 3.11; Trauma center - 2.74; Emergency - 2.61; Medicine - 2.02; and Pediatrics - 1.97. Conclusions: The overall CTR of the hospital is high indicating suboptimal transfusion practice. Introducing transfusion guidelines and type and screen with abbreviated cross-match method can help toward apt requisition and utilization of blood thereby reducing wastages

Effect of Plasma Storage on Prothrombin Time and Activated Partial Thromboplastin Time at a Nigerian Public Laboratory

Background: Prothrombin time (PT) and activated partial thromboplastin time (APTT) are the tests used in the investigation and monitoring of hemostatic disorders. Plasma is used to perform these tests immediately or stored for later use. The time and storage temperature have been shown to affect the results of these tests. Thus; all coagulation laboratories need guidelines for plasma storage to ensure reliable results. Objective: To determine the effect of varying storage times and temperatures on plasma PT and APTT. Materials and Methods: PT and APTT were run on plasma from 40 healthy adults using a semi-automated coagulometer. PT and APTT were measured at 0; 4; 6; and 24 h on samples stored at room temperature; refrigerated samples; and frozen samples. The values at 0 h were compared with the values at 4; 6; and 24 h. Results: PT and APTT values were within the reference ranges at 0 h. For refrigerated plasma; PT values at 4 h were within normal; but at 6 and 24 h; they were significantly deranged (P 0.05). PT was significantly different at 4; 6; and 24 h for both room temperature and frozen plasma (P 0.05). The APTT showed significant differences between 0 h value and values at 4; 6; and 24 h for all the varying temperature conditions. Conclusion: For reliable PT and APTT results; samples should be processed and run immediately after collection. However; plasma for PT can be stored at 2o-4oC for only 4 h

Morphology of Colorectal Carcinoma among Nigerians: A 30-Year Review

Background: The incidence of colorectal carcinoma has been on the increase in the developing countries; including Nigeria; as a result of change in diet and adoption of western lifestyle. Objectives: The aim of this review is to highlight the prevalence; age and sex distribution; anatomical location; and morphological characteristics of colorectal carcinomas in Ilorin; Nigeria. Materials and Methods: This is a retrospective study of all cases of histologically diagnosed colorectal carcinoma in the University of Ilorin Teaching Hospital; Ilorin; Nigeria; over a 30-year period (January 1979-December 2008); using the departmental record and histological slides of the cases. Result: A total of 241 cases of colorectal carcinoma were reported; 144 cases (60) in males and 96 cases (40) in females with a male: female ratio of 1.5:1. The peak age of occurrence for males was between 51 and 60 years; while that of the females was between 41 and 50 years. The malignancy was found in the rectum in 60.2of the cases; while the least affected site is the descending colon (1.2). The exophytic occluding masses were found in 82.2of the cases; and the most common histological type is adenocarcinoma (77.2) with well-; moderately; and poorly differentiated forms constituting 52.3; 32.8; and 14.9respectively. Of the 241 cases that were seen over the last 30 years; 93 cases (38.6) were seen in the last 5 years. Conclusion: Colorectal carcinoma is no longer a rare disease in Nigeria. The surge in the incidence reported in the last 5 years in this center calls for a pragmatic action in its control; with emphasize on colonoscopic screening for those with family history; and possibly making digital rectal examination a mandatory aspect of clinical examination; because most colorectal carcinomas are within the reach of examining finger

Aspects of Microbial Quality of some Milk Products in Abuja Nigeria

Purpose: To assess the microbiological quality of some milk products in Abuja; Nigeria capital city; and the resistance of isolates to some broad spectrum antibiotics. Method: Three packs of different brands of yoghurt and pasteurized milk purchased from four different locations were assessed in duplicate. Isolates were identified using growth on agar and broth; Gram's reaction; colony morphology; biochemical tests results and criteria for disregarding negative cultures. Resistance of isolates from pasteurized milk was determined using the antibiotic sensitivity test (zones of inhibition). Results: 33 bacterial and 12 fungal isolates belonging to 9 and 3 genera respectively were identified from the yoghurt samples. Presence of yeast was found to increase the microbial load of bacteria groups and decrease the load of live and active cultures which was absent in 33of yoghurt samples. 27of samples were heat-treated and contained no LAC. A total of 19 bacterial isolates belonging to 6 genera were identified from the pasteurized milk samples. Milk quality based on methylene blue decolourization time measurement revealed that 49of the assessed samples were of excellent quality; 37of good quality; 14of fair quality; and 0of poor quality. No milk sample was sterile. Among the three antibiotics tested for resistance on the isolated bacterial strains; three different resistance patterns were observed. Conclusion: Our study shows that mesophilic yeast was the main cause of yoghurt spoilage. Sampled yoghurt is unlikely to make a vital input to LAC intake in Nigerian diets and poses some yet undefined risk. Visual inspection of packages; quality assessment of diary plants/vessels and packaging materials; dye reduction tests; refrigeration at all times; and resistance testing should be critically considered before the use of recommended antibiotics.of yoghurt samples. 27of samples were heat-treated and contained no LAC. A total of 19 bacterial isolates belonging to 6 genera were identified from the pasteurized milk samples. Milk quality based on methylene blue decolourization time measurement revealed that 49of the assessed samples were of excellent quality; 37of good quality; 14of fair quality; and 0of poor quality. No milk sample was sterile. Among the three antibiotics tested for resistance on the isolated bacterial strains; three different resistance patterns were observed. Conclusion: Our study shows that meso- philic yeast was the main cause of yoghurt spoilage. Sampled yoghurt is unlikely to make a vital input to LAC intake in Nigerian diets and poses some yet undefined risk. Visual inspection of packages; quality assessment of diary plants/vessels and packaging materials; dye reduction tests; refrigeration at all times; and resistance testing should be critically considered before the use of recommended antibiotics