Prevalence of hepatitis B & C infections in prospective blood donors deferred due to history of jaundice

Background & objectives: As per national guidelines, prospective blood donors with a history of jaundice of unknown cause are deferred permanently to prevent the transmission of hepatitis B and C. The validity of this guideline was tested by comparing prevalence rates of hepatitis B and C in prospective blood donors deferred due to a history of jaundice, with that of donors who were found fit. Methods: Blood samples of 212 consecutive donors (male, n=203) deferred due to a history of jaundice were studied for hepatitis B and C by rapid test kits as well as by chemiluminescence (n=115) or ELISA (n=97). Consecutive healthy donors (n=549; male, n=518) were also studied by ELISA (n=266) or chemiluminescence (n=283). Results: The cumulative prevalence detected by rapid test kit and ELISA/chemiluminescence tests of hepatitis B (n=10) and C (n=2) among donors deferred due to a history of jaundice (n=212) was 5.7 per cent [95% confidence interval (CI): 2.9, 9.9]. The prevalence of reactive results among healthy donors (n=549) by ELISA/chemiluminescence tests was 3.3 per cent (95% CI: 1.9, 5.2), which included hepatitis B (n=15) and hepatitis C (n=3) cases. Compared to healthy donors, the odds of seropositivity among jaundice-deferred donors was 1.7 (95% CI: 0.8, 3.6), P=0.15. For rapid test-negative deferred donors, the odds of seropositivity by ELISA/chemiluminescence declined to 0.4 (0.1, 1.5), P=0.19. Interpretation & conclusions: The prevalence rates of hepatitis B and C in prospective blood donors deferred due to a history of jaundice of unknown aetiology did not differ significantly from that in healthy donors. The current practice of permanently deferring such donors depletes valuable donor pool. A strategy of rejecting only those donors who are found reactive on pre-donation testing by rapid test needs further validation.

The Passage Effect on the Senescence Profile of Cryopreserved Bone Marrow and Adipose-Derived Mesenchymal Stem Cells

Background: Although bone marrow serves as the ‘gold standard’ MSC source, adipose tissue has become a promising alternative source. Passage and cryopreservation are two effective methods to multiply, pool, and store MSC without altering its function Aims: To investigate the passage effects on the senescence profile of cryopreserved bone marrow and adipose-derived mesenchymal stem cells (MSCs). Study Design: Analytical observational study. Place and Duration of Study: Stem Cell Medical Technology Integrated Service Unit, Faculty of Medicine, Universitas Indonesia—Cipto Mangunkusumo Hospital, Jakarta, Indonesia, during the period of April to September 2016. Methodology: We analyzed the viability, cell size, population doubling time (PDT), percentage of senescent cells, and colony forming unit. Samples were bone marrow and adipose MSCs at passage one, which was cryopreserved for the first and second time. Numerical data were analyzed using the Student’s T test and analysis of variance (ANOVA) test. Results: Both in once and twice cryopreservation group, PDT and senescent cell percentage of bone marrow and adipose tissue MSCs differed significantly, where the PDT senescent cell percentage values of bone marrow MSCs were higher in all passages compared to adipose tissue. Regarding 30% confluence cell size and viability, significant differences between once and twice cryopreservation group varied and did not show any trend. The cell size and viability were less 2500 µm2, and more than 85%, respectively. Therefore, the difference in cell size at 30% confluence and viability might be regarded as normal variations. Conclusion: Cryopreserved adipose-derived MSCs showed better results compared to cryopreserved bone marrow-derived MSCs in terms of population doubling time (PDT) and senescence.

Effect of Septoplasty on Mean Platelet Volume in Patients of Deviated Nasal Septum.

Background: Mean platelet volume corresponds to average size of platelets and studies proved that large platelets are enzymatically and metabolically more active and have prothrombotic potential. Chronic upper airway like marked nasal septal deviation leads to higher Mean platelet volume and vice versa septoplasty operation lowers the volume of the platelets over a period of time and hence reduces other associated comorbidities. Objectives: This study was done with an aim to analyze the effect of Septoplasty on Mean Platelet Volume Levels in patients with Marked Nasal Septal Deviation. Methods: A prospective study was done in a total of 50 patients who were selected from ENT OPD and ENT Ward of Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh after proper history and examination. Results: Data obtained from preoperative and postoperative blood investigation were analysed using paired t-test and it was statistically proved that after Septoplasty, Mean Platelet Volume was significantly lowered in patients who had Marked Nasal Septal Deviation. Conclusion: Septoplasty plays an important role in reducing the MPV value in cases with Marked nasal septal deviation and thus other comorbid conditions can be prevented by doing septoplasty in these patients.

Role of Imprint Cytology in Diagnosis of Lymph Node Lesions.

Introduction: Imprint cytology is proved to be rapid inexpensive tool in the diagnosis of various lymph node lesions. Objective: The present study was conducted to correlate the diagnostic accuracy, sensitivity and specificity of imprint cytology of various lymph node lesions with histopathological diagnosis. 102 cases were included in the study comprising inflammatory lesion, tubercular lymphadenitis, lymphomas and metastatic carcinomas. Material and Method: From 102 cases of lymph node excision, imprint smears were taken and stained with Hematoxylin & Eosin and Papanicolaou stains. The findings of imprint cytology were then compared with final histopathological diagnosis. Result: When compared with final histopathological diagnosis, imprint smears showed overall diagnostic accuracy of 97.8% with sensitivity and specificity of 95.05% and 98.69% respectively. Accuracy rate for metastatic lymphadenopathy was 100%, whereas, for tubercular lymphadenitis it was 98.04% and for lymphomas 96.04%. Conclusion: Imprint cytology proved to be very useful for diagnosis of metastatic tumour as it gave 100% diagnostic accuracy, sensitivity and specificity. Imprint cytology is also considered to be useful in superficial ulcers to differentiate between benign and malignant lesions without surgical intervention.

Central nervous system tuberculosis and adjuvant corticosteroid therapy.

Tuberculous involvement of central nervous system is one of the important health issues causing high mortality and morbidity. Uncertainty and doubt dominate all aspects of CNS tuberculosis. Diagnosis is mainly based on clinical features, cerebrospinal fluid changes, and imaging characteristics. Few studies have shown that corticosteroids improve the clinical outcome, although the precise mechanism of action remains tentative. All the cases were selected on strong clinical suspicion of CNS tuberculosis. They were graded according to tuberculous meningitis (TM) severity grades. In this connection, we studied 13 patients in one medicine unit over 12 month's period to see the effect of corticosteroid as part of the outcome. Nine patients (69.23%) were in grade II, three (23.08%) patients were in grade III, and one (7.69%) was in grade I. Seven patients (53.85%) had tuberculous meningitis and six (46.15%) had tuberculoma (CT or MRI). Out of 13 cases 3 patients (23%) died in the hospital and 10 patients (77%) improved, of whom 2 patients (20%) recovered completely and 8 patients (80%) had residual neurological deficit. Our study suggests that the early detection of CNS tuberculosis is the most important prognostic factor. Timely started anti-Koch's treatment with adjuvant corticosteroid therapy has a direct bearing on patient outcome.

Microfilariae in Testicular Fine Needle Aspiration Biopsy.

Filariasis due to Wucheria bancrofti is endemic to Southern Asia. While the laboratory diagnosis has been conventionally made by demonstrating microfilariae in peripheral blood smears, these have also been occasionally diagnosed on aspiration cytology of various organs. This paper reports the finding of microfilariae in material obtained from the testicular mass in an eighteen year old male by fine needle aspiration (FNA) cytology.

Comparison of hybrid capture and reverse transcriptase polymerase chain reaction methods in terms of diagnosing human cytomegalovirus infection in patients followings hematopoietic stem cell transplantation

Human cytomegalovirus [CMV] is a life threatening cause of infection among hematopoietic stem cell recipients. Developing reliable methods in detecting the CMV infection is important to identify the patients at risk of CMV infection and disease. The aim of this study was to compare the 2 tests- hybrid capture test, which is routinely used in the diagnosis of CMV infection among hematopoietic stem cell recipients, and reverse transcriptase polymerase chain reaction [RT-PCR] detecting UL21.5 mRNA transcripts of the active virus. In this prospective study, a total of 178 blood samples obtained from 35 patients following allogeneic hematopoietic stem cell transplantation at the Bone Marrow Transplantation Unit of the Hematology Department, Ibn-i Sina Hospital of Ankara University School of Medicine, Turkey between January 2003 and September 2003 were analyzed. Hybrid capture and RT-PCR using UL21.5 gene transcript method to investigate HCMV in blood samples were performed at the Department of Microbiology and Clinic Microbiology Ankara University School of Medicine, Turkey. When hybrid capture test was accepted as the golden standard, the sensitivity of RT-PCR was 33%, specificity 100%, false negativity 67%, false positivity 0%, positive predictive value 100%, negative predictive value 74%, and accuracy was 77%. Improving this test by quantification, and application of additional gene transcripts, primarily the late gene transcripts can help increase the sensitivity and feasibility

Oxidative stress in chronic renal failure patients treated by peritoneal dialysis

To evaluate the role of oxidative stress [OS] in chronic renal failure [CRF] and the effect of peritoneal dialysis on the OS in uremic patients. Also, to investigate the role of the studied parameters of OS as early markers for the detection of peritonitis in peritoneally dialyzed patients. The study was conducted on 80 chronic renal failure Iraqi patients who were admitted to the dialysis centers at Al-Kadhumiya, Baghdad, Al-Yarmouk and Al-Karama teaching hospitals, Baghdad, Iraq, during the period November 1999 through to July 2000 for peritoneal or hemodialysis therapy. Their ages range between 15-75-years. This was carried out by measuring the plasma values of malondialdehyde [MDA], thiol group, albumin, uric acid and total bilirubin before and after the dialysis session, compared to age and sex matched healthy controls. The significantly higher plasma MDA with lower plasma thiol levels prior to the dialysis session indicated most likely an increased OS in CRF patients, which has significantly decreased after the dialysis session. This OS was found to be significantly correlated with the degree of renal insufficiency measured by serum creatinine levels. In patients who developed peritonitis, post dialysis findings were in favor of an increase rather than a decrease in OS. Such findings were found prior to the clinical or biochemical diagnosis of peritonitis or both in most patients. Finally, in patients on regular hemodialysis therapy, results suggested a minor OS compared to patients admitted for peritoneal dialysis therapy. Patients with CRF are subjected to an increased OS, the degree of which is related to the severity of renal failure. Moreover, plasma levels of the studied markers of OS do point in the direction of a decrease in the OS post dialysis. Such markers can be used for early detection of peritonitis in peritoneally dialyzed patients. Finally, chronic regular dialysis therapy is a more effective replacement therapy

Serum immunoglobulin levels in neoplastic disorder of breast.

Serum IgG, IgA and IgM were estimated in 42 cases of carcinoma and 12 cases of fibroadenoma of breast. The results were compared with 20 healthy female controls. Results showed increased levels of serum IgA in carcinoma breast cases. This increase was statistically significant (p = 0.001) when compared with healthy controls while IgG and IgM values were found to be insignificant. Values of IgG, IgA and IgM in cases of fibroadenoma breast when compared with the controls were found to be insignificant. Statistically significant increased value of IgA was also observed in medullary carcinoma and non-metastasizing tumours when viewed separately, suggestive of good prognostic index of serum IgA level estimation in the case of carcinoma breast.

Stroke in patients having inadequate or irregular antihypertensive therapy.

One hundred consecutive hypertensive patients with stroke admitted to the medicine units of Dhaka Medical College Hospital were studied. The main objective was to study the extent of drug compliance and control of blood pressure in hypertensive patients who had suffered a stroke. Detailed history and clinical examinations were performed in all patients and outcome was recorded. Of the 100 patients studied there were 73(73%) males, 27 (27%) patients had no formal schooling and 53 (53%) had some education. 48 (48%) patients were from middle class and 36 (36%) were poor, 66 (66%) patients were aware that they were hypertensive though only 8 (12.9%) were taking anti-hypertensive drugs regularly. 62% of the patients had suffered from stroke within 5 years of detection of hypertension, and 15 (15%) patients died in the hospital.