ABSTRACT
Aim: The aim of this study was to determine the levels of basic biochemical parameters like uric acid, potassium, sodium, bicarbonate and chloride in umbilical cord blood with a view to assess its suitability for stem cell transplantation. Study Design: This is a cross-sectional prospective study. Place and Duration of the Study: The study was carried out at the Departments of Obstetrics and Gynaecology, and Chemical Pathology University of Benin Teaching Hospital, Benin City Nigeria between July 2010 and March 2011. Methodology: Cord blood from a total of 164 pregnant women (HIV, hepatitis B and C negative) who delivered in University of Benin Teaching Hospital from July 2010 to March 2011 were analyzed for some basic biochemical parameters. Results: The levels of the biochemical parameters were sodium 135.4±6.1mmol/L (128 to 150mmol/L), potassium 7.08±1.9mmol/L (4.5 to 14.7mmol/L), bicarbonate 19.6±2.4mmol/L(14-25mmol/L), chloride 101.7±3.8mmol/L (90-109mmol/L) and uric acid 1.63±0.9mmol/L (0.19-3.09mmol/L) chloride was the most stable with a CV of 3.71% while uric acid was the least stable with a CV of 12.63%. Conclusion: Umbilical cord blood could become an important source of stem cell in sub-sahara Africa especially with the large number of deliveries. However careful selection of quality cord blood must be enforced to avoid contaminants and haemolysis which may be responsible for the hyperkalaemia as seen in this study.
ABSTRACT
Hematopoietic Stem cell Transplantation (HSCT) is an approved therapy by the World Health Organization (WHO) for non-malignant and malignant disorder. This is readily assessable and available in developed countries. In 2006 a total of 50,417 first HSCT was recorded worldwide and majority was done in Europe (48%) and the America’s (36%). While only 2% in East Mediterranean and Africa.In a global perspective study the first factor for the low HSCT in poor resource country was Government health care expenditure representing 77.33% of the variance. Second factor was team density and the third Gross National Income (GNI) per capital which added another 4.41% explanation. The first HSCT in Nigeria was done in September 2011 with several challenges in setting up a functioning unit. The challenges range from inadequate manpower compounded by brain drain of health workers. Only a Hematologist, two Nurses, two Laboratory scientists and a Hematopathologist trained for HSCT was available in Hospital. With respect to the challenges of infrastructure and equipment, a four bed isolation unit was constructed with HEPA-filtration and High-pressure machine, an Aphaeresis and platelet storage machine. Most of the supportive, diagnostic unit in the laboratory and Radio-imaging technique are below international substandard. There is need for improved laboratory culture especially for fungal and viral infections. In selecting patients we started with a seven years old child who had severe Sickle Cell disease from a 14 years sibling donor. Also supportive care with parentheral nutrition, blood support (irradiate products), and procurement of rare drugs was a huge challenge. The cost of the first patient transplant patient was paid for by the hospital and is beyond the reach of most Nigerians. The health insurance policy of the nation is still ineffective. Challenges in setting up the first HSCT unit in Nigeria are enormous but with a good political will from government and improved health insurance policy. HSCT could be made available, assessable and affordable to Nigerians who will require this form of therapy.
ABSTRACT
Background:The increased need of safe blood and blood products and their unavailability in hospitals remain a formidable challenge faced by healthcare providers in developing countries such as Nigeria.Aim: To determine the level of awareness of blood donation among tertiary institution undergraduates in an urban setting of Southern Nigeria. Methodology: Semi-structured questionnaire was used to collect information from undergraduates of the University of Benin and Delta State University both in southern Nigeria. Data analysis was done using SPSS software version 16. Results: A total of 396 people were surveyed. Of these; 370 (93.4) were aware that blood can be donated; while 172 (43.4) were aware of the WHO policy on blood donation. Three hundred and forty-one (86.1) were aware that blood donation should be nationally coordinated while 306(77.3) did not agree that medical workers have created enough awareness on blood donation. Two hundred and twenty-two (56.1) were aware that blood donation should be voluntary and 209(52.8) were willing to donate blood if there is an attached financial reward. Conclusion:This study has revealed a high level of awareness on blood donation among tertiary institution undergraduates in Southern Nigeria and have demonstrated a poor level of awareness of the WHO policy on blood donation
Subject(s)
Awareness , Blood Donors , StudentsABSTRACT
Background: The prevalence of anemia in HIV/ AIDS patients is high; with a multitude of possible etiologies; autoimmune hemolytic anemia (AIHA) in HIV/AIDS patients has been associated with a poor prognosis when treated with red cell transfusion. Our aim was to demonstrate the frequency of AIHA in a cohort of adult Nigerian HIV/AIDS patients and to see if the presence or not of AIHA is related to the severity of the disease with regards to the CD4 counts and the presence or absence of opportunistic infections. Method: Ninety- eight adult patients with HIV infection were screened for the presence of AIHA using the packed cell volume (PCV); direct antiglobulin test (DAT) and reticu- locyte count (RC). Results: The frequency of AIHA was 3.06; 36.74of our study population were anemic; 11.22had a positive DAT. Mean RC was 2.22 +/- 0.90 for all the patients. There was no statistically significant difference in the PCV of patients that had positive and negative DAT. There was no correlation between the presence of AIHA; use of ART; presence of opportunistic infections or CD4 counts. Conclusion: We conclude that in spite of the low frequency of AIHA in HIV/AIDS patients; the fact that most patients will respond to standard treatment makes it imperative to screen HIV/AIDS patients with anemia for the presence of AIHA. Again since HIV/AIDS patients with AIHA may have a fatal reaction to red cell transfusion; we suggest that anemic patients with HIV/AIDS in non-emergency situations be screened for the presence of AIHA before receiving red cell transfusions when indicated
Subject(s)
HIV , Acquired Immunodeficiency Syndrome , Anemia , HemolysisABSTRACT
Background: The prevalence of anemia in HIV/ AIDS patients is high; with a multitude of possible etiologies; autoimmune hemolytic anemia (AIHA) in HIV/AIDS patients has been associated with a poor prognosis when treated with red cell transfusion. Our aim was to demonstrate the frequency of AIHA in a cohort of adult Nigerian HIV/AIDS patients and to see if the presence or not of AIHA is related to the severity of the disease with regards to the CD4 counts and the presence or absence of opportunistic infections. Method: Ninety- eight adult patients with HIV infection were screened for the presence of AIHA using the packed cell volume (PCV); direct antiglobulin test (DAT) and reticulocyte count (RC). Results: The frequency of AIHA was 3.06; 36.74of our study population were anemic; 11.22had a positive DAT. Mean RC was 2.22 +/- 0.90 for all the patients. There was no statistically significant difference in the PCV of patients that had positive and negative DAT. There was no correlation between the presence of AIHA; use of ART; presence of opportunistic infections or CD4 counts. Conclusion: We conclude that in spite of the low frequency of AIHA in HIV/AIDS patients; the fact that most patients will respond to standard treatment makes it imperative to screen HIV/AIDS patients with anemia for the presence of AIHA. Again since HIV/AIDS patients with AIHA may have a fatal reaction to red cell transfusion; we suggest that anemic patients with HIV/AIDS in non-emergency situations be screened for the presence of AIHA before receiving red cell transfusions when indicated