Analysis of ABO discrepancies occurring at a university hospital, Al-Khobar, Saudi Arabia

To assess the incidence and causes of all ABO discrepancies. The King Fahd Hospital of the University [KFHU], Al-Khobar in Eastern Saudi Arabia. Retrospective study. The study was performed between January 1992 to December 2005. ABO discrepancies were detected during routine blood bank laboratory testing by comparing either two current blood specimens or a current and historical specimen. Two hundred and sixty-one discrepancies were discovered in a series of 549,229 blood group tests performed during the study period, a frequency of 0.05%. The most common cause involved ABO subgroups, then errors of blood collection during phlebotomy that is collecting from a wrong patient and finally clerical errors during patient registration or identification. ABO discrepancies can result from inaccuracy made by hospital staff during phlebotomy and collection of specimens, clerical errors and ABO subgroups. Technical errors are also a cause but none was found in this study. Careful techniques are needed to ensure proper collection and labeling of specimens during and after specimen collection to avoid any fatal complications. Repeat testing and investigation for ABO subgroups is very important

case of haemolytic disease of the newborn due to maternal anti-E and anti-c

Hemolytic disease of the fetus and newborn [HDN] is a condition in which the lifespan of an infant's red blood cells [RBCs] is shortened by the action of specific IgG antibody/ies derived from the mother. These antibodies may be directed against Rhesus or other blood group antigens on fetal RBCs that are inherited from the father but are not expressed by the mother. The widespread use of Rh immune globulin has dramatically decreased occurrence of anti-D HDN among D-Negative pregnant women, but alloimmunization and importance of antigens other than D has increased. We report a case of HDN due to maternal Anti-E and anti-c in an O positive mother. The newborn received double phototherapy and exchange transfusion followed by a top up transfusion and was discharged with no further problems

Curriculum reform and the future direction of the medical laboratory technology program

A periodic review of the curriculum is a key element for the success of any educational program. The Medical Laboratory Technology [MLT] program at King Faisal University has undergone repeated reviews of its curriculum. Recently, we evaluated the curriculum through an academic staff members committee which thoroughly reviewed, it proposed certain changes and finally implemented those changes into the program structure. We also investigated the student's views about the changes in the curriculum through a structured questionnaire. This paper describes the different changes that have occurred in the MLT curriculum and the senior students' and recent graduates' view of the program. It also discusses the introduction of Problem Based Learning [PBL] as one of the future directions of curriculum change, the challenges and barriers of introducing PBL and how PBL could be best adopted in the curriculum

Glanzmann's thrombasthenia

To study the clinical presentation and laboratory findings of Glanzmann's thrombasthenia [GT]. This retrospective study was carried out from 1st January 1983 to 31[st]December, 2003. The records of the coagulation laboratory, Hematology clinic and medical records department were reviewed. Clinical data and family history were recorded. Laboratory investigations done included; complete blood count [CBC] peripheral blood smear [PBS], bleeding time [BT], activated partial thromboplastin time [APTT], prothrombin time [PT] clot retraction, platelet aggregation and in some patients flow cytometric analysis of platelet glycoproteins was carried out. Thirty-one patients were diagnosed with Glanzmann's thromboasthemia, seventeen were males and 14 were females. All were Saudi patients [most from eastern province and the southern part of the Kingdom] except for one Sudanese male patient. The mean age of patients was 26 +/- 12.34 years. The oldest was 71 years and the youngest 20 days. Many patients had bleeding from more than one site. The clinical presentations are as follows: epistaxis 16 [52%] menorrhagia 11 [35.5%], gum bleeding 10 [32.3%], bruises 7 [22.6%], bleeding at circumcision 4 [13%], hemoarthrosis 4 [13%], ecchymosis and petechial rash 5 [16.1%], gastrointestinal [GIT] bleeding 7 [23%], hematuria 2 [7%], delayed wound healing 1 [3%], bleeding with tooth eruption 1 [3%] and hemoptysis 1 [3%].Thirty patients had a prolonged bleeding time, all 31 patients had normal APTT and PT. Thirteen patients [42%] had poor clot retraction, 12 [39%] had no clot retraction and 6 [19%] had normal clot retraction. All patients had a marked reduction or absent aggregation to platelet agonists; adenosine diphosphate [ADP], collagen, epinephrine and arachidonic acid. Thirteen patients also had a reduction in aggregation with ristocetin. Flow cytometric analysis done on some patients showed a reduction in platelet membrane glycoproteins 41 and 62 [CD41, CD62]. In spite of the fact that GT is a rare disease worldwide, the situation might be different in our country. The spectrum of clinical presentation and complications in patients with GT appears to be wide, in addition to different platelet aggregation patterns i.e. reduction in aggregation with ristocetin. Still more studies are needed to clarify the pattern in Saudi patients and to raise awareness hoping to help in early recognition, presentation, and more appropriate management. Extensive collaborated studies are needed to predict the true incidence of hereditary bleeding disorders including GT among the Saudi population, as well as a national registry for these disorders