ABSTRACT
Background & objectives: Anemia is considered as important clinical manifestation of haematological and non-haematological disease while thalassemia and sickle cell disease considered now as genetic disorders. The purpose is to investigate prevalence of anemia, β-thalassemia trait and sickle cell trait. Materials & Method: The present study was carried in 250 medical students (194 male & 56 female) for screening of for anemia, β thalassemia trait and sickle cell trait with help of tests like Haemoglobin estimation, Peripheral blood smear examination, NESTROFT and Dithionate turbidity test5,6 and Hb electrophoresis. Results: The prevalence of anemia was higher in female 25 (44.6%) as compared to male medical students 59 (30.4%) & difference was statistically significant (p<0.05) but anemia detected in male & female medical students was not correlated with MCV & PCV value (p>0.05). Only 2 (1.03%) male shows β thalassemia trait and sickle cell trait while in case of female 2 (3.57%) shows prevalence of β thalassemia trait & 1 (1.7%) shows prevalence of sickle cell trait. Conclusion: Knowledge of heterozygote for β-thalassemia trait and sickle cell trait impart great impact on society for genetic counselling and prevention of their offspring became homozygote for thalassemia major and sickle cell disease. Also evaluate sensitivity of simple screening test like NESTROFT and dithionate solubility test for detection of β-thalassemia trait and sickle cell trait.
ABSTRACT
Background: Thalassemias are a group of congenital anemias that have in common deficient synthesis of one or more of the globin subunits of normal human hemoglobin. They are one of the commonest inherited hemolytic disorders Beta Thalassemias major is the clinically most significant homozygous form resulting in reduced or absent beta chain production.In India there is variable carriage rate in different parts of the country. It is more common in Sindhis, Lohanas, Bhansalis and some tribal communities. State wise Punjab, Gujarat, West Bengal have higher incidence. Mainstay of management of thalassemia is 2-4 weekly packed red cell transfusion. Major complications of this treatment are iron overload and chance of contracting transfusion transmitted infections. Most concern amongst them are HIV infection, hepatitis B and C. Objectives of the study: To determine the prevalence of HIV, Hepatitis B and Hepatitis C in multi transfused thalassemia major children & to find some measures to reduce the risk of transfusion transmitted disease in them. Methods: Blood samples of patients attending thalassemia clinic of paediatric department of the Medical college of Saurashtra region were tested for HIV, HbsAg and HCV after obtaining written consent when they came for receiving blood transfusions.. The samples were tested with standard ELISA kit for detection of HIV 1 and 2, HCV and HbsAg on Biorad automatic ELISA reader and washer. Results: Incidence rate for HIV was 3.1%, HCV was 7.8%& HbsAg was 0.52%.The increased sero positivity coincided with increased number of transfusions. There was simultaneous existence of more than one infection in 2 of the cases. Conclusion: Incidence of HIV positivity has decreased due to mandatory screening of all blood bags, proper selection criteria of donors and use of newer techniques for detection. HCV infection can causes chronic liver disease and increased risk of hepatocellular carcinoma. The low incidence of HbsAg positivity can be correlated with high proportion of the children getting vaccinated. The focus is now on minimizing window period donation. Hence selection of donors is of utmost importance. HIV minipool nucleic acid testing (MP-NAT), HIV-1 p24 antigen testing of donor’s blood.Window period is reduced up to 6 days.