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@#Introduction: Many countries struggle to supply enough blood while maintaining their quality and safety. Increasing the number of regular donors is expected to increase the donor pool and blood safety. Thus, this study describes lapsed and regular blood donors’ characteristics, knowledge, motivation, and barriers concerning blood donation. Methods: This observational cross-sectional study has adopted an assisted self-administered questionnaire, which was distributed to blood donors at the Department of Transfusion Medicine, Hospital Sultanah Bahiyah, Kedah. A total of 328 participants consisting of 164 lapsed and 164 regular donors were selected. Logistic regression tests were used to determine the factors that predict lapsed donors. Results: Out of the selected 328 respondents, 54.3% were in the 25–39 age group, 66.2% were males, and 85.1% were Malays. Most of the respondents (88.4%) showed adequate blood donation knowledge, and 99.7% cited altruism as a motivator for blood donation. About 47.0% of the respondents claimed they lack enough time as their donation barrier. Donors who were younger in age, had a moderate blood donation knowledge (adjusted OR, 3.60; 95% CI, 1.34-9.64), didn’t know where to donate (adjusted OR, 2.79; 95% CI, 1.47-5.29), lack enough time (adjusted OR, 1.83; 95% CI, 1.04-3.24), and insufficient information about blood donation campaigns (adjusted OR, 2.19; 95% CI, 1.23-3.91) were more likely to lapse. Conclusion: Donor education, convenient time and location, and sufficient information about blood donation campaigns targeted at young donors are critical for preventing lapsed donors, which could subsequently increase the regular donor pool.
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@#Introduction: ABO blood group can be associated with chronic diseases, for example, cancer and coronary heart disease, however it is not proven in Type 2 Diabetes Mellitus (T2DM). The aim of this study was to identify the association between the ABO blood group and disease control among T2DM patients at Kepala Batas, Penang. Methods: Approximately two mL vials of fresh blood were collected and typed using the tube method from 129 T2DM and 132 non-diabetic (control) patients, who visited the specialist clinic. The sociodemographic characteristics of the T2DM patients was analysed using descriptive analysis. The proportions of A, B, AB, and O blood groups among the diabetic and control patients were compared using the chi-square test. Any association between the ABO blood group and disease control was identified using the bivariate correlation test. Results: No significant association was found between the ABO group and T2DM patients (p = 0.152) when compared with the control group. However, blood group B was the most frequent among T2DM patients (33.3%) compared to blood group O within the control group (36.4%). Negative associations were observed between the ABO blood group and BMI (r = 0.098, p = 0.268), as well as the HbA1C value (r = -0.065, p = 0.464). Conclusion: No association was found between the ABO blood group and the associated risk factors (BMI and HbA1C). However, individuals with blood group B and risk factors, such as older age group, obesity, and high HbA1C value (more than 7.0%), should be monitored.
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@#Introduction: The association between clinical characteristics and endoscopic profile of acute non-variceal upper gastrointestinal bleeding (NVUGIB) patients with red blood cell (RBC) transfusion has not been well explored in Malaysia. Therefore, a retrospective study was performed using a five-years database to analyse the factors clinically and endoscopically for RBC transfusion. Methods: All adult NVUGIB patients who received RBC transfusion within the study period of 2012-2017 in Putrajaya Hospital were enrolled. There were 180 patients selected by systematic random sampling. Our composed clinical data include demography, risk factor, aetiology, presenting symptoms, Glasgow-Blatchford Score (GBS), endoscopic findings according to Forrest Classification and number unit of RBC transfusion. These data were analysed using Mann-Whitney U-Test, Pearson Correlation and Multiple Linear Regression (MLR). Results: Total 180 patients, the mean age was 63.9 (SD 11.6). Their presenting symptoms were melaena (62.8%), haematemesis (38.3%), and haematochezia (10.6%), with the cause of bleeding was gastric erosion (65.6%), duodenitis/duodenal ulcer (26.1%), and oesophagitis (7.8%). The mean GBS score was 10.7, and the number of RBC transfusion unit was 2.8. The Forrest Classification showed Forrest III (36.1%), Forrest IIc (22.8%), Forrest IIb and Ib (14.4%) respectively. Pearson’s Correlation showed a strong correlation between GBS and unit of RBC transfusion (r = 0.922, p-value <0.001). MLR analysis revealed haematochezia (p = 0.022) and higher GBS (p <0.001) were independent factors associated with a higher number of RBC transfusion unit. Conclusion: Haematochezia and higher GBS score were two predictive factors for a higher RBC transfusion unit in NVUGIB patients.
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@#Introduction: Acute transfusion reactions (ATR) are commonly reported in clinical transfusion practice, which may result in significant morbidity and mortality. This study aims to explore the impact of transfusion practice on the prevalence, characteristics, and associated factors of ATR at Hospital Sultanah Bahiyah, Kedah, Malaysia. Methods: This was a retrospective study using records from haemovigilance forms of reported transfusion reactions, E-Delphyn (blood bank system), and E-His (hospital information system). A total of 118 cases of ATR from January 1, 2015 until December 31, 2017 were selected and analysed. For each case, a control was selected from a patient who did not develop ATR. Results: A total of 122,215 units of whole blood and blood component transfusions have been performed and 415 ATR were reported. The prevalence of ATR was 0.34% or one in 294 units transfused. There was a significant association between ATR and red cell concentrate (RCC) stored for more than 14 days (adj OR = 65.29, 95% CI 9.29-458.85). The most common ATR were allergic reactions with 63 cases (53.4%), followed by febrile non-haemolytic transfusion reactions (FNHTR) with 45 cases (38.1%). Allergic reactions were significantly associated with female patients (p = 0.038) and the paediatrics age group (p = 0.038). Multivariate analysis revealed a significant association between FNHTR and RCC stored more than 14 days (p = 0.002). Conclusion: The prevalence of ATR in this hospital was low and associated with RCC stored for more than 14 days. Implementation of pre-storage leucoreduction is recommended.
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@#Apolipoprotien E (apoE) polymorphism is a human genetic risk factor and has been well-established to be associated with Alzheimer’s disease, lipid abnormalities, and cardiovascular disease (CVD). ApoE gene polymorphism is reported to correlate with lipid metabolism disturbances and coronary artery stenosis. Furthermore, ε4 allele carriers were found to have poor prognosis in survival rates of post-myocardial infarction. The purpose of the review is to distinguish the possible of apoE gene polymorphism as a determinant for CVD and its association. Preliminary data suggest ε4 allele carrier identification could be beneficial for risk stratification of CVD and initiation of statin therapy as primary intervention. Numerous studies have been done, however, results varied between studies as well as in different population. The evidence presented herein can help describe the risk prediction based on apoE gene polymorphism.
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Abstract@#Introduction: The practice of uncrossmatched red blood cells (URBC) transfusion has been accepted as part of resuscitation efforts in Emergency Departments (ED), especially in the case of hypovolemic shock secondary to blood loss. This study aimed to evaluate the outcome of patients who received URBC during the resuscitation process. Methods: This was a retrospective cross-sectional study among patients who received at least one unit of URBC in the ED at Hospital Universiti Sains Malaysia between March 1, 2016 and December 31, 2017. The outcome of patients who received URBC were analysed descriptively and presented as numbers and percentages. Simple log regression was used to analyse the association between the number of URBC given and the outcome of the patients. Results: A total of 106 patients were involved in this study, with 63 (59.4%) of them were male and 43 (40.6%) were female. The mean age of these patients was 41.58 years old. For the outcome, 25 patients (23.6%) had an activation of massive transfusion protocol (MTP), 37 patients (34.9%) received emergency surgical procedure, and 28 patients (26.4%) died during hospitalisation. The mean length of hospital stay was 10.65 days (SD: 17.4). Numbers of URBC received have a statistically significant association with mortality status (p = 0.015) and activation of MTP (p = 0.02), but no significant association with the need for emergency procedure (p = 0.469). Conclusion: The numbers of URBC transfused can be associated with mortality and the activation of MTP.
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Abstract@# Introduction: Recruitment of potential blood donors from a younger age group is a good effort because they would be in good health and may have a long journey in blood donation. This study evaluated the motivating and deterring factors for donating blood among blood donors, who are students pursuing higher education. Methods: This was a cross-sectional study using a set of questionnaires, involving 391 students in Kota Bharu, Kelantan, Malaysia. The research tool was adapted and modified, as well as validated and pilot-tested to ensure its validity and reliability. Data were analysed using the SPSS and Stata software. Results: The most highly rated motivating factor for donating blood was to help others and to create a good practice (98%). The motivating factor of being interested in a blood donation campaign was highly rated by female respondents (87%) compared to male respondents (79.1%). The most highly rated deterring factor was the dislike for skipping a class to donate blood (30.9%), which was highly rated as a positive response by female blood donors (35.1%). There was a significant difference between the motivating factors (p = 0.043) and the deterring factors (p = 0.011), as seen between gender. Items that have the logo of the blood donation centre, such as T-shirts, towels, mugs or bags are rated as the most attractive incentive (87%). Conclusion: Altruism was the main reason for young blood donors choosing to donate blood. Social media usage should be considered when promoting blood donation campaigns to this age group.