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Background: It is being increasingly recognised thatthalassemia major patients, like intermedia, have increasedpropensity for thromboembolism. Deficiency of naturalanticoagulants is more recently defined finding contributingto the hypercoagulable state. The aim this study is todetermine natural anticoagulants levels and their correlationwith maternal characteristics, haematological andbiochemical markers.
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Background: Blood transfusion safety commences with healthy donor recruitment. The threat of transfusion transmitted infections is greatly minimized by serological tools but not entirely eliminated. Recently, nucleic-acid testing for blood donor screening has virtually eliminated this jeopardy. Methods: This prospective study was conducted from February 2015 to February 2016. Samples from seronegative donors were run on multiplex assay (Cobas, S-201 system platform, Roche) in a batch of six [MP-NAT]. In case of reactive pool, tests were run on every individual sample [IDNAT]. Results: Of 16957 donors, 16836 (99.2%) were replacement donors and the remaining 121 (0.7%) were voluntary donors, with a mean age of 29.09 ± 7.04 years. After serologic screening of all 16957 donors, 955 (5.6%) were found to be reactive; 291(1.71%) were reactive for hepatitis-B surface antigen, 361 (2.12%) for antibody to hepatitis C virus (anti-HCV), 14 (0.08%) for antibody to human immunodeficiency virus, 287 (1.69%) for syphilis and 2 (0.01%) for malaria. 14 (0.08%) NAT reactive donors were identified after testing the 16002 seronegative donors, with an overall NAT yield of one reactivity out of 1143 blood donations; 10 donors for HBV-DNA (HBV NAT yield-1:1600) and remaining 4 for HCV-RNA (HCV-NAT yield-1:4000). None were HIV positive. Conclusion: NAT has improved the safety attributes in blood products. Although the positivity rate for NAT testing is low but in view of the high prevalence of transfusion transmitted infections in our country, we recommend the parallel use of both serology and NAT screening of all donated blood.
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Back ground: Immune thrombocytopenic purpura (ITP) is a hemorrhagic diathesis, characterized by platelets destruction alongside impaired production. Patients from Asian regions often exhibit distinctive characteristics in comparison to the western patients. We accomplished this study to evaluate the prevalence of primary versus secondary ITP along with the comparative analysis between them. The secondary objective was to determine the etiological spectrum of secondary ITP. Methods: We illustrate the results of a large cohort of newly diagnosed adults ITP from southern Pakistan. The study extended from January 2009-December 2013. Complete blood counts, HbsAg, Anti-HCV, ANA, stool for Helicobacterpylori were done on all. HIV, TSH, anti-dsDNA, RA factor, APLA and direct coombs test were evaluated in cases where indicated. Results: A total of 417 patients were included with a mean age of 40.95±14.82 years. Primarily disease was observed in the 3rd decade of life. Male to female ratio was 1:1.5. Mean platelets count was 46.21±27.45x109 /l. At diagnosis 43.16% (n=180) patients had hemorrhagic manifestations whilst 56.8% (n=237) were asymptomatic. None of the patient presented with visceral, retropharyngeal or intracranial bleed. The prevalence of secondary ITP was substantially higher (64.8%) as compared to primary ITP (35.2%). Secondary ITP was predominantly seen in HCV reactive patients (24.4%) followed by helicobacter-pylori infection (11%). Nevertheless 16.4% patients had underlying autoimmune disorders. Providentially no study subject was found to be HIV reactive. Conclusions: Our study revealed predominance of secondary ITP. However bleeding manifestations and degree of thrombocytopenia were high in primary-ITP. Infectious etiology followed by autoimmune disorders is mainly implicated for secondary ITP in our setting.
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Objectives: Fragmented blood transfusion services along with an unmotivated blood donation culture often leads to blood shortage. Donor retention is crucial to meet the increasing blood demand, and adverse donor reactions have a negative impact on donor return. The aim of this study was to estimate adverse donor reactions and identify any demographic association
Methods: We conducted a prospective study between January 2011 and December 2013. A total of 41,759 healthy donors were enrolled. Professionally trained donor attendants drew blood and all donors were observed during and following donation for possible adverse events for 20 minutes. Blood donors were asked to report if they suffered from any delayed adverse consequences
Results: Out of 41,759 blood donors, 537 [1.3%] experienced adverse reactions. The incidence was one in every 78 donations. The mean age of donors who experienced adverse events was 26.0 +/- 6.8 years, and all were male. Out of 537 donors, 429 [80%] developed vasovagal reaction [VVR], 133 [25%] had nausea, 63 [12%] fainted, 35 [6%] developed hyperventilation, 9 [2%] had delayed syncope, and 9 [2%] developed hematoma. Arterial prick, nerve injury, cardiac arrest, and seizures were not observed. Donors aged less than < 30 years and weighing <70 kg were significantly associated with VVR, hyperventilation, and nausea [p < 0.005]. Undergraduates and Urdu speaking donors also had a significant association with fainting and nausea, respectively [p < 0.05]
Conclusion: The prevalence of adverse events was low at our tertiary center. A VVR was the predominant adverse reaction and was associated with age and weight. Our study highlights the importance of these parameters in the donation process. A well-trained and experienced phlebotomist and pre-evaluation counseling of blood donors could further minimize the adverse reactions
Subject(s)
Humans , Male , Female , Adult , Tertiary Healthcare , Prospective Studies , Syncope, Vasovagal , Nausea , Hyperventilation , Syncope , Hematoma , Developing CountriesABSTRACT
Objective: Serum fasting lipid profile has been studied in various clinical spectrum of Beta (β)- thalassaemia syndrome. Premature cardiac impairment in thalassaemia major appears primarily due to iron accumulation and oxidative injury; however it might be a sequel of abnormal lipoprotein concentrations. The rational of this study is to analyse the serum fasting lipid profile in cardiovascular disease free β-thalassaemia major (β-TM) patients. Relationships with age, gender, haematological parameters, liver enzymes and serum ferritin were observed. Method: Fasting serum lipid levels, liver function test (LFT), complete blood count (CBC) and serum ferritin were measured in 36 patients with homozygous β-TM from March 2012 to March 2014. Patients were stratified into two groups, age ≤15 and >15 years, to determine the possible lipid profile distinction in relation to age. Results: 17 were males and 19 were females, with median age of 12.0 years. The mean total cholesterol (TC) and triglyceride (TG) were 5.01±1.32 and 8.36±5.28 mmol/L respectively. High TG was detected in 36.1%, while high density lipoprotein cholesterol (HDL) and low density lipoprotein cholesterol (LDL) were markedly low, 0.98±0.51 and 2.35±1.22 mmol/L respectively. No statistically significant difference was noted between the two age groups. The median TC to HDL ratio (TC:HDL) was elevated, 5.7 (4.0). We established significant correlation of total bilirubin with TC (r=-0.4), HDL(r=-0.5) and LDL (r=-0.4) (P<0.05). Conclusion: Dyslipidaemia in β-TM patients is irrespective of age and gender including low HDL and high TC:HDL, whilst high TC:HDL may contribute as a significant risk marker for future cardiac events in these patients.
ABSTRACT
β-thalassemia is the most common genetic disorder worldwide with an increased prevalence around the Mediterranean, Indian subcontinent and in South-East Asia. Various siderotic and non-siderotic complications significantly impact the quality of life. Thalassemic patients are also at risk of zinc deficiency due to diverse causes including desferrioxamine chelation. This study sought to investigate the prevalence of zinc deficiency in beta thalassemia major patients on desferrioxamine for iron chelation. Study design: This was a descriptive, prospective, cross-sectional study over a 6-month period. 63 cases of beta thalassemia major within the age group of 5-15 years on desferrioxamine for at least 1 year, were included. Basic patient demographics such as age, gender and duration of disease were recorded. Serum zinc levels were determined by atomic absorption spectrophotometry. Results: The mean age of patients was 10.84±3.47 (5 to 15) years. There were 35 (55.6%) males and 28(44.4%) females. The prevalence of zinc deficiency (zinc levels < 50 μg / dl) was 22.2%. Proportions of deficiency were higher in males with a duration of disease beyond 10 years. Conclusions: Zinc deficiency is not uncommon in beta thalassemia patients on desferrioxamine. We suggest that zinc levels be regularly monitored in these patients.