Current Situation of Health Technology Assessment in Traditional Chinese Medicine Hospitals / 中国实验方剂学杂志

ObjectiveThis study aims to understand the recognition of practitioners in traditional Chinese medicine （TCM） hospitals on hospital-based health technology assessment （HB-HTA）， assessment needs， challenges， and suggestions， so as to provide references for the future work. MethodThe convenient sampling method was adopted to survey the relevant practitioners in TCM hospitals. The questionnaire included 39 questions in 4 dimensions and was distributed through the online platform Weijuanxing. ResultA total of 244 questionnaires were recovered， and the obtained data were analyzed in SPSS. The results showed that 137 practitioners were very familiar with HB-HTA and there was no significant difference in the recognition of practitioners in different occupations （F=0.251； P=0.778）. The practitioners in Hong Kong， Macao， and Taiwan had lower recognition than those in other regions. In terms of the assessment needs， 127 practitioners believed that it was very necessary to carry out HB-HTA in TCM hospitals in the future. Chinese patent medicines/Chinese herbal medicine decoction pieces （5.91） and TCM appropriate technology （5.57） had higher assessment priority scores. The assessment needs were high for the effectiveness （235 practitioners） and safety （224 practitioners） of health technology. The lack of specialized organization and standardized evaluation process system and the shortage of talents were considered to be the major challenges for the future development in this field. ConclusionThe stakeholders carrying out the health technology assessment in TCM hospitals had certain awareness of HB-HTA. Most practitioners believed that it was necessary to carry out HB-HTA in TCM hospitals in the future， while the work might face challenges such as the lack of organizations and system and the shortage of talents， which requires policy support.

Clinical Profile and Quality of Life of Incident Hemodialysis Patients

Hemodialysis is the most commonly used treatment modality for end stage renal disease. A 6 months observational study was conducted in the Dialysis unit of Kasturba Hospital, Manipal to study the clinical profile, quality of life with the help of KDQoL SF 36 questionnaire and factors affecting quality of life of hemodialysis patients. A total of 45 participants were included who initiated dialysis in the year 2018 and 2019 and were receiving dialysis in our hospital. Out of 45 participant 77.8% were males and 22.2% were females, the mean age was 55.29 (11.29) years. 23 patient-initiated dialysis in the year 2018 22 patients-initiated dialysis in the year 2019. The prevalence of hypertension, diabetes mellitus and cardiovascular diseases in this population were found to be 95.2%, 35.6% and 8.9% respectively. The mean scores of the sub scales were analyzed with the help of scoring manual and descriptive statistics. In the result it was found the hemoglobin, intradialytic weight gain were found to be positively correlated with the Physical component summary (PCS) and Mental component summary (MCS). Effects of kidney disease was found to be very strongly and positively correlated with dialysis vintage. In the result of the study due to its smaller population we cannot determine more factors which were affecting the Quality of life scores.

Application of blood/fluid warmer during plateletpheresis in winter and its nursing / 中国输血杂志

【Objective】 To study the safety, effectiveness and nursing of blood/fluid warmer during the process of plateletpheresis in winter. 【Methods】 The blood re-transfusion speed during plateletpheresis in winter and the time of blood passing through the blood return pipeline was counted. The vitro blood was heated with a blood/fluid warmer under different temperature settings, and the rising speed of blood temperature was recorded. The blood samples were tested for blood routine examination, free Hb and erythrocyte morphology at 0, 15 and 30 minutes. In the process of plateletpheresis in winter, the blood donors′ ear temperature and the skin temperature near the reinfusion needle in the observation group and the controls were measured, and the blood donors were observed for shivering, arm chills, pain or other discomfort. After the blood donation, the thermal comfort was evaluated. 【Results】 There was no difference in the results of routine blood test and plasma free Hb test of vitro blood after warming at 41℃, 42℃ and 43℃ for 0, 15 and 30 minutes (P>0.05), and no change in erythrocyte morphology was found. The skin temperature near the reinfusion needle (before vs. after the start of phlebotomy) was statistically different by applying blood/fluid warmer or not(P0.05). The vitro blood heating experiment showed that when the room temperature was within 22~24℃, the blood retransfusion speed was (100-120) mL/min; after the application of blood/fluid warmer, the temperature of reinfusion blood could be raised from 27℃ to 33~37℃. The proportion of feeling comfortable and very comfortable and the score of thermal comfort in the blood donors who used the warmer were higher than those in the controls (P<0.05). When the temperature of the warmer was set above 38℃, the average score of thermal comfort of blood donors was above 8. 【Conclusion】 It is safe to apply the blood/fluid warmer during the plateletsapheresis in winter, which can significantly improve the comfort of blood donors and reflect the humanized service of blood stations, and is worth popularizing.

Relationship between lactate and alkali deficiency and blood transfusion therapy in patients with traumatic hemorrhagic shock / 中国输血杂志

【Objective】 To explore the effect of lactate and alkali deficiency on the need for red blood cell transfusion in emergency of patients with traumatic hemorrhagic shock. 【Methods】 A total of 126 patients with traumatic hemorrhagic shock in our hospital from January 2019 to December 2021 were retrospectively analyzed, and the 99 cases with effective treatment were divided into two groups according to the outcome of blood transfusion within 24 hours after admission: non-transfusion group (n=36) and transfusion group (n=63). The changes of lactic acid (Lac), alkali deficiency (BE), hemoglobin (Hb), hematocrit (Hct) at admission, hemoglobin (Hb), hematocrit (Hct) 24 hours after admission and the length of stay in ICU were compared between the two groups. The binary logistic regression was used to analyze the risk factors of whether there was a need for blood transfusion at the time of emergency admission. The correlation between individual and combined indicators of each risk factor and the need for blood transfusion were analyzed by the receiver operating curve (ROC). 【Results】 The mean level of Lac (2.90±1.82) in the non-transfusion group at admission was lower than that in the transfusion group (5.80±2.83) (P0.05)The maximum AUG of Lac and BE(0.875, 0.766) in predicting the need for emergency red blood cell transfusion in patients with traumatic hemorrhagic shock was significantly better than that of Hb and Hct (0.692, 0.682); the optimal threshold for Lac was >3.6 mmol/L, while the optimal threshold for Hb is ≤106 g/L; the maximum AUG obtained by ROC curve analysis combined with Lac, BE, Hb and Hct was 0.910, which was higher than that of the sole virable. Comparative predictive value using the optimal thresholds of Lac and Hb as indications for transfusion showed that Lac had better predictive value than Hb. 【Conclusion】 Lac and be can be instructive for patients with traumatic hemorrhagic shock as to whether they need red blood cell transfusion in an emergency setting, and combination of Lac, BE, Hb and Hct may help to determine the transfusion needs of patients more timely and accurately and optimize the transfusion management of emergency patients.

Evaluation de Perfomances analytiques de l'hémoglobinomètre HEMOCUE® Hb 201+: étude observationnelle analytique monocentrique réalisée aux Cliniques Universitaires de Kinshasa, République Démocratique du Congo / Evaluation of analytical performance of the hemoglobinometer HEMOCUE® Hb 201+: A monocentric study from the Kinshasa University Hospital, Democratic Republic of Congo

Context and objective The dosage of hemoglobin (Hb) is challenging particularly in rural setting. This dosage can be done using "Point of Care" (POC) material within rural areas and emergency situations. The present study aimed to assess the POC HemoCue® Hb 201+. Methods. This was an analytical cross-sectional study comparing the rates of the dosage of Hb carried out on HemoCue® Hb 201+ hemoglobinometer and those obtained with Mindray BC-5150 automaton in Kinshasa University Hospital, Democratic Republic of Congo (DRC). Results. Two hundred subjects were involved in the study. Mean and median Hb rates were 10,438 ± 2,741 g/dl and 10,600 g/dl (IQR: 8,675-12,300 g/dl) by Mindray BC-5150, respectively and mean rate of Hb was 10,5 ± 2,756 g/dl and the median rate was 10,900 g/dl (IQR: 8,775 ­ 12,300 g/dl) by the HemoCue® Hb 201+, respectively. The linear regression revealed a positive relationship between the Hb rates obtained on an automaton Mindray BC- 5150 and those obtained on the HemoCue® Hb 201+. The diagram of Bland Altman showed limits of agreement between automaton Mindray BC- 5150 and HemoCue® Hb 201+. Conclusion. This study showed that the POC HemoCue® Hb 201+ provided similar results to those of the automaton Mindray BC-5150. Thus, HemoCue® Hb 201+ can be used in emergency services or even in medical institutions that do not have or do not meet the conditions for the use of hematology analyzers in the DRC.

Contexte & objectif Le dosage du taux de l'hémoglobine est un véritable défi en milieu rural où les laboratoires sont moins équipés. Et pourtant, cette analyse, réalisée au moyen des équipements plus au moins sophistiqués, permettant de confirmer une anémie, peut être facilitée par l'utilisation des Points of care (POC). Le POC Hemocue® Hb 201+, utilisé dans certains sites pour ce faire, n'a jamais été évalué. L'objectif de la présenté étude était d'évaluer les performances du POC Hemocue® Hb 201+ à Kinshasa /RDC. Méthodes. Il s'agissait d'une étude transversale, analytique comparant les taux d'Hb obtenus sur Hemocue® Hb 201+ et sur Mindray BC-5150 comme référence, aux Cliniques Universitaires de Kinshasa. Résultats. Deux cents sujets ont été inclus. Les taux moyen et médian d'Hb sur l'automate Mindray BC5150 ont été respectivement, de 10,438 ± 2,741 g/dl et de 10,600 g/dl (IQR : 8,675-12,300 g/dl). Le taux moyen d'Hb sur le POC Hemocue® Hb 201 a été de 10,5 ± 2,756 g/dl et le taux médian de 10,900 g/dl (IQR : 8,775 - 12,300 g/dl). La régression linéaire a mis en évidence une relation positive entre les taux d'Hb dosés sur automate Mindray BC- 5150 et ceux dosés sur HemoCue® Hb 201+. Le diagramme de Bland Altman a montré des limites d'accord entre l'automate Mindray BC- 5150 et Hemocue® Hb 201. Conclusion. Cette étude a montré que le POC HemoCue® Hb 201+ fournissait des résultats identiques à ceux de l'automate Mindray BC-5150. Ainsi, l'HemoCue® Hb 201+ peut être utilisé dans les services d'urgence ou dans les institutions médicales ne possédant pas ou ne remplissant pas les conditions d'utilisation des automates d'hématologie en RDC

To Evaluate The Incidence Of Diabetic Retinopathy In Newly Diagnosed Diabetic Patients Presented At Tertiary Care Hospital

Background:Diabetes mellitus is defined as metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action, or both. It occurs in two forms: Insulin dependent diabetes mellitus and Non –insulin dependent diabetes mellitus1. This disease results in generalized macrovascular and microvascular complication directly affects kidneys, eyes, peripheral nerves and heart. The incidence of diabetes retinopathy in Indian population was 21.7%. Material And Methods:In this cross sectional study all the patients attending eye OPD and indoor patients at tertiary eye care were screen for eligibility. Total of 150 patients were included in the study for duration of 28 months. Detail history including hypertension and other systemic illness was asked. Best corrected visual acuity was taken after refraction. Anterior segment examination was done with slit lamp, specially looking for rubeosis iridis, pupillary reaction and type of lens opacity. Statistical analysis was done using Z test, unpaired T test and chi-square test with the help of software and methods. Result: Patients with type 2, diabetes have more incidence of developing diabetic retinopathy thanpatients with type 1. Hypertension was more commonly associated disease than other systemic illness. Diabetic retinopathy is more prevalent in patients with higher FBS and HB1Ac.Conclusion:The frequency of retinopathy is more common in patients with high blood sugar profile. Hypertension is more commonly associated with diabetes than other systemic illness.

Ayurvedic Management of Hepatitis

Hepatitis is inflammation of liver parenchyma mostly caused by viruses and other factors. It’s a non-specific prodromal illness characterized by headache, myalgia, arthralgia, nausea, anorexia, dark urine, yellow discoloration of skin, mucosa, sclera and other tissues etc. Methodology: A diagnosed case of hepatitis, 37yrs old female patient, admitted in at Government Ayurvedic college & Hospital, Kadam Kaun, Patna, Having IPD No.1006, RN.7178. Based on symptoms, supported by blood investigation reports and Ayurvedic parameters, the condition diagnosed as Yakritsotha. Oral medicines given: Aryogyavardhini Vati, Punarnava Mandur, Shallaki, Syp. Kalmegh, Kasis Bhasm, Liv 52 HB, Phaltrikadi Kwatha, cap. Stresscom along with Pathya apathya ahara vihara were prescribed. Result: There was drastic decrease in all the symptoms. The effect of treatment was monitored during the follow up with routine blood examinations. The bilirubin level decreased from initial 6.2mg/dl to 1.0mg/dl. Discussion: This article is a discussion about a case of Hepatitis which was successfully treated by Ayurvedic line of treatment. The signs and symptoms, causes, pathos-physiology of Hepatitis, along with its co-relation in Ayurveda as Yakritsotha, its line of treatment and possible the mode of action of drugs were the main points of consideration. Conclusion: Use of medicines such as Aryogyavardhini Vati, Punarnava Mandur, Shallaki, Syp. Kalmegh, Kasis Bhasm, Liv 52 HB, Phaltrikadi Kwatha, cap. Stresscom along with Pathya apathy ahara vihara showed good result without any complication in the present study.

Osteoporosis imperfect caused by P4HB gene variation:report of one case and literature review / 中华全科医师杂志

A 6-month-oldgirl was admitted in Affiliated Children′s Hospital of Capital Institute of Pediatrics with the complaint of “Recurrent fractures within 3 months”. She presented with frequent fractures, skeletal deformities,and distinctive facial features, including wide forehead, ocular proptosis and a flat nose bridge. She was diagnosed as osteoporosis imperfecta based on the clinical characteristics and given pamidronate disodium treatment. The whole exon sequencing showed heterozygous mutation of P4HB gene c.1178A>G (p.Y393C), which leads to a rare type of osteoporosis imperfect a Cole-Carpenter syndrome-1. Eight cases of osteoporosis imperfecta affected by P4HB mutation involving 5 mutationsites were retrieved from literature review. Different mutation sites lead to different clinical manifestations and severity of disease. The genotype-phenotype correlation of osteoporosis imperfect may be associated with the domains of coding proteins.

One case of mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency and literature review / 中国基层医药

Objective:To summarize the clinical phenotype and genetic characteristics of one child patient with mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency (mHS) caused by HMGCS2 gene mutation. Methods:One child patient with mHS who received treatment in Chongqing University Three Gorges Hospital on April 10, 2020 was included in this patient. The child was hospitalized due to cough, shortness of breath and deep coma. After admission, gas chromatography-mass spectrometry of the blood and urine samples and high-throughput whole genome sequencing were performed. The pedigree of the child with gene mutation was analyzed. The child was diagnosed with mHS. Related publications published by June, 2020 were searched in Wanfang database, Chinese Journal Full Text Database, PubMed and HGMD databases using search terms "mitochondrial 3-hydroxy-3-methylglutaryl-CoA synthase deficiency", "HMGCS2" "mHS deficiency". Forty-three papers addressing mHS deficiency were retrieved. The clinical phenotype and genotypes of the child with HMGCS2 mutation were summarized. Results:As of June 2020, there were 44 children with mHS deficiency, including the child reported in this study. These children consisted of 15 males, 11 females and 18 unknown genders. Among these children, 29 were aged 0-24 months, 4 were aged > 24 months, 6 had no symptoms, and 5 were of unknown age of disease onset. The first symptoms of most children were fever, cough, acute gastroenteritis, and coma. Twenty-seven children had hypoglycemia, 21 children had metabolic acidosis, 15 children developed hepatomegaly, 16 children had increased FFA/D-3-HB, and 10 children were tested 4-hydroxy-6-methyl-2-pyrone positive. The child included in this study had hepatomegaly, elevated alanine aminotransferase and metabolic acidosis. Gas chromatography-mass spectrometry results showed that a variety of metabolites were increased. Tandem mass spectrometry results showed that C40 level was elevated, and long-chain carnitine contents were increased. High-throughput whole genome sequencing results revealed that there were two heterozygous mutations in HMGCS2 gene, (NM_0055) c.559+1G > A; c. 758 T > C heterozygous mutation. Sanger sequencing and parental origin analysis showed that the mutations in this child were from parents. The two gene mutations in this child were new mutations, which have not been reported in China and countries outside China. According to the criteria and guidelines for interpretation of ACMG sequence variation, the variation was determined to be pathogenic. Conclusion:When a child has hypoketotic hypoglycemia and/or metabolic acidosis, increased FFA/D-3-HB and acetylcarnitine levels, mHS deficiency should be considered. HMGCS2 gene examination can help diagnose mHS deficiency.

Clinical Diagnosis and Prenatal Screening of Hb Lepore-BW Associated with IVS-II-654 Heterozygous Mutation / 中国实验血液学杂志

OBJECTIVE@#To identify one case of rare Hb Lepore-BW associated with IVS-II-654 heterozygous mutation in Sichuan area.@*METHODS@#The blood routine examination and hemoglobin electrophoresis methods were used to analyze the blood routine parameters, HbA2 and HbF in the samples of peripheral blood in proband and his parents, as well as the cord blood of pregnant woman. The detection of thalassemia gene and Sanger sequencing methods were used to detect the hemoglobin mutations.@*RESULTS@#The result showed that the Hb Lepore-BW heterozygous mutation was detected in the father of the proband, while a rare Hb Lepore-BW with IVS-II-654 heterozygous mutation was detected in the proband, as well as his mother and cord blood were both detected as IVS-II-654 heterozygous mutation.@*CONCLUSION@#The study identified a rare Hb Lepore-BW with IVS-II-654 heterozygous mutation, which was characterized by intermediate β-thalassemia. It is necessary to hemoglobin electrophoresis combined with routine blood testing in prenatal screening.

Analysis of blood donor pre-donation deferral in Zhengzhou / 中国输血杂志

【Objective】 To identify low-risk donor population and optimize blood screening, recruitment and consultation strategies via retrospectively analyzing the unqualified results of Hb, ALT, HBsAg, TP before whole blood donation from 2015 to 2018. 【Methods】 Pre-donation examinations of Hb, ALT, HBsAg and TP were conducted by copper sulfate method, dry chemical method, and TPPA etc. 【Results】 A total of 70 146 out of 685 469 blood donors in Zhengzhou city from 2015 to 2018 were deferred due to unqualified pre-donation. The unqualified rates of Hb, ALT, HBsAg and TP were 1.75%(11 996/685 469), 7.78%(53 329/685 469), 0.60%(4 113/685 469) and 0.10%(685/685 469), respectively. For Hb deferral, 2.5%(17 137/685 469) were male and 97.5%(668 332/685 469)female; for ALT deferral, 85.9%(588 818/685 469) male and 14.1%(96 651/685 469) female. 【Conclusion】 The causes of pre-donation deferral in whole blood donors were mainly ALT, then Hb. Hb deferral showed an increasing trend and dominated by female donors, while ALT deferral was dominated by male donors. The overall unqualified rate of ALT, HBsAg and TP, however, are decreasing year by year through taking targeted measures, strengthening the publicity and education of blood donation, standardizing the blood collection and supply process.

Is There Any Correlation Between Computed Tomography (CT) Attenuation Value (Hounsfield Unit) Of Dural Venous Sinuses And Hemoglobin Level: A Prospective Observational Study

Background:In our routine practice patient were undergone CT scan of brain as well as other laboratory investigation for various traumatic brain injury and neurological complain and its management. They visit many premises for diagnosis and investigation. If we can predict the hemoglobin level from CT brain itself, we can reduce turnaround time for patient and increase throughput of patients for hospital. Keeping this in mind we had conducted this study to see the correlation between hemoglobin level and CT attenuation value of cranial Dural sinuses.Material And Methods:A prospective observational study was performed to demonstrate association between computed tomography (CT) attenuation value (Hounsfield unit (HU)) of dural venous sinuses and hemoglobin level from unenhanced CT scan of the brain. The non-contrast CT brain of total 245 patients done during October 2017 to September 2018 at medical college attached tertiary care was observed. Two measurements of HU value were taken on two adjacent slices using 10mm2 of ROI for each site, from superior sagittal sinus (SSS) and torcular herophili (TOH). The value was averaged for superior sagittal sinus, confluence of sinus and is compared with hemoglobin of patients.Result:Mean HU VALUE in SSS of females and male had 48.47 and 51.85 respectively. Mean HU VALUE in TOH of females and male had 47.46 and 50.93 respectively. Positive and significant correlation was noted between HB and SSS average, HB and TOH Average.Conclusion:Based on our result CT attenuation value (HU) value of torcular herophili and superior sagittal sinus from unenhanced CT scan of brain can be used to predict the hemoglobin level of a person. The HU value of sinus can give insight into pathology such as anemia, polycythemia or cranial sinus thrombosis.

Effect of short-chain thioesterase deficiency on P(3HB-co-LA) biosynthesis in Escherichia coli / 生物工程学报

Polyhydroxyalkanoates (PHAs) have obtained much attention in biomaterial fields due to their similar physicochemical properties to those of the petroleum-derived plastics. Poly(3-hydroxybutyrate-co-lactate) [P(3HB-co-LA)] is one member of the PHAs family, and has better toughness and transparency compared to existing polylactic acid (PLA) and poly[(R)-3-hydroxybutyrate] [P(3HB)]. First, we confirmed the one-step biosynthesis of P(LA-co-3HB) with the lactate fraction of 23.8 mol% by introducing P(3HB-co-LA) production module into Escherichia coli MG1655. Then, the lactate fraction was increased to 37.2 mol% in the dld deficient strain WXJ01-03. The genes encoding the thioesterases, ydiI and yciA, were further knocked out, and the lactate fraction in the P(3HB-co-LA) was improved to 42.3 mol% and 41.1 mol% respectively. Strain WXJ03-03 with dld, ydiI and yciA deficient was used for the production of the LA-enriched polymer, and the lactate fraction was improved to 46.1 mol%. Notably, the lactate fraction in P(3HB-co-LA) from xylose was remarkably higher than from glucose, indicating xylose as a potent carbon source for P(3HB-co-LA) production. Therefore, the deficiency of thioesterase may be considered as an effective strategy to improve the lactate fraction in P(3HB-co-LA) in xylose fermentation.

Molecular Mechanisms of Hemoglobin Adaptation to High Altitude Hypoxia in Pseudopodoces humilis / 中国生物化学与分子生物学报

As the main carrier of oxygen delivery in the blood circulation system, hemoglobin (Hb) plays a key role in the adaptation of animals to high altitude hypoxia.In this paper, we combined analysis of genome, transcriptome, molecular evolution, homology modeling and molecular dynamics simulation, and explored the molecular mechanisms of increased blood oxygen affinity of Pseudopodoces humilis.Our results showed that the prenatal expressed p gene was highly expressed in the adult Pseudopodoces humilis (RPKM = 32.22) compared to Parus major (RPKM = 0), and this may result in the presence of two additional p-type Hbs with high oxygen affinity in the blood of P.humilis, i.e.(al>p)2 and (aAp)2.The PA25G-A and pA55L-I mutations may increase the van der Waals force between the B and D helices, which might eventually make the entire Pv subunit more compact and finally reduce the number of hydrogen bonds between a dimers, hence the transition from T state to R state is prone to occur.The two mutations of (3a43A-S and pA44S-N could change the conformation and polarity of the heme pocket opening, thus making the solution easier to flow into/out of the heme pocket and therefore facilitating the gas exchange.The pA90E-K mutation in P.humilis has undergone strong positive selection, which could increase the basicity of pA-type Hb, thereby offsetting the decrease in Hb-02 affinity caused by the Bohr effect.In addition, we also found that aA44P-S and pA43A-S mutations may increase the hydrophilicity of otA and pv type Hbs, which is beneficial to the accumulation of Hb to a higher concentration in red blood cells.Collectively, the prenatal Hb genes highly expressed in the adult together with the genetic based changes in intrinsic 0, affinity and physicochemical property of aA and pA Hb could be the main causes for the increase in blood oxygen affinity of P.humilus.

Prevalencia de marcadores del virus de la hepatitis B en donantes de sangre cubanos / Prevalence of Hepatitis B virus markers in Cuban blood donors

Introducción: La incidencia de la hepatitis B en Cuba se redujo notablemente desde la incorporación de la vacuna cubana Heberbiovac HB. Objetivo: Determinar la prevalencia de marcadores del virus de la hepatitis B en donantes de sangre de tres provincias y la persistencia de los anticuerpos contra el antígeno de superficie de este virus en donantes nacidos posterior a la introducción de la vacuna cubana en el Programa Nacional de Inmunización. Métodos: Se aplicó el diseño de un estudio de prevalencia. Se incluyeron 433 donantes que acudieron a los bancos de sangre de las provincias La Habana, Villa Clara y Santiago de Cuba, entre enero y diciembre de 2018. Se detectaron los marcadores HBsAg, anti-HBc y anti-HBs; este último en donantes con edades entre 18 a 26 años. Se realizó la proteína C reactiva (PCR) en tiempo real para identificar la replicación viral en individuos positivos al HBsAgo al anti-HBc. Resultados: La prevalencia de HBsAg y de anti-HBc fue de 1,15 por ciento (5/433) y 7,85 por ciento (38/433), respectivamente. En los individuos nacidos después de la introducción de la vacuna, la prevalencia de HBsAg y anti-HBc fue 0 por ciento y 0,95 por ciento, respectivamente. El 36,1 9 por ciento (38/105) de estos donantes tenían niveles protectores de anti-HBs (≥ 10 UI/L). El ADN viral se detectó en un donante positivo al HBsAg y anti-HBc; no se identificó infección oculta por el virus de la hepatitis B. Conclusiones: La prevalencia del HBsAg es baja en donantes de sangre cubanos, con tendencia a ser nula en donantes nacidos después de la aplicación de la vacuna cubana Heberbiovac HB(AU)

Introduction: The incidence of hepatitis B in Cuba has decreased significantly since incorporation of Cuban vaccine Heberbiovac HB. Objective: To determine the prevalence of hepatitis B virus markers in blood donors from three provinces and the persistence of antibodies against surface antigen of this virus in blood donors born after introduction of Cuban vaccine in the National Immunization Program. Methods: The design of a prevalence study was applied. We included 433 donors who attended the blood banks of the provinces of Havana, Villa Clara and Santiago de Cuba, between January and December 2018.The HBsAg, anti-HBc and anti-HBs markers were detected; the latter was detected in donors aged 18-26 years. The real-time analysis of C-reactive protein (CRP) was performed to identify viral replication in individuals positive to HBsAg-positive and to anti-HBc. Results: The prevalence of HBsAg and anti-HBc was 1.15 percen t (5/433) and 7.85 percent (38/433), respectively. In individuals born after introduction of the vaccine, the prevalence of HBsAg and anti-HBc was 0 percent and 0.95 percent, respectively. 36.19 percent (38/105) of these donors had protective levels of anti-HBs (≥10UI/L). Viral DNA was detected in a donor positive to HBsAg and to anti-HBc. Hidden infection with the hepatitis B virus was not identified. Conclusions: The prevalence of HBsAg is low among Cuban blood donors, with a tendency to be null in donors born after application of Cuban vaccine Heberbiovac HB(AU)

Comparison of haemoglobin assessment by HemoCue 301 and automated haematology analyser using flowcytometry among school going children: a one year study at a tertiary care hospital

Background: Anaemia defined as reduction in the concentration in Haemoglobin is one of the key health indicators of health care system of the country. Accurate screening methods are required to estimate the levels of haemoglobin for diagnosing the cause of anaemia. Objectives of the study was to analyze and compare the results of haemoglobin concentrations estimated with automated haematology analyzer and point of care device HemoCue Hb301.Methods: It is a prospective cross-sectional study was conducted for one year after ethical approval. Non fasting capillary and venous blood samples were collected from the selected cases of children and Haemoglobin concentrations were estimated by automated analyzer and HemoCue Hb301 system and the values were noted. Quality control checks were performed for both. Statistical analysis was done using IBM SPSS Version 24.0.Results: Mean Hb% concentration was estimated in 108 children with 44 female and 64 males. The mean value of Automated hematology analyzer (11.965±1.012) was significantly higher when compared with the mean value of HemoCue Hb301 (11.697±1.312) (p=0.002). There was a significantly strong correlation between HemoCue Hb301and Automated hematology analyzer (r-value = 0.732, p <0.0001).Conclusions: The HemoCue is useful in many different settings and remains a widely used method in field settings as it has several advantages and is relatively inexpensive compared with automated haematology analysers. Further studies are needed to better understand potential sources of error in the Hb assessment by HemoCue with the aim to better train phlebotomists and implement appropriate standardised procedures.

Association of Maternal Serum Ferritin Level in Gestational Diabetes Mellitus and its Effect on Cord Blood Hemoglobin

Introduction: Gestational Diabetes Mellitus is thedevelopment of carbohydrate intolerance of variable severitywith onset or first recognition during pregnancy. Many studieshad suggested that an elevated serum ferritin level in maternalblood in early as well as mid-pregnancy is an independent riskfactor for development of GDM. In the present study we aimto find the association of serum ferritin levels with serum ironand Hb% in the GDM patients at the time of delivery and alsocorrelate it with cord blood Hb% and iron levels of the newborn.Material and Methods: The study group was composed of50 diagnosed cases of GDM and the control group comprisedof age matched 50 cases of normal pregnancy. Maternal bloodwas used to measure mother’s hemoglobin, iron levels, serumferritin and hsCRP. Cord blood sample was used to estimatehemoglobin and iron levels of the newborns.Results: Our study shows that in the GDM cases the levelof serum ferritin was significantly higher (p <0.001) than inthe non GDM controls at the time of delivery. Cord bloodhemoglobin is negatively correlated with maternal serumferritin levels in GDM.Conclusion: Elevated serum ferritin level in GDM is a markerof inflammation due to increased ROS production caused byiron overload. This oxidative stress might affect the placentaliron transfer to the fetus and fetal Hb synthesis.

Multidisciplinary diagnosis and treatment of a child with hepatoblastoma and suspected coronavirus disease / 中国肿瘤临床

Objective: To discuss the diagnosis, treatment, and multidisciplinary management of a child with hepatoblastoma (HB) and suspected coronavirus disease (COVID-19). Methods: A child with HB and suspected COVID-19 was admitted to the Children's Hospital, Zhejiang University School of Medicine, in February 2020. The diagnosis and treatment plan were discussed by a multidisciplinary team (MDT). After the MDT discussion, necessary examinations and tests were performed, including routine blood tests, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA) and antibody tests, tumor marker tests, chest and abdomen computed tomography (CT), and an ultrasound. The administered treatment included the cisplatin+5-fluorouracil+vincristine (C5V) regimen and cefotaxime. Results: The patient was diagnosed as low-risk HB and completed the first stage of HB chemotherapy after the diagnosis of COVID-19 was ruled out. After 1 week in the hospital, the patient's body temperature returned to normal, the disposition and appetite improved, and all indexes reached the discharge standard. After 14 days of isolation, the patient was discharged. Conclusions: For children with newly diagnosed HB suspected of having COVID-19 during the pandemic period, clinicians must consider the prevention and control of COVID-19 while diagnosing and treating HB as soon as possible. Multidisciplinary management is beneficial for ensuring the development of a safe and efficient treatment plan.

Occupational risk factor of health care workers of Hepatitis B infection and its prevention / Монголын Анагаах Ухаан

@#Hepatitis B (HBV) and C (HCV) are viral infections which can cause acute and chronic hepatitis and are the leading causes for hepatic cirrhosis and cancer, thus creating a significant burden to healthcare systems due to the high morbidity/mortality and costs of treatment. The risk of HBV infection in an unvaccinated person from a single HBV-infected needle stick injury ranges from 6–30. The prevention of HBV infection among HCWs has become a crucial issue. HBV can effectively be prevented by vaccination. A safe and effective HBV vaccine has been available since the 1980s and can prevent acute and chronic infection with an estimated effectivity of 95%. In 2017, the São Paulo Declaration on Hepatitis was launched at the World Hepatitis Summit 2017, calling upon governments to include hepatitis B vaccines for HCWs in national immunization programs. The vaccine is 95% effective in preventing infection and its chronic consequences and has an outstanding record of safety and effectiveness. Data on current hepatitis B vaccine coverage among HCWs in Mongolia is scarce. According to Azzaya et al, the protection level of the subjects was 67.2% >100 mIU/ml, 18.8%, 11-100 mIU/mL and 14.1%, 0-10 mIU/mL based on antibody titer level respectively among the vaccinated HCWs at the 2nd Central hospital. Thus, the HBV vaccination among public and private sector HCWs in Mongolia to inform the health authorities about the HCWs HBV vaccination status along with associated problems and challenges for further improving vaccination strategy among HCWs.

A Comparative Study of Plasma Protein and Hemoglobin in 18-21 Years Age Group Students of MGM Medical College, Jamshedpur, Jharkhand

Background: Anaemia is a global public health problem. InIndia, Jharkhand state is one of the state where under nutritionis highly prevalent. Most of the health problems like lowimmunity, Anaemia, hypoprotienemia arise due to low proteinintake. During erythropoiesis, Haemoglobin synthesis requiresprotein, Vitamin B12, Folic acid, Vitamin C as well as mineralslike Fe, Cu etc. Adequate nutrition is of prime importance andthis is reflected in plasma also.Objectives: To assess the level of Hb and plasma proteinamong study subjects with a co-relation of Hb with plasmaprotein.Materials and Methods: Present study was undertaken atMGM Medical College, Jamshedpur. 177 participants wereselected for the study and the data were obtained on differentvariables. Blood samples were also taken from the participants.Results: Most of the study subjects were anaemic. Anaemiawas more common among female subjects in comparison withmales. The present study found a positive co-relation betweenHb and Plasma protein.Conclusion: There is a strong co-relation observed betweenplasma protein, daily protein intake, and BMI withhaemoglobin.