Antithrombin levels in healthy Pakistani males

To determine the antigenic concentration and percent functional activity of antithrombin in healthy Pakistani males. Over a period of one year, 50 healthy male volunteers divided into two age groups were tested for antithrombin levels by radial immunodiffusion[RID], at the Departments of Pathology King Edward Medical College and Postgraduate Medical Institute, Lahore. None of them were suffering from any acute or chronic disease, nor were taking any medications. Plasma samples were used to determine the antigenic and derived percent activity from NOR-Partigen* plates supplied by Dade Behring. The younger group of healthy male volunteers [n=25], mean age 23.5 years showed a higher antithrombin concentration 46.7mg/dl or 155% functional activity: while the older volunteers [n=25], with mean age 44.0 years, showed 42.4 mg/dl concentration or 142% functional activity. The p value was insignificant between the groups [p> 0.05]. The younger healthy individuals in our population show higher antithrombin concentration and functional activity, which tends to decrease insignificantly with age

Neurofibromatosis type II: a rare neurocutaneous syndrome

Neurocutaneous syndromes are heterogeneous group of disorders with abnormalities of central as well as peripheral nervous system. Neurofibromatosis type II [NF-II] is an autosomal dominant neurocutaneous syndrome rarely diagnosed in pediatric population. Diagnosis is based on clinical history and radioimmaging. We present a 14 years old boy with headache and decreased hearing, who turned to be a case of neurofibromatosis type II

Risk of malaria transmission through blood transfusion and its detection by serological method

To assess the risk of transmission of malaria through blood transfusion, and compare efficacy of testing by immunochromatographic[ICT] devices vis a vis peripheral blood film [PBF]. Design: 300 blood samples were tested divided into three equal groups of healthy volunteers, voluntary non-remunerated blood donors and patients suffering from malaria. Testing was carried out by a serological screening method, together with observation of peripheral blood films. Setting: Samples were collected from different sites and tested at the Institute of Haematology and Blood Transfusion Service, Punjab. Subjects: One hundred blood donors were selected from persons donating blood at the Institute or on mobile sessions. An equal number of healthy controls were students and staff of different colleges and the Institute. Samples of 100 patients of pyrexia and diagnosed clinically as suffering from malaria were collected from multiple clinics, laboratories and hospitals in Lahore. Main outcome measures: Assessment of the risk of transmission of malaria through blood and blood products and the comparison of serological testing for malaria with conventional peripheral blood film detection. Amongst healthy blood donors we did not find even a single case of malaria and there was no report of persistent post transfusion pyrexia. We are unable to comment on species frequency in blood donors. However, amongst known patients of malaria we found a higher frequency of Plasmodium vivax[P.v] as compared to Plasmodium falciparum[P.f]. Testing by serological method, helped us to diagnose 5% of our patients who were missed by peripheral blood films. Between properly selected voluntary non-remunerated blood donors the incidence of malaria transmission is zero and the blood is safe for transfusion. Serological testing shows good correlation with peripheral blood film detection. In fact, it can detect the disease even when film detection has been unsuccessful. If proper donor selection criteria are observed there is little risk of transmitting malaria through transfusion. However, as the donor pool in the Service is not necessarily totally that of voluntary non-remunerated donors and substantive numbers of replacement/first time, occasionally uneducated/unaware donors, are being bled, screening for malaria will not be totally unrewarding

Seroprevalence of hepatitis-C antibodies in blood donors

To assess the prevalence of anti HCV antibodies in blood donors. Design: The retrospective sero-epidemiological data of the Institute of Haematology and Blood Transfusion Service, Punjab over a period of one year after starting HCV screening, was analysed to estimate the percentage prevalence. The data was obtained regularly from the blood units established by this Institute at the public sector hospitals and retesting on initially reactive serum samples by EIA was done at the Institute. A total of 166183 directed first time donors or replacement blood donors aged 18-60 years who donated blood at these blood banks or at mobile sessions have been included in the study. All initially reactive donors who tested non-reactive on EIA were excluded from the study. Main Outcome Measures: Assessment of prevalence of HCV in blood donors. 4.45% of the total donors initially tested reactive; of these 0.36% were falsely reactive on initial screening. Further testing by EIA, indicated the correct prevalence of HCV in blood donors at 4.1%. The blood transfusion service started screening for HCV in April 2000 and the prevalence of HCV, amongst the transfusion transmitted infections [TTIs] being screened for in the Punjab, is the highest. It is almost double the prevalence of HBV and several thousand times that of HIV. Meticulous and total screening coverage is needed to curtail impending catastrophe. With experience, the choice of testing methodology might have to be reviewed

Seroprevalence of syphilis in the blood donors in Lahore

To assess the prevalence of syphilis in blood donors in Lahore. Design: Serum samples were obtained from prospective predominantly first time blood donors who consented to testing for syphilis from June to September 2000. TPHA test was conducted on the samples. Setting: The blood donors were bled and tested at the blood banks attached to the teaching hospitals in Lahore and at the Institute of Haematology and Blood transfusion Service, Punjab. Subjects: 8161 prospective predominantly first time blood donors aged 18-60 years. Main Outcome Measures: Assessment of the prevalence of syphilis in the blood donors. 0.78% of the blood donors tested were found to be positive. Conclusions: Blood safety is compromised due to lack of screening for syphilis and TPHA testing should be started in routine practice

Transfusion transmitted HIV and HBV infections in Punjab, Pakistan

To assess the prevalence and risk of transfusion transmitted HIV and HBV infections in Punjab. The retrospective sero epidemiological data of the Institute of Haematology and Blood Transfusion Service, Punjab from 1996-2000 was analysed with regard to: a] Number of donors bled, b] Percentage of screening coverage, c] Percentage prevalence of HIV and HBV, d] Probability of receiving an infective unit P[R], probability of transmitting infection P[I] and spreading index evaluation and e] Cost assessment. The data was obtained regularly from 71 field units established in the government hospitals throughout the Province of Punjab from 1996- 2000. A total of 1176284 directed first time or replacement blood donors as well as voluntary non-remunerated blood donors who donated blood at these blood banks or at mobile sessions have been included in this study. Assessment of prevalence of HIV and HBV in blood donors and risk estimation. The screening coverage on the average has been 77.42% for HIV and 86.84% for HBV. The prevalence of HIV is 0.001% and of HBV is 2.259%. The probability of receiving an infective unit P[R] per 10000 donations is 0.023 for HIV and 29.72 for HBV. The probability of transmitting infection P[I] per 10000 donations is 0.021 for HIV and 26.75 for HBV The spreading index for both viral infections combined is 26.75 per 10000 donations. The cost of collecting and screening a single unit is Rs.350, while the cost of preventing the transfusion of a single infective unit is Rs.17836. Efforts should be made to extend 100% screening coverage, with development of altruistic voluntary non-remunerated blood donor registries, donor deferral registries and donor counseling service. There is a need to move away from hospital based blood donation system to a community-based system which would mean moving to a central and regional service concept in blood transfusion. An independent external QA programme or monitoring system is needed. The target should be to decrease prevalence to a minimum to ensure blood safety

natural anticoagulants

The incidence of inherited thrombotic diseases have generally been overlooked, however, data has shown that their incidence is three times more common than the more dramatically presenting inherited bleeding disorders. This article deals specifically with the inbuilt anticoagulant systems within the body; a defect or deficiency in this system would lead to a hypercoagulable state. Catastrophic situations like myocardial infarction in conventional risk free young individuals, strokes, peripheral embolic phenomena and placental infarctions are some of the resultant clinical settings of a hypercoagulable state. In this paper, an attempt has been made to describe the different mechanisms of action, clinical implications and laboratory methodologies available for the diagnosis of these conditions, as well as available therapeutic remedies