RESUMO
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.
RESUMO
To assess the advantage of palpation of CBD during exploratory laparotomy in patients with acute abdomen. Material and A prospective study was conducted from July 1998 till December 2002 at Tehsil Head Quarter Hospital Matta, District Swat, Saidu Group of Hospitals Swat and DHQ Hospital Timergara District Dir Lower. Eleven patients, 5 male and 6 female [mean age 9.8+2.6 years] were included in this study. All the operations were performed under general anesthesia. Four patients were diagnosed preoperatively by abdominal ultrasonography and subjected to operative extraction of worms on next operation list. Seven patients presented with acute abdomen and turned out to have biliary ascariasis on palpating the CBD during exploratory laparatomy. T tube was inserted in 10 patients to drain the CBD, while in one patient primary repair was done. Their postoperative course was smooth and uneventful. Biliary ascariasis though not a common problem must be considered as a possibility in patients presenting with acute abdomen in endemic areas especially when no other cause for the patient's symptoms is apparent