How much blood transfusion protocols are followed among health care providers in the tertiary care hospitals of Rawalpindi and Islamabad

The high-ceilinged importance given to safe blood transfusion, a study was conducted in the teaching hospitals of Islamabad and Rawalpindi to ascertain how much blood transfusion protocols are followed. Cross sectional study. This study was carried out in the Teaching Hospitals of Islamabad and Rawalpindi, between Oct, 2007 to Dec, 2007. A total of seventy six health care professionals from surgical and allied specialties were put forward a questionnaire Performa relating to as to whether departmental guidelines for blood transfusion are followed or not. Out of total studied sample i.e. seventy six in total, forty health care personals i.e. 52.63% affirmed that they do follow departmental guidelines for blood transfusion, whereas thirty six personals i.e. 47.37% were lacking the follow-up of standard protocols in their settings. In the study 47.37% i.e. thirty six in number of considered health care professionals were of the opinion that they do not pursue in spirit departmental guidelines regarding blood and blood product transfusion

Single flexible postprandial plasma glucose test as a new screening modality for diabetes mellitus

The study was aimed at assessing the adequacy of single flexible potprandial plasma glucose [FPPPG] test with time of sampling between 30-120 min after breakfast/meal as a screening test for diabetes mellitus and IGT. Cross sectional study. Study was carried out in the Department of Chemical Pathology and Endocrinology at Armed Forces institute of Pathology, Rawalpindi from January to November 1995. Eighty eight consecutive patients referred to AFIP for oral glucose tolerance test were included. The ages of patients ranged from 30-65 y. In the first step, on day 1 oral glucose tolerance test and in the second step, on day 2 flexible time based postprandial plasma glucose [FPPPG] 30-120 min after breakfast/snack/meal were performed. 12 patients did not turn up on day 2 for FPPPG test. In this study we performed FPPPG test on 76 patients as a screening test, with a cutoff point of 7.0 mmol/l. The study revealed that all 22 diabetic patients [100%] had levels above the limit whereas, 15 [83.3%] out of 19 patients of IGT had levels above cutoff level. On the other hand out of 35 healthy subjects only 2 [5.71%] had values above the limit. This study proposes a new screening test [FPPPG] for diabetes mellitus and IGT, which has a sensitivity of [100%], specificity of [66.7%] and positive predictive value of [55%]

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