ABSTRACT
Objective: To compare the platelet count, platelet concentration/yield, residual Red blood cells (RBCs) and White blood cells (WBCs) counts in platelet-rich plasma (PRP) samples prepared from the single- and the double-centrifugation protocols. Methods: It was a Cross-Sectional study, conducted at the Department of Hematology & Transfusion Medicine, The Children's Hospital and UCHS, Lahore from October 2021 to January 2022 including 50 voluntary, healthy individuals of age 20-45 years of both genders, after taking informed consent. Complete blood count analysis of all participants was done initially by drawing 3ml blood in EDTA vial. From all the participants, 20 ml venous blood sample was taken in syringes containing tri-sodium citrate and then shifted to harvest tubes. Group-I comprised of PRP samples prepared by single- centrifugation method. While Group-II samples were prepared by Double-centrifugation method consisting of soft and hard spin. The platelet, RBC and WBC counts in prepared PRP samples were determined by using automated SYSMEX XP-100 hematology analyzer. Platelet yield or Platelet concentration (%) was calculated for samples using formula. The data analysis was done using SPSS version 23. Results: The mean PRP platelet count in Group-I was 594.6±157.4×103/µl whereas in Group-II was 923.06 ± 127.58×103/µl. In Group-I, the mean platelet concentration/yield in PRP was 175.75 ± 55.08% while in Group-II, it was 276.78 ± 112.7%. Significant difference was observed between the platelet counts and platelet concentration/yields from the PRP samples of two Group-s (p < 0.01). Significant difference between the WBCs count was also observed (p < 0.01) with higher WBCs in Group- I PRP. Residual RBCs were almost same among two Group-s. Conclusions: The double centrifugation protocol resulted in higher platelet quantity and yield with less contamination by red and white blood cells than did the single centrifugation protocol for PRP preparation. So, double centrifugation method is beneficial in preparation of autologous as well as allogenic PRP.
ABSTRACT
Objectives: To determine the effects of donor and red blood cells concentrate characteristics on recipient hemoglobin increment following red blood cells transfusion in pediatric patients. Methods: This cross-sectional study was conducted at The Hematology & Transfusion Medicine Department of The UCHS & The Children's Hospital, Lahore from 23rd December 2020 to 31st July 2021 after Institutional Ethical committee approval. After taking informed consent from parents/guardians, One hundred recipients receiving RBCs unit transfusion studied along with the respective donors. The donor's details were recorded on a pre-designed proforma which included age, gender, Body Mass Index (BMI), CBC analysis (Hemoglobin [Hb] & Hematocrit) and blood group. Components' preparation, storage and modifications details were also recorded. Hb levels of recipient were determined 12 hours prior to transfusion and 12-18 hours after transfusion. The data was analyzed on SPSS version 26. Results: Among recipients, the mean age was 5.25 ±3 years and male to female ratio was 1.16:1. The mean pre-transfusion Hb level of patients was 6.48g/dl (SD: 2.15) and mean post transfusion Hb was 8.824 g/dl (SD: 2.03) with a significant raise after transfusion (p< 0.001). Majority donors (60%) were between 18 to 30 years of age and mean age was 30.7 years (SD: 9.04). The hemoglobin increment was reduced for transfusion of RBC units from donor with greater age. Post- transfusion Hb rise was more in Rh D positive donations than Rh D negative (p< 0.0001). No significance of donors' gender, BMI, Hb and hematocrit was found in relation to Hb increment. Among RBCs concentrate features, washing with normal saline found to have greater Hb increment, particularly in Thalassemia patients (p< 0.0001). Conclusion: Donors' age and Rh blood group and red blood cell concentrates' washing accounts for significant rise in recipient's post-transfusion hemoglobin. These factors may be used to predict changes in recipients' hemoglobin before transfusion.
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Objectives: To assess the utility of ISTH-BAT (International Society on Thrombosis and Hemostasis- Bleeding Assessment Tool) in the diagnosis of Glanzmann Thrombasthenia (GT) in comparison to controls. Methods: It was a case-control study carried out at The Children's Hospital, Lahore from January 2012 to May 2021. All patients from neonates to 18 years with a final diagnosis of GT were studied retrospectively. The clinical details were collected from hospital records and telephonically on ISTH-BAT questionnaire after taking informed consent. The same proforma was obtained from 75 healthy controls. Data was analyzed on SPSS version 26. Results: Out of 427 patients with suspected platelet function disorders, 133 were diagnosed as GT. The mean age was 7.29±5 years. Male to female ratio was 1.1:1. Among cases, 76.6% were products of consanguineous marriage. Epistaxis was the commonest symptom with highest score (p value<0.001). Cutaneous and oral cavity bleeds were more severe and frequent in patients than controls (p value < 0.004). The median ISTH-BAT score among patients was nine while in control group was one. Sensitivity was 86.4%, specificity was 77.3%, positive predictive value was 0.87 and negative predictive value was 0.76. Area under the receiver operator curve was 0.78 (95% confidence interval 0.82-0.90, p< 0.001*). Conclusion: ISTH-BAT scores were significantly higher in GT patients than controls. So, we recommend the inclusion of ISTH-BAT in diagnostic evaluation of patients with suspected Glanzmann Thrombasthenia.
ABSTRACT
OBJECTIVES: To investigate the patterns of bone marrow involvement in in Non-Hodgkin's Lymphoma (NHL) patients and to correlate the patterns with ß2 microglobulin (ß2m) and lactate dehydrogenase 2 (LD2) levels in these patients. METHODS: It was a cross sectional study which was conducted in two years at Post Graduate Medical Institute, Lahore and at Centre of Excellence in Molecular Biology (CEMB), Lahore. The study was conducted on 50 subjects irrespective of age and sex divided into two groups i.e. Group-A comprising 20 normal healthy controls while Group-B consisted of 30 patients of NHL with bone marrow infiltration. Bilateral bone marrow trephine biopsy was done to assess the patterns of bone marrow infiltration. Serum ß2m and LD2 isoenzyme levels were determined in already diagnosed 30 patients of NHL. The values were compared with 20 healthy age and sex matched controls. Correlation coefficients were determined using Pearson's Correlation Coefficient. The estimations were made prior to the institution of chemotherapy. RESULTS: ß2m and LD2 levels were significantly (p-Value < 0.05) raised in NHL patients with disease advancement and were compared with controls. These serological markers showed negative correlation (-0.235 for ß2m and -0.133 for LD2) with the spread of disease and patterns of involvement in NHL patients. CONCLUSION: By observing the patterns of bone marrow involvement in NHL patients possible guidelines about prognosis and treatment protocols can be obtained as the serological markers levels correlate well with the spread of disease and patterns of involvement in NHL patients.
