Pub Date : 2024-06-13DOI: 10.9734/ibrr/2024/v15i2338
B. West, W. Wonodi
Introduction: Blood transfusion is a life-saving procedure best carried out as soon as it is recommended to avoid morbidity and mortality. Aim: To determine the Pattern, complications and social problems of blood transfusion in a neonatal unit in Southern Nigeria. Methodology: A prospective descriptive study of 179 neonates admitted in the neonatal unit of the Rivers State University Teaching Hospital over a period of 3years. Results: Out of 179 neonates for which blood transfusion was recommended, 172(96.1%) received blood transfusion whereas 7(3.9%) did not. Majority of the children transfused were preterm 144(80.4%), delivered via Caesarean section 108(60.3%) and weighed < 2.5kg 144(80.4%). Most were admitted in their first week of life 143(79.9%) with morbidity pattern for most babies transfused being prematurity, neonatal sepsis and neonatal jaundice. Most transfusions occurred after the first week of admission with first degree relatives 76(45.2%) and commercial donors being the most source of blood transfused. Non-availability of donors and compatibility issues were the commonest reasons for use of commercially donated blood. Most received single blood transfusion 72(71.2%), sedimented cells 160(89.3%) and within 24hours following its recommendation. The reasons for transfusion beyond 24hours were financial constraints 31(57.4%) and no donor 26(48.1%). Commonest reasons for not consenting to blood transfusion were social; financial constraint 4(57.1%) and religious reasons 2(28.6%). Only 1(0.6%) neonate had obvious blood transfusion reaction while 22(13.2%) had post transfusion malaria. Conclusion: Not all neonates who required blood transfusion received it. The commonest morbidity pattern among recipients were prematurity, neonatal sepsis and neonatal jaundice. Financial constraint was the commonest reason for both delayed blood transfusion and for not consenting to blood transfusion thus policies must be made to ensure ready availability and accessibility of blood in hospitals including the National Health Insurance Scheme in order to reduce neonatal morbidity and mortality.
{"title":"Pattern, Complications and Social Problems of Blood Transfusion in the Neonatal Unit of a Tertiary Hospital in Southern Nigeria","authors":"B. West, W. Wonodi","doi":"10.9734/ibrr/2024/v15i2338","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i2338","url":null,"abstract":"Introduction: Blood transfusion is a life-saving procedure best carried out as soon as it is recommended to avoid morbidity and mortality. \u0000Aim: To determine the Pattern, complications and social problems of blood transfusion in a neonatal unit in Southern Nigeria. \u0000Methodology: A prospective descriptive study of 179 neonates admitted in the neonatal unit of the Rivers State University Teaching Hospital over a period of 3years. \u0000Results: Out of 179 neonates for which blood transfusion was recommended, 172(96.1%) received blood transfusion whereas 7(3.9%) did not. Majority of the children transfused were preterm 144(80.4%), delivered via Caesarean section 108(60.3%) and weighed < 2.5kg 144(80.4%). Most were admitted in their first week of life 143(79.9%) with morbidity pattern for most babies transfused being prematurity, neonatal sepsis and neonatal jaundice. Most transfusions occurred after the first week of admission with first degree relatives 76(45.2%) and commercial donors being the most source of blood transfused. Non-availability of donors and compatibility issues were the commonest reasons for use of commercially donated blood. Most received single blood transfusion 72(71.2%), sedimented cells 160(89.3%) and within 24hours following its recommendation. The reasons for transfusion beyond 24hours were financial constraints 31(57.4%) and no donor 26(48.1%). Commonest reasons for not consenting to blood transfusion were social; financial constraint 4(57.1%) and religious reasons 2(28.6%). Only 1(0.6%) neonate had obvious blood transfusion reaction while 22(13.2%) had post transfusion malaria. \u0000Conclusion: Not all neonates who required blood transfusion received it. The commonest morbidity pattern among recipients were prematurity, neonatal sepsis and neonatal jaundice. Financial constraint was the commonest reason for both delayed blood transfusion and for not consenting to blood transfusion thus policies must be made to ensure ready availability and accessibility of blood in hospitals including the National Health Insurance Scheme in order to reduce neonatal morbidity and mortality.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"10 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141346686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-13DOI: 10.9734/ibrr/2024/v15i2337
Luca Collodel, Gianluca Gessoni
Background: A considerable number of RHD alleles responsible for weak and partial D phenotypes have been identified. Serological determination of these phenotypes is often doubtful and makes genetic analysis of RHD gene highly desirable in transfusion recipients and pregnant women. Aim: We report the experience of Mestre Blood Bank in analysis of the RHD gene in six years from 2018 to 2023. Methods: Subjects for RHD gene analysis were selected for presence of a serological weak D phenotype, defined as reactivity of RBCs with an anti-D reagent giving no or weak (≤2+) score in initial testing but agglutinating moderately or strongly with anti human globulin (AHG). These samples were selected for genotyping using the microarray-based method Bead-Chip supplied by Werfen. Results: From 2018 to 2023, we selected, for RHD gene analysis, 555 subject with D weak phenotype; 86 subjects (15.5%) were D positive and 56 (10.1%) were D negative, without variant, in 413 subjects a D weak or a D variant was observed. Discussion: Many serological weak D phenotypes are associated to RHD gene mutations leading to one or more amino acids substitutions in the RhD protein predicted to be within or below the RBC membrane, causing decreased antigen expression on the red cell surface. Prevalence of serological weak D phenotypes varies by race and ethnicity. Serological weak D phenotypes are the most common D variants detected in Caucasians (0.2%-1.0%). The majority, as in our series, are associated with weak D type 1, 2 or 3. Our data confirmed a high prevalence of weak D type 1 and type 2, but we observed a high prevalence of type 11 and 15 and of the uncommon type 18 too. The most common partial D phenotypes in Europe are DNB, DVI, and DVII. Our data confirmed a high prevalence of D partial type VI. Studies indicate that D partial transfusion recipients are at risk of forming alloanti-D when exposed to conventional RhD-positive blood units.
背景：目前已发现相当多的 RHD 等位基因可导致弱 D 表型和部分 D 表型。对这些表型的血清学测定往往是可疑的，因此对输血受者和孕妇进行 RHD 基因分析是非常必要的。目的：我们报告了 Mestre 血库在 2018 年至 2023 年六年间分析 RHD 基因的经验。方法：RHD基因分析的受试者是根据血清学弱D表型的存在情况选择的，弱D表型的定义是红细胞与抗D试剂的反应性在初始测试中没有得分或得分较弱（≤2+），但与抗人球蛋白（AHG）有中度或强烈的凝集。这些样本被选中使用由 Werfen 公司提供的基于芯片的 Bead-Chip 方法进行基因分型。结果：从2018年到2023年，我们选择了555名D弱表型的受试者进行RHD基因分析；86名受试者（15.5%）为D阳性，56名受试者（10.1%）为D阴性，无变异，在413名受试者中观察到D弱或D变异。讨论：许多血清学弱D表型与RHD基因突变有关，突变导致RhD蛋白中的一个或多个氨基酸发生置换，从而导致红细胞膜内或膜下的抗原在红细胞表面的表达减少。血清学弱 D 表型的患病率因种族和人种而异。血清学弱 D 表型是白种人中最常见的 D 变异型（0.2%-1.0%）。在我们的研究中，大多数人都与弱 D 1、2 或 3 型有关。我们的数据证实弱 D 1 型和 2 型的发病率很高，但我们也观察到 11 型和 15 型以及不常见的 18 型的发病率也很高。欧洲最常见的部分 D 表型是 DNB、DVI 和 DVII。我们的数据证实，D 部分型 VI 的发病率很高。研究表明，D 偏型输血者在接触常规 RhD 阳性血液单位时，有形成异体抗 D 的风险。
{"title":"RHD Genotyping to Resolve Weak and Discrepant RHD Phenotypes: The “Serenissima” Experience","authors":"Luca Collodel, Gianluca Gessoni","doi":"10.9734/ibrr/2024/v15i2337","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i2337","url":null,"abstract":"Background: A considerable number of RHD alleles responsible for weak and partial D phenotypes have been identified. Serological determination of these phenotypes is often doubtful and makes genetic analysis of RHD gene highly desirable in transfusion recipients and pregnant women. \u0000Aim: We report the experience of Mestre Blood Bank in analysis of the RHD gene in six years from 2018 to 2023. \u0000Methods: Subjects for RHD gene analysis were selected for presence of a serological weak D phenotype, defined as reactivity of RBCs with an anti-D reagent giving no or weak (≤2+) score in initial testing but agglutinating moderately or strongly with anti human globulin (AHG). These samples were selected for genotyping using the microarray-based method Bead-Chip supplied by Werfen. \u0000Results: From 2018 to 2023, we selected, for RHD gene analysis, 555 subject with D weak phenotype; 86 subjects (15.5%) were D positive and 56 (10.1%) were D negative, without variant, in 413 subjects a D weak or a D variant was observed. \u0000Discussion: Many serological weak D phenotypes are associated to RHD gene mutations leading to one or more amino acids substitutions in the RhD protein predicted to be within or below the RBC membrane, causing decreased antigen expression on the red cell surface. Prevalence of serological weak D phenotypes varies by race and ethnicity. Serological weak D phenotypes are the most common D variants detected in Caucasians (0.2%-1.0%). The majority, as in our series, are associated with weak D type 1, 2 or 3. Our data confirmed a high prevalence of weak D type 1 and type 2, but we observed a high prevalence of type 11 and 15 and of the uncommon type 18 too. The most common partial D phenotypes in Europe are DNB, DVI, and DVII. Our data confirmed a high prevalence of D partial type VI. Studies indicate that D partial transfusion recipients are at risk of forming alloanti-D when exposed to conventional RhD-positive blood units.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141128654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There is a thin line between a safe blood transfusion and transfusion-related fatality hence the need to be diligent in every aspect of the blood transfusion process. Appropriate and complete documentation on a blood transfusion request form is one of the most important preanalytic activities serving as a communication tool between the clinician and the blood transfusion laboratory personnel. Aims: To evaluate compliance with appropriate and complete documentation of information on our blood transfusion request forms for a reliable preanalytic process towards an efficient blood transfusion service. Study Design: It is a retrospective study. Place and Duration of Study: Blood Bank of the Jos University Teaching Hospital between January to December 2023. Methodology: Six thousand, three hundred and sixty (6360) blood transfusion request forms from the Jos University Teaching Hospital Blood bank were evaluated for complete or incomplete documentation retrospectively and results were presented in frequencies and percentages. Results: There was 100% compliance in filling in the patients' surnames and other names as well as the laboratory number and blood groups of the patients while only 4779 (75.14%) filled in the patients' ages with 1416(22.26%) using the prefix of adult(ad) while 165(2.59%) fail to document the patients' age. There were 2829 (44.48%) males with 3522 (55.38%) females while no sex was indicated in 9 of the reviewed forms. Obstetrics history has the least cumulated documented response of 0.38% while a significant 1008 (15.85%) did not indicate either blood grouping or blood grouping with cross-match request. Conclusion: Appropriate and complete documentation of information on blood transfusion request forms is a problem among clinicians and will require continuous education on its importance, periodic auditing, provision of electronic data system and attitudinal change for a better blood transfusion compatibility service.
{"title":"Evaluation of Blood Transfusion Request form: The Experience in a Tertiary Health Facility in Jos, Nigeria","authors":"Jatau ED, Iheanacho Cu, Okeke Cn, Zakari A, Bangalu DY, Damulak Od, Egesie OJ","doi":"10.9734/ibrr/2024/v15i2336","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i2336","url":null,"abstract":"Background: There is a thin line between a safe blood transfusion and transfusion-related fatality hence the need to be diligent in every aspect of the blood transfusion process. Appropriate and complete documentation on a blood transfusion request form is one of the most important preanalytic activities serving as a communication tool between the clinician and the blood transfusion laboratory personnel.\u0000Aims: To evaluate compliance with appropriate and complete documentation of information on our blood transfusion request forms for a reliable preanalytic process towards an efficient blood transfusion service.\u0000Study Design: It is a retrospective study.\u0000Place and Duration of Study: Blood Bank of the Jos University Teaching Hospital between January to December 2023.\u0000Methodology: Six thousand, three hundred and sixty (6360) blood transfusion request forms from the Jos University Teaching Hospital Blood bank were evaluated for complete or incomplete documentation retrospectively and results were presented in frequencies and percentages.\u0000Results: There was 100% compliance in filling in the patients' surnames and other names as well as the laboratory number and blood groups of the patients while only 4779 (75.14%) filled in the patients' ages with 1416(22.26%) using the prefix of adult(ad) while 165(2.59%) fail to document the patients' age. There were 2829 (44.48%) males with 3522 (55.38%) females while no sex was indicated in 9 of the reviewed forms. Obstetrics history has the least cumulated documented response of 0.38% while a significant 1008 (15.85%) did not indicate either blood grouping or blood grouping with cross-match request.\u0000Conclusion: Appropriate and complete documentation of information on blood transfusion request forms is a problem among clinicians and will require continuous education on its importance, periodic auditing, provision of electronic data system and attitudinal change for a better blood transfusion compatibility service.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":" 932","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140989253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-11DOI: 10.9734/ibrr/2024/v15i2335
S. Ojeka, Blessing Ukoro, Ebebi Elizah Onwoke
The study investigated the effects of vitamin C on platelet parameters, white blood cell count and white blood cells differentials in Wistar rats exposed to lead acetate. A total of twenty-four male Wistar rats weighing between 160g and 200g were utilized. The experimental animals were divided into four groups of six rats each (n=6). Group 1 served as the control group (received normal feed and water), group II received 10mg/kg body weight of lead acetate, group III received 100mg/kg body weight of Vitamin C, and group IV received 10mg/kg body weight of lead acetate followed by 100mg/kg body weight of Vitamin C. Lead and Vitamin C, along with normal feed, were administered for four weeks. Blood samples were collected via jugular puncture and stored in EDTA bottles for analysis to determine the blood profile of the rats. The results showed significant increase in Platelet Count (PLT) in group III and a significant decrease in Mean Platelet Volume (MPV) in group IV (Pb + vitamin C). The Mean Platelet Width (MPW) showed decrease in groups 2, 3, and 4 compared to the control group, although this decrease was not statistically significant. The study also noted an elevated level of white blood cells (WBC) in response to the antioxidant treatment, indicating a potential positive impact on immune function. In conclusion, this study demonstrates the therapeutic effect of Vitamin C against the toxic effects of lead on platelet parameters and white blood cell count and differentials.
{"title":"Antioxidant Effects of Vitamin C on Some Hematological Parameters of Male Wistar Rats Exposed to Lead Acetate","authors":"S. Ojeka, Blessing Ukoro, Ebebi Elizah Onwoke","doi":"10.9734/ibrr/2024/v15i2335","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i2335","url":null,"abstract":"The study investigated the effects of vitamin C on platelet parameters, white blood cell count and white blood cells differentials in Wistar rats exposed to lead acetate. A total of twenty-four male Wistar rats weighing between 160g and 200g were utilized. The experimental animals were divided into four groups of six rats each (n=6). Group 1 served as the control group (received normal feed and water), group II received 10mg/kg body weight of lead acetate, group III received 100mg/kg body weight of Vitamin C, and group IV received 10mg/kg body weight of lead acetate followed by 100mg/kg body weight of Vitamin C. Lead and Vitamin C, along with normal feed, were administered for four weeks. Blood samples were collected via jugular puncture and stored in EDTA bottles for analysis to determine the blood profile of the rats. The results showed significant increase in Platelet Count (PLT) in group III and a significant decrease in Mean Platelet Volume (MPV) in group IV (Pb + vitamin C). The Mean Platelet Width (MPW) showed decrease in groups 2, 3, and 4 compared to the control group, although this decrease was not statistically significant. The study also noted an elevated level of white blood cells (WBC) in response to the antioxidant treatment, indicating a potential positive impact on immune function. In conclusion, this study demonstrates the therapeutic effect of Vitamin C against the toxic effects of lead on platelet parameters and white blood cell count and differentials.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"20 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140714032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: D-Dimer is considered a pivotal biomarker in diagnosis of disseminated intravascular coagulation and in differential diagnosis of thrombosis and pulmonary embolism. Case Summary: BL, Caucasian woman, 81 years old, was admitted to hospital, in October 2023, for concussive head trauma after an accidental fall. The patient had a "non-assayable D-Dimer due to excess antigen" utilizing Sysmex Innovance D-dimer using a Sysmex CS 5100 analyser. This abnormal result was firstly observed in March 2022. A second Laboratory confirmed the raised D-dimer concentration. The patient had undergone periodic D-dimer checks which had always confirmed the results and had been treated with a direct FXa inhibitor. Methods: Patient’s samples were tested for D-dimer using different assays and different analysers, moreover sample diluted in phosphate buffer and heterophilic antibodies blocking reagent have been tested. Results: The Sysmex Innovance D-dimer assay gave us, constantly “non-assayable D-dimer due to excess antigen" results; the HemosIL D-dimer HS assay gave us, constantly a raised D-dimer concentration (four to five higher than upper reference values); the Quidel Triage D-dimer gave us, constantly D-dimer normal concentration. Results obtained from dilution curves confirmed the presence of high concentration high avidity heterophilic antibodies. Conclusions: Reports regarding the influence of heterophilic antibodies on the measurement of D‐dimer are quite uncommon in literature however, they constitute a significant potential risk. Interference from heterophile antibodies often has a different impact using different instruments and methods in the measurement of D‐dimer. Using a combination of different assays and analysers, of dilution strategy with heterophilic antibody blockers, and combining laboratory results with clinical examinations and imaging data, we were able to identify the interference and exclude the presence of thrombosis.
{"title":"Interference of Heterophilic Antibody in D-dimer Determination in an Asymptomatic Elderly Woman","authors":"Valverde Sara, Masiero Elena, Seguso Mara, Giordano Martina, Inglese Margherita, Gessoni Gianluca","doi":"10.9734/ibrr/2024/v15i2334","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i2334","url":null,"abstract":"Background: D-Dimer is considered a pivotal biomarker in diagnosis of disseminated intravascular coagulation and in differential diagnosis of thrombosis and pulmonary embolism.\u0000Case Summary: BL, Caucasian woman, 81 years old, was admitted to hospital, in October 2023, for concussive head trauma after an accidental fall. The patient had a \"non-assayable D-Dimer due to excess antigen\" utilizing Sysmex Innovance D-dimer using a Sysmex CS 5100 analyser. This abnormal result was firstly observed in March 2022. A second Laboratory confirmed the raised D-dimer concentration. The patient had undergone periodic D-dimer checks which had always confirmed the results and had been treated with a direct FXa inhibitor.\u0000Methods: Patient’s samples were tested for D-dimer using different assays and different analysers, moreover sample diluted in phosphate buffer and heterophilic antibodies blocking reagent have been tested.\u0000Results: The Sysmex Innovance D-dimer assay gave us, constantly “non-assayable D-dimer due to excess antigen\" results; the HemosIL D-dimer HS assay gave us, constantly a raised D-dimer concentration (four to five higher than upper reference values); the Quidel Triage D-dimer gave us, constantly D-dimer normal concentration. Results obtained from dilution curves confirmed the presence of high concentration high avidity heterophilic antibodies.\u0000Conclusions: Reports regarding the influence of heterophilic antibodies on the measurement of D‐dimer are quite uncommon in literature however, they constitute a significant potential risk. Interference from heterophile antibodies often has a different impact using different instruments and methods in the measurement of D‐dimer. Using a combination of different assays and analysers, of dilution strategy with heterophilic antibody blockers, and combining laboratory results with clinical examinations and imaging data, we were able to identify the interference and exclude the presence of thrombosis.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"97 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.9734/ibrr/2024/v15i1333
Tatiana Baglo, Alban Zohoun, B. Houssou, R. Massi, Charlotte Orou Guiwa, Ludovic Anani, D. Gazard, Awa Omar Touré Fall
Aim: determine the prevalence of a FVIII inhibitors and identify the genetic mutations associated with their development in beninese personne with hemophilia (PwH) A. Study Design: this is cross-sectional descrptive study conducted from June 2022 to May 2023 in hemophilia treatment centers in Benin. Methodology: Inhibitor screening was carried out systematically in all PwHs A receiving FVIII infusion through determination of the circulating anticoagulant index and the Nijmegen-Bethesda assay. The molecular study strategy used for the F8 gene associated with hemophilia A is dependent on the severity of the hemophilia. Other data were collected either from patients' responses to the questionnaire or by studying their medical records and the center's hemophilia registry. Results: Of the 97 PwHs A followed up, 57 had been treated with FVIII infusion. Of these, 21 had developed inhibitors, representing a frequency of 36.8% of treated PwHs A and 43.75% of severe PwHs. None of the moderate or mild PwHs A had developed anti-FVIII antibodies. PwHs A with inhibitors had a median age of 11 years, ranging from 1 to 66 years. The Nijmegen-Bethesda test revealed 11 high responders and 10 low responders. Mutation analysis of the F8 gene revealed seven cases of intron 22 inversion, seven cases of nonsense mutations, three cases of deletion and one case of missense mutation. Mutations weren’t identified in three patients because their DNA did not amplify on long-distance PCR. In terms of therapy, immune tolerance induction wasn’t achieved in any of the 21 patients, but they are treated with emicizumab and bypass depending on the context. Conclusion: Although a cross-sectional study with a limited sample size, this study provides valuable information on beninese PwHs A with inhibitors. The frequency of inhibitors is high in treated PwHs A, and almost all patients who have developed inhibitors have high-risk genetic mutations.
{"title":"Study of Factor VIII Inhibitor and F8 Gene Mutations in Persons with Hemophilia A from Benin","authors":"Tatiana Baglo, Alban Zohoun, B. Houssou, R. Massi, Charlotte Orou Guiwa, Ludovic Anani, D. Gazard, Awa Omar Touré Fall","doi":"10.9734/ibrr/2024/v15i1333","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i1333","url":null,"abstract":"Aim: determine the prevalence of a FVIII inhibitors and identify the genetic mutations associated with their development in beninese personne with hemophilia (PwH) A.\u0000Study Design: this is cross-sectional descrptive study conducted from June 2022 to May 2023 in hemophilia treatment centers in Benin.\u0000Methodology: Inhibitor screening was carried out systematically in all PwHs A receiving FVIII infusion through determination of the circulating anticoagulant index and the Nijmegen-Bethesda assay. The molecular study strategy used for the F8 gene associated with hemophilia A is dependent on the severity of the hemophilia. Other data were collected either from patients' responses to the questionnaire or by studying their medical records and the center's hemophilia registry.\u0000Results: Of the 97 PwHs A followed up, 57 had been treated with FVIII infusion. Of these, 21 had developed inhibitors, representing a frequency of 36.8% of treated PwHs A and 43.75% of severe PwHs. None of the moderate or mild PwHs A had developed anti-FVIII antibodies. PwHs A with inhibitors had a median age of 11 years, ranging from 1 to 66 years. The Nijmegen-Bethesda test revealed 11 high responders and 10 low responders. Mutation analysis of the F8 gene revealed seven cases of intron 22 inversion, seven cases of nonsense mutations, three cases of deletion and one case of missense mutation. Mutations weren’t identified in three patients because their DNA did not amplify on long-distance PCR. In terms of therapy, immune tolerance induction wasn’t achieved in any of the 21 patients, but they are treated with emicizumab and bypass depending on the context.\u0000Conclusion: Although a cross-sectional study with a limited sample size, this study provides valuable information on beninese PwHs A with inhibitors. The frequency of inhibitors is high in treated PwHs A, and almost all patients who have developed inhibitors have high-risk genetic mutations.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"117 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140089485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-23DOI: 10.9734/ibrr/2024/v15i1332
N. E. Ahajumobi, J. C. Asika
Background: Sickle cell anemia is a disease that affects largely Africans and people in the tropics. It affects an average of 7.74 million and the mortality rate was 376,000 in the year 2021. Sickle cell disease was discovered in 1910 by a Famous scholar Herrick who described it as a hematological (Blood) disease and nearly three decades later, in 1949, Linus Pauling discovered the pathology of sickle cell anemia. Through molecular studies we further learned that sickle cell disease is caused by certain abnormalities in the hemoglobin of the patient, which costs millions of lives, plant products offer hope. Aims: The objectives were to determine the plants that are in use and the consensus clinical evidence about the plants and sickle cell diseases treatment. To provide easy access to consensus evidence to busy healthcare professionals and to educate the public. Place and Duration of Study: Department of Public Health, College of Health Science, Walden University, Minneapolis, USA, between July 2022 and October 2023. Methodology: A systematic review supported by a community approach to intervention services and native medicine theories supported the study. Search engines were Safari, Google, Google scholar, and Firefox. Results: Showed that while there were various approaches adopted by modern medicine to provide palliative care for persons with sickle cell diseases, which were directed at raising depleting nutrients, preventing infections and delaying the gelling point of the erythrocyte, no significant achievement has been made at reducing the disease and treating it effectively. Also, over 80% of the patients cannot afford the cost of the treatment. Thankfully, phytochemical compounds isolated from some medicinal plants- Carica papaya, Piper guineense, Cajanus cajan, Zanthoxylum zanthoxyloides, Terminalia catappa L, and formulations made from them such as Niprisan and Ciklavit, which have been approved for use for treating sickle cell diseases stands to be sustainable and efficacious offer hope. Outcome will bring a significant social change in local and global public health and economic activities. Conclusion: Clinically tested phytochemical compositions of implicated plants, herbal preparations, and specific nutrients investigated in this study possess anti-sickling properties and a couple of the preparations have been approved for sickle cell disease treatment in Nigeria.
{"title":"Afro Medicinal Plants a Promising Remedy for Sickle Cell Anemia","authors":"N. E. Ahajumobi, J. C. Asika","doi":"10.9734/ibrr/2024/v15i1332","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i1332","url":null,"abstract":"Background: Sickle cell anemia is a disease that affects largely Africans and people in the tropics. It affects an average of 7.74 million and the mortality rate was 376,000 in the year 2021. Sickle cell disease was discovered in 1910 by a Famous scholar Herrick who described it as a hematological (Blood) disease and nearly three decades later, in 1949, Linus Pauling discovered the pathology of sickle cell anemia. Through molecular studies we further learned that sickle cell disease is caused by certain abnormalities in the hemoglobin of the patient, which costs millions of lives, plant products offer hope. \u0000Aims: The objectives were to determine the plants that are in use and the consensus clinical evidence about the plants and sickle cell diseases treatment. To provide easy access to consensus evidence to busy healthcare professionals and to educate the public. \u0000Place and Duration of Study: Department of Public Health, College of Health Science, Walden University, Minneapolis, USA, between July 2022 and October 2023. \u0000Methodology: A systematic review supported by a community approach to intervention services and native medicine theories supported the study. Search engines were Safari, Google, Google scholar, and Firefox. \u0000Results: Showed that while there were various approaches adopted by modern medicine to provide palliative care for persons with sickle cell diseases, which were directed at raising depleting nutrients, preventing infections and delaying the gelling point of the erythrocyte, no significant achievement has been made at reducing the disease and treating it effectively. Also, over 80% of the patients cannot afford the cost of the treatment. Thankfully, phytochemical compounds isolated from some medicinal plants- Carica papaya, Piper guineense, Cajanus cajan, Zanthoxylum zanthoxyloides, Terminalia catappa L, and formulations made from them such as Niprisan and Ciklavit, which have been approved for use for treating sickle cell diseases stands to be sustainable and efficacious offer hope. Outcome will bring a significant social change in local and global public health and economic activities. \u0000Conclusion: Clinically tested phytochemical compositions of implicated plants, herbal preparations, and specific nutrients investigated in this study possess anti-sickling properties and a couple of the preparations have been approved for sickle cell disease treatment in Nigeria.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"175 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140437999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.9734/ibrr/2024/v15i1331
LT Ocko Gokaba, JA Elira Samba, OF Galiba Atipo-Tsiba, Grj Buambo, LO Ngolet, RC Iwandza, P. I. Amboulou, J. N. Mboumba, C. Bango, C. Itoua, A. E. Dokekias
Low-dose acetylsalicylic acid (ASA) has been recommended for pregnant women since 2011 by the OMS to prevent thrombotic phenomena. Despite the variability of its clinical efficacy (resistance phenomena), its non-standardized biological monitoring can be performed using platelet occlusion time (POT). The aim of this study was to assess the response to ASA using POT. A multicenter, cross-sectional, analytical study was conducted in the obstetrics and gynaecology departments of six Brazzaville hospitals over a period of 09 months and included pregnant women on ASA 100 mg daily for at least 7 days. POT was measured using the INNOVANCE® PFA®-200 system. The variables studied were clinical (age, medical and obstetrical history) and biological (blood count, POT). Non-response to ASA was defined by a POT of 150 seconds or less. Data analysis was performed using STATA 12 software. Logistic regression was used to assess the determinants associated with non-response. The incidence of obstetric complications according to ASA resistance was evaluated by the Kaplan-Meier method and the Log-Rank test. The significance threshold was p<0.005. The study involved 39 pregnant women, mean age 33.9 ± 5.4 years, treated with ASA for hypertensive disorders of pregnancy n=19 (48.7%), chronic arterial hypertension n=7 (18%), diabetes n=3(7.7%) fetal death n=3(7.7%), unexplained miscarriage n=3(7.7%), advanced age n=2 (5.1%) and twin pregnancy n=2(5.1%). The median body index was 25.5 kg/m2 [23.7;29.4] with 35.9% women of normal weight, 48.7% overweight and 15.4% obese. Non-response to ASA was found in 12 pregnant women (30.7%). No statistically significant differences were observed between non-responders and responders with regard to epidemiological, clinical and haematological determinants (p>0.05). Non-response was more observed in women with complications 23.08% versus 7.7% (p=0,008). Non-response to ASA, present in a third of hypertensive pregnant women, is associated with the occurrence of obstetrical complications in Brazzaville.
{"title":"Evaluation of the Biological Response to Acetylsalicylic Acid by Platelet Occlusion Time in Pregnant Women in Brazzaville","authors":"LT Ocko Gokaba, JA Elira Samba, OF Galiba Atipo-Tsiba, Grj Buambo, LO Ngolet, RC Iwandza, P. I. Amboulou, J. N. Mboumba, C. Bango, C. Itoua, A. E. Dokekias","doi":"10.9734/ibrr/2024/v15i1331","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i1331","url":null,"abstract":"Low-dose acetylsalicylic acid (ASA) has been recommended for pregnant women since 2011 by the OMS to prevent thrombotic phenomena. Despite the variability of its clinical efficacy (resistance phenomena), its non-standardized biological monitoring can be performed using platelet occlusion time (POT). The aim of this study was to assess the response to ASA using POT. \u0000A multicenter, cross-sectional, analytical study was conducted in the obstetrics and gynaecology departments of six Brazzaville hospitals over a period of 09 months and included pregnant women on ASA 100 mg daily for at least 7 days. POT was measured using the INNOVANCE® PFA®-200 system. The variables studied were clinical (age, medical and obstetrical history) and biological (blood count, POT). Non-response to ASA was defined by a POT of 150 seconds or less. Data analysis was performed using STATA 12 software. Logistic regression was used to assess the determinants associated with non-response. The incidence of obstetric complications according to ASA resistance was evaluated by the Kaplan-Meier method and the Log-Rank test. The significance threshold was p<0.005. \u0000The study involved 39 pregnant women, mean age 33.9 ± 5.4 years, treated with ASA for hypertensive disorders of pregnancy n=19 (48.7%), chronic arterial hypertension n=7 (18%), diabetes n=3(7.7%) fetal death n=3(7.7%), unexplained miscarriage n=3(7.7%), advanced age n=2 (5.1%) and twin pregnancy n=2(5.1%). The median body index was 25.5 kg/m2 [23.7;29.4] with 35.9% women of normal weight, 48.7% overweight and 15.4% obese. Non-response to ASA was found in 12 pregnant women (30.7%). No statistically significant differences were observed between non-responders and responders with regard to epidemiological, clinical and haematological determinants (p>0.05). Non-response was more observed in women with complications 23.08% versus 7.7% (p=0,008). \u0000Non-response to ASA, present in a third of hypertensive pregnant women, is associated with the occurrence of obstetrical complications in Brazzaville.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"75 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140485781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-16DOI: 10.9734/ibrr/2024/v15i1330
Robert H Sirait
Aims: Intraoperative hypotension (IOH) is a common condition faced by anesthesiologists intraoperatively which poignanting patients undergoing surgery under general and neuraxial anesthesia. Its occurrence is associated with dangerous morbid situations found perioperatively that can lead into fatal complications, such as acute kidney failure, direct myocardial injury, and even can end in mortality. Despite advanced closed hemodynamic monitoring and protocols utilizing goal directed therapy, recent trend of management is remaining reactive. Anesthesiologists tend to intervene when the episode of hypotension has already occurred. This literature review aimed to discuss the incidence of intraoperative hypotension and its urgency to overcome intraoperatively. Conclusion: The incidence of IOH varies based on the type of surgery, type of anesthesia and fragility of the patient, for example having comorbidities. Due to the rapid development of IOH which is unwanted, the effort reducing the hypotensive burden intraoperatively, as soon as possible is mandatory. By carefully predicting and preventing IOH through closed monitoring of patient’s blood pressure will surely improve patient outcome and prevent adverse unwanted post-operative event.
{"title":"The Incidence of Intraoperative Hypotension and the Importance of Timely Detection","authors":"Robert H Sirait","doi":"10.9734/ibrr/2024/v15i1330","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i1330","url":null,"abstract":"Aims: Intraoperative hypotension (IOH) is a common condition faced by anesthesiologists intraoperatively which poignanting patients undergoing surgery under general and neuraxial anesthesia. Its occurrence is associated with dangerous morbid situations found perioperatively that can lead into fatal complications, such as acute kidney failure, direct myocardial injury, and even can end in mortality. Despite advanced closed hemodynamic monitoring and protocols utilizing goal directed therapy, recent trend of management is remaining reactive. Anesthesiologists tend to intervene when the episode of hypotension has already occurred. This literature review aimed to discuss the incidence of intraoperative hypotension and its urgency to overcome intraoperatively. \u0000Conclusion: The incidence of IOH varies based on the type of surgery, type of anesthesia and fragility of the patient, for example having comorbidities. Due to the rapid development of IOH which is unwanted, the effort reducing the hypotensive burden intraoperatively, as soon as possible is mandatory. By carefully predicting and preventing IOH through closed monitoring of patient’s blood pressure will surely improve patient outcome and prevent adverse unwanted post-operative event.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":" 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139619601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-04DOI: 10.9734/ibrr/2024/v15i1329
Nwika Goodnews Nkabari, Eze, Evelyn Mgbeoma, A. Obioma, Ken-Ezihuo Stella U.
Introduction: Despite significant advances in transfusion medicine, concerns about the inherent risks of blood transfusion persist, even under optimal temperature and duration of storage. This makes the evaluation of blood viability a global task (1). Maintenance of adequate temperature is considered a key factor in the viability and quality of stored blood in healthcare institutions. Evaluating the haematological and haemostatic functionality of blood elements at different storage temperature and duration is therefore imperative for improving patient care and resource utilization in Rivers State University Teaching Hospital (RSUTH) blood bank in Port Harcourt. Methods: In this cohort study design, a total of sixteen (16) male and female blood donors in equal proportion of sex and ABO blood groups were randomly selected from the Port Harcourt blood donors' population and recruited as study subjects for this research. A well-structured questionnaire and the immunoassays were used to assess the donors' health and serological status respectively. Also the sample obtained were analayzed by automation and data statistically analyzed using ANOVA. Results: The results of this study shows a statistically significant decrease in white blood cell count from 4.93×109/L ± 0.33 to 2.79×109/L ± 1.68 (p=0.00) and platelet count from 227.38×109/L ± 32.17 to 153.75×109/L ± 58.39 (p=0.00) at day 7. Also, a significant decrease in platelet count from 227.38×109/L ± 32.17 to 141.50±60.92 at day 14. A significant decrease in Fibrinogen from 340.75mg/L±18.69 to 281.2575 mg/L ±46.41 at day 1 and day 14 respectively, and rise in PT and aPTT from 17.02s ±1.28 to 24.31s ±6.67 and 41.25s±3.23 to 46.63s±6.28 at day 14th to day 21 respectively (p=0.00). Conclusion and Implications for Translation: Pooled plasma at 4-60C contain clinically significant amount of coagulation factors up to day 21 in storage. The WBC and platelet is lost within seven day of storage at 4-60C. Lower temperatures, especially freezing at -60°C accelerate the loss of haematological viability of blood especially the depletion of white blood cells and platelets (p=0.00). Antihaemophilic factor and fibrinogen is maintained in FFP at 180 day in storage at -600C.
{"title":"An Assessment of the Viability of Haematological and Haemostatic Parameters of Blood under certain Storage Conditions at the Rivers State University Teaching Hospital Blood Bank in Port Harcourt, Nigeria","authors":"Nwika Goodnews Nkabari, Eze, Evelyn Mgbeoma, A. Obioma, Ken-Ezihuo Stella U.","doi":"10.9734/ibrr/2024/v15i1329","DOIUrl":"https://doi.org/10.9734/ibrr/2024/v15i1329","url":null,"abstract":"Introduction: Despite significant advances in transfusion medicine, concerns about the inherent risks of blood transfusion persist, even under optimal temperature and duration of storage. This makes the evaluation of blood viability a global task (1). Maintenance of adequate temperature is considered a key factor in the viability and quality of stored blood in healthcare institutions. Evaluating the haematological and haemostatic functionality of blood elements at different storage temperature and duration is therefore imperative for improving patient care and resource utilization in Rivers State University Teaching Hospital (RSUTH) blood bank in Port Harcourt. \u0000Methods: In this cohort study design, a total of sixteen (16) male and female blood donors in equal proportion of sex and ABO blood groups were randomly selected from the Port Harcourt blood donors' population and recruited as study subjects for this research. A well-structured questionnaire and the immunoassays were used to assess the donors' health and serological status respectively. Also the sample obtained were analayzed by automation and data statistically analyzed using ANOVA. \u0000Results: The results of this study shows a statistically significant decrease in white blood cell count from 4.93×109/L ± 0.33 to 2.79×109/L ± 1.68 (p=0.00) and platelet count from 227.38×109/L ± 32.17 to 153.75×109/L ± 58.39 (p=0.00) at day 7. Also, a significant decrease in platelet count from 227.38×109/L ± 32.17 to 141.50±60.92 at day 14. A significant decrease in Fibrinogen from 340.75mg/L±18.69 to 281.2575 mg/L ±46.41 at day 1 and day 14 respectively, and rise in PT and aPTT from 17.02s ±1.28 to 24.31s ±6.67 and 41.25s±3.23 to 46.63s±6.28 at day 14th to day 21 respectively (p=0.00). \u0000Conclusion and Implications for Translation: Pooled plasma at 4-60C contain clinically significant amount of coagulation factors up to day 21 in storage. The WBC and platelet is lost within seven day of storage at 4-60C. Lower temperatures, especially freezing at -60°C accelerate the loss of haematological viability of blood especially the depletion of white blood cells and platelets (p=0.00). Antihaemophilic factor and fibrinogen is maintained in FFP at 180 day in storage at -600C.","PeriodicalId":249518,"journal":{"name":"International Blood Research & Reviews","volume":"33 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139450545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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