International Blood Research & Reviews
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ISSN: 2321–7219
Frequency: Quarterly
Language: English
Open Access Peer-reviewed journal
Web site: https://www.sciencedomain.org/journal-home.php?id=28
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Item Erythropoietic and bone marrow stimulating activity of terminalia catappa extract: Possible role of nitric oxide signaling.(2013-01) Aimola, I A; Inuwa, H M; Nok, A J; Mamman, A I; Habila, N; Muhammad, A; Agbaji, A S; Igoche, A; Ogungbemi, K; Tighil, M; Usman, YAims: We assessed the capacity and mechanism of Terminalia catappa (TC) to induce erythropoiesis in vivo in phenylhydrazine- induced anemic mice. Place and Duration of Study: Sample: This study was carried out at Department of Biochemistry and Center for Biotechnology Research and Training Ahmadu Bello University Zaria, and National Research Institute for Chemical Technology, Zaria. The duration spanned between Jan 2011 and Feb 2012. Methodology: Solvent fractions of Terminalia catappa aqueous extract was used to treat phynylhydrazine-induced anemic mice. Treatment was done for four days, erythropoietic activity of each fraction was assayed by determining the effect of these fractions on intracellular hemoglobin and reticulocyte level from the blood, arginase was also assayed. Bone marrow carbonic anhydrase was assayed to monitor bone marrow erythropoietic stimulation. Results: Terminalia catappa was able to up-regulate the synthesis of intracellular hemoglobin (0.135 ±0.004 μmol/0.1ml) significantly comparable to hydroxyurea (HU) (0.158±0.006 μmol/0.1ml), and normalize the peripheral blood reticulocyte index significantly at P<.05 0.94±0.25% close to the non anemic mice 0.97±0.25% and bone marrow carbonic anhydrase activity. TC inhibited arginase activity significantly (P<.05) comparable to hydroxyurea. Conclusion: The results demonstrate Terminalia catappa extract as an erythropoietic agent that supports normal erythroid differentiation in vivo in phenylhydrazine- induced anemic mice in a synergistic fashion.Item Lenalidomide, p53 and del(5q) Myelodysplastic Syndrome: Ribosome Stress Relief.(2013-01) Yasar, Demet Gokalp; Liu, Johnson MWhereas deletions involving the long arm of chromosome 5 are among the most common chromosomal abnormalities in myelodysplastic syndrome (MDS), isolated del(5q) MDS, which includes the 5q- syndrome, is rare and characterized by hypoplastic anemia and a moderate risk of transformation to acute myeloid leukemia (AML). The 5q- syndrome is now recognized as a ribosomopathy, and both the classic 5q- syndrome and del(5q) MDS are uniquely responsive to lenalidomide. However, the mechanism of action of lenalidomide is controversial and involves modulation of p53 activity, which may be beneficial in anemia remission but suggested to lead to malignant cell outgrowth. Here, we critically review the literature on this important controversy, which has obvious implications for therapy of del (5q) MDS.Item Haematological Values at Moderate Altitude in a Low-Income Population.(2013-01) Gahutu, Jean BoscoAim: To illustrate haematological adaptation to moderate altitude in Rwanda. Study Design: A population-based cross-sectional study. Place and Duration of Study: The study was carried out at moderate altitude (1,649-1,768 m) among students of the National University of Rwanda and blood donors from Buhanda, Ruhango and Nyaruteja centres, from August to December 2011. Methods: Healthy volunteers (238 males and 106 females, age range: 18-40 years) were recruited in the study. Complete blood count was performed on a Coulter AcT 5diff and for some samples on a Sysmex KX-21N automated haematology analyzer. Results: Results (mean ± SD) were: erythrocyte count: males: 5.28 ± 0.53 X 1012/L, females: 4.72 ± 0.63 X 1012/L; haemoglobin concentration: males: 160 ± 16 g/L, females: 140 ± 18 g/L; haematocrit: males: 45 ± 4 %, females: 40 ± 5 %. The differential leukocyte count showed eosinophilia (4%) and increased lymphocytes (44%). Conclusion: The values for erythrocyte count, haemoglobin concentration, haematocrit, erythrocyte indices and leukocyte count are comparable to sea level values. The fact that haemoglobin concentration is not low as is the case in low-income populations living at sea level can be attributed to adaptation to moderate altitude.Item Incidence of Rh Antigens, Phenotype & Probable Genotype in the Population of Gwalior and Chambal Region, Central India.(2013-01) Sharma, Dharmesh Chandra; Singhal, Sachin; Rai, Sunita; Iyenger, Sudha; Sao, Satya; Jain, BharatIntroduction: Rhesus (Rh) antigen was discovered in 1940 by Karl Landsteiner and Wiener. In later years, because of its immunogenecity along with ABO grouping, RhD antigen testing was made mandatory before issuing a compatible blood. Presently there are five major antigens i.e. D, C, E, c and e in Rh blood group system. Aims: To know the distribution of major Rh antigens, its phenotype and most probable genotype in the population of Gwalior region i.e. Central India. Place and Duration of Study: This study was carried out at Blood Bank, Department of Pathology, Gajra Raja Medical College, Gwalior, India from 1st October 2008 to 30th September 2010. Methodology: The distribution of Rh antigens, its phenotype and most probable genotype was studied in 1000 samples collected from blood donors, blood recipients and other patients. Samples were tested for ABO blood group and five major antigens of Rh system by tube agglutination method /or by gel technology. Results: Out of 1000 samples studied, the incidence of RhD was 91.6% and only 8.4% samples were negative for D antigen (p=.000005). The Incidence of other Rh antigens i.e. C, E, c and e was 84%, 25.6%, 58.3% & 78.5% respectively (p=.000005) Most common phenotype in RhD positive samples were DCCee (41%) and in RhD negative it was dccee (5.6%) (p= .000005). Eleven samples (1.1%) were negative for antithetical antigens E & e. Most probable genotype in order of frequency was DCe/DCe (R1R1)-41%, DCe/Dce (R1R0)-25.5% & dce/dce (rr)-5.6% (p= .000005). Conclusion: Like previous studies, our study also concluded that there is a wide range of racial and geographical variation in the distribution of Rh phenotype and genotype. The Rh blood group system has vital role in population genetic study, in resolving medico legal issues and more importantly in transfusion practice.Item Atrial Function and Glutathione in Children with Iron Deficiency Anemia- Tanta-Egypt-2012.(2013-07) Biltagi, Mohammed Al; Tolba, Osama; Elshanshory, Mohammed; Badraia, Ibrahim; Hazaa, Sahar MAims: is to correlate the atrial function with the level of oxidative stress marker (Glutathione) in children with Iron deficiency anemia (IDA). Materials and Methods: Thirty children with IDA and 20 healthy children had serum Ferritin, total blood Glutathione level and studied with conventional trans-thoracic 2-D echocardiography, Tissue Doppler (TDI) and Speckle Tracking Strain (STI) analysis. Study Design: A case–controlled study Place and Duration of Study: Pediatric Outpatient Clinic; Pediatric Hematology Unit; Pediatric Cardiology Unit; Pediatric Department; Faculty of Medicine; Tanta University Hospital; Egypt. The study was conducted between January; 2012 to December; 2012. Results: Children with IDA had significantly low Glutathione [4.63 ±3.4 ng/ml] (P =.013) and Ferritin [11.88 ±5.3 ng/ml] (P < .0001) levels than that observed in the control group. There was no significant increase in LA dimension and volume (minimum) [31± 27 ml] (P = .433), by M-mode but there was significant decrease in e/a ratio assessed by tissue Doppler in IDA patients [1.29 ±0.5] than in controls [1.6±0.7] (P = .038). There were significant decrease in LA velocity (P = .02) and increase in RA velocity (P = .04) compared to left atrial and atrial septal velocity and insignificant increase in left atrial velocity compared to atrial septal velocity. There was no significant correlation between Glutathione level and echo-Doppler parameters of atrial function (P >.05), but there was significant negative correlation between Hemoglobin% and atrial septal velocity (P < .05). Conclusion: IDA is associated with diastolic dysfunction. Tissue Doppler and STI were more sensitive than conventional echocardiography in detection of subclinical structural and functional changes due to hemodynamic abnormality in children with IDA.Item The Role of Invariant Natural Killer T Cells in Cancer.(2013-07) Nur, Haneen; Valckenborgh, Els Van; Bruyne, Elke De; Vanderkerken, Karin; Menu, ElineInvariant natural killer T (iNKT) cells are a unique subset of T lymphocytes that recognize glycolipid antigens presented by the class I-like non-polymorphic histocompatibility complex (MHC) molecule, CD1d. They express both innate and adaptive immune cells’ surface receptors, but act more like cells of the innate immune system. Although iNKT cells represent a relatively small population of T lymphocytes, they can rapidly produce copious amounts of cytokines after activation which can polarize different axes of the immune response. Many glycolipid agonists have been discovered of which the marine sponge-derivative called α-Galactosylceramide (α-GalCer) is a potent ligand for iNKT cells. iNKT cells have been described by many researchers as a critical immunotherapeutic target characterized by having tumor-suppressive potential. However, their actual role in immune responses is still unclear. In addition, the need for appropriate preclinical models that mimic human diseases is important for better understanding the iNKT cell biology. This review describes the characteristics of iNKT cells and their role in immunotherapy in cancers such as multiple myeloma and how they can interact with the components of the neighbouring environment.Item JAK-2V617F Mutation in Acute Leukemia (South Egypt Experience).(2014-01) Badrawy, Hosny; Ibrahim, AbeerAim: To search for JAK2V617F mutation in patients with acute myeloid and acute lymphoblastic leukemia in south Egypt. Study Design: JAK2V617F mutation detected by amplification refractory mutation system (ARMS) -PCR. Place and Duration of Study: Department of clinical pathology and department of medical oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt, between December 2010 and December 2012. Method: We included 90 patients (58 men and 32 women; age range 2-67 years) with denovo acute leukemia (30 acute myeloid leukemia and 60 acute lymphoblastic leukemia), JAK-2 V617F mutation using ARMS-PCR was done for all the patients. Results: JAK-2 V617F mutation was absent in all of the studied patients. Conclusion: Our results confirm the finding published previously which reported that JAK2 V617F mutation is very rare or absent in acute leukemia.Item Pure Red Cell Aplasia in a Patient with Cri-Du-Chat.(2014-01) Ai, Jing; Visconte, Valeria; Rogers, Heesun J; Sekeres, Mikkael A; Tiu, Ramon VBackground: The Cri-Du-Chat syndrome also known as 5p- syndrome is a rare genetic autosomal disorder with the characteristic deletion of the short arm (p) of chromosome 5. To date, hematologic manifestations characteristic of BM failure have not been linked to this syndrome. Aims: To evaluate the safety and efficacy of cyclosporine to treat pure red cell aplasia in the clinical setting of 5p- syndrome. Presentation of Case: We report here a patient with 5p- syndrome who subsequently developed idiopathic pure red cell aplasia. He was treated with cyclosporine 1mg/kg twice a day, and achieved a complete remission, with no toxicities. Conclusion: This case suggests that cyclosporine can be used safely and effectively in such clinical scenario.Item Prostate Specific Antigen (PSA) Screening among Apparently Healthy Men of African Descent in Sokoto, North Western, Nigeria.(2014-01) Erhabor, O; Zama, Isaac; Mainasara, A S; Shehu, R A; Iwueke, I P; Festus, Aghedo; Ikhuenbor, D; Uko, E K; Igbineweka, O OBackground: Globally prostate cancer is the sixth leading cause of cancer-related death in men. Prostate Specific Antigen (PSA) is present in small amount in the serum of men with healthy prostates, but is often elevated in the presence of prostate cancer and other prostate-related disorders. The aim of this present study was to determine the PSA levels among healthy men of African descent resident in Sokoto, North Western Nigeria. Methods: Testing was carried out using the CTK Biotech PSA kit (CTK Biotech Inc, San Diego, USA). The Onsite PSA Rapid Test is a lateral flow chromatographic immunoassay for the qualitative detection of prostate specific antigen (PSA) in human serum or plasma at a cut-off level of 4.0 ng/mL. Result: We investigated the PSA levels in 106 consecutively recruited men of African descent with age range and mean age of 40-70 years and 44.75 ± 7.91 years respectively. We observed a PSA of > 4ng/mL among 7 (6.6%) of subjects studied. Men > 60 had the highest prevalence of raised PSA level (33.3%) compared to those younger men (p= 0.001). We observed a higher prevalence among farmers (11.1%) compared to business men, civil servants and students. Conclusion: In this present study we observed a high prevalence of PSA >4ng/mL and a positive and significant correlation between age and raised PSA levels among men in Sokoto, North Western Nigeria. We recommend an annual PSA blood test for men ≥ 40 years of age and that those with a PSA value > 4.0 ng/mL should be considered for further evaluation. There is also the need to build capacity among biomedical and medical staff in Nigeria to facilitate effective diagnosis of prostate cancer. There is also the need for increased prostate cancer awareness in the area to facilitate voluntary testing.Item Iron Status and Red Cell Parameters in Pregnant and Non-pregnant Adolescents in Côte d’Ivoire (West Africa).(2014-01) Bleyere, Mathieu Nahounou; Bi, Anthelme Semi Nene; Kone, Mama; Sawadogo, Duni; Yapo, Paul AngoueAims: The objective of this study was to evaluate iron metabolism and compare iron stores between pregnant and non-pregnant adolescents in Côte d’Ivoire. Place and Duration of Study: The study was undertaken with 187 volunteers adolescents aged from 15 to 19 years. For this study, adolescents were divided into 2 groups with 75 non-pregnant adolescents and 112 pregnant adolescents. Study population was recruited January 2006 to January 2008 in 4 urban community health centers, of Abidjan. Assays of blood samples were performed in Laboratory of Physiology, Pharmacology and Phytotherapy (Nangui Abrogoua University) and in Laboratory of Medical Biochemistry of University Hospital Centre (Cocody, Félix Houphouët-Boigny University). Methodology: In each pregnant adolescent a blood sample was collected by venipuncture on a dry and EDTA tubes of 5 ml. With these blood samples, haematological and biochemical parameters were determined. Results: Haematological parameters were decreased in pregnant adolescents at the third trimester of pregnancy compared with control adolescents. Pregnant adolescents were more anaemic during pregnancy (77.7 %) compared with non-pregnant adolescents (42.7 %). Iron stores were greatly decreased in 72.3 %, 83.9 % and 95.6 % of adolescents respectively during the 3 trimesters of pregnancy compared with non-pregnant adolescents (34.7 %). In addition, high prevalence of iron deficiency anaemia was recorded throughout pregnancy in adolescents. Therefore, iron status was more altered in pregnant adolescents (11.6 %, 9.8 % and 0.0 % respectively) compared with non-pregnant adolescents (13.3 %). The results of this study show that the causes of pronounced degradation in iron status are insufficient in size of iron stores in pregnant adolescents and non-pregnant adolescents. Conclusion: Iron metabolism alteration is important in pregnant adolescents in Côte d’Ivoire, causing severe anaemia in this group of population.Item Comparison Effect of Moringa oleifera Leaf Meal and Oxytetracycline on Haematology and Serum Biochemical Profile of Broiler Finishers.(2014-01) Ologhobo, A D; Adejumo, I O; Akangbe, E IAims: The study was carried out to assess the effects of Moringa oleifera leaf meal on the haematological parameters and serum biochemical profile of broiler finishers in comparison with oxytetracycline. Study Design: The design of the study was a completely randomised design. Place and Duration of Study: The study was carried out at the Poultry Unit of the Teaching and Research Farm, University of Ibadan, Nigeria. The study lasted for four weeks. Methodology: One hundred and eight 4 weeks old un-sexed arbor acre broiler chicks were used for the study. Four dietary treatments containing 3064.27-3073.55 Kcal/kg of energy and 19.75% -21.94% crude protein were formulated and each treatment had three replicates with nine birds per replicate. The experimental diets contained 250g of oxytetracycline per 100kg of feed for treatment 1 (T1), 200g, 400g and 600g of Moringa oleifera leaf meal per 100kg of feed for treatments 2 (T2), 3 (T3) and 4 (T4) respectively. Results: The results of the study revealed that there was no significant difference across the treatments for most of the parameters measured. Red blood cell (RBC) counts for birds fed T4 (4.70 x106/mm3) were significantly (P<0.05) higher than those fed the control diet (3.61 x106/mm3). Birds fed T4 recorded highest aspartate amino transferase (AST) mean value (72.18%) which was significantly (P<0.05) higher than the mean value of those fed the control diet T1 (52.26%). Conclusion: It can be concluded from the result of the study that Moringa oleifera leaf meal could be used as alternative antibiotic in place of oxytetracycline. The result of the study suggested that Moringa oleifera leaf has antimicrobial properties.Item Type the Characteristics of Pacemaker (PM) Patients Admitted in Stroke Unit: The Stroke Pacemaker Study (SPACES).(2014-03) Spinelli, M; Silvestrelli, G; Micheli, S; Paciaroni, M; Agnelli, G; Lanari, A; Corea, FAims: According to recent surveys, despite health care authority’s budget reductions, the total amount of PM implants increased worldwide. Even if the diffusion of these devices is large no data are available concerning the characteristics of PM patients hospitalized for stroke. Study Design: The SPACES study is a retrospective observational study conducted in 3 hospital centres including paced patients consecutively admitted for acute stroke. The objective is to determine the characteristics of patients with PM admitted in the stroke units. Place and Duration of Study: In 3 Italian general hospital (Perugia, Milano, Mantova), from January 2005 to September 2008. Method: At admission all patients underwent non-contrast computed tomography (CT), routine biological tests, 12-lead ECG. The ECG was categorized in following subgroups: a) sinus rhythm; b) AF rhythm; c) PM-induced activity (when was not possible to state the underlying rhythm). Results: In the study population were recorded 73 ischemic strokes, 10 hemorrhagic events and 19 TIA. At the basal ECG a “pacemaker-induced” rhythm was diagnosed in 37 cases, sinus rhythm in 28, AF in 32 subjects. At the univariate analysis patients with an ECG-detected AF rhythm at admission were more often those with positive AF medical history (p<.001) and treated with aspirin prior to the index event (p=.023). Patients with an ECG-detected AF at admission more often suffered a Total Anterior Cerebral Infarction (TACI) subtype of stroke (p=.038) having cardioembolism as cause (p<.001). Conclusions: Our survey suggests that paced patients suffer more often, than unselected case-series, of ischemic strokes due to cardioembolic events. Moreover AF is the leading risk factor in PM subjects. Probably PM-induced electric activity may further confound the detection of the baseline ECG, with an underestimation of AF.Item Osteoporosis in Hemophilia.(2014-03) Merchan, E Carlos RodriguezAim: The aim of this paper is to review the pathophysiology, risk factors, prevention and treatment of osteoporosis in persons with hemophilia (PWH). Study Design and Methodology: In a search of PubMed up to September 24, 2013 using as keywords "osteoporosis" and "hemophilia" the author found 61 references, of which only the 22 focused on the aim of this study were revised. Results: Prevention of osteoporosis in PWH is crucial. Risk factors are lack of hematological prophylaxis and development of an inhibitor (antibody) against the deficient coagulation factor, lack of exercise due to chronic pain and loss of joint function (hemophilic arthropathy), low body mass index and abnormal liver function because of viral infection (HIV, HCV). It has not been demonstrated that hemophilia has any effect on osteoclast development and/or osteoblast loss. Hemophilia does not impair mineral Ca/P/K mobilizations and metabolisms. Hemophilia does not have any general effects on the endocrine system. Substitution treatment with clotting factors does not interfere with the treatment of osteoporosis. Conclusion: Continuous primary hematological prophylaxis and rehabilitation and exercise are paramount in PWH. PWH over the age of 50 should have routine screening for detection of osteoporosis. In PWH prevention should encourage good habits (such as a diet adequate in calcium and vitamin D) and discourage harmful habits (such as tobacco, alcohol and immobilization). Osteoporosis is multi-facial. Osteoporosis ought to be promptly treated regardless of the underlying cause.Item Effect of Momordica charantia (Bitter Melon) Leaves on Haemoglobin Concentration in Male Albino Rats.(2014-03) Temitope, Adedeji G; Lekan, Ojulari SThis research work was carried out to investigate the effect of the aqueous extract of Momordica charantia on haemoglobin concentration in albino rats. The aqueous extract of Momordica charantia was prepared from the leaves of the Momordica charantia plant and given orally to the experimental animals. Haemoglobin concentration was determined after two weeks of administration. The aqueous extract was prepared and given orally at doses of 80, 100, 120 and 140 mg/kg body weight daily to the experimental animals. This study was carried out at the Department of Physiology, College of Medicine, University of Ilorin between July and August 2010. The results of the work showed that there was significant decrease in mean haemoglobin concentration in test animals in comparison with the control (p<0.05). Oral administration of aqueous extract of Momordica charantia causes a decrease in haemoglobin concentration which can lead to anaemia.Item Effects of Co-infusion of Plasma, Whole Blood and Anticogulants on Their Clotting Activities.(2014-03) Fujita, Hiroshi; Ishihama, Yumiko; Nishimura, ShigekoAims: Nafamostat mesilate (NM), a protease inhibitor is available for treating acute pancreatitis and disseminated intravascular coagulopathy and it is used as an anticoagulant for hemodialysis in Japan. A plasmapheresis circuit using NM can easily be blockaded. Therefore, we investigated the influence of co-infusion of fresh frozen plasma (FFP), whole blood and NM on clotting activities mainly in the static condition compared with other anticoagulants including heparin sodium and gabexate mesilate. Study Design: In vitro study. Methodology: We investigated the effect of co-incubation of expired FFP and various concentrations of NM (0–0.1mg/mL). We measured the plasma fibrinogen level and activities of factor XIII, anti-thrombin III, protein C (PC) and protein S (PS). In addition, we examined the influence of NM on coagulation tests using whole blood from healthy volunteers. Results: NM reduced PC and PS activities in FFP, although it did not affect plasma fibrinogen levels or the activities of anti-thrombin III or factor XIII. While anti-thrombin III activity and plasma fibrinogen level increased in NM-containing whole blood, PC and PS activities decreased. Gabexate mesilate, sodium heparin and citrate did not reduce the activities of PC or PS. Conclusion: Co-infusion of FFP, whole blood and NM reduces PC and PS activities and we speculate that it may lead to the obstruction of the plasmapheresis circuit when using NM as an anticoagulant.Item Isolation and Antibiotic Susceptibility Pattern of Bacteria Associated with Blood Stream Infections.(2014-03) Ogunlowo, Oladejo Peter; Arimah, Babatunde David; Olajubutu, James John; Jesumirhewe, ChristianaAim: To determine the pattern of bacterial agents responsible for blood stream infection and determine the antibiotic susceptibility pattern of the bacterial isolates. Study Design: Experimental Place and Duration of Study: blood samples were collected from general out patient clinic of the University College Hospital, Ibadan, Oyo-State, Nigeria between February 2013 July 2010. Methodology: The study population was drawn from patients attending the General Out patient clinic of the University College Hospital, Ibadan, Oyo-State, Nigeria. Total blood samples of One hundred and fourty (140) were collected from adultsand children. Samples were immediately dispensed into blood culture bottles and incubated at 37ºC for six days. On the bottles were indicated Name, Age, Sex,and Time of collection. The samples were analysed, all the patientshad clinical evidence of varying degree of illness such as ferbrile illiness, sepsis,bilateral discharge, head injury, endocarditis, pyrexia, gastroenteritis, pneumonia, and poorly treated pnuemonia.Those patients who have been on antibiotics therapy were excluded from the study. Results: from 140 samples collected, only 100 samples showed turbidityindicating an incidence rate of 71.43%. When plated on blood agar, 60 showed microbial growth, 35 samples showed no growth and 5 were contaminated. The difference in prevalence among different sex groups was observed to be significant. The females (77/140, 55%) appeared to be more susceptible to blood stream infection than the males (66/140, 47.1%) in all the age groups.The commonest pathogenic bacteria in blood stream infection was seen to be Staphylococcus aureus having the highest frequency of 58.3%, while Pseudomonas aeruginosa was the least with the frequency of 1.7%.The bacteria harvested were subjected to In-vitro antibiotic susceptibility test using standardized disc agar diffusion methodand showed resistance to one or more of the ten (10) antibiotics used for the study. The lowest resistance of 40%and 60% (36 out of 60) sensitivity was observed in the organisms to Ofloxacinand amoxicillin. Conversely, the highest resistance of 85% (51 out of 60) and 15% (9 out of 60) was observed with Cefuroxime and Erythromycin. However some of the S. aureus (6) and E.coli (3) strains were multidrug resistance. Conclusion: The study confirmed the diverse nature of bacteria causing blood stream infection and the increase in drug-resistant pathogens needs to be periodically reviewed for epidemiologically data and clinical prescription.Item Prophylaxis with Low Molecular Weight Heparin for Prevention of Placenta-related Recurrent Adverse Pregnancy Outcomes.(2014-05) Kamda, Joel H; Ghidini, Alessandro; Pezzullo, John C; Poggi, Sarah HAims: To determine whether antenatal administration of low-molecular-weight-heparin (LMWH) reduces the recurrence of adverse pregnancy outcomes (APO). Study Design: Retrospective cohort study. Place and Duration of the Study: Inova Alexandria Hospital, Alexandria, VA and Georgetown University Medical Center, Washington, DC during the period of January 1, 2006 and December 31, 2009. Methodology: All pregnant women with history of APOs, including preeclampsia or abruption at <35 weeks, birth weight <5th centile, fetal loss at ≥20 weeks, or ≥2 spontaneous losses between 12 and 20 weeks, were administered LMWH or not at the discretion of the managing physician. Excluded were cases with antiphospholipid syndrome. The independent effect of LMWH on recurrence was assessed using logistic regression analysis with odds ratios (OR) having 95% confidence interval (CI) not inclusive of the unity considered significant. Results: Of the 140 women in the cohort, 44 (31%) received LMWH during the subsequent pregnancy and the remainder did not. APO recurred in 23.6% (33/140). Logistic regression analysis demonstrated that LMWH significantly and independently lowered the risk of recurrent APO (adjusted OR=0.08, 95% CI 0.01-0.45), whereas history of fetal growth restriction (OR=3.88, 95% CI 1.51-9.99) and positive results for inherited thrombophilias (OR=6.96, 95% CI 1.58-30.67) increased the risk. Conclusion: In patients with rigorously defined history of severe APO, prophylaxis with LMWH is associated with a significant reduction in recurrence of severe APO.Item Effect of Leaf Essential Oil of Citrus sinensis on Haematological Parameters of Alloxan-induced Diabetic Rats.(2014-05) Omoniwa, O Soji; Muhammad, N O; Omoniwa, B P; Usman, L AAim: The aim of this study was to investigate the effect of leaf essential oil of Citrus sinensis (Rutaceae) on haematological parameters of alloxan – induced diabetic rats. Methodology: Diabetes was induced in albino rats by intraperitoneal administration of single dose of alloxan monohydrate (150 mg/kg body weight). The leaf essential oil of Citrus sinensis at a dose of 110 mg/kg b.wt was administered every other day to the diabetic rats during 15 days. The effects of leaf essential oil on the erythrocyte and leucocyte indices were then evaluated. Results: Red Blood Cell, Packed Cell Volume, White blood cell, Neutrophils and Leucocytes were reduced significantly in diabetic animals. However, treatment with leaf oil of C. sinensis increased these parameters subsequently. Conclusion: It is concluded that leaf essential oil of Citrus sinensis improved the erythrocyte and leucocyte indices of diabetic rats.Item Some Blood Cell Changes and Alteration in Renal and Hepatic Function in Pre-eclampsia: A Study in Owerri Nigeria.(2014-05) Alisi, Precious Nc; Buseri, F I; Alisi, Chinwe SAims: We studied some blood cell changes and alterations in renal and hepatic functions in pregnancy and pre-eclampsia and determined baselines for the population in owerri, south east Nigeria. Study Design: It was a cross sectional case control study conducted prospectively among antenatal women attending clinic at Holy Rosary, Federal Medical Centre and General Hospitals Owerri. The study included fifty non-pregnant, fifty pre-elampsia and fifty normotensive pregnant women of singleton gestation in their third trimester Place and Duration of Study: Sample: Antenatal unit of Holy Rosary, Federal Medical Centre and General Hospitals Owerri between May 2009 and June 2010. Methodology: The study included fifty (50) non-pregnant women, fifty (50) pregnant normotensive women and fifty (50) pre-eclamptic women of singleton gestation in their third trimester. Full blood count, liver function enzymes assay and some kidney function parameters was determined in all subjects. The subjects were selected under defined criteria. PE patients were at 28 to 42 wks of single-diastolic pressure of 110mmHg or more or two measurements of 90mmHg or more on two consecutive occasions of 6hours or more apart, urinary protein 2+ or more. The exclusion criteria include history of hypertension and proteinuria before conception or before 20wks of gestation, a history of antioxidant vitamins therapy during the last one year and smoking. Results: The result showed a significant (P = 0.05) decrease in Red cell distribution width coefficient of variance (RDW-CV), mean cell haemoglobin (MCH), platelet count (PC) and mean platelet volume- platelet count (MPV-PC) ratio in pre-eclampsia comaperd to normal pregnancy. Significant increases (P= 0.05) in red blood cell count, haemoglobin concentration, haematocrit, mean cell volume, mean platelet volume, platelet distribution width (PDW) and circulating large platelet ratio (PLCR) were found among the pre-eclamptic women. There was a significant (P = 0.05) increase in ALT, AST, ALP and LDH activities in pre-eclampsia when compared to both the normal and the pregnant controls. Urea, Creatinine and Uric acid concentrations had a significant increase (P = 0.05) in pre-eclampsia when compared to normal and pregnant controls Conclusion: The significant variation seen in these red cell parameters between the PC and NPC is attributable mainly to pregnancy than to pre-eclampsia. Pre-eclampsia though resulted in a marked platelet usage with a resulting shorter platelet life-span. A burden on the liver and kidney resulting from pre-eclampsia could have adversely affected protein metabolism which in turn may have affected erythropoesis. Results indicate that renal function is impaired in the presence of pre-eclampsia.Item Iron Overload, Chelation Therapy and Survival in Lower-Risk Myelodysplastic Syndromes: State of the Evidence.(2014-05) Lyons, Roger MMyelodysplastic syndromes (MDS) are clonal stem cell disorders that primarily affect older persons and are associated with peripheral blood cytopenias, increased risk of conversion to acute myeloid leukemia and shortened survival. Treatment strategies in MDS are guided by patient risk categories, with higher-risk patients receiving more aggressive interventions. Patients with lower-risk MDS receive less aggressive therapies or supportive care/red blood cell transfusion. Transfusion-dependent patients with lower-risk MDS are likely to develop iron overload because of their longer predicted survival and, hence, greater transfusion burden. Transfusion requirement and elevated serum ferritin further complicate the treatment landscape because they have dose-dependent effects on overall and leukemia-free survival, with increasing serum ferritin levels associated with increased risk of death. Lower iron burden could provide a survival benefit, and an association with improved survival has been shown in retrospective studies. However, lack of random assignment to treatment is the major flaw in these studies, which potentially introduces patient selection bias. Despite the lack of randomization and other issues with trial design, available studies have shown consistent results, which suggest a survival benefit in transfusion-dependent patients with MDS who have received chelation therapy. Prospective studies are needed to confirm this observation. The possible mechanisms by which chelation therapy appears to benefit patients with MDS need further research. The data suggesting a survival benefit from chelation therapy in lower-risk, iron-overloaded patients with MDS are reviewed, including the strength of evidence, recent scientific advances and ongoing clinical trials.