International Blood Research & Reviews

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https://imsear.searo.who.int/handle/123456789/151216

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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Haemagglutination Activity of Arachis Hypogaea, Vigna Unguiculata and Glycine Max: As Alternatives to Abo Blood Grouping Sera
(Ms. M. B. Mondal, 2025-03) Olumide, OO; Olayemi, OK; Adebayo, NS; Oluwaseun, OJ; Funke, AR; Samuel, OO.
Introduction: Accurate and cost-effective blood group identification remains a critical challenge in resource-constrained healthcare settings. Therefore, this study investigates the potential of locally sourced legumes [Arachis hypogaea (groundnut), Vigna unguiculata (brown beans), and Glycine max (soybeans)] as alternative blood typing reagents against human ABO blood groups. Lectins, as part of these legumes’ constituents, have antigen-binding capabilities that offer promising prospects for blood group serology. Methods: Crude lectin extracts were prepared from the three selected indigenous legume species using a sequential ammonium sulfate precipitation process (10-80% w/v saturation). Blood samples were obtained from 20 healthy donors (five from each blood group A, B, AB, and O), and each was prepared a 4% erythrocyte suspension, which was obtained after washing the blood three times with lectin buffer, and adding 2mL of the washed red blood cell to 50mL lectin buffer. Hemagglutination activity was then evaluated using a microtitre plate method across the four blood groups (A, B, AB, and O) at two different extract dilutions and the baseline concentration. The data obtained was analyzed with IBM SPSS v23. Results: The study revealed significant variations in haemagglutination activity of the three legumes evaluated. Glycine max lectins exhibited the strongest haemagglutination activity of the three legumes, showing 100% reactivity across all blood groups at baseline concentration, with consistent pan-agglutination properties. On the other hand, Arachis hypogaea demonstrated moderate haemagglutination activity for blood groups A, B, and O, while Vigna unguiculata displayed the weakest haemagglutination activity, limited to only blood groups A and B. Conclusion: Glycine max exhibited the highest and most consistent haemagglutination activity across all ABO blood groups and is presumed to be the most suitable alternative to ABO blood groups sera compared to Arachis hypogaea and Vigna unguiculata. Further comparative studies using other lectin-containing plants may provide insights into improving lectin efficacy and specificity.
Effect of Menstrual Cycle on Absolute Platelet Count among Female Students of Lead City University, Ibadan, Oyo State
(Ms. M. B. Mondal, 2025-03) Raphael, A; Oluwabukunmi, AF; Olatunbosun, AF; Ebun, AB; Ehilenbalu, IS; Peter, AR; Helen, OA.
Introduction: Hormonal changes associated with menstruation, or the periodic shedding of the uterine lining, can affect a number of physiological measures, including the absolute platelet count. The impact of menstruation on platelet counts in female students at Lead City University in Ibadan is investigated in this study. Aim/Objective: The purpose of this study is to examine how menstruation affects platelet counts and determine whether there are notable differences across the various stages of the menstrual cycle. Methods: One hundred participants, fifty of whom were menstruation and fifty of whom were not, participated in a descriptive cross-sectional study. A Neubauer counting chamber was used to measure platelet counts, and SPSS version 23 was used to analyze the results. Results: Participants who were menstruation had a substantially lower mean platelet count (200.66 ± 30.73/cu.mm) than those who were not (255.42 ± 53.52/cu.mm) (p < 0.01). Nevertheless, no meaningful correlations between platelet counts and particular menstrual days or lengths were discovered. Conclusion: Young women's platelet counts are considerably reduced by menstruation. These results emphasize the significance of taking menstrual status into account while performing hematological evaluations and the necessity of more investigation into the underlying mechanisms.
Antioxidant Effects of Vitamin C on Some Hematological Parameters of Male Wistar Rats Exposed to Lead Acetate
(Ms. M. B. Mondal, 2024-06) Ojeka, S.O; Ukoro, Blessing; Onwoke, Ebebi Elizah
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.
Evaluation of Blood Transfusion Request form: The Experience in a Tertiary Health Facility in Jos, Nigeria
(Ms. M. B. Mondal, 2024-06) Jatau, ED; CU, I; CN, O; Zakari, A; Bangalu, DY; OD, D; Egesie, OJ.
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.
RHD Genotyping to Resolve Weak and Discrepant RHD Phenotypes: The “Serenissima” Experience
(Ms. M. B. Mondal, 2024-06) Collodel, L; Gessoni, G.
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.
Interference of Heterophilic Antibody in D-dimer Determination in an Asymptomatic Elderly Woman
(Ms. M. B. Mondal, 2024-06) Sara, V; Elena, M; Mara, S; Martina, G; Margherita, I; Gianluca, G.
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.
Study of Factor VIII Inhibitor and F8 Gene Mutations in Persons with Hemophilia A from Benin
(Ms. M. B. Mondal, 2024-03) Baglo, T; Zohoun, A; Houssou, B; Massi, R; Guiwa, CO; Anani, L; Gazard, DK; Fall, AOT.
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.
Assessing Abo and Kell Blood Group Phenotypes and Antigens in Donated Blood Units at University College Hospital, Ibadan, Nigeria
(Ms. M. B. Mondal, 2024-12) Nurudeen, YO; Igbeneghu, C; Oyeleke, KO; Nassir, SA.
Introduction: The ABO blood group system is the most clinically recognized and routinely investigated blood group system in donated blood used for transfusions in Sub-Saharan Africa, due to its immunogenicity and the potential for antibodies against ABO antigens to cause the destruction of transfused red blood cells. However, research has shown that the unrecognized Kell antigen and its associated phenotypes also have potent immunogenic potential that could contribute to transfusion reactions. Therefore, this study aims to investigate the prevalence of ABO and Kell blood group antigens in 287 donated blood units at the University College Hospital in Ibadan, Nigeria. Methods: A total of 287 blood units donated between February and November 2022 at the University College Hospital, Ibadan, were analyzed using standard serological techniques. Positive and negative controls for red blood cell antigens were included with each batch of samples to ensure accuracy. For each blood unit, 2 mL of blood was drawn into a plain container, and ABO and Kell blood grouping was carried out using the slide technique for direct agglutination of antigens with their corresponding antibodies and the tube method for the indirect antiglobulin test. Results: Out of the 287 donated blood units, the distribution of ABO blood groups was as follows: A 62 (21.6%), B 46 (16.0%), AB 17 (5.9%), and O 162 (56.5%). The frequency of identified Kell blood group antigens was: K+ 17 (6.0%), K- 270 (94.0%); k+ 22 (7.7%), k- 265 (92.3%); Kpa+ 34 (11.9%), Kpa- 253 (88.1%); and Kpb+ 21 (7.3%), Kpb- 266 (92.7%). Distribution of Kell phenotypes was as follows: K+k- 80 (27.9%), K-k+ 95 (33.1%), K+k+ 77 (26.8%), K-k- 35 (12.2%); Kp (a+b+) 66 (23.0%), Kp (a+b-) 15 (5.2%), Kp (a-b+) 206 (72.0%), and Kp (a-b-) 0 (0%). Conclusion: This study provides valuable data on the prevalence of Kell phenotypes and its blood group antigens in donated blood units at the University College Hospital, Ibadan. The findings call attention to the importance of considering these antigens, alongside the ABO system, as they may influence transfusion outcomes, in terms of immunogenicity and the risk of transfusion reactions.
Evaluation of the Biological Response to Acetylsalicylic Acid by Platelet Occlusion Time in Pregnant Women in Brazzaville
(Ms. M. B. Mondal, 2024-03) Gokaba, LO; Samba, JE; Atipo-Tsiba, OG; Buambo, G; Ngolet, L; Iwandza, R; Amboulou, PI; Mboumba, JN; Bango, C; Itoua, C; Dokekias, AE.
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.
Afro Medicinal Plants a Promising Remedy for Sickle Cell Anemia
(Ms. M. B. Mondal, 2024-03) Ahajumobi, NE; Asika, JC.
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.
The Incidence of Intraoperative Hypotension and the Importance of Timely Detection
(Ms. M. B. Mondal, 2024-03) Sirait, RH.
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.
Diagnostic Challenges in Hematological Malignancies in Nigeria and their Impact on Treatment Outcome
(Ms. M. B. Mondal, 2024-12) Obu, Sylvia Ifeoma; Dibigbo–Ibeaji, Ndudi; Obu, Gabriel Obisike; Ilikannu, Samuel Okwuchukwu
Haematological malignancy constitutes a major public health disease burden globally due to the degree of mortality and morbidity they cause. Aim: This review was aimed at exploring and reporting some of the difficulties that hinder early/accurate diagnosis and management of haematological malignancies in Nigeria emphasizing a single centre experience and to further highlight how they affect treatment outcome. Methodology: Google scholar, Pubmed and African Journals online sites were explored in July 2024. Relevant articles were selected. The most senior consultant haematologist in the single centre in South South Nigeria being studied was interviewed and account was documented. Results: The difficulties encountered in the prompt/proper diagnosis and management of haematological malignancies reported by the studies and the clinician interviewed include, visiting orthopaedic and other specialists as well as herbalists and spiritualists for several months before reporting to the haematology clinic, mis – and/or missed diagnosis due to inadequate diagnostic equipment and techniques like use of morphological studies alone for Rowmanawsky stained blood picture examination and histological diagnosis without cytogenetics, immunophenotyping, polymerase chain reaction fluorescent insitu hybridization, poverty, cultural and religious beliefs. Poor treatment outcome as a result of these challenges were also reported. Conclusion: Enlightenment campaigns on the benefits of early diagnosis and prompt presentation to the hospital should be encouraged. Provision of up-to-date advanced technologies for early/accurate diagnosis and sub classification of haematologiacl malignancies should be made in main health facilities across the country. Diagnosis and treatment of haematological malignancies should be built into the National Health Insurance scheme to strengthen the system in this regard.
An Investigative Study of Prothrombin Time, Activated Partial Thromboplastin Time and Antithrombin Levels in Patients with Ischaemic Stroke
(Ms. M. B. Mondal, 2024-09) Nnachi, OC; Ezenwenyi, IP; Akulue, JC; Nnachi, OA; Nwadum, FE; Onoh, TJ; Ezeokoli, OE; Ugwu, CG.
Background: The haemostatic system maintains a balance between prothrombotic and antithrombotic components in the body. The role of this system in ischaemic stroke is not certain. Objective: Prothrombin time (PT) and Activated Partial Thromboplastin Time(APTT) are widely used screening tests to assess the haemostatic cascade. We sought to evaluate the relevance of these test and antithrombin (AT) levels in patients with ischaemic stroke. Methods: AT, platelet count, PT and APTT tests were carried out for 65 patients with ischaemic stroke and 65 controls with no history of stroke. Results: The mean age of stroke subjects was 60.4 ± 12.3yrs. PT and APTT in the test and control groups were similar and Antithrombin levels did not show significant difference. But there was a significant association between functional AT deficiency and diabetes mellitus in the ischaemic stroke group. A significant negative correlation existed between functional AT activity and prothrombin and between AT Ag levels and APTT Conclusion: There was no difference in the Antithrombin levels, PT and APTT values in patients with ischaemic stroke and those without a history of stroke and carrying out these tests routinely to assess hypercoagulable states in ischaemic stroke patients may not have any diagnostic value in our population.
Assessment of Plasma Levels of Calcium, Creatinine and Glucose among Hypertensive Patients in Edo State, Nigeria
(Ms. M. B. Mondal, 2024-12) Umeche, IE; Nwoka, NC; Osahenye, PC; Obi, CU; Ogueze, AC.
The present study needs to assess the plasma levels of calcium, creatinine and blood glucose among hypertensive patients in Edo State, Nigeria in order to ascertain whether plasma levels of these parameters are associated with hypertension in this population which will provide improved insight on proper management of hypertensive conditions. Several hereditary and lifestyle factors, including nutrition, influence blood pressure. In this regard, sodium is an important mineral that, in addition to its functions in fluid balance, action potential generation, digestive secretions, and nutrient absorption, also plays a key role in blood pressure regulation, with lower sodium intake linked to lower systolic and diastolic blood pressure. patients compared with their non-hypertensive counterparts. This could be as a result of an overactive parathyroid gland leading to excessive secretion of parathyroid hormone and the attendant increase in plasma calcium level. Regular screening for the plasma level of calcium, creatinine and blood glucose should be considered as routine tests for hypertensive patients. Adequate awareness of the risk of ignoring these parameters in hypertensive patients should be ensured.
Anesthesia Management in an Eclampsia Patient
(Ms. M. B. Mondal, 2024-09) Sirait, RH.
Eclampsia is always considered as a very serious complication of pregnancy which is responsible for numerous maternal and perinatal mortality in global setting. Eclampsia is characterized by seizures in a pregnant or postpartum patient as a result of hypertension. It is an escalation of preeclampsia, which is characterized by high blood pressure associated with pregnancy and is usually accompanied by protein in the urine. This report a case of eclampsia diagnosed in a pregnant woman which underwent anaesthesia management prior to section caesarea. Role of an anesthesiologist in this case is basically to help the obstetrician in charge to prepare the patient for safe operation and prevent any complication. The case is being reported to improve awareness regarding this life threatening entity in women. Case Presentation: A 27 years old (G2P0A1) patient at 36 weeks of gestation, referred to our ER with a history seizure, reduced consciousness with a bitten tongue and gestational hypertension. Her vital signs: NIBP 185/115 mmHg, HR: 90 beats/minute, RR 38x/minute, SpO2 96-97% on NRM 10 lpm. The patient has been infusion with a 5% Dextrose + 6 g MgSO4 (2 g IV + 4 g drip) and a 100 ml Dower Catheter from the regional general hospital. Working diagnosis when admitted to our hospital was 36 weeks of pregnancy G2P0A1 with severe eclampsia and gestational hypertension. Physical and laboratory examinations showed that the lungs showed smooth wet rhonchi (+/+), then on the extremities there were bilateral leg edema with hemoglobin of 10.8 g/dL, hematocrit 33.9%, platelet count was 85.000/mm3, and proteinuria +2. The clinico-pathologic features were consistent with the diagnosis of eclampsia. The patient was planned for Sectio Caesaria (SC) Cito with general anesthesia. After 7 minutes incision, the baby was born with an APGAR ssore 6/9. The operation procedure took 40 minutes. After surgery the patient transferred to ICU room, connect to ventilator, infusion of MgSO4 was continued, hemodynamic improvement, awareness, extubated, and then discharge from ICU because the anticipated medical complications did not arise and the patient has been deemed fit for step down care.
Using Soluble CD38 to Overcome Daratumumab Interference in Pretransfusion Compatibility Testing
(Ms. M. B. Mondal, 2024-09) PIVETTA, M; GESSONI, G.
Background: CD38 is a protein highly expressed on myeloma (MM) cells that has been shown to be an effective target antigen for monoclonal antibody therapies, so treatment with anti-CD38 monoclonal antibodies is a first line therapy for patients with MM. Although CD38 is weaker expressed on erythocytes anti-CD38 binds to CD38 on reagent RBCs and cause panreactivity in vitro and subsequent false positive reactions in indirect antiglobulin tests (IAT), antibody detection (screening) tests, antibody identification panels, and anti-human globulin (AHG) crossmatches. These findings suggest that the soluble CD38 method could improve transfusion safety for patients receiving anti-CD38 therapy, particularly in urgent clinical settings This study aims to evaluate the effectiveness of a new soluble CD38-based method in mitigating Daratumumab interference during pretransfusion compatibility testing." Methods: We evaluated the Grifols sCD38 method in 20 patients and compared it with the DTT method Results: In our experience the sCD38 method reduced testing time from 150 to 50 minutes and demonstrated 100% efficacy, compared to 90% with DTT. The sCD38 effectively mitigated the interference caused by anti-CD38 antibodies in 10 (100% efficacy) of patient samples tested while DTT was successful in only 9/10 (90% efficacy); no interference was observed in patients presenting anti erythrocyte antibodies. Moreover, there was no negative influence on DTT sensitive blood group systems such as KEL upon sCD38 treatment. Conclusions: In our Laboratory, in the year 2023, we processed 129 patients treated with anti-CD38. Therefore the reduction from 150 to 50 minutes in the time needed to perform tests for mitigation of anti-CD38 interference appears to be relevant with a recovery of approximately 210 technical-hours per year. Another highly appreciated operational aspect was the possibility of treating the patient's plasma and perform tests using automatic instruments (Erytra Grifols) available in our laboratory. In the evaluation of this new method, we did not observe failures in the mitigation of anti-CD38 interference. Furthermore, the results obtained in the samples that presented allo or auto antibodies were not affected by the treatment with sCD38. In our experience Grifols sCD38 assay is straightforward and quick to perform ant it is superior to DTT treatment in the mitigation of anti-CD38 antibody interference in MM patients treated with Daratumumab.
Sonographic Evaluation of Carotid Intima-Media Thickness and Iron Status of Regular and First-Time Blood Donors in a Tertiary Hospital in South-West Nigeria
(Ms. M. B. Mondal, 2024-09) O. F., Okeke; A. A. O., Adeyomoye; A. S., Akanmu; O. C., Nwanna-Otolehi; G., Iyizoba
Background: Regular blood donation which decreases blood iron levels may protect against cardiovascular diseases (CVD). This protection against atherosclerosis can be assessed by Carotid Intima-Media Thickness (CIMT) a biomarker for atherosclerosis. This study sought to determine and compare the mean and maximum CIMT, the serum level of iron and plaque prevalence among regular and first-time blood donors in Lagos University Teaching Hospital (LUTH), Lagos. Methods: A comparative, cross-sectional study involving 214 randomly-selected blood donors (107 regular and first-time blood donors each). Using a structured proforma, sociodemographic, anthropometric, radiological and laboratory data were collected from blood donors in the two groups. high frequency linear probe was used to assess CIMT, and presence of plaque in both extra-cranial carotid arteries. CIMT was the distance between the intima–blood interface and the adventitia–media junction and iron study included serum total iron, ferritin, transferrin and total iron binding capacity. Comparison between the study groups was done by Chi-square test and Student t-test/Mann-Whitney U-test for categorical and continuous variables respectively. Level of significance was set at p<0.05. Results: The mean and maximum CIMT of both carotid arteries in regular blood donors (mean right CIMT-0.49+/-0.11mm, maximum right CIMT-0.58+/-0.14mm, mean left CIMT-0.51+/-0.16mm, maximum left CIMT-0.60+/-0.27mm) were significantly(p<0.05) lower than those of the first-time blood donors(Mean right CIMT-0.79+/-0.17mm, maximum right CIMT-0.93+/-0.25mm, mean left CIMT-0.83+/-0.31mm, maximum left CIMT-0.96+/-0.27mm). Median serum iron(10.5µmol/L; IQR:8.8-13.5µmol/L), ferritin(30.50µg/ml; IQR:16.2-600µg/ml) and transferrin(2.1g/L;IQR:0.9-2.3g/L) in regular blood donors were significantly lower(p<0.05) than serum iron (16.1µmol/L; IQR:13.7-18.6µmol/L), ferritin(158.0µg/ml; IQR:115-365.2µg/ml) and transferrin(2.3g/L; IQR:2.1-2.4g/L) in first-time donors. Plaque prevalence was significantly higher (?2=5.81; p – 0.016) in first-time (11.2%) than regular (2.8%) donors. Conclusion: Regular blood donation significantly lower CIMT values, and iron parameters. Regular blood donation may offer protection against atherosclerosis.
Pattern, Complications and Social Problems of Blood Transfusion in the Neonatal Unit of a Tertiary Hospital in Southern Nigeria
(Ms. M. B. Mondal, 2024-06) West, BA; Wonodi, W.
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.
Positive Outcome in a Pregnancy with Anti-kell Alloimmunization Treated with Intravenous Immunglobulin and Therapeutic Plasma Exchange Despite Persistence of High Titre Antibody: A Case Report
(Ms. M. B. Mondal, 2024-09) Vio, C; Colpo, A; Collodel, L; Marson, P; Gessoni, G.
Background: Few reports have been published about the current clinical management of anti-Kell alloimmunization in pregnancy; its low frequency of occurrence means that the few long series published have covered an extensive time period in which different treatment approaches have overlapped. The objective of the present paper is to present our experience in the clinical management of a pregnant woman who was positive for the anti-Kell antibody. Materials and Methods: The laboratory follow-up included the weekly measurement of the antibody titre, and identification of the paternal and fetal genotype. The clinical management included TPE and IVIG administration. Obstetric monitoring included ultrasonographic monitoring of the fetus. Case Description: We report a case of anti-Kell alloimmunization with high antibody titre at first observation. Testing for fetal DNA circulating in maternal blood confirmed positivity for KEL1 gene. The patient underwent fifteen sessions of TPE after 18 weeks of gestational age, followed by weekly IVIG infusion, which continued until 27 weeks of pregnancy. Anti-Kell titres were measured before and after each TPE session. The patient had no need for IUBT and delivered by cesarean section at 34 weeks of gestational age. Pregnancy resulted in a live birth with mild HDFN. Discussion: HDFN is a potentially lethal complication of alloimmunization, and IUBT is the standard treatment for severe fetal anemia. TPE and IVIG are two alternative treatment modalities described in the literature to avoid or postpone the need for IUBT transfusion. In the case reported, despite any substantial change in antibody titre, pregnancy resulted in a live birth. This result suggests that the use of TPE and IVIG in alloimmunization during pregnancy could be an effective treatment strategy.
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
(Ms. M. B. Mondal, 2024-03) Nkabari, NG; Mgbeoma, EE; Obioma, A; 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.

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