Open Access Original Research Article

Audit of Platelets Usage among Patients: A Descriptive Study of Various Platelet Concentrates

Dharmesh Chandra Sharma, Lokesh Tripathi, Poonam Woike, Sunita Rai, Rajesh Gaur

International Blood Research & Reviews, Page 1-9
DOI: 10.9734/IBRR/2016/29327

Background: Transfusion services are aimed to provide only those components which patients require and keep the rest for others. Platelet transfusion is critical due to lack of alternative; and therefore should be used rationally.

Aim: To elucidate the rational use of different platelet concentrates, its comparative efficacy in thrombocytopenia patients at our tertiary care hospital. 

Materials and Methods: This prospective cross-sectional two-year study was carried out at a tertiary care hospital in India. Relevant clinical findings, pre/post transfusion platelet count along with complete haemogram and diagnosis of patients were considered in compiling the data. Quality of Platelet was maintained as per the standard protocol of American Association of Blood Bank (AABB).

Results: Total 4157 units of platelet concentrates from recruited donors were prepared, where 3483 (83.97%) units were utilized and 674 (16.21%) were unfit for transfusion. 3483 fit Platelet concentrates were transfused to 1225 patients. Out of 3483 transfusions, 1080(31%) were therapeutic and 2403(69%) were prophylactic. In the study 3104 Random Donor Platelet (RDP) and 379 Single Donor Platelets (SDP) were transfused to 978 and 247 patients respectively. Mean absolute increase in platelet count was 4.8x109/L (SD= 2.9x109/L) for RDP and for SDP it was 33.2x109/L (SD=6.0x109/L). Out of 3483 platelets transfusion, about 80% were found to be rational according to British Committee for Standards in Haematology (BCSH) criteria.

Conclusion: A healthy rationality of 80% was observed in the present study. Platelet concentrates should be used rationally and scientifically as per proven criteria because it has no alternative. 

 

Open Access Original Research Article

Pattern, Determinants, and Costing Review of Send-out Tests in a Secondary Care Hospital Setting in Saudi Arabia

Abdulla Al Amri, Raouf Afifi

International Blood Research & Reviews, Page 1-17
DOI: 10.9734/IBRR/2016/29818

Background: The need for advanced laboratory tests, mostly performed at reference laboratories, increases over time. Officials have to choose between “send-out” testing or introducing such tests among their test menus, bearing necessary cost.

Aim: This study aims to identify the distribution pattern of send-out testing at the A Hada Armed Forces Hospital (AHAFH), in Taif relevant cost and associated factors.

Methods: A study review of all send-out tests of all varieties during fiscal year (FY) 2011 was conducted.

Results: It was found that 2,986 reference laboratory tests out of total 3,675,000 tests were processed during the study period, comprising 0.11% of the total test volume. The total cost of send-out testing accounted up to €168,903.5 [range €370.8, minimum €12.2, maximum €383.0, median €50.0, inter-quartile range (IQR) €48.86], and constituting 11.7% of the total laboratory budget in fiscal year (FY) 2011. The variability in the cost of send-out tests was statistically significant [H(6)=898.39, p<0.001]. The cost of send-outs highly correlated with the turnaround time (TAT) (r=0.77, p<0.001).

Conclusions: The study furnishes a database that can be used for conducting an in-depth cost-effectiveness analysis to help introduce priority reference tests to AHAFH laboratory test menu to minimize the “wait time” until disease diagnosis has been done. New measures to adjust send-out testing may be developed to help physicians make sound send-out decision choices.

 

Open Access Original Research Article

Enzymatic and Non-enzymatic Biomarkers Levels in Pregnancy Trimesters in Ilesa South Western Nigeria

Stephen Olajide Awofadeju

International Blood Research & Reviews, Page 1-11
DOI: 10.9734/IBRR/2016/29410

Aims: The aim of this study was to see the effect of pregnancy on some selected enzymatic and non-enzymatic biomarkers based on trimesters.

Study Design: One-factor, one control - three test group quasi - experimental design.

Place and Duration of Study: Department of Chemical Pathology, Obafemi Awolowo University Teaching Hospitals Complex, Wesley Guild Hospital Unit, Ilesa, Osun State, Nigeria, between September 2015 and April 2016.

Methodology: A total of eighty (80) subjects were recruited for the study, and were grouped into 1st trimester pregnant women (n=20), 2nd trimester pregnant women (n=20), 3rd trimester pregnant women (n=20), and non-pregnant women (n=20). Blood samples (10 mL venous blood) were collected, centrifuged and stored as plasma before subjection to biochemical analysis. Blood plasma was analyzed for enzymatic and non-enzymatic biomarkers using standard approved methods.

Results: This study revealed that from first to third trimester, the following biomarkers: CK (creatine-kinase), LDH (lactate dehydrogenase), GGT (gamma-glutamyl transferase), AMY (amylase), TRP (troponin), CRP (c-reactive protein), MYO (myoglobin), AFP (alphafetoprotein), CB (conjugated bilirubin), and UR (urea) progressively increased while AST (aspartate aminotransferase), ALT (alanine aminotransferase), ALP (alkaline phosphatase), TB (total bilirubin), CR (creatinine), Na+ (sodium),and K+ (potassium) gradually decreases respectively. TP (total protein), and ALB (albumin), decreases in first and second trimester before rising in the third trimester of pregnancy. Moreover, in statistical analysis of the pregnancy trimesters with non pregnant women, ALP, AMY, TRP, MYO, and AFP were significantly increased while UR was significantly decreased in first trimester comparison with control subjects. In second trimester of pregnancy, CK, LDH, ALP, AMY, TRP, CRP, MYO, and AFP, were significantly elevated while UR was significantly decreased when compared to non pregnant subjects. In third trimester of pregnancy, CK, LDH, ALP, GGT, AMY, TRP, CRP, MYO, AFP, and CB were significantly raised while Na+ was significantly reduced when compared to the non pregnant women. Other biomarkers investigated with controls has differences that were statistically non significant.

Conclusion: Pregnancy irrespective of the trimester exerts positive influence on both enzymatic and non enzymatic biomarkers, which when investigated during pregnancy prevent pregnancy associated medical complications and gives improved antenatal care for  safe delivery of a healthy baby by healthy mother.

 

Open Access Original Research Article

Study of Association between Platelet Function and Anthropometry of Blood Donors in a Single Institution

Somesh Raju, Narsingh Verma, Sunita Tiwari, Tulika Chandra, Rina Kumari, Kshitij Bhardwaj

International Blood Research & Reviews, Page 1-8
DOI: 10.9734/IBRR/2016/28567

Objective: To determine the association between obesity indices e.g. body mass index, waist circumference and platelet function in healthy blood donors.

Methodology and Procedures: A cross-sectional study conducted on 100 healthy blood donors in Transfusion Medicine Department of King George’s Medical University, Lucknow. Subject selection based on inclusion and exclusion criteria. Anthropometric measures were recorded and sample of blood taken after blood donation and platelet count and platelet release test performed by specific method. Collected data analysed by Student’s t tests to assess the associations.

Results: According to body mass index, 44% subjects have normal BMI and remaining 27% and 24% of the subjects have BMI within range from 23 to 24.9 and >25 respectively. Subjects based on waist circumference, 54% of subject have WC <85.9 cm and 21% of the subject have WC >90 cm. platelet count shows significant association with body weight and waist circumference of the healthy blood donor subject. However, no significant correlation was found between platelet function (Platelet release test) and anthropometric variables.

Conclusion: Anthropometric variables like body weight, body mass index, and waist circumference can give a quantitative idea of platelet function including platelet count in blood of normal healthy donors.

 

Open Access Original Research Article

Occurrence of Hepatitis B, Hepatitis C and HIV Infections among Individuals Undergoing Preemployment and Premarital Medical Examination in Mediterranean Port City Tobruk, Libya

Faisal Ismail, Atiya Farag, Md. Abdul Ilah

International Blood Research & Reviews, Page 1-6
DOI: 10.9734/IBRR/2016/30576

Hepatitis C Virus (HCV), Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) still posed to be ultimate threats to the community in Libya. The rapid screening and identification of these infections has been the important subject of research globally to rid of these viral infections.  We have reported here the incidence of HBV (6.1%) and HCV (1.2%) infections among individuals who performed preemployment and premarital medical examination in Tobruk city, Libya.  

The aim of the study is to identify and estimate the frequency of HBV, HCV and HIV in individuals who are undergoing pre-employment and premarital stage in Tobruk.

A three years long (2014 to 2016) meticulous research study was carried out in the Public and Family Health Clinic, Tobruk. The blood samples were collected for analysis from 328 multinational public servants and premarital couples of Tobruk city. 

A total of 79 (24.1%) cases out of total 328 cases were Libyans and 249 (75.9%) were non-Libyan. The HBV infections had been detected in which 5 cases were among Libyans, 6 among Sudanese, 4 among Egyptians, 4 among Syrians and 1 among Tunisian. The HCV infection was only 1 case, found among Libyans and 3 cases among Egyptians whereas, no HIV case was found over the period of investigations.