Open Access Review Article

Sickle Cell Disease - A Comprehensive Study and Usage of Technology for Diagnosis

Sagar Yeruva, M. Sharada Varalakshmi, B. Pavan Gowtham, Y. Hari Chandana, P. E. S. N. Krishna Prasad

International Blood Research & Reviews, Page 6-14
DOI: 10.9734/ibrr/2020/v11i230125

Sickle cell is haematological disorder (haematology is a study of blood in health and diseases) which may lead to an organ damage, heart strokes and serious complications. It may also reduce human life span. Most of the sickle cells are observed in new born babies. At the start of sickle cells in human people though it’s a kind of feature in tribal people but it has spread over the world. Sickle cell Symptoms are observed in human beings as episodes of pains (crisis), Vision problems, swelling of hands and Feet. Sickle Cell Disease (SCD) can harm patient’s spleen (slightly pain at left Ribs). If one organ is affected in human body, then slowly it affects the entire body by spreading into Brain, Lungs, Heart, Liver, Kidneys, Joints, Eyes, Penis, Skin or Bone. This paper is aimed at presenting the complete details of the SCD with its properties, symptoms, signs, treatment for this disease. This is also a comprehensive study and characteristics of this disease with other similar diseases. The technological implications and usage in the field of SCD for better accuracy of identification of the disease is presented.

Open Access Original Research Article

Platelet Volume Indices in Patients with Acute Coronary Syndrome

Ekta Paramjit, S. Sudhamani, Anita Sharan, Sonali Pitale, Prakash Roplekar

International Blood Research & Reviews, Page 1-5
DOI: 10.9734/ibrr/2020/v11i230124

Background & Aims: Acute coronary syndrome is one of the leading causes of morbidity and mortality in the world and platelet hyperactivity with local platelet activation plays a crucial role in its genesis. As there is discrepancy regarding the significance of deranged platelet parameters, we aimed to study the role of platelet volume indices in the spectrum of coronary artery syndrome and to correlate them clinically.

Study Design: The study was conducted by collecting the data of patients with Myocardial infarction from the Cardiac care unit registry along with their clinical history and investigations. Stable coronary artery cases were collected from the Catheterization Lab and compared with Age and Sex matched controls. All CBCs of the above groups were processed by a 5-part counter and the data generated was transferred to a master chart for statistical analysis.

Place and Duration of study: The study was conducted in the Central Laboratory & Department of Pathology at D.Y. Patil Hospital, Navi Mumbai, India in collaboration with the Cardiac Care Unit and Catheterisation Lab of the hospital for a period of two years.

Methods: A total of 122 cases were studied and grouped into 5 groups according to presentation and the platelet volume indices of these were compared with 38 matched controls and statistically analysed.

Results: Mean Platelet Volume and Platelet Distribution Width of patients with ST elevation Myocardial Infarction (STEMI) and Non ST elevation Myocardial Infarction(NSTEMI) were increased marginally in number when compared to Stable Coronary Artery Disease(SCAD) and Control group, however this was not statistically significant. Platelet Large Cell Ratio (PLCR) was significantly raised in STEMI cases only (P = 0.09), so it may prove to be a better marker for the disease (P = 0.09). Platelet counts in various groups when compared with controls gave inconsistent results i.e SCAD vs Control significantly decreased (P = 0.07) and STEMI vs Control significantly increased (P = 0.01).

Conclusion: The platelet volume indices in suspected acute coronary syndrome cases showed various changes, but present data failed to be diagnostically significant. However this data may later help to characterise further relationship between Acute coronary syndrome and platelet function in subsequent studies.

Open Access Original Research Article

Transfusion Transmitable Infections and Reasons for Release of Total Blood to the Blood Bank of the Yaounde Centrall Hospital

Chetcha C. Bernard

International Blood Research & Reviews, Page 15-22
DOI: 10.9734/ibrr/2020/v11i230126

Blood banks in sub-Saharan Africa regularly face shortages of blood products (PS). Several factors are responsible for this, including transfusion-transmissible infections (ITT) and deficiencies in the transfusion system. This study aims to determine the prevalence and the various reasons for rejection at the blood bank of the Central Hospital of Yaoundé. We first conducted a retrospective study at the blood bank of the Central Hospital of Yaoundé for 12 months between January 01, 2014 and December 31, 2014.Secondly, we carried out a prospective study in October 2015. Five milliliters (05 ml) of venous blood were taken from each participant in a tube without anticoagulant; patient samples were stored at -24°C. A rapid screening test and ELISA were used to test for HIV, HCV, HBs and syphilis on the samples taken. Approximately 15,028 bags of whole blood were drawn in 2014, of which 3,688 bags were rejected. This equates to a rejection rate of 24.54%. Discards for non-infectious reasons represented 3.51% and rejections for infectious reasons 21.03%. During the prospective study, among those selected, there were 95.74% men and 4.26% women. The average age of the participants was 30 years. Among the 705 people in this investigation, 185 blood bags were rejected. Infectious causes represented 22.55% (Hepatitis B and C, HIV and syphilis with a respective prevalence of 9.08%, 0.71% 6.95% and 5.82%) and non-infectious causes represented 3.68 % (clots, insufficient volume of PST, hemolysis and expiration with a respective prevalence of: 1.84%, 0.71 0.14% and 0.99%).The association between rejection of blood bags and qualitative variables was assessed. There emerged a significant association between the risk of rejection of a blood bag and the type of donor; condom use, number of partners, history of STIs. At the Yaoundé Central Hospital blood bank, the reasons for rejecting blood bags are divided into two categories: Mainly infectious and non-infectious. Also, certain risk variables such as not using a condom, multiple sexual partners and a history of STIs are risk factors that can encourage rejection of blood bags.

Open Access Original Research Article

Coagulation Parameters among Women with Obstetric Complications in Specialist Hospital Sokoto, Nigeria

Onuigwe Festus Uchechukwu, Khadija Bello Tudu, Erhabor Osaro, Buhari Hauwa Ali, Bagudo Aliyu Ibrahim, Amilo Grace Ifechukwudebelu, Ibeh Nancy Chitogu

International Blood Research & Reviews, Page 23-33
DOI: 10.9734/ibrr/2020/v11i230127

Background and Aim: Obstetric complications are part of the leading causes of maternal mortality worldwide. This study was carried out to investigate the effect of   complications on the Prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet count (PLC). Women with obstetric complications were recruited as subjects). Pregnant women without complications were included as controls.

Study Design: This is a case-control study.

Place and Duration of Study: The study took place in Obstetrics and Gynaecology Department of Specialist Hospital Sokoto and the duration was six months.

Methodology: Pregnant women aged 18–41 years (mean age 29.5 years) were recruited for the study. The determination of PT and APTT was done by manual methods using commercially prepared Agappe reagent kits, whereas PLC was done by manual methods using a haemocytometer (Improved Neubauer counting chamber). Data were analyzed using SPSS version 23.

Results: The results of PT and APTT were significantly higher among women with obstetric complications (14.26±0.23 seconds and 31.32±0.70 second) compared to normal pregnant women (13.00 ± 0.13 seconds and 29.66±0.33) (P<0.05). The PLC was significantly lower among women with obstetric complications compared to women without obstetric complications (P< 0.05).Obstetric complications in subject show a significant association when compared with PT and APTT (P< 0.05). The age group of subjects shows a significant association when compared with APTT (P< 0.05).

Conclusion: Findings from this study have shown that obstetric complications causes decrease in platelet count and prolongation in PT and APTT. There is need to assess the PT, APTT and Platelet count routinely for pregnant women to improve the ante-natal care in Specialist Hospital Sokoto.

Open Access Original Research Article

Comparative Study of Fibrinolytic Response amongst Malarious Pregnant and Non Malarious Subjects in Rivers State, Nigeria

Stella Urekweru Ken-Ezihuo, Barinaaziga Sunday Mbeera, Chiatugu Nancy Ibeh, Zacchaeus Awortu Jeremiah

International Blood Research & Reviews, Page 34-45
DOI: 10.9734/ibrr/2020/v11i230128

Aim: The study was designed to comparatively assess the degree of fibrinolytic response amongst   malaria-positive pregnant women, and non-malaria positive subjects in Rivers State, Nigeria.

Methods: The study area covered University of Port Harcourt Teaching Hospital, Port Harcourt [UPTH] and Rivers State University Teaching Hospital, [RSUTH] both in Port Harcourt metropolis Rivers State.  It was a cross-sectional study carried out on a total of two hundred and forty female attendees at the obstetrics and gynecology clinics of the two hospitals. The subjects were grouped into three comprising of eighty subjects in each group; malarious pregnant women, non- malarious pregnant women and apparently healthy non-pregnant women. Venous blood sample measuring 5 milliliter volume was drawn from each subject, The sample was dispensed into two separate EDTA anticoagulant bottles, 3 milliliter and 2 milliliter meant for measuring the levels of markers of fibrinolysis which were Plasminogen, Plasminogen activator inhibitor-1, Plasminogen activator inhibitor-2, Tissue Plasminogen activator, alpha-2-antiplasmin, D-dimers and fibrinogen, and      preparation of blood films for malaria microscopy respectively.

Results: Fibrinogen result; 760.44±16.18 ng/ml of malaria-positive pregnant women was elevated compared to the malaria-negative women; 697.70±18.84 ng/ml and the non-pregnant control values of 704.73±15.25 ng/ml. These values were significantly different [P<.011] between the study groups. Results of tissue plasminogen activator [tPA]; 46.39±2.69 ng/ml, D-dimer; 77.64±6.94 ng/ml, plasminogen activator inhibitor-1 [PAI-1]; 89.73±2.14 ng/ml, plasminogen activator inhibitor-2 [PAI-2]; 568.00±12.51 ng/ml, plasminogen; 23.82±0.75 ng/ml and 2-antiplasmin; 1314.06±34.64 ng/ml of the malaria-positive pregnant women were significantly different [P=0.0001] from  non-positive pregnant women; tPA; 28.87±1.38 ng/ml, D-dimer; 53.90±1.18 ng/ml., PAI-1; 80.00± 1.81 ng/ml, PAI-2; 456.31±5.94 ng/ml, Plasminogen; 16.63±0.67 ng/ml and 2-antiplasmin; 1130.61±29.74 ng/ml . Both results were significantly different [P=0.0001] from the non-pregnant control group; tPA; 31.34±1.64 ng/ml, D-dimer; 30.24±1.04 ng/ml, PAI-1; 65,47±2,33 ng/ml, PAI-2; 427.86±6.95 ng/ml, plasminogen; 16.49±0.04 ng/ml and 2-antiplasmin; 1016.98±24.51 ng/ml.

Conclusion: The study witnessed significantly high concentrations of fibrinolytic markers in malaria-positive pregnant women. This could be due to compromised endothelial cell function resulting to overproduction of biomarkers of fibrinolysis. The implication is thrombus formation and excessive bleeding in pregnancy which could lead to miscarriages, fetal death or maternal mortality.