Asymptomatic immune thrombocytopenia in immediate post surgery following fresh frozen plasma transfusion

Occurrence of thrombocytopenia in immediate post operative period is less frequently encountered, and identifying the cause(s) is also challenging. Because multiple interventions in the form of fluid administrations, blood products transfusion, use of drugs (heparin) and increased risk of infection and organ dysfunction in post operative period can all cause thrombocytopenia. Fresh frozen plasma transfusion (FFP) transfusion is an uncommon cause of drastic thrombocytopenia, with only 14 such reported cases in the literature. And this complication is most frequently witnessed in perioperative period, 11 out of 14 of all reported cases. It is explained by transfusion of plasma containing antibodies against platelets, which develop as a consequence of plasma donors being exposed to varied platelet antigen via previous blood transfusion or during pregnancy. Here we are presenting a case of a young male who was transfused with FFP in post-operative period which led to a drastic fall in platelet count without any bleeding manifestations, which was a diagnosis of exclusion and managed with suspension of FFP transfusion.

IgG Subclasses and Congenital Transmission of Chagas Disease

The mechanism of vertical transmission of Trypanosoma cruzi is poorly understood. In this study, we evaluated the role of IgG subclasses in the congenital transmission of Chagas disease. We conducted a case-control study in a public maternity hospital in Santa Cruz, Bolivia, enrolling women at delivery. Thirty women who transmitted T. cruzi to their newborns (cases), and 51 women who did not (controls) were randomly selected from 676 total seropositive women. Trypanosoma cruzi–specific IgG1, IgG2, and IgG3 levels were measured by in-house ELISA. The IgG4 levels were unmeasurable as a result of low levels in all participants. Quantitative polymerase chain reaction results and demographic factors were also analyzed. One-unit increases in normalized absorbance ratio of IgG1 or IgG2 levels increased the odds of congenital T. cruzi transmission in Chagas-seropositive women by 2.0 (95% CI: 1.1–3.6) and 2.27 (95% CI: 0.9–5.7), adjusted for age and previous blood transfusion. Odds of congenital transmission were 7.0 times higher in parasitemic mothers (95% CI: 2.3–21.3, P < 0.01) compared with nonparasitemic mothers. We observed that all mothers with IgG1 ≥ 4 were transmitters (sensitivity = 20%, specificity = 100%). Additionally, no mothers with IgG2 < 1.13 were transmitters (sensitivity = 100%, specificity = 21.6%). We demonstrated that IgG subclasses and parasite presence in blood are associated with vertical transmission of T. cruzi and could identify women at increased risk for congenital transmission by measuring IgG subclasses. These measures have potential as objective screening tests to predict the congenital transmission of Chagas.

PREVALENCE AND RISK FACTORS OF CYTOMEGALOVIRUS INFECTION AMONG HAEMODIALYSIS PATIENTS IN SOUTHERN GAZA STRIP, PALESTINE

Introduction: End-Stage Renal Disease patients (ESRD) on maintenance Haemodialysis (HD) are at high risk of acquiring Cytomegalovirus (CMV). The aim of the study was to determine the prevalence and risk factors of CMV infection among HD patients from Nasser's medical complex and Abu Yousef Al Najjar Hospital Southern Gaza strip. Methods: This study was an analytical cross-sectional from March to September 2019. Serum samples were taken from 96 patients (51.1% of them from Nasser medical complex and 48.9% of them from Abu Yousef Al Najjar Hospital), analyzed for CMV-specific immunoglobulin G (IgG) by using the Chemiluminescence immunoassay (CLIA) techniques, questionnaire, and Virological identification. Results: CMV-IgG was detected in 80 patients (83.3%), were 16 patients (16.7%) were CMV IgG Negative. The prominent risk factors were HD duration time, Receiving Injection, and previous blood transfusion. Conclusion: The prevalence of CMV infection among HD patients in the Southern Gaza strip was very high. We recommend that HD patients should be vaccinated against CMV.

Prevalence of Hepatitis C in pregnant patients visiting a Tertiary Care Hospital in Faisalabad.

Objectives: To determine prevalence of Hepatitis C among pregnant female visiting a tertiary care hospital. Study Design: Observational study. Setting: Independent University Hospital Faisalabad. Period: 1-1-2018 to 31-12-2018. Material & Methods: Total 4210 pregnant patients visited during this time period. Results: During the study period i-e from 1-1-2018 to 31-12-2018, total 4210 obstetric patients visited Independent University Hospital. Among them 463 were Anti HCV +with % age of 10.9. Our study showed that 28 patients (6%) were <19 yrs of age, 35 patients (7%) were 20 to 25 yrs. 48 patients (10%) were 26 to 29 yrs.151 patients (32%) were 30 to 35 yrs of age. 201 patients (43%) were more than 35 yrs. Our result has shown that most of the infected patients were having their 5th or more pregnancy (202%). 182 patients (39%) were G4 or G5.47 patients (10%) were having their 2nd or 3rd pregnancy while only 32 (6%) primigravidas had this infection. Our study has shown that 325(70%) patients were of rural background while 135(29%) patients belonged to urban areas. When these Hepatitis C+ve patients were analyzed for risk factors, 91 had some dental manipulation in the past (19%), 104 had history of previous blood transfusion or some parental infusions (22%) 32 patients (6.9%) had their partners infected with Hepatitis C. 161 patients (34%) had history of some surgery or previous vaginal delivery at some centre where sterilization was not standardized. 75 patients (16%) had no identifiable risk factor. Conclusion: The prevalence of Hepatitis C is quite high in pregnant patients of Faisalabad. There is a dire need to address the factors involved in transmission of disease. Health policies should be revised to decrease the spread of this virus. Increased awareness is needed among the people regarding its transmission and early diagnosis so that curative measures should be timely taken to avoid the dreadful complications of Hepatitis C.

The Prevalence of Hepatitis C Virus Among Blood Donors Attending Samarra's General Hospital

Background: Hepatitis C is an infectious disease that affects primarily the liver; it is caused by hepatitis C virus (HCV). Cirrhosis and liver cancer are the common complications of the disease. So identifying prevalence and certain risk factors of the disease will promote preventive measures for the disease. Aim and Objectives: By conducting this study, we will determine the prevalence of hepatitis C among blood donors who attended Samara General Hospital for donating blood. Methods: A descriptive study was conducted on blood donors attending the hospital. The study was conducted during the period from February 2016 -November 2017. The sample included 850 persons. The demographic information, personal data and results of investigations were obtained according to a certain designed questionnaire. The subjects’ blood samples were tested to detect HCV antibodies by ELISA test. Results: The prevalence of hepatitis C disease among blood donors in the current study according to HCV-Ab detection was 20/850 (2.4%) . The positive cases were more prevalent among males, married, those with previous blood transfusion, previous surgical procedures and those with an HIV positive spouse. Conclusion: HCV infection is more prevalent in certain subjects with certain risk factors such as blood transfusion, surgical process, infected spouse.

Seroprevalence of Hepatitis G Virus IgG antibody among blood donors, pregnant women, neonates and apparently healthy population

This cross sectional and observational study was conducted in the Department of Microbiology, Sylhet MAG Osmani Medical College, Sylhet, during the period from 1st January 2012 to 31st December 2012 with a view to explore the seropositivity of Hepatitis G virus (HGV) in blood donors, pregnant women, new born and apparently healthy subjects. For this purpose 45 blood donors, 45 pregnant women, 45 new born babies of same mothers and 45 apparently healthy subjects were selected according to the inclusion and exclusion criteria. The HGV antibody was measured in venous blood from blood donor, pregnant women and apparently healthy subjects; and cord blood from newborn babies with a commercially available enzyme-linked immunosorbent assay (ELISA) method. The mean age of the blood donors, pregnant women and healthy subjects was 24.9 (SD ± 3.5) years; 24.9 (SD ± 3.5) years and 22.1 (SD ± 1.5) years respectively. The overall seropositivity of HGV was 3 (1.7%). The seropostivity of HGV of blood donors, new born babies and healthy subjects was 1 (2.2%) in each group but no HGV antibody positivity among the pregnant women (p=0.797). Among the male patients 2 (2.2%) patients were seropositive for HGV; while in female patients, 1 (1.1%) patient was seropositive for HGV (p=0.547). Among the patients with previous blood transfusion 1 (1.9%) patient was seropositive for HGV; while among patients without previous blood transfusion 2 (1.6%) patients were seropositive for HGV (p=0.882). This study yielded that there is high prevalence of HGV seropositivity among population in this region of Bangladesh. So, screening of blood units for HGV would deserve consideration.Faridpur Med. Coll. J. 2014;9(1): 28-31

IRON DEFICIENCY ANAEMIA AMONG PRE-SCHOOL CHILDREN WITH SICKLE CELL ANAEMIA: STILL A RARE DIAGNOSIS?

Background: The frequent need for blood transfusion in children with SCA creates the impression that IDA is rare in this class of children. Objectives: The objective of the study is to determine the prevalence of IDA in a population of under-five children with SCA in Lagos, Nigeria. Methodology: Serum iron, total iron binding capacity, transferrin saturation and serum ferritin were assayed in 97 under-five children with SCA and 97 age/sex matched controls. The diagnosis of IDA was established based on the following criteria: haemoglobin <11.0 g/dl plus two or more of the following: MCV <70fl, transferrin saturation (Ts) <16% or serum ferritin (SF) <25ng/dL Results: Overall prevalence of IDA was significantly higher among AA controls. In the younger age group, the prevalence of IDA was significantly higher among HbAA controls while in the older age group the odds of having IDA was three times higher among HbSS subjects but the difference was not statistically significant. Two of the three SCA children with IDA have history of previous blood transfusion. Conclusion: IDA is uncommon in pre-school aged children with SCA. A multi-centre study is necessary to yield large number of transfused subjects to examine the effects of blood transfusion on prevalence of IDA.

Risk factors associated with hepatitis C virus infection in Taiwanese government employees

This study evaluated the roles of multiple factors in hepatitis C virus (HCV) infection, with emphasis on the modification of various individual characteristics on the risk associated with percutaneous exposure to blood. Serum samples taken from 4869 men in Taiwan within a cohort study were tested for HCV antibody. The overall positive rate of anti-HCV was 1·6 %. In a logistic regression, factors positively associated with anti-HCV positivity were previous blood transfusion (odds ratio [OR] = 7·28; 95 % confidence interval [CI] = 4·26–12·45), a history of surgery (OR = 2·06; 95 % CI = 1·23–3·46), and lower educational levels (OR = 1·94; 95 % CI = 1·14–3·32). The anti-HCV positive rate was significantly lower in hepatitis B surface antigen (HBsAg) carriers than in non-carriers (OR = 0·60; 95 % CI = 0·37–0·95). Ageing, lower educational levels, O blood group, and Taiwanese ethnicity enhanced the likelihood of HCV infection through blood transfusion/surgery, whereas HBsAg status, cigarette smoking, and habitual alcohol drinking reduced it.