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Prevalence and Demographic Analysis of Hemoglobinopathies in Newborns: A Three-Year Study at Thumbay Teaching Hospital, Ajman-UAE.

Hemoglobinopathies are hereditary blood disorders affecting hemoglobin in red blood cells. This study aimed to determine the prevalence and types of hemoglobinopathies among newborns in Thumbay Teaching Hospital, Ajman-UAE, over three years (2020-2022), and to analyze demographic trends. A laboratory-based retrospective cross-sectional study was conducted, involving 6,050 newborns screened using High-Performance Liquid Chromatography (HPLC). We consider this study and its results as a new effort in the field of hemoglobinopathy research and management in Ajman in the United Arab Emirates. The final main findings revealed different hemoglobinopathy cases. In 2020 Two cases (2) involving Hb C variant were recorded, both of African origin (from Sudan and Egypt). The third case was Hb D variant which was also of African origin (Egypt). In 2021 no case was found. In 2022, the results showed a widespread of cases; A patient from Nigeria reported having Hb C, three cases of Hb D from Pakistan, two cases of Hb E trait from people in Bangladesh and India, one case of Hb S from Malawi, five cases of Hb S trait from people in Africa (two from Kenya, one from Tanzania), and two cases from Asian people from Yemen. The total number of detected hemoglobinopathies was 15 cases, accounting for a percentage of (0.2%). The study reveals a diverse presence of hemoglobinopathies among newborns in Ajman and underscores the importance of newborn screening programs to facilitate early diagnosis and treatment, particularly in regions with high genetic disorder prevalence. The study revealed almost an obvious African origin of Hb C and S cases and Asian one of Hb E and D cases.

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The Effect of Spinach (Amaranthus hybridus) on the Pharmacokinetic and Pharmacodynamic Profile of Warfarin in New Zealand White Rabbits.

Spinach (Amaranthus hybridus) is a green vegetable containing 380μg/100 g of vitamin K, while warfarin serves as an antagonist in inhibiting vitamin K epoxide reductase subunit C1 (VKORC). In this context, the co-administration of warfarin and spinach is frequently encountered among Indonesian patients, potentially leading to drug-food interactions. This study aimed to investigate the effect of concomitant administration of spinach on the pharmacokinetic and pharmacodynamic profile of warfarin in New Zealand White rabbits. A total of 24 New Zealand White rabbits weighing about 1.5-2 kg were used in this study. For 16 days, these rabbits were given oral warfarin at a dose of 0.4 mg/kg BW by 10.00 am. Subsequently, 3 mL of blood samples were withdrawn in the lateral vein of the ear on the 13th and 16th days. The Prothrombin Time-International Normalized Ratio (PT-INR) is used to evaluate the pharmacodynamic profile, while the plasma concentration of S(R)-warfarin (Cp (AV)), half-life (t½), area under the curve (AUC), volume of distribution (Vd), and clearance (CL) are analyzed to determine the pharmacokinetic effects of warfarin. In the Fluconazole (FZ) group, there was a significant increase in the area under the curve (AUC) at maximum concentration (Cmax) after treatment, with a p-value of < 0.05. In the Amaranthus hybridus dose 1 (AH-1) and Amaranthus hybridus dose 2 (AH-2) groups, AUC and plasma drug concentration (Cp (AV)) were higher after treatment but the results of statistical analysis were not significant. There was no pharmacokinetic or pharmacodynamic interaction between spinach (Amaranthus hybridus) and warfarin. Additionally, patients subjected to warfarin therapy could consume spinach with a recommended portion size below 100 grams per day.

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The Effects of High Particulate Matter Levels on Platelet Recovery in Patients Receiving Prophylactic Platelet Transfusion.

Exposure to fine particulate matter, particularly PM2.5, has been associated with increased platelet activation and cardiovascular risks. However, its effect on platelet recovery after transfusion remains unclear. This study aims to assess the influence of PM2.5 exposure on platelet recovery in patients with hematologic malignancies receiving prophylactic platelet transfusions. We conducted a cross-sectional study involving 66 patients with hematologic malignancies who developed chemotherapy-induced thrombocytopenia and received prophylactic platelet transfusions between January and December 2021. A total of 191 transfusion events were analyzed. Platelet increment and corrected count increment (CCI) were measured one hour post-transfusion. Transfusions were categorized based on mean PM2.5 levels one day prior to platelet collection: the control group (< 37.5μg/m³) and the case group (≥ 37.5μg/m³). Multivariate analyses were used to adjust for potential confounders. No significant differences were observed in platelet increment (p = 0.128) or CCI (p = 0.828) between the PM2.5 exposure groups. Correlation analyses showed no significant association between PM2.5 levels and platelet increment (r = 0.0565, p = 0.437) or CCI (r = 0.0370, p = 0.614). These findings suggest that exposure to elevated PM2.5 levels one day before donation does not significantly impair platelet recovery. Short-term exposure to elevated PM2.5 levels does not significantly affect platelet recovery in patients receiving prophylactic platelet transfusions. These results provide important reassurance regarding the immediate effects of air pollution on transfusion outcomes, while highlighting the need for further research into potential long-term impacts.

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Comparison of Platelet Indices, Lymphocyte, and Systemic Inflammation Indices on Days 1 and 8 in Surviving and Non-Surviving COVID-19 Patients at Hasan Sadikin General Hospital, Bandung, Indonesia.

This study aimed to compare platelet count, platelet indices, lymphocyte, and systemic inflammation indices between surviving and non-surviving COVID-19 patients, measured at admission and on the eighth day of hospitalization. A retrospective cohort study was conducted on COVID-19 patients hospitalized at Hasan Sadikin General Hospital, Bandung, from March to December 2020. Patient characteristics and laboratory data were sourced from medical records and the Clinical Pathology Laboratory. Bivariate analysis was performed to determine the comparison of platelet indexes between Surviving and Non-Surviving COVID-19 patients depending on data distribution. Significantly correlated variables in Bivariate analysis were included in the ROC analysis, with the AUC used to identify optimal threshold values for laboratory parameters. Data from 132 patients were analyzed, with 106 (80.3%) surviving and 32 (19.7%) not surviving. Non-surviving patients had lower platelet count, PLTCT, and lymphocyte levels but higher MPV and PDW compared to survivors. Receiver operating characteristic (ROC) analysis revealed that on day 1, lymphocytes had a higher area under the curve (AUC) than MPV. On day 8, lymphocytes had the highest AUC, followed by platelet count, MPV, PLTCT, and PDW. Platelet indices, lymphocyte counts, and systemic inflammation index have the potential to distinguish the severity of COVID-19.

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Phenotypic Identification of Blood Groups in Blood Donors: A Peruvian Multicenter Analysis.

Red blood cell alloimmunization currently continues to be a significant problem during the blood transfusion process, where phenotypic identification plays a clinically relevant role in its prevention. The objective of the study was to carry out the phenotypic identification of blood groups in blood donors from three hospitals in Lima. A cross-sectional study was conducted, including 20,141 blood donors in three hospitals in Lima, Perú during the period from January to June 2023. Red blood cell phenotyping was performed by the gel agglutination method using gel cards with the IH-500 automated system. A predominance of donors within the age group of 29 to 38 years (30.9%) was observed, with the majority being men (69.5%). Most donors were Peruvian (97.9%), and among foreign donors (2.1%), Venezuelans predominated (1.5%). In the distribution of the ABO and RhD blood groups, the O Rh+ phenotype predominated in 79% of the donors. In the phenotypic distribution of the Rh system, the presence of the D antigen was observed in 98.1% of the donors, with the c phenotype being the most frequent (76.4%). For the Kidd system, 70.7% of the donors presented the Jka antigen and 81.9% the Jkb antigen. In the Duffy system, 77.7% of the donors presented the Fya antigen and 50% the Fyb antigen. For the MNS system, 93.7% of donors had the S antigen and 76.1% had the s antigen. It was also found that 1.5% of donors are carriers of the Kell antigen, all of which are clinically important. The phenotypic identification of blood groups in blood donors from three hospitals in Lima highlighted the clinical relevance of identifying less common antigens in the Kell, Kidd, Duffy, and MNS systems to prevent alloimmunization during blood transfusions.

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A Microflow Chip Technique for Monitoring Platelets in Late Pregnancy: A Possible Risk Factor for Thrombosis.

To study the platelet adhesion and aggregation behaviour of late pregnancy women under arterial shear rate using microfluidic chip technology and evaluate the risk of thrombosis in late pregnancy. We included pregnant women who were registered in the obstetrics department of our hospital between January 2021 and October 2022 and underwent regular prenatal examinations. Blood samples were collected at 32-35weeks of gestation for routine blood tests and progesterone, oestradiol, and platelet aggregation function. A microfluidic chip was used to construct an in vitro stenosis vascular model to explore the platelet reactivity at shear rates of 1000s-1, 1500s-1 and 4000s-1. Flow cytometry was used to analyse the effect of shear rate induction on the expression of platelet membrane surface fibrin receptor (PAC-1) and P-selectin (CD62P) in pregnant women. Compared to the non-pregnant healthy control group, the white blood cell count increased and platelet count decreased significantly in late pregnant women (P < 0.05), and platelet reactivity to agonists increased under non-flow conditions (adhesion and aggregation rates, P < 0.05). Microfluidic chip technology showed that platelet aggregation in late pregnant women increased significantly (P < 0.05) in the shear-rate environment and was positively correlated with the shear rate. The degree of aggregation at 4000s-1 was more evident, but the stability of platelet aggregates was low. Shear rate increased PAC-1 and CD62P expression. Microfluidic chip technology was used to analyse the platelet aggregation function under arterial shear rate combined with flow cytometry to detect platelet activation, which was consistent with the traditional non-flow conditions used to evaluate platelet function. However, microfluidic technology can simulate a more realistic in vivo shear rate environment, providing more effective clinical application data and a theoretical basis for the diagnosis and prevention of platelet dysfunction and thrombotic diseases during pregnancy.

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Prevalence of High Titre Anti-A and Anti-B Haemolysins Amongst Blood Group "O" Voluntary Donors at Mbale Regional Blood Bank, Eastern Uganda.

Blood Group O donors with high antibody IgG anti-A and anti-B titers of 1:256 or higher was considered high antibody titer and generally referred to as dangerous donors because their plasma has the potential to haemolyse or agglutinate red blood cells in non-Group O recipients. Titration for the IgG anti-A and anti-B prior to transfusion is required to prevent transfusion reactions. There is a monthly blood collection of 5000 blood units per-month with ABO RhD distribution of A 27%, B 20%, O 48%, AB 5%, and Rh(D) negative 2%. This study aimed at determining the prevalence of high-titer immune anti-A and anti-B in blood group O donors at Mbale regional blood bank. A total of 382 blood group "O" donors were randomly selected and recruited after obtaining informed consent during the period of May 2022-January 2023. The titration for the anti-A and anti-B hemagglutinins (IgG class) titers was done by use of the tube titration technique. Data were summarized as means, standard deviations, percentages, and frequencies then presented in the form of pie charts and tables. Of the recruited participants, 270(70.7%) were males. Total number of group O donors with high-titer were 27(7.1%) of which 15(55.5%) were male. The most frequent occurring antibody was Anti-B with 17/27 (62.9%). In male with high titer, anti-B was the most occurring and significantly raised, while anti-A was the most raised in female. There is a high proportion of blood group O donors having high titers of anti-A and anti-B (dangerous group O donors), with the most raised antibody being anti-A, which compromises the quality and safety of the blood products. We recommend screening for high-titer anti-A and anti-B antibodies in all blood group O donated units to make them safe for transfusion to non-group O recipients, especially where large volumes of plasma are required.

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Clinical Outcomes Among Patients With Sickle Cell Disease and Transfusion-Dependent Beta-Thalassemia Treated With Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Literature Review.

The purpose of this study is to synthesize evidence on disease-specific outcomes in patients with sickle cell disease (SCD) or transfusion-dependent beta-thalassemia (TDT) following allogeneic hematopoietic stem cell transplant (allo-HSCT). A systematic literature review (SLR) was conducted in MEDLINE and Embase to identify publications up to May 2023, including patients with SCD or TDT treated with allo-HSCT. Occurrence of vaso-occlusive crises (VOCs) including acute pain, acute chest syndrome, priapism, and splenic sequestration in SCD, and red blood cell transfusion (RBCT) requirements in TDT were the main outcomes of interest. Transplant-related outcomes such as graft-versus-host disease (GVHD) and graft failure/rejection were summarized in the studies that reported main outcomes. Proportion of patients experiencing VOCs or RBCTs, GVHD, and graft failure/rejection after allo-HSCT were aggregated and descriptively reported with range across studies. Thirty-one SCD studies met inclusion criteria. Twenty-nine studies assessed for VOC and pain crisis events after allo-HSCT; 11 studies reported ≥1 VOCs after allo-HSCT in 6.9% of the 2,760 patients. Graft failure was reported in 14.4% (0.9%-18.8%, 14 studies) of patients, graft rejection in 5.5% (1.6%-100.0%, 12 studies) of patients, acute GVHD in 22.4% (1.6%-50.0%, 19 studies) of patients, and chronic GVHD in 20.4% (3.3%-57.1%, 14 studies) of patients. Seventy-eight TDT studies met inclusion criteria. Fifty-six studies reported that 8.8% of the 3,107 patients required RBCTs after allo-HSCT. Graft failure was reported in 5.4% (1.1%-80.0%, 21 studies) of patients, graft rejection in 7.5% (0.5%-42.9%, 50 studies) of patients, acute GVHD in 28.4% (5.2%-100.0%, 57 studies) and chronic GVHD in 15.2% (1.3%-50.0%, 51 studies) of TDT patients. Based on this SLR, after allo-HSCT, a portion of patients with SCD continue to experience VOCs and a portion of patients with TDT continue to require RBCTs, in addition to experiencing GVHD and graft failure or rejection.

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