History Of Transfusion Research Articles

Immune Erythrocyte Alloantibodies among Pregnant Women Attending an Antenatal Clinic in a Tertiary Health Facility, Benin City, Nigeria

BACKGROUND: Maternal alloimmunization is associated with adverse outcomes such as hemolytic disease of the fetus and newborn. At-risk pregnant women include those with previous multiple gestations or multiple blood transfusions. This study aimed to determine the proportions and specificities of irregular maternal alloantibodies among antenatal attendees at a federal teaching hospital in Nigeria. An understanding of the pattern of alloimmunization, associated morbidities, and attendant risk factors will guide improved antenatal/perinatal health planning. MATERIALS AND METHODS: A hospital-based, cross-sectional survey was conducted among 150 pregnant women. Data on parity, transfusion history, and other clinical details were obtained with an interviewer administered questionnaire. ABO/Rh D blood groups and hemoglobin phenotypes were retrieved from their antenatal records and confirmed during the study. Alloantibody screening and identification and other serological tests were subsequently performed. Association of independent parameters with other variables was tested using Chi-square analysis or Fisher's exact as appropriate. Level of statistical significance was set at 5% confidence (P = 0.05). RESULTS: Most of the participants (60%) were in their third trimester, while 9.3% were in first trimester of pregnancy. Ninety-one percent of the participants (90.7%) were blood transfusion naïve. Seven of the participants (4.7%) had positive alloantibody screens, of which two (1.33%) were clinically significant maternal alloantibodies (Anti-D and Anti-Lub). No statistically significant association was observed between alloimmunization and variables such as gestational age, parity, hemoglobin phenotype, previous blood transfusions, and Rh D negativity. CONCLUSIONS: The authors recommend routine alloantibody screening for at risk pregnancies.

Hepatitis B and C virus infections and associated factors among HIV-positive and HIV-negative tuberculosis patients in public health facilities, Northeast Ethiopia: A comparative cross-sectional study.

Viral hepatitis, particularly hepatitis B virus and hepatitis C virus, is the leading cause of global liver-related morbidity and mortality. Concomitant infections of hepatitis B virus, hepatitis C virus, and tuberculosis are risks of hepatotoxicity and death due to antituberculosis therapy. Hepatitis and human immunodeficiency virus coinfection poses challenges in treating hepatotoxic patients and leads to mortality during antituberculosis treatment. Thus, this study aimed to determine the prevalence of hepatitis B virus and hepatitis C virus infections, and associated factors among human immunodeficiency virus-positive and human immunodeficiency virus-negative tuberculosis patients attending public health facilities, Northeast Ethiopia. A comparative cross-sectional study was conducted among 229 tuberculosis patients from January 1 to April 30, 2021 in public health facilities' tuberculosis treatment centers. Study participants were selected using a consecutive sampling technique. Data on sociodemographic and other risk factors were collected using an interviewer-based pretested questionnaire by trained data collectors. Anti-hepatitis C virus and hepatitis B surface antigen were determined in serum using enzyme-linked immunosorbent assay. Data were entered and analyzed using SPSS version 22. Logistic regression analysis was computed, and then variables with a p value <0.05 were considered as statistically significant. The overall hepatitis virus infection among human immunodeficiency virus-positive and human immunodeficiency virus-negative tuberculosis patients was 14.03% and 8.14%, respectively. The prevalence of hepatitis B virus infection in human immunodeficiency virus positives and human immunodeficiency virus negatives was 10.5% and 6.4% and hepatitis C virus infection in human immunodeficiency virus positives and human immunodeficiency virus negatives was 3.5% and 1.75%, respectively. Hepatitis B virus and hepatitis C virus coinfections were not observed. Older age, history of problematic alcohol use, history of blood transfusion, ear-noise piercing, and history of multiple heterosexual partners were predictors for the hepatitis virus infection. Hepatitis virus infection increases morbidity and mortality of tuberculosis patients. Therefore, screening tuberculosis patients for hepatitis virus infection is necessary to reduce the risk of antituberculosis complications.

Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study.

The objective of the study was to determine the diagnostic accuracy of Mentzer Index in children with hypochromic microcytic anemia by taking serum ferritin levels as a gold standard. This cross-sectional study was conducted in the Department of Pediatric Medicine, Liaquat National Hospital Karachi, from 1st January to 30th June 2022. Children age 1 to 5 years and both genders were included in this study. Children who have had a history of blood transfusion in the past 3 months or Thalassemia or blood disorders, chronic liver disease or kidney diseases, and children with malignancy and congenital abnormalities were excluded. Eligible children were enrolled after taking written informed consent. Complete blood count (CBC) and serum ferritin were sent to the laboratory. Sensitivity, specificity, diagnostic accuracy, and likelihood ratio were calculated taking serum ferritin levels as a gold standard. A total of 347 subjects were enrolled. The median age was 26 (IQR-18) months and 42.9% were males. The most common symptom was fatigue 40.9%. The sensitivity of the Mentzer index was 80.7% while the specificity was 77.7%. Similarly, the positive predictive value (PPV) was 56.8% while the negative predictive value (NPV) was 91.6%. Finally, the accuracy of the Mentzer index in determining iron deficiency anemia was 78.4%. Diagnostic accuracy was 78.4% and the likelihood ratio was 3.6. Mentzer index is a valuable tool in the early detection of IDA in children. It has got high sensitivity, specificity diagnostic accuracy, and likelihood ratio.

Seroprevalence of Human Papillomavirus Infection among Female Sex Workers in a Tertiary Care Hospital in Southern India

Introduction: Sexually Transmitted Infections (STIs) are generally acquired through sexual contact, and the risk is very high for Female Sex Workers (FSWs). The most common STI in FSWs is Human Papillomavirus (HPV) infection. Majority of the HPV infection is asymptomatic, while a minority of the infection is responsible for causing cervical cancer. High-Risk HPV (HR-HPV) serotypes, HPV 16 and HPV 18, are known to cause cervical cancer. Aim: To determine the seroprevalence of HPV infection among FSWs attending STD clinic at a tertiary care hospital in Southern India. Materials and Methods: This cross-sectional study was done during the period between September 2015 and August 2016 in a total of 65 FSWs in Govt. Stanley Medical College, a tertiary care hospital in Chennai, Southern India. The serum was separated after 5 mL of blood was drawn to test for the presence of HPV 16 and 18, Human Immunodeficiency Virus (HIV), and syphilis. Endocervical and vaginal swab specimens were taken to look for the presence of other STIs. Necessary socio-demographic and clinical information such as mode of sex, any sexual exposure, extramarital or premarital, protected sex or not, history of associated STIs, and any history of blood transfusion, i.v. drug abuse, or surgery was also obtained. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) 20.0 software. Probability value (p-value) &lt;0.05 was considered statistically significant. Results: Analysis of the blood samples showed that four samples were found positive for HPV infection, while two samples each were positive for HIV and syphilis. Analysis of the swab specimens showed the presence of other associated STIs in 20 samples. Among the four HPV positive samples, three were found positive for HPV 16, and one was positive for HPV 18. Risk factors such as age, marital status, HIV, and syphilis had a very strong association with HPV infection (p-value&lt;0.01). Conclusion: The prevalence of HR-HPV serotype HPV 16 was higher than HPV 18. Hence, education about STIs, safer sexual practices, and HPV vaccination are essential in this population in order to prevent the transmission of infection to the general population.

Incidence, risk factors, progression, and involution in retinopathy of prematurity at a tertiary care center in South India.

Retinopathy of prematurity (ROP) is a vasculoproliferative disorder of immature retina, seen in preterm babies. Multiple risk factors attribute to this condition. Our aim was to correlate the role of any early neonatal surgeries with low gestational age (GA) and birth weight (BW) on preterm babies as a risk factor on the progression of ROP. A prospective, cohort study conducted in a hospital in South India over 3 years, including 600 babies with GA <35 weeks and BW <2500 g. Babies were divided into Group A (ROP) and Group B (no ROP). Group A included A1 (severe ROP) and A2 (nonsevere ROP) based on early treatment of ROP classification. We compared various risk factors of ROP, specifically the association of any early neonatal surgery undergone by these babies, on progression of ROP. The Chi-square test, unpaired t-test, and one-way analysis of variance tests were used for the comparisons and considered statistically significant if P < 0.05. 28.7% babies developed ROP, with 37.6% requiring treatment (Aggressive ROP in 2.1% of babies). Low GA and BW, longer duration on ventilator, respiratory distress syndrome, apnea of prematurity, Patent Ductus Arteriosus, sepsis, anemia, thrombocytopenia, history of blood transfusion, and history of early neonatal surgery under GA were associated with babies with ROP (P < 0.005), strongly with severe ROP. The most common surgeries undergone by the babies developing ROP were inguinal herniotomy under general anesthesia. The study predicts preterm babies undergoing early surgical interventions are at risk of progressing to severe ROP, hence warranting frequent follow-ups.

Anaemia among Pregnant Women Visiting Obstetric Department of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Anaemia is one of the common health problems of pregnant women and children in developing countries. Anaemia in pregnancy is related to poor foetal and maternal outcomes contributing to significant morbidity and mortality. Anaemia is a treatable and preventable condition. The objective of this study was to find out the prevalence of anaemia in pregnant women visiting the Obstetric Department of a tertiary care centre. A descriptive cross-sectional study was conducted among the pregnant women visiting the Department of Obstetrics and Gynecology of a tertiary care centre for their antenatal checkup. The study was conducted from 2 November 2022 to 11 November 2022 after obtaining ethical approval from the Institutional Review Committee (Reference number: 11(6-11)E2/079/080). Pregnant women with a history of blood transfusion, anaemia of chronic disease like chronic kidney disease, history of recurrent bleeding, and referral cases from other centres were excluded from the study. Serum haemoglobin was used for diagnosing anaemia according to criteria given by the World Health Organization. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Among 442 pregnant women, the prevalence of anaemia was 24 (5.43%) (3.32-7.54, 95% Confidence Interval). The prevalence of anaemia among pregnant women was lower in comparison to other studies done in similar settings. anemia; maternal-child health services; prevalence.

A Prospective Study on the Prevalence of Red Cell Alloimmunization via Fetomaternal Hemorrhage and its Association with Bad Obstetric History

Background and Objectives: The presence of irregular red cell antibodies in the serum of pregnant women is named maternal alloimmunization. Sensitizing events such as traumatic delivery and miscarriage can cause fetomaternal hemorrhage, increasing the risk of alloimmunization. Our objective was to estimate the prevalence of red cell alloantibodies among multigravidae and to study its association with those cases with bad obstetric history (BOH). Methods: This was a 1-year cross-sectional study done on 900 multigravidae in the Department of Transfusion Medicine, Medical College, Thiruvananthapuram. We excluded patients with a history of blood transfusion. Results: Out of 900 subjects, 49 (5.4%) were alloimmunized. The RhD-positive cases were predominant (77.4%), while 203 (22.6%) were RhD negative. Among the D-positive women, the prevalence of alloimmunization was 1.3%. The most frequent alloantibody identified was anti-D, followed by anti-G (18.4%). The alloantibodies identified among RhD-positive were anti-E, anti-c, anti-C, anti-Fya, anti-M, anti-Jka, and anti-Leb. We identified a total of 58 clinically significant alloantibodies. Thus, Rh blood group alloantibodies constitute 93.1% and the remaining 6.9% by other blood groups. Out of 159 cases with BOH, 17 were alloimmunized, and there was a statistically significant association between them (P = 0.001). Conclusion: Alloantibodies potentially causing hemolytic disease of the fetus and newborn were found in D-negative (19.7%) and D-positive (1.3%) mothers. The clinicians should change the current practice of screening only D-negative pregnant women, and antibody screening should be offered to all females or at least those with BOH. We may thus ensure early detection and periodic monitoring of all alloimmunized women.

DETERMINATION OF THE PRA POSITIVITY PERCENTAGE IN MALE PATIENTS WITH CHRONIC KIDNEY DISEASE BY USING FLOW CYTOMETRY TECHNIQUE.

The antibodies directed against human leukocyte antigen (HLA) molecules, which play a crucial role in allograft histocompatibility, are called anti-HLA antibodies. Anti-HLA antibodies against foreign HLA molecules may be present in patients with chronic kidney disease even before transplantation. The panel reactive antibody (PRA) test is used to measure the renal transplant candidate's immune sensitivity to HLA molecules other than their own HLA molecules by assessing the diversity of anti-HLA antibodies in the blood of these patients. This study aimed to determine the PRA values and the percentage of PRA positivity of Turkish male patients with chronic kidney disease (CKD), who had not been sensitized by the major known causes (those with no history of organ or tissue transplantation, those with no history of blood transfusion), who had not been diagnosed with any autoimmune diseases, and who had not been under immunosuppressive treatment. The study included 60 male patients aged over 18 years. All of the patients were followed up with a diagnosis of CKD at the Nephrology Clinic, Internal Medicine Department, Akdeniz University Medical Faculty Hospital. None of the patients included in the study was sensitized by a known mechanism previously (they did not have blood transfusion or organ transplantation). Glomerular filtration rate (GFR) levels of all patients were below the level of 60 mL/min/1.73 m2. Patient data including their age information, etiology of CKD, accompanying diseases, and information about dialysis modalities were recorded. HLA antibody percentage was determined by the flow cytometry technique. Statistical data analysis was performed by using SPSS 22.0 (Statistical Package for Social Sciences, Version 22.0). The values of p less than 0.05 were considered statistically significant. Twenty patients were receiving dialysis treatment due to end-stage renal disease. Of the 60 patients included in the study, 25% showed PRA positivity; 28.3% of all study patients were found to be positive for anti-HLA class I antibodies and 26.7% of all study patients were found to be positive for anti-HLA class II antibodies on separate analysis for anti-HLA class I and anti-HLA class II antibody positivity. When the patients were categorized as PRA negative and PRA positive in two groups, there were no differences between the groups according to mean age, percentage of hemodialysis patients, percentage of peritoneal dialysis patients and presence of accompanying chronic diseases (such as hypertension, type 2 diabetes mellitus, hyperlipidemia, nephrolithiasis, coronary artery disease). In addition to this, evaluation of the GFR levels showed that the PRA positive group contained a significantly higher percentage of end-stage renal disease patients (GFR <15 mL/min/1.73 m2) as compared with the PRA negative group. Detailed analysis of the percentages of PRA levels in the PRA positive patients, which was carried out to determine the degree of sensitization, showed that the PRA values were over 80% in 11.77% of the patients positive for anti-HLA class I antibodies. On the other hand, PRA values were within the range of 15%-80% in 88.23% of the patients who had anti-HLA class II antibodies. The PRA values were below 80% in all of the patients positive for anti-HLA class II antibodies and those positive for both anti-HLA class I and class II antibodies. In conclusion, PRA levels of the candidates for kidney transplantation should always be measured to assess their state of sensitization before transplantation, even though they have no risk factors known to cause anti-HLA antibody development.

Comparison of vaginal, abdominal and laparoscopic hysterectomy performed in our hospital

Hysterectomy is the most common pelvic surgical operation and is often performed for benign reasons. We aimed to compare clinical total abdominal hysterectomy (TAH), total laparoscopic hysterectomy (TLH), and vaginal hysterectomy (VH) in benign gynecological conditions. Patients' age, operation duration (min), length of stay in the hospital (days), Preop Hb (g/dL), Postop Hb (g/dL) values, complications according to the performed surgical procedures were analyzed. Determining which procedure will be the most appropriate option for which patient is the most important factor in preventing complications. it was observed that the patients' ages were significantly higher in the VH group (H=71.721; p=0.000), the operation duration was significantly shorter in the TAH group (H=125.689; p=0.000), and the length of hospital stay was significantly shorter in the TLH group (H=71.492; p=0.000). Preoperative and postoperative hemoglobin values were significantly higher in the VH group (H=57.222; p=0.000, H=52.824; p=0.000). It was determined that the complication rate was lower in the TAH group. The type of surgical procedure was found to not have a statistically significant effect on transfusion requirement (χ2=4.852; p&gt;0.05) and history of previous surgery (χ2=0.115; p&gt;0.05). The surgical approach of hysterectomy plays a significant role in postoperative morbidity. Determining which procedure will be the most appropriate option for which patient is the most important factor in preventing complications.

Machine learning predicts cancer-associated venous thromboembolism using clinically available variables in gastric cancer patients

Stomach cancer (GC) has one of the highest rates of thrombosis among cancers and can lead to considerable morbidity, mortality, and additional costs. However, to date, there is no suitable venous thromboembolism (VTE) prediction model for gastric cancer patients to predict risk. Therefore, there is an urgent need to establish a clinical prediction model for VTE in gastric cancer patients. We collected data on 3092 patients between January 1, 2018 and December 31, 2021. And after feature selection, 11 variables are reserved as predictors to build the model. Five machine learning (ML) algorithms are used to build different VTE predictive models. The accuracy, sensitivity, specificity, and AUC of these five models were compared with traditional logistic regression (LR) to recommend the best VTE prediction model. RF and XGB models have selected the essential characters in the model: Clinical stage, Blood Transfusion History, D-Dimer, AGE, and FDP. The model has an AUC of 0.825, an accuracy of 0.799, a sensitivity of 0.710, and a specificity of 0.802 in the validation set. The model has good performance and high application value in clinical practice, and can identify high-risk groups of gastric cancer patients and prevent venous thromboembolism.

Molecular detection of human parvovirus B19 DNA amongst pregnant women attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria

Background: Parvovirus B19 infection causes a wide range of complication in pregnant women including spontaneous abortion, severe fetal anaemia, non-immune hydrops fetalis and even intrauterine fetal death, erythema infectiosum (5th) disease and aplastic crisis. Objective: To perform molecular detection of human Parvovirus B19 among pregnant women attending antenatal clinic in Nnamdi Azikiwe Teaching Hospital Nnewi, Anambra State, Nigeria. Materials and Methods: This is a cross-sectional study conducted among 92 consented pregnant women, between the ages of 20-40 years who are attending antenatal clinic in Nnamdi Azikiwe University Teaching Hospital Anambra State, Nigeria, from May 2020-November 2020. A total of 92 blood specimen was collected from the pregnant women. Result: Out of the 20 IgM positive samples analyzed for Parvovirus B19 DNA, 13(65.0%) had Parvovirus B19 DNA and 7(35.0%) were negative for Parvovirus B19 DNA. Prevalence of Parvovirus B19 DNA in relation to gestational age was highest (69.2%) among pregnant women who were in their 2nd trimester and the prevalence was lowest (0.0%) among pregnant women who were in their 3rd trimester. Prevalence of Parvovirus B19 in relation to history of blood transfusion was highest (100.0%) among pregnant women who have had transfusion history and the prevalence was lowest (0.0%) among pregnant women who had no transfusion history. Conclusion: The frequency rate of Parvovirus B19 DNA seropostivity was highest (65.0%) among the pregnant women investigated. The association of Parvovirus B19 DNA seroposivity with gestation age and history of blood transfusion was statistically significant.

Hepatitis C Seroconversion Remains High among Patients with Regular Hemodialysis: Study of Associated Risk Factors.

An analytical cross-sectional study involving patients from 2 dialysis units (1 referral hospital and 1 private dialysis unit) in Denpasar, Bali, Indonesia, from January 2020 to December 2021. We evaluated age, gender, duration of hemodialysis, vascular access, history of transfusion, history of surgery, diabetes mellitus, hepatitis B, human immunodeficiency virus (HIV) infection, and type of dialyzer as possible risk factors of hepatitis C seroconversion among hemodialysis patients. A total of 338 hemodialysis patients were enrolled in this study. We found hepatitis C seroconversion in 94 patients (27.8%), all of which occurred after regular dialysis was started. Vascular access type (OR 42.07, 95% CI 5.757-307.472) and dialyzer reuse (OR 8.324, 95% CI 4.319-16.044) were showing a statistically significant association with hepatitis C seroconversion. A separate analysis on each dialysis unit found common evidence that the duration of dialysis was significantly associated with hepatitis C infection among hemodialysis patients. Hepatitis C seroconversion among dialysis patients remains high. Factors related to the dialysis procedure itself played a major role in transmitting the virus.

Trends of Erythrocyte Alloimmunization in Transfused Women

Objective: To identify the trends of red cell alloimmunization in multi-transfused females using red blood cell panels.Study design: Cross-sectional study.&#x0D; Place and Duration of Study: Army Medical College and Armed Forces Institute of Transfusion with the collaboration of Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Aug 2018.&#x0D; Methodology: Blood samples of 75 females with prior history of blood transfusion were collected from Pak Emirates Military Hospital, Rawalpindi Pakistan, selected by a non-probability consecutive sampling technique. After pilot diagnostic tests for ABO and Rh D blood grouping, samples were screened by three cell panels to identify the presence of RBCs alloimmunization. Positive results were further recognized by 11 cell panels.&#x0D; Results: Seventy-five women with a history of at least one blood transfusion were selected for the screening of red cell alloimmunization. The frequency of alloantibodies in transfused women was 1(1.3%). The only alloantibody identified was anti-e, which was a rare alloantibody.&#x0D; Conclusion: Study confirmed that Rh alloantibodies are the most prevalent antibodies, regardless of age, ABO blood grouping, Rh grouping and ethnicity. Our study also confirmed that multiple transfusions are associated with the development of red cell alloimmunization.

Human parvovirus B19 infection in hospitalized patients suspected of infection with pathogenic microorganism.

Human parvovirus B19 (HPV B19) is a single-stranded DNA virus. The detection rate of HPV B19 in the blood of healthy blood donors using PCR technology was reported to be 6.323/100000. However, that among hospitalized patients suspected of being infected with a pathogenic microorganism is unknown. A retrospective analysis was conducted on 2,182 high-throughput NGS results for 1,484 inpatients admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to October 2021 who were suspected of being infected with a pathogenic microorganism, as well as on clinical data of some HPV B19-positive patients. Human parvovirus B19 was detected in 39 samples from 33 patients. The positivity rate was 2.22% among patients and 1.78% among samples. HPV B19 was detected in 20 cerebrospinal fluid samples, 13 blood samples, 3 alveolar lavage fluid samples, 2 tissue samples, and 1 throat swab. Based on clinical symptoms and NGS results, 16 patients were diagnosed with HPV B19 infection. The number of HPV B19 sequences in these patients was greater than 6, and the patients showed common symptoms such as fever (14 cases), anemia (11 cases), and severe nervous system symptoms such as meningoencephalitis (9 cases) and Guillain-Barré syndrome with peripheral motor and sensory nerve axon damage (4 cases). All 16 patients had experienced events likely to lead to decreased immunity (11 had a history of trauma/surgery/major disease, 4 had a history of precursor infection, and 3 had used immunosuppressants) and 7 had a history of blood transfusion during hospitalization. After treatment with antiviral drugs (12 cases) and intravenous human immunoglobulin (3 cases), of the 16 patients, 14 patients improved. The HPV B19 infection rate in hospitalized patients suspected of microbial infection was 2.22%. Most patients with HPV B19 infection had a history of low immunity and blood transfusion. HPV B19 could be detected in various bodily fluids and tissues (especially cerebrospinal fluid) using NGS. Patients with severe HPV B19 infection may have nervous system damage such as Guillain-Barré syndrome and meningoencephalitis. Early diagnosis using NGS and treatment with antiviral drugs and immunoglobulin can improve prognosis.

45 ROLE OF GALECTINE-3 AND ST-2 IN THE CHARACTERIZATION OF MYOCARDIAL INVOLVEMENT IN PATIENTS WITH TRANSFUSION DEPENDENT BETA THALASSEMIA

Abstract Rationale and Aim of the Study Cardiac involvement is very common in transfusion dependent beta-thalassemia (TDT) and is mainly related to cardiac iron overload and myocardial damage with progressive systolic and diastolic dysfunction of the left and right ventricles. It has also been observed that in patients with TDT, cardiac fibrosis may not be directly related with iron deposition and is associated with a higher risk of cardiovascular complications. CMR is the gold standard for the evaluation of iron overload with T2* sequences and for the detection of cardiac fibrosis with late gadolinium enhancement (LGE) Apart from the use of imaging techniques, it is well known that the fibrosis and inflammation biomarkers, Galectin-3 (Gal-3) and ST2, are involved in the early stages and progression of various fibrosis-related diseases, such as heart failure, liver cirrhosis, renal and pulmonary fibrosis. To date, the role of Gal-3 and ST-2 as markers of cardiac fibrosis and myocardial damage and their possible association with myocardial damage detected by CMR, has never been studied in patients with TDT. The aim of the study was to evaluate the role of Gal-3 and ST-2 in the characterization of myocardial involvement, especially cardiac fibrosis in a population of TDT patients. Methods Twenty-six patients with a confirmed diagnosis of TDT, based on βglobin genotype, transfusion history and clinical evaluation, undergoing periodic blood transfusion and iron-chelation therapy were enrolled. None presented overt clinical signs of heart failure, CMR with T2* technique, haematochemical routine, ferritinemia assay, Gal-3 and ST-2 assay and dynamic ECG Holter were performed on all patients. Results Both Gal-3 and ST-2 have a positive correlation with systemic markers of inflammation, such as erythrocyte sedimentation rate (ESR) (10 0.65 p 0.042 and 26 0.58 p 0.002, respectively). A Gal-3 value &amp;gt; 17.9 ng/mL is associated with inflammatory comorbidities such as diabetes (p 0.010) and with cardiac iron overload evaluated using CMR T2 * technique (p 0.007) (Fig.1). A positive correlation was also observed with medium values of ferritine (rho 0.46 p 0.017). There was a statistically significant positive association between an ST-2 value &amp;gt; 35 ng/mL and cardiac fibrosis detected by CMR (p 0.020) (Fig. 2). Higher ST-2 values have been detected in patients with cardiac fibrosis when compared to those without (42 ± 14 vs 28 ±8 p 0.006). Conclusions The present study demonstrates that, in a small population of TDT patients undergoing periodic blood transfusion and iron-chelation therapy with no overt clinical signs of heart failure, Gal-3 appears to be a marker of cardiac iron overload detected with CMR T2* sequences and systemic inflammation associated with higher ESR values and inflammatory comorbidities such as diabetes mellitus. ST-2 is a marker of cardiac fibrosis detected by CMR LGE.

Posterior reversible encephalopathy syndrome (PRES): A case report

Patients with preeclampsia or eclampsia may be associated with hypertension, seizures and other neurologic symptoms and deficits. A young female patient presented with a neurological and visual disturbance which included variable symptoms like visual disturbances, headache, seizures and altered consciousness or mental status with a history of postpartum eclampsia after an uneventful LUCS. She also gave a history of a two-bag blood transfusion one month ago. A neurological and ophthalmic evaluation was performed. Detailed history taking and clinical evaluation followed by an imaging study, potentially magnetic resonance imaging (MRI), helped to confirm the diagnosis of Posterior reversible encephalopathy syndrome (PRES). PRES is a clinico-neuroradiological disorder of neurotoxicity that typically involves headache, mental confusion, seizures, and occasionally loss of vision. The exact pathophysiology of PRES is still unclear and has not been thoroughly explained. Hypertension and endothelial cell injury may be pathognomic. Prompt management may help to recover early.

Evaluating patients with autoimmune hemolytic anemia in the transfusion service and immunohematology reference laboratory: pretransfusion testing challenges and best transfusion-management strategies

The serologic evaluation of autoimmune hemolytic anemia (AIHA) confirms the clinical diagnosis, helps distinguish the type of AIHA, and identifies whether any underlying alloantibodies are present that might complicate the selection of the safest blood for any needed transfusion. The spectrum of testing is generally dependent on the amount and class (immunoglobulin G or M) of autoantibody as well as the resources and methodologies where testing is performed. The approach may range from routine pretransfusion testing, including the direct antiglobulin test, to advanced techniques such as adsorptions, elution, and red cell genotyping. When transfusion is needed, the selection of the optimal unit of red blood cells is based on urgency and whether time allows for the completion of sophisticated serologic and molecular testing methods. From the start of when AIHA is suspected until the completion of testing, communication among the clinical team and medical laboratory scientists in the transfusion service and immunohematology reference laboratory is critical as testing can take several hours and the need for transfusion may be urgent. The frequent exchange of information including the patient's transfusion history and clinical status, the progress of testing, and any available results is invaluable for timely diagnosis, ongoing management of the patient, and the safety of transfusion if required before testing is complete.

Sutimlimab provides clinically meaningful improvements in patient-reported outcomes in patients with cold agglutinin disease: Results from the randomised, placebo-controlled, Phase 3 CADENZA study.

Cold agglutinin disease (CAD) is a rare chronic autoimmune haemolytic anaemia, driven mainly by classical complement pathway activation, leading to profound fatigue and poor quality of life. In the Phase 3 CADENZA trial, sutimlimab-a C1s complement inhibitor-rapidly halted haemolysis, increased haemoglobin levels and improved fatigue versus placebo in patients with CAD without a recent history of transfusion. Patient-reported outcomes (PROs) included Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), 12-Item Short Form Health Survey (SF-12), EuroQol visual analogue scale (EQ-VAS), Patient Global Impression of Change (PGIC) and Patient Global Impression of (fatigue) Severity (PGIS). Sutimlimab resulted in significant rapid and meaningful improvements versus placebo in PROs. From Week 1, the FACIT-Fatigue mean score increased >5 points above baseline (considered a clinically important change [CIC]). Least-squares (LS) mean change in FACIT-Fatigue score from baseline to treatment assessment timepoint was 10.8 vs. 1.9 points (sutimlimab vs. placebo; p< 0.001). Improvements in physical (PCS) and mental (MCS) component scores of the SF-12 were also considered CICs (LS mean changes from baseline to Week 26: PCS 5.54 vs. 1.57 [p= 0.064]; MCS 5.65 vs. -0.48 [p= 0.065]). These findings demonstrate that in addition to improving haematologic parameters, sutimlimab treatment demonstrates significant patient-reported benefits. Study registered at www.clinicaltrials.gov: NCT03347422.

Seroprevalence of Cytomegalovirus infection among pregnant women in some selected hospitals in Lokoja Metropolis, Kogi State, Nigeria

Cytomegalovirus is one of the most common viruses which causes congenital defects in babies from infected mothers. Sensoneural hearing loss (SNHL) and neurodevelopmental delay are typical occurrences in childhood resulting from congenital defects which presents no symptoms at birth. The aim of this study was to determine the cytomegalovirus IgM infection among pregnant women attending antenatal clinics at KSSH and FMC in Lokoja metropolis, Kogi State, Nigeria. A total of 184 serum samples were collected and analyzed using CMV IgM ELISA kit diagnostic Automation, INC (USA). The study revealed that out of the 184 samples collected, 40 turned out positive for CMV IgM antibodies giving a prevalence of 21.7% while the negative sample result had a prevalence of 78.3%. a total of 92 samples each was collected from both hospitals; KSSH had 30 CMV IgM positive samples having a percentage 32.6% and FMC with 10 CMV IgM having a percentage of 10.86%. Based on the research, there was no significant association between the risk factors such as marital status, type of marriage, occupation and scarification related to the infection. This could be due to the limited number in sample size. Other socio-economic factors that had statistical significant p value with the infection were education (0.035), hand wash (0.027) and previous history of blood transfusion (0.003). The study has shown the need for sensitization of the populace especially to pregnant women, the need for constant and proper personal hygienic practices be done to reduce the risk of infection and possibly stop its transmission to fetus. In addition, inclusion of screening for cytomegalovirus antibodies among blood donors may be useful tool in preventing transmission of cytomegalovirus to blood recipients.

Clinical Study on the Distribution Frequency of Anti-Mur in Southern Fujian Area and Its Cause of Hemolytic Disease of the Newborn

To investigate the distribution frequency of anti-Mur and the characteristics of hemolytic disease of the newborn by anti-Mur in this region, and to provide basis for guiding clinical safe blood transfusion. Anti-Mur detected in blood preparation or transfusion cases from November 2020 to December 2021 in our hospital were retrospectively analyzed, the laboratory test data and relevant clinical data of the patients were statistically analyzed. Among 39 069 cases of blood preparation or transfusion, 345 cases of irregular antibody were detected, including 23 cases of anti-Mur, 7 cases of male, and 4 cases of blood transfusion history. Among the 16 women, 9 had history of only pregnancy, 2 had history of only blood transfusion, and 5 had history of both blood transfusion and pregnancy. The median age of anti-Mur patients was 59(19-78) years old, which was higher than the median age of other positive patients in the same period, 45(1 day-93 year) years old (P<0.05), but there was no significant difference in gender between groups (P＞0.05). A child with hyperbilirubinemia was diagnosed with hemolytic disease of the newborn by anti-Mur after detection of anti-Mur in erythrocyte elution liquid and maternal serum. Anti-Mur has important clinical significance in Southern Fujian area, and its generation is closely related to the history of immunization. The age of anti-Mur detected is higher than that of other positive patients. Hemolytic disease of the newborn caused by anti-Mur has severe anemia symptoms and is easy to miss detection, which should be paid more attention to.