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December 2013
Volume 4 | Issue 2
Page Nos. 5-35
Online since Wednesday, December 27, 2017
Accessed 8,415 times.
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| EDITORIAL |
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Contemporary Issues in Postgraduate Medical Education in Nigeria: A Trainees' Perspective |
p. 5 |
| Blessing Odia, Omolade Adegoke |
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| ORIGINAL ARTICLES |
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Incidence of Acute Haemolytic Transfusion Reaction in ABO Group-Compatible Compared with Group-Identical Blood Recipients in Ilorin, Ni!!geria |
p. 7 |
Background: Acute haemolytic transfusion reaction (AHTR) is a rare but fatal complication of blood transfusions especially in developing countries.
Objectives: To determine the relative frequencies of group-compatible and groupidentical blood transfusions and to compare the incidences of acute haemolytic transfusion reactions in the two types.
Methods: A prospective study of 140 patients above 15 years who received one unit of either group-compatible or group-identical blood for correction of anemia was carried out. Five ml of pre- and post-transfusion blood samples were collected from every patient and analyzed for evidence of hemolysis by estimating: PCV, intravascular agglutinates, plasma hemoglobin and total bilirubin concentrations, Direct Coombs' test (DCT) and visual plasma inspection.
Results: All subjects had 1 unit of either group-compatible (42.9%) or group-identical (57.1%) blood transfusions each. None of the patients suffered AHTR, as none of the samples was positive for DCT. Group-identical transfusions however, were associated with higher increments in PCV (xx% vs. xx%; p=).
Conclusion: Group-identical transfusion was associated with a higher increament in PCV than group compatible one, but the latter can still be practiced in developing countries where there is no availability of blood of all groups. |
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Impact of seasonal agriculture on blood donations in Kano, Northwest Nigeria and its implications on health care |
p. 15 |
| Sagir G Ahmed
Background: Blood donation is generally inadequate in Nigeria. Kano state is the most populous state in northern Nigeria where agriculture is a major occupation. Hence, we hypothesized that blood donations would be lower during rainy season as eligible donors become more engrossed in farming activities that distract them from blood donation.
Materials and Methods: Accordingly, we retrospectively studied the amount of blood donations at Aminu Kano Teaching Hospital in Kano, northern Nigeria (2009 to 2012).
Results: Data analysis using Chi square test revealed significantly lower mean number of monthly donations during rainy seasons (Mean + SD: 587.2+15) in comparison to dry seasons (Mean + SD: 693.4+18), p<0.05.
Conclusion: There is therefore the need to offset this seasonal shortfall in blood donations, and its potentially adverse implications on health care, by intensifying community enlightenment in order to boost blood donations during the rainy season.
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Evaluation of request forms submitted to Haematology Laboratory in a Rural Tertiary Hospital in South-South Nigeria |
p. 21 |
| OD Ikponmwen, DO Olanrewaju, EM Isoa, OS Otumu, AO Ehizogie, FE Okogun
Objective: To evaluate the level of completeness of information on laboratory request forms at Irrua Specialist Teaching Hospital, Irrua.
Method: 4,500 laboratory request forms sent to the haematology department of Irrua Specialist Teaching Hospital, Irrua, within 7 months period were analyzed for specific parameters. The information provided on each request form was recorded in a spreadsheet and analyzed.
Results: Information mostly omitted were patients' age (58.02%), physician's name and signature 67.80% each of the request forms sampled. Complete documentation was observed in patients' names and investigation requested. Accurate recording of ward/clinic of patients was observed on 90.23% of the forms analyzed with hospital number, clinical details and consultant name appearing on 79.45%, 79.01% and 93.52% respectively. The date was observed in about 93.74% of the request forms audited and 80.66% showed eligible handwriting.
Conclusion: This study showed that the pattern of completing request forms was poor. Vital information needed on the forms was missing. Inadequate information on laboratory request forms can lead to misinterpretation of laboratory results which inturn lead to misdiagnosis of patient's disease condition. Emphasis on the importance of adequate and completeness of data on laboratory request test form is strongly supported and periodic orientation should be given to the physician especially the newly inducted doctors by the laboratory personnel.
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Prevalence of Hepatitis B surface Antigen (HBsAg) seropositivity in sickle cell anaemia patients in Benin City, Mid-Western Nigeria |
p. 25 |
| EC Okocha, OA Ejele, CC Ibeh, JC Aneke
Background: Conditions that may require regular blood transfusion are particularly prone to acquiring transfusion transmissible infections.
Objective: To determine the prevalence of HBsAg seropositivity among sickle cell anaemia (SCA) patients.
Subjects and Methods: Ninety-six (SCA) patients age range 1–69 years, and 92 age-matched controls were screened for exposure to Hepatitis B virus (HBV) using, solid base wet ELISA test kits (Monolisa® from Sanofi diagnostics). All the participants were further stratified into those with a prior history of transfusion and those without, the prevalence of HBsAg was compared in the two groups.
Results: The prevalence rate of HBsAg was 29.2% in SCA patients, while it was 27.2% in the controls. The difference was not statistically significant (P>0.05). The overall risk of HBV infection in SCA patients was not clearly increased by blood transfusion, even though the Relative risk (1.4%), compared to that of the control population (1.2%) and Attributable risk (8.4%), compared to that of the control population (6.6%) were increased.
Conclusion: Transmission of hepatitis B virus infection from blood transfusion does not appear to contribute significantly to the high prevalence of seropositivity in our population of SCA patients. Universal vaccination of these subjects against hepatitis B virus is advocated as a way to possibly reduce this prevalence.
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| CASE REPORT |
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Non secretory multiple myeloma in a Nigerian: A case report |
p. 30 |
| Okocha E Chide, Odenigbo U Charles, Aneke C John
Non secretory multiple myeloma is a rare variant of multiple myeloma characterized by the absence of paraproteins in the serum/or urine. It may present a diagnostic challenge, hence the need for a high index of suspicion while excluding multiple myeloma as a cause of bone pain and lytic lesions. The objective of this study was to report a case of non secretory myeloma, which has not been previously reported in a Nigerian. A 55year old female teacher presented with a 2 month history of painful swelling on the sternum, with no antecedent trauma. Bone marrow aspiration cytology and skeletal surveys revealed plasmacytosis and multiple osteolytic lesions, respectively. Urinary and serum paraproteins were not detected; neither was Cyclin D1 over expression. She was managed as a case of non secretory multiple myeloma with good response to therapy.
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