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- ItemOpen AccessA Survey of Knowledge and Practices of Transfusion Medicine among Medical Doctors in Private Practice in Ibadan, Nigeria(Journal of Biomedical Research & Clinaical Practice, 2021) Ogbenna A.A; Salami I.O; Adewoyin A.S; Ajetunmobi I.AComprehensive knowledge of blood transfusion practices among clinicians has an important role in provision of safe blood but continuous education and the academic rigor is not as versatile in private sector as in tertiary hospitals. The objective of this study is to evaluate the knowledge of clinicians in private practice in Ibadan on transfusion medicine. Eighty-one medical doctors from the 5 urban local government areas were enlisted in a multistage sampling technique. Self-administered questionnaires were employed and data analyzed using SPSS. Majority of clinicians were between the ages of 30-40 years (43.2%), had practiced for 0-5 years (42.0%) and prescribed blood transfusion at least once a month (44.4%). Male: female ratio was 4:1. The proportion of correct answers to the questions about age, minimum weight, Systolic Blood Pressure and Diastolic Blood pressure as criteria for selection of blood donor were as; 56.8%, 72.8 %, 71.6% and 81.5%, respectively. The proportion of correct answers to the questions on contraindications for the transfusion of platelet and cryoprecipitate were as; 54.3% and 9.9 %, respectively. The overall Knowledge score ranged from 22.0% to 93.0% (Mean= 49.0%; SD=37.7%). The mean knowledge score of indications and contraindications for transfusion of blood components are 79.2% and 34.2%, respectively. The study demonstrated significant gaps in knowledge of transfusion medicine. This can be closed by a more deliberate review of medical curricula, continuous medical education by professional groups and relevant stakeholders, as well as, a state-wide clinical audit of transfusion services
- ItemOpen AccessAnti-Inflammatory properties of the fruit of allanblanckia floribunda oliv. (Guttiferae)(Botany Research International, 2009) Ayoola, GA.; Akpanika, GA.; Awobajo, FO.; Sofidiya, MO.; Osunkalu, VO.; Coker, HAB.; Odugbemi, TO.The present study aims to investigate the anti-inflammatory properties of the fruits of Allanblackia floribunda Oliv. [Guttiferae]. The fruits are traditionally used in the treatment of anti-inflammatory conditions. The methanolic extracts of the fruits (100-400 mg/kg, p.o) inhibited carrageenan induced paw oedema in rats in a dose dependent manner. At 400 mg/kg A. floribunda(AF) produced an inhibition of 76.9% compared to 64.3% for indomethacin (10 mg/kg). Acetylsalicylic acid(100 mg/kg - ASA) did not show significant activity in the inhibition of the neurogenic phase, butwas more active thanA. floribunda in the inhibition of the inflammatory phase of formalin-induce pain.A. floribunda was not active as an anti-inflammatory agent up to 2 h in the histamine-induced rat paw oedema but a significant reduction in paw size was observed after 2 h. This suggests that AF was more active in the later phase of the inflammatory process. AF also reduced hot plate latency in a dose dependent manner. Hot plate latency of 26.8 s was recorded for AF at 400 mg/kg compared to 18.12 s for normal saline and 30.6 s for ASA. LD,, value was determined in Swiss albino mice as 20 g/kg and so can be regarded as relatively safe.
- ItemOpen AccessAntioxidant supplementation for sickle cell disease (Protocol)(Cochrane Database of Systematic Reviews, 2020) Bolarinwa, A.B; Oduwole, O; Okebe, J; Ogbenna, A.A; Otokiti, O.E; Olatinwo, A.TObjectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of antioxidant supplementation for improving health outcomes in people with SCD.
- ItemOpen AccessAssessment of MTR Rs1805087 SNP as Possible Modifier of Sickle Cell Disease Severity in a Nigerian Population(West African Journal of Medicine, 2022) Osunkalu V.O; Ogbenna A.A; Davies N.O; Olowoselu F.O; Aiyelokun O.E; Akinsola O.J; Taiwo I.AABSTRACT BACKGROUND: Sickle cell disease is the commonest genetic disorder in Nigeria, affecting 2–3% of an estimated population of 160 million people. The role of genetic mutations in folate cycle genes, and the variable phenotypic expressions constituting disease severity, needs to be critically examined. OBJECTIVE: This study was carried out to establish the pattern of methionine synthase gene mutations (rs1805087 SNP), and its possible association with disease severity in adults with sickle cell anaemia in Lagos, Nigeria. METHODOLOGY: This is a cross-sectional study of seventy (70) subjects with sickle cell disease (HbSS) matched for age and gender with known apparently healthy haemoglobin genotype AA (HbAA) subjects, as cases and controls respectively. Structured questionnaires were used to obtain demographic, clinical and other phenotypic data needed to compute disease severity. Pattern of MTR A2756G gene mutation and homocysteine assay (Hcy) were assessed by Polymerase Chain Reaction and Enzyme- linked Immunosorbent Assay respectively. Full blood count analysis of participants was done using the KX-21 Automated Analyzer (Sysmex Corporation, Japan). RESULTS: The mutant genotypes MTR 2756 AG/GG were recorded in 46.4% (n =55) of subjects with disease severity score >7. Elevated plasma homocysteine (HHcy) was significantly associated with disease severity among HbSS subjects (OR=17.2, CI: 3.490-86.079; p=0.0001). Conversely, no significant association was observed with the mutant genotypes MTR 2756 AG/GG and disease severity (p>0.05). CONCLUSION: While HHcy is significantly associated with phenotypic expression of HbSS, the MTR 2756 SNPs did not appear to independently influence homocysteine level or disease severity in HbSS subjects.
- ItemOpen AccessAssociation of alpha-thalassemia and Glucose-6-Phosphate Dehydrogenase deficiency with transcranial Doppler ultrasonography in Nigerian children with sickle cell anemia(Wiley Periodicals, LLC, 2021) Ojewunmi, OO; Adeyemo, TA; Oyetunji, AI; Benn, Y; EKPO, MG; Iwalokun, BABackground: Stroke is a devastating complication of sickle cell anemia (SCA) and can be predicted through abnormally high cerebral blood flow velocity using transcranial Doppler Ultrasonography (TCD). The evidence on the role of alpha-thalassemia and glucose-6-phosphate dehydrogenase (G6PD) deficiency in the development of stroke in children with SCA is conflicting. Thus, this study investigated the association of alpha-thalassemia and G6PD(A−) variant with abnormal TCD velocities among Nigerian children with SCA. Methods: One hundred and forty-one children with SCA were recruited: 72 children presented with normal TCD (defined as the time-averaged mean of the maximum velocity: < 170 cm/s) and 69 children with abnormal TCD (TAMMV ≥ 200 cm/s). Alpha-thalassemia (the α-3.7 globin gene deletion) was determined by multiplex gap-PCR, while G6PD polymorphisms (202G > A and 376A > G) were genotyped using restriction fragment length polymorphism—polymerase chain reaction. Results: The frequency of α-thalassemia trait in the children with normal TCD was higher than those with abnormal TCD: 38/72 (52.8%) [α-/α α: 41.7%, α -/α -:11.1%] versus 21/69 (30.4%) [α-/α α: 27.5%, α -/α -:2.9%], and the odds of abnormal TCD were reduced in the presence of the α-thalassemia trait [Odds Ratio: 0.39, 95% confidence interval: 0.20–0.78, p = 0.007]. However, the frequencies of G6PDA− variant in children with abnormal and normal TCD were similar (11.6% vs. 15.3%, p = 0.522). Conclusion: Our study reveals the protective role of α-thalassemia against the risk of abnormal TCD in Nigerian children with SCA.
- ItemOpen AccessAsymptomatic malaria infection among children with Sickle Cell Anaemia: The role of IL-10 and possible predisposing factors(PAMJ, 2020) Oyetunji, AI; Amoo, AJ; Adeyemo, TA; Ojewunmi, OOIntroduction: malaria is a major contributor to morbidity and mortality of under five children with Sickle cell anaemia (SCA) in malaria endemic regions. Asymptomatic malaria infection carriers constitute a reservoir for malaria transmission which could be detrimental in patients with SCA despite the use of malaria chemoprophylaxis. This study, therefore, determined the prevalence of asymptomatic malaria, levels of IL-10 and association between asymptomatic malaria infection, possible predisposing factors and levels of IL-10 in children living with Sickle cell anaemia. Methods: a case-control study was conducted involving children aged 2-16 years; 60 children with SCA in steady state and 40 control subjects with HbAA. Blood samples were collected by veni-puncture and asymptomatic malaria infection was detected using Rapid diagnostic test (RDT), Giemsa-stained thin and thick blood films and nested Polymerase Chain Reaction (PCR) technique. Serum IL-10 levels were determined using ELISA method. Results: among patients with SCA, two samples (3.3%) were positive for RDT, three samples (5%) were positive for microscopy, and four samples (6.7%) were positive for nested PCR technique. None of the patients in the control group was positive for Plasmodium falciparum detection using the three diagnostic methods. The mean ± (SD) of IL-10 levels in SCA patients with asymptomatic malaria (9.14(1.08)pg/ml) was significantly higher than those without asymptomatic malaria (4.8(2.62) pg/ml) (P<0.0001). Conclusion: this study demonstrated accurate diagnosis of asymptomatic malaria infection using PCR-based technique. We established that asymptomatic malaria is present in steady state SCA children and is associated with elevated IL-10 levels.
- ItemOpen AccessAn audit of request forms submitted in a multidisciplinary diagnostic center in Lagos(PanAfrican Medical Journal, 2015) Oyedeji, O.A; Ogbenna, A.A; Iwuala, S.OIntroduction: Request forms are important means of communication between physicians and diagnostic service providers. Pre-analytical errors account for over two thirds of errors encountered in diagnostic service provision. The importance of adequate completion of request forms is usually underestimated by physicians which may result in medical errors or delay in instituting appropriate treatment. The aim of this study was to audit the level of completion of request forms presented at a multidisciplinary diagnostic center. Methods: A review of all requests forms for investigations which included radiologic, laboratory and cardiac investigations received between July and December 2011 was performed to assess their level of completeness. The data was entered into a spreadsheet and analyzed. Results: Only 1.3% of the 7,841 request forms reviewed were fully completed. Patient's names, the referring physician's name and gender were the most completed information on the forms evaluated with 99.0%, 99.0% and 90.3% completion respectively. Patient's age was provided in 68.0%, request date in 88.2%, and clinical notes/ diagnosis in 65.9% of the requests. Patient's full address was provided in only 5.6% of requests evaluated. Conclusion: This study shows that investigation request forms are inadequately filled by physicians in our environment. Continuous medical education of physicians on the need for adequate completion of request forms is needed.
- ItemOpen AccessAn audit of request forms submitted in a multidisciplinary diagnostic center in Lagos(Pan African medical journal, 2015-04-29) Oyedeji, O.A.; Ogbenna, A.A.; Iwuala, S.O.Introduction: Request forms are important means of communication between physicians and diagnostic service providers. Pre-analytical errors account for over two thirds of errors encountered in diagnostic service provision. The importance of adequate completion of request forms is usually underestimated by physicians which may result in medical errors or delay in instituting appropriate treatment. The aim of this study was to audit the level of completion of request forms presented at a multidisciplinary diagnostic center. Methods: A review of all requests forms for investigations which included radiologic, laboratory and cardiac investigations received between July and December 2011 was performed to assess their level of completeness. The data was entered into a spreadsheet and analyzed. Results: Only 1.3% of the 7,841 request forms reviewed were fully completed. Patient's names, the referring physician's name and gender were the most completed information on the forms evaluated with 99.0%, 99.0% and 90.3% completion respectively. Patient's age was provided in 68.0%, request date in 88.2%, and clinical notes/ diagnosis in 65.9% of the requests. Patient's full address was provided in only 5.6% of requests evaluated. Conclusion: This study shows that investigation request forms are inadequately filled by physicians in our environment. Continuous medical education of physicians on the need for adequate completion of request forms is needed.
- ItemOpen AccessBlood Coagulation Normalization Effect of Parkia Biglobosa Seed on Potassium Bromate-induced Coagulopathy(West African Journal of Medicine, 2023) Ugwu N.I; Uche C.I; Ogbenna A.A; Okite U.P; Chkezie K; Ejikem P.I; Ugwu C.N; Otuka O.A.I; Ezirim E.O; Onyekachi O.I.N; Nwobodo M.U; Abali I.O; Iwuoha C.E; Airaodion A.IABSTRACT BACKGROUND: Potassium bromate (KBrO3) has been reported to be toxic, adversely affecting many body tissues and organs. The aim of this study was to determine the blood coagulation effect of Parkia biglobosa (P. biglobosa) seed on potassium bromate induced coagulopathy. METHODOLOGY: P. biglobosa was extracted with soxhlet extractor with ethanol as the solvent. Twenty-four adult male Wistar rats were acclimatized under laboratory conditions and were randomly grouped into A, B, C and D. Group A was given distilled water orally. Animals in groups B, C and D were administered 100 mg/kg body weight of potassium bromate, but groups C and D were also treated with 100 and 200 mg/kg body weight of P. biglobosa respectively. Both potassium bromate and P. biglobosa were freshly prepared on daily basis and administered to rats by oral gavage for 28 days. At the end of the treatment period, blood samples were collected in sodium citrate bottles and were used for analysis of Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), fibrinogen and vitamin K levels using standard methods. RESULTS: Administration of potassium bromate increased Prothrombin Time (PT) from 11.67±2.15 seconds (in control animals) to 19.53±2.83 seconds. Treatment with 100 and 200 mg/kg body weight of P. biglobosa seed extract neutralized this effect in a dose-dependent manner. Likewise, KBrO3 was observed to have significantly elevated Activated Partial Thromboplastin Time (APTT) from 29.67±3.93 to 41.10±4.79 seconds and Thrombin Time (TT) from 15.36±2.06 to 25.43±2.83 seconds when compared with those in the control group. The result further showed that exposure of animals to KBrO3 significantly declined the levels of fibrinogen (from 4.05±0.72 to 2.59±0.30 g/dL) and vitamin K (from 3.18±0.73 to 1.84±0.18 ng/mL) when compared with the untreated animals. The effect of KBrO3 on PT, APTT, TT, Fibrinogen and vitamin k were attenuated by P. biglobosa in a dose-dependent manner. CONCLUSION: The results of this investigation demonstrated that potassium bromate caused prolongation of PT, aPTT and TT and decreased levels of fibrinogen and vitamin K, but P. biglobosa treatment counteracted these effects. Thus, it is recommended that these results be investigated in clinical trials in human volunteers.
- ItemOpen AccessBlood transfusion service in a tertiary hospital in sub- Saharan Africa during the COVID 19 pandemic: Experience from Lagos University Teaching Hospital, Nigeria(African Society for Blood Transfusion, 2021) Adeyemo, TA; Bolarinwa, AB; Olatinwo, AT; Oyewole, A; Akanmu, ASBlood transfusion services are as pivotal to the health system during a pandemic as before the pandemic. The effect of a pandemic on transfusion services depends on the nature, potential for community spread and risk of transfusion transmissibility. As the total number of cases and deaths from COVID-19 rises, and to prevent the community spread of the SARS‐CoV‐2 virus, governments worldwide, as well as the Nigerian government, announced national lockdowns. Lockdowns have affected blood transfusion services. In Nigeria, blood transfusion services are still decentralized and tertiary health centres run independent transfusion units. The Lagos University Teaching Hospital blood transfusion unit was also impacted by the pandemic and the consequent lockdown. The major challenges experienced are in recruitment of voluntary blood donors, follow‐up of donors and patients with concomitant reduction in blood and blood component supply derived from family replacement donation, inventory and consumable management, staff safety and adequacy for emergency work. These challenges were compounded by the inadequate infrastructure and policies at the outset of the pandemic. Countries in sub-Saharan Africa should invest in health infrastructure and their transfusion services and encourage local manufacture of basic laboratory reagents and consumables. The blood transfusion services and units should put in place strategic continuity of operations plans (COOP) to respond adequately to challenges generated during a pandemic which should focus on shortage, wastage and supply of blood and components in a cost‐effective manner and human resource management.
- ItemOpen AccessBuilding the Nigerian Palliative Care Workforce: An Interdisciplinary Distance Learning Training Program(Annals of Global Health, 2022) Ogbenna A.A; Drane D; Crowe A.N; Oyedele O; Hauser J; Soyannwo O; Ogunseitan A; Doobay-Persaud ABackground: Education and capacity building in palliative care are greatly needed in Nigeria. Currently, two institutions integrate palliative care into the undergraduate medical curriculum and no post graduate training exists. A team from the University of Lagos in Nigeria and Northwestern University in the US collaborated to design, implement, and evaluate a 12-hour virtual palliative care training program for Nigerian health professionals. Objective: This study investigated the impact of the first session of the training program on healthcare professionals’ knowledge, skills, attitudes, and confidence in palliative care. Methods: The Education in Palliative and End-of-Life (EPEC) curriculum and the Kenya Hospices and Palliative Care Association (KEHPCA) curriculum were used as foundations for the program and adapted for the Nigerian context. Delivered online, the training focused on goals of palliative care, whole patient assessment, communication skills, pain management, psychosocial issues, palliative care in COVID, oncology, and HIV. A mixed-methods evaluation based on Kirkpatrick’s evaluation framework was used and data were gathered from surveys and focus groups. Findings: Thirty-five health professionals completed the training. The training had a positive impact on knowledge, skills, and attitudes. Confidence in providing end-of-life care increased from 27.3% to 92.9% while confidence in prescribing medication to relieve symptoms at the end of life increased from 42.9% to 92.0%. Performance on multiplechoice knowledge tests increased by 10% (p < 0.01). All participants stated that they would recommend the program to a peer while 96.4% reported the program was relevant to the Nigerian context. Qualitative analysis suggested that the training would help participants provide more holistic care for patients, communicate better, and change how they interacted with families. Topics to be addressed in future training were identified. Conclusions: This virtual training can be an important element in palliative care capacity building in Nigeria and represents a model for global health collaboration.
- ItemOpen AccessCare seeking determinants among adolescents in Lagos, Nigeria(Sierra Leone J Biomed Res, 2010-06) Onajole, AT.; Dolapo, CD.; Osunkalu, VO.; Uwem, E.; Adenike, E.; Odiakosa, A.; Okpechi Felix-Mary, U.Adolescents often lack basic reproductive health information, knowledge, and access to affordable confidential health services for reproductive health. This cross-sectional descriptive study aimed to examine the careseeking determinants of adolescents accessing the adolescentfriendly services at the Action Health Incorporated Adolescent Clinic in Lagos, Nigeria. A structured interviewer administered questionnaire was used to elicit information about demographics; past medical history; family history; reproductive/sexual history. The study was explained to the adolescents and their consent was obtained before interviewing them. Data analysis was done using SPSS Version 15. A multiple logistic regression was used to model the relationship between client facility-use status and selected individual characteristics. Odd ratio and confidence interval were computed, and a level of significance of 0.05 was chosen. The mean age of the adolescent was 16.3 ± 2.8 years. A high proportion (77.5%) of them reported not to be sexually active. Thelogistic regression model identified preferred/adopted contraceptive during last visit (OR = 0.60, 95% CI = 0.35 to 1.00), sexual status (OR = 0.40, 95% C.I= 0.27 to 0.60) and religion OR = 2.04, 95% C.I = 1.43 to 2.92) as determinantsof adolescents’ booking for a re-visit to the clinic. The determinants of adolescents’ booking for re-visit to Action Health Incorporated clinic were preferred/adopted contraceptive during last visit, sexual status and religion. The implication of this may be that those who did not book for re-visits felt that they were not adequately benefiting from the services rendered at the clinic. More varieties of adolescentfriendly services that meet the needs of all adolescents should be included at the clinic
- ItemOpen AccessCase Report on Hodgkin Lymphoma and Decompensated Chronic Liver Disease in a Patient With Chronic Hepatitis B Virus Infection: A Cause or an Effect?(American Journal of Clinical Pathology, 2018) Bolarinwa, A.B; Adebayo, L.A; Otokiti, O; Ogbenna, A.AChronic hepatitis B infection has been associated with the development of non-Hodgkin lymphoma (NHL), but its role in the etiology of Hodgkin lymphoma (HL) has been sparsely reported. This case report highlights the possibility of hepatitis B infection playing a major role in the etiology of Hodgkin disease and the complexity of managing HL in the presence of a decompensated liver disease. The chemotherapy in a patient with Hodgkin lymphoma and a liver disease requires dose adjustment and may reactivate a latent hepatitis infection. Our patient is a 23-year-old male who presented with symptomatic anemia, multiple cervical lymphadenopathies, abnormal liver function, and chronic HBV infection. A histologic diagnosis of nodular sclerosing HL was made following an excisional biopsy. There was a progressive liver disease with bleeding from the gums, generalized petechial and ecchymotic rashes, thrombocytopenia, prolonged PT (INR >5), deepening jaundice, and markedly elevated bilirubin and liver enzymes. He had blood component support, and tenofovir 300 mg daily was initiated. Liver functions improved, but liver enzymes were still four times the upper limit of normal when chemotherapy was commenced. He had dose-adjusted ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) chemotherapy with gradual improvement in the liver function and resolution of lymphadenopathy. It is unclear whether HBV infection is a nidus for Hodgkin lymphoma in this patient as it is for non-Hodgkin lymphoma or if the progression of Hodgkin disease leads to the flare of this. The outcome in this patient also buttresses the fact that, with appropriate dose adjustment, chemotherapy can be administered in the settings of decompensated liver disease.
- ItemOpen AccessClinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria(Pan African medical journal, 2016-08-30) Oluyemi, A; Awolola, N; Oyedeji, O.AIntroduction: Colorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria. Methods: This is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 –July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria. Results: A total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%).The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis. Conclusion: The study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.
- ItemOpen AccessCoagulation profile in normal full-term neonate in the first week of life in Lagos-Nigeria(International Journal of Medical Research & Health Sciences, 2016) Garba, N; Ogbenna, A.A; Adediran, A; Fajolu, I.BNormal reference values of haemostatic profile are frequently needed to assist in diagnosis and management of bleeding disorders. Because of the anatomical and physiological differences between neonates and adults, it is essential to know the reference range of coagulation profile in neonates in the first week of life. The aim of this study is to establish a normal reference range for coagulation profile in normal full-term neonates in the first week of life in Lagos-Nigeria. This is a cross-sectional study carried out among normal full-term neonates born in Lagos Island Maternity Hospital and Lagos University Teaching Hospital. Neonates’ demographic data were documented. Citrated plasma was collected and tested for Prothrombin Time (PT), Partial Thromboplastin Time with Kaolin (PTTK) and Thrombin Time (TT) using Coatron M2 Coagulation Analyzer (TECO GmbH in Germany). Reference values were established for neonates in the 1st week of life by using the formula of Mean ± 2 Stan dard Deviation (SD) that is at 95% confidence level. Comparative analysis was carried out between the mean values of neonates and adults established mean values. The Mean ± Stan dard Deviation of PT, PTTK and TT at the first week of life were 13.41 ± 1.33 seconds, 43.38 ± 6.75 seconds and 24.01 ± 3.03 seconds respectively. Using the formu la of Mean ± 2SD, the reference ranges of PT, PTTK and TT were 10.7-16.07seconds, 29.88-56.88 seconds and 17.95-30.07 seconds respectively. Statistically significant difference was observed when mean values of PT, PTTK and TT of neonates at the 1st week of life were compared with adults established values done in the country and elsewhere in the world (p-value < 0.05). This research provides a reference range of PT, PTTK and TT for the management of neonates in the 1st week of life in Lagos, Nigeria. It indicates that reference values of PT, PTTK and TT in neonates during the 1st week of life are different from that of adults as described in literature. Therefore we cannot use adult reference values of PT, PTTK and TT to manage neonates during the 1st week of life.
- ItemOpen AccessCoinheritance of Β-Thalassemia and Sickle Cell Anaemia in Southwestern Nigeria(Ethiopian Journal of Health Sciences, 2016-11) Osunkalu, VO; Bamisaye, O; Babatunde, J; Lawal, SBACKGROUND: Genes for haemoglobin S are found in high frequencies in Nigeria. However, there islittle information on beta thalassemia in sickle cell anaemia in this population. The clinical presentation of HbS-β thalassemia is enormously variable, ranging from an asymptomatic state to a severe disorder similar to homozygoussickle cell disease.MATERIALS AND METHODS: Haemoglobin A2and HbF were determined in sickle cell anaemia patients attending LAUTECH Teaching Hospital, Osogbo,by elution after electrophoresis and alkaline denaturation methods respectively. Haematologicalparameters were estimated using Sysmex KX-21N and percentage target cells using Leishman’s staining technique.RESULTS: Exactly 6%f the SCA patients were found to have elevated HbA2(>3.3%) and HbF (>1.3%).These patients also had normal erythrocyte indices, increased platelet count, a significantly higher HCT and an increased % target cell.CONCLUSION: These findings confirm that the frequency of beta thalassaemia in sickle cell patients in Nigeria is higher than previously thought. It is therefore important to consider the possibility of this variant in patients with sickle cell anaemia since their course may differ from that of patients with homozygous sickle cell anaemia.
- ItemOpen AccessA Comparative Study of Factor VIII Levels in Fresh‑Frozen Plasma from Whole Blood Stored at Varying Temperatures and Durations(Ann Trop Pathol, 2022) Ogbenna, A.A; Oyewole, K.M; Adeyemo, T.A; Oyedele, F; Oyelaran, D.OIn Nigeria, fresh‑frozen plasma (FFP) is an important plasma product to provide coagulation factors such as factor VIII (FVIII) in patients with FVIII deficiency and is still the only product available for the treatment of hemophilia A and B in some countries where recombinant factor concentrate is not available. FVIII is a labile coagulation factor and a quality marker of fresh‑frozen plasma. In this study, we assessed the effect of storage temperature and time on FVIII yield. Methods: This was a descriptive‑analytical study of a random selection of 136 blood donors, randomly divided into four groups. Whole blood (WB) was collected into 450 ml of blood bag from each participant and an additional 4.5 ml was collected into citrated bottle containing 0.5 ml citrate for baseline FVIII assay. WB from donors in Group A and Group B were stored at 20°C–24°C for 6 h or less and 12 h, respectively, while Group C and Group D were stored at 4°C for 12 h and 24 h, respectively. FFP was prepared from the WB after storage and FVIII levels were determined using Sysmex CA‑101 based on the principle of turbo‑densitometry principle with automatic zero adjustment and magnetic stir bar for homogenizing the test suspension and for increased sensitivity. The level of FVIII in FFP produced at various storage conditions was determined. Percentage yield was calculated as median level of FVIII in FFP per group/median level of FVIII in citrated plasma per group ×100. This is the proportion of FVIII in FFP relative to the level at baseline in the donor unit, whereas the FVIII level is an indication of just the level in the produced FFP. Results: The median FVIII level in FFP from Group A and B was 0.87 IU/ml and 0.82 IU/ml, respectively. Similarly, the median for Group C and D were 0.86 IU/ml and 0.76 IU/ml, respectively. The highest yield was observed in FFP prepared within 6 h or less of blood sample collection and least yield after 24 h of storage at 4°C. Conclusion: The yield of FVIII produced from WB under the varying temperatures and durations of storage studied is above the recommended level of 0.7 IU/ml; hence will be effective for replacement therapy in hemophiliacs. However, the best yield is obtainable from WB stored at 20°C–24°C for 6 h.
- ItemOpen AccessA comparative study of serum ferritin levels among unfit and fit blood donors(Nigerian Medical Journal, 2019-02-24) Olowoselu, OF; Uche, F; Oyedeji, O; Otokiti, OE; Ayanshina, OA; Akinbami, A; Osunkalu, VBackground: Cheap methodologies are being utilized by low‑resource countries to determine blood donors’ fitness. Important hematological biomarkers might have to be evaluated to enhance the use of these methods. Aims: The study evaluated the pattern of serum ferritin in 18–24 fit and unfit prospective blood donors (PDBs) and the prevalence of iron store deficiency. Settings and Design: This study was a cross‑sectional, study which was conducted at the blood donor clinic of the Lagos University Teaching Hospital. Materials and Methods: Blood samples were collected by venipuncture into sodium‑ethylenediaminetetraacetic acid and plain bottles. The latter was centrifuged and used for ferritin determination via human ferritin enzyme‑linked immunosorbent assay test kit, while the former was used for red cell indices analysis using an autoanalyzer. Statistical Analysis: Data were analyzed using SPSS version 20, values were presented as mean ± standard deviation, and P ≤ 0.05 was considered statistically significant. Results: A total of 263 PDB were recruited into the study consisting of 210 (79%) males and 53 (21%) females, with a mean age of 32.88 ± 8.22. Only 110 (41.8%) of the participants were considered fit, while 153 (58.2%) were unfit using copper sulfate specific gravity. There was no statistically significant difference (P = 0.301) in the mean level of serum ferritin in unfit blood donors (74.5 ± 90.8 µg/L) compared to that of the fit blood donors (61.5 ± 54.5 µg/L). The prevalence of iron store depletion among blood donors in Lagos state was 11.8% (31 of 263) with a higher proportion (7.6%) occurring among unfit donors. However, low levels of serum ferritin (<15 µg/L) were significantly associated with the occurrence of anemia (hemoglobin < 12.5 g/gl) among unit donors (19%; P = 0.05). Conclusion: Although serum ferritin depletion appears to be higher in the unfit blood donors, the use of serum ferritin as an index for the screening and determination of PDBs’ fitness requires further evaluation.
- ItemOpen AccessComparing Efficacy of Low Dose Cytoreduction and Manual Exchange Blood Transfusion in Managing Hyperleukocytosis: A Case Report(American Journal of Clinical Pathology, 2019) Otokiti, O; Ogbenna, A.A; Bolarinwa, A; Olatinwo, AObjectives: Hyperleukocytosis is defined as white cell count greater than 100,000 cells/mm3. Symptomatic hyperleukocytosis (leukostasis) is a medical emergency and can complicate hematological malignancies. It is commoner in myeloid leukemia but can occur in extremely high-count lymphoid leukemia causing tumor lysis syndrome and death. Immediate management is hydration, cytoreduction, and leukapheresis. In a developing country without leukapheresis, how effective is manual exchange blood transfusion compared to low-dose cytoreduction? We present a case of chronic lymphocytic leukemia with severe hyperleukocytosis, comparing response to different treatment modalities in the absence of leukapheresis. Case Summary: A 57-year-old woman with complaints of a vaginal protrusion and an incidental finding of a splenomegaly with moderate anemia. Hemogram showed a white cell count of 301,000 cells/mm3, and blood film revealed a chronic lymphocytic leukemia. She had two cycles of cyclophosphamide, vincristine, and prednisolone and presented 8 months later with worsening leukocytosis of 697,000 cells/mm3, severe anemia, dizziness, headaches, fatigue, and hyperkalemia. Two manual exchange blood transfusions insignificantly decreased count by 40,000 cells/mm3 with slight reduction of hyperkalemia. She had low-dose cytoreduction with weekly vincristine and prednisolone. White cell count reduced from 653,000 cells/mm3 to 467,000 cells/mm3 with normal electrolytes. She was then commenced on cyclophosphamide, mini-hydroxorubicin, vincristine, and prednisolone. There was a steady decline in counts with improvement in hematological parameters and overall well-being. Conclusion: Due to nonavailability of leukapheresis, we attempted a manual exchange without a significant decrease in white cell count. However, with low-dose cytoreduction, there was a considerable decrease in white blood cell count and improvement of electrolyte with no tumor lysis syndrome, and it was more affordable. Therefore, in a resource-poor setting, using lowdose cytoreduction might be cheaper, safer, and more effective than exchange blood transfusion in managing hyperleukocytosis.
- ItemOpen AccessCord blood haemoglobin and ferritin concentrations in newborns of anaemic and non-anaemic mothers in Lagos, Nigeria(Nigerian Medical Journal, 2013-02) Adediran, A; Gbadegesin, A; Adeyemo, TA; Akinbami, A; Osunkalu, VO; Ogbenna, A; Akanmu, ASBackground: Pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers were determined, and cord blood haemoglobin and serum ferritin concentrations of their newborns were compared. This is to establish the mean values for pre-delivery haemoglobin and serum ferritin concentrations of anaemic and non-anaemic mothers and the cord blood haemoglobin and serum ferritin concentrations of their newborns at term. Materials and Methods: A case–control study was done involving 142 pregnant women and their newborns. They were divided into two groups - the anaemic group (n = 65) and the non-anaemic (n = 77) group. Five millilitres of blood was collected from each woman and 2 ml was collected from the cord of their newborns into ethylenediaminetetraacetic acid (EDTA) bottle and plain bottle for full blood count analysis and ferritin assay, respectively. Results: The mean pre-delivery haemoglobin concentrations of the women in anaemic group and non-anaemic group were 9.5 ± 1.01 g/dl and 12.15 ± 1.07 g/dl, respectively, and their mean serum ferritin concentrations were 64.45 ± 138.76 μg/l and 32.83 ± 35.36 μg/l, respectively. The mean cord blood haemoglobin concentrations for anaemic and for non-anaemic groups were 12.54 ± 2.54 g/dl and 13.44 ± 2.23 g/dl (P = 0.02), respectively, and the mean cord blood serum ferritin concentrations (non-anaemic, 69.38 ± 78.88 μg/l; anaemic, 7.26 ± 115.60 μg/l) (P = 0.00) were higher in the newborns of non-anaemic than of anaemic mothers. Significant association was found between maternal anaemia and cord blood ferritin concentrations (P = 0.025). Conclusion: Maternal anaemia has significant effects on cord blood haemoglobin and serum ferritin concentrations.