Haematology and Blood Transfusion- Scholarly Publications

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    Open Access
    Abnormal Haematological Profile caused by Potassium Bromate in Wistar Rats is corrected by Parkia Biglobosa Seed
    (Niger. J. Physiol. Sci., 2024) Uche, C.L; Ugwu, N.I; Airaodion, A.I; Ogbenna, A.A; Okite, U.P; Jibiro, P; Chikezie, K; Esonu, C.E; Agu, F.U; Oladele, F.C; Onyekachi, O.I.N; Abali, I.O
    Many biological tissues and organs are affected by the toxicity of potassium bromate (KBrO3). The purpose of this study was to evaluate the Parkia Biglobosa (P. Biglobosa) seed's ability to treat KBrO3-induced haematological parameters derangement. After becoming accustomed to the lab, 24 Wistar rats were randomly assigned to groups A, B, C, and D. Group A was given distilled water to drink. Each of the groups in B, C, and D got 100 mg/kg of KBrO3. Also, for 28 days prior to sacrifice, groups C and D received 100 and 200 mg/kg of P. biglobosa, respectively. Blood was drawn, and the haemogram was examined using a haematology autoanalyzer. When KBrO3 was added compared to the control, the results showed a substantial decrease in both haemoglobin concentration, packed cell volume (PCV), and red blood cell count from 17.26±2.84 g/dL, 39.73±2.58%, 5.12±0.83 x 1012/L to 13.25±1.25 g/dL, 27.93±1.44%, and 3.47±0.22 x 1012/L, respectively. The effect of KBrO3 was dose-dependently counteracted by P. biglobosa treatments of 100 and 200 mg/kg body weight. However, there was no discernible difference in the MCV, MCH, and MCHC values between the control and test groups. Similar to how P. biglobosa reduced the effects of KBrO3 in a dose-dependent manner, P. biglobosa also induced a substantial decrease in white blood cell count, its differentials, and platelet counts (P≤0.05). KBrO3-induced deranged haematological parameters were mitigated by Parkia biglobosa in a dose dependent manner. Care must be taken with the consumption of this addictive due to its numerous toxic effects. However, consumption of P. biglobosa, a tropical homemade food is recommended for families to benefit from the barrage of its health benefits. This will also alleviate the toxic effect of KBrO3 if consumed inadvertently. Human clinical trial is needed to substantiate these findings.
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    Open Access
    Antioxidant supplementation for sickle cell disease (Review)
    (Cochrane Database of Systematic Reviews, 2024) Bolarinwa, A.B; Oduwole, O; Okebe, J; Ogbenna, A.A; Otokiti, O.E; Olatinwo, A.T
    Background Sickle cell disease (SCD) refers to a group of genetic disorders characterized by the presence of an abnormal haemoglobin molecule called haemoglobin S (HbS). When subjected to oxidative stress from low oxygen concentrations, HbS molecules form rigid polymers, giving the red cell the typical sickle shape. Antioxidants have been shown to reduce oxidative stress and improve outcomes in other diseases associated with oxidative stress. Therefore, it is important to review and synthesize the available evidence on the eKect of antioxidants on the clinical outcomes of people with SCD. Objectives To assess the eKectiveness and safety of antioxidant supplementation for improving health outcomes in people with SCD. Search methods We used standard, extensive Cochrane search methods. The latest search date was 15 August 2023. Selection criteria We included randomized and quasi-randomized controlled trials comparing antioxidant supplementation to placebo, other antioxidants, or diKerent doses of antioxidants, in people with SCD. Data collection and analysis Two authors independently extracted data, assessed the risk of bias and certainty of the evidence, and reported according to Cochrane methodological procedures. Main results The review included 1609 participants in 26 studies, with 17 comparisons. We rated 13 studies as having a high risk of bias overall, and 13 studies as having an unclear risk of bias overall due to study limitations. We used GRADE to rate the certainty of evidence. Only eight studies reported on our important outcomes at six months. Vitamin C (1400 mg) plus vitamin E (800 mg) versus placebo Based on evidence from one study in 83 participants, vitamin C (1400 mg) plus vitamin E (800 mg) may not be better than placebo at reducing the frequency of crisis (risk ratio (RR) 1.18, 95% confidence interval (CI) 0.64 to 2.18), the severity of pain (RR 1.33, 95% CI 0.40 to 4.37), or adverse eKects (AE), of which the most common were headache, nausea, fatigue, diarrhoea, and epigastric pain (RR 0.56, 95% CI 0.31 to 1.00). Vitamin C plus vitamin E may increase the risk of SCD-related complications (acute chest syndrome: RR 2.66, 95% CI 0.77 to 9.13; 1 study, 83 participants), and increase haemoglobin level (median (interquartile range) 90 (81 to 96) g/L versus 93.5 (84 to 105) g/L) (1 study, 83 participants) compared to placebo. However, the evidence for all the above eKects is very uncertain. The study did not report on quality of life (QoL) of participants and their caregivers, nor on frequency of hospitalization. Zinc versus placebo Zinc may not be better than placebo at reducing the frequency of crisis at six months (rate ratio 0.62, 95% CI 0.17 to 2.29; 1 study, 36 participants; low-certainty evidence). We are uncertain whether zinc is better than placebo at improving sickle cell-related complications (complete healing of leg ulcers at six months: RR 2.00, 95% CI 0.60 to 6.72; 1 study, 34 participants; very low-certainty evidence). Zinc may be better than placebo at increasing haemoglobin level (g/dL) (MD 1.26, 95% CI 0.44 to 1.26; 1 study, 36 participants; low-certainty evidence). The study did not report on severity of pain, QoL, AE, and frequency of hospitalization. N-acetylcysteine versus placebo N-acetylcysteine (NAC) 1200 mg may not be better than placebo at reducing the frequency of crisis in SCD, reported as pain days (rate ratio 0.99 days, 95% CI 0.53 to 1.84; 1 study, 96 participants; low-certainty evidence). Low-certainty evidence from one study (96 participants) suggests NAC (1200 mg) may not be better than placebo at reducing the severity of pain (MD 0.17, 95% CI -0.53 to 0.87). Compared to placebo, NAC (1200 mg) may not be better at improving physical QoL (MD -1.80, 95% CI -5.01 to 1.41) and mental QoL (MD 2.00, 95% CI -1.45 to 5.45; very low-certainty evidence), reducing the risk of adverse eKects (gastrointestinal complaints, pruritus, or rash) (RR 0.92, 95% CI 0.75 to 1.14; low-certainty evidence), reducing the frequency of hospitalizations (rate ratio 0.98, 95% CI 0.41 to 2.38; low-certainty evidence), and sickle cell-related complications (RR 5.00, 95% CI 0.25 to 101.48; very low-certainty evidence), or increasing haemoglobin level (MD -0.18 g/dL, 95% CI -0.40 to 0.04; low-certainty evidence). L-arginine versus placebo L-arginine may not be better than placebo at reducing the frequency of crisis (monthly pain) (RR 0.71, 95% CI 0.26 to 1.95; 1 study, 50 participants; low-certainty evidence). However, L-arginine may be better than placebo at reducing the severity of pain (MD -1.41, 95% CI -1.65 to -1.18; 2 studies, 125 participants; low-certainty evidence). One participant allocated to L-arginine developed hives during infusion of L-arginine, another experienced acute clinical deterioration, and a participant in the placebo group had clinically relevant increases in liver function enzymes. The evidence is very uncertain whether L-arginine is better at reducing the mean number of days in hospital compared to placebo (MD -0.85 days, 95% CI -1.87 to 0.17; 2 studies, 125 participants; very low-certainty evidence). Also, L-arginine may not be better than placebo at increasing haemoglobin level (MD 0.4 g/dL, 95% CI -0.50 to 1.3; 2 studies, 106 participants; low-certainty evidence). No study in this comparison reported on QoL and sickle cell-related complications. Omega-3 versus placebo Very low-certainty evidence shows no evidence of a diKerence in the risk of adverse eKects of omega-3 compared to placebo (RR 1.05, 95% CI 0.74 to 1.48; 1 study, 67 participants). Very low-certainty evidence suggests that omega-3 may not be better than placebo at increasing haemoglobin level (MD 0.36 g/L, 95% CI -0.21 to 0.93; 1 study, 67 participants). The study did not report on frequency of crisis, severity of pain, QoL, frequency of hospitalization, and sickle cell-related complications. Authors' conclusions There was inconsistent evidence on all outcomes to draw conclusions on the beneficial and harmful eKects of antioxidants. However, Larginine may be better than placebo at reducing the severity of pain at six months, and zinc may be better than placebo at increasing haemoglobin level. We are uncertain whether other antioxidants are beneficial for SCD. Larger studies conducted on each comparison would reduce the current uncertainties.
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    Open Access
    Blood Usage by Speciality in Health Institutions in Abia State: Documentation, A Major Challenge
    (Clinics in Nursing, 2024) Uche, C.L; Ezirim, E.O; Ogbenna, A.A; Chikezie, K; Owojiyugbe, T.O; Iwuoha, E.C; Ndukwe, P.E; Eke, O.K; Abali, I.O; Ndukwe, C.O; Ngwudo, S; Agu, F.U; Airaodion, A.I
    Background: Efficient blood usage is essential for optimal healthcare delivery. However, poor documentation remains a significant challenge in accurately assessing blood usage by specialty. This study explores blood utilization across specialties in health institutions in Abia State, Nigeria, highlighting the challenges in documentation and the distribution patterns of blood use. Materials and Methods: This cross-sectional, retrospective study was conducted over six months, involving 13 health institutions in the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Health facilities that met inclusion and exclusion criteria were included. Data were collected using a semi-structured, interviewer-administered questionnaire and blood bank records from January to June 2022. Analysis was performed using SPSS version 23, with descriptive statistics and frequency distributions presented for demographic and categorical data. Results: A total of 4,724 blood donations were documented, with government institutions contributing the majority (51.9%) of collections. Internal Medicine utilized the highest proportion of blood (51.04%), followed by Accident and Emergency (16.81%), Obstetrics and Gynecology (14.67%), Surgery (8.30%), and Paediatrics (9.20%). The absence of computerized documentation in all institutions and lack of standardized record-keeping hindered efficient data retrieval. Conclusion: Internal Medicine accounted for the highest blood usage among specialties, while Paediatrics used the least. Documentation inconsistencies and manual record-keeping practices present significant barriers to reliable blood usage tracking. Enhancing data documentation and implementing computerized systems in health institutions are recommended to improve accuracy and efficiency.
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    Open Access
    Challenges of Blood Transfusion Services in Abia State: A Study on Infrastructure and Manpower
    (Journal of General Medicine and Clinical Practice, 2024) Uche, C.L; Owojiugbe, T.O; Abali, I.O; Eke, O.K; Ogbenna, A.A; Ngwudo, S; Ndukwe, C.O; Iwuoha, E.C; Ndukwe, P.E; Ezirim, E.O; Chikezie, K; Agu, F.U; Airaodion, A.I
    Background: Blood transfusion services are vital to healthcare delivery, yet many health institutions face challenges related to infrastructure and manpower. This study aims to assess the availability and adequacy of blood transfusion equipment and staff in healthcare institutions across Abia State, Nigeria. Materials and Methods: A cross-sectional, retrospective study was conducted over six months in 13 public and private health institutions across the three senatorial zones of Abia State: Abia North, Abia South, and Abia Central. Data were collected using a semi-structured, pretested interviewer-administered questionnaire, supplemented by blood bank records, covering the period from January to June 2022. The study assessed the availability of dedicated blood transfusion staff, the existence of blood transfusion committees, quality policies, and the types of blood screening methods used. Statistical analysis was performed using SPSS version 23, with results expressed in frequencies, percentages, and means. Results: The majority of institutions were secondary (77%) and had poor availability of blood transfusion equipment (92.3%), with only 38.5% having a dedicated blood bank and 84.6% possessing benchtop centrifuges. Critical equipment such as apheresis machines, cold centrifuges, -20°C freezers, and platelet agitators were entirely absent. In terms of manpower, 92.3% of blood banks had dedicated staff, but none reported adequate staffing. Only 7.7% had a consultant haematologist, and 23.1% employed trained phlebotomists. Screening methods for HIV, hepatitis B, hepatitis C, and VDRL relied entirely on rapid tests, with no ELISA use reported. Conclusion: The study highlights significant challenges in blood transfusion services in Abia State, with inadequate infrastructure and insufficient manpower being key issues. Urgent interventions are needed to improve equipment availability and staffing to ensure safe and effective blood transfusion services.
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    Open Access
    Investigating the Complications of Blood Donation in Health Institutions in Abia State, Nigeria
    (Journal of Hematology Research and Blood Disorders, 2024) Uche, C.L; Ogbenna, A.A; Chikezie, K; Owojiugbe, T.O; Iwuoha, E.C; Ndukwe, P.E; Eke, O.K; Abali, I.O; Ndukwe, C.O; Ngwudo, S; Ezirim, E.O; Airaodion, A.I
    Background: Blood donation is a critical component of healthcare systems globally. However, complications associated with blood donation can affect donor safety and the quality of services provided by health institutions. This study aims to investigate the occurrence and nature of complications of blood donation in health institutions in Abia State, Nigeria. Materials and Methods: A cross-sectional, six-month retrospective study was conducted across public and private health institutions in Abia State, Nigeria, involving 13 hospitals from the three senatorial zones: Abia North, Abia South, and Abia Central. Data was collected from November 2023 to February 2024 through a semi-structured, pretested intervieweradministered questionnaire and review of blood bank records covering January to June 2022. The questionnaire assessed 20 complications of blood donation, including agitation, sweating, cold skin, nausea, and more, using a 5-point Likert scale. Statistical analysis was performed using SPSS version 23, with significance set at p ≤ 0.05. Results: The highest occurring complication was pain, which often affected donors, but other complications like agitation, sweating, fatigue, venous hematoma, and thrombophlebitis were observed sometimes. Most complications, such as pallor, low blood pressure, syncope, and convulsions, were rare or never occurred. The study found that none of the complications occurred consistently in all donations, highlighting variability in donor reactions. Conclusion: Complications from blood donation in Abia State health institutions are generally infrequent, with pain being the most common. The findings underscore the need for continuous monitoring of donor health and the implementation of preventive strategies to enhance donor safety.