Day 3 :
- Symposium on Tropical Blood Disorders
Session Introduction
Erhabor Osaro
Usmanu Danfodiyo University, Nigeria
Title: Effect of plasmodium parasitaemia on some haematological parameters in children living in Sokoto, North Western, Nigeria
Biography:
Erhabor Osaro completed his PhD in Immuno-hematology at Rivers State University of Science and Technology at Rivers State, Nigeria. He is a fellow of the Institute of Biomedical Science London. He has many scientific awards including the British Blood Transfusion Society and Margaret Kenwright- young scientist’s awards. He has written more than 140 articles, 4 books and 5 book chapters. He is reviewer and editor of several scientific journals from around the World.
Abstract:
Objectives: Malaria infection is a major public health problem and cause of morbidity and mortality particularly among children in tropical and subtropical regions of the world. The aim of this present study was to determine the effect of plasmodium parasitaemia on some haematological parameters of children visiting the children emergency unit of Sokoto State Specialist Hospital in Sokoto, North Western, Nigeria. Method: This study was conducted among 126 children aged 2-11 years with mean age 5.36± 2.50 years presenting to the children emergency unit of Sokoto Specialist Hospital with history of febrile illness. Out of the children studied, 66 (52.4%) were positive for malaria while 60 (47.6%) were negative. Haematological parameters were analyzed using Mythic 22 CT 5- part differential Haematology analyzer (Orphée, Switzerland). Testing for malaria was carried out using the Onset Malaria Plasmodium falciparum (Pf) antibody (Ab) rapid test (CTK Biotech, Inc., USA) and speciation and number of parasites per high field was carried out on the Giemsa stained thing blood film. Results: The mean PCV, haemoglobin and platelet count of plasmodium- parasitized children was significantly lower compared to un-infected controls (29.48, 10.36 and 188.68) versus (32.76, 11.34 and 327.50) respectively (p=0.01). The prevalence of anaemia and thrombocytopenia was significantly higher among Plasmodium parasitized subjects compared to non-parasitized controls. Plasmodium falciparum was the predominant specie among the parasitized subjects. A negative and significant correlation was observed between the high number of parasite per high field and platelet count as index of thrombocytopenia and haemoglobin as index of anaemia (r=0.62 and p=0.75) respectively (p= 0.01) among parasitized subjects. Plasmodium parasitaemia was more prevalent among children in the 2-5 years age group (52.4%) compared to children in the 6-11 years age group (47.6%). Male children were more predisposed to malaria (53.0%) compared to female children (47.0%). Conclusion: Plasmodium parasitaemia has a significant impact on the haemoglobin, packed cell volume and platelet count of malaria parasitized children in Sokoto, Nigeria. Preventative strategies including regular chemoprophylaxis, intermittent preventative treatment with anti-malarials, provision of iron supplementation and insecticide-treated bed nets should be implemented urgently to prevent the negative impact of malaria parasitaemia on the haematological parameters of children in the area. There is need for community and peer-based awareness and education initiatives to strengthen the malaria prevention programme by educating parents on the benefits of effective environmental sanitation to destroy the breeding sites of Anopheles mosquito –the vector of malaria.
Biography:
Erhabor Osaro- completed his Ph.D. in Immuno-hematology at Rivers State University of Science and Technology at Rivers State, Nigeria. He is a fellow of the Institute of Biomedical Science London. He has many scientific awards including the British Blood Transfusion Society and Margaret Kenwright- young scientist’s awards. He has written more than 140 articles, 4 books and 5 book chapters. He is reviewer and editor of several scientific journals from around the world.
Abstract:
Despite the availability of adequate preventatives, falciparum malaria is still responsible for the deaths of hundreds of thousands of people yearly. The majority of these victims are young children and pregnant women. The key question is why does this occur? The vulnerability of these populations is likely caused by a deficiency in nutrition affecting the host immune system. Scientists have demonstrated that falciparum malaria patients (FMP) have a biochemical deficiency caused by insufficient amounts of the amino acid L-arginine (L-arg). L-arg is substrate for the enzyme- nitric oxide synthase 2 (NOS2) which generates large amounts of nitric oxide (NO). NO reacts with a form of oxygen which generates a substance which can kill the malarial parasite. The parasite protects itself by producing and releasing L-arginase which degrades the l-arginine of the host thus preventing the NO-based toxicity. Children need L-arginine as an essential amino acid to be healthy so the parasite depletes this amino acid and prevents a needed substance from being used by their body and it also prevents the production of this key ingredient to fight the parasite. This same scenario likely occurs to the unborn child in pregnant women. In addition, pregnancy produces a somewhat immunosuppressed state causing increased morbidity and mortality. We plan to study the combination of artemether and lumefantrine with several types of sustained release nitric oxide nutritional supplements compared to drugs alone in these two populations
Biography:
Okorie, H. M. is the Faculty of Health Sciences, Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Abstract:
Platelet selectin (P-selectin or CD62P) is an intercellular adhesion molecule with a strategic role in malaria. Homogenous sampling of subjects with normal haemoglobin (Hb AA), Sickle Cell trait (Hb AS) and Sickle Cell anemia (Hb SS) subjects was carried out in the ratio of 50:30:20 and by real time PCR, the normalized transcript level of P-selectin (SELP-ncn) were measured in malaria infections compared to non-infection control group within the sampled population. I also established malaria infection by standard PCR method, blood film microscopy and rapid diagnostic testing (RDT). Haemoglobin levels and age distribution of the participants across the different genotype groups were analyzed. The results show that the ABI-1 quantity passed normality test (Kruskal Wallis test, P = 0.0403) but did not differ significantly when compared across groups indicating good sample quality. SELP-ncn showed no significant difference across all Hb genotypes studied (Kruskal Wallis test, P = 0.2796) suggesting that P-selectin is expressed in both normal and sickle haemoglobins. Though the SELP-ncn did not differ significantly when compared across the groups studied, targeting it may help reduce the complications of malaria. RDT showed moderate sensitivity (41%; 95% CI: 21%-64%) and a high specificity (98%; 95% CI: 89.7%-99.9%). Blood film microscopy had a moderate sensitivity (68%; 95% CI: 52%-81%) and specificity (90.3%; 95% CI: 74%-97.6%) when PCR was considered as the gold standard. Median Hb concentrations of M-AA and M-SS; M-AA and NM-SS; M-AS and M-SS, M-AS and NM-SS; M-SS and NM-AA; M-SS and NM-AS; NM-AA and NM-SS; NM-AS and NM-SS differed significantly (Kruskal Wallis test, P = 0.0001). Median age of participants across groups differed significantly between M-AA and M-SS; M-AA and NM-SS (Kruskal Wallis test, P = 0.0020).
Iwunze Vincent Okechukwu
Life-link Medical Diagnostic & Laboratories Ltd, Nigeria
Title: Effect of malaria infection on packed cell volume and hemoglobin levels among patients at Ojo district of Lagos State Nigeria
Biography:
Iwunze Vincent Okechukwu has graduated from the University of Calabar, Nigeria in 1991. He has specialized in Hematology and Blood Transfusion. Presently, he is the MD/CEO of Life-link Medical Diagnostic and Laboratories Nigeria Ltd, one of the fast growing diagnostic and research centers in the country. It is situated at the former capital of Nigeria, Lagos. He has delivered many scientific papers on some conferences especially in Nigeria. He has also headed many scientific workshops and has served in several scientific Ad-hoc committees.
Abstract:
Malaria is a worldwide migrating diseases associated with anemia especially in tropical Africa. It causes high rate of mortality and morbidity among Sub-Saharan Africans. Anemia is a hematological disorder caused by a decrease in the production of Red blood cells, a born marrow failure or by an increase in the Red blood cells destruction. The study is to evaluate the effect of malaria infection on the packed cell volume and hemoglobin levels of patients. Blood samples were collected in EDTA bottles from patients attending Life-link Medical Diagnostic and Laboratories Ltd and patients from Ojo Health Center, all in Ojo district of Lagos state Nigeria. Presence or absence of malaria identified by staining with Giemsa stain and examined under oil immersion, PCV and Hb were estimated using Hawskley Haematocrit machine and Microfield colorimeter respectively. A total of 250 patients were studied between the month of June to October 2013, 180 (72%) malaria infected patients, 160 (89% Adult), 20 (11% children) and 70 (28%) of non-infected. The overall means for the Packed Cell Volume and Hemoglobin showed a significant difference in malaria infected patients. The mean Hb, PCV in infected were lower than the non-infected. Conclusively, there was a decrease in packed cell volume and Hemoglobin which seems to be due to the excessive destruction of red blood cells by the malaria parasite
Echonwere Beauty
Rivers State University of Science and Technology, Nigeria
Title: Changes in some haemostatic parameters in pregnancy and peurperium in Port Harcourt
Biography:
Echonwere Beauty is a researcher in Rivers State University of Science and Technology, Nigeria. Her main area of research is haematology.
Abstract:
Introduction: This was a cross-sectional study carried out in Braithwaite Memorial Specialist Hospital, Port Harcourt with the aim of determining the changes in some haemostatic parameters in pregnancy and puerperium. Method: A total of four hundred (400) apparently healthy women of reproductive age, which consisted of 200 (40%) pregnant women and 200 (40%) puerperium mothers constituted the subjects in this case-controlled study. One hundred aged-matched non-pregnant women served as controls. The study was carried out between March, 2012 and January, 2014. The ages of the subjects ranged from 16 to 41 years (mean 27.4±4.3 years). Platelets count was carried out as described by Bain and Seed, PT and (PTTK) by Quick’s methods while modified Clauss method was used in the determination of fibrinogen concentration. Result: The pregnant women had significantly lower values of platelet count, 203.89±65.2×109/L (range, 78-416) as compared to 257.0±69.0×109/L, (range, 90-396×109/L,) for the non-pregnant controls and the 249.1±75.0×109/L, (range, 95-406×109/L) of the puerperium women (F=28.437; p<0.05). The prevalence of thrombocytopenia among the pregnant, puerperium mothers and non pregnant control women were 53 (26.5%), 15 (7.5%) and 12 (12.0%) respectively. The mean prothrombin time (PT) of the non-pregnant control women 15.48±2.49 seconds (range, 14-16 seconds) was significantly higher than the mean prothrombin time of the pregnant and the puerperium women 11.36±3.12 seconds (range, 10-16 seconds) and 14.28±4.22 seconds (range, 13-16 seconds) respectively (F=57.843; p<0.05). The International Normalized Ratio (INR) of the pregnant women as compared to the non-pregnant and puerperium women were not statistically significant (F=2.206; p>0.05). The mean partial thromboplastin time with Kaolin (PTTK) of the pregnant women, 44.1±7.2 seconds (range, 43.3-46.1 seconds) were significantly higher than the mean partial thromboplastin time with Kaolin (PTTK) of the non-pregnant women, 39.4±8.1 seconds (range, 38.4-44.3 seconds) and the puerperium women, 40.32±6.4 seconds (range, 41.3-43.3 seconds) (F=20.512; p<0.05). Conclusion: The mean fibrinogen concentration, 4.4±0.80 g/L (range, 2.9-5.1 g/L) of the pregnant women were significantly higher than the mean fibrinogen concentration, 3.6±0.88 g/L (range, 2.8-4.4 g/L) of the puerperium women and the non-pregnant control women, 2.6±0.72 g/L (range, 2.6-4.3 g/L) (F=164.877; p<0.05). The results point towards a hypercoagulable state in pregnant women, which is normal during pregnancy.
Azuonwu Obioma
Rivers State University of Science, Nigeria
Title: Screening for HBsAg and HCV antibodies among military personnel in the Niger Delta of Nigeria
Biography:
Azuonwu Obioma is working currently for Rivers State University of Science and Technology, Nigeria. His field of research is Health Sciences, Medicine and Infectious Diseases.
Abstract:
Despite the high job-related risk of exposure to sexually -transmitted diseases including HBV and HCV among the military, there is paucity of data regarding Hepatitis B and C viruses’ prevalence among military personnel in Nigeria. The aim of this present study therefore was to determine the prevalence of HBV and HCV among military personnel in the Niger Delta of Nigeria. In this cross-sectional case study, a total of One hundred and fifty military personnel aged 20 and 55 years attending the Nigerian Army Hospital, Air Force Clinic and Police Clinic in Port-Harcourt in the Niger Delta of Nigeria were consecutively recruited for the study. Samples were tested for HBV and HCV using Acon Diagnostics (USA) HBsAg and anti-HCV kits. Results of the study showed an overall HBV and HCV prevalence rate of 4% and 0% respectively. The prevalence of HBV was significantly higher among subjects in the 20-39 years age group (4%) compared to 40-55 (3.85%) (p = 0.05). The HBV prevalence was investigated based on gender of subjects. The HBV prevalence was concentrated among male subjects (4.76%) compared to female (0%) military personnel (p = 0.001). There is need for the development of a strategic plan that integrates STIs into existing prevention and control programme particularly among the military to foster behavior change through information dissemination. Policies should be instituted to make condoms regularly available and freely distributed among military personnel to reduce the risk of HBV and other sexually transmitted infections. There is the need for an effective voluntary counseling and testing (VCT) and sentinel surveillance survey among military personnel. A fully integrated and comprehensive care and support system including provision of universal access to hepatitis B vaccination, treatment and support for military personnel should be establishment
Emmanuel Kufre Uko
University Of Calabar, Nigeria
Title: Disharmony and lack of teamwork among health professionals; an emerging challenge in the management of blood disorders in Nigeria
Biography:
Emmanuel Kufre Uko is a Professor of haematology and Blood Transfusion Science, University of Calabar. He received his Doctorate in Immuno-Hematology from University of Calabar. He is also a holder of Associate and Fellowship of Medical Laboratory Science Council of Nigeria (MLSCN). Before becoming a full time Lecturer, he worked as a practicing Medical Laboratory Scientist, undertaking routine Hematology Laboratory investigations, take Emergency calls and organizing hematology practical to Medical students and Medical Laboratory Science students of College of Medical science, University of Calabar. He is up to present a Professor of Medical Laboratory Hematology at College of Medical Science, University of Calabar, where he is teaching and supervising projects in Hematology and Blood Group Serology to Medical students, Medical Laboratory Science students and several Msc & PhD Students. He is a Consultant Laboratory Hematologist with University of Calabar Teaching Hospital up to present. He has attended many International and local conferences which includes: International Conference on Hematology & Blood Disorders held in Baltimore, USA and he is a reviewer of many articles in many international and local journals which include: Journal of Medical Disorders (open access journal), Journal of Medical Laboratory Science. His interest in Antioxidant Immunology of diseases revolves around the evaluation of Malaria and HIV infections, management and cause- effect of treatment of these diseases. In Immuno- Hematology, he is interested in molecular models, particularly the pathogenesis and survival pattern of these diseases in the host. He has published his Research in leading International journals.
Abstract:
Primary hematologic diseases are common in the aggregate but hematologic manifestations secondary to the disease occur even more frequently. Patient with Blood disorder in Nigeria make about 1: 1000 ratio of overall patients that visit the outpatients department of Nigerian hospitals. Blood disorders basically can affect Red blood cells, which carry oxygen to the body tissues; White blood cells which fight infections; and Platelet which help blood to clot. Blood disorder can also affect the liquid portion of the blood cell plasma. Harmony is an agreement or being in one accord. It is a pleasing combination of elements that makes things successful, while a team is a group of people involved in the same activity or work. However with harmonious agreement, a group of health professionals involved in the management of blood disorders could accomplish a better patient recovery outcome. Health professionals in Nigeria include: Medical Doctors, Medical Laboratory Scientist, Nurses, Physiotherapists, Radiologists/Radiographers, Occupational Therapist, Pharmacists, Social care professionals, Cleaners etc. Team work cannot be accomplished in the absence of disharmony. Global best practice advocates that patient management through team work and harmonious working relationship between health professionals results in better patient outcomes. Lack of harmony and team work among health workers have been reported as the greatest factor resulting in unproductive teams. Reports show that there is lack of harmony and teamwork among health professionals in Nigeria. This is traceable to many factors which include, struggle for supremacy “who is who” and “who is above who” in our hospitals. Self glorification, superiority, ego, self realisation and feeling of being an island of knowledge are all root causes of disharmony in the Nigerian health sector. Literature and reports from previous studies indicate that harmony among health workers is very vital to improving health indices. The aim of this paper is to have in-depth look at the scope of harmony and teamwork among health workers in Nigeria in the management of blood disorders, arranging them in categories that cover the full array of human concerns, from professionalism to the materialism and from corporate to the personal agenda. However, it is concluded that the degree of disharmony among health professionals in Nigerian Health care system is censorious. This has translated into poor team working, resulting in poor patients’ management.
Fredrick Christy C
1University of Abuja, Nigeria
Title: Malaria parasitaemia among long distance truck drivers in the Niger Delta of Nigeria
Biography:
Christy C Fredrick is currently working with Department of Haematology, University of Abuja, Abuja, Nigeria. Area of interests includes blood malignancies and haematology.
Abstract:
Introduction: Malaria is a life threatening disease caused by the Plasmodium parasite which is transmitted through the bite of the infected female mosquito. Malaria poses an enormous public health burden and greater than 75% of the global clinical episodes of malaria infection each year are concentrated in Africa. Methods: A comparative cross-sectional descriptive study was conducted among long distance truckers plying one of the major national highways in the Niger Delta of Nigeria. The study was conducted between April and June 2009. A total of one hundred consecutively recruited long distance truck drivers aged 21-60 years with a mean age of 42.36±5.23 years were screened for the presence of malaria parasitaemia. Results: Out of the 100 truck drivers screened, 35 (35%) were positive for malaria while 65 (65%) were negative. Plasmodium falciparum was responsible for all cases of malaria infection. The highest prevalence of malaria occurred among drivers in the 51-60 years age group (40.5%). The mean and standard deviation (SD) of parasite load was 1020 (125) parasites/l in subjects positive for malaria. The mean CD4 count was significantly higher among non-parasitized truck drivers compared to P. falciparum parasitized drivers 820±42.0 (731-902 cells/μl) and 570±30.0 (510-630 cells/μl) respectively (chi square=74.00; p=0.03). We observed a significant negative correlation between plasmodial infection and CD4 lymphocyte count among Plasmodium falciparum-infected subjects with r=-0.56 (p=0.001). Conclusion: This study indicates that long distance drivers are susceptible to malaria infection. There is a need for interventions such as mass media campaigns, peer/outreach education and life skill programs in the halting point where these drivers meet in order to bring about a reduction in the prevalence of malaria infection. There is also the need for the promotion of long lasting insecticidal bed nets (LLINs), intermittent preventive treatment (IPTp) and effective case management of malarial illness among long distance drivers.
- Special session
Location: 2
Session Introduction
Robert Michael Davidson
The American Institute of Stress, USA
Title: Biophysical aspects of the Sanarelli-Shwartzman phenomenon
Biography:
Robert Michael Davidson completed his PhD in Pharmaceutical Chemistry at the age of 26 from UCSF, NSF postdoctoral fellowship at the National Bureau of Standards, Center for Analytical Chemistry, MD degree at St Louis University School of Medicine, Nuclear Medicine residency at Baylor College of Medicine, Houston, Texas, and Internal Medicine residency in Phoenix, Arizona. He was Associate Medical Director for DuPont Pharma’s Radiopharmaceutical Division 1990-1992. He has published more than 30 papers in peer-reviewed journals. He is a Fellow of The American Institute of Stress (2012-present) and presently practicing complementary/alternative/integrative internal medicine in Gladewater, Texas (USA).
Abstract:
In consideration of the “universal nonspecific mesenchymal reaction”, also referred to as the Sanarelli-Shwartzman phenomenon, we raise the question: how can the SULTs (sulfotransferases) and PAPS molecules assemble and perform the multitude of sulfation reactions required to produce all of the many posttranslational modifications of mucopolysaccharides and proteoglycans? It seems improbable to us that SULTs, which are typically highly-specific in their stereochemical requirements, would have sufficient enzymatic “promiscuity” to permit the proper positioning of the sulfuryl groups for each of many distinct locations in the 3-dimensional structure of heparan sulfate proteoglycans (HSPGs) and proteoglycans which typically populate the “mesenchyme”. We have proposed a novel chiral, paramagnetic orthomolecule as a potential candidate universal “sulfation factor”, which would potentially circumvent the high metabolic energy requirement of the SULTs/PAPS system, thru use of ELF EM energy sources. We postulate that such a factor may involve miRNAs, molecular mimicry, water-mediated allostery, and highly-stereotyped, nonspecific chemistry of the type that might have taken place on a primordial/prebiotic planet where, at least initially, only smaller and simpler orthomolecules existed. We propose that enantionmeric enrichment and chiral induction was enabled by the effect of ELF EM fields on nanoassociates of water which formed adjacent to hydrophilic surfaces in various mixtures of solutes. Hexagonal symmetry, helices of variable pitch and helix angle, and fractality are predicted to arise from an ice-like hexameric, cyclic radical-cationic cluster of water, as the basis for the “fractal dimension”, within “fractones”, which have been identified in the brain, heart, gut, and bone marrow.
- Various Aspects of Haematology
Location: 1
Chair
Harald Engan
Mid Sweden University, Sweden
Session Introduction
Harald Engan
Mid Sweden University, Sweden
Title: Hemoconcentration following spleen contraction
Biography:
Harald Engan completed his PhD in Health Sciences in 2015 at Mid Sweden University and is now working as a Researcher in the Norwegian Lung and Heart Association as well as at the Department of Health Sciences at Mid Sweden University. He is working in a multidisciplinary research field including experimental environmental physiology, cardiac exercise and cancer rehabilitation research. He has published 5 papers in reputed journals regarding the effects of spleen contraction on hemoconcentration during physiological stress.
Abstract:
Hemoconcentration following stress has often been explained in terms of increased number of erythrocytes and unchanged plasma volume (polycythemia vera, secondary polycythemia), and decreased plasma volume and constant number of erythrocytes (stress-polycythemia). However, another potential mechanism is hemoconcentration following contraction of the spleen. During exercise and hypoxia many mammals can mobilize large numbers of erythrocytes from the spleen in order to improve oxygenation of metabolically active tissue. Such “autotransfusion” of erythrocytes improves O2-carrying capacity, and increases both the aerobic performance in terrestrial mammals and the diving capacity of, e.g., seals. In adult humans, the splenic reservoir contains on the average 200-250 ml of blood, with more than twice the hematocrit of normal arterial blood. The extent of splenic contraction after apnea and exercise in humans has been reported to be 18-56% resulting in a concomitant increase in hemoglobin concentration by typically 3-6%, a response not seen in splenectomized individuals. The response is not due to hemoconcentration from extravasation of plasma, and is reversible within approximately 10 minutes. Numerous animal studies implicate the importance of the sympathoadrenergic system for initiation of splenic contraction. Adrenoreceptors are located in the splenic capsule and parenchyma, and the splenic nerve is composed of 98% sympathetic nerve fibers. Consequently, neurostimulation, epinephrine, norephineprine all cause α-mediated contraction of the spleen, and infusion by low-dose ephineprine also produce rapid spleen contraction in humans. It is known that spleen contraction can be increased by hypoxia and hypercapnia, and is evident in healthy subjects and COPD and OSA patients.
Biography:
Nilanjan Ghosh earned his medical degree from University of Mumbai, India. He obtained a PhD in Molecular Biology from the University of South Florida. After completing his Internal Medicine Residency he obtained a fellowship in Hematology and Medical Oncology from the Johns Hopkins University, School of Medicine where he also served as faculty. He is currently the Director of Lymphoma program, and Associate Director of Clinical Trials at the Levine Cancer Institute, Charlotte, NC. He has published numerous papers in reputed journals and earned awards from the Leukemia and Lymphoma Society as well as the American Society of Clinical Oncology.
Abstract:
Curative treatment options for relapsed or refractory lymphoma are limited. Both autologous and allogeneic hematopoietic stem cell transplantation have been used in this setting. Traditionally, allogeneic stem cell transplantation has been associated with a lower relapse rate than autologous stem cell transplantation due to the graft versus lymphoma effect. Traditionally, this benefit from allogeneic transplantation was offset due to higher non-relapse mortality when compared to autologous transplant. With the introduction of reduced intensity and non-myeloablative regimens, the non-relapsed mortality from allogeneic transplantation has decreased in the last decade. However, in selected high risk lymphomas, the use of reduced intensity transplant alone may lead to early relapse prior to the emergence of an effective graft versus lymphoma effect. In such situations a tandem approach of autologous transplantation followed by reduced intensity allogeneic transplantation has been successful. In addition, the use of alternative donor transplants has widely expanded the donor pool for allogeneic transplants. Careful selection of transplant modality based on disease characteristics and comorbidities is key to successful stem cell transplantation in lymphoma.
Dalia Omran
Cairo University, Egypt
Title: Epidemiological aspects of intrafamilial spread of HCV infection in Egyptian population: A pilot study
Biography:
Dalia Omran is an associate Professor of Hepatology and gastroenterology at Kasr Al Ainy School of Medicine, Cairo University. She is interested in HCV and HBV related chronic liver disease, factors associated with hepatic fibrosis progression, non alcoholic fatty liver disease, and molecular pathogenesis of HCC. She has many publications in peer reviewed journals
Abstract:
Background: Liver disease is a leading cause of morbidity and mortality among Egyptians. The major cause is infection with HCV, with 70,000 up to 140,000 newly reported cases annually. The objective of this study was to determine the prevalence of anti-HCV antibodies among household contacts of HCV index cases and to identify the possible risk factors of transmission of HCV among Egyptian families. Materials & Methods: The present external pilot study (multi-centre study) was performed on a convenient sample of 125 index cases and their 321 household family contacts recruited from Mansoura and Cairo University where 2 questionnaires were used to collect data from the index and their related contacts. The all were exposed to clinical examinations, routine laboratory testing and screening for the prevalence of Anti-HCV antibodies. Results: The prevalence of anti- HCV seropositivity among household contacts of index cases was found to be 13.7%. Husbands of female index cases ranked first followed by wives of male index cases (36.36% versus 17.86% respectively, p < 0.0001) while sons and daughter followed (6.84% and 4.94% respectively). When the distribution of household contacts by risky behaviour towards index cases was investigated, it was found that significant prevalence of anti-HCV antibodies positivity was detected between household contacts reporting their index cases having haematemsis and/or bleeding wound (p < 0.05), and household contacts giving IV injection to their index cases (p < 0.05) and household contacts visiting the same dentist as the index cases (p < 0.01) when compared to household contacts not exposed to the same risk factors. Conclusion: Transmission might occur during family contact and sexual behavior
Amar Ranjan
All India institute of medical college, India
Title: Extramedullary plasmablastic plasma cell myeloma presenting as plasmablastic lymphoma
Biography:
Amar Ranjan Singh is currently working as an assistant professor at All India Institute of Medical Sciences, under Institute Rotary Cancer Hospital, India in Laboratory Oncology.
Abstract:
Introduction: Multiple myeloma (MM) is a clonal plasma cell proliferative disorder that accounts for 1% of all malignancies and 10% of malignant hematologic neoplasms. Plasmablastic MM is a morphologic subset of myeloma, in which the bone marrow (BM) aspirate smear shows ≥2% of plasmablasts. Short clinical history: 31 year old male presented with pain & rapidly growing swelling in right side of oral cavity & face for one month. Clinical examination showed ulceroproliferative growth covering 40% of oral cavity & cervical lymphadenopathy. Mass lesion was seen in right maxilla on CECT. Skeletal survey was normal at presentation. There was no B symptom. Viral markers were negative. Serum electrophoresis (SEP) shows no M-band. FNAC showed large atypical cells with LCA (CD45)+ve & HMB 45-ve (excludes malignant melanoma) suggestive of NHL. Biopsy showed malignant cells positive for CD79a, CD138, MUM1 & negative for CD20, CD3, CD56, CK & HMB45, suggestive of plasmablastic lymphoma (PL). Peripheral blood smear was normal. BMA smear showed 50% Plasma cells predominantly plasmablasts, was supported by BM biopsy. After 6 cycles of CHOP, repeat BMA showed 20% plasma cells, SEP showed no M-band, Serum free light chain (SFLC) ratio kappa/lambda 429/15.84=27.09 (0.26 to 1.65), B2 microglobulin 3.263 (1.21-2.70 mcg/mL) & creatinine 1.8 mg/dl. Therapy for Plasmablastic myeloma (PBM)/Multiple myeloma (MM) started. After 4 cycles of thalidomide +dexamethasone plan was switched to Bortezomib + dexamethasone. Symptomatic improvement was seen with normal hemogram/biochemistry. Discussion: This case presented with PL, later turned out to be PBM. Initially showed no feature of myeloma, with passage of time on SFLC ratio & B2 microglobulin gave the clue in this case. A careful monitoring of therapeutic response is must for these two.
Ravisekhar Gadepalli
All India Institute of Medical Sciences, India
Title: Role of protease-activated receptors (PARs) and G-proteins in thrombin induced monocyte/macrophage migration
Biography:
Ravisekhar Gadepalli after completing his Postdoctoral studies (2009-2013) from St. Jude Children Research Hospital, Memphis, USA, has joined as a Faculty at AIIMS Jodhpur in 2013. He is an active Member of American Society for Microbiology and American Heart Association. He has several notable achievements and awards to his credit. His work in the field of Clinical Microbiology, Immunology and Vascular Biology has culminated in the publication of 18 research papers in peer reviewed journals (Proceedings of National Academy of Sciences USA, Journal of Biological Chemistry. Arteriosclerosis, Thrombosis and Vascular Biology, etc) of national and international repute with cumulative impact factor: 78.046 (Citation Index: 410).
Abstract:
The recruitment of monocytes/macrophages to the sites of dysfunctional endothelium and transformation of these cells into foam cells by the uptake of oxidized lipoproteins in the sub endothelium are the major pathophysiological features of atherosclerosis. Since thrombin is produced at the sites of vascular injury and in order to understand its involvement in atherosclerosis, we tested its role in the modulation of THP-1 cell migration. Thrombin induced THP-1 cell migration in a dose dependent manner. Thrombin induced sequentially the tyrosine phosphorylation of Pyk2, Gab1 and p115 RhoGEF leading to Rac1 and RhoA-dependent Pak2 activation. Downstream to Pyk2, Gab1 formed a complex with p115 RhoGEF involving their PH domains. Furthermore, depletion of Pyk2, Gab1, p115 RhoGEF, Rac1, RhoA or Pak2 levels using their respective antisense oligos substantially attenuated thrombin-induced THP-1 cell cytoskeleton formation and migration. In addition, SCH79797, a selective PAR1 antagonist, inhibited thrombin-induced Pyk2, Gab1 and p115 RhoGEF tyrosine phosphorylation and Rac1-RhoA-depenedent Pak2 activation resulting in diminished THP-1 cell cytoskeleton formation and migration. Together, these observations reveal that thrombin induces THP-1 cell migration via PAR1-dependent Pyk2-mediated Gab1 and p115 RhoGEF interactions leading to Rac1-RhoA-Pak2 activation. Based on these findings, we envision a role for thrombin and its receptor PAR1 in atherosclerosis.
Udodirim Evelyn Okoro
Federal Medical Center Umuahia, Nigeria
Title: The effect of hematology in African hospitals and patients
Biography:
Udodirim Evelyn Okoro has completed her Postgraduate program at the Imo State University of Education Department. She is the Director of Adult Education Career at the Umuahia South Local Government of Abia state Nigeria. She supervises hospital and patients of about 25 daily at the Federal Medical Center Umuahia. She is an English Instructor that carries health information to Nigerians and the World.
Abstract:
Objectives: This article was designed to investigate and confirm the effect of hematology and blood disorder in Africa hospital and patients with effects of hematology. The purposes are to investigate, analyze, challenges and proffer solutions that would easy the sufferings of the patients as several authorities were consulted. Methods: Reports, articles and references on hematology and blood disorder should be used; reports on people who have blood disorder through HIV status which involved men, women and younger people at the age of 18-28 weeks gestation; Male (12) and Female (18) making 30 patients and one huge hospital were used in the investigations. Clinical study of participants was asked to sign informed consent form. These participants may withdraw from this study at any time; qualitative method usage explores, classify, phenomena being studied. It uses observation and interview; quantitative method was used; surveys, questionnaires or laboratory experiments are used and collected with statistical analysis; interview listens to patients and doctors recount something that happened with open-ended questions; questionnaires gather information among hospitals and patients who have hematology or blood disorder or participated or help evaluate behavior and lifestyle; observation here is “the systematic description of events, behavior and artifacts in the social setting chosen for study.”; “Participant observation involves genuine process of learning through exposure to day-to-day activities of participants in the researcher setting”. Results: This writer spotted hypertension in 14% of the patients. Range age was 18-75 years of the patients. 1 and 4 years duration with 44.2% of males and 55.8% were females had blood disorders, myelofibrosis and thrombocythemia. Others are vein thrombosis, blood clot, portal diagnosis, hepatomegaly and splenomegaly etc. Results patterned include nonverbal expression of patients, reactions, monitor events, observation and better understanding of the context under study. Validity is stronger through the use of interviewing, document analysis, surveys and questionnaires, build theory and answer research questions. Conclusion: We must collectively and individually not rest in the past glory but improve the healthcare, safety and patient effective treatments in our respective hospitals.
EMMANUEL KUFRE UKO
Universityof Calabar, Calabar Nigeria
Title: Impact of an anti-retroviral African herbal preparation with a trade mark ‘Winnie cure’, on some haematological parameters of HIV infected patients in Nigeria
Biography:
E K Uko is a Professor of haematology and Blood Transfusion Science, University of Calabar. He received his Doctorate in Immuno-Hematology from University of Calabar. He is also a holder of Associate and Fellowship of Medical Laboratory Science Council of Nigeria (MLSCN). Before becoming a full time Lecturer, he worked as a practicing Medical Laboratory Scientist, undertaking routine Hematology Laboratory investigations, take Emergency calls and organizing hematology practical to Medical students and Medical Laboratory Science students of College of Medical science, University of Calabar. He is up to present a Professor of Medical Laboratory Hematology at College of Medical Science, University of Calabar, where he is teaching and supervising projects in Hematology and Blood Group Serology to Medical students, Medical Laboratory Science students and several Msc & PhD Students. He is a Consultant Laboratory Hematologist with University of Calabar Teaching Hospital up to present. He has attended many International and local conferences which includes: International Conference on Hematology & Blood Disorders held in Baltimore, USA and he is a reviewer of many articles in many international and local journals which include: Journal of Medical Disorders (open access journal), Journal of Medical Laboratory Science. His interest in Antioxidant Immunology of diseases revolves around the evaluation of Malaria and HIV infections, management and cause- effect of treatment of these diseases. In Immuno- Hematology, he is interested in molecular models, particularly the pathogenesis and survival pattern of these diseases in the host. He has published his Research in leading International journals.
Abstract:
The crystalline powder preparation of the herbal extract was prescribed at a dose of 5 ml containing 250 mg, taken three times daily. Preliminary laboratory studies in animals and humans were reported to be safe in humans. This herbal preparation is reported to manifest a reasonable degree of recovery from HIV symptoms. This may suggest inhibition of viral replication and or a possible restore of human immunity by mobilizing TWBC, especially the CD4+ and other cells. As a supposed anti-retro viral agent, we suspect that it may have some consequences on haematological parameters. The study was to assess the impact of this African herbal preparation; a supposed anti-retro viral agent on some haematological parameters. Thirty one (31) HIV patients on this preparation were enrolled for this study. The haematological parameter assessed were Hb, PCV, TWBC, differential WBC, platelet count and ESR were estimated using coulter ACT differential Analyzer and Westagreen methods respectively. Blood collection was by standard venopuncture method. The haematological parameters were assessed among the 31 confirmed HIV infected patients before they started treatment and three weeks interval from the time they started treatment till the 9th week (second, third, and fourth visits). At the first, second, third and fourth visits, the ESR (mm/hr) values were decreasing, thus indicating a positive patient response to the drug. It was observed that all the parameters showed significant variation at 3rd visit, level of platelets and PCV values being markedly raised (6 weeks of treatment). From the appreciative changes observed in the haematological parameters under assessment it was observed that the herbal preparation (Trade mark – winner cure) seems to obtain peak activity at 3rd and 4th visit (there is the 6th and 9th weeks of treatment). Clinical and pharmaceutical evaluation of the preparation for the possible use in the treatment of HIV patients is suggested.
Erhabor Osaro
Usmanu Danfodiyo University, Nigeria
Title: Challenges associated with the effective management of major haemorrhage in developing countries
Biography:
completed his Ph.D. in Immuno-hematology at Rivers State University of Science and Technology at Rivers State, Nigeria. He is a fellow of the Institute of Biomedical Science London. He has many scientific awards including the British Blood Transfusion Society and Margaret Kenwright- young scientist’s awards. He has written more than 140 articles, 4 books and 5 book chapters. He is reviewer and editor of several scientific journals from around the world.
Abstract:
Major haemorrhage is defined as the replacement of a patient’s blood volume or transfusion of >10 units of packed red cells within a 24 hours period. It can also be defined as the loss of 50% of blood volume within a 3 hours period or a loss of 150 ml per minute. Haemorrhage is a leading cause of early death in most settings in Africa following traumatic injury, intra and post - surgical and ante and post - partum. It is the cause of morbidity in 44% of maternal death in developing countries. More than 536,000 women die every year from pregnancy –related complications including ante and post partum haemorrhage. Haemorrhage accounts for 40% of deaths from trauma and is the most common cause of preventatable mortality in developing countries. The challenges associated with the effective management of haemorrhage particularly in developing countries include; chronic blood shortages, high prevalence of TTI's, reliance on whole blood transfusion, lack of other component required to manage coagulopathy, absence of a functional fit for purpose national blood transfusion service, poor inventory control of blood and blood products, suboptimal use of indication coding tool, poor management of coagulopathy, educational, cultural and awareness-related issues associated with donation and transfusion, absence of specially selected products to meet the special needs of certain patients groups, lack of infrastructure (uninterrupted power supply and challenge of cold chain management of blood product), absence of O Rhesus Negative blood for emergency use, challenge of a diminishing blood supply, challenge associated with the recruitment and retention of voluntary non –remunerated donors, reliance on family replacement and commercial blood donors, inadequate use of pharmacologic and non - pharmacologic alternatives to allogeneic blood. The aim of blood volume replacement with concentrated red cells and other plasma products following massive haemorrhage includes; to rapidly and effectively restore adequate blood volume, prevent hypovolemic shock, allow for adequate haemostasis, oxygen carrying capacity and blood biochemistry, to allow for an early and aggressive correction of coagulopathy, allow for optimal resuscitation, and to reduce potentially preventable deaths. Blood components that can play a role in the management of coagulopathy include; red cell concentrate, fresh frozen plasma, cryoprecipitate and platelet concentrate. Pharmacologic agent that can play a role in the management of coagulopathy and major haemorrhage include; anti-fibrinolytic (aprotinin and tranexamic acid), vitamin K, prothrombin complex concentrate (PCC) and Novo-7. Non-blood components and non-pharmacologic measures to manage major haemorrhage include; direct pressure /tourniquet if appropriate, stabilization of fractures, surgical interventions (damage control surgery, interventional radiology, use of endoscopic and obstetrics techniques and thromboelastometry. Evidenced based management of major haemorrhage require a coordinated approach by all stake holders involved in the management of major haemorrhage; from the managing clinician to the transfusion laboratory scientist to the porters to ensure that the management of haemorrhaging patients is timely and optimal.