Open Access Original Research Article

Determinants of Adverse Transfusion Reactions at Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Nwagu Marcellinus Uchechukwu, Borke Moghene Emona, Ikusemoro Augustina Isioma

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2016/28816

Background: Blood transfusion is a very essential part of medical practice. However, blood and blood component transfusions are associated with some adverse transfusion reactions. Some of these reactions can lead to loss of patients’ lives and hence defeating the essence of blood usage in saving lives.

Objectives: This study aims to establish those factors promoting and increasing the susceptibility of patients for adverse transfusion reactions.

Methodology: Two-year records (July 2014-June 2016) of our patients reported to have blood transfusion reactions were retrieved, data collated and analysed using IBM SPSS version 22 software.

Results: Forty-six cases out of 5,342 transfusions were reported giving a prevalence of 0.86%. The youngest case was two years while the oldest was 70 years. The mean age was 38.69±14.95 years. Thirty five (76.1%) of the cases were females while 11(23.9%) were males. Chills/rigors (63%) and fever/pyrexia (58.7%) were the major presenting symptoms. Fourteen of the cases (30.4%) complained of itching/urticaria while 19.6% presented with nausea/vomiting. The clinical signs were hypotension (6.5%), tachypnea (4.3%) and tachycardia (2.2%). The adverse transfusion reactions were mainly associated with whole blood (93.5%) and 58.7% of the reactions occurred at night. Anaemia was the major indication for the transfusions (80.4%). Twenty-seven of the subjects (58.7%) had above the normal body temperature. Thirty four of the cases (73.9%) had earlier been transfused in the past while (26.1%) were being transfused the first time. On the other hand 93.5% of the cases have never experienced any form of adverse transfusion reactions while only 6.5% have had transfusion reactions previously.

Conclusion: We conclude that gender of the patient, age, component of blood being transfused and history of previous blood transfusions play determining factors on adverse transfusion reactions. Detailed transfusion history will go a long way in preventing adverse transfusion reactions.

 

Open Access Original Research Article

Risk Evaluation of Drug Safety in the Emergency Treatment Process Using a Modified HFMEA-based Associated Matrix

Chien-Chih Wang, Li-Jung Huang, Hsin-Ning Pan

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2016/28922

Error reduction is important for quality medical services and certification requirements. Patients have mostly complained of poor medical quality in the emergency care department. Therefore, the purpose of this study was to develop a risk assessment procedure for the emergency treatment process to ensure drug quality for patients. The associated matrix technique was proposed to improve the evaluation criteria of traditional Health Care Failure Mode and Effect Analysis (HFMEA). We used a medical center in Taiwan as a model to describe and validate the proposed process. Analysis revealed that most drug usage errors originate from prescription drugs and controlled substances. The results demonstrated the feasibility of a risk assessment procedure to identify emergency flow problems and thus improve drug safety management in hospitals.

 

Open Access Original Research Article

In vitro Impact Assessment of Aqueous Extract of Sida cordifolia Linn. Upon Rat Spermatozoa Parameters

Mradu Gupta, Saikat Chowdhury, Sukumar Manna

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/AJMAH/2016/29211

Sida cordifolia Linn. finds frequent mention in Ayurvedic System of Medicine for many therapeutic properties including beneficial effect upon male reproductive processes. Aim of present in vitro study was to evaluate impact of aqueous extract of Sida cordifolia roots on rat spermatozoa in terms of count, motility & morphology and through HOS study following standard assessment methods to assess any likely reproductive toxicity, spermicidal action, lethality or abnormalities in animal experimentation. Sexually mature (18–22 weeks old) male Wister rats weighing 180 to 260 gm were used. Sperms were collected from cauda epididymis of rat testes and sperm suspension was prepared by mixing them with 2 ml of 5% Sucrose at 37°C, dividing into 4 samples – control (A) and 3 drug treated samples (B, C & D) containing 10, 20 or 30 mg/ml of aqueous extract of Sida cordifolia. The various sperm parameters were observed under Olympus CX41 microscope. Sperm concentration, Progressive and Non-Progressive motility were calculated using the Neubauer Chamber. The viability and morphology of sperm suspensions were assessed using Eosin Y and Nigrosin staining method using 400 X magnification under Phase contrast microscope. Hypo-osmotic swelling (HOS) test was used to evaluate the functional integrity of plasma membrane. Treatment with aqueous extract of Sida cordifolia resulted in no significant adverse impact upon sperm count up to 30 mg/ml dose, suggesting no noticeable spermicidal effect. Progressive motility increased marginally due to intervention of Sida cordifolia in a concentration-dependent manner from 40.00 ±1.07 in Sample A to 43.50 ± 2.05 in Sample D. Similarly, percentage of normal sperms and their viability exhibited steady enhancements with increasing concentrations of research drug. The HOS test indicated no adverse structural changes in plasma membrane integrity of sperms up to 30 mg/ml level. Thus, in vitro assessment of sperm motility, morphology and viability due to treatment with Sida cordifolia aqueous extract indicated no spermicidal or toxic effect and indicated small but significant enhancement in various parameters which was concentration-dependent.

 

Open Access Original Research Article

Phytochemical Screening and Antimicrobial Activity of Three Medicinal Plants against Urinary Tract Infection Pathogens

R. U. B. Ebana, U. O. Edet, U. M. Ekanemesang, C. A. Etok, G. M. Ikon, M. K. Noble

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2016/29460

Urinary tract infections are a global health issue. Although antibiotics exist, most people for fear of stigmatization often prefer medicinal treatments. Three plants Acanthus montanus, Aspilia africana and Desmodium velutinum were investigated for their antimicrobial activity against human urinary tract infection pathogens and also screened for phytochemicals. The phytochemical screening and quantification, characterisation of isolates, antimicrobial screening and minimum inhibitory concentration were all done using standard techniques. Replicate readings were then subjected to analysis of variance. The results of the phytochemical screening and quantification of the plants showed the presence alkaloids (2.40 – 3.12%), glycosides (3.50 – 4.20%), saponins (3.02 -- 6.27%), tannins (0.17 – 0.47%), flavonoids (9.22 – 11.42%), polyphenol (9.72 – 9.90%) and reducing compounds (7.40- 9.18 mg %) in studied plants. Analysis of the replicate readings showed significance (p < 0.05). The results of the microbial characterization showed that isolates were Esherichia coli, Staphylococcus species and Pseudomonas aeruginosa. The antimicrobial sensitivity assay showed that the isolates responded differently to the test plants extracts. Staphylococcus species and E. coli were more sensitive to the test extracts than P. aeruginosa. The least inhibition was 11.50 mm while the highest was 14.00 mm. Consistently, all the studied plants showed very good inhibition at a minimum inhibitory concentration of 200 mg. The findings in this study confirms their use in the treatment of urinary tract pathogen and the need for further studies aimed at determining the bioactive compounds in these plants.

 

Open Access Original Research Article

Effect of Previous Stillbirth on the Formation of Alloantibody among Women in Sokoto Tertiary Hospital

I. Z. Isaac, R. T. John, M. Imoru, F. P. Udomah, O. Erhabor, I. G. Ango, S. Nasir

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2016/29065

Aim: Stillbirth is one of the most common adverse pregnancy outcomes with numerous causes and effects. We intend to investigate the effect of previous stillbirth on the formation of alloantibodies among women requiring blood transfusion.

Study Design: One hundred and fifty three women with mean age of 29.97±9.724 years were recruited for the study which was conducted from August to October 2015.

Materials and Methods: The patients’ plasma samples were screened for the presence of clinically significant alloantibodies by Ortho Biovue system cassettes (AHG/Coombs) technique using the Lorne Laboratories of UK antibody screen cells and panel cells.

Results: The prevalence of previous stillbirth was found to be 25.5%, and was highest among reproductive age group (21 – 40 years). There was a statistically significant relationship between age groups and stillbirth (P = 0.011). The study revealed that the prevalence of alloantibodies was 16.3% among the women. We observed that 10 out of 25 (40%) of alloantibodies positive women were women with previous stillbirth and 10 out of 39 women with previous stillbirth formed alloantibodies. Although, 96.4% of the women were Rh D positive and 4(2.6%) were Rh D negative, only 1(0.7%) with Rh D negative had alloantibodies. The effect of the number of previous stillbirth on the formation of alloantibodies was found to have a statistical significant relationship               (P = 0.021). The Odds Ratio of 1.949 was obtained for cohort alloantibodies positive of previous stillbirth.

Conclusion: We concluded from this study that the prevalence of alloantibodies among these women was high, and the number of stillbirths has a significant effect on the formation of alloantibodies. We therefore recommend for alloantibodies screening in women who had a history of stillbirth.