European Journal of Molecular & Clinical Medicine

Pre-operative anaemia has been linked to poor outcomes in patients undergoing major surgical procedures. As a result, early detection and treatment of pre-operative anaemia is advised.
Objectives: to estimate the prevalence of anaemia in pre-anaesthetic clinic and requirement of perioperative blood transfusion.
Material and methods: The present observational study was done in the department of anaesthesiology at tertiary Centre for the duration of 6 months. A total of 200 patients were included in the study. Patients coming for preanesthetic checkup who were posted for elective surgery and of age 18-65 years were included in the study. According to WHO definition male patients with Hb less then 13gm% and female patients with Hb less then12gm% will be considered anaemic.
Results: The prevalence of preoperative anaemia in the present study was 64.5%. Anaemia was seen most commonly in the age group 21-40 years (34.9%) and most commonly seen in males (56.6%). Anaemia was seen in 23.3% of the patients with co-morbidities. Preoperative blood transfusion was done in 20.2% of the patients with anaemia.
Conclusion: In the preoperative patient, anaemia creates a unique set of challenges. A thorough history and physical examination, as well as a methodical approach to diagnostic testing, are required for an accurate assessment of anaemia.

Placenta Previa is the complete or partial covering of the internal os of the cervix with placenta. It is the major risk factor for postpartum haemorrhage and lead to morbidity and mortality of the mother and new born. Uncontrolled postpartum hemorrhage from placenta previa and PAS (placenta accreta spectrum may necessitate need for blood transfusion, hysterectomy, ICU admissions and even death.
Aim: To compare the maternal and fetal outcome between primigravida and multigravida women with placenta previa admitted in Government Vellore Medical College, Tamil Nadu.
Results: The incidence of placenta previa was highest among the following age groups
20-29yrs i.e.67.32%, most common risk factors are caesarean section 45.5%(1 LSCS-30%, 2LSCS-16%), 1 bleeding episode cases-78% followed by 15% of cases has 2 episodes of bleeding,79% of cases in our study participants had cephalic presentation followed by breech 16% followed by transverse lie 5%,Type 2A Placenta previa had 46%, Type 2B placenta previa had 18%,Type 3 Placenta previa 16%,Type 4-11% Lowest incidence.
Type 1 placenta previa 9%, 82% of cases underwent emergency LSCS, 50% of cases underwent prophylactic uterine artery ligation, 32% of cases had PPH managed medically and surgically, 9% of cases underwent elective LSCS, for all 9 cases prophylactic uterine artery ligation done, no postpartum hemorrhage.
Type 2A placenta previa - 46 cases (6 cases elective LSCS, 40 cases emergency LSCS) 15 cases had foley tamponade with uterine artery ligation, 12% cases had foley tamponade, 1 cases underwent subtotal hysterectomy).
Type 2B placenta previa -18 cases (2 cases elective lscs, 16 cases emergency lscs) 9 cases had foley tamponade with uterine artery ligation, 4 cases had uterine artery ligation, 2cases had uterine artery ligation with B lynch).
Type 4 placenta Previa, 11 cases (emergency lscs), 5 cases – Foley with uterine artery ligation, 3 cases total hysterectomy, 1 case subtotal hysterectomy1 bladder repair.
Out of 9 perinatal deaths, Asphyxia and prematurity were major contributions 4.3% and 2.6% respectively followed by RDS1.6%) Neonatal mortality was 8-9% with placenta previa. Perinatal death were higher in gestational age between 30-33 weeks.

Hemovigilance terminology is entitled to the surveillance of adverse reactions that could be encountered by blood donors and untoward effects of blood transfusion in a recipient [1]. This is a broad-spectrum aspect of blood transfusion services (BTS) as it begins from the collection of blood to the transfusion of the same to a recipient. There are a number of quality steps involving various sections of blood banking while a unit of blood is collected for the purpose of blood transfusion. Hemovigilance programmes are currently in place in a vast majority of countries to monitor donor and transfusion reaction in the view of prevention of future occurrences. This article aims to review the various hemovigilance systems across the world.

Background: Total hip arthroplasty could be associated with major intra-operative as well as post-operative blood loss. Post-operative anaemia is a recognized complication which can prolong hospital stay, delay rehabilitation and is poorly tolerated by elderly patients. Blood transfusion carries the risk of infections, anaphylaxis, etc. We examined whether tranexamic acid given before and after total hip arthroplasty reduces intra-operative, post-operative and total operative blood loss and whether the need for post-operative blood transfusion is reduced.
Materials & Methods: A total of 40 patients were included in this study. Group A (n=20, study group) received I.V tranexamic acid (15mg/kg body weight) infusion 10 minutes before incision. 4 hours later, 10mg/kg body weight I.V tranexamic acid was given. Group B (n=20, control group) did not receive any anti fibrinolytic agent. The amount of blood loss, post-operative drop in haemoglobin and the amount of blood transfused was recorded in each case.
Results: Tranexamic acid significantly reduced intra-operative blood loss by 35.68% and total operative blood loss by 22.87% with a 30% reduction in blood transfusion rates compared to the control group. There was no significant effect on post-operative blood loss, duration of surgery or length of hospital stay.
Conclusion: Tranexamic acid when administered perioperatively significantly reduces the operative blood loss in primary total hip arthroplasty surgery with minor side effects. Thus, it can be used effectively in patients undergoing primary total hip arthroplasty to reduce intra-operative blood loss and the need for blood transfusions.

Aims: The aim of the study was to compare the effect of the short term (2-4 weeks) pretreatment of BPH with dutasteride and finasteride on bleeding after TURP. To date no study has been done which has compared 2 weeks of preoperative finasteride and placebo with 2 and 4 weeks of preoperative dutasteride.
Materials and methods: A prospective randomized double blind study was conducted in for a period of 2 years. All patients presenting with lower urinary tract symptoms (LUTS) suggestive of enlarged prostate were evaluated further as required. All cases who were diagnosed to have BPH and were planned for surgery were included in the study.
Results: There was no significant difference in duration of surgery, amount of irrigation fluid used, weight of the resected tissue and duration of postoperative irrigation. Statistically significant differences were seen in total volume of blood loss, blood loss per minute of operating time and blood loss per gram of resected prostatic tissue.  When compared to placebo (P2) group, the total volume of blood loss, blood loss per minute of operating time, blood loss per gram of resected tissue, fall in hemoglobin at 24 hours, fall in hematocrit at 24 hours and requirement of blood transfusion was significantly less in D2 and F2 groups.
Conclusion: Short term preoperative dutasteride and finasteride for 2 weeks can significantly reducethe blood loss during the perioperative period. Both the 5-ARIs, dutasteride and finasteride are equally effective in reducing the perioperative blood loss during TURP and they significantly reduce the requirement for blood transfusion.

Aim: To annalyseseroprevalence of HIV, HbsAg, HCV, syphilis and malaria in
pretransfusion blood and comparison with general population.
Methodology:It was retrospective study, conducted at Osmania General Hospital,
Telangana during the year from July 2016-June 2018. HIV, HBsAg, HCV tests were
done by enzyme-linked immunosorbent assay (ELISA) procedure using the third
generation kits.The donor questionnaire form with details of donor and results of
serological tests are maintained in the blood bank.Venous blood so collected is screened
for HIV, hepatitis B surface antigen (HBsAg), HCV, syphilis and malaria.HIV, HBsAg,
HCV tests were done by enzyme-linked immunosorbent assay (ELISA) procedure using
the third generation kits.

Context: Beta Thalassemia major is a genetic disease with an autosomal recessive pattern of
inheritance that occurs as a result of disorder in haemoglobin synthesis. In Beta Thalassaemia
major patients multiple blood transfusions, ineffective erythropoiesis and increased
gastrointestinal iron absorption lead to iron overload in the body. Iron overload can be
determined by Serum Ferritin measurement.
Aim and Objectives
1. To Assess the average frequency of blood transfusion in Beta Thalassemia Major patients
2. To measure Serum Ferritin level in Beta thalassemia Major patients
3. To determine the association between Serum ferritin level and age, average frequency of
blood transfusion in Beta Thalassemia Major Patients.
Methods and Material: Fifty blood samples of clinically diagnosed Beta Thalassemia major
patients were collected for estimation of Serum Ferritin levels. Serum Ferritin measurement
was performed using indirect enzyme linked immune sorbent based assay kit. Data were
analysed to determine association between Serum Ferritin and age, gender and frequency of
blood transfusion.
Statistical analysis used: Descriptive statistics, Regression, Correlation
Results: The mean Serum Ferritin level was found to be 3639.75 mg/ml. Five patients had
Serum Ferritin <1000 mg/ml, Twenty three patients had Serum Ferritin between 1000-3500
mg/ml and twenty two patients had Serum Ferritin >3500 mg/ml.
Conclusion: The study showed high levels of Serum Ferritin in Beta Thalassemia major
patients. Serum Ferritin levels should be monitored regularly to assess the status of iron
overload and to rationalize the use of chelation therapy and avoid complications related to
iron overload.

Background: Blood transfusion plays important role in medical and surgical practice. The
present study assessed clinical and demographic profile of blood transfusion recipients.
Materials & Methods: The present study was conducted in the department of Forensic
Medicine. It comprised of 128 blood transfusion recipients of both genders. Ethical
clearance was taken prior to the study. All patients were informed regarding the study and
written consent was obtained. General information such as name, age, gender etc. was
recorded. Data such as blood group, product requested, ward and clinical diagnosis was
obtained.
Results: Out of 128 recipients, males were 61 and females were 67. Maximum recipients
were of A+ (67) followed by O+ (50), B+ (3) respectively. The difference was significant (P<
0.05). Clinical wards of recipients was medical in 3, orthopedics in 31, surgical in 42,
gynae in 20, casualty in 15, ENT in 10 and pediatrics in 7 cases. The difference was
significant (P< 0.05).
Conclusion: From the results of the present study, this can be concluded that female
recipients of blood transfusions were higher than males. Most of the patients were A+
recipients. Maximum cases of blood transfusion were seen in surgical ward followed by
orthopedics and gynae.The least number of blood transfusion recipients were in medicine
department.

Volunteers of Blood or who called donors are screened for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection by ELISA in the National center of blood bank in Baghdad. The risk of enzyme immunoassay (EIA) negative samples is not estimated till now in Iraq. The aim of this study is to screen the seronegative plasma of blood donors by a commercially available multiplex NAT test with mini-pooling. One thousands (1000) blood donors plasmas were screened by EIA and then NAT was performed on pools of ten blood plasma. A total of 100 minipools donors plasmas were screened by NAT. Positive HBV NAT minipools of plasma were (3%), 3 HCV (3%), and 3 (3%) HIV minipools by NAT. Accordingly, the use of NAT was shown to detect occult HBV and reduce window period in HCV and HIV in sero-negative plasma from blood donors. Therefore, the implementation of NAT with mini-poling for routine blood donor screening will provide a safe and cost-effective mean of screening for blood transfusion in Iraq

Human herpesvirus type 8 (HHV-8) or known as Kaposi sarcoma-associated herpesvirus
(KSHV) is the etiologic agent for all clinic-epidemiological forms of Kaposi’s sarcoma (KS).
Many studies have been documented that blood transfusion plays an important role in
HHV-8 transmission. This study was prepared to determine the frequency of HHV-8
antibodies among blood donors. A cross-sectional study was conducted on ninety blood
donors who attended the Iraqi National Centre for Blood Transfusion in February 2019 to
detect HHV-8 IgG antibodies using an enzyme-linked immunoassay method. Anti-HHV8-
IgG were detected in 78 out of 90 (86.6%) serum samples. A significant association has
been found between anti-HHV-8 detection and associated risk factors in blood donors such
as sexual relationships (legal and illegal), occupation, surgical and dental operations, blood
transfusion, cupping, tattooing, smoking and numbers of blood donation. Our results
confirmed that a high percentage of HHV8-IgG among blood donors may indicate an
increased threat to HHV-8 infection via blood transfusion.