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Socio-Demographic and Maternal Determinants of Birth Preparedness among Pregnant Women Seeking Skilled Birth services at a Rural General Hospital, Mid Western Uganda

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Open Journal of Nursing 2019年第1期9卷 68-77页

作者： Munguiko Clement Masereka Enos Mirembe Twesigye Deus Bahizi Archbald department of Nursing and Midwifery Mountains of the Moon University Fort Portal Uganda Uganda blood transfusion services Ministry of Health Kampala Uganda

Background: Although the practice of preparing for childbirth among pregnant women is associated with 24.0% and 53.0% reduction in neonatal and maternal mortality respectively in low income countries, it remains inadequately practiced in Uganda. This study sought to assess socio-demographic and maternal determinants of birth preparedness among pregnant women at one of the rural hospitals in Uganda. Methods: This was a descriptive cross sectional study conducted among 332 pregnant women in first stage of normal labour between April and May 2017 at Kagadi hospital, mid western Uganda. In order to understand socio-demographic and maternal determinants of birth preparedness, we considered overall level of birth preparedness as our dependent variable and determined it using five elements. Data were collected using a researcher administered questionnaire. We used descriptive statistics to understand characteristics of respondents and multivariable logistic regression model to determine factors associated with birth preparedness. Results: Only 94 (28.3%) of the 332 pregnant women who were included in the study were prepared for childbirth. We found that male partners having secondary level of education (aOR 1.86, CI 1.107 - 3.243, p 0.02), discussing birth plan with spouse (aOR 1.97, CI 1.06 - 3.490, p 0.03), monthly income of at least eighty three dollars (aOR 2.98, CI 1.847 - 5.981, p 0.002), being escorted by the spouse during ANC visit (aOR 1.73, CI 1.010 - 2.964, p 0.04), intention to conceive (aOR 1.99, CI 1.087 - 3.65, p 0.026) and being health educated about birth preparedness during antenatal visit (aOR 1.90, CI 1.006 - 3.59, p 0.048) were associated with birth preparedness. Conclusion and Recommendations: We observed that the level of birth preparedness among respondents was associated with many socio-demographic and maternal factors. To scale up birth preparedness in rural settings, we recommend improving household financial income, reducing contraceptive unmet

关键词： Magnitude Birth Preparedness Rural Skilled Birth services

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TSR:A User-friendly R Shiny Application for Assessment of Optimal blood Product Selection in ABO-incompatible Hematopoietic Stem Cell Transplantation

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Current Medical Science 2023年第4期43卷 716-722页

作者： Juan WANG Lin-feng DENG Quan ZHANG Lei HE department of blood transfusion Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China department of Laboratory Medicine Hubei Provincial Hospital of Integrated Chinese&Western MedicineWuhan 430015China

Objective:Patients undergoing hematopoietic stem cell transplant(HSCT)need frequent transfusions,until their red blood cells(RBCs)and platelets start to *** safe transfusion for patients who receive ABO-incompatible HSCT is essential to the transplant *** date,there is no user-friendly tool to choose the right blood product for transfusion treatment,despite the number of guidelines and expert advice on the ***:R/shiny is a powerful programming language for clinical data analysis and *** can create interactive web applications that work in *** web application named TSR was built using R programming,simplifying blood transfusion practice for ABO-incompatible HSCT witha one-click ***:The TSR is divided into four main *** home tab provides an overview of the application,while RBC,plasma and platelet transfusion tabs offer tailored suggestions for blood product selection in each *** traditional methods that rely on treatment guidelines and specialist consensus,TSR leverages the power of the R/Shiny interface to extract critical content based on user-specified parameters,providing an innovative approach to improve transfusion ***:The present study highlights that the TSR enables real-time analysis,and promotes transfusion practice byoffering a unique and efficient one-key output for blood product selection to ABO-incompatible *** has the potential to become a widely-utilized tool for transfusion services,providing a reliable and user-friendly solution that enhances transfusion safety in clinical practice.

关键词： transfusion practice peripheral blood stem cell transplant transfusion risks

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Iron Status of Multiple Transfused Sickle Cell Anaemia Patients Attending a Sickle Cell Clinic in Benin City, Nigeria

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Open Journal of Pathology 2014年第2期4卷 25-31页

作者： A. I. Ikusemoro N. K. D. Halim O. A. Awodu F. A. Ehiaghe E. M. Isoa I. J. Ehiaghe department of haematology and blood transfusion University of Benin Teaching Hospital Benin City Nigeria department of Hematology and blood transfusion Irrua Specialist Teaching Hospital Irrua Nigeria department of Hematology College of Health Sciences Igbinedion University Okada Okada Nigeria department of Medical Laboratory Science Nnamdi Azikiwe University Awka Nigeria

This study was aimed at evaluating the iron status of multiple blood transfused sickle cell anaemia (SCA) patients in Benin City, Nigeria. A total of 86 subjects participated in the study, comprising of 30 multiple transfused SCA subjects, 30 of rarely transfused SCA subjects and 26 of age and sex matched healthy control subjects. Serum ferritin was determined by enzyme linked immuno sorbent assay technique. Serum iron and Total iron binding capacity was determined by spectrophometric method. The mean serum ferritin concentration was elevated in the sickle cell anaemia patients whose multiple transfusions (MT) are more than those who were rarely transfused (RT) as compared with the control groups (p blood transfused (r = 0.719, p = 0.000). This study revealed that a high level of serum ferritin, percentage transferrin saturation and a reduction in total iron binding capacity were observed in sickle cell anaemia patients who received ≥3 units of packed cells in one year.

关键词： Sickle Cell Anaemia Multiple transfusions Serum Ferritin Enzyme Linked Immuno Sorbent Assay

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Risk Assessment and Refined Management of blood Collection and Supply during the COVID-19 Epidemic

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Open Journal of Nursing 2021年第8期11卷 668-675页

作者： Ying Li Shuchao Zhang Shaoqiang Zhang Haiyan Wang department of blood transfusion The Affiliated Hospital of Qingdao University Qingdao China

Since the end of 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continued to spread worldwide and has become a major global public health threat. SARS-CoV-2 has the characteristics of a long incubation period and asymptomatic infection, which are undoubtedly major challenges to blood transfusion safety. Although no research has suggested that there is a risk of SARS-CoV-2 transmission through blood transfusion, the safe use of clinical blood during the epidemic is a serious problem faced by blood collection and supply institutions. Herein, we elaborate on the management of blood collection and supply during the coronavirus disease 2019 (COVID-19) pandemic from aspects such as blood inventory management, clinical blood use, and reducing the risk of transmission of SARS-CoV-2 via blood transfusion. blood service departments should adopt flexible policies to ensure that blood collection networks can meet clinical needs, while at the same time protecting staff and blood donors, maintaining blood safety, and reducing blood risks during the epidemic.

关键词： COVID-19 blood Management blood transfusion services Clinical blood Safety

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Some Haematological Parameters in Primary Hypertensive Subjects Attending a Tertiary Hospital in Nigeria

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Open Journal of blood Diseases 2023年第2期13卷 69-77页

作者： Eledo Benjamin Onyema Akanno Kelechi Ajugwo Anslem Onuoha Emmanuel Chinedu department of Medical Laboratory Science Madonna University Elele Nigeria department of haematology and blood transfusion Federal Medical Centre Yenagoa Nigeria department of Medical Laboratory Science Federal University Otuoke Nigeria

Background: Hypertension is a persistent elevation of blood pressure in the arteries which if not properly managed can lead to stroke, heart failure, atrial fibrillation, peripheral vascular disease and other life threatening outcomes. This study investigated some haematological parameters of Primary hypertensive subjects. Objectives: To compare some haematological parameters (haematocrit, haemoglobin concentration, Platelets count, White blood Cells count, red blood cell count and Red Cells Indices between hypertensive and normotensive subjects. Materials and methods: blood samples were collected from 76 known hypertensive subjects between 30 - 70 years attending the Cardiology clinic of the University of Abuja Teaching Hospital Gwagwalada. Another 37 normotensive subjects between 30 - 65 years served as the control. All subjects gave their consents. Platelets count, Haemoglobin estimation, Packed Cell Volume, Red blood Cell Count, Mean Cell Volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration and White blood Cell count were determined using Mythic 22 five parts haematology analyzer. Results: Results for Hypertensive and Control subjects were, White blood Cell, 5.76 ± 1.45 × 109/l and 4.76 ± 1.03 × 109/l, Platelet count, 248.7552.45 × 109/l and 284.95 ± 27.66 × 109/l, Mean Cell Volume, 91.81 ± 3.05 fl and 85.68 ± 6.48 fl, Mean Cell Haemoglobin, 30.59 ± 1.04 pg and 27.922 ± 2.74 pg, Mean Cell Haemoglobin Concentration, 33.34 ± 0.61 g/dl and 32.32 ± 0.93 g/dl, Red blood Cell, 4.33 ± 0.39 × 109/l and 4.50 ± 0.52 × 109/l, Packed Cell Volume, 39% ± 3.15% and 40% ± 4.41% and Haemoglobin, 13.21 ± 1.10 g/dl and 13.50 ± 1.63 g/dl respectively. Mean Cell Volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration (Red cells indices) were significantly higher in hypertensive compared to normotensive subjects (P 0.05), total White blood Cell count was also higher in hypertensive than normote

关键词： Hypertension Haematological Parameters Tertiary Hospital Nigeria

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The Pattern of Haematological Changes in the Baseline blood Cell Counts and the CD4⁺T Lymphocyte Levels among Antiretroviral Therapy Naïve Adult HIV Positive Patients in a Nigerian Hospital

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Open Journal of blood Diseases 2020年第3期10卷 77-88页

作者： Taiwo Modupe Balogun Abiola Omosalewa Alao Olawunmi Femi Olaosebikan Adewunmi James Aremu Oladunni Olajumoke Adegbite department of haematology and blood transfusion Igbinedion University Okada Edo State Nigeria HIV Laboratory HIV Clinics Lagos State University Teaching Hospital Ikeja Lagos Nigeria

Background: Haematological abnormalities are strong independent predictors of morbidity and mortality in HIV infection. Objectives of the Study: This study was carried out to assess the pattern of the changes in the baseline peripheral blood cell counts among adult HIV positive patients. To also determine the CD4+ T cell levels and its correlation with the changes in the baseline cell counts of the patients using HIV negative blood donors as controls. Methods: This was a case controlled prospective study. The subjects were antiretroviral therapy naive adult HIV positive patients and HIV negative blood donor controls. Five milliliters (5 mls) of venous blood was collected from the cubitus of every consecutive consenting subject. Blood sample was analysed for baseline complete blood cell counts and the CD4+ T lymphocyte levels using Sysmex and Cyflow R Counter autoanalysers respectively. Obtained data was analysed with the statistical package for the social scientist (SPSS version 20.0). The Erythrocy

关键词： haematology Complications HIV Infection Nigeria

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Clinical utility of viscoelastic testing in chronic liver disease: A systematic review

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World Journal of Hepatology 2020年第11期12卷 1115-1127页

作者： Henry Wei Lauren Jane Child department of Gastroenterology and Hepatology Middlemore HospitalAuckland 1071New Zealand department of haematology New Zealand Blood Services EpsomAuckland 1051New Zealand

BACKGROUND Conventional coagulation tests are widely used in chronic liver disease to assess haemostasis and to guide blood product *** is despite the fact that conventional tests do not reliably separate those with a clinically significant coagulopathy from those who do *** testing such as thromboelastography(TEG)correlate with bleeding risk and are more accurate in identifying those who will benefit from blood product *** this,viscoelastic tests have not been widely used in patients with chronic liver disease outside the transplant *** To assess the utility of Viscoelastic Testing guided transfusion in chronic liver disease patients presenting with bleeding or who require an invasive *** PubMed and Google Scholar searches were performed using the key words“thromboelastography”,“TEG”or“viscoelastic”and“liver transplantation”,“cirrhosis”or“liver disease”and“transfusion”,“haemostasis”,“blood management”or“haemorrhage”.A full text review was undertaken and data was extracted from randomised control trials that evaluated the outcomes of viscoelastic test guided transfusion in those with liver *** study subjects,inclusion and exclusion criteria,methods,outcomes and length of follow up were *** was extracted by two independent individuals using a standardized collection *** risk of bias was assessed in the included *** A total of five randomised control trials included in the analysis examined the use of TEG guided blood product transfusion in cirrhosis prior to invasive procedures(n=118),non-variceal haemorrhage(n=96),variceal haemorrhage(n=60)and liver transplantation(n=28).TEG guided transfusion was effective in all five studies with a statistically significant reduction in overall blood product transfusion compared to standard of *** of the five studies reported a significant reduction in transfusion of fresh frozen plasma and *** studies showed a signif

关键词： Viscoelastic testing Thromboelastography Rotational thrombelastometry Coagulation Chronic liver disease End stage liver disease Cirrhosis Haemostasis

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New-Onset Seizures in HIV Patients on Antiretroviral Therapy at a Tertiary Centre in South-West, Nigeria

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World Journal of AIDS 2013年第2期3卷 67-70页

作者： Oshinaike Olajumoke Akinbami Akinsegun Okubadejo Njideka Ojo Oluwadamilola Ojelabi Olaitan Dosunmu Adedoyin Adediran Adewumi Dada Akinola Ajibola Sarah department of haematology and blood Trans- fusion Lagos State University College of Medicine Lagos Nigeria department of haematology and blood transfusion College of Medicine University of Lagos Lagos Nigeria department of Medicine College of Medicine University of Lagos Lagos Nigeria department of Medicine Lagos State University College of Medicine Lagos Nigeria

Background: Seizures are associated with neurological manifestations of HIV. They may be the presenting symptom and can occur at any disease stage. Aim: To determine the frequency and clinical aspects of new-onset seizures in patients with human immunodeficiency virus (HIV) infection. Methods: A study of an HIV-infected patient cohort on highly active anti-retroviral therapy (HAART) in the out-patients clinic of the Lagos state university teaching hospital, Nigeria. In a cross-sectional design, 308 HIV infected patients were recruited over a period of 1 year. Cases with a first seizure during this period were further examined. Details of demographic data, the first seizure date, seizure characteristics, neurologic complications and CD4 count at the time of the seizure were documented. Results: A total of 20 (6.5%) had new-onset seizures during the study period. 6/20 (30%) were males and 14/20 (70%), females. Their ages ranged between 22 - 51 years with a mean of 34.2 ± 8.7 years. The seizure was focal in 2/20 (10%) of cases and generalised in 90% (18/20) of cases. A total of 13/20 (65%) had recurrence of their seizures. None of the cases had focal neurological deficit at the time of the first seizure. The mean CD4 count was 165.3 ± 145.7. The mean duration on HAART was 19.5 ± 12.7 months. Cases with CD4 counts ≤200 cells/mm3 constituted 70% (14/20) whilst those with CD4 counts >200 made up 30% (6/20) [p = 0.666]. Conclusions: Seizures remain a significant neurological manifestation of HIV infection and has a high recurrence rate. It occurs more commonly in the advanced stage with severe immune suppression and may be attributable to HIV encephalopathy. Early treatment would reduce the burden and improve patient’s quality of life.

关键词： New-Onset Seizures HIV/AIDS

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The equivalents of human blood and spleen dendritic cell subtypes can be generated in vitro from human CD34 ＋ stem cells in the presence of fins-like tyrosine kinase 3 ligand and thrombopoietin

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Cellular & Molecular Immunology 2012年第6期9卷 446-454页

作者： AI Proietto D Mittag AW Roberts N Sprigg L Wu Molecular Immunology Division The Walter and Eliza Hall Institute of Medical Research Parkville Vic. Australia Autoimmunity and Transplantation Division The Walter and Eliza Hall Institute of Medical Research Parkville Vic. Australia transfusion Research Australian Red Cross Blood Services West Melbourne Vic. 3003 Australia Cancer and haematology Division The Walter and Eliza Hall Institute of Medical Research Parkville Vic. Australia Tsinghua U niversity-Peking University Joint Center for Life Sciences Tsinghua University School of Medicine Beijing China

Dendritic cells （DCs） are immune cells specialized to capture, process and present antigen to T cells in order to initiate an appropriate adaptive immune response. The study of mouse DC has revealed a heterogeneous population of cells that differ in their development, surface phenotype and function. The study of human blood and spleen has shown the presence of two subsets of conventional DC including the CDlb/c＋ and CD141＋CLEC9A＋ conventional DC （cDC） and a plasmacytoid DC （pDC） that is CD304＋CD123＋. Studies on these subpopulations have revealed phenotypic and functional differences that are similar to those described in the mouse. In this study, the three DC subsets have been generated in vitrofrom human CD34＋ precursors in the presence of fins-like tyrosine kinase 3 ligand （FIt3L） and thrombopoietin （TPO）. The DC subsets so generated, including the CDlb/c＋ and CLEC9A＋ cDCs and CD123 ＋ pDCs, were largely similar to their blood and spleen counterparts with respect to surface phenotype, toll-like receptor and transcription factor expression, capacity to stimulate T cells, cytokine secretion and cross-presentation of antigens. This system may be utilized to study aspects of DC development and function not possible in vivo.

关键词： dendritic cells fms-like tyrosine kinase 3 ligand thrombopoietin

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Validity and Reliability of Total Lymphocyte Count as Alternative Biomarker for CD4 Count in the Management of HIV Positive Patients on HAART in Osogbo, Nigeria

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World Journal of AIDS 2015年第4期5卷 313-321页

作者： B. E. Egbewale O. A. Oyedeji V. O. Mabayoje M. A. Muhibi C. A. Akinleye A. A. Adejimi department of Community Medicine College of Health Sciences Osogbo Ladoke Akintola University of Technology Ogbomoso Nigeria department of Paediatrics College of Health Sciences Osogbo Ladoke Akintola University of Technology Ogbomoso Nigeria department of haematology and blood transfusion College of Health Sciences Osogbo Ladoke Akintola University of Technology Ogbomoso Nigeria department of haematology and blood transfusion LAUTECH Teaching Hospital Osogbo Ladoke Akintola University of Technology Ogbomoso Nigeria department of Community Medicine LAUTECH Teaching Hospital Osogbo Osun State Nigeria

Introduction: To determine the possibility of utilizing total lymphocyte counts (TLC) instead of CD4 counts in the initiation and management of patients with HIV on highly active antiretroviral therapy (HAART). The commencement of HAART CD4 lymphocytes has been employed in the management HIV. However it has been found that determination of CD4 counts is expensive and somewhat laborious to perform in already overburdened healthcare systems especially in the developing countries. Methodology: Five hundred and three (503) consenting patients already on HAART (commenced at CD4 count < 350 cells/μl) who attended our HIV clinic between February 2014 and February 2015 were enrolled into the study. The patients had already been diagnosed as HIV positive. Kappa statistic was computed as a measure of reliability of TLC. Various cut-off marks for TLC in respect of the CD4 counts were determined in addition to the computation of both sensitivity and specificity. Receiver operating curves (ROC), showing area under the curve indicating agreement in classification, were plotted. Results: Majority of patients were female (73.8%). Most of the patients were in the age range of 25 - 34 years (37.2%). Males were found to be significantly older than females (P < 0.05). Area under the receiver operating curves (ROC) revealed that 4 out of 10 patients would be missed using total lymphocyte count (TLC) as the indicator for commencement of HAART. A low correlation coefficient and Kappa statistic r = 0.18, and K = 0.20 respectively, were observed between TLCs and CD4 counts. Conclusion: Total lymphocyte count is not a suitable alternative to CD4 counts in the management of HIV/AIDS.

关键词： HIV CD4 TLC HAART

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