Seroprevalence of Hepatitis B, Hepatitis C, HIV Infections in Blood Donors of Khulna, Bangladesh

To determine changes (Trends) in infection rates of Hepatitis B surface antigen (HBsAg), Hepatitis C virus (HCV) and Human immunodeficiency virus (HIV) in blood donors of Khulna Population. Specimens of 34953 voluntary blood donors & party or relative donors in Transfusion Medicine Department of Khulna Medical College Hospital from 2007 to 2009 were screened for HBsAg, anti-HCV, anti-HIV 1 & 2 reactivity in a cross-sectional survey by rapid test method. Reactive samples were verified using a recognized confirmatory test which consisted of a second generation enzyme immune assay (HBsAg), anti-HCV antibodies by anti-HCV EIA & for HIV by western Blot, respectively. The seroprevalence of HBsAg, Anti-HCV, HIV antibody 1 & 2 was 1.4%, 0.09% & 0.03% respectively in all blood donors. Prevalence of confirmed positivity was 0.62% for HBsAg, 0.04 % for Anti-HCV, 0.02% for HIV Western Blot. Between 2007 to 2009 a decreasing trend was observed in HBsAg frequency, HCV frequency decreased in 2009 compared to 2007. One HIV positivity found in 2009. Although the frequency of transfusion transmitted infections is low, party or relative donors have some risk factors than voluntary blood donors. Through more scrutiny in donor selection, improved serological test & reevaluation of infections routes in donor, infection reduction can be achieved.

Update of pathogen reduction technology for therapeutic plasma

In the developed world, blood products are tested for the presence of some of pathogens prior to administration. There exists a small, but definite risk of transmission of infectious agents. The risk of transmission of viral infection is due to the "window period": the period of time between the infection of a donor and the development of detectable level of antibodies. Nucleic acid amplification testing (NAT) was introduced for HIV and HCV in the United States in 1998 and has shortened the window period and further decreased the incidence of pathogens in transfused units of blood products. The development of increasingly sensitive laboratory screening methods and restrictive donor criteria has greatly decreased the risk of transmission of many pathogens through blood transfusion; however, transfusion is still not risk free. Blood is currently not tested for many potentially dangerous known pathogens. The emergence of new agents such as West Nile Virus (WNV) demonstrates that potential threats to the blood supply continue to emerge world wide. The testing and donor rejection methods currently used to screen the blood supply may not offer complete protection against all of these emerging infectious agents. This overview aims to provide an update on the continual improvements in blood component safety in particular using methods that target pathogen's nucleic acid.

Prospective Study of Saline Infusion Sonography and Office Hysteroscopy

BACKGROUND

To evaluate the diagnostic potential of saline infusion sonography to pick up uterine cavity lesions and compare it with the gold standard office hysteroscopy.

METHODS

Study population consisted of women scheduled for office hysteroscopy for various indications. Uterine cavity of 208 women of the study group were evaluated first by saline infusion sonography and then by office hysteroscopy by two separate examiners. Findings were recorded separately for both procedures and compared. Pain rating was also noted after each procedure.

RESULT

In eight patients either or both the procedures could not be performed for various reasons, hence were excluded from the analysis. With saline infusion sonography, pathological findings were identified in 93 (46.5%) patients and hysteroscopy detected lesions in 88 (44%) patients. For all findings combined sensitivity of saline infusion sonography was 90.9%, specificity 88.3%, positive predictive value 86.0% and negative predictive value 92.5% as compared to hysteroscopy. Former was less painful and easier to perform than the latter.

CONCLUSION

The findings of saline infusion sonography and office hysteroscopy did not differ significantly. Thus saline infusion sonography is an excellent option for uterine cavity evaluation.

Relationship between blood groups and coronary artery disease

There are mounting evidences of relationship of different blood groups to disease. For many years, ABO blood group has been associated with predisposition to both arterial and venous disorders, such as venous thromboembolism, peripheral vascular disease and coronary artery disease. To evaluate the relationship of ABO and Rhesus blood groups with coronary artery disease. Total ninety five patients with coronary artery disease admitted in the Cardiac Surgery Department of Zarina Sikhder Women Medical College, Dhaka, and ninety five healthy stuff of same Medical College were studied. Their ABO and Rhesus Blood Groups were determined by standard method in the department of Transfusion Medicine, Zarina Sikhder Women Medical College, Dhaka, Bangladesh with full support from the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The results obtained in this study show that the prevalence of Coronary Artery Disease (CAD) in blood group O is invariably higher than in all other ABO blood groups (p<0.05). It is striking that despite the fact that the most prevalent blood group among Bangladeshi people is phenotype B, the prevalence of CAD risk is associated with phenotype O (Odd ratio 2.034, 95% confidence interval 1.127 to 3.67). This suggests that a certain CAD risk is associated with phenotype O. Thus we conclude that, in Bangladeshi people, blood group phenotype O is associated with a substantially increased risk for CAD.

Changing patterns of Vibrio cholerae isolation over three consecutive cholera seasons (1992-1994) in east Delhi

The emergence of new strains of Vibrio Cholerae has added a new dimension to the variability in pathogenicity and potential virulence of the organisms precipitating diarrhoeal diseases. Considering the shifting patterns of V. cholerae 01 there is a continuous need to monitor the strain characteristics. In this study total 541 stool specimens of acute secretory diarrhoea were investigated between May 1992 and November 1994 for strains of Vibrio Cholerae and anti-microbial susceptibility testing of all the confirmed V. Cholerae strains. In 1992, 50 of the 125 strains (40%) were positive for V. cholerae 01 predominantly biotype El Tor serotype ogawa, and 10 (80%) of non 01 type, with most strains susceptible to tetracycline (100%), chloramphenicol (98%) and Cotrimoxazole (98%), but all resistant to polymyxin B and furazolidine. In 1993, 44 (43.6%) of the 010 strains were positive for V. cholerae 0139 and the rest V. cholerae 01. In 1994, another sero group of V. cholerae 010 emerged, with 42 (13.3%) being positive. Isolates did not agglutinate with any of these antisera and have been labelled as 'other than non-01 vibrio cholerae'.

Cluster of cases of clinical cholera due to Vibrio cholerae 010 in east Delhi

A total of 514 samples of acute diarrhoeal stools received over a period of four months yielded 315 isolates morphologically and biochemically resembling V. cholerae. Out of 315 isolates, 223 (70.8%) were identified as V. cholerae 01, 20 (6.4%) as 0139 and 42 (13.3%) as 010. Thirty (9.5%) isolates did not agglutinate with any of the available antisera. All V. cholerae 010 isolates showed complete homogeneity in their biochemical and physiological properties. This strain appears to be closely related to El Tor biotype of V. cholerae 01, since it was positive for some of the tests used for identification of El Tor. The ability of strain 010 to grow in the presence of 6 per cent salt provides it the status of an important environmental pathogen. Acquisition of some virulence genes from El Tor vibrios by this strain 010 appears to be one of the mechanisms involved in the emergence of this serogroup.