Health care workers who have occupational exposure to blood are at increased risk for acquiring blood-borne infections. The level of risk depends on the number of patients with that infection in the health care facility and the precautions the health care workers observe while dealing these patients. There are more than 20 blood-borne diseases, but those of primary significance to health care workers are hepatitis due to either the hepatitis B virus (HBV) or hepatitis C virus (HCV) and acquired immunodeficiency syndrome (AIDS) due to human immunodeficiency virus (HIV). 1The prevalence of HBsAg in healthy blood donors in Saudi Arabia ranges from 2.7% to 9.8%.2-3 Seroprevalence studies suggest that the overall anti-HCV positivity is about 3.5% to 5%.4-5 Thalassemia and sickle cell disease are common in Saudi Arabia and prevalence of hepatitis C virus antibodies among this high-risk group is about 40%. 6 The prevalence of HIV sero-positivity has been reported to be about 0.09% in the Kingdom. 7 These figures suggest that a sizable number of individuals are a potential risk for transmission of blood-borne diseases to doctors, laboratory technicians, blood bank workers, nurses, personnel working in renal dialysis and transplant units, and other health care workers. The aim of our study was to assess the knowledge, and attitude among health care workers on needle stick injuries. Subjects and MethodsThis study was carried out at the 100-bed Armed Forces Hospital, Sharourah, in January 2002. This hospital provides medical services to army personnel and their families serving in the area. Of a total of 104 health care workers, 70 nurses and paramedical staff (67%) from different departments/wards of the hospital were surveyed. These health care workers are normally directly exposed to blood products and needle-stick injuries while dealing with patients. Of the 36 Saudi health care workers, only seven (19.5%o) were able to participate in the study. Data collection was carried out using a standardized questionnaire. The respondents were given a briefing on the aims of the study, and were asked not to disclose their identity to assure them that this survey was only for academic purposes. A researcher was present during the survey administration to answer queries raised by respondents. The survey was conducted in two batches on two days so that the maximum number of health care personnel working in the hospital could participate. The first part of the questionnaire contained information on demographic data, job category, HBsAg, anti HCV and HIV status of the health care worker. The second part was on the knowledge and use of preventive measures regarding needle-stick injuries. There was no written standing order procedure (SOP) regarding needle-stick injuries in the hospital at the time of the survey. Data was entered and analyzed using the Epilnfo-version 6 statistical package.
Objective: To assess the clinicohaematological presentation and outcome of patients with antibodies to high frequency antigen(HFA) in our setup.Study Design: Cross sectional study. Place and Duration of Study: Armed Forces Institute of Transfusion, Rawalpindi, from Jan 2016 to Jan 2018. Methodology: We diagnosed 29 cases of uncommon red cell antibodies including antibodies to HFA, in a span of two years (2016-2018). Information regarding patient’s age, diagnosis, transfusion history, incompatible cross match and history of pregnancy was obtained. Venous blood sample of 3ml was taken in EDTA for grouping, red cell phenotyping and Direct AntiGlobulin Test (DAT) and 5 ml venous blood was taken for Indirect Antiglobulin Test (IAT), antibody screening and identification. Tube method was used for forward and reverse blood grouping, DAT and IAT. Column Agglutination Technique (CAT) was used for antibody screening, identification and red cell phenotyping. Results: Out of a total of 29 cases, 24 (83%) were of anti H antibody (Bombay blood group). Rest of 5 (17%) included one each of anti Rh 17, anti Rh 29 (Rh null), anti P1Pk, anti-ENA/WRB and anti P antibodies. Anti H Lectin (Ulexeuropaeus) was used for confirmation of H antigen absence, while rest of antibodies were confirmed by IBGRL Bristol, UK. Conclusion: The sources of antigen negative blood are family members, rare donor registry, autologous donations and frozen blood banks. Finding compatible blood for patients with an antibody to HFA may be a challenge.
Objective: To determine the frequency of Rh alloantibodies in pregnant women of the Rh-D negative blood group. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Transfusion (AFIT) Rawalpindi, from Jan to Dec 2017. Methodology: The blood samples of pregnant women received for blood grouping, cross matching and antibodies screening were included in the study. The blood was typed for Rh-D along with ABO blood groups by Column Agglutination Technique (CAT), commonly known as the gel card method. Then, the samples included in the study were subjected to antibody screening by three cell antibody screening panel (Dia Cell, a product of Bio-Rad) by Column Agglutination Technique. The samples with positive antibody screening were further processed by 11 cell antibody screening panel (Dia Cell, BioRad) for Rh antibody identification by Column Agglutination Technique, the same as the indirect antiglobulin test (IAT). Results: 453 Rh-D negative pregnant women were screened for alloantibodies during the study period. Rh alloantibodies were present in 55 (12.08%) cases. The most common alloantibody identified was anti-D in 48 (87.3%) samples, followed by anti-C in 6 (10.9%) and anti-E in 1 (1.8%) case. Conclusion: The most prevalent Rh alloantibody identified in Rh-D negative pregnant women was anti-D, while the anti-C and anti-E were less prevalent. However, no case of anti-c and anti-e alloantibody was identified.
Objective: To assess the frequency of smear positive pulmonary tuberculosis patients diagnosed at private laboratories ofSargodha not included in the national DOTS (Direct Observational Therapy Short Course) programme. Study Design: A retrospectivestudy. Place and Duration of Study: Private laboratories of Sargodha from January 2007 to December 2012. Methodology: Dataanalysis of 3952 patients who reported to private laboratories of Sargodha for staining of sputum for AFB was carried out. They were allself reporting and were either suspects of pulmonary tuberculosis or had a history of contact with a smear positive case of TB. Stainingwas done by Ziehl-Neelson method. The smear results were reported as positive or negative. Results: Out of total 3952 specimens 373(9.21%) were found to be positive for the presence of acid fast bacilli. From these 373 positive cases 164 (44%) were female and 209(56%) were males. The age group most frequently associated with the smear positive result was aged > 55 years (13.89%) followed byage < 15 years (10%). Conclusions: A large number of smear positive patients are diagnosed in private sector. These patients are notregistered in DOTS programme of World Health Organization. Their number is not included in the calculating the prevalence TB in ourcountry. It is recommended that TB case notification should be made mandatory by law by private sector health care providers.
The audit has become an essential tool in the management of the blood transfusion sector of healthcare. The audit is based on a set guidelines to determine the difference between the directions given and what has actually been done. 1 Review of blood ordering habits and blood utilization statistics can help in measures to regulate blood ordering and utilization, and thus help in improving these services.2 This study was carried out at a primary care hospital to evaluate the red blood transfusion practice in gynecology and obstetrics. Material and MethodsThis study was carried out at the Armed Forces Hospital in Sharourah, Kingdom of Saudi Arabia, from January 2000 to December 2001. There are written standing order procedures (SOP) for maximum surgical blood ordering schedule (MSBOS) and guidelines for blood components utilization in this hospital. The Gynecology and Obstetrics ward is comprised of 20 beds. During the study period, 2349 patients were admitted in this ward. The laboratory and hospital records were examined and analyzed for all red blood cells transfusion events in the ward during this period. The cross-match to transfusion ratio was used as a measure of the efficiency of blood ordering practice. (This match should ideally be between 2-2.5:1). Figures more than these values were considered over-ordering. The appropriateness of red cell transfusion was judged by comparison with guidelines of the American College of Physicians.
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