Objective: To compare the platelet count, platelet concentration/yield, residual Red blood cells (RBCs) and White blood cells (WBCs) counts in platelet-rich plasma (PRP) samples prepared from the single- and the double-centrifugation protocols. Methods: It was a Cross-Sectional study, conducted at the Department of Hematology & Transfusion Medicine, The Children’s Hospital and UCHS, Lahore from October 2021 to January 2022 including 50 voluntary, healthy individuals of age 20-45 years of both genders, after taking informed consent. Complete blood count analysis of all participants was done initially by drawing 3ml blood in EDTA vial. From all the participants, 20 ml venous blood sample was taken in syringes containing tri-sodium citrate and then shifted to harvest tubes. Group-I comprised of PRP samples prepared by single- centrifugation method. While Group-II samples were prepared by Double-centrifugation method consisting of soft and hard spin. The platelet, RBC and WBC counts in prepared PRP samples were determined by using automated SYSMEX XP-100 hematology analyzer. Platelet yield or Platelet concentration (%) was calculated for samples using formula. The data analysis was done using SPSS version 23. Results: The mean PRP platelet count in Group-I was 594.6±157.4×103/µl whereas in Group-II was 923.06 ± 127.58×103/µl. In Group-I, the mean platelet concentration/yield in PRP was 175.75 ± 55.08% while in Group-II, it was 276.78 ± 112.7%. Significant difference was observed between the platelet counts and platelet concentration/yields from the PRP samples of two Group-s (p < 0.01). Significant difference between the WBCs count was also observed (p < 0.01) with higher WBCs in Group-I PRP. Residual RBCs were almost same among two Group-s. Conclusions: The double centrifugation protocol resulted in higher platelet quantity and yield with less contamination by red and white blood cells than did the single centrifugation protocol for PRP preparation. So, double centrifugation method is beneficial in preparation of autologous as well as allogenic PRP. doi: https://doi.org/10.12669/pjms.39.3.7264 How to cite this: Saqlain N, Mazher N, Fateen T, Siddique A. Comparison of single and double centrifugation methods for preparation of Platelet-Rich Plasma (PRP). Pak J Med Sci. 2023;39(3):634-637. doi: https://doi.org/10.12669/pjms.39.3.7264 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To determine the frequency of ABO discrepancies in pediatric patients of lymphoma and solid organ tumors and to categorize these discrepancies and their resolution. Study Design: Cross-sectional study. Setting: Department of Hematology & Transfusion Medicine, The University of Child Health Sciences & The Children’s Hospital, Lahore. Period: November 2020 to September 2021. Material & Methods: ABO blood group discrepancies were assessed by tube method of blood grouping, using antisera A, B, AB & D for forward grouping and A, B, and O cells for reverse grouping. Auto control was also run. The resolution techniques were used accordingly. The collected data was checked for its completeness, consistency and accuracy before analysis which was done on SPSS version 26. Results: In this study, a total of 105 subjects were included with mean age of 5.64 ±2.1 years. Among them 72(68.6%) were male and 33(31.4%) were female. Out of total samples processed, three (2.9%) discrepancies found, 1 in female and 2 in male patients. There were two cases of Group I ABO discrepancies, one of which was resolved by elution, antibody screening and identification and other by incubation at 37oC and correlation with previous transfusion history. One case of Group II ABO discrepancy which was resolved by incubation at 40C for 30 minutes. Conclusion: This shows that ABO discrepancies occur in pediatric patients of lymphoma and solid organ tumors. So, the interpretation of forward and reverse ABO blood grouping, identification and resolution of ABO discrepancies in these patients should be done very carefully to avoid any transfusion related adverse reactions.
Aim: To determine frequency of alloimmunization and autoimmunization among the patient of thalassemia with history of multiple blood transfusions. Methods: This study was conducted by consecutive sampling in six months duration from September 2020 to August 2021 at the department of Hematology and blood Transfusion Medicine, of University of Child Health Sciences, The Children's Hospital Lahore. Any patient with a positive Direct antiglobulin test (DAT) was labeled as auto-immunized and a positive indirect antiglobulin test (IAT) was labeled as alloimmunized. Results: Total 90 cases were enrolled with 62% male and 38% females with a mean age 6.04 + 3.3 years (range of age: 7 months to 14 years). Antibody screening and auto-antibodies were positive in 4.4% (n= 4) cases each, and allo-antibodies in 6.7% (n=6) cases (anti-E in 2, anti-C in 2, anti-K and anti-e in 1 each). Among all these patients of beta thalassemia, spleen was enlarged in 71% cases; around half of these were <5 years old. Around 96% had first transfusion <2 years. The frequency of patients positive on DAT, IAT and on anti-body screening was significantly related to the frequency of blood transfusion Practical Implications: Autoantibodies produce a positive direct antiglobulin test (DAT), resulting in hyperhemolysis of red cells in thalassemic patients, which exacerbates the existing alloantibodies factor in children who have received several blood transfusions. The gap between transfusions will be shortened. Routinely, greater emphasis is placed on the identification of allo-antibodies, but auto-antibodies should also be evaluated so that this phenomena may be better understood and handled. This study was conducted to examine the link between a greater transfusion demand and the existence of auto or allo antibodies in Thalassemia patients. I Conclusion: We found Alloimmunization and autoimmunization together not very uncommon in transfusion dependent patients of Thalassemia. The frequency of transfusions is affected in co-existing states. Extended matching, as well as early diagnosis and control of Auto and allo-antibodies both can improve the efficacy of blood transfusion. Keywords: Autoantibodies, IAT, DAT, Coomb’s test, Thalassemia, Allo-immunization
ORIGINAL PROF-3471 ABSTRACT… Background: In 1939 Rh antigen was discovered by Levine and Stetson. Rh system antigens are very immunogenic, they can produce significant Hemolytic Disease of the fetus and Newborn as well as hemolytic transfusion reactions. There are numerous variants of D, the most common subtypes are Weak D and Partial D, now called as abnormal D antigens. The incidence of Rh negativity worldwide varies between 3%-25% and that of weak D antigen ranges from 0.2%-1%. Objectives: To find out the frequency of Rh negativity and weak D antigen among the donors coming to the blood bank of The Children's Hospital & Institute of Child Health, Lahore and to review the clinical significance of weak D antigen in transfusion perspective especially its role in alloimmunization caused by Weak D antigen when transfused to Rh negative individuals. Study Design: Cross-sectional study. Setting: The Children's Hospital and Institute of Child Health, Lahore. Period: 1 st Jan 2015 to 31st May, 2015. Materials and Methods: 6320 healthy donors were randomly selected. All samples were grouped for ABO and Rh-D factor by immediate spin tube technique. All samples found Rh negative, were further processed for weak D antigen with monoclonal anti D sera by using indirect Coomb's technique. The presence of macroscopic or microscopic agglutination was recorded as Rh positive. In case there was no agglutination the mixture was washed 4 times with normal saline. After the last wash, saline was decanted and 2 drops of monoclonal, polyvalent anti human globulin was added. Macroscopic and microscopic agglutination was looked for and any agglutination at this stage was recorded as weak D antigen. Positive control (check cells i.e. washed O positive cells with diluted anti D) and negative control (washed O positive cells) were always put. Results: Among the 6320 healthy donors, 1224(19.4%) were Rh-D negative and 5096(80.6%) were Rh-D positive. Of the 1224 Rh D negative samples, 3 (0.2%) samples found positive for weak D antigen. Conclusion: The frequency of Rh negative blood group was 0.2% among the healthy donors at The Children's Hospital and ICH, Lahore. Although the frequency is low but it's proven by literature that weak D antigen can produce alloimmunization if transfused to Rh-D negative subjects. At the same time the cases of hemolytic reactions reported previously with Weak D antigen have been scarce.
Introduction: Frequent contribution of blood can cause iron exhaustion in blood donors along with the problems related to it. Curtailing the proportion of iron reduction among blood donors is a crucial plan for boosting donor’s well-being. Aim & objectives: The aim of this analysis is to determine iron stocks by measuring serum ferritin in pre-donation male blood donors along with their relation with the hemoglobin concentration and frequency of blood donations. Study design: Cross-sectional study. Place and duration: Pathology (immunohematology) department and blood bank of University of Child Health Sciences, The Children Hospital Lahore from Aug 2021 to July 2022 Material and Methods: A total of 350 serum samples were processed to determine hemoglobin and serum ferritin concentrations. The study involved was performed on healthy blood donors. The method used was chemiluminescence for the simultaneous measurement of serum ferritin. Results: An aggregate of 350 serums were collected from the contributors in blood bank. Among them, 154 were the first-time donor and 196 were the frequent donors; the serum ferritin was markedly reduced in constant contributors. The mean value 105ng/mL was found in infrequent donors and 79.35ng/mL was found in frequent donors. There was no notable variance in hemoglobin of newbie and regular blood givers. However, a momentous variation in the pervasiveness of iron depletion between first‑time and regular donors is found. Conclusion: Blood donation has a noteworthy impact on iron stores and is one of the most important factors for iron shortage in contributors, specifically in those who donate blood again and again. Serum ferritin measurement ought to be incorporated in the blood donor preference especially in the evaluation of consistent blood givers to assure enough iron pools in the donor community in order to sustain a pertinent potential donor.
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