Pattern, indications and review of complications of neonatal blood transfusion in Ibadan, southwest Nigeria

Background and objectives: There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period, there is paucity of local data on the pattern, indications and reactions to blood transfusions in Nigerian newborns. This study evaluates the blood transfusion indications and patterns in special care baby unit and C12nd of University College Hospital, Ibadan, Nigeria. Methodology: A cross sectional study was carried on the recruited newborns and structured questionnaires were used to obtain bio data, medical problems, indications for blood transfusion, type of blood products transfused and clinical signs. Urinalysis was performed out before and after the transfusion. Results: A total of 100 neonates were recruited into the study with a male: female ratio of (M: F= 1:1). The age range was 2–34 days and their weight ranged between 0.8kg to 3.6 kg with a mean weight of 1.64 kg. The main indications for transfusion were anaemia from prematurity & neonatal sepsis(NNS) 46%; (red cell replacement), NNS, Disseminated intravascular coagulation(DIC) & anaemia 24%; (partial exchange + top up + Fresh frozen plasma), neonatal jaundice(NNJ) & anaemia 14%; (whole blood), NNJ, NNS + anaemia 6%(Blood transfusion + Fresh frozen plasma), NNS + anaemia 10% (whole blood). Conclusion: Blood transfusion is still frequent in the study area and prematurity, neonatal sepsis and jaundice rank high in the indications. Transfusion reactions are rare in the evaluated neonates

Abdominal Pain in Adult Sickle Cell Disease Patients: A Nigerian Experience

Background: Abdominal pain is a relatively frequent occurrence in sickle cell disease. The aetiology of abdominal pain in sickle cell disease is often difficult to diagnose clinically. Despite the frequent occurrence, diagnostic dilemma, and the need for an accurate, early diagnosis, abdominal pain insickle cell disease has not been rigorously studied.Objective: We therefore sought to describe the different presentations and patterns of abdominal pain in persons with sickle cell disease.Methods: A prospective case series of 20 patients was done in which data was collected on demographic characteristics, hemoglobin electrophoresis patterns, a description of the abdominal pain including sites, severity, and type of pain, packed cell volume and the provisional and final diagnosis.Results: Haemoglobin S patients were 17 in number constituting eightyfive percent (85%) of our study population whilst the rest 3 were Hb S+C. Most patients (70%) had one site of abdominal pain. The pain was mainly colicky or tightening, moderate to severe in nature and, in some cases, associated with vomiting. We did not find any significant difference between the steady state PCV and the PCV during the acute abdominal pain episodes. The final diagnosis showed that only 38.8% of the patientshad vasoocclusive crises and the reliability index between the provisional diagnosis and the final diagnosis was 67%.Conclusion: Abdominal pain in sickle cell disease may present in different ways and it is important to recognize that the possible diagnoses are numerous. Not all cases are due to vasoocclusive crises. Early diagnosisand prompt treatment can be life saving.Keywords - Abdominal Pain, Sickle Cell Disease, Anaemi

Altered calcium metabolism: the probable major biochemical lesion in many pathological and clinical states of lead toxicity

The study was designed to provide evidence for altered calcium metabolism in lead toxicity and its pathological and clinical implications, which are incompletely elucidated in humans. Eighty-six lead (Pb) workers and 51 age, sex, dietary and anthropometric indices matched controls participated in this study. Blood lead level (BLL), serum total and ionized calcium, inorganic phosphate, serum albumin, total alkaline phosphatase (ALP) and the Bone form (isoenzyme) of alkaline phosphatase (B- ALP) and indices of renal function were evaluated in both lead workers and controls. The result showed blood lead level was higher in Pb workers than in controls (P0.05) respectively. Nineteen percent (19%) of Pb workers demonstrated calcium level below the lower limit of reference range (0.05; P>0.05) respectively. Urinary protein related to creatinine was significantly higher in Pb workers than in controls (P0.05; P>0.05) respectively. These data are suggestive of altered calcium metabolism impairing cell membrane stabilization, the vasorelaxing effect of calcium and cell signaling. Altered calcium metabolism may be the major biochemical lesion underlying many pathological and clinical states of lead toxicity.Journal of Biomedical Investigation Vol. 5 (1) 2007: pp. 9-1