Complement factor H levels in steady state sickle cell anaemia

Objective: The red cell membrane of sickle cell anaemia is vulnerable to attack from the alternative complement pathway. The activation of the alternative complement pathway is initiated by externalization of  phosphatidylserine on red cell membrane. Serum and cell bound regulators normally prevent amplification of the cascade. However, red blood cells in sickle cell anaemia appear to be exposed and the cell lysing membrane attack complex is ubiquitous on irreversible sickle red blood cells. It is possible that there are deficiencies (either functional or quantitative) of  complement regulators. In this study the quantitative defects of the most abundant serum phase regulator,   complement factor H in sickle cell anaemia was investigated.Methods: We compared the plasma levels of complement factor H (a serum phase regulator of the alternative pathway) in 61 steady state Hb SS with 60 healthy Hb AA using an enzyme linked immunosorbent assay to analyze complement factor H level in the plasma. The full blood count parameters were estimated using flow cytometry.Results: There was no significant difference in the serum complement factor H levels between the steady state Hb SS and healthy Hb AA.  Significant inverse relationships existed between complement factor H, total white cell count, granulocyte cell count and platelet count as well as  significant direct relationships between complement factor H, haematocrit, and the haemoglobin concentration.Conclusion: Complement factor H in patients with sickle cell anaemia who are in steady state is not significantly lower than in controls.Keywords: Complement factor H, sickle cell anaemia, alternative pathwa

Optimal timing of post-operative haematocrit check in obstetric and gynaecological surgeries

Background: Haemorrhage is a feared albeit common complication of surgery in Obstetrics and Gynaecology. Measurement of haematocrit post operatively is believed to be part of good medical practice since it gives an inkling to intraoperative and immediate post-operative blood loss and the need for blood transfusion. The objective of the study is to determine if there was any difference between haematocrit values gotten on day 1 and 2 and also to determine the optimal time for the post-operative haematocrit check.Methods: One thousand patients who had surgery in the department of Obstetrics and Gynaecology of LAUTECH Teaching Hospital (LTH) and Bowen University Teaching Hospital (BUTH), Ogbomoso were recruited. Capillary blood samples were obtained at 24hours and 48 hours post operatively. The haematocrit was determined using a 24 place micro haematocrit centrifuge and the values checked using a haematocrit reader. Frequency tables and charts were made and results were tested for significance with level of significance (x) set at 0.05.Results: The mean age of the patients was 32.88±9.45, with a modal age group of 21-30years. The commonest obstetric surgery done was caesarean section (60.6%) while the commonest gynaecological surgery was myomectomy (13.8%). There is a significant difference between the haematocrit values gotten on day one and two (p= 0.000). There was significant difference between the haematocrit values on both days and the unit the patient was managed; the type of surgery done and the age group of the patient.Conclusion: The haematocrit on postoperative day 2 is more representative of the blood loss.Keywords: postoperative, haematocrit, obstetrics, gynaecolog

Retracted: A double blind, placebo controlled randomized evaluation of the efficacy of a Polyherbal Preparation (FaradinR) in treating sickle cell anaemia in Nigerian children

The Editorial Board of the Research Journal of Health Sciences has retracted this publication, Research Journal of Health Sciences, 2021, 9(3): 254-263’ arising from complaint of one of the authors, (Adeyeye M.C.), whose permission was not obtained before inclusion as a co-author.  The lead author did not also include the ethical approval details in the publication. We tender unreserved apology to the complainant. Editor. Introduction: The goal of management of sickle cell anaemia (SCA), for many years, has been to manage acute intermittent crises and  slow down chronic end organ damage. In the past few decades, with increasing understanding of its pathophysiology, compounds primarily preventive in action are being investigated and used. Faradin® (a poly-herbal traditional supplement mixture) has been used aspreventive measure against painful episodes by SCA patients as an over the counter medication and anecdotal evidence suggests that it reduced the frequency and severity of painful crises as well as transfusion requirements. Alternative medications that are both affordable and available should be considered viable alternatives provided safety and efficacy are assured because of the high disease burden in Nigeria.Methods: This was a double controlled randomized study was carried out on twenty children. Each enrolled patient was randomized into either the herbal mixture or placebo after permission to participate in the study was obtain from the parents/guardian for children below 15 years or from both parents/guardian and the patients where the latter are older than 15 years. The main exclusion criterion was prior use or exposure to Faradin. Primary end points were pain alteration, death during study and blood transfusion frequency. Secondary endpoints were hemoglobin levels, neutrophil count, platelet count, hemoglobin F and A2 levels, serum bilirubin, nitric oxide  concentration, drug toxicity and severe complications of sickle cell anemia reported during the study.Results: There was no severe adverse event, deaths or transfusion recorded in the two groups throughout the duration of the study. Mean hematocrit was increased in the Faradin group and reticulocyte count was increased by 12 %. Faradin reduced the total white cell count to half its baseline level and increased hemoglobin F levels by 10%. Weight and appetite were reported to increased and engenders a generalfeeling of wellbeing.Conclusion: Faradin appears to be an efficacious, nontoxic, available and affordable remedy for treating SCA patients in our setting