Open Access Case Study

Mid Shaft Femoral Fracture in a Young Haemophilia A Patient - A Case Report

W. A. Shokunbi, B. J. Brown, M. O. Okunola, T. S. Akingbola, O. W. Aworanti

International Journal of Research and Reports in Hematology, Page 1-5

Introduction/Aim: Haemophilia is a rare X chromosome linked inherited bleeding disorder, characterized by deficiency of coagulation factor VIII in Haemophilia A or factor IX in Haemophilia B. Patients deficient of either of these coagulation factors are prone to fracture as a result of reduced bone mineral density. Our aim is to present a case of Haemophilia A with mid shaft femoral fracture and difficulties in his management.

Presentation of Case: We present a case of mid shaft femoral fracture in a eight year old boy with Haemophilia A who slipped on a wet floor in his home. He initially presented at a private facility where he experienced mismanagement by the use of intramuscular injection before coming to our tertiary health care center, University College Hospital (UCH), Ibadan. Management of the fracture was also hampered by non availability of recombinant factor VIII concentrate at presentation; he was transfused with both whole blood and fresh frozen plasma. He had skin tractions done on two occasions with no alignment of the fractured bones before he subsequently had Plaster of Paris cast under recombinant factor VIII concentrate cover. He was discharged after 14 weeks on admission with x-ray at discharge showing over riding of the involved bones.

Conclusion: Management of fracture in this haemophilia patient was a difficult task especially with his active lifestyle. Delayed presentation at a tertiary health care facility and unavailability of recombinant factor VIII concentrate negatively affected the outcome.

Open Access Original Research Article

Seroprevalence of Hepatitis B Surface Antigen in Pregnant Women of General Hospital Agbor, Delta State

A. A. Aigbiremolen, S. E. Ehebha, B. O. Pereye, K. E. Asemota

International Journal of Research and Reports in Hematology, Page 1-7

Reportedly transmitted through unprotected sexual intercourse with infected person(s), experts have estimated new cases of hepatitis B virus (HBV) infections to be over 70,000 per year in the United States. With little or no records of such in Nigeria, this study investigated the prevalence of hepatitis B surface antigen at different trimesters of pregnancy in women who visit general hospital Agbor, Delta state, Nigeria; for antenatal care. A total of one hundred (100) pregnant and fifty (50) non-pregnant (control) women were ethically recruited for the exercise. They were then sub-grouped by age and duration of pregnancy (trimester); and an Acon serological strip was used to obtain blood samples from each subject. Obtained blood was then assayed for the presence of hepatitis B virus (in serum) and compared with those of control (non-pregnant) group. Following careful comparison of differences in mean (using the Analysis of variance), study found a 5% prevalence rate (of hepatitis B) in pregnant than non-pregnant (2% prevalence) women. Study also observed a statistically significant increase in hepatitis B surface antigen for non-pregnant women of age bracket 20-24 years (2.6% prevalence) to pregnant women of between 20-24 years. HBV infection therefore has high prevalence rate in pregnant than non-pregnant women as they are often more exposed to unprotected sexual intercourse. We recommend regular and continuous HBV screening in pregnancy to help circumvent HBV infection related ailments and complications. The same is also suggested for non-pregnant women for purpose of proper vaccination. 

Open Access Original Research Article

Carboxyhaemoglobin, Methaemoglobin and Sulphaemoglobin Level are Increased in Automobile Workers and Spray Painters; A Study in Calabar Cross River State, Nigeria

Okafor, Ifeyinwa M., Inyang, Samuel E., Thompson, Bright E.

International Journal of Research and Reports in Hematology, Page 1-9

Background: Methemoglobin (Hi) is a metaloprotein in which the iron in the haem group is in ferric state. Sulphaemoglobin (SHb) is a stable, green- pigmented molecule, which is made by the oxidation of the iron in haemoglobin to a ferric state by drugs and chemicals that contain sulphur. Carboxyhaemoglobin (COHb) is a stable complex of carbon monoxide and haemoglobin that forms in red blood cells upon contact with carbon monoxide (CO).

Aim: This study set out to determine Hi, SHb and COHb level of automobile workers and spray painters in Calabar Nigeria. Ninety subjects were recruited for this study, 30 automobile workers, 30 spray painters and 30 non-automobile workers and non-spray painters.

Methods: Standard Evelyn and Malloy method was used for Hi and SHb estimation, Differential Spectrophotometric method was used to measure COHb while microhaematocrit method was used to determine packed cell volume.

Results: The result of this study shows that mean Hi and COHb level were significantly higher (p = 0.02) in spray painters and automobile workers than in the control. The mean Hi, COHb and SHb value of automobile workers and spray painters that are smokers were shown to be significantly higher than those that are non smokers. The result also shows that the COHb, Hi and SHb level of spray painters significantly increased as the duration of work increases.

Conclusion: This study has shown that there is increased level of Hi, COHb and SHb among automobile workers and spray painters in Calabar Cross River State, Nigeria. We therefore recommend enlightenment campaign to educate these set of workers on the negative health implication of exposure to the fumes, gasoline and spray paint.

Open Access Original Research Article

Relationship between Folate Status and Complete Blood Count (CBC) Parameters in Sickle Cell Anaemia (SCA) at Steady State in Aminu Kano Teaching Hospital, Kano, Nigeria

Aisha Amal Galadanci, Ibrahim Abdulqadir, Aisha Kuliya Gwarzo, Sagir Ahmed Gumel

International Journal of Research and Reports in Hematology, Page 1-6

Aim: To determine the relationship between folate status and CBC parameters in SCA patients at steady state.

Study Design: Comparative cross-sectional study.

Setting: Departments of Haematology and Blood Transfusion and Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria between April and August, 2017.

Methodology: One hundred and ten (110) each of SCA patients (subjects) in steady state and their age and sex matched controls were enrolled. Haemogram and folate levels were determined. Data were analysed with SPSS version 21.0 and p≤0.05 was considered significant.

Results: The mean age of the participants was 15.2±7.4 years with a range of 4 – 32 years. There was no significant difference between the SCA patients and controls on basis of age, sex and level of education (p >0.05). The prevalence of folate deficiency among SCA patients was 46.4% (serum) and 49.1% [red blood cell (RBC)] compared to controls 22.0% (serum) and 22.9% (RBC), p<0.05. SCA patients were more likely to develop folate deficiency than controls [OR (95% CI) for serum 3.1(1.7 to 5.5) and RBC 3.2(1.8 to 5.8)], p<0.05. Red cell folate deficiency is associated with low haematocrit and high red cell distribution width while serum folate deficiency was associated with low haematocrit, p<0.05.

Conclusion: Despite routine prescription of folic acid, SCA patients had a higher prevalence of folate deficiency and this was associated with lower haematocrit. We therefore recommend that, physicians should device criteria for assessing compliance with routine prescription and do folate assay for patients with persistent high RDW and low haematocrit in steady state.

Open Access Review Article

Implication of Sugar Intake in Haemorrhoid and Menstruation

Augustine I. Airaodion, Peace R. Adejumo, Onyinyechi C. Njoku, Emmanuel O. Ogbuagu, Uloaku Ogbuagu

International Journal of Research and Reports in Hematology, Page 1-9

This review discusses the implication of sugar intake in haemorrhoid and menstruation. Haemorrhoid is the clustering of veins in the rectum leading to swollen anus. This occurs due to pressure exerted on the rectum. When these veins swell, they expand outward into the membranes around the rectal and anal tissue. Most people believed that sugar is the onset of haemorrhoid. Haemorrhoid occurs as a result of pressure exerted on the rectum leading to the swelling of the veins in the rectum. Since sugar does not exert pressure on the rectum, it doesn't cause haemorrhoid but can aggravate it and increase the grade. To reduce or avoid haemorrhoid, it is advisable to visit the toilet and excrete as soon as one is pressed. The rectum should not be allowed to be filled for a long time. Menstruation is the regular monthly discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina.  This stops after menopause, which usually occurs between 45 and 55 years of age. It also stops during pregnancy and typically do not resume during the initial months of breastfeeding. There is a general believe that sugar intake increases menstrual flow but this review shows otherwise. High intake of sugar has not been implicated in increasing menstrual flow but cause increased severe menstrual cramps by increasing the production of prostaglandins. Prostaglandins act by contracting the uterine walls and constricting the blood vessels of the uterus which results in pain during menstruation.