Open Access Case Study

The Prophylactic Treatment of COVID-19 in a Renal Failure and Hodgkin Lymphoma Patient with Convalescent Plasma

Soykan Biçim, İlhami Berber, Mehmet Ali Erkurt, İrfan Kuku, Emin Kaya, Yılmaz Bilgiç, Ahmet Sarıcı, Ahmet Kaya, Emine Hidayet, Ayşe Uysal

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

COVID-19 is a viral infectious disease that is thought to have emerged from an animal market in Wuhan, People's Republic of China, in December 2019, and subsequently caused a pandemic. Despite the fact that one year has passed since the onset of the epidemic and many treatment agents have been tried, there is still no approved treatment. Convalescent plasma therapy is a passive immunization method and holds promise in the treatment of COVID-19. In this study, we observed that asymptomatic COVID-19 infection was effectively treated with convalescent plasma in a young patient with a diagnosis of Hodgkin lymphoma, acute renal failure also who received R-DHAP (Rituximab – Cisplatin – Cytarabine - Dexamethasone) chemotherapy treatment. We think that this treatment may be more effective when it is administered in an earlier stage of disease in asymptomatic patients.

Open Access Case Study

Rituximab Induced Late Onset Neutropenia

K. H. B. P. Fernandopulle, J. Bavanthan

International Journal of Research and Reports in Hematology, Page 6-10

Rituximab is a monoclonal antibody against CD20 a leucocyte cell marker expressed on normal and neoplastic B lymphocytes .Although first used for treatment of CD20 positive non-hodgkin’s lymphoma it’s use has expanded to include a varied spectrum of diseases mostly autoimmune disorders. Thus it is used in the treatment of autoimmune haemolytic anaemia, immune thrombocytopenia, rheumatoid arthritis, pemphigus vulgaris, vasculitis and many more autoimmune conditions.

Rituximab is generally a well tolerated drug although many acute and delayed adverse effects are noted. Rituximab induced late onset neutropenia [LON] is a rare and life threatening adverse effect which needs to be suspected in patients presenting with neutropenia after four weeks of completing Rituximab therapy.

We report a case of a 73year old man who presented with severe grade 4 neutropenia of 0.04x109/L and life threatening sepsis 19 weeks after treatment of autoimmune haemolytic anaemia with four doses of Rituximab. He recovered with prompt initiation of G-CSF and made a complete recovery.

LON is a delayed drug-induced reaction, which appears several months (usually 1 to 5 months) after cessation of rituximab treatment. With widespread use of Rituximab for autoimmune diseases in different medical disciplines it is important that these physicians are aware of and monitor patient’s post-Rituximab therapy for this delayed reaction.

Open Access Short Research Article

RHD Gene Amplification on Reused FTA Card: A Pilot Study

Mujtaba A. Allawati

International Journal of Research and Reports in Hematology, Page 26-29

Aims: RHD gene analysis performed directly from repeatedly extracted DNA on FTA card disc has not been studied. Here we demonstrate a direct real-time PCR of RHD gene exon 10 by reusing FTA card.

Study Design: This is an experimental pilot study to observe the RHD exon 10 amplification on repeatedly extracted DNA on FTA card.

Methodology: Five samples from dry blood spot on FTA cards were subjected to wash and lysis four times without additional extraction process. The lysates on each round was demonstrated for signs of amplification by melting curve analysis and agarose gel electrophoresis.

Results: Successful amplification of RHD gene exon 10 was observed by melting curve analysis (melting temperature 84.85oC) and reconfirmed by 2% agarose gel electrophoresis (393 bp fragment). 

Conclusion: Repeated amplification of DNA from direct FTA card with dried blood sample without the need of time consuming extraction process was possible.

Open Access Original Research Article

Haematological Parameters of Sickle Cell Disease Patients on Prophylactic Antimalarial Regimen within Port Harcourt, Nigeria

B. E. Echonwere-Uwikor, O. E. Chukuigwe-Igbere, P. H. Chukwu, F. K. Uwikor, T. N. Aleruchi-Didia, R. G. Atele

International Journal of Research and Reports in Hematology, Page 11-17

Introduction: Sickle cell disease (SCD) is caused by mutation in the β-globin, which results in gene substitution of Valine for Glutamic acid. SCD is prevalent in Plasmodium falciparum endemic regions such as Nigeria. Thus, haematological parameter of SCD patients during malaria infection may be affected. Prophylaxis against malaria is therefore important in SCD patients, as antimalarial chemoprophylaxis has also been shown to be beneficial in SCD patients, reducing parasitaemia and anaemia, and the requirement for blood transfusion.

Aim: This study evaluated the haematological parameters of sickle cell disease patients on prophylactic antimalarial regimen within Port Harcourt, Rivers State, Nigeria.

Methods: This cross sectional study investigated 50 Sickle Cell Disease Patients attending different hospitals within Port Harcourt and 50 apparently healthy staffs and students of River State University who served as control. Three (3ml) of blood was collected aseptically from each participant and analyzed for complete blood count using Haematology auto-analyzer (Sysmex XN-550)

Results: The result show that male (51%) are more exposed to SCD in Port Harcourt than female (49%). There was a statistical significance in the Haemoglobin of Male (8.81±3.61) as compared to that of the female (11.62±3.77) (p=0.0097) while other parameters showed no statistical significance. The result showed a lower mean value for RBC, PCV, HB, MCV, MCH and MCHC of SCD patients on antimalarial regimen when compared to the control subjects. Higher mean value for WBC, Lymphocytes, Monocytes, and Eosinophils where statistically significant when compared with the control subjects. The result gotten emphasised the need for proper management of P. falciparum malaria in SCD.

Conclusion: This study discovered that sickle cell disease patients are more of the age range between 18-21 years (50%), this might be attributed to the fact that many of the SCD patients pass away before they get old due to the disorder. This study has also established that Sickle Cell Disease patients on prophylactic anti-malarial regimen have low haemoglobin, haematocrit, RBC, MCV, MCH, and MCHC, but increased WBC, lymphocytes, monocytes and eosinophils. Results from this study can help in the differential diagnosis of malaria infection in HbSS genotype based on haematological parameters in resource limited setting where sickle cell genotyping remains a challenge.

Open Access Original Research Article

Anti-Pyretic Effects of Aqueous Extract of Alchornea cordifolia in Albino Wistar Rats

Dikoye Peters, E. Harrison Ogheneochuko, A. A. Wake, Ukoro Blessing

International Journal of Research and Reports in Hematology, Page 18-25

Anti-pyretic effect of aqueous leaf extract of Alchornea cordifolia on Wistar rats were investigated. Twenty Wistar rats of both genders weighing between 110-178g were used for this study. Baker’s yeast was used for induction of pyrexia. The rats were grouped into five groups of 5 per group in each study. Groups 3, 4 and 5 received 400, 800mg/kg b.w of aqueous extract and reference drug respectively after induction. Groups 1 and 2 served as normal and negative controls. Rats were sacrificed and blood samples collected for hematological and biochemical analyses. Phytochemical screening of the plant revealed the presence of alkaloid, phenolic compounds, Tannins and Quinine.  Result showed significant in (p≤ 0.05) in paw size, rectal temperature and number of writhing in group 2 and non-significant reduction (p ≥ 0.05) in group 4 were seen when compared to group 1 and 2 respectively. Significant (p≤0.05) increase in C-reactive protein and nitric oxide concentrations were observed in groups 3 and 4 when contrasted to group 2 in the studies. Non-significant differences in all hematological parameters in all treated groups were observed when compared to group 2. Aqueous leaf extract of Alchornae cordifolia displayed pyretic effects at 800mg/ kg b.w after 4 hours of treatment.

Open Access Original Research Article

Haematological Parameters and Oxidative Stress Changes in Apparently Healthy Pregnant Women in Bori, Nigeria

Jonathan Awajiomowa, Bruno Chukwuemeka Chinko, Kinikanwo Innocent Green

International Journal of Research and Reports in Hematology, Page 30-39

Introduction: Pregnancy is associated with alterations in haematological and oxidative stress parameters as physiological adjustments are made to accommodate the increasing demand from the fetus and the maintenance of maternal wellbeing. No study has evaluated the interaction between these parameters in normal pregnancy.

Method: In this cross-sectional case-controlled study, baseline values for haematological and oxidative stress changes were evaluated in pregnant women attending an ante-natal clinic at selected private clinics in Bori. A total of 100 subjects (80 pregnant women and 20 non-pregnant women) were recruited for the study. Haematological and oxidative stress parameters were determined following standard protocols.

Results: The result of the study shows a significant increase in the mean values of white blood cells, neutrophils, monocytes and catalase among the pregnant women compared to non-pregnant control while the mean value of the eosinophils was found to decrease among the pregnant women compared to the non-pregnant control (p<0.05). Neutrophils and catalase were significantly higher in the third trimester when compared with the non-pregnant control (p<0.05). A significant negative correlation was observed between catalase and mean cell volume; superoxide dismutase significantly correlated negatively with haemoglobin concentration, packed cell volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, total white blood cell and neutrophil counts. Glutathione significantly correlated negatively with neutrophils and monocytes while malondialdehyde significantly correlated with mean corpuscular hemoglobin concentration, total white blood cell, monocytes and eosinophil and basophile counts.

Conclusion: This study has demonstrated that there may be an association between oxidative stress and haematological parameters among pregnant women.

Open Access Original Research Article

Haematological Parameter and Indices in Hospitalized COVID 19 Positive Patients at Centre for Communicable Disease Control and Research (CCDCR), Federal Medical Centre, Asaba, Delta State, Nigeria

Obu Sylvia Ifeoma, Asiodu Anthony Uchenna, Osiatuma Victor Azubuike, Ojimba, Anastacia Okwudili, Oburo Ngozichukwuka Andrew, Iyasele Anthony Chukwuemeka, Nnanna Tochi Praise, Aigbokhaode Adesuwa, Dibigbo-Ibeaji Ndudi, Jisieike Obianuju Nkemjika, Edet Samuel Eno, Sadoh Odion Rosemary

International Journal of Research and Reports in Hematology, Page 40-48

Aims: To assess some haematological parameters and indices of hospitalized COVID-19 infected patients treated during the first wave of the pandemic in the Centre for Communicable Disease Control and Research (CCDCR) Federal Medical Centre Asaba, Delta State, Nigeria.

Study Design:  Retrospective observational study.

Place and Duration of Study: Centre for Communicable Disease Control and Research, Federal Medical Centre, Asaba, Delta State, Nigeria., between May and September, 2020.

Methodology: Descriptive data was collected from the records of 52 patients who were hospitalized and treated at the CCDCR FMC Asaba, within the months of March to September, 2020 and 40 non Covid-19 subjects as control subjects. The patient samples that were previously collected and analyzed for haematological parameters (lymphocytes, neutrophil, eosinophil, basophil, monocytes, platelets count, mean cell volume (MCV), mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC), using an automated hematology analyzer. Data collected was analyzed using SPSS version 25 and P values less than .05 were considered statistically significant.

Results:  The outcome of statistical analysis showed that the mean levels of lymphocytes, MCH and MCHC were significantly lower (P<.05) in COVID-19 positive subjects when compared with that of COVID-19 negative control group.  Also, the mean level of total white cell count was significantly higher (P<.05) in COVID-19 positive subjects when compared with that of the control group. There was no significant difference (P<.05) in PCV, neutrophil, eosinophil, basophil, monocytes, platelet and MCV in the case study when compared with the control group. No correlation was observed between severity and PCV, total WBC, eosinophil, monocyte, platelet count, MCV and MCHC. Whereas, a weak negative correlation (r = -.284, P=.041) was observed between severity and neutrophil. On the other hand, a weak positive correlation between severity and MCH (r=.303, P=.029) as well as between severity and lymphocytes (r=.0305, P=.029) was observed. No significant difference (P>.05) was observed in the outcome of haematological indices of COVID-19 positive subjects who are below fifty (50) years and those more than fifty (50) years of age. Also, no correlation was observed between haematological indices of the case subjects and their age. There is a significant difference in PCV (P<.05) based on gender. However, other haematological indices did not differ based on gender.

Conclusion: Assessing the outcome of haematological indices in COVID 19 positive patients provides insight into the physiological state of these subjects which in turn aids management, treatment monitoring and prognostication. Further observational and experimental studies using larger sample size is hence recommended as this will give a more promising outlook of these indices in COVID 19 subjects.

Open Access Original Research Article

Frequencies of Rh Phenotypes and Probable Genotypes in RhD Negative Blood Donors in Oman: A Cross-sectional Study

Mujtaba Allawati, Amour Ali Al Harthi, Badriya Al Balushi

International Journal of Research and Reports in Hematology, Page 49-55

Aims: Knowledge of Rh phenotype frequencies guides in assessing the probability of Rh alloantibody formation and finding Rh-negative antigen donors.  There is limited information on the RhCE phenotypes and probable genotype frequencies among D negative Omani population, hence this study was conducted to determine that and compared it with other populations.

Study Design: Cross-sectional study.

Place and Duration of Study: The study was conducted in Oman College of Health Sciences between July 2016 and April 2017.

Methodology: A total of 205 RhD negative blood samples were collected from Omani blood donors.  Haemagglutination methods were used for Rh typing. The data was collected to determine the Rh phenotype, probable genotype and haplotype frequencies.

Results: The most prevalent Rh antigen was e followed by c, C and E. The most common probable genotype/phenotype and haplotype were rr / rr and r with frequencies of 0.766 and 0.887 respectively.

Conclusion: There was no difference in Rh phenotype / probable genotype distribution from other populations. However, a significant difference was found in the frequencies of Rh antigens C, E, and c with some of the other populations.  Likewise, haplotype r and probable genotype rr frequencies were found to be significantly different from some other populations.

Open Access Original Research Article

The Impact of Citrus aurantium Fruit Juice on Bodyweight and Haematological Parameters of Wistar Rats

Ezeigwe Obiajulu Christian, Oladejo Afees Adebayo, Iloanya Ebele Lauretta

International Journal of Research and Reports in Hematology, Page 56-67

Background: Citrus aurantium L. (Rutaceae), commonly known as bitter orange is widely consumed owing to its numerous therapeutic potentials.

Purpose: This study evaluated the impact of Citrus aurantium fruit (bitter orange) juice on bodyweight and haematological parameters of wistar rats.

Method: The animals were administered Citrus aurantium juice orally at three divided doses (2 ml/kg, 4ml/kg and 8ml/kg) for a period of three months and their bodyweight were monitored and taken weekly with the aid of electronic weighing balance while the haematological parameters were analyzed at the end of every month using standard methods.

Results: Result showed that administration of C. aurantium juice caused a significant (p<0.05) weight reduction in the experimental animals from the first week through the twelfth week. Result further showed significant increase (p<0.05) in haemoglobin, platelet, red blood cells (RBC) and white blood cell (WBC) counts of the animals with no significant difference in the mean corpuscular volume (MCV), the mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) levels.

Conclusion: The findings in this study have shown that oral administration of C. aurantium juice is capable of causing weight loss without any detrimental effect on the haematological parameters.  

Open Access Original Research Article

Evaluation of Haematological Parameters of Hypertensive Patients Based on Age Groups in Tertiary Hospital in Owo, Ondo State

Emmanuel Ifeanyi Obeagu, Chidimma Maureen Chukwueze, Ibukunoluwa Pius Famodimu

International Journal of Research and Reports in Hematology, Page 68-71

Hypertension is a major health issue that affects people all over the world. It can cause cardiovascular illness as well as functional issues, such as alterations in haematological parameters. At the Federal Medical Centre in Owo, Ondo State, the goal of this study was to analyse some haematological markers of hypertensive persons based on age groups. The study was a hospital based cross-sectional in which subjects were selected randomly using a well-structured questionnaire who were age matched. 5 ml of blood was collected for haematological test analysis using ADVIA® 2120i Haematology system (SIEMENS). Data were presented in tables and shown as mean ± standard deviation and added using statistical packages for social sciences (SPSS, Version 20.0) with level of significance set at as p≤ 0.05. One hundred (100) hypertensive individuals were enrolled in this study. There was no significant differences in the haematological parameters of the study participants based on age groups.

Open Access Original Research Article

Effects of Consumption of Campus Buka Diets (CBD) on Some Health Indicators of Apparently Healthy Students of Abia State University Uturu

C. D. Ubani, Chijioke I. Ugboaja, D. C. Ejiofor, Ogwo Elisha Uko

International Journal of Research and Reports in Hematology, Page 72-75

The aim of this study was to determine the effect of consumption of Campus Buka Diets on some health indicators of apparently healthy students of Abia State University, Uturu. A total of 350 students were randomly selected from the various faculties that constitute the university. They were sorted according to sex. Inclusion criteria were the instrument for selecting subjects. Blood sample was aseptically collected into suitable containers. Analysis to determine Hemoglobin levels (Hb), Packed Cell Volume (PCV), and White Blood Cell (WBC), monocyte, lymphocyte, neutrophils, basophil and eosinophils was performed using standard procedures. Being on Buka diets for three months reduced Hb, PCV, WBC, neutrophil, lymphocyte below reference values in male subjects similar to what obtained for their female counterparts where the lymphocyte count was within reference range. Eosinophil in both male and female subjects was reportedly higher than that reported for the reference values. Monocytes and basophils were within reference ranges in both female and male subjects in addition to lymphocyte counts for males. In conclusion, Campus Buka Diets (CBDs) can be said to be unhealthy to consumption, the right action needs to be invoked to stimulate the cafeteria system for proper service delivery.

Open Access Original Research Article

Hydroxyurea Uptake among Children with Sickle Cell Anaemia at a Tertiary Hospital in Nigeria

Okechukwu Chioma, Josiah Appollus, Nri-Ezedi Chisom Adaobi

International Journal of Research and Reports in Hematology, Page 76-82

Sickle cell anaemia (SCA) is the most common genetic disease in the world, with Sub-Saharan Africa bearing the heaviest burden. Despite the availability and known benefits of hydroxyurea, its use in low- and middle-income countries has been limited. The purpose of this study was to determine the proportion of children with SCA who receive HU at Rivers State University Teaching Hospital (RSUTH)’s paediatric haematology clinic, as well as to highlight the sociodemographic correlates of users.

A descriptive cross-sectional study was done at the Paediatric Haematology clinic of RSUTH. The study participants were children with SCA attending the clinic. An interviewer administered semi-structured questionnaire was used to obtain socio-demographic data and information concerning the uptake of HU from caregivers of the subjects.

This study enlisted the participation of 88 children. There were 38 (43.2%) males and 50 (56.8%) females, for a male to female ratio of 1:1.3. The subjects' ages ranged from 2 to 18 years. Approximately half of the study participants came from affluent families. In total, 26 (29.5 percent) of the study participants used hydroxyurea. The use of hydroxyurea was significantly higher in the upper socioeconomic class compared to the middle and lower classes. Its use was also significantly higher among those suffering from sickle cell disease complications.

Hydroxyurea uptake remains low. Some of the factors to consider when attempting to increase Hydroxyurea uptake should be affordability and advocacy, taking into account the socioeconomic status relationship between users and uptake.

Open Access Original Research Article

Associating Decrease in Platelet Count with Gestational Attendees in Rivers State University Teaching Hospital, Port Harcourt Antenatal Clinic

Beatrice Wobiarueri Moore-Igwe, Beauty Eruchi Echonwere-Uwikor, Ransom Baribefii Jacob, Benson Utibe Etang

International Journal of Research and Reports in Hematology, Page 83-88

Maintenance of hemostasis is enabled by the presence of nonnucleated blood cell type known as platelets, produced by the cellular fragments of megakaryocytes. Platelet count below <150,000×103/mm3 can pave way for the occurrence of thrombocytopenia. Occurrence of thrombocytopenia in pregnancy is one of the commonest abnormalities encountered, though benign in nature, resolves after birth. It is important to investigate for thrombocytopaenia due to the need for good haemostasis during pregnancy and the risk of neonatal hemorrhage. This study aimed at associating decrease in platelet count with gestational attendees in Rivers State University Teaching Hospital, Port Harcourt antenatal clinic.   A total of 120 apparently healthy pregnant women were coopted into the study. Whole blood samples were drawn into EDTA anticoagulant bottles for analysis of platelet count using a Sysmex autoanalyser. Data was analysed using graph pad prism version 6.0. Revelations from the study showed the prevalence of thrombocytopaenia in pregnancy as 3.33%, the mean platelet count was (218.1±63.94). Mean platelet count did not differ in groups based on gestational age (first trimester - 202.6 ± 63.08, second trimester - 221.8 ± 60.54 , third trimester - 226.3±69.36, P=0.2784) and maternal age (<21=204.5±34.65, 21-30=211.3±60.59, 31-40=219.2±62.12,> 40=304.0±128.2 P=0.1083). Mean platelet count based on parity showed significant increase between the second and the third group (0-1=221.4±71.78, 2-3=203.0±49.45, 4 and above=269.7±33.80, P=0.0128). It is important that pregnant women be examined for platelet count in early stage of pregnancy to avoid maternal and fetal consequences.

Open Access Original Research Article

Treatment Free Remission Assessment after Discontinuation or dose Reduction of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia Patients

Dalia Ahmed Nafea, Ayda Aly Nazer, Mohamed H. Khalaf, Sameh Omara

International Journal of Research and Reports in Hematology, Page 89-98

Chronic myeloid leukaemia (CML) is now more than ever the model for targeted treatment in human cancers. The success of imatinib and second-generation tyrosine kinase inhibitors (TKIs) has significantly improved the prognosis of CML patients. Because TKI-treated CML patients have a near-normal life span, two key concerns must be addressed in the future: (1) the treatment's quality of life and ethical implications, and (2) the economic effect of treating patients during their lifespan. One of the most effective methods to examine these two concerns is to ask about quitting TKI in excellent responder patients. Such a technique has now been advocated in multiple studies, and hundreds of patients have formally ceased TKI in clinical trials throughout the world for molecular efficacy.

Aim of the Work: The aim of the present study is to assess:

  • Treatment free remission over one year in chronic phase CML patients in deep molecular response for two years or more.
  • Quality of life of CML patients and economic factor after treatment discontinuation or dose reduction.

Open Access Original Research Article

Xylopia aethiopica Fruit Increased Prothrombin Time, Activated Partial Thromboplastin Time and Erythrocyte Sedimentation Rate of Wistar Rats

Emmanuel O. Ogbuagu, Augustine I. Airaodion, Chika L. Uche, Uloaku Ogbuagu, Edmund O. Ezirim, Prince C. Unekwe, Ifeoma N. Nweke

International Journal of Research and Reports in Hematology, Page 99-106

Background: Traditionally, the use of Xylopia aethiopica fruit for therapeutic purposes is on the increase without any consideration of its safety and toxicity.

Aim: This study was therefore designed to examine its effect on coagulation factors of Wistar rats.

Methodology: The fruits of Xylopia aethiopica were air-dried and extracted by Soxhlet extractor using ethanol as solvent. The median lethal dose (LD50) of the extract was assessed using standard method. Thirty adult female Wistar rats were divided into five groups of six rats each. Animals in groups A, B, C, and D were treated with 130, 259, 389 and 518 mg/kg body weight of X. aethiopica fruit extract respectively, while those in group E received normal animal feeds and water only. The oral method was used to provide the medication once a day for 28 days. Standard procedures were used to determine prothrombin time, activated partial thromboplastin time, and erythrocyte sedimentation rate.

Results: The extract of Xylopia aethiopica fruit was observed to show a significant (p˂ 0.05) increase in prothrombin time, activated partial thromboplastin time and erythrocyte sedimentation rate when compared with those of the control group.

Conclusion: Xylopia aethiopica significantly prolongs prothrombin time (PT) and activated partial thromboplastin time (aPTT) and in addition has thrombocytopenic property. These anticlotting properties have clearly elucidated and unraveled mechanisms of action which have laid credence to its use by women in flushing out remnants of product of conception post-delivery. Increase in ESR by Xylopia aethiopical may result from an inherent property in this fruit that is yet to be identified.

Open Access Original Research Article

Neutrophils to Lymphocytes Ratio and Some Cytokines in Patients with Schizophrenia in Southeast, Nigeria

Emmanuel Ifeanyi Obeagu, Ayodeji David Johnson, Onyinye Cecilia Arinze-Anyiam, Arinze Favour Anyiam, Gina Flor Ramos, Bessie Nonyelum Esimai

International Journal of Research and Reports in Hematology, Page 107-112

Schizophrenia is likely to be associated with immunological abnormalities. The aim of the study is to investigate the changes in NLR and some cytokines of patients with schizophrenia in Southeast, Nigeria. A total number 100 subjects were recruited for the study comprising 50 for the patients with Schizophrenia and 50 apparently healthy subjects both aged 25 – 60 years. Blood was collected from each subject and levels of cytokines were measured by Enzyme Linked Immunosorbent Assay WBC (x109/L), Neutrophils and Lymphocyte were measured using manual counting method. Interleukin - 6, TNF-α, WBC and Neutrophil values were significantly higher in Schizophrenic subjects than control subjects (p=0.00, 0.00, 0.00, and 0.001) respectively. Lymphocyte value was lower than control subjects (p<0.05). NLR was higher in patients with Schizophrenia than the control. In conclusion, there were significantly higher values in IL-6, WBC and Neutrophil levels of schizophrenic subjects when compared apparently healthy subjects.

Open Access Original Research Article

ABO Blood Groups and Gestational Diabetes among Pregnant Women Attending University of Ilorin Teaching Hospital, Kwara State, Nigeria

Arinze Favour Anyiam, Emmanuel Ifeanyi Obeagu, Ejeatuluchukwu Obi, Pius Omoruyi Omosigho, Emmanuel Anyachukwu Irondi, Onyinye Cecilia Arinze-Anyiam, Musa Kemi Asiyah

International Journal of Research and Reports in Hematology, Page 113-121

Introduction: The ABO blood group system is defined based on the presence of blood group antigens present on the cell membrane of erythrocytes. The blood group system is associated with some disease conditions and some epidemiological studies have demonstrated the linkage among the “ABO” blood group and the risk of diabetes mellitus (DM). This study aimed to find out the possible linkage between “ABO” and “Rhesus” blood groups with gestational induced Diabetes Mellitus (DM).

Methods: The study was carried out among the pregnant women attending antenatal clinic in University of Ilorin Teaching Hospital. A total of 200 serially recruited pregnant women were screened for DM using fasting blood sugar (FBS), thereafter, the ABO and Rhesus group of the participants were determined using standard slide agglutination test. Data obtained were analyzed to determine any association between Gestational Diabetes Mellitus (GDM) and different ABO and Rhesus blood groups. The outcome was expressed as percent and absolute number of frequency. Results: Highest prevalence of gestational Diabetes Mellitus (GDM) was observed among the individuals with O +ve blood group, followed by A +ve blood group. Both AB -ve and B-ve blood groups were not associated with incidence of GDM in this study. For the Rhesus blood group system, Rhesus positive had the highest percentage (94%) of GDM incidence.

Conclusion: Blood group might be a risk factor and it can be helpful for the evaluation of the disease, a study to investigate causal effect is advisable.

Open Access Original Research Article

Sickle Cell Anemia Contributes to Liver Abnormality

Chika L. Uche, Abali O. Isaiah, Edmund O. Ezirim, Augustine I. Airaodion

International Journal of Research and Reports in Hematology, Page 122-134

Aim: This study sought to investigate the implication of sickle cell anemia on hepatic biomarkers.

Methodology: This is a case-control study which enrolled 60 sickle cell anemia patients (30 males and 30 females) in a stable state at the Obafemi Awolowo University Teaching Hospital in Ile-Ife, Osun State, Nigeria, as well as 60 healthy controls (30 males and 30 females). Each participant had five millilitres (5 mL) of venous blood taken and dispensed into a lithium heparin sample vial. Hepatic biomarkers were assessed using established procedures utilizing the blood sample.

Results: Hepatic indices were higher in sickle cell anemia patients than in control subjects, according to the findings of this study. It's worth noting that the effect of sickle cell anemia on liver parameters was stronger in male patients than in females. The activity of ALP in male sickle was 280 UI/L compared to the 198 UI/L in their female counterparts. Both values were significantly (p<0.05) higher than those found in the control subjects. This was not different in other hepatic parameters investigated in this study.

Conclusion: The findings of this investigation revealed that sickle cell patients had significantly higher liver indices than control persons. This could indicate that its synthesis in the liver has been increased or metabolism was reduced sequel to sickle cell disease.

Open Access Original Research Article

Assessment of Circulating Levels of Platelet Activation Biomarker - Platelet Factor 4 in Sickle Cell Anaemia Patients in Edo State, Nigeria

Destiny Osarumwense Imade, David Bolaji Akinbo, Sylvia Ifeoma Obu, Samuel Eno Edet, Ndudi Dibigbo-Ibeaji

International Journal of Research and Reports in Hematology, Page 135-142

Aim: To assess the circulating levels of platelet activation biomarker platelet factor 4 in sickle cell anaemia patients attending a sickle cell foundation in Edo State, Nigeria.

Study Design:  Case-controlled observational Study.

Place and Duration of Study: Sickle Cell Foundation Benin City, Edo State and Afe Babalola University, Multisystem Hospital, Ado Ekiti, Ekiti State, Nigeria, between April 2020 - September 2020.

Methodology: Thirty (30) Haemoglobin (Hb) SS genotype subjects diagnosed by haemoglobin electrophoresis and aged 10 to 40 years were selected for the study. Twenty-eight (28) Hb AA and 22 Hb AS apparently healthy subjects were used as control. The Hb SS subjects in their steady and crisis states who met the eligibility criteria were used as test subjects and verbal and written consents were obtained from all participants. Venous blood was collected for this study, in which 5ml of the subjects’ venous blood was collected with a syringe, 3ml was put into an Ethylene Diamine Tetra acetic acid container for the evaluation of Platelet count. Platelet indices and the Haemoglobin Genotyping, while 2ml was put into a plain container for the serological assay (Platelet Factor 4 assay), using ELISA method. The platelet count was estimated manually using an improved Neubauer counting chamber and 1% ammonium oxalate, the Haemoglobin Genotype was evaluated manually using an electrophoresis tank and Tris buffer, Platelet indices was evaluated using an Hematology Auto Analyzer. Statistical Package for Social Sciences (SPSS) version 23 was used for statistical analysis and p values less than 0.05 were considered statistically significant.

Results: The results showed no significant difference (p=0.772) and (p=0.878) in the distribution of age and gender respectively on the study participants. The mean serum Platelet Factor 4(PF-4) was significantly increased in the Sickle Cell Disease (SCD) crisis, reduced in the AS and SCD steady groups (p<0.05), compared to the control group. There was also a significantly positive correlation between PF-4 and PDW/MPV (p=0.029 and 0.189 respectively) of SCD steady subjects.

Conclusion: This study serves to prove that the platelet activation biomarker (platelet factor 4) indeed has a significant role and indication in sickle cell anaemia and hence should be put in consideration in laboratory assessment of platelet function in sickle cell disease crisis.

Open Access Original Research Article

Assessment of Human Fibrinogen Antigen and Tissue Plasminogen Activator as Hypercoagulability Markers in Type 2 Diabetic Patients in Obio/ Akpor Local Government Area, Rivers State, Nigeria

Anusiem Nneoma

International Journal of Research and Reports in Hematology, Page 143-149

This is a case controlled study carried out on type 2 Diabetic Patients in Obio/ Akpor Local Government, Rivers State with the aim of determining the haemostatic status. The haemostatic markers were assessed and compared with apparently healthy control subjects without diabetes. A total of 66 Type 2 diabetic patients (36 females and 30 males) aged between 24 and 77 years; 54 subjects (31 females and 23 males) that were apparently healthy of age between 24 and 76years, enrolled as control, with all participants recruited between November 2019 and January 2020. Human fibrinogen antigen and tissue plasminogen activator were analysed with reagents obtained from Elabscience, Wuhan, China and the test carried out with an ELISA machine (STAT FAX-2100).Results showed a significant increase (p<0.05) respectively in mean tissue plasminogen activator and mean human fibrinogen antigen when compared with control. Also there were strong significant correlations (p<0.05) respectively between human fibrinogen antigen and blood glucose, tissue plasminogen activator and blood glucose.There was no significant differences (p<0.05) observed in tissues plasminogen activator and human fibrinogen antigen between Type 2 Diabetic male and female patients. These two haemastatic markers can be used as a predictor indices for management of hypercoagulability in type 2 diabetic patients.

Open Access Original Research Article

Evaluation of Inhalation Effect of Insecticides on Haemorheological Profiles of Rabbits

Emily Funmilayo Eyitayo, Olusegun Taiwo Oke, Emmanuel Ifeanyi Obeagu

International Journal of Research and Reports in Hematology, Page 161-166

Background: High malaria burden has led to the increase use of insecticides in the tropics and subtropics. This study thus aimed at assessing the effect of insecticides inhalation on haemorrheological parameters using experimental animal model.

Materials and Methods: Sixteen adult male rabbits divided into four groups  A, B, C and D. Group A,B and C were exposed to  20ml of pyrethroid insecticides containing 0.05% pralletrin and 0.15% cyfluthrin by inhalation for 10mins,20mins, and 30mins respectively. Group D serve as the control and was not exposed. Baseline study was done on all the animals before grouping for exposure.  The pyrethroid insecticides was soaked in cotton wool (2.5g) in a container  that was able to prevent the animal from ingesting it, which was placed inside  the room A, B and  C  for 10mins,20mins and 30mins respectively. The rabbits were exposed for three weeks and sample were collected at the end of each week. Exposure was discontinued after day 21 and samples were collected again on day 28 and 35 respectively which is the fourth and fifth week. All the animals were monitored twice daily for clinical signs like jerky movement, skin scratching, licking of legs and other body parts.

Results: Data analysis revealed that there was significant effect of inhalation of   insecticides on some haemorrheological parameters of rabbits at 10min, 20mins and 30mins of exposure. There was decreased in Plasma viscosity. But there was no significant effect on whole blood viscosity and plasma fibrinogen concentration.

Conclusion: The results from this study have shown that aerosol of these pyrethroid insecticides (pralletrin and cyfluthrin) has effect on haemorrheological parameters. It is thus recommended that one should avoid exposure to the aerosol of these insecticides during domestic, veterinary,agricultural or industrial use.

Open Access Original Research Article

T-Cells Expression in HBV Infected Subjects in Port Harcourt, Rivers State, Nigeria

Baribefe Banavule Daniel Koate, Charles Teddy Adias, Ebirien-Agana Samuel Bartimaeus, Zacchaeus Awortu Jeremiah

International Journal of Research and Reports in Hematology, Page 167-182

Hepatitis B virus infection is a potential life-threatening liver infection caused by hepatitis B virus capable of causing chronic infection and puts people at high risk of death from cirrhosis and liver cancer. This study was a comparative cross sectional study carried out on 260 hepatitis B patients and blood donors attending hepatitis B clinics and blood banks in Rivers State University Teaching Hospital, Military Hospital, and University of Port Harcourt Teaching Hospital. The aim of this study was to evaluate T-Cells expression in HBV Infected Subjects in Port Harcourt, Rivers state, Nigeria. HBV 5-parameter (panel) Rapid Test kit was used to assess HBV serological markers; BD Fascount automated machine was used in determining CD4, CD8, CD3, and CD4/CD8 ratio. SOP, GLP, External/Internal Quality Control were used accordingly and Quality Assurance ensued. All statistical tests conducted were 2-tailed, and probability value of < 0.05 was used as the threshold for declaring statistical significance. Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA). 84.2% participants were males, 15.8% females aged between 19 and 65 years, Mean ±SD age 30.57±9.70. Participants from 20 states, South-South, South-East, and other Geo-political Zones of Nigeria, resident in the cosmopolitan city of Port Harcourt were recruited for the study. Result obtained showed serological markers among test subjects as 77.3% HBsAg, 43.97% HBsAb, 48.94% HBcAg, 36.17% HBcAb, and 46.81% HBeAg. The serological markers were grouped into four (4) categories based on HBsAg positivity: (i) HBV positive 1 – ‘Occult HBV prior to treatment’ (naïve previously unknown HBV: HBsAg -ve, other HBV markers +ve) 7.8% positive, [n=11]; (ii) HBV positive 2 (HBsAg +ve, other HBV markers +ve) 73.76% positive, [n=104]; (iii) HBV positive 3 – ‘chronic or post treatment occult HBV’ (known HBV case now occult’: HBsAg -ve, other markers +ve) 14.18% positive, [n=20]; (iv) HBV positive 4 (HBsAg +ve, other markers -ve) 4.26% positive, [n=6]. CD3 and CD8 were significantly decreased in HBV infected subjects compared to healthy controls. CD4/CD8 ratio was significantly increased in HBV infected subjects compared to control group. CD4 count was decreased in HBV infected subjects than in healthy control though it was not statistically significant. CD3 and CD8 were significantly decreased (p<0.0207 and P<0.0041 respectively), in HBV positive subjects who were HBsAg negative but positive for other HBV serological markers, (HBV positive 3), when test subjects were compared by HBV panel assay. CD3 and CD4 showed very strong positive correlation (p<0.0001) among test subjects. CD8 and CD4, DC8 and CD3 also showed strong positive correlations (p=0.0070 and p<0.0001 respectively); CD4/CD8 ratio showed strong positive correlation with CD4, (p=0.0002). CD4, CD3, CD8, and CD4/CD8 ratio showed no statistically significant difference when compared by demographic indices including sex partner(s), marital status, and age group. CD4, CD3, CD8, and CD4/CD8 ratio may serve as prognostic markers in HBV infected subjects. Regular evaluation of these markers in HBV patients is advocated as it could be helpful for improved patient care/management. Periodic screening of some target population for HBV infection is recommended for our environment to check spread. Cost of diagnostic assays and treatment should be subsidized by government and capable cooperate organizations to help patients access regular and comprehensive health care.

Open Access Original Research Article

Distribution of ABO and Rhesus Blood Groups among COVID-19 Positive Subjects in Rivers State, Nigeria

Onengiye Davies, Serekara G. Christain, Stella U. Ken-Ezihuo

International Journal of Research and Reports in Hematology, Page 183-190

Coronavirus-2019 (COVID-19) is a novel disease that is ravaging society today. It has been reported that individuals with some blood group antigens are more predisposed or susceptible to certain diseases. This study was carried out to determine the distribution of some blood group antigens among COVID-19-infected individuals. The study involved one hundred (100) subjects, comprising 75 males and 25 females, within the ages of 20 and 60 years, who were infected with COVID-19, and receiving treatment at the COVID-19 Isolation Centre. The bio-data of the subjects were obtained using a well-structured questionnaire. Five mililitres (5 ml) of blood collected asceptically from each of the subjects who gave informed consent were dispensed into K3EDTA bottles for the determination of the ABO and Rh blood groups. The bio-data show that 74% of the subjects were married while 26% were single. Also, 87% of the subjects had university degree or HND, 6% had OND while 7% had only secondary school education, indicating that majority of the subjects were educated. The results from the study showed that the distribution of ABO blood group among the subjects were 75% blood group O, 11% blood group A, 10% blood group B and 4% blood group AB. Also, 91% of the subjects were Rh positive while 9% were Rh negative. The results indicate that the blood group antigens found in the subjects were similar to the pattern reported in the population where the research was conducted. It is concluded that the prevalent blood group in this study was blood group O, while the most prevalent Rh group was Rh-D positive. It is recommended that blood groups be considered in the testing menus for the management of COVID-19 infection, since some subjects may have such blood group antigens that can predispose to the infection.

Open Access Review Article

Autoimmune Hemolytic Anemia in Children: Diagnostic Approach and Management

Muhammad Matloob Alam

International Journal of Research and Reports in Hematology, Page 150-160

Autoimmune Haemolytic Anaemia (AIHA) is not very uncommon in childhood and mainly caused by the presence of auto-antibodies directed against antigens on the surface of red blood cells, leading to premature destruction of the cells. Many children are hospitalized every year due to sequelae of this heterogeneous group of disorders to which pediatric hematologist take a variety of diagnostic and therapeutic approaches. AIHA is generally categorized as "warm" or "cold" based on the thermal reactivity of the autoantibodies and is further classified as primary (idiopathic) or secondary. Early recognition and diagnosis are very important for successful management and outcome of hemolytic anemia. The evaluation of suspected immune hemolytic anemia includes a thorough history, physical examination and laboratory workup assessing for evidence of acute hemolytic anemia, possible diagnosis of an acute event, to evaluate for concurrent causes and to rule out alternative causes.

In this review article we will discuss the classification, diagnostic approach and general management of hemolytic anemia in children especially focusing on newly diagnosed autoimmune hemolytic anemia. Specific recommendations for difficult to diagnosed cases, definitions  of response assessment and treatment i.e. dosage and tapering plan of  steroid therapy; indications of rituximab, supportive therapy and second-line therapy are  discussed.