CONCLUSION: The demand for blood products is ever increasing. Concurrently, blood donor recruitment becomes more and more difficult. In this situation volunteer blood donation should be promoted, especially among the youngsters, as they can supply blood continuously. Volunteering behavior is culturally based and determined by various factors like religion, age, sex, attitude of person, family support, and geographical locations. Volunteer donors feel it as a responsibility to help others, regardless of personal connection. Our study found that all the respondents were willing to donate blood again if required in future. This positive feeling should be encouraged with proper knowledge regarding blood safety to meet the demand of blood requirement.
prevails in replacement donors compared to voluntary donors. 8 Compared with the above studies, prevalence of co-infection in our study was low and the most common co-infection associated with syphilis was hepatitis B infection. A study was done by Sultan et al. 14 observed higher prevalence of TTIs in replacement donors compared with regular voluntary donors. In a study done by Pallavi et al. 15 observed the prevalence of TTI (HIV, HBV, HCV, venereal disease research laboratory [RPR] and malaria) was higher in replacement donors compared with voluntary donors. Studies 5,7,17 have showed high seropositivity rate in replacement donors compared to voluntary donors. Compared with above studies, in our study, high seropositivity for TTIs was also found in replacement donors compared to voluntary donors. In a study done by Pallavi et al. 15 the prevalence of TTI showed a decreasing trend among voluntary donors, a similar finding was noted by Singh et al. 16 in RPR reactivity. Pahuja et al. 17 have also noted a decreasing trend in the prevalence of TTI. In contrast, Bhattacharya et al. 18 have reported a significant increase in the TTI seroprevalence. Compared with above studies, a raising trend in prevalence of syphilis was found in our study. It may because of low awareness about syphilis among blooddonors.
replacement persons are traced and tracked to become regular voluntary blooddonors. Following measures like blood donation awareness programmes for general public, screening of HBsAg & HIV by rapid slide tests before bleeding, not to bleed rare blood groups until required, need to be taken into consideration. To follow blood grouping and Rh typing & screening protocol. Awareness in this regard for blood donation be created among the general population and more so in rural areas as a token of social responsibility.
The present study has shown that transfusion trans- missible infections (TTIs) constituted much (78.05%) of the deferral cases. On individual probe, we observed that HBV was the major cause of deferral (31.71%) as well as the leading cause of permanent deferral (40.63%) followed by HCV and HIV. Previous studies [3, 7, 20] have indicated similar trends. The national survey in Nigeria showed similar trend of higher prevalence of hepatitis B (12.2%)  than HIV . Decline of HIV seroprevalence has been reported [46, 47]. This has been credited with the several intervention programmes geared towards HIV over the years; PEPFAR  FHI 360  and NACA . Conversely, there is low awareness of HBV, the causative agent, mode of transmission and its health consequences when com- pared to HIV . The trend of deferral based on TTIs in this study partly mirrors the prevalence of the TTIs in the general Nigerian population. Even in the general population of Nigerians, the prevalence of HBV is greater than that of HIV. Earlier World Health Organization (WHO) report had estimated HBV and HCV prevalence of 11.2 and 2.0%, respect- ively , while HIV prevalence (WHO/UNAIDS) is estimated at 2.8% [52, 53]
This record based study was conducted in the bloodbank of our institute from the period 1 st September 2017 to 30 th September 2017. After clearance from the Institutional ethical committee and waiver of consent, due permission was granted from the Superintendent of the hospital. Data were collected from the record section of the BloodBank in a predesigned format on Blood units collected from January 2012 to December 2016. Any discrepancies found in the data were verified from the manually documented data during the same period. All the blood units collected in the Bloodbank and in the camps in the above mention period were included in the study. The format was designed to collect information on type of donors (voluntary /Replacement), gender of the donors, total transfusion transmitted infection detected in each group of donors.
More than one-fifth (28.48%) of the study sub- jects had sexual partner who were positive for HIV. Majority (93.04%) of the clients practiced high risk behaviour. About 78.48% clients claimed that they have acquired HIV through unprotected heterosexual route and 08.86% and 06.33% were involved in homosexual and bisexual practices, respectively; whereas one male (0.99%) client has developed HIV due to unsafe injec- tion and parent-to-child transmission rate was 5.70%. None of the patients gave a history of blood transfusion (Table 3).
Yet, the high prevalence obtained among blooddonors who visited the hospital suggests that few people undergo immunization within the region. This is because the cost of immunization and/or testing is not within the means of the people. Most developing coun- tries are facing multiple threats to the safety of blood supply because the cost of HBsAg screening is borne by the patients and their families who do not enjoy health coverage . Generally also, there is no prevention of transmission between mother and child. High preva- lence of HBsAg markers in donors who were >10 years is consistent with the concept that most primary HBV infections are transmitted either vertically or horizon- tally before age 10. Although most new infections occur among infants and young children, HBV-related morbid- ity and mortality is not immediately apparent . The prevalence of HBsAg among women of childbearing age in Ghana is 11.5% . This may also explain why low percentages of positive cases were >50 years. It is likely that by age 50 years, most carriers in the general popu- lation would have died. Low HBsAg detection in older donors might also be due to well known continuous decrease of HBsAg levels in chronic carriers over time. Most probably, HBV infection occurred before the age of 20 in these old donors. Even though there were more replacement donors, compared to voluntary donors, the difference in prevalence between the two groups was not significant (Chi2 = 0.6117; p = 0.434).
Medicines play a very significant role for treating many diseases and conditions, butat the end of the treatment it is very important to dispose them of properly. So, the knowledge and awareness of proper drug disposal are essential for safe environment. Lack of knowledge and practice can lead to various problems like environmental pollution and various health hazards directly or indirectly. Hence, the study was aimed to assess the knowledge, practice, and awareness towards disposal of unused/expired drugs among healthcare professionals such as doctor, medical students, pharmacy students and nurses. This was a cross-sectional questionnaire-based study conducted in a tertiarycare teaching hospital. About 400 participants in each category were included in the study. The questionnaire consisted of three parts which included demography, and multiple choice questions related to knowledge and awareness of the drug disposal. The collected data was expressed in percentage. A total of 393 participants have completed the survey which includes 32% males and 68% females. It was found that the commonest discarding pattern of the expired/ unused medicineswasthrough household trash (67%).A total of 349 (89%) were aware of the significance of improper disposal.It was observed that the participants 44(11.1%)had partial knowledge about proper drug disposal but there was a lack of practice264 (67.1%) of safe disposal methods. This study aimed tocreate an awareness to bridge the lacunae between knowledge, practice of proper and environmental safe methods of disposing expired/ unused drugsamong health care professionals.
The most common gram-positive organism isolated was Staphylococcus aureus (25.8%), followed by CoNS (21.5%) and Enterococcus spp. (6.8%) of the total bacterial isolates (n=116). We suspect that the observed low isolation of CoNS in our study could be due to or related to strict aseptic practices of collection method followed for blood sampling of blood culture. Staphylococcus seems to be emerging as the dominant organisms in blood stream infections with 32% MRSA isolates. Nosocomial infection due to Staphylococcus aureus constitutes a major part of the total annual nosocomial infections 20 . Erythromycin and ampicillin were found to be the highly resistant antibiotics among gram positive organisms. The study also showed that Staphyloccocus aureus was found to be highly sensitive to vancomycin, linezolid, tigecycline, gentamicin and ciprofloxacin as reported by other investigators 21 .
the limitations on drug safety evaluation in pre- marketing trials and post marketing surveillance and increased usage of cardiovascular drugs made the need for the present study. Hence this study was conducted to monitor and to analyze the pattern of occurrence of adverse drug reactions reported with cardiovascular drugs in intensive cardiac care unit of a tertiarycarehospital, Chennai.
Ten ml of blood samples was received from patients and analyzed in the laboratory. The sera were separated and screened for HBsAg by Hepa Card (J. Mitra & Co. Pvt. Ltd., New Delhi, India), and positive sera were stored frozen (-20 °C) until tested for viral markers. The HBsAg-positive serum samples were tested for HBsAg using a commercially available ELISA kit (ERBA Transasia Bio-medicals Ltd. Daman, India). The positive serum samples were retested for HBeAg (ELISA; Beijing Kewei Clinical Diagnostic Reagent Inc., Beijing, China). DNA isolation from the serum samples was performed using the QIAamp DNA Mini Kit (Qiagen, Germany) and based on the manufacturer’s recommendations. The isolated DNA was amplified by RGQ real-time PCR using the artus HBV RG PCR Kit (Qiagen, Germany) according to the recommendations provided by the manufacturer. Two sets of primers (two forward and two reverse) were used for both Pre-S gene and Pre-core/core region and one set for detecting the existence of HBV/B in a mixed population. A GEN B-specific PCR using HBV/B GEN-specific primers (PS-B1 and PS-B2) was also performed (Table 1).
There is currently a trend to use automation to reduce personnel costs .The automated test are usually in ELISA formats. For TTI testing in out institute, we perform the entire test on (DA VINCI Quatro, Biomeriux, France). For detection of larger number of specimens EIAs are ideally suited but has a limitations in terms of time and cost whenever small number of samples are to be processed. But in bloodbank settings like ours where EIAs are being performed for HIV, HCV and HBV by automated ELISA machine. ELISA because of it sensitivity, specificity and its suitability made it as an ideal screening method for syphilis.. Another advantage are that it has capacity to automated process large number of samples and an objective reading of results.
The study was conducted after the protocol was cleared by the institutional ethics committee. It is retrospective study based data collected from the hospital records. Prescriptions of epileptic patients of all age groups admitted to Kasturba Medical College Hospital, Attavara, Mangaluru from 2017-2018 were analyzed and the following data were collected in the study proforma. Demographic details of the patient, clinical diagnosis, co-morbid conditions and the drug details such as the number of drugs per prescription, route, dose, dosage form and duration were noted. Patients with secondary seizures were excluded from the study.The data was analysed for WHO prescribing indicatorswhich included the percentage of: a. drugs prescribed by generic name b.encounters with antibiotics prescribed c. encounters with injections prescribed d. drugs prescribed from essential drug list and the average number of medicines per prescription. 8 Statistical
This is to certify that this dissertation titled “ A STUDY ON MICROBIOLOGICAL PROFILE OF BLOOD STREAM INFECTIONS IN PATIENTS ADMITTED IN INTENSIVE CARE UNIT IN A TERTIARYCAREHOSPITAL” is a bonafide record of work done by DR.N.DEEPA, during the period of her Post graduate study from 2009 to 2013 under guidance and supervision in the Institute of Microbiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai-600003, in partial fulfillment of the requirement for M.D. MICROBIOLOGY degree Examination of The Tamilnadu Dr.M.G.R. Medical University to be held in April 2013.
In our study, which aimed to find out the incidence and patterns of the acute poisoning cases in a tertiarycarehospital in urban Chennai, we collected 218 case sheets of patients reported to the emergency department of a tertiarycarehospital in the study period of 3 months. The sex ratio of patients who consumed poison was almost equal (1:1.04). The most common type of poisoning consumed by the patients was drug(tablet) overdose (34%) followed by organophosphorous poisoning (29%) and then rest of the agents (mosquito repellant, rat killer etc.,) were 37%. Most of the patients belonged mostly to semi urban and urban category. The drugs which were misused for the purpose of poisoning were sedatives (39%) especially Alprazolam and Diazepam and antipsychotics (27%) followed by antibiotics and Antihypertensives across all cross sections of age. Results of our study showed tablet overdose as a major reason for acute poisoning correlated with the findings of a study done by Das RK in AIIMS 5 ; whereas in many studies done on
The leukopenia observed in this study was largely due to the significant reductions in both the absolute lymphocyte (P = 0.019), percent lymphocyte (P = 0.016), and percent monocyte count (P = 0.008). Anemia was obviously due to the reduction in the red blood cell (RBC) count, PCV, hemoglobin (Hb), mean cell Hb (MCH), and red cell distribution width (RDW) values. Significant positive correlations were found between PCV and total WBC count (r = 0.309; P , 0.01) while a negative correlation was found between PCV and absolute lymphocyte counts (r = -0.191; P , 0.005) and RDW (r = -0.219; P , 0.05). Comparison of the mean values of the first-time versus regular blood donor parameters revealed that six parameters were significantly reduced in the regular blooddonors (PCV, absolute WBC count, percent monocytes, RBC count, Hb, PCV). The reference ranges of hematological parameters for Port Harcourt donors are also presented in this study. No thrombocytopenia was observed.
Healthcare professionals knowledge was gauged based on important parameters, 53.4 % of the respondents gave correct response regarding the definition of Pharmacovigilance. 51.7 % of the respondents were aware of the importance of pharmacovigilance. 61.7 % of the healthcare professionals had knowledge about Post Marketing Surveillance (PMS). 59.5 % of the respondents were aware of the regulatory body responsible for monitoring ADR’s in India (Table 2). The results of the present study are slightly lower with regard to knowledge when compared to a similar study done by Gupta et al 9 and Dharmadhikari PP et al 10 . Response
Our results show a variation between total leukocyte counts of apparently healthy Nigerians with Caucasian textbook values. This variation was noted to be more significant among commercial donors than apparently healthy relatives of patients (Table 2). This finding when combined with reports of no significant differences in cord blood of Africans and Caucasians disagrees with suggestions of genetic origin of leucopenia common in Africans. The result substantially with Nigerian study by Nwobodo et al., 2002 and suggests factors like diet, socioeconomic/health status as well as environmental factors as possible culprits in this apparent racial difference in leukocyte profile. Leukocyte count of over 9000 cells/mm3 was absent in our study population and this can be explained by the fewer population in our study as well as the apparent healthy status of our study group since leukocytosis is a known indicator of infective process (Cawley, 1997).
A total of 11,162 apparently healthy adult donors were screened during the 3-year study period. Among them 10,689 (95.8%) were found to be fit for donation while 473 (4.2%) were deferred for various reasons. Of which, 171 (36.2%) from the deferred population were due to positive markers for TTIs or 1.5% from the entire donor population. The overall prevalence of HBV, HCV, HTLV I/II, syphilis and malaria were 1.2, 0.04, 0.07, 0.2 and 0.02%, respectively (Table 1). No blood donor showed positive for HIV. Among the donors positive for TTI markers, 73 (42.7%) were voluntary donors while 98 (57.3%) were replacement donors and majority were of age 30-39 years (35.1%). Consistently, higher number of positive TTI (37.8%) is noted on age 30-39 years among the replacement donors while younger age is observed among the voluntary donors on age 20-29 years with 37% positive TTI markers. Least number of positive TTI markers was observed among donors below 20 years (Table 2). There was no significant difference observed among different age groups (p=0.832).
Better response towards blood donation in the present study was seen in the younger age group i.e. (68.7%) in 18-30 years, followed by (23.1%) in 31-40 years which is similar to that observed in the study of Thakral et al (16) .It is also comparable with study by Sethi B et al (9) where majority of donors (41.12%) were from age group of 18-25 years. Thereafter, the contribution towards blood donation decreased with increase in age in both voluntary as well as replacement donors; the donors beyond 50 years contributing the least. This might be due to the fact that large numbers of elderly age group donors were rejected due to their lower health standards. Females made a very small section of the present study, only 113 (0.74%) female donors contributed in present study out of which 99 females donors (87.6%) were voluntary and 14 (12.3%) were replacement donors. The prevalence of female donors in current study (0.74%) is comparable to Makroo RN et al (12) , Dobariya GH et al (17) where prevalence of female donors was around 4.14%and 2.84% respectively.