Displaying publications 41 - 60 of 159 in total

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  1. Fulltext Serum ferritin concentrations in transfusion dependent beta-thalassaemia
    George E, Wong HB, George R, Ariffin WA
    Singapore Med J, 1994 Feb;35(1):62-4.
    PMID: 8009283
    Patients on a moderate red cell transfusion programme have iron overload where the concentrations of the serum ferritin were inappropriate to increases in the transfusion load as a result of limitations of apoferritin synthesis and conversion of ferritin into haemosiderin. This study confirms the limitations for the use of estimations of the serum ferritin to evaluate the iron status in patients with expected high overload as would be seen in patients on many years of maintenance red cell transfusions in the absence of iron chelation therapy. Poor compliance, inadequate dosage of Desferal (deferoxamine), and the late initiation of iron chelation therapy were factors that were considered in the patients with failure of response to iron chelation.
    Matched MeSH terms: Blood Transfusion*
  2. Fulltext Hb E beta +-thalassaemia in west Malaysia: clinical features in the most common beta-thalassaemia mutation of the Malays [IVS 1-5 (G-->C)]
    George E, Wong HB
    Singapore Med J, 1993 Dec;34(6):500-3.
    PMID: 8153710
    Patients with the Hb beta + [IVS 1-5 (G-->C)] clinically presented as beta-thalassaemia intermedia and remained asymptomatic in the absence of blood transfusions. With or without blood transfusions the patients were short and had moderate to marked thalassaemia facies. Children who received blood transfusions showed progressive iron loading with age. The serum ferritin and serum alanine transaminase levels were significantly raised in the patients who were given blood transfusions. In the presence of blood transfusions, and absence of adequate iron chelation therapy, splenectomy became an inevitable event at some stage of the disease because of increasing transfusing requirements.
    Matched MeSH terms: Blood Transfusion
  3. Serobiological features and risk factors of hepatitis C virus infection in multiply transfused thalassaemia patients
    Ghazali, F., Jamal, R., Zakaria, S.Z., Ismail, Z.H., Malik, Y.
    Malaysian Journal of Paediatrics and Child Health, 1998;10(2):14-18.
    MyJurnal
    The two vital aspects of treatment for patients with tha-lassaemia are regular blood transfusions and iron chela-tion therapy. Unfortunately, the use of blood transfu-sions exposes these patients to the risks of acquiring transfusion related viral infections such as hepatitis C. Patients who acquire the hepatitis C virus (HCV) may develop chronic hepatitis and later on hepatocellular carcinoma. Hence, patients with thalassaemia should be regularly screened for the presence of HCV. We report here the results of a cross-sectional study conducted in a typical day-care centre for thalassaemics at the Hospital Universiti Kebangsaan Malaysia, involving 85 multiply transfused patients. We found that 19 patients (22.4%) were seropositive for HCV and two of them had positive HCV-RNA. Those who had started receiv-ing their transfusions before 1995, i.e. the year routine screening for HCV amongst blood donors were com-menced, and those who received transfusions 2-4 week-ly had a significantly higher risk of acquiring HCV infection.
    Matched MeSH terms: Blood Transfusion
  4. Uterine bleeding with an IUD requiring emergency hysterectomy
    Glew S, Singh A
    Adv Contracept, 1989 Mar;5(1):51-3.
    PMID: 2782134
    A case is described of profuse uterine bleeding with a dislodged Multiload Cu 250 intrauterine device (IUD). Multiple blood transfusions were necessary, and ultimately, an emergency hysterectomy was performed.
    Matched MeSH terms: Blood Transfusion
  5. Fulltext Growth velocity in transfusion dependent prepubertal thalassemia patients: results from a thalassemia center in Malaysia
    Hamidah A, Arini MI, Zarina AL, Zulkifli SZ, Jamal R
    Southeast Asian J. Trop. Med. Public Health, 2008 Sep;39(5):900-5.
    PMID: 19058587
    Growth impairment is commonly seen in children with thalassemia despite regular blood transfusions and desferrioxamine treatments. We investigated the growth velocity of 26 prepubertal patients with beta-thalassemia or HbE-beta thalassemia who were transfusion dependent aged between 2 and 13 years. The prevalence of impaired growth velocity (ie, growth velocity less than the third percentile) amongst the transfusion dependent prepubertal thalassemics was 57.7% compared to 19.2% in the control group. The mean height velocity of the thalassemics was 11.1% less than controls but this difference was not statistically significant (4.23cm/year vs 4.76cm/year, p = 0.08). The mean serum ferritin level of the thalassemics with a height < 3rd percentile was higher compared to those with a height > 3rd percentile (4,567.0 vs 2,271.0, p = 0.01). Our study showed that there was a high prevalence of impaired growth velocity amongst our transfusion dependent prepubertal thalassemics. This highlights the problem of inadequate chelation therapy, and compliance with chelation therapy amongst our patients. This study emphasizes the importance of monitoring growth parameters and optimal iron chelation therapy in these patients.
    Matched MeSH terms: Blood Transfusion/adverse effects*
  6. Prolonged remission after splenectomy for refractory Evans syndrome--a case report and literature review
    Hamidah A, Thambidorai CR, Jamal R
    Southeast Asian J. Trop. Med. Public Health, 2005 May;36(3):762-4.
    PMID: 16124452
    We describe a patient with Evans syndrome (autoimmune hemolytic anemia and autoimmune thrombocytopenia) who was refractory to steroids and intravenous immunoglobulin. She responded to splenectomy and has remained in clinical remission for 3 years. In the majority of cases, splenectomy rarely induces a durable remission but it may be beneficial in a small group of patients, hence should be considered as alternative therapy in the management of these patients.
    Matched MeSH terms: Blood Transfusion
  7. Fulltext Short stature and truncal shortening in transfusion dependent thalassemia patients: results from a thalassemia center in Malaysia
    Hamidah A, Rahmah R, Azmi T, Aziz J, Jamal R
    Southeast Asian J. Trop. Med. Public Health, 2001 Sep;32(3):625-30.
    PMID: 11944728
    One of the major complications in patients with transfusion dependent thalassemia is growth impairment secondary to iron overload. We studied the growth status in 66 patients with beta-thalassemia major and HbE-beta thalassemia who were transfusion dependent, aged from 2 to 24 years, and 66 controls matched for sex and age. The prevalence of short stature in transfusion-dependent thalassemics was 54.5% compared to 4.5% in control group (p<0.001). Short stature was more prevalent in those above the age of 10 years in this study group (83.3% vs 16.7%). Transfusion dependent thalassemics with short stature were found to have significantly lower mean standing height standard deviation scores (SDS), sitting height SDS and subischial leg length SDS values (p<0.001). There was also a significant difference between the mean sitting height SDS and the mean subischial leg length SDS in our thalassemics with short stature, suggesting that the short stature was due to disproportionate truncal shortening. Serum ferritin levels were significantly higher in transfusion dependent thalassemics who were short compared to those who were of normal height (p = 0.002). However, the mean pre-transfusion hemoglobin levels did not differ significantly between patients with short stature and those with normal height (p = 0.216). The prevalence of short stature also did not differ significantly between those with beta-thalassemia major and those with HbE-beta thalassemia (p = 0.32). This study highlighted the importance of providing optimal treatment in these patients, including monitoring of growth parameters and optimizing iron chelation therapy.
    Matched MeSH terms: Blood Transfusion
  8. Fulltext A cross-sectional survey of knowledge and attitude towards HIV/AIDS patients among nursing students in teaching hospital
    Hamidah Othman, Noor Azizah Mohd Ali
    The Malaysian Journal of Nursing, 2017;8(3):27-34.
    MyJurnal
    HIV/AIDS is a matter of concern and has become a pandemic disease that threatens the world population. It
    has remained one of the priorities in global public health challenges. Caring for people with HIV/AIDS
    requires clinical expertise as well as high-quality skills for health care providers. The purpose of the study was
    to examine knowledge and attitude on HIV/AIDS patients among nursing students. A cross-sectional study
    was conducted in Public University at Wast Cost Malaysia. The 126 respondents of nursing students agreed to
    participate in the study using a self-administered questionnaire that was designed and modied after reading
    and referring to articles, books, and journals. The results of the research revealed that nursing students, in
    general, have a satisfactory knowledge (mean score 30.71), but had a moderate attitude toward HIV/AIDS
    patient with total mean score 2.34. Most of the students (89.3%) get the knowledge regarding HIV/AIDS
    through the internet. The majority of the students knew that blood transfusion (99.4%) and sharing
    needles/syringe (99%) were the higher sources HIV/AIDS modes of transmission. Most of the students agreed
    that peoples with HIV/AIDS should be treated in society with support from the community (97.0%). Although
    the knowledge level of nursing students seems to be satisfactory, but they still showed the moderate attitude
    towards HIV/AIDS patients. Thus, structured education programmes should be conducted by nursing faculty
    to ensure that nursing students gain the necessary accurate knowledge and an appropriate attitude towards the
    care of HIV/AIDS patients.
    Matched MeSH terms: Blood Transfusion
  9. Effect of intraoperative autologous transfusion techniques on perioperative hemoglobin level in idiopathic scoliosis patients undergoing posterior spinal fusion: A prospective randomized trial
    Hasan MS, Choe NC, Chan CYW, Chiu CK, Kwan MK
    J Orthop Surg (Hong Kong), 2017 May-Aug;25(2):2309499017718951.
    PMID: 28675975 DOI: 10.1177/2309499017718951
    BACKGROUND: Massive blood loss during posterior spinal fusion for adolescent idiopathic scoliosis remains a significant risk for patients. There is no consensus on the benefit of acute normovolemic hemodilution (ANH) or intraoperative cell salvage (ICS) in scoliosis surgery.

    METHODS: Patients were randomized to one of two groups. Group A received ANH and ICS during operation, while group B received only ICS. Patients' age, sex, height, weight, body blood volume, number of fusion level, Cobb angle, number of screws, duration of surgery, and skin incision length were recorded. Hemoglobin and hematocrit levels were obtained preoperatively and postoperatively (0 h and 24 h).

    RESULTS: There were 22 patients in each group. There was no significant difference in total blood loss. The perioperative decrease in hemoglobin levels between preoperation and postoperation 24 h (group A 2.79 ± 1.15 and group B 2.76 ± 1.00) showed no significant difference ( p = 0.93). Group A observed a larger decrease in hemoglobin levels at postoperative 0 h relative to preoperative level (2.57 ± 0.82 g/dl), followed by a smaller decrease within the next 24 h (0.22 ± 1.33 g/dl). Group B showed a continued drop in hemoglobin levels of similar magnitude at postoperation 0 h (1.60 ± 0.67 g/dl) and within the next 24 h (1.16 ± 0.78 g/dl). One patient from group B received 1 unit of allogenic blood transfusion ( p = 0.33).

    CONCLUSIONS: The addition of ANH to ICS in posterior spinal fusion surgery for AIS resulted in a similar decrease in hemoglobin levels between preoperative values and at 24 h postoperatively.
    Matched MeSH terms: Blood Transfusion/methods*
  10. Severe anti-D haemolytic disease of fetal and newborn in rhesus D negative primigravida
    Hassan MZ, Iberahim S, Abdul Rahman WSW, Zulkafli Z, Bahar R, Ramli M, et al.
    Malays J Pathol, 2019 Apr;41(1):55-58.
    PMID: 31025639
    INTRODUCTION: Anti-D alloimmunisation may occur from the blood transfusion or fetomaternal haemorrhage which can lead to haemolytic disease of fetal and newborn (HDFN). The morbidity and mortality of HDFN related to anti-D is significantly reduced after introduction of anti-D prophylaxis and furthermore, anti-D HDFN in RhD negative primigravida is uncommonly seen.

    CASE REPORT: A case of unusual severe HDFN due to anti-D alloimmunisation in undiagnosed RhD negative primigravida Malay woman is reported here. This case illustrates the possibility of an anamnestic response from previous unknown sensitisation event or the development of anti-D in mid trimester. The newborn expired due to hydrops fetalis and severe anaemia. Antenatally, the mother was identified as RhD positive and thus there was no antenatal antibody screening, antepartum anti-D prophylaxis or close fetal monitoring for HDFN.

    DISCUSSION: The thorough antenatal ABO and RhD blood grouping with antibody screening is mandatory as part of prevention and early detection of HDFN especially due to anti-D alloimmunisation. Improper management of RhD negative women might lead to severe HDFN including in primigravida.

    Matched MeSH terms: Blood Transfusion
  11. Fulltext Human immunodeficiency virus infection in recipients of living unrelated donor renal transplants--a report of 4 cases
    Hooi LS
    Med J Malaysia, 1993 Jun;48(2):232-5.
    PMID: 8350803
    Four cases of Human Immunodeficiency Virus (HIV-1) infection, probably following living unrelated donor renal transplantation done in India, are reported. One of them subsequently developed Acquired Immunodeficiency Syndrome (AIDS).
    Matched MeSH terms: Blood Transfusion/adverse effects
  12. Fulltext A retrospective review of cryoprecipitate transfusion practice in Kuala Lumpur Hospital
    Iliassa II, Mohammad WM, Tan JJ, Ayob Y
    Asian J Transfus Sci, 2016 Jul-Dec;10(2):145-9.
    PMID: 27605853 DOI: 10.4103/0973-6247.187934
    BACKGROUND: Cryoprecipitate is generally used to treat bleeding patients with hypofibrinogenemia, and the transfusion decision is guided based on published guidelines.
    AIM: This study aimed to evaluate the practice appropriateness in accordance to cryoprecipitate transfusion guidelines in Hospital Kuala Lumpur.
    METHODOLOGY: This cross-sectional study of 117 cryoprecipitates transfused adult patients was conducted in Kuala Lumpur Hospital from January to June 2012. The compliance of the indication of cryoprecipitate was considered as appropriate if indicated for patients who have hypofibrinogenemia (<1.0 g/L) with bleeding, or otherwise inappropriate if pretransfusion fibrinogen level was more than 1.0 g/L, pretransfusion fibrinogen level was not examined and posttransfusion fibrinogen level more than 1.5 g/L.
    RESULTS: Most of the cryoprecipitate prescriptions were found to be inappropriate, which read 81.2% (95% confidence interval = 0.740, 0.880). Patients who underwent neurovascular surgery were the major recipient of cryoprecipitate, but majority of the prescription was found not appropriate. The decision to transfuse cryoprecipitate was found mostly appropriate when was guided by fibrinogen (52.2%), but the percentage dropped to 10.6% when pretransfusion fibrinogen test was not performed. Regrettably, only 19.7% of total cryoprecipitate were given based on pretransfusion fibrinogen level.
    KEYWORDS: Appropriateness; bleeding; cryoprecipitate transfusion; guideline
    Matched MeSH terms: Blood Transfusion
  13. Fulltext Antibody to hepatitis C virus in thalassemia patients
    Isahak I, Baharin R, Hakim AS, Abu Bakar M, George E
    Malays J Pathol, 1993 Jun;15(1):85-7.
    PMID: 8277796
    A specific enzyme immunoassay (EIA) for the diagnosis of hepatitis C virus (HCV) infection was developed by recombinant DNA technology. Abbott HCV EIA was used to detect antibody to HCV (anti-HCV) in non-transfused and multiply-transfused thalassemia patients. None of 11 non-transfused patients had anti-HCV but 3 of 52 (5.8%) multiply-transfused patients had anti-HCV. This study showed that the prevalence rate of HCV infection is low in thalassemia patients. However, it is still important to identify hepatitis C virus infected patients in high risk groups because hepatitis C is associated with chronic hepatitis, cirrhosis and hepatocellular carcinoma.
    Matched MeSH terms: Blood Transfusion
  14. Health Related Quality of Life in Malaysian children with thalassaemia
    Ismail A, Campbell MJ, Ibrahim HM, Jones GL
    Health Qual Life Outcomes, 2006;4:39.
    PMID: 16813662
    Health Related Quality of Life (HRQoL) studies on children with chronic illness such as thalassaemia are limited. We conducted the first study to investigate if children with thalassaemia have a lower quality of life in the four dimensions as measured using the PedsQL 4.0 generic Scale Score: physical, emotional, social and role (school) functioning compared to the healthy controls allowing for age, gender, ethnicity and household income.
    Matched MeSH terms: Blood Transfusion
  15. Development of de novo HLA donor specific antibodies (HLA-DSA), HLA antibodies (HLA-Ab) and allograft rejection post blood transfusion in kidney transplant recipients
    Jalalonmuhali M, Carroll RP, Tsiopelas E, Clayton P, Coates PT
    Hum Immunol, 2020 Jul;81(7):323-329.
    PMID: 32327243 DOI: 10.1016/j.humimm.2020.04.002
    BACKGROUND: Blood transfusion during the post-operative period of kidney transplantation is common as part of a life-saving procedure, especially in the event of acute blood loss. However, there have been conflicting opinions since the pre-cyclosporine era. The risk of sensitization post-transfusion remains the main limiting factor following transfusion in kidney transplant recipients. Thus, the objective of this study is to assess the development of de novo HLA-DSA, HLA-Ab and allograft rejection post blood transfusion.

    METHODOLOGY: This is a retrospective cohort study recruiting all kidney transplant recipients in South Australia from January 2010 till December 2018. Following that, the incidence of blood transfusion within one week post-operatively were traced (transfusion group). The outcomes were compared with all other transplant recipients (non-transfusion group). Recipient's demographic, donor characteristics and immunological risk profiles were obtained from the transplant unit database, while the biopsy report, history of blood transfusion, latest serum creatinine and follow-up status was gathered from the electronic medical system (OASIS). The HLA-DSA and HLA-Ab results were collected from the NOMS database. Finally, the survival data were merged with the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry for South Australia recipients graft survival.

    RESULTS: A total of 699 patients were eligible for analysis. The mean age was 50.64 ± 13.23 years old. There were more elderly (>65 years old) and females who needed transfusion. The majority had glomerulonephritis as the primary disease. There was no statistical difference in donor characteristics, cold ischemic time and immunological risk between the transfusion and non-transfusion group. There was no difference in the development of de novo HLA-DSA, HLA-Ab and rejection episodes between the group and the results were consistent in a model adjusted for all potential confounders. Median graft survival in days between the transfusion vs non-transfusion group was 1845 IQR (961,2430) and 1250 IQR (672,2013).

    CONCLUSION: Blood transfusion under strong immunosuppressive cover within a one-week post-operative period is safe with no significant association with the development of de novo HLA-DSA, HLA-Ab or clinical rejection.

    Matched MeSH terms: Blood Transfusion
  16. Evaluation of two types of leukocyte removal filters on transfusion dependent thalassaemics
    Jamal R, Mazeni NR, Hussin H
    Malays J Pathol, 2000 Dec;22(2):79-83.
    PMID: 16329539
    The advent of leukocyte filters has enabled effective removal of leukocytes from certain blood products thus avoiding many adverse effects of blood transfusion. Many different materials have been incorporated into these filters to achieve >95% leukocyte removal. In this study we evaluated the efficacy of leukocyte removal of two different filters, using actual bedside transfusion settings involving patients with transfusion dependent thalassaemia. Fifty-one transfusion events were randomised to use either a polyurethane filter or a non-woven polyester filter. We found that the two filters achieved 98.4% and 96.2% leukocyte removal respectively (p = 0.022). We also found no significant correlation between pre-filtration white blood cell count and the volume transfused with the efficacy of leukodepletion. No untoward events or transfusion reactions were observed during the study.
    Matched MeSH terms: Blood Transfusion/adverse effects
  17. Fulltext Abnormalities in lung function among multiply-transfused thalassemia patients: results from a thalassemia center in Malaysia
    Jamal R, Baizura J, Hamidah A, Idris N, Jeffrey AH, Roslan H
    Southeast Asian J. Trop. Med. Public Health, 2005 Jan;36(1):265-9.
    PMID: 15906681
    The aim of this study was to: (1) determine the prevalence and patterns of lung dysfunction among transfusion dependent thalassemics; (2) determine the associated factors that might contribute to this problem. This was a cross-sectional study involving 66 patients with transfusion dependent thalassemia aged 10 years and above. All patients underwent physical examination, standardized pulmonary function tests including spirometry, lung volume, and the carbon monoxide diffusion capacity. A restrictive pattern of lung dysfunction was observed in 22 patients (33.3%) and none showed the presence of obstructive ventilatory impairment. A reduction in the carbon monoxide diffusion capacity (DLCO) was seen 87.9% of the patients, including 7.6% who had evidence of hypoxemia. Ten patients showed a reduction in the FEF25-75% although they did not fulfil the criteria for small airway disease. No correlation was found between lung dysfunction and serum ferritin levels in the patients. Restrictive lung dysfunction and diffusion impairment were the predominant abnormalities found in our cohort of patients.
    Study site: Thalassemia clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Blood Transfusion*
  18. Fulltext Seroprevalence of hepatitis B, hepatitis C, CMV and HIV in multiply transfused thalassemia patients: results from a thalassemia day care center in Malaysia
    Jamal R, Fadzillah G, Zulkifli SZ, Yasmin M
    Southeast Asian J. Trop. Med. Public Health, 1998 Dec;29(4):792-4.
    PMID: 10772566
    Regular blood transfusions for patients with thalassemia have improved their overall survival although these transfusions carry a definite risk of the transmission of certain viruses. Infection with hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) leads to complications which contribute to the morbidity and mortality of patients with thalassemia. We analyzed the blood samples taken from 85 transfusion dependent thalassemics receiving treatment at the day care center in Hospital Universiti Kebangsaan Malaysia and found that the seroprevalence rates for HBV, HCV and CMV were 2.4%, 22.4% and 91.8% respectively. None of the patients tested positive for HIV. Those positive for HBV and HCV will require further tests and treatment if chronic hepatitis is confirmed.
    Matched MeSH terms: Blood Transfusion/adverse effects*
  19. Fulltext Iptacopan monotherapy in patients with paroxysmal nocturnal hemoglobinuria: a 2-cohort open-label proof-of-concept study
    Jang JH, Wong L, Ko BS, Yoon SS, Li K, Baltcheva I, et al.
    Blood Adv, 2022 08 09;6(15):4450-4460.
    PMID: 35561315 DOI: 10.1182/bloodadvances.2022006960
    Iptacopan (LNP023) is a novel, oral selective inhibitor of complement factor B under clinical development for paroxysmal nocturnal hemoglobinuria (PNH). In this ongoing open-label phase 2 study, PNH patients with active hemolysis were randomized to receive single-agent iptacopan twice daily at a dose of either 25 mg for 4 weeks followed by 100 mg for up to 2 years (cohort 1) or 50 mg for 4 weeks followed by 200 mg for up to 2 years (cohort 2). At the time of interim analysis, of 13 PNH patients enrolled, all 12 evaluable for efficacy achieved the primary endpoint of reduction in serum lactate dehydrogenase (LDH) levels by ≥60% by week 12 compared with baseline; mean LDH levels dropped rapidly and durably, namely by 77% and 85% at week 2 and by 86% and 86% at week 12 in cohorts 1 and 2, respectively. Most patients achieved a clinically meaningful improvement in hemoglobin (Hb) levels, and all but 1 patient remained transfusion-free up to week 12. Other markers of hemolysis, including bilirubin, reticulocytes, and haptoglobin, showed consistent improvements. No thromboembolic events were reported, and iptacopan was well tolerated, with no severe or serious adverse events reported until the data cutoff. In addition to the previously reported beneficial effect of iptacopan add-on therapy to eculizumab, this study showed that iptacopan monotherapy in treatment-naïve PNH patients resulted in normalization of hemolytic markers and rapid transfusion-free improvement of Hb levels in most patients. This trial was registered at www.clinicaltrials.gov as #NCT03896152.
    Matched MeSH terms: Blood Transfusion
  20. An analysis of blood utilization for elective surgery in a tertiary medical centre in Malaysia
    Jayaranee S, Prathiba R, Vasanthi N, Lopez CG
    Malays J Pathol, 2002 Jun;24(1):59-66.
    PMID: 16329557
    The purpose of this study is to determine the efficiency of blood utilization for elective surgery at the University of Malaya Medical Centre (UMMC). A similar study conducted six years earlier in the same unit resulted in the introduction and implementation in December 1997 of the local Maximum Surgical Blood Order Schedule (MSBOS) and the Group Screen and Hold (GSH) procedure instead of a full crossmatch. This paper compares the findings of the current study with that conducted earlier.
    Matched MeSH terms: Blood Transfusion/utilization*; Blood Transfusion/statistics & numerical data
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