The rare condition of neutrophils agglutination in-vitro may give inaccurate neutrophils count. We reported a case of a 71-year-old female admitted with a diagnosis of extended-spectrum beta-lactamase (ESBL) Escherichia Coli (E.coli) septicaemia secondary to the left lower limb cellulitis. Despite underlying infection, total white blood cell count (TWBC) and absolute neutrophil count remained in a normal range. An accidental finding of full blood picture (FBP) using K2 ethylenediaminetetraacetic acid (EDTA) tube presented numerous neutrophils agglutination. Further tests were carried out using citrated and heparinised tubes and tested at room temperature, 4 C, and 37 ͦC. The findings showed a significant reduction in neutrophils agglutination in both citrated and heparinised tubes, including when tested at room temperature (RT) and 4 ͦC. Surprisingly, at 37 ͦC, no neutrophil agglutination was observed. This indicates that temperature-dependent anti-neutrophil IgM antibody may be found in the patient's serum that reacted with the EDTA anticoagulant. In conclusion, white blood cells (WBC) agglutination has been associated with malignancy, sepsis, liver disease, and autoimmune disease. Thus, a baseline FBP is recommended, especially in these categories of patients to optimise their clinical management.
Introduction: Inadequate mixing during the blood collection process might affect the quality of platelet concentrates (PCs). Currently, two different mixing methods are used during whole blood collection: manual mixing and mixing using an automated blood collection mixer. However, the cost between manual and automated blood collection mixer differed largely and pose a dilemma for a blood transfusion service. The objective of this study was to evaluate PCs quality using either manual mixing or automated procedure. Methods: This was a cross-sectional study conduct- ed at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. Thirty eligible participants aged 20 to 45 were included in this study, and a unit of 450 mL whole blood was collected from each participant. Fifteen units of whole blood were mixed by an automated blood collection mixer and the other 15 units were mixed using the man- ual mixing. All PCs were produced from platelet-rich plasma and stored at 20–24°C for 5 days. Quality parameters such as platelet count, leucocyte count, and pH were measured for each PCs on day 1 and day 5. Results: Platelet count on day 1 was significantly higher than on day 5 (p = 0.01) for both mixing methods. There was no statistically significant difference in any of the PCs quality parameters between the two types of mixing methods at either day 1 or day 5 of storage (p > 0.05). Conclusion: Comparable PCs quality is achieved from both manual mixing and auto- mated procedures.
Blood supply shortage is a worldwide problem including Malaysia. According to statistical data from 2011 to 2015, Terengganu which is one of the states in Malaysia has the lowest blood donation rate. The objective of this study was to determine the knowledge and attitude score towards blood donation and their associated factors among nondonors of Kuala Terengganu. Methods: This was a cross-sectional study using a self-administered questionnaire involving systematically random sampling of 320 nondonors attending Hospital Sultanah Nur Zahirah. Data were analysed using Multiple Logistic Regression and Pearson correlation. Results: The mean knowledge and attitude scores were 5.19 (1.87) and 70.79 (8.19), respectively. Sixty-four percent (64.69%) and 92.81% of the participants have good knowledge and attitude, respectively. Gender, education level, and occupation have a significant association with knowledge, while education level and occupation were found to be significantly associated with attitude. No significant association found between the knowledge and attitude level. Most reported barriers to blood donation were a refusal to give blood to other religion and race. The main source to acquire information pertaining to blood donation was mainly from social media. Conclusion: Refusal of giving blood to other religion and race is recognised as the main issue that hinders participants to donate their blood. Thus, proper education and aggressive promotion regarding blood donation are needed especially among the nondonor in this region of Malaysia.
Introduction: Unsafe blood products cause transfusion-transmissible infections. A good knowledge and perception about blood safety issues is crucial to ensure safe blood supply. The objective is to develop and validate a question- naire about the knowledge and perception among blood donors on blood safety issues. Method: A cross-sectional study was conducted among 130 blood donors who attended the National Blood Centre, Kuala Lumpur in April and May 2018. The questionnaire was developed in the Malay language after extensive literature search. The self-admin- istrated questionnaire consisted 39 items which required around 20 minutes to complete. The validation involved content validity, construct validity using exploratory factor analysis and reliability using test-retest analysis in IBM SPSS statistics. The same group of respondents was retested after two weeks using the same questionnaire. Results: Content validity was established through multidisciplinary expert meeting and two content reviewers. The factors loadings of all questionnaires were more than 0.40. Knowledge questions were divided into three domains; percep- tion questions were divided into four domains. The intraclass correlation (ICC) values of the test-retest were more than 0.80 for the three knowledge domains and more than 0.60 for the four perception domains. The third domain of the perception section which consisted two questions had the lowest ICC value of 0.686 (95% CI 0.583-0.767). One of the questions was restructured to improve clarity. Conclusions: The questionnaire on knowledge and perception on blood safety issues has good validity and reliability, with appropriate items which warranted its utilization among blood donors.
Dengue virus is one of the emerging agents that can be transmitted via blood transfusion from infected blood donors to recipients. In Malaysia, the increase in dengue infection may contribute to the existence of asymptomatic blood donors and increase the risk of blood supply contaminated with this virus. The aims of this study were to investigate the prevalence of NS1 dengue antigen among blood donors and to ascertain the demographic data of blood donors in Penang and and Perak. Methods: A total of 374 voluntary blood donors were recruited from two blood donation campaigns organised by Hospital Pulau Pinang, Penang and Hospital Raja Permaisuri Bainun, Ipoh, Perak from April to May 2016. From each centre, 187 voluntary blood donors were enrolled, blood was collected and Dengue NS1 Ag was screened on all the samples using Platelia dengue antigen test kit from Bio-Rad Laboratories, France. Results: All 374 samples were found to be negative for the Dengue NS1 antigen. Demographic data of these blood donors showed that the most common blood group was O Rh positive, men donated more than women and Chinese blood donors were the biggest group of donors. Conclusion: Even though dengue is endemic in Malaysia, none of the blood donors was screened positive for dengue NS1 antigen in the areas studied. This indicates that none of the blood donor at the time of donation was in viraemia stage. The established donor screening program ensures that the dengue transmission through transfusion is minimal in the areas studied.