Online ISSN: 2515-8260

Keywords : Thalassemia


STUDY OF MATERNAL AND PERINATAL OUTCOME IN PREGNANCY ASSOCIATED WITH SICKLE CELL ANEMIA AND THALASSEMIA

Dr Abhinaya Chengala,Dr M. Balasaraswathi, Dr V Suvarna, Dr B Aparna

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 263-275

Background:
Aims: The aim of my study is to evaluate the maternal and perinatal outcomes in pregnant women with Sickle cell anemia and Thalassemia.
Material and methods: The present study was undertaken in Mamata General Hospital with an aim to know the occurrence of sickle cell anemia and thalassemia in antenatal women and to evaluate the maternal and perinatal outcome.
Results: Out of the 30 women considered for the study, 20 had sickle cell disease and 10 had thalassemia. Most common age group was between 21-25years of age in both groups of women with 85% and 50% in each respectively. Mean age is 23±2years. Contracted pelvis was the indication in 17% in SCD. However abnormal color doppler study was the indication in 8% of SCD women and 17% in women with thalassemia. Maternal request and abruption were the indications in 8% each in SCD group. The need for transfusion was seen in about 45% of the SCD women and in 30% of the women with thalassemia. The incidence of Low birth weight of <2.5kg was among the most probable cause for neonatal morbidity in 40% of the neonates born under in each group with SCD and thalassemia.  There was 5% intrauterine fetal death and another 5% of the women had intrauterine growth retarded babies.  In thalassemia the most common fetal complications were neonatal jaundice in 30%, low birth weight in 20% and respiratory distress in 20% respectively.  The perinatal outcome in the 20 neonates born to women with SCD, 80% neonates were alive, intrauterine death was seen in 5% and neonatal deaths were 15%. Whereas in 10 neonates born to thalassemia women 70% of the neonates were alive and 30% neonatal deaths were recorded. Among the study group, the most preferred mode of family planning for the women with SCD in the present study was permanent sterilization in 50%. Next most preferred modality was injectable (DMPA) in 45%, and remaining 5% opted for barrier method of contraception.
Conclusion:   The obstetric outcome in women with Sickle-cell disease showed significant maternal morbidity. However though low in prevalence, the obstetric outcome in the group of women with thalassemia had low incidence of complications when compared to pregnancies with SCD. However both the groups were prone to neonatal morbidity and mortality.

Detection of abnormal haemoglobin variants and its characterization among anaemicsby high performance liquid chromatography (HPLC): A prospective study from North India

Sushanta Chakma, Sumanta Das, Krishna Chakma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2552-2561

Background: Hemoglobinopathies are one of the most common inherited blood illnesses
in India and are one of the country's most serious public health issues. In India, it is
estimated that there are approximately 45 million carriers and 15,000 babies born with
hemoglobinopathies per year. The carrier rate of hemoglobinopathy in various Indian
demographic groups ranges from 3 to 17 percent. Automated cation-exchange High
Performance Liquid Chromatography (HPLC) has surfaced as an outstanding
screening tool for identifying this abnormal hemoglobin or thalassemic conditions. So,
the purpose of this study was to identify common haemoglobin disorders, in anaemia
patients using HPLC.

SEROPREVALENCE OF HEPATITIS C VIRAL INFECTIONS IN THALASSEMIA PATIENTS UNDERGOING MULTIPLE BLOOD TRANSFUSIONS IN A TERTIARY CARE HOSPITAL

Anupriya Yadav, Preeti Garg, Rameshwari Bithu, Manju Yadav, Rakesh Maheshwari, Bharti Malhotra

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1842-1853

Introduction: Thalassemia is one of commonest hereditary disease worldwide, prevalent in humid climates and affects all races. The Transfusion Dependent Thalassemia require regular blood transfusion to survive. The thalassemia patients require lifelong blood transfusion on regular basis- usually administered every 2 to 5 weeks. Due to regular blood transfusion, transfusion transmitted disease e.g. HBV, HCV, HIV infections can occur.
Materials and Methods: Observational study conducted over a period of one year, a total of 284 thalassemia patients were studied. Patients were screened for Hepatitis C viral infections by rapid test kit Tridot and the conformation was done by ELISA.
Results: Out of 284 thalassemia patients, 176(61.9%) were male and 108(38%) were females. Rural population 223 (78.52%) was more affected than urban population 61 (21.47%). Maximum patients of thalassemia belong to B+ ve 109 (38.24%) and O+ ve 101 (35.56%) blood group. Maximum 120 (42.25%) patients belong to 5.1 to 10 years age group and 86 (30.28%) belong to 0-5 years age group. Out of 118 patients 85(29.92%) patients were anti–HCV reactive. Maximum anti-HCV positive patients belong to 5.1- 10 years (35.29%) age group and 10.1 -14 years (29.41%) age group. Anti- HCV positivity increase with number of transfusions, 38.8% patients had blood transfusion more than 100 times.
Conclusion: Multi transfused patients must be regularly tested and monitored to ensure safe blood transfusion practices. Stringent donor screening with modern advents such as NAAT (nucleic acid amplification test) and PCR must be done. Bringing awareness in community will help in reducing the problem statement.

Prevalence of HIV seropositivity among thalassemic patients in a tertiary care centre

Rehana Barkat, Khurrum Hayat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 777-780

Background:Thalassemia also known as “Cooley’s anemia” is an inherited disease of the
red blood cells classified as a hemoglobinopathy. The present study was conducted to
assess prevalence of HIV seropositivity among thalassemic patients in a tertiary care
teaching centre.
Materials & Methods: 80 thalassemic patients of both genders were included. All the
samples for detection of anti- HIV antibodies was done as per the guidelines of National
AIDS Control Organisation (NACO).
Results: Out of 80 patients, males were 45 and females were 35. Age group 0-5 years had
10, 5-10 years had 25, 10-20 years had 40 and >20 years had 5 patients. Seroprevalence of
HIV were 1 case in age group 0-5 years, 3 in age group 5-10 years and 2 in age group 10-
20 years of age.
Conclusion: Authors found lowseroprevalence of HIV among thalassemia patients.

Serum ferritin and liver function test response to oral versus subcutaneous iron chelating agent

Aymen Abd. Albakaa; Faris M. Al- Haris; Alaa Jumaah Mnaji Nasrawi; Jassim Mohammed Al Musawi; Talib Abdul Jalil Al Madany

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 130-135

Thalassemias are group of inherited autosomal recessive blood disorder. The genetic defect, which could be either mutation or deletion, results in complete absence or reduction synthesis of one of the globin chain that make up hemoglobin. This cause reduction of haemoglobin molecules production ,resulting in decreased of oxygen carrying capacity of the circulation thus causing anemia, the characteristic presenting symptom of the thalassemia. Good chelation therapy and regular blood transfusion protocol have increased the life expectancy.
Objectives : is to compare serum ferritin level and liver function test in a group of patients with beta thalassemia major in response to subcutaneous and oral chelating agent .
Patients and Methods: Prospective analytic study design done on group of 60 patients with beta thalassemia major diagnosed by hemoglobin electrophoresis registered in thalassemia center in AL – Zahra Teaching Hospital for Maternity and Children in AL- Najaf AL- Ashraf , during a period from
1st of February 2019 to 1st of February 2020, aged 2.5 to 17.9 years with serum ferritin levels above 1000 ng/ml and liver transaminases below 5 folds the normal upper limit .
The patients divided into 2 groups, 30 patients were on Deferasirox {Exjade} therapy and 30 patients were on Deferoxamine {Desferal} therapy .
Base line S. Ferritin value as well as LFT (S. GOT , S. GPT , ALP and TSB) value, were taken as base line level and then every (8-12) weeks and were used to assess the changes that occurred in response to subcutaneous and oral chelating agent .
Results : Our study show significant decline in SF (P value <0.05) in both groups after 1 year of treatment with oral or subcutaneous chelating agent. Patients on Exjade show more rate of decrement of serum ferritin (11%) compared to patients taken Desferal who a rate of decrement (6%). Patients on Exjade and Desferal therapy show increment in liver enzymes after 1 year of treatment with statistically significant results, p-value < 0.05 .
Conclusions
We found superiority in oral iron chelating agents (Exjade) to subcutaneous iron chelating agents (Desferal). Serum ferritin level is suitable for long term monitoring as an indicator of efficacy than liver biopsy .

Estimate Viral RNA Of Hepatitis C Of Β-Thalassemia Patients In Nineveh Province

Ali Adel Dawood; Asmaa Mohammed Khaleel; Ahmed Mohammed Hayawi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1-8

Hepatitis C infection is the main occasional agent of chronic liver disease and might lead to cirrhosis and hepatocellular carcinoma. β-thalassemia and hemodialysis patients are most susceptible to HCV as a result of the continuous blood transfusion. Aim of the study: This study aimed to estimate the quantitative of HCV-RNA in the serum of β- thalassemia patients in Nineveh province using RT-PCR in the GeneXpert system. Methods: We detected anti-HCV using ELISA. Determine the viral RNA using Xpert® HCV viral load technique. Result: The positive detection result of anti-HCV is 48 out of a total of 752 thalassemia patients. Only 12 out of 48 enrolled HCV Ct value with a rate of 1.59% of the total β- thalassemia patients. Conclusions: The prevalence of HCV in thalassemic patients in Nineveh province is less than those found in the other Iraqi provinces or adjacent countries. The routine using of immunobiological and biochemical tests for hepatic enzymes should be the routine pursuit in thalassemia and dialysis clinical centers.

Prevalence of Hepatitis B and C in Thi-Qar Province - Iraq from 2015-2019

Rana A. Othman; Yahya A. Abbas

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 43-48

Background: Hepatitis B virus and hepatitis C virus are two of the most commonly
transmitted infectious agents by Blood transmitting so it is still remains a considerable
global health problem, this prospective cross-sectional study was conducted
between 2015 and 2019 at the directorate of main Blood Bank, dialysis center,
thalassemia center and public health laboratory in Thi-Qar Province -Iraq, during that
period a total of 1323 patients, 948 (71.7%) males and 375 (28.3%) females, they
suffering from signs and symptoms of liver diseases.
The aim of study: There were no adequate epidemiological studies on the prevalence
of viral hepatitis, especially in last years and there were no national solutions to limit
it’s, we conduct this study to determine the prevalence of both types at Thi-qar
province.
Sampling and methods: This study was conducted in January 2015 to December 2019,
on main blood bank, patients referred to the thalassemic center, renal dialysis unit and
public health laboratory at Thi-Qar province, the study was conducted on 176848
individuals, from those (1323) cases, (515) blood donors, (45) thalassemic patients, (91)
renal failure patients and public health laboratory (672), the following data were
recorded: Age, sex, date, resident, type of infection, data were collected by from
statistical units. Data were analyzed using SPSS for windows (version 23.0, SPSS lnc,
Chicago, III), for comparison between groups as appropriate; P ≤ 0.01 was considered
statistically significant.
The results: The results of infection were found 1323(0.7%), its distributed as :672
(50.8%) were public health laboratory patients, 515 (38.9%) blood donors, 91 (6.9%)
renal dialysis patients and 45(3.4%) thalassemic patients, the results was showed
higher infection in males more than females, with high prevalence in age groups (31-
40) and (41-50) years, with significant difference (P<0.01) .
Conclusions: despite the findings revealed that Thi-Qar is acceptable percentage rate
of prevalence of infection, but may be increased the infection by Immigration from
endemic areas, especially for business , transfusion of blood, a major roots of
infections by renal dialysis, thalassemic patients were a risk groups because
administration of blood.