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.
This paper evaluates the practice of fresh frozen plasma (FFP) transfusion at the University Hospital, Kuala Lumpur, and analyses its usage by the various clinical departments. The aim of this study is to identify where it is inappropriately used and the clinical indications in which such misuse is common. A retrospective analysis of the blood bank request forms and work sheets during a 6-month period between January 1998 and June 1998 formed the basis of this study. Overall, 40% of 2665 units transfused were considered appropriate. However, out of the 931 episodes of FFP transfusions only 31% were for appropriate indications. The average FFP requirement when used for appropriate indication was about 4 units per episode, whereas for inappropriate indication it was 2.5 units per episode. Inappropriate use in terms of the number of units was highest by the surgical services (68%) and Orthopaedics (64%), while the Department of Paediatrics had the lowest incidence of inappropriate use (40%). When Paediatrics was used as the benchmark, the incidence of inappropriate use by other departments was significantly higher (p < 0.01). As for FFP usage in common clinical indications, there was a high incidence of inappropriate use in burns (82%), perioperative period (73%), cardiac surgery (68%), massive bleeding (62%) and trauma (60%). The findings in this study, specifically the use of FFP for volume support in trauma, massive bleeding and burns, routine requests without identified indication in cardiac bypass surgery, and prophylactic use in the perioperative period can be the basis for recommendations to minimize the inappropriate use of FFP in the future.
In this modern industrialized era of large-scale production of agrochemicals, various emerging contaminants form the main components of waste water and sludge in most of the developing countries of the world. In this concern, phenol- an inevitable and alarming chemical pollutant in aquatic ecosystem, gains a speedy access into the water bodies as an industrial by-product. Though the detrimental effects of phenol have been studied in various aspects of aquatic life, current study is an initiative to unravel the toxic effects of phenol at molecular level in Cirrhinus mrigala. Plasma cortisol level and acetylcholine esterase activity in fish was estimated by Chemiluminescent immunoassay technique and Ellman assay respectively. Scanning electron microscopic studies were carried out to unravel the gill histopathological alterations in exposed fish. It was observed that phenol (22.32 mg/l) inhibits 50 % of acetylcholine esterase activity in brain thereby affecting the locomotion of the targeted carp. Cortisol elevated during the 7th day in exposed fish, but declined progressively on the forthcoming 21st and 28th days. Manifestations in gill encompass curling, fusion, aberrations, sloughing of gill epithelium, wider inter filamentary space and mucus coating in the primary gill filament. It concludes that the discernable deviations produced in both biochemical parameters and key organ gill can be used as a biomarker and bio-indicator respectively for assessing the existence of emerging toxicants in aquatic ecosystem.
Acute toxicity (96 h LC50) of phenol was analyzed in the cat fish Mystus vittatus in static bio-assay over a 96-h exposure period using probit method. The 24, 48, 72, and 96 h LC50 values (with 95% confidence limits) of phenol for fingerling catfish were found out as 13.98, 13.17, 12.62, and 12.21 mg/l respectively. Investigations pertaining to the histopathological sections have shown high degree of pathological lesions observed in various parts like gill, liver intestine, and kidney of the fish species. Analysis of gill section revealed observable changes in the experimental species such as fusion, malformation at the tip of secondary lamellae, vacuolation, hyperplasia, and epithelial damage. Exposure of phenol showed cytoplasmic vacuolation, tissue damage, and loss of hepatic cell wall in the liver of experimental organism. Lesions of tissue damage at the epithelial site, inflammation, and clumping of adjacent villi made of columnar epithelium have been observed in the intestine of fish, and also the excretory part of the fish kidney revealed various changes like glomerular atrophy, damage of Bowman's capsule, vacuolization, and degeneration of renal epithelium. The current study on histological changes observed in the experimental organisms has thrown light on the current scenario which poses threat and danger to the whole aquatic ecosystem, and this study plays a vital role in assessing the aquatic pollution.
Phenol, an aromatic chemical commonly found in domestic and industrial effluents, upon its introduction into aquatic ecosystems adversely affects the indigenous biota, the invertebrates and the vertebrates. With the increased demand for agrochemicals, a large amount of phenol is released directly into the environment as a byproduct. Phenol and its derivatives tend to persist in the environment for longer periods which in turn poses a threat to both humans and the aquatic ecosystem. In our current study, the response of Labeo rohita to sublethal concentrations of phenol was observed and the results did show a regular decrease in biochemical constituents of the targeted organs. Exposure of Labeo rohita to sublethal concentration of phenol (22.32 mg/L) for an epoch of 7, 21 and 28 days shows a decline in lipid, protein, carbohydrate content and phosphatase activity in target organs such as the gills, muscle, intestine, liver and kidney of the fish. The present study also aims to investigate the toxic effects of phenol with special reference to the haematological parameters of Labeo rohita. At the end of the exposure period, the blood of the fish was collected by cutting the caudal peduncle with a surgical scalpel. And it was observed that the red blood corpuscle count (RBC), white blood corpuscle (WBC), haemoglobin count (Hb), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) values showed a decline after exposure to phenol for 7 days, while white blood corpuscle (WBC) shows an increased count. At 21 days and 28 days, all the haematological parameters showed a significant decrease.