Blood safety is a major global issue. Transfusion transmitted parasitic infections (TTPI) like malaria are rare and possibly under-reported, a situation which could be attributed to lack of awareness of the mosquito-borne transmission of infection. Such infections are still considered potential health hazards, as they can pose a significant threat especially in immunocompromised patients, where they have proven to be fatal. Prevention of the transmission depends solely on the donor’s questionnaire which addresses previous or current infection with aetiologic agents. Donor deferral is effective however clear guidelines are needed. This case report features the transfusion-transmitted of Plasmodium Falciparum in a 15-year-old splenectomised patient with underlying beta thalassaemia major.
Introduction: The aim of thalassaemia screening is to reduce thalassaemia syndromes with significant clinical implication. Therefore, detection of α0 thalassaemia with two genes deletion is clinically more important than α+ thalassaemia with one gene deletion. The aim of this study is to determine the mean corpuscular haemoglobin (MCH) cut-off point for α0 thalassaemia screening. Method: A total of 688 α0 and α+ thalassaemia cases confirmed by DNA analysis were analysed. Red cell indices (MCV, MCH, RBC, Hb) were retrieved from the laboratory information system. Receiver operating characteristic (ROC) curve is generated to determine the MCH cut-off point for α0 thalassaemia. The diagnostic performance of MCH cut-off value was evaluated with a validation group comprising 100 samples of alpha thalassaemia carriers. Results: ROC curve analysis with area under the curve (AUC) of 0.969 showed that MCH at cut-off of 23.5pg has high sensitivity and specificity in detecting α0 thalassaemia with 98% sensitivity and 85% specificity. Conclusion: MCH cut-off value of 23.5pg can be adopted as the cut-off point for α0 thalassaemia screening to detect clinically significant thalassaemia syndrome and reduce cost and burden of screening.
Introduction: Immune response against viral infections and tumors not only requires the recruitment of immune cells but also cytokines. Cytokine dysregulation is associated with inflammatory diseases such as cancer, autoimmune diseases, infections and allergy. Intake of fruit and vegetables are known not only to reduce inflammation but may also provide protection against various diseases. Methods: Effects of selected fruits and herbs on cytokines profile of IL-8, IL-1β, IL-6, IL-10, TNF and IL-12p70 were examined using the CBA flow cytometric assay. Peripheral blood mononuclear cells (PBMC) obtained from blood samples of twelve healthy subjects aged 20 to 30 years [males = 6 and females = 6] were treated with papaya, mata kucing, dang shen and pu-erh tea, respectively, for 6 and 48 hours at various concentrations. In vivo effects was further tested on healthy volunteers [males = 2, females = 4] by 2-days consumption of papaya following 2-days washout period without papaya. The diet of volunteers was controlled with fixed meals. Results:In vitro results after 6 hours of culture showed that papaya-treated PBMC significantly increased IL-8, IL-1β and IL-6 but reduced IL-10. Mata kucing-treated PBMC significantly increased IL-8 but reduced IL-6 while pu-erh tea significantly reduced IL-8, IL-1β, IL-6 and TNF. Cytokine analysis for dang shen-treated PBMC was only conducted at 48 hours. After 48 hours, papaya extract significantly reduced IL-8, IL-6 (8000 μg/ml), IL-10 and TNF. Significant increase of IL-6 was observed at 4000 and 16000 μg/ml. Mata kucing extract significantly increased IL-1β, IL-6 but reduced TNF. Significant increase of TNF was observed at 16000 μg/ml. Dang shen and pu-erh tea reduced IL-8, IL-1β, IL-6, IL-10 and TNF. However, in vivo papaya consumption did not show any significant changes and levels were low. Conclusion: This study showed fruits such as papaya and mata kucing had both stimulatory and inhibitory effect on various pro-inflammatory cytokines while effect of herbs such as dang shen and pu-erh tea were inhibitory. Immunomodulatory studies of natural food such as fruits and herbs may provide better understanding and subsequently improve management of inflammatory diseases.
Percentage of haemolysis is widely used as a quality parameter to assess red blood cell viability in blood banking. In certain blood banks, serum potassium level is used due to the unavailability of the former test. The relationship between these two tests, however, is still unclear. The objective of this study is to determine the association between haemolysis measured using two different methods for quality control. Methods: A total of forty-four samples of packed red cell in citrate-phosphate-dextrose with optisol were randomly selected from donation drives. Nine millilitres of blood was collected weekly starting from day-2 of storage, followed by day-7, 14, 21, 28, 35 and 42 for assessment of red blood cell haemolysis by measuring serum potassium level and percentage of haemolysis.Results: These two parameters were correlated significantly with a positive moderate linear relationship on day 7, 21 and 28 with r = 0.393, 0.448 and 0.425, respectively and p-values less than 0.01. The linear regression analysis showed there was a significant regression equation which could be used to predict the serum potassium level from the percentage of haemolysis. Conclusion: There were significant increases in the percentage of haemolysis and serum potassium level in the packed red cell units with storage. The serum potassium level would be able to be predicted from the percentage of haemolysis using the regression equations on day 7, 21 and 28. The serum potassium measurement could be used as an alternative test to the percentage of haemolysis before issuing blood.
Screening for alpha (α) thalassaemia trait (TT) is challenging especially in the presence of iron deficiency (ID). Red blood cell size factor (RSf) is a parameter introduced by Beckman Coulter capable of detecting acute and chronic changes to cellular haemoglobin status and iron supply. The research aimed to investigate the clinical usefulness of RSf as screening parameter for α TT and the effect of concomitant ID to RSf mean values (m.v) among respondents with α TT. Methods: A cross-sectional retrospective laboratory analysis involved 55 respondents’ data selected from January 2014 to December 2015 in Pathology Department, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan. The significant difference at p
Introduction: Drug-resistance is a major hindrance to successful treatment of AML. Current predictive biomarkers are mainly genetic aberrations and insufficient in foretelling treatment outcome in all acute myeloid leukaemia (AML) due to its heterogeneous and aggressive nature. Proteins are stable and reliable. Secreted proteins in AML may have predictive or prognostic values for early intervention. Proteomic studies on AML are few and further investigations will benefit in selection of best markers. The aim of the study was to identify differentially expressed plasma proteins in AML with different treatment outcome. Methods: Two-dimensional electrophoresis (2-DE) technique was utilised to identify proteins differentially expressed in chemo-sensitive/chemo-resistant AML. Plasma and peripheral blood mononuclear cell (PBMC) lysate proteome analysis were performed on six chemo-resistant, four chemo-sensitive and six healthy controls and seven chemo-resistant, three chemo-sensitive and six healthy controls, respectively. Each experiment was conducted in duplicate or triplicate. Images were captured and protein spots detected by software. Differentially expressed protein spots were excised from gel and proteins were identified using LC/MS/MS. Proteins spots that were also detected in healthy controls were excluded. Results: Comparing mean % volume of each spot demonstrated significantly enhanced expression of apoliprotein-E (APO-E) and haptoglobin (HP) (p
Insights into molecular karyotyping using comparative genomic hybridization (CGH) and single nucleotide polymorphism (SNP) arrays enable the identification of copy number variations (CNVs) at a higher resolution and facilitate the detection of copy neutral loss of heterozygosity (CN-LOH) otherwise undetectable by conventional cytogenetics. The applicability of a customised CGH+SNP 180K DNA microarray in the diagnostic evaluation of Acute Myeloid Leukaemia (AML) in comparison with conventional karyotyping was assessed in this study. Methods: Paired tumour and germline post induction (remission sample obtained from the same patient after induction) DNA were used to delineate germline variants in 41 AML samples and compared with the karyotype findings. Results: After comparing the tumour versus germline DNA, a total of 55 imbalances (n 5-10 MB = 21, n 10-20 MB = 8 and n >20 MB = 26) were identified. Gains were most common in chromosome 4 (26.7%) whereas losses were most frequent in chromosome 7 (28.6%) and X (25.0%). CN-LOH was mostly seen in chromosome 4 (75.0%). Comparison between array CGH+SNP and karyotyping revealed 20 cases were in excellent agreement and 13 cases did not concord whereas in 15 cases finding could not be confirmed as no karyotypes available. Conclusion: The use of a combined array CGH+SNP in this study enabled the detection of somatic and germline CNVs and CN-LOHs in AML. Array CGH+SNP accurately determined chromosomal breakpoints compared to conventional cytogenetics in relation to presence of CNVs and CN-LOHs.
The immune system responds to stimulus by activation/increase or inhibition/decrease in activities. These immu-nomodulatory effects may be triggered by various factors in the environment including cytokines, hormones and growth factors, as well as flavonoids, antioxidants and various antigens in food and the environment. Immunosup-pression has a direct effect on the capacity of the immune system to fight against infection and cancer formation. A pro-inflammatory response, however, may induce further progression of tumours that had formed. Inflammation is also associated with many chronic illnesses including pain. The suppressive effects from phytochemicals have been shown in the potential to reduce T-lymphocyte proliferation in vitro and in vivo. Studies have demonstrated inhibi-tion of pro-inflammatory cytokines from flavonoid such as naringenin, green tea polyphenol extract, encapsulated fruit and vegetable juice powder concentrate. Feijoa sellowiana Berg var. coolidge fruit juice consumption exerted anti-inflammatory activity on edema-induced mice within first hour of treatment while agipenin, a natural flavonoid reduced neuroinflammation by protection against damage from dendritic cells stimulated T cells in experimental autoimmune encephalomyelitis mouse models. Dietary polyphenols were found to exert a regulatory role on den-dritic cell function. Our own study showed immunosuppressive effect from increased T regulatory cells from papaya consumption. Increased regulatory cells are associated with cancer conditions. On the other hand, grape juice con-sumption mobilized gamma–delta T cells. Ginseng berry extract increased pro-inflammatory molecules in dendritic cells in the spleen while polysaccharide fractions from Momorica charantia, an edible medicinal vegetable increased various immune indexes. Fruits may also have endo-immunomodulatory function causing differential effects in male and female. Sex hormones can influence immune changes based on sex as seen in increased NK cells in males and antibodies in females. We observed a population of CD4-CD45RA-CD69+CD25- cells was significantly lower in males. However, none of these studies have been directly conducted on cancers. Investigation into this area may help improve decision making in cancer management.