Haematinic deficiences in British patients with recurrent aphthous stomatitis

Recurrent aphthous stomatitis (RAS) affects up to 25 percent of the population. Though predominantly idiopathic, there are many aetiological factors, among them anaemia and deficiencies of iron, folic acid and vitamin B12. There continues to be controversy over the necessity for haematinic analysis in addition to a complete blood count. The records of 222 patients with RAS (85.6 percent minor, 8.6 major, 2.7 percent herpetiform and 3.1 percent Behcet's syndrome), ranging in age from 4 to 79 years, were therefore scrutinised for the results of the complete blood count, serum ferritin and vitamin B12 and red blood cell folate levels. Anaemia was diagnosed in 14 percent of patients, aged 15 years or less, male and female, and 6 percent of patients of both sexes aged over 15 years. Around 25 percent of females and 10 percent of males had reduced ferritin, 9 percent and 5 percent, respectively, had reduced vitamin B12 and 3 percent had reduced red cell levels. There was poor correlation between the finding of haematinic deficiency and abnormalities in the complete blood count. It is concluded that haematinic deficiency investigations are justified in cased of RAS and that a full blood count alone is adequate.(AU)

Clinical aspects of blood transfusion in adults

The transfusion of blood or blood products may be life-saving or may reduce morbidity but also carries risks. Therefore, it should be prescribed only when it is clearly indicated, after a careful assessment of the benefits and risks for the patient. The pattern of blood usage in developing countries differs from that in developed countries. This reflects the better infrastructure (e.g. availability of safe water and adequate sanitation), public health services and more sophisticated health systems in developed countries, and the prevalence of some hereditary haematological disorders in developing countries. There are also differences in usage among developing countries, with the pattern in a small group similar to that of developed countries. In this paper we discuss the indications and the precedures for transfusion of blood and blood products, and outline the complications of haemotherapy and methods for avoiding or correcting them at the time of transfusion or afterwards (AU)

Blood disorders in maternal morbidity and mortality: a public health education and guide for maternal care in the third world

This book is intended to be a health education and guidance to those of various levels in the medical field involved in the maternal and child care services in our hospitals and health centres. For those attending the maternal and child care services who can read, they will find this book useful for their own general self-awareness(AU)

HTLV-I-associated leukemia : a model for chronic retroviral diseases

Human T-lymphotropic virus type I (HTLV-I) has been associated with adult T-cell leukemia/lymphoma (ATL), a malignancy of mature CD4-positive lymphocytes, and tropical spastic paraparesis (TSP), a demyelinating neurological syndrome. This article describes the clinical and pathological features of ATL and reviews the epidemiology of this disease and of its putative etiological agent, HTLV-I. From what is known about the molecular biology and epidemiology of HTLV-I, hypotheses on the etiology of TSP are proposed, and strategies for studying the neurological syndrome are suggested. (AU)

Hematology notes

Hematology, the study of blood, is traditionally restricted to a study of the cellular elements (the red cells, white cells, and platelets) and some of the plasma protein - particularly those involved in the maintenance of normal homeostasis. The aim of these notes is to act as a guideline to the lectures which are designed to supplement the information in the standard texts. In particular, much of the information available in standard physiology text-books is out-of-date. Section I deals with the physiology of the blood and should be useful not only in the pre-clinical but in the clinical years. Diagnosis has been deliberately excluded from this section. The clinical and laboratory aspects of the blood disorders are covered in Section II. Here the aim is to sufficiently equip the student to investigate and manage satisfactorily, patients with common hematological problems. Like the preceding section, these notes are not meant to be exhaustive or to replace the standard texts recommended, but to supplement these and where appropriate provide data from a West Indian viewpoint (AU)

Screening for glucose-6-phosphate dehydrogenase deficiency in haemolytic disorders: The methylene blue reduction test

The methylene Blue reduction (MeBl) test was evaluated in patients with a variety of haemolytic disorders by comparing it with the spectro photometric assay and, in some cases, with a cytochemical test for the detection of G6PD deficient cells. The MeBl test is as sensitive as the spectrophotometric assay. In addition some individuals who were identified as deficient using the cytochemical technique but whose enzyme activity was not decreased were detected using the MeBl test. The final optical density in the test increased with decreasing packed cell volume, particularly if this was less than 0.25, and with increasing plasma haemoglobin concentrations, but was unaffected by bilirubin concentrations up to 175umol/l. Results are reliable on blood samples anticoagulated with ethylene diamine tetraacetic acid or with acid citrate dextrose for up to three days or two weeks, respestively, if they are stored at 4 degrees C. The MeBl test is a reliable screening test for G6PD deficiency and is particularly useful in those countries whose resources are limited. (AU)