Advancing life: innovative approaches to enhance survival in sickle cell anemia patients.

Sickle cell anemia (SCA) is a severe genetic disorder characterized by the production of abnormal hemoglobin S, leading to the formation of sickle-shaped red blood cells that cause chronic anemia, pain, and organ damage. This review explores recent innovative strategies aimed at improving survival rates and quality of life for SCA patients. Genetic therapies, particularly gene editing with CRISPR-Cas9 and gene therapy using lentiviral vectors, have shown significant potential in correcting the genetic defects responsible for SCA. Clinical trials demonstrate that these approaches can reduce sickle cell crises and minimize the need for blood transfusions by enabling the production of healthy red blood cells. Novel pharmacological treatments such as voxelotor, crizanlizumab, and L-glutamine provide additional mechanisms to prevent hemoglobin polymerization, reduce vaso-occlusive episodes, and decrease oxidative stress, respectively. These therapies offer new hope for patients, particularly those who do not respond adequately to existing treatments. Improved blood transfusion protocols, including automated red cell exchange and advanced donor-matching techniques, have enhanced the safety and efficacy of transfusions, reducing complications like alloimmunization. Comprehensive care models, integrating multidisciplinary care teams, patient education, and telemedicine, have further contributed to better disease management. By providing holistic care that addresses both medical and psychosocial needs, these models improve patient adherence to treatment and overall health outcomes. This review highlights the importance of these innovative strategies and calls for continued research and development to sustain and expand these advancements in SCA care.

Soluble platelet selectin and platelets in COVID-19: a multifaceted connection.

The COVID-19 pandemic has brought to light the intricate relationship between platelets, soluble platelet selectin (sP-selectin), and disease pathogenesis. Platelets, traditionally recognized for their role in hemostasis, have emerged as key contributors to the immunothrombotic complications observed in COVID-19 patients. Concurrently, elevated levels of sP-selectin, indicative of platelet activation and endothelial injury, have been consistently identified in COVID-19 patients and have shown associations with disease severity and adverse outcomes. This multifaceted connection underscores the pivotal role of platelets and sP-selectin in orchestrating thromboinflammation, vascular dysfunction, and disease progression in COVID-19. Platelet activation triggers the release of inflammatory mediators and promotes platelet-leukocyte interactions, amplifying the systemic inflammatory response and exacerbating endothelial injury. Additionally, platelet-derived factors contribute to microvascular thrombosis, further exacerbating tissue damage and organ dysfunction in severe COVID-19. Elevated sP-selectin levels serve as biomarkers for disease severity and prognostication, aiding in risk stratification and early identification of patients at higher risk of adverse outcomes. Therapeutic strategies targeting platelet dysfunction and sP-selectin-mediated pathways hold promise in mitigating thromboinflammation and improving outcomes in COVID-19 patients. Antiplatelet agents, platelet inhibitors, and anti-inflammatory therapies represent potential interventions to attenuate platelet activation, inhibit platelet-leukocyte interactions, and alleviate endothelial dysfunction. A comprehensive understanding of the multifaceted connection between platelets, sP-selectin, and COVID-19 pathogenesis offers opportunities for tailored therapeutic approaches aimed at mitigating thromboinflammation and improving patient outcomes in this complex and challenging clinical setting.

Menstrual cycle-associated effects on some acute phase reactants parameters of Students in Usmanu Danfodiyo University Sokoto, North Western Nigeria.

BACKGROUND: The menstrual cycle is the cycle of natural variations that occurs in the uterus and ovary as an essential part of making sexual reproduction possible. It is characterized by hormonal changes but the changes that occur in some active phase reactants (APR) parameters have not been fully elucidated. OBJECTIVE: The aim of this study was to compare the serum albumin, ESR, and C-reactive protein levels in follicular and luteal phases of menstruation. METHODS: A total of 90 healthy regularly menstruating women where used for this study. Forty-five of the study participants were in their follicular phase while the other 45 where in their luteal phase. Four milliliters of blood were withdrawn from each patient under aseptic condition and two milliliters was dispensed into EDTA container while the other two milliliters were dispensed into a plane container. The EDTA anticoagulated blood was used for ESR and full blood count while the serum from the plain tubes was used for analysis of C-reactive protein and Serum Albumin. Sysmex K-3 auto-analyser (Sysmex, Kobe Japan) was used for te determination of full blood count, the Westergren method was used for ESR estimation, Bromo Cresyl Green method was used for serum albumin and ELISA method was used for CRP determination. Data analysis was carried out using SPSS version 23. RESULTS: This study showed a statistically significant difference in the ESR (p= 0.03) among menstruating women in the follicular and luteal phases of menstruation. Sociodemographic factors had no statistically significant effect on the APR parameters of menstruating women in the follicular and luteal phases of menstruation (p> 0.05). There were no statistically significant differences between acute phase proteins of menstruating women in the follicular phase and luteal phases (p> 0.05). Also, age and marital status did not affect the acute phase proteins among menstruating women in the follicular phase and luteal phases (p> 0.05). CONCLUSIONS: There is need to generate data on menstrual disorders and their impact on women's health status, quality of life and social integration. It is vital that evaluation and treatment of menstrual complaints should be given a higher priority in primary care programs. There is need to invest in public enlightenment program to increase awareness in secondary schools to increase the level of awareness among adolescents as well as young females.

Evaluation of coagulation parameters and liver enzymes among alcohol drinkers in Port Harcourt, Nigeria.

Alcohol is a major contributor to the global burden of disease, disability, and death in high, middle, and low-income countries. Harmful use of alcohol is one of the main factors contributing to premature deaths and avoidable disease burden worldwide and has a major impact on public health. The aim of this present cross-sectional study was to investigate the effect of alcohol consumption on coagulation parameters and liver enzymes of subjects in Port Harcourt, Nigeria. Two hundred adults consisting of 120 alcohol dependent subjects and 80 age, gender-matched nondrinkers aged 25-65 years (mean age 45.25 ± 11.50 years) were enrolled in this study. Of the 120 chronic alcohol drinkers, 37 were dependent on local dry gin, while 83 were dependent on other alcoholic beverages. The mean values of the liver enzymes, aspartate aminotransferase and gamma glutamyl transferase, were significantly higher (P = 0.002 and P = 0.02 respectively) among the chronic alcohol consumers compared with their nondrinker counterparts. Although the value of alanine aminotransferase was higher in the chronic drinkers, it did not reveal any significant difference (P = 0.11). The coagulation parameters, prothrombin time and activated partial thromboplastin time were investigated among chronic drinkers and nondrinkers. The mean value of prothrombin time and activated partial thromboplastin time was significantly higher in the chronic alcohol drinkers compared to the nondrinkers (P = 0.04 and P = 0.02 respectively). We observed a positive and significant correlation between values of liver enzymes, serum gamma glutamyl transferase and aspartate aminotransferase, and values of prothrombin time among alcohol consumers (r = 0.72 and r = 0.68 respectively). The implementation of policies to target harm reduction strategies among alcoholics is urgently needed, alongside the building of a strong base of public awareness and community support required for the continuity and sustainability of alcohol policies. There is also the need for the Nigerian government to enforce tighter regulations and restrictions on the production and distribution of alcoholic beverages to reduce harmful use, and protect young people and other vulnerable groups.

Autologous blood transfusion--a review.

The discovery of HIV and other transfusion-transmissible infections has increased the demand for alternatives to allogeneic blood transfusion. One such alternative is autologous transfusion. This review presents an analysis of autologous transfusion. We conclude that autologous transfusion should form part of a strategy to minimise the risk associated with allogeneic transfusion in Nigeria and other developing countries.