Impact of calcium channel blockers and angiotensin receptor blockers on hematological parameters in type 2 diabetic patients.

Antihypertensive medications have been associated with a reduction in hemoglobin (Hb) levels, leading to clinically significant anemia. We aimed to provide valuable insights into the impact of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on hematological parameters by measuring the levels of erythropoietin (EPO), ferritin, and complete blood count (CBC) in individuals with type 2 diabetes mellitus (T2DM), particularly considering the duration of the antihypertensives use. In addition to comparing their effects on blood pressure, glycemic status, and renal function, a retrospective cohort study was conducted at the consultation unit of Alsalam Teaching Hospital, Mosul, Nineveh Province, between October 2022 and February 2023. A total of 160 participants were enrolled after being fully examined by the consultants to detect their eligibility for inclusion in the study and to rule out any abnormality. They consisted of 40 healthy controls, 30 T2DM patients (T2DM group), 30 T2DM patients with newly diagnosed hypertension (HT) (T2DM+HT group), 30 type 2 diabetic-hypertensives on ARBs (T2DM+HT+ARBs group), and 30 type 2 diabetic-hypertensives on CCBs (T2DM+HT+CCBs group). Five milliliters of blood was drawn from a vein and divided into two parts. Two milliliters was transferred into an anticoagulant tube for the measurement of HbA1c and complete blood picture. Serum was obtained from the remaining blood and used for assessment of ferritin, EPO, FSG, creatinine, urea, and uric acid. Significantly reduced FSG and HbA1c levels were observed in T2DM+HT+CCBs and T2DM+HT+ARBs groups vs T2DM+HT group (p < 0.05). The T2DM+HT+CCBs group had statistically higher urea levels than the T2DM group (p < 0.05). Both CCBs and ARBs use resulted in reduced creatinine clearance (CrCl). T2DM+HT+CCBs group exhibited slightly higher uric acid levels compared to controls (p < 0.05). Prolonged use of CCBs and ARBs led to disturbances in hematological parameters, with CCBs users showing the lowest levels of hemoglobin (Hb), RBCs, and hematocrit (Hct) among the groups. ARBs users displayed the lowest values of EPO and ferritin compared to other patient groups, along with reduced levels of Hb, RBCs, and Hct, albeit slightly higher than CCBs users. Our study highlights the importance of a balanced approach in prescribing ARBs and CCBs to patients with T2DM, given their potential to induce blood abnormalities, particularly with prolonged usage.

Cyclic voltammetry growth and characterization of Sn-Ag alloys of different nanomorphologies and compositions for efficient hydrogen evolution in alkaline solutions.

Electrodeposition of silver, tin and their alloys from different aqueous electrolytes suffer from various environmental issues and deposits are affected by H2 evolution and metal oxide formation. In this work, these metals and their alloys are electrodeposited by cyclic voltammetry utilizing ionic liquids based on C5H14ClNO (choline chloride) that permits deposit properties control. Both Ag and Sn concentrations in the ionic liquid were varied from 0.01 to 0.15 mol L-1. Methionine effect on the reduction potential of Sn and Ag was studied. Different techniques were applied to explore the structures, morphologies, and electrochemical (EC) activities of the deposits. A single Ag3Sn phase with orthorhombic packed structure was observed for all alloys, whereas the preferred growth orientation was varied from (202) to (112) depending on Ag%. Also, the dislocation density is decreased by increasing Ag content. EDX spectra showed only Ag and Sn signals indicating the high purity of the Sn-Ag alloys. The deposit from Sn-rich liquid showed rougher and larger agglomerates at the surface than that formed from the Ag-rich liquids with or without methionine. The electrochemical activities of the deposits toward the H2 evolution reaction (HER) were investigated through electrochemical polarization (ECP) measurements and EC impedance spectroscopies (EISs). The Sn-Ag alloys possess higher performance, as a catalyst for HER using alkaline solution, than Ag or Sn electrodes. The highest rate of HER was recorded for Sn-35% Ag and Sn-97% Ag deposits, which correlated strongly to the microstructure and surface morphology. The ECP results were confirmed by EIS investigations. The measured impedance values are close-fitting to a hypothetical model for the electrode/electrolyte interface.

Study of red blood cell alloimmunization risk factors in multiply transfused thalassemia patients: role in improving thalassemia transfusion practice in Fayoum, Egypt.

BACKGROUND: ß-Thalassemia is considered the most common chronic hemolytic anemia in Egypt. Alloimmunization can lead to serious clinical complications in transfusion-dependent patients. The objective of this study was to determine the frequency and types of alloantibodies, and, in addition, to study the risk factors that might influence alloimmunization in multiply transfused thalassemia patients in Fayoum, Egypt, with the goal that this study could help minimize some of the transfusion-associated risks in those patients. STUDY DESIGN AND METHODS: A total of 188 multiply transfused thalassemia patients attending Fayoum University Hospital were analyzed. Alloantibody identification was performed by DiaMed-ID microtyping system. RESULTS: Alloimmunization prevalence was 7.98%. The most common alloantibody was D-related; anti-D was the most frequent alloantibody found in eight of the 188 patients (4.25 %), followed by anti-C in two patients (1.1%), anti- E in two (1.1 %), anti-c in two (1.1 %), anti-Fya in two (1.1%), anti-K in one (0.53 %), and an unknown antibody in one patient (0.53%). Higher rates of alloimmunization were found in female patients, in patients with ß-thalassemia intermedia, in splenectomized patients, in D- patients, and in patients who started blood transfusion after 3 years of age. CONCLUSION: The study reemphasizes the need for cost-effective strategy for thalassemia transfusion practice in developing countries. Red blood cell antigen typing before transfusion and issue of antigen-matched or antigen-negative blood can be made available to alloimmunized multiply transfused patients. Early institution of transfusion therapy after diagnosis is another means of decreasing alloimmunization.

Priority needs and wisdom strategy for blood transfusion safety in developing low-resource countries.

OBJECTIVE: To evaluate the implementation of alternative safety measures that reduce the risk of transfusion transmissible infections as an affordable measure in low resource countries. BACKGROUND: It is still difficult in developing countries with limited resources to mandate nucleic acid testing due to its high cost. Although NAT reduces the window period of infection, the developing countries are still in need of an efficient and effective transfusion programme before implementing the complex high cost NAT. STUDY DESIGN AND METHODS: Two thousand eight hundred eighty sero-negative first-time and repeat donations from Fayoum University Hospital blood bank were individually analysed by NAT for HIV, HBV and HCV. Only discriminatory-positive NAT were classified comparing the non-remunerated and family replacement donations. RESULTS: Significant discriminatory-positive differences were observed for HBV NAT results, 2 remunerated donations compared to 0 non-remunerated sero-negative donations. The discriminatory positive differences were also significant for HCV NAT results, 4 remunerated donations compared to 1 non-remunerated sero-negative donation. No sero-negative, discriminatory-positive NAT HIV case was found. Seven out of 8 discriminatory positive cases were from first time donations. CONCLUSION: In order to ensure blood safety, the recruitment and retention of voluntary, non-remunerated repeat donors should be a major commitment for low resource countries in which NAT implementation is costly and not feasible.

Combining serology and molecular typing of weak D role in improving D typing strategy in Egypt.

BACKGROUND: Rh discrepancies are a problem during routine testing because of partial and weak D phenotypes. Some blood units with weak and partial D expression may escape detection by serology. Limitations of serology can be overcome by molecular typing. The objective of study was to compare currently used serologic methods with molecular analysis to determine the potential application of molecular methods to improve D typing strategies and to estimate the frequency of weak D types among the Arab population. STUDY DESIGN AND METHODS: Fifty blood donor and patient samples with discrepant results of D phenotyping were subjected to routine serology to define the D phenotype including monoclonal anti-D immunoglobulin M and indirect antiglobulin test. Commercially available panels of monoclonal anti-D were used for identification of partial D and weak D phenotypes. Genomic DNA was evaluated using allele-specific amplification polymerase chain reaction with sequence-specific primers to define weak D type. RESULTS: Molecular typing confirmed most of the serology results; three samples that were not clear-cut serologically were identified by molecular typing, two samples as weak D Type 4.2 (DAR), and one sample as weak D Type 4.0. Another two samples identified by serologic panel as weak D were unresolved by molecular typing. A sample with partial D Type II by serology revealed a Weak D Type 4.0 by molecular typing. Results interestingly showed the high frequency of weak D Type 4.2 (DAR) in Egypt. CONCLUSION: RHD molecular typing can solve discrepancies during routine testing due to partial and weak D phenotypes for better transfusion outcome.