Blood components have been in use in clinical practice for many decades now. In spite of fairly clear guidelines regarding their use, inappropriate prescriptions for components are still rampant. We undertook this work to assess the appropriateness of fresh frozen plasma (FFP) transfusions in our hospital. A prospective audit of 504 transfusion orders for 1761 FFP units was conducted over a 6-month period which was followed by a re-audit of 294 FFP prescriptions for 961 units. In the initial audit, we identified 304 (60.3%) prescriptions which were inappropriate according to the British Committee for Standardization in Hematology (BCSH) guidelines. The re-audit performed after an educational campaign among clinicians showed a reduction in inappropriate requests by 26.6%. The specific areas of misuse were FFP transfusions in patients with hypoproteinaemic states (40.5%), anaemia (36.5%), bleeding without coagulation factor deficiency (10.2%) and volume depletion (9.2%). A significant 50.3% of requests in the initial audit and 38.4% in the re-audit were for single- or two-unit transfusions, which were subtherapeutic. FFP transfusions carry the same risks to the patients as any other blood component. Prescribers of these transfusions need to be aware of the clinical setting where their use is appropriate. Local hospital transfusion committees can play a vital role in overseeing transfusion practices to ensure optimal use of blood/component therapy.

Homocysteine(Hcy) has been implicated as a novel risk factor of Coronary Artery Disease (CAD) among Asian Indians, but many studies done in India failed to reveal any direct correlation. It has also been reported that Folic acid and Vitamin B12 levels inversely affect serum levels of homocysteine. In this study, we looked at the levels of homocysteine among patients with CAD. The effect of Vitamin B12, Folate and other risk factors on homocysteine levels were also evaluated. Mean homocysteine levels in cases (22.81±13.9, n=70) were significantly higher (p=<0.001) than the controls (7.77±7.3, n=70). However no statistically significant correlation could be deduced between homocysteine Vitamin B12, and Folate. Cumulative analysis have indicated an increase in homocysteine levels among patients with CAD with every additional risk factor.

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BACKGROUNDTuberculous lymphadenitis is the commonest cause of lymphadenopathy in developing countries. This study was conducted to analyse the clinical presentation, complications and recurrences in patients presenting with tuberculous lymphadenitis. MATERIALS AND METHODSThis descriptive study is based on the observation of two groups of patients: a retrospective and prospective group of patients attending the outpatient department and the patients admitted in Christian Medical College & Hospital, Ludhiana. The retrospective group included all patients over 12 years of age who had presented with lymphadenopathy and were diagnosed as tuberculous lymphadenitis and their medical records reviewed. The prospective group were clinically examined, haematological and histopathological investigations were carried out. They were followed up for assessment of complications. RESULTSA total number of 171 cases were qualified to be included in this study. Patients with matted lymph nodes constituted 53.8% and discrete lymph nodes constituted 46.2%. Lymph nodes with a firm consistency constituted a significant proportion of 74.9% compared with lymph nodes with soft and hard consistencies constituting 20.5% and 4.7% respectively. Cervical node involvement was there in 70.7% of patients. The mean lymph node size was 6.9 cm with a variation between 0.5-20 cm. Nearly 38% of them had positive reaction for PPD. Chest X-ray findings were normal in 57.9% of patients. Nearly 50% of patients had fever as the chief complaint.