Action plan to regain unnecessary deferred blood donors due to malaria risk in Turkey

Malaria was expected to be a major problem during blood donation in Turkey due to existence of malaria cases in southeastern region of Turkey. The present study aimed for the first time, to investigate malaria in "donors deferred for malaria risk" and to determine the regional rates of malaria deferral in Turkey. Blood samples were collected from several Blood Banks of southeastern provinces where local malaria cases still exist and from Blood Bank of Ege University Medical School (EUMS) located in western Turkey where malaria is eradicated decades ago. Plasmodium spp. and specific antibodies were investigated by stained smears, antigen detection, PCR and ELISA. Among the donors deferred for malaria risk, Plasmodium spp. were not detected by microscopy, PCR or antigen detection. Seroprevalances were 2% and 3.92% in western and southeastern regions, respectively. Rate of donor deferral for malaria risk was 0.9% in EUMS and deferrals were exclusively because of travel to southeastern Turkey. In southeastern provinces, deferrals were mainly due to malaria like fever history. The present study first time assessed regional rates of donor deferral due to malaria risk in Turkey. Previously, malaria was expected to be a major problem during blood donation in Turkey due to existence of malaria cases in southeastern region of Turkey. The results of the study showed that 97% of the deferrals were unnecessary. In conclusion, to reduce unnecessary donor deferrals in Turkey, in addition to comprehensive questioning for malaria history, the usage of a malaria antibody screening method should be initiated prior to deferral decision.     

Evaluation of cardiac autonomic function by various indices in patients with primary premature ovarian failure

Background

The association between premature ovarian failure (POF) and cardiovascular diseases (CVD) was investigated previously, but none of the studies have looked at cardiac autonomic functions in these patients. In this study, we aimed to evaluate cardiac autonomic functions in patients with POF.

Methods

We enrolled 26 female patients (mean age 37.5?±?10.1?years) with primary POF and 31 healthy subjects (mean age 37.5?±?9.0?years). All participants underwent 24-h Holter recording. Heart rate recovery (HRR) indices were calculated by subtracting 1st-, 2nd- and 3rd-min heart rates from maximal heart rate. Heart rate variability (HRV) and heart rate turbulence (HRT) parameters were analyzed in all patients.

Results

Both groups were similar with regard to age, gender, body mass index and left ventricular ejection fraction. Mean HRR1 (p?=?0.018), HRR2 (p?=?0.021) and HRR3 (p?=?0.027) values were significantly higher in the control group. When HRV considered SDNN, SDANN, RMSSD, PNN50 and HF were significantly decreased in patients with POF compared to healthy controls, but LF and LF/HF were significantly higher in POF patients. Both HRT onset and slope were more abnormal in POF patients. Also, there was a significant correlation between HRR, HRV and HRT parameters and FSH, LH and estradiol levels.

Conclusion

Our study results suggest that cardiac autonomic function is impaired in patients with POF despite the absence of overt cardiac involvement and symptoms. Further studies are needed to elucidate the prognostic significance and clinical implications of impaired autonomic functions in patients with POF.     

Institutionalization of the NACP and Way Ahead

In India, HIV prevention and control activities started way before the reporting of the first case of HIV infection. On reporting of evidences of HIV infection from different parts of the country and varied groups, Government launched the National AIDS Control Program (NACP). The program was launched on the foundation of early interventions and Mid-Term Plan, which evolved in three phases over the period of eighteen years. With progression of time, epidemiological situation changed and knowledge/capacity to tackle HIV improved. In the course of the evolution, NACP has moved from the centrally controlled program to district driven. Also different strategies were inducted/refined and many important institutes like Task Force, a high-powered National AIDS Committee, National AIDS Control Board, National AIDS Control Organization, State AIDS Control Societies, Project Support Units/Project Management Units, National Council on AIDS, Department of AIDS Control, Technical Support Unit, District AIDS Prevention and Control Unit (DAPCU) were created. Currently program is implemented vertically with good impetus and is able to contain the spread of HIV in India. For enhancing the effectiveness and sustainability, future of the NACP is strongly linked with the well-performing DAPCU and good synergy/integration with General Health System. HIV/AIDS epidemic in India has entered into the third decade. Evidences show that this epidemic in India is of concentrated type and characterized by the heterogeneity, following the type 4 pattern, where the epidemic shifts from the most vulnerable populations [such as female sex workers, men who have sex with men, injecting drug users to bridge populations (clients of sex workers, sexually transmitted infection patients, partners of drug users, long route truck drivers, short stay cyclical single male migrants], then to the general population and from urban centers to rural areas (ruralization of epidemic) with increasing involvement of youth and women (feminization of epidemic).     

Incidental finding of a bilateral complete ossification of stylo‐hyoid chain and thyro‐hyoid ligaments

Ossification of stylohyoid chain corresponds to the ossification of stylohyoid ligament that can vary from thin short to thick long ossification and can be associated with other calcifications. We report in this case a bilateral non painful complete ossification of the stylohyoid complex extended to the thyrohyoidien ligament.