Achalasia, a primary esophageal motility disorder, manifests as impaired peristalsis and dysfunctional relaxation of the lower esophageal sphincter. Treatment aims to alleviate the functional obstruction at the gastroesophageal junction, facilitating esophageal emptying. For end-stage cases, esophagectomy is often recommended as the primary intervention, despite the considerable postoperative complications it entails. In this case series, we present instances of various complications post-McKeown's esophagectomy in achalasia patients with sigmoid oesophagus. These complications encompass anastomotic strictures, leaks, hydrothorax, tracheal injury, and laryngeal nerve damage.
Objective: To assess the effectiveness of two methods of delivering a fixed total monetary incentive to improve blood pressure self-monitoring behavior in hypertensive patients. Design: This study is a randomized, double-blinded controlled trial. Methods: A 3-arm trial with 99 participants, randomly assigned to a control group and two intervention groups (1:1:1 ratio). Participants utilized internet-based blood pressure monitors and implemented guideline-based standardized hypertension management through an online platform. The two intervention groups received different time-dependent incentives (1 RMB per day) over a 3-month period: immediate or delayed. Results: In the first month, no significant difference was observed in blood pressure self-monitoring among three groups (P > 0.05). In the second month, the intervention groups showed significantly higher monitoring days compared to the control (immediate incentive: 21.5 days vs. 16.3 days, P = 0.009; delayed incentive: 21.3 vs. 16.3 days, P = 0.029). In the third month, the intervention groups had significantly more measurements (31.1 and 31.4 vs. 17.9 times, P = 0.013 and P = 0.014). Monitoring behavior declined in all groups over 6 months, with the delayed incentive group declining at a slower rate (p < 0.001 for regression coefficient comparison). Conclusions: Monetary incentives effectively improved blood pressure monitoring behavior in the short term. However, their impact diminished after the incentives were withdrawn, with delayed incentives resulting in a slower decline. Small, delayed monetary incentives may provide benefits for remote hypertension management. Future research should investigate the long-term effects and clinical outcomes.
Background: Papilledema, or optic disc swelling because of elevated intracranialpressure, was sorted using the Frisen Scaling. Optical coherence tomography (OCT) is a possible device to measure variations in the degrees of papilledema and to displaythe effectiveness of treatments. Objective: To identify and correlate the role of the OCT of the optic nerve head with the clinical grading of papilledema using the Frisen Scale via digital fundus photographs. Patients and methods: This was a randomized trial in which 50 eyes with papilledema have been enrolled from the cases attending the outpatient clinic of Beni-Suef University Hospital. Digital optical disc photos of the left or right eye have beenchosen for comparison with OCT optic nerve head (ONH) images results. To correlate OCT results with clinical grading of papilledema using the Frisen scale. Results: There was a highly significant association between stages of papilledema by OCT and stages of papilledema by modified Frisen scale (p.value<0.001). A strong positive significant association among stages of papilledema by OCT and stages of papilledema by modified Frisen scale (r= 0.871, P <0.001). Conclusion: Present OCT measurements may be beneficial as an adjunct to clinical grading. For lower-stage anomalies, OCT compares positively with clinical grading of optic nerve photos. With elevated stages, OCT-RNFLT processing algorithms frequently failed.
Introduction: Emergency care in hepato-gastroenterology (HGE) at CHU-Kara is expanding. Objective: To assess the management of emergencies in the general hospital ward at CHU-Kara. Materials and methods: This was a retrospective study of patient records from 1 January 2023 to 30 June 2024. It ran from July 1 to September 31, 2024. Results: 170 emergencies were identified, with a hospital frequency of 20.90% and a sex ratio of 1.6. The average age was 49 years. Digestive haemorrhage was the leading emergency (69.41%), dominated by ruptured oesophageal varices (RVO), followed by peptic ulcers. Other emergencies were hepatic encephalopathy (12.94%), acute abdominal pain (11.77%), ingestion of caustic products (2.94%) and chronic vomiting (2.94%). All patients had undergone an initial assessment combined with non-specific resuscitation. All patients had not undergone aetiological investigation. Vasoactive drugs in the splanchnic territory were not available. In addition to secondary prevention of RVR, their management was based on the administration of non-cardioselective beta-blockers used alone. The course of treatment was marked by a high mortality rate of 31.76%, due to the delay in consultation, the severity of the life-threatening condition, the patients' lack of financial resources, the absence of health insurance and the inadequacy of the technical facilities. Conclusion: Emergencies in the Emergency Department are frequent at CHU-Kara; they are dominated by upper digestive haemorrhage, which is life-threatening.
Vibrational impact syndrome caused by biophotons is a syndrome resulting from excessive and ultra-weak photon emission. It is worth noting that at the beginning of the clinical picture, the photon emission was diffuse and disseminated, covering several organs and systems, subsequently leading to excessive long-term retention of biophotons, with energy elimination perceived throughout the body surface. This syndrome involves peripheral nerves with changes in electromyography, as well as damage to blood vessels leading to bleeding in the nose, lips and mouth, as well as damage to the saphenous vein in the right leg and metabolic changes, such as elevated blood levels of triglycerides, cholesterol, fasting glucose and testosterone, as well as a reduction in Vitamin B12 that can damage peripheral nerves. Furthermore, in August 2024, Prostaglandin E2 was measured with a significant increase, with titers above 4,000%, leading to several clinical implications. In fact, this is a case report in a 72-year-old patient with pathological photon emission for 10 years that persists to this day. I assume this is the first study reported in the literature and the most surprising, reported by the patient and also the author of this essay who, fortunately, is a physician. It arose spontaneously and without interference from any external factor. However, there appears to have been internal interference. In fact, it appeared a week after his wife underwent breast cancer surgery. Here it became clear that the role of Consciousness in the emission of biophotons is unquestionable. It follows an intelligent and intentional pattern. Consciousness, the Intelligent Principle of the Universe, is the product of Universal Consciousness, the Supreme Intelligence of the Universe, the first cause of all things. It is undoubtedly the one that actually absorbs and metabolizes the photon captured from the sun, which ultimately comes from the “sea of energy” called the ‘zero-point quantum field’ [ZPF] studied by contemporary science.
The capsular polysaccharide Type 1 and type 6 of the human clinical local pneumotropic isolates of Streptococcus pneumoniae were separated, characterized and purified. Then quantified to concentrations of 1 mg/ml. To be ready as immunogens they were admixed with an equal volume of lanline. These were standing as the test immunogens. The test immune system was that of rabbits. The test rabbit groups were assigned as C 1 group,C6 group and saline S control group each of five animals. The test rabbit groups C 1 and C6 were primed once through intramuscular route separately with capsule-lanoline mixtures and left for 21 days, then bleed. Sera were saved from the primed rabbits blood samples in 0.5 ml aliqoutes till use. Trachial mucosal immunoglobulin were separated, partially characterized and kept in alqoutes of 0.5 amounts in forml normal saline till use. One step sandawich eliza technique for TNF alfa, TNF beta, IL6 and IL10 were performed for both sera and mucosal globuilin of the primed rabbits and controls. The immune features of the capsule-lanline primed rabbits were found as; capsules were weak immunogen needs adjuvant in order to become good immunogen, cytokine responses were serotype dependent, mucosal cytokines have shown to be of higher levels than systemic responses, C1 was higher immune convertor than C 6, and both associated with cytokine imbalance towards pro-inflammatory cytokines.
Tumours or strictures compressing the trachea /bronchial tree cause central airway obstruction (CAO). Subglottic stenosis are a cause of respiratory symptoms and distress. Idiopathic sub glottic stenosis (ISGS) is a rare disease occurring mainly in women and has a history of recurrences. Endoscopic laser microsurgery and balloon dilatation are used in the management of strictures. Recurring strictures may require tracheoplasty. Poly chondrites is a rare disorder causing poly arthritis and inflammation of cartilaginous tissue. Inflammatory changes in the lung cause tracheobronchomalacia (TBM) and lung collapse. Relapsing polychondritis (RP) effecting the airway is life threatening as there is dynamic airway closure during expiration. The medical therapy in RP includes steroids, disease modifying agents ( methotrexate) and biologics. Surgical interventions include tracheostomies and tracheobronchial stents for severe forms of the illness.
Introduction: Endophthalmitis is a devastating sight-threatening condition following open globe injury. The study aims to determine the rate of endophthalmitis and assess risk factors for the development of endophthalmitis following open globe injury (OGI). Methods: A retrospective review of all children treated for OGI at the Drashti Netralaya from January 2008 to December 2022 was conducted according to predefined inclusion and exclusion criteria. The main outcome measures were the rate of endophthalmitis, different variables, and visual outcome. Result: In this study, 53/1551 (3.42%) eyes had endophthalmitis. Cross-tabulation and descriptive analyses identified presenting vision (0.012), corneal condition (0.009), vitreous opacities (0.000), and age group (0.003) as high-risk factors of developing endophthalmitis. The type of interventions and subconjunctival antibiotic injection at the time of globe closure (0.011) was associated with a decreased risk of developing endophthalmitis. Conclusion: Careful aggressive management according to clinical findings, has a statistically significant impact on the visual outcome even in the pediatric age group.
Homeopathy is a clinical methodology discovered about two centuries ago by the Saxon doctor Samuale Hahnemann, it is based on the law of similarities and treats the individual with a "small dose" of a specific substance that, in "high doses" would make him sick. The infinitesimal homeopathic doses are prescribed after a long medical visit during which the homeopath listens carefully to the patient's narrative, takes into account the smallest narrative details, evaluates every kind of disorder accused by the patient and, based on the law of similarities, prescribes the appropriate, personalized, individualized homeopathic therapy. The attention paid to the patient, and not only to the disease, makes the narrative medical approach of classical homeopathy typical, which takes into account global, physical, mental and existential suffering. Listening homeopathically, therefore, means expanding listening based on a clear and precise motivation aimed at humanly understanding the overall meaning of pain. Generative AI, not having an internal motivation, is different from natural and human intelligence, that's why the natural and well-motivated listening of a homeopath is very different from the artificial and unmotivated listening of a robot. To establish a natural and human relationship with the patient, one must listen naturally and humanely, but this does not exclude that the good use of artificial intelligence, in homeopathy, can prove extremely useful.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by muscle atrophy, weakness, and loss of motor function. ALS patients are often bedridden for extended periods, increasing their risk of pressure ulcers. However, clinical data suggests that the incidence of pressure ulcers in ALS patients is lower compared to other bedridden patients. This review analyzes the factors contributing to reduced pressure ulcer risk in ALS patients, focusing on "pressure redistribution due to muscle atrophy," "stabilized postures caused by joint contractures," and "comprehensive care provided by caregivers." Additionally, this paper discusses a comprehensive approach to pressure ulcer prevention, including nutritional management, skincare, pressure redistribution techniques, and advanced technologies. Challenges in pressure ulcer prevention and the importance of ALS-specific care are also emphasized.
Introduction: Considering the increased incidence of noncommunicable diseases (NCDs) and the need for novel approaches to health promotion, this study investigates the feasibility of cross-country mHealth interventions in Sub-Saharan Africa. The study, which focuses on using digital platforms for health communication, intends to investigate the feasibility and effectiveness of cross-country mhealth interventions aimed at disseminating health promotion materials in Sub-Saharan Africa across various platforms. The study is based on the NCDs 365 project, a year-long health promotion initiative in five nations aimed at promoting NCD literacy. Methodology: The study utilized a multi-stage sample technique, including an intentional selection of five nations (Cameroon, Kenya, Nigeria, Uganda, and Zimbabwe) with active local partner organizations conducting the initiative. The following stage was convenience sampling of members of these organizations who participated in the NCD365 project activities. Data gathering included the distribution of questionnaires via local partners, followed by thorough analysis using descriptive techniques and comparison tests such as ANOVA and the Kruskal-Wallis test. The extensive methodology ensured a broad and representative sample, which increased the findings' validity and generalizability. Results: The findings demonstrated the potential of mHealth interventions to close health literacy gaps and promote positive health behaviors throughout Sub-Saharan Africa. According to an analysis of online communication platform usage, WhatsApp was the most popular (58.6%), followed by X (20.8%) and Facebook (6.8%). The study also found significant trends in platform preference across all five countries. Furthermore, gender-specific study indicated comparable literacy rates, with males slightly outperforming females. The Kruskal-Wallis test found no significant difference in the efficacy of various online communication channels for health promotion, confirming the viability of cross-country mHealth programs. Conclusions: This study highlights the significant potential of cross-country mHealth interventions for health promotion in Sub-Saharan Africa. The study's strong methodology, agreement with current research, and gender-specific analysis add to its dependability and credibility. The findings of this analysis provide significant recommendations to policymakers seeking to optimize platform-specific policies and stimulate cross-country collaborations in health promotion. Finally, these findings expand the discussion on health literacy promotion and establish the groundwork for evidence-based recommendations that might drive effective health communication initiatives in the region and beyond.
Background: Alignment of global health initiatives (GHIs) with national health priorities is crucial for effective and sustainable healthcare interventions and strengthening health systems. Despite widespread recognition of this need, achieving alignment between GHIs and national priorities has proven challenging. The importance of addressing this challenge has led to a growing focus on GHIs alignment, evident in forums such as the Paris Conference in 2015 and the Lusaka Agenda in 2023. As Nigeria embarks on a new mid-term health agenda based on the sector-wide approach (SWAp), understanding the country-level implications of alignment becomes paramount. Method: This study utilized qualitative research methods to examine the issues affecting GHI alignment within the context of the sexual, reproductive, maternal, neonatal, adolescent, elderly, nutrition health plus nutrition (SRMNCAEH+N) program. Through 24 interviews and focus group discussions with key stakeholders including government officials, representatives of global health institutions, civil society actors, health workers, and community members, this research identified and validated six critical issues influencing GHI alignment at the country level. Result: The findings shed light on current practices, challenges, and recommendations, highlighting Nigeria's readiness to implement the new health agenda and SWAp effectively. The research identified and validated six critical issues influencing GHI alignment at the country level through the perspectives of diverse stakeholders. Conclusion: The paper underscores the importance of extensive stakeholder involvement, including communities, in achieving optimal alignment between GHIs and national health priorities. The study's insights into the alignment dimensions of Nigeria’s SRMNCAEH+N program reveal key areas for improvement and collaboration, essential for the successful implementation of Nigeria's new health agenda.
The aim of this study was to take stock of perioperative acute renal failure (ARF) in intensive care at Kara University Hospital. This was a retrospective, descriptive and analytical study of the records of patients with renal failure in the surgical intensive care unit of Kara University Hospital from 1 January 2021 to 31 December 2023. The parameters studied were: epidemiological, diagnostic, therapeutic and evolutionary aspects. Results: 94 cases of ARF were studied, with a frequency of 2.11%. The average age of the patients was 45.65 ± 20.02 years. The most common age group was elderly patients aged 60 and over. The sex ratio was 4.7. The majority of patients were rural (71.30%). The most common type of ARF was functional ARF (76%), followed by obstructive ARF (18%). Digestive surgery was the most common in 60.63% of cases, followed by uronephrological surgery (19.1%) and traumatological surgery (11.7%). General anaesthesia was most common, accounting for 85.10% of cases. The average length of stay in intensive care was 4.25 ±6.42 days. Complications accounted for 40.42% of cases, dominated by infections and hyperkalaemia. Management was associated with a high mortality rate of 31.91%. Conclusion: Perioperative ARF was the result of a combination of numerous factors related to the patient's condition, delay in consultation, type of surgery, precarious haemodynamic events and perioperative infections. Management of perioperative acute renal failure is primarily preventive and aetiological.
Blood transfusion is required in the management of life threatening orthopaedic trauma hemorrhage. However, this practice is faced with erratic supply, increasing demand for safe blood and inappropriate transfusions which may expose patients to transfusion associated risks. Appropriate use of blood and related products as well as adherence to transfusion guidelines has been shown to ameliorate these challenges. This study set out to determine the appropriate blood and blood components usage and adherence to guidelines in orthopaedic patients managed at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Descriptive cross-sectional study design was and involved 132 transfused orthopedic trauma patients, recruited by consecutive sampling, between March 2019 and January 2020. Data was collected using interviewer administered structured questionnaire. Continuous data were summarized as median (inter-quartile range) and categorical data as frequency tables and proportions. Fisher’s Exact Test was used to assess associations between categorical variables and non-parametric Kruskal-Wallis Test was used for continuous independent variables. A p value < 0.05 was considered statistically significant. The results: Males were 101 (76.5%), median age was 36 (IQR 28, 47) years, majority of the patients, 95 (72%) were referrals, 64 (48.5%) were unskilled workers and 64 (48.5%) had primary school level of education. Most of the patients, 105 (79.5%) were injured in road traffic accidents. Most patients, 105 (79.5%) and 115 (87.1%) had normal pulse rate and systolic blood pressure respectively while 77 (58.3%) had increased respiratory rate. The median pre-transfusion haemoglobin was 8.90 (IQR 7.98, 10.35) g/dl and the commonest blood group was O positive. Patients with isolated femur fractures were 62 (47.0%). Patients who underwent primary open reduction and internal fixation were 61(46.2%). Majority of the patients, 127 (96.2%) received packed red blood cells. The proportion adherent to transfusion guidelines was 16.7% [95% CI: (10.75, 24.14)]. The factors associated with adherence were pre-transfusion haemoglobin and haematocrit levels, Fisher’s Exact and Kruskal-Wallis p value being < 0.001. Mild transfusion reactions were noted in 15 (11.4%) patients. Conclusions made were that most patients were males, transfused with packed red blood cells and majority of injuries sustained were due to road traffic accidents. The level of adherence to the institutional transfusion guidelines was low at 16.7%. Factors associated with transfusion guidelines adherence were pre-transfusion haemoglobin and haematocrit levels. The recommendation was that Moi Teaching and Referral Hospital Transfusion Committee should increase transfusion guidelines awareness among clinicians in orthopaedic trauma.
Introduction: Sigmoid colon volvulus is produced by torsion on itself, which causes an obstruction and endangers the blood supply to the organ and represents a condition because of another underlying pathology, the highest prevalence is in men over 70 years of age. Objective: Presentation of a case. Method: A 73-year-old man with paranoid schizophrenia under treatment presented to the emergency department for acute constipation of 72 hours, with no evacuation and flatus. She refers to abdominal distension of 48 hours prior in a sudden and evolutionary way, continuous abdominal pain of a colic type and generalized oppressiveness. An emergency exploratory laparotomy was performed initially, with the finding of volvulus of the giant sigmoid colon not perforated, but with intestinal ischemia. Intestinal resection of the sigmoid colon and stoma is performed. Discussion: Strangulated colon volvulus makes it a surgical emergency due to intestinal necrosis, septic shock and death; the computed tomography study is the gold standard for confirming the diagnosis of colon volvulus, surgical treatment is definitive. Conclusion: Sigmoid colon volvulus is a consequence of another pathology (such as benign prostatic hypertrophy) and not a disease. Its initial treatment (endoscopically) will depend on the time of evolution, infrastructure, expertise and/or each case. But at the end of the day, management is urgent, priority to scheduled, with partial resection of the colon, stoma, and/or bowel reconnection.
Background: Ethnopharmacological study of Mucuna pruriens, a creeping and leguminous plant used in the treatment of anaemia in the eastern part of Kogi State, Nigeria was carried out. The aim was to evaluate the effect of aqueous extract of the leaves of M. pruriens on haematinic activities in mice. Method: Leaves of M. pruriens was extracted by maceration in water. Phenyl hydrazine 4 mg/kg was administered for four days. Mice were grouped and treated with normal saline 10 ml/kg (normal and anemic control), M. pruriens (100, 200 and 400 mg/kg) and Fersolate (0.0214 mg/kg) p.o for 7 days. Hematological parameters measurements were carried out before treatments, days 1, 7, 14 and 21. The red blood cell count (RBC), haemoglobin concentration (Hb), white blood cell count (WBC) and hematocrit (HCT) were analyzed as indices of anemia. Phytochemical fingerprint using HPLC chromatography and mineral contents were also carried out. Results: Plant extraction percentage yield was 15%. M. pruriens (aq) significantly (p<0.01) produced a 61% recovery from anemia at 400 mg/kg after 7 days of treatment and between 94 to 146.52 % 1 and 2 weeks after treatment at all test doses. Hb, and HCT levels also significantly increased especially at 100 and 200 mg/kg doses of M. pruriens compared to the anemic control both at 1 and 2 weeks after treatment. HPLC analysis showed the presence of alkaloids, glycosides, saponin, terpernoids, carbohydrates, chlorogenic acid, caaffeic acid, rutin, ferulic acid and resins. The extract also contained substantial amounts of vitamins B6, C and E, as well as folic acid and iron. Conclusion: These results provide some evidence to support the traditional use of M. pruriens leaves in the treatment of anaemia.
Thyroidectomy is a usual surgery done by surgeons around the world, its difficulty remains in the anatomical variation of the cervical region and the multiple aspect of the thyroid pathology. In this optic we report a rare multinodular goiter with an accessory thyroid associated with a NIFTP lesion. This unique association make a double challenge firstly in surgery and secondly in the fellow up.We present the experience of our department and a review of the literature to draw attention of surgeons and pathologists about these variant of embryology and pathology.
Background: Thrombotic thrombocytopenic purpura is a rare entity that represents a diagnostic challenge due to clinical manifestations that may be nonspecific. In addition, the diagnostic approach requires expensive and poorly accessible laboratory tests (for example, measurement of ADAMTS13 enzyme activity levels). The first reported case was in 1924, described by Eli Moschcowitz in a 16-year-old girl who died suddenly and in whom the post-mortem biopsy showed thrombi in the kidney, heart and spleen. It is estimated that TTP has an annual incidence of 1.5 to 6 cases per 106 inhabitants, with a prevalence of 10 to 15 cases per 106 inhabitants, and is more frequent in the female sex with a female/male ratio of 2:1. Thrombotic thrombocytopenic purpura (TTP) is characterized by the concomitant appearance of often severe thrombocytopenia, microangiopathic hemolytic anemia, and multiple organ involvement due to ischemia secondary to the formation of thrombi in various parts of the vascular system. The organs most frequently affected are the brain, heart, and kidneys. Currently, it has been identified that the pathophysiology is related to the alteration in the enzyme metalloproteinase with thrombospondin motifs 13 (ADAMTS13), which has protease activity that is responsible for cleaving the ultra-long multimeric chains of the von Willebrand factor (vWF). These alterations can be congenital (recessive mutations of the ADAMTS13 gene) or acquired (formation of antibodies against ADAMTS13). In this review we present the clinical case of a woman from Merida, Yucatan, Mexico, who was admitted to the internal medicine service due to the presence of tension-type headache and jaundice of more than 1 month of evolution. During her care in the emergency room, laboratory studies documented data of intravascular hemolytic anemia and thrombocytopenia, with no involvement of other organs. An approach to autoimmune hemolytic anemia was started, later she presented clinical worsening, neurological involvement (psychosis), increased hemolysis and thrombocytopenia, empirical treatment with steroids was started without response, she was later evaluated by hematology who, due to the clinical characteristics she presented plus the finding of schistocytes in the peripheral blood smear, an approach for PTT was started requesting ADAMTS13 activity levels, and empirical management with plasmapheresis was started, presenting a favorable response. Days later, the results of the studies were collected, reporting 0% ADAMTS13 activity, confirming the diagnosis of PTT. Methods: A search was performed for literature related to the epidemiology, pathophysiology, clinical manifestations, diagnosis, differential diagnosis and treatment of thrombotic thrombocytopenic purpura, as well as literature related to thrombosis, hemolysis, hemolytic anemia, thrombocytopenia, thrombotic microangiopathy, von Willebrand factor in open access search engines and databases such as PubMed, Springer Link, Science Direct, Web of Science and others. Results: We found and analyzed 80 articles that met the search criteria, of which we selected 34 articles with the most relevant information, and with a publication period of less than 10 years. Conclusions: Thrombotic thrombocytopenic purpura is a rare but potentially fatal disease. Its true incidence is unknown, since the clinical presentation is varied with many pathologies that share the same characteristics. In addition, laboratory tests to confirm the diagnosis are not routinely available. A timely diagnosis can improve the prognosis and survival of patients. Currently, there are more therapeutic alternatives available, reducing mortality, which in the past was over 90%, with plasma exchange being the intervention with the greatest benefit.
Objectives: Hyperimmune - convalescent plasma transfusion appears to be a great resource in the current SARS-CoV-2 coronavirus pandemic and seems to be one of the few effective treatment modality available. However, its efficacy is variable and dependent on antibody/plasma volume concentration. Methods & Results: This single center analysis from a forefront COVID-19 Italian hospital in 43 convalescent plasma donors demonstrated that this variability in neutralizing antibody (NAB) levels is related to the harvesting period after SARS-CoV-2 recovery and interestingly, on blood group type. Specifically, the optimal plasmaferesis time point was approximately two weeks post test negativation with a significant drop in NAB plasma levels (112±102 vs 60±26.9, p=0.003) observed at 30 days. In contrast, no correlation between NAB and IgG plasma levels was observed over time (r=0.48.). Subgroup analyses demonstrated that NAB levels where higher in male (115.1±110.7, p=0.0001) and in blood group AB (200±138.6, p=0.036) donors while group A patients (81.2±82.7, p=0.062) had the lower levels of NAB concentration. Conclusion: This analysis demonstrated that male patient with a AB blood group plasma which was donated within three weeks of convalescence contains the highest therapeutic levels of antibodies and these patients should be actively recruited to become donors.
