Explore the vast range of titles available.

Background Millions of lives around the world are being saved annually through blood transfusion. However, blood transfusion is among the essential vehicles for transmitting infections. The overall prevalence of Transfusion Transmissible Infections among blood donors differs around the world, reflecting the variation in the prevalence of these infections. This study aims to assess the prevalence and trends of Transfusion Transmissible Infections among blood donors in Qatar. Methods This is a cross-sectional study utilizing donation records of 5 years from January 2013 to December 2017. We included in the study results for all screening and confirmatory tests for Hepatitis B Virus, Hepatitis C Virus, Human T-lymphotropic Virus-I/II, Syphilis and Malaria. Results Among the 190,509 donations received at the donation centre during the study period, about 91% of donations were received from males and 9% from females. The overall positivity rate for all tests was 1.87, 2.23, 1.78, 2.31, 2.67% for the years 2013 through 2017, with an increasing yearly trend by 6% each year. The overall positivity rates for Hepatitis C Virus, Human T-lymphotropic Virus-I/II, Hepatitis B Virus, Syphilis and Malaria (2013–2017) were 0.60, 0.18, 0.30, 0.43 and 0.20%, respectively. Conclusion The overall positivity rate of all tests combined for the Transfusion Transmissible Infections demonstrated a gradually increasing trend from 2013 to 2017. However, the trend for each infection (Hepatitis C Virus, Hepatitis B Virus, Syphilis and Malaria) was fluctuating except for Human T-lymphotropic Virus-I/II, which was increasing. Supporting the development of effective prevention and control strategies requires further comprehensive investigations for better estimation of the burden of these infections.

Background Upper gastrointestinal endoscopy often causes discomfort and anxiety, requiring effective sedation to ensure patient comfort and procedural safety. This study compared the efficacy and safety of Midazolam and Fentanyl versus Dexmedetomidine and Fentanyl sedation during upper endoscopy, it was conducted as a preliminary investigation to guide the design of a future definitive trial. Methods A prospective pilot study was conducted at An-Najah National University Hospital, Palestine, from October 2021 to January 2022. Sixty-eight ASA I and II outpatients aged 18–60 years were assigned to receive either Dexmedetomidine (0.3 mcg/kg) or Midazolam (0.05 mg/kg), both with Fentanyl (1 mcg/kg). Sedation depth was assessed using the Ramsay Sedation Scale (RSS) and recovery by the Post-Anesthesia Recovery Score (PARS). All procedures were performed by the same endoscopist; sedation was administered by an independent anesthesiologist. Results Dexmedetomidine led to significantly higher patient and endoscopist satisfaction, shorter recovery time (9.5 ± 1.1 vs. 22.4 ± 7.7 min, p  < 0.05), and reduced anxiety and discomfort. Adverse effects were fewer but not significantly different. Vital signs remained stable in both groups. Conclusion Dexmedetomidine and Fentanyl offers a more effective and better-tolerated sedation option than Midazolam and Fentanyl for upper endoscopy, with higher satisfaction and faster recovery.

Ectopic varices are portosystemic collaterals that occur away from the gastroesophageal junction and account for 1-5% of all variceal bleeding. Its occurrence in the jejunum is rare. Most common cause of ectopic jejunal varices is portal hypertension especially in those patients who have undergone prior abdominal surgery. Portomesenteric thrombosis is a rare cause of ectopic jejunal varices. Ectopic varices are rare cause of obscure GI bleeding and hence should be always suspected in patients with history of portal hypertension who present with GI bleeding and have negative upper and lower GI endoscopies. Management of patients with ectopic varices is often very challenging and requires multidisciplinary approach. Therapeutic options include endoscopic therapy, interventional radiologic procedures, surgically creating shunting, or surgical resection. We present the case of a 52-year-old patient who was on anticoagulation for extensive portomesenteric thrombosis secondary to factor V Leiden heterozygous mutation and presented with melena and symptomatic anemia. Investigations showed bleeding jejunal varices as the cause of anemia. We discuss the therapeutic options and dilemma in the management of such cases.