The association of paraneoplastic rheumatic disorder and acute lymphoblastic leukaemia is rarely reported in the adolescent male. The clinical manifestations develop within two years before the diagnosis of associated malignancy. We report a case of an 18-year-old male, who presented with pyrexia of unknown origin, bicytopenia and autoantibodies that was consistent with the diagnosis of systemic lupus erythematosus. The peripheral blood film was eventually consistent with pancytopenia, devoid of any dysplastic changes or abnormal cells. When his cytopenia persisted despite empirical steroid therapy, a trephine biopsy revealed a diagnosis of acute lymphoblastic leukaemia. He was started on chemotherapy with UKALL regime and was well in his recent follow-up early this year where he was on maintenance therapy.

Introduction: Unsafe blood products cause transfusion-transmissible infections. A good knowledge and perception about blood safety issues is crucial to ensure safe blood supply. The objective is to develop and validate a questionnaire about the knowledge and perception among blood donors on blood safety issues. Method: A cross-sectional study was conducted among 130 blood donors who attended the National Blood Centre, Kuala Lumpur in April and May 2018. The questionnaire was developed in the Malay language after extensive literature search. The self-administrated questionnaire consisted 39 items which required around 20 minutes to complete. The validation involved content validity, construct validity using exploratory factor analysis and reliability using test-retest analysis in IBM SPSS statistics. The same group of respondents was retested after two weeks using the same questionnaire. Results: Content validity was established through multidisciplinary expert meeting and two content reviewers. The factors loadings of all questionnaires were more than 0.40. Knowledge questions were divided into three domains; perception questions were divided into four domains. The intraclass correlation (ICC) values of the test-retest were more than 0.80 for the three knowledge domains and more than 0.60 for the four perception domains. The third domain of the perception section which consisted two questions had the lowest ICC value of 0.686 (95% CI 0.583-0.767). One of the questions was restructured to improve clarity. Conclusions: The questionnaire on knowledge and perception on blood safety issues has good validity and reliability, with appropriate items which warranted its utilization among blood donors.

Background: Unsafe blood products may cause transfusion-transmissible infections. This study aimed to evaluate the knowledge and perceptions of blood donors regarding blood safety. Methods: This was a cross-sectional study conducted in the Kelantan state of Malaysia. The questionnaire comprised 39 questions that covered areas such as donors’ social demographic information, knowledge of transfusion-transmitted diseases, blood screening and donor eligibility and perceptions towards blood safety. The knowledge score was categorised as good or poor. Results: Of the 450 distributed questionnaires, 389 were suitable for analysis. Only 18.5% of the donors had good knowledge, with 81.5% having poor knowledge. Less than 30% were aware that people with multiple sexual partners, bisexual people and male homosexual people are permanently deferred from blood donation. Only 29.4% agreed that donors are responsible if their blood causes infection. Furthermore, 39.3% assumed that they could check their HIV status through blood donation, and 10.3% and 5.4% of the respondents believed that donors are free from infection if they wear a condom during sex or only have oral sex when involved in prostitution, respectively. Conclusion: Poor knowledge and notable misperceptions concerning safe blood donation were found among blood donors. The Ministry of Health should incorporate safe blood education in future public awareness programmes.

Background: Thalassemia and hemoglobinopathies are inherited red blood cell disorders found worldwide. Hemoglobin (Hb) E disorder is one of the hemoglobinopathies known to have the high prevalence in South East Asia. Most of transfusion-dependent thalassemias were genotypically compound heterozygous Hb E/ β-thalassemia. In Malaysia, the national screening program for thalassemia was implemented for early pregnancy or secondary school girls; however many participants do not turn-up and missed the screening test. Screening for thalassemia using samples from cord blood is an alternative choice as it is a readily available source of blood and hence early detection of the disease. The purpose of this study was to determine the potential use of cord blood for the screening of HbE hemoglobinopathy by using capillary electrophoresis (CE). Methods: Cord blood samples were collected from 300 newborns of healthy mothers. Hematological parameters were determined and hemoglobin quantitation for all cord blood samples were performed using capillary electrophoresis system (CES) and high performance liquid chromatography (HPLC). Results: Majority of cord blood samples (63%) revealed Hb AF followed by Hb AFA2 (20%). Hb AFE was detected in 10.7% with the mean value of Hb E ranging from 2.3%-11.1%. Conclusion: Hemoglobin E was detected in cord blood using capillary electrophoresis system. It can be recommended in areas where Hb E/β is prevalent. Implementation of a screening strategy using CE on cord blood sampling will identify the disease early. With regular follow-up on these patients, the status of their disease can be determined earlier and appropriate management implemented.