1
|
Abstract
OBJECTIVE To discover the common triggers for AIHA in children, their clinical profile, treatment response, and outcome. METHODS This was an ambispective descriptive study conducted between 2013 and 2020. Children aged 1 mo to 14 y with hemolytic anemia and a positive direct antiglobulin test (DAT) were included. Children with a positive DAT but without any clinicolaboratory evidence of hemolysis were excluded. Data were collected from a structured pro forma with particulars comprising clinicolaboratory profile, treatment administered, and disease outcome. RESULTS A total of 46 children (aged between 1 mo and 14 y) were enrolled in the study. The mean age of onset was 8.7 (± 4.34) y, and 24 (52.8%) were males. Secondary causes were observed in 29 (63%) cases, while the primary cause was found in 17 (37%). Systemic lupus erythematosus (SLE) was the common trigger in 13 (45%) cases, followed by malignancy in 4 (14%) cases. Pallor (98%), hepatomegaly (72%), and splenomegaly (48%) were the most commonly observed clinical signs. The mixed immunophenotype was observed in 27 (59%) cases, followed by warm type in 12 (26%) and cold agglutinin type in 7 (15%) cases. All children received glucocorticoid therapy, and mycophenolate mofetil was commonly used as second-line therapy in 15 (33%) cases. 13 cases (71%) of primary AIHA and only 4 (14%) cases of secondary anemia achieved complete remission. Overall, 7 children (15%) died, all belonging to secondary AIHA. CONCLUSION Secondary AIHA was more common than primary in the present study, and SLE was the standard trigger. Primary AIHA carries a better prognosis than secondary.
Collapse
Affiliation(s)
- Shrutiprajna Kar
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India
| | - C G Delhi Kumar
- Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India.
| | - Rakhee Kar
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
2
|
Noushad S, Basavarajegowda A, Toora E, Sahoo D, Hari Priya KM. Evaluation of a scoring system for vein suitability in platelet apheresis donors. J Clin Apher 2024; 39:e22106. [PMID: 38334167 DOI: 10.1002/jca.22106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/07/2023] [Accepted: 01/11/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Donor vein assessment for the selection of good quality veins is crucial for a successful apheresis procedure. This study intends to find out the effectiveness of a vein assessment scoring tool (VST) used and found to be effective in selecting whole blood donors to reduce the difficulty in identifying good quality veins for the plateletpheresis procedure. MATERIALS AND METHODS This was a prospective observational study on platelet apheresis donors with the application of a VST consisting of three vein descriptor parameters (vein visibility, vein palpability, and vein size) with 5 Likert-type responses constituting a score of 0-12 for each arm. Two vein assessors independently evaluated the vein in both arms and marked their responses blinded from each other as well from the principal investigator. The scores were then calculated and analyzed at the end of the study for their association with phlebotomy and procedural outcomes. RESULTS A total of 190 donors were recruited. The mean scores for the arms with successful and failed phlebotomy were 9.1 and 9.4 (SD 2.3), respectively. The intra-class correlation Alpha Cronbach value was 0.834 and 0.837 for total scoring in the left arm and right arm, respectively, between the two assessors. Scores neither showed a correlation with other outcomes like low flow alarms, hematoma formation, number of phlebotomy attempts, and procedure completion. CONCLUSION The study showed that the vein score tool did not truly predict the phlebotomy outcome in apheresis donors, though there was a good degree of inter-assessor reliability.
Collapse
Affiliation(s)
- Shahida Noushad
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | | | - Esha Toora
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Dibyajyoti Sahoo
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - K M Hari Priya
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
3
|
Toora E, Kulkarni RG, Manivannan P, Sastry AS, Basavarajegowda A, Sahoo D. Quality assessment of platelet concentrates prepared by platelet-rich plasma, buffy-coat, and apheresis methods in a tertiary care hospital in South India: A cross-sectional study. Asian J Transfus Sci 2023; 17:239-245. [PMID: 38274963 PMCID: PMC10807519 DOI: 10.4103/ajts.ajts_73_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/21/2022] [Accepted: 07/03/2022] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION In blood banking and transfusion medicine, it is of paramount importance to improve transfusion safety and provide a higher quality of product to maximize the therapeutic outcomes and minimize the risk of developing transfusion-associated complications for patients receiving a blood transfusion. MATERIALS AND METHODS This was a cross-sectional study conducted at the department of transfusion medicine in a tertiary care hospital of South India from February 2019 to December 2020. The primary objective of the study was to assess the quality of platelet concentrates (PC) prepared by platelet-rich plasma (PRP), buffy-coat (BC), and apheresis method. A total of 760 PCs were subjected to quality assessment, among which 124 were PRP-PC, 176 were BC-PC, and 460 were single donor platelet (SDP). RESULTS The total percentage of platelets meeting all the six quality control parameters in PRP, BC and SDP was 78.23%, 81.81%, and 89.96%, respectively. Apheresis PCs showed a significantly higher platelet concentration per µL on comparison with whole-blood-derived platelets. BC-PCs were found to be better than PRP-PC with regard to lower white blood cell (WBC) contamination (P < 0.05) and red blood cell (RBC) contamination (P < 0.01). No statistically significant difference was found with regard to platelet yield, volume, swirling, and pH. CONCLUSION Ex vivo quality of PCs prepared by BC-PC, PRP-PC, and apheresis-PC fulfilled the desired quality control parameters. BC-PC was better than PRP-PC in terms of lesser WBC and RBC contamination and comparable in terms of volume, platelet yield, swirling, and pH. Apheresis PCs showed a higher platelet concentration per microliter on comparison with whole-blood-derived platelets; hence in a blood center where facilities for collection of apheresis product are available, SDPs should be the choice of platelet transfusion.
Collapse
Affiliation(s)
- Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rajendra G. Kulkarni
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Prabhu Manivannan
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Apurba Sankar Sastry
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
4
|
Anuragaa S, Chaturvedula L, Basavarajegowda A. Blood component therapy in patients having massive obstetric hemorrhage in a tertiary care center in Puducherry. Asian J Transfus Sci 2023; 17:210-216. [PMID: 38274969 PMCID: PMC10807513 DOI: 10.4103/ajts.ajts_101_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/12/2022] [Accepted: 10/02/2022] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION A proper transfusion protocol must be followed for every patient with massive obstetric hemorrhage (MOH), as each patient may need a different pattern of transfusion support. In this background, it is prudent to understand the current prevalent practices and devise preparatory strategies for managing blood requirements during such scenarios. This study helps us know the pattern and type of blood components given to patients with MOHs. METHODOLOGY This prospective cross-sectional study was conducted on patients with a MOH admitted to a single center at a tertiary care teaching hospital in Puducherry between January 2020 and October 2021. During the hospital stay, patient parameters such as diagnosis, obstetric history, blood loss, transfusion of blood products, transfusion reaction, blood group, length of hospital stay, laboratory parameters, and patient vitals and comorbidities were recorded in a predesigned pro forma and tabulated into Excel sheet and analyzed using SPSS software version 19.0. RESULTS Fifty-four patients with MOH were included in our study. The median blood loss was 2.15 L, with a range of 2 L. The mean difference between the baseline and posthemorrhage hemoglobin is 1.7 g/dl. No correlation was observed between the number of packed red blood cell (PRBC) transfused and baseline hemoglobin or between random donor platelets (RDP) transfusion and baseline platelet count. The median number of hospital stays was 10 days, ranging from 7 to 14.5 days. Eleven (20.38%) patients had a hysterectomy done to control bleeding. The remaining 43 patients were managed successfully by other measures such as medical management, compressive surgical suturing, and arterial ligation. Forty-eight (88.9%) patients survived, and 6 (11.1%) patients expired. CONCLUSION The percentage of RDP and cryoprecipitate transfused to the patients was less than PRBC and fresh frozen plasma (FFP). The FFP-to-PRBC ratio was 2. Regular transfusion audits must be conducted to assess the flaws and improve current strategies.
Collapse
Affiliation(s)
- S. Anuragaa
- Departments of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Latha Chaturvedula
- Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Departments of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
5
|
Gnanaraj J, Nadeem N, Toora E, Basu D, Basavarajegowda A. White thrombus "fibrin" in the blood bag. Asian J Transfus Sci 2023; 17:305-306. [PMID: 38274954 PMCID: PMC10807516 DOI: 10.4103/ajts.ajts_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/20/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- John Gnanaraj
- Departments of Transfusion Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Naadia Nadeem
- Departments of Transfusion Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Esha Toora
- Departments of Transfusion Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Debdatta Basu
- Departments of Transfusion Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Departments of Transfusion Medicine and Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
6
|
Gnanaraj J, Basavarajegowda A, Kayal S, Sahoo D, Toora E, Dubashi B, Ganesan P. Optimising platelet usage during the induction therapy of acute myeloid leukaemia: Impact of physician education. Transfus Med 2023. [PMID: 36942594 DOI: 10.1111/tme.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Platelet products are scarce and expensive resources to be used judiciously. However, inappropriate usage is common. Lack of physician awareness is an important issue. We implemented a physician education program (PEP) along with repeated WhatsApp reminders at our centre. We audited the platelet usage practise before and after the intervention. METHODS Charts of patients with acute myeloid leukaemia (AML) treated between January 2020 and August 2020 was reviewed, and the mean platelet usage per patient per day was calculated. Physician education was implemented between September 2020 and December 2020 (2 PowerPoint lectures of 20 min each and weekly WhatsApp messages containing the guidelines). Data of patients treated between Jan 2021 and August 2021 was prospectively audited to understand platelet usage and the indications for transfusions. The British Committee for the Standards in Haematology (BCSH) platelet transfusion guidelines were used as the adjudication tool to evaluate compliance. The mean platelet usage per day per kg body weight of a patient before and after the PEP was compared using the t-test. RESULTS Group A (before physician education) consisted of 22 patients, and group B (after physician education) consisted of 23 patients. The mean number of platelet transfusions for each patient in a day per kg body weight was 125.7 × 108 in group A whereas, after the PEP, it had reduced to 73.9 × 108 amounting to an absolute reduction of 51 × 108 (58.8%) from the baseline with a statistical significance of P = 0.001. After implementing the PEP, the mean number of random donor platelets used reduced by 10.25 units (34% reduction), and the mean single donor platelets used reduced by 0.83 units (19% reduction). The 190 requests for platelet transfusion received during this period were classified as appropriate (157/190), which constituted 82.63% of the requests, or inappropriate (33/190), which accounted for 17.36%. CONCLUSIONS A short-duration education programme supplemented with weekly WhatsApp messages and an active feedback mechanism on the rationale of platelet transfusion by the treating physician and transfusion specialist could significantly reduce platelet consumption during the therapy of acute myeloid leukaemia patients. This is a measure that can be considered by all high-volume haematology centres, which can improve patient safety and reduce costs.
Collapse
Affiliation(s)
- John Gnanaraj
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Smita Kayal
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Dibyajyothi Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Biswajit Dubashi
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Prasanth Ganesan
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|
7
|
Gnanaraj J, Toora E, Basavarajegowda A. Herniation of blood bag during component preparation. Asian J Transfus Sci 2023; 17:139-140. [PMID: 37188015 PMCID: PMC10180783 DOI: 10.4103/ajts.ajts_37_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- John Gnanaraj
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
8
|
Sahoo D, Noushad S, Basavarajegowda A, Toora E. Feasibility of high-yield plateletpheresis in routine practice: Experience from tertiary health center from South India. Asian J Transfus Sci 2023; 17:34-40. [PMID: 37188018 PMCID: PMC10180781 DOI: 10.4103/ajts.ajts_103_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES High-yield plateletpheresis donations can reduce donor exposure and be economically beneficial as well. However, obtaining a high-yield plateletpheresis from a maximum number of donors with low basal platelet count and its effect on postdonation platelet count of donors undergoing high-yield plateletpheresis has been a matter of concern. This study aimed to assess the feasibility of making high-yield platelet donation as a routine practice. METHODS It was a retrospective observational study to determine the effect of high-yield plateletpheresis on donor reactions, efficacy, and quality parameters. It was conducted from January 1, 2019 to June 30, 2021, at the Department of Transfusion Medicine in a tertiary care hospital of South India. RESULTS Out of the 669 procedures, 564 (84.3%) of the collection had a platelet yield of ≥5 × 1011, 468 (70%) of the collection had a platelet yield of 5.5 × 1011, whereas 284 (42.5%) met the target of 6 × 1011 by coulter. The mean drops in platelet count were 95 ± 16 × 103/μl (77,600-113,000/μl), mean platelet recruitment was 1.31 ± 0.51. The mean collection efficiency of the procedure for the 669 cases was shown to be 80.21 ± 15.34, and the mean collection rate was 0.07 × 1011 ± 0.02 per minute. Only forty donors (5.5%) experienced adverse donor reactions. CONCLUSIONS High-yield plateletpheresis can be done in routine practice with no added adverse donor reaction with effective quality products.
Collapse
Affiliation(s)
- Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shahida Noushad
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
9
|
Basavarajegowda A, Plakkal N. Transfusion reactions in neonates and pediatrics: How and why are they different? Asian J Transfus Sci 2023; 17:97-102. [PMID: 37188035 PMCID: PMC10180791 DOI: 10.4103/ajts.ajts_27_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/03/2022] [Indexed: 05/17/2023] Open
Abstract
Neonates and children are physically as well as physiologically different from adults. They are immunologically vulnerable, and the effects of transfusion can be longstanding, including with respect to their development. The transfusion reactions in children differ from those in adults in the type of reactions, incidence, and severity. The incidence is more than that in adults for the common type of reactions noted in children. Transfusion reactions are most commonly associated with platelets, followed by plasma and red blood cell transfusions in children. Febrile, allergic, and hypotensive reactions or volume overload are the common types in children. Standardizing pediatric adverse transfusion reaction definitions and criteria are necessary to improve studies and reports. Several modifications are needed to be adapted for transfusing blood products in neonates and children to evade the reactions as much as possible and make transfusion safer in this vulnerable population. This article provides a brief articulation of the transfusion reactions in neonatal and pediatric populations describing how they are different from adults.
Collapse
Affiliation(s)
- Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nishad Plakkal
- Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
10
|
Thulasiram N, Sahoo D, Basavarajegowda A. Clinical significant anti-P1 antibody with wide thermal amplitude: A tale of successful blood management. Asian J Transfus Sci 2023; 17:125-127. [PMID: 37188025 PMCID: PMC10180787 DOI: 10.4103/ajts.ajts_165_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 11/04/2022] Open
Abstract
The P blood group system was introduced in 1927 by Landsteiner and Levine. About 75% of the population possesses P1 phenotype. P2 simply implies P1 negative and there is no P2 antigen. Individuals with P2 may have anti-P1 antibodies in there serum are cold-reacting antibodies which are clinically insignificant and occasionally active at 20°C or higher temperatures. However, in certain cases, anti-P1 is clinically significant and may cause acute intravascular hemolytic transfusion reactions. Our case report confirms the complexity and difficulty in the diagnosis of anti-P1. In India, very few cases are reported regarding clinical significant anti-P1. Here, we report a case of IgM type of antibody anti-P1 which was reactive at 37°C and AHG phase in a 66-year-old female planned for Whipple's surgery, who had grouping discrepancies in reverse typing and incompatibility during routine crossmatch.
Collapse
Affiliation(s)
- Nallagondla Thulasiram
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
11
|
Anuragaa S, Sahoo D, Silwal P, Basavarajegowda A, Toora E. Management of Bombay Rh negative with clinically significant anti-S for CABG surgery. Asian J Transfus Sci 2022; 16:269-272. [PMID: 36687554 PMCID: PMC9855206 DOI: 10.4103/ajts.ajts_180_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/24/2021] [Accepted: 01/26/2022] [Indexed: 01/25/2023] Open
Abstract
The Bombay Rh D negative is the rarest of the rare in blood groups. A 65-year-old male patient with coronary artery disease was admitted for CABG. During grouping, forward showed no agglutination in A, B, D, and H, and reverse showed agglutination in A, B, and O cell. The blood group was confirmed as Bombay Rh D negative. Four units of PRBC was requested for the surgery as it was cardiothoracic surgery. We checked our inventory and rare donor list for Bombay-negative blood. Acute normovolemic hemodilution was done for 2 units preoperatively with saline replacement. Autologous platelet apheresis was done for this patient. During routine cross-match, one unit was incompatible. The patient had naturally occurring anti-S, which was reactive at 37°C and clinically significant. A total of 4 PRBC (Packed Red Blood Cell), 1 Single Donor Platelet (SDP), 12 Fresh Frozen Plasma (FFP), and 9 cryoprecipitate were transfused throughout the hospital stay. The patient was Bombay Rh negative with anti-S with major surgery, which was re-explored twice; the patient was managed successfully in spite of all these difficulties with cooperation from different blood banks from all over India.
Collapse
Affiliation(s)
- S. Anuragaa
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Pragya Silwal
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Esha Toora
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
12
|
Shastry S, Chenna D, Basavarajegowda A, Das S, Chaudhary RK. Red blood cell alloimmunization among recipients of blood transfusion in India: A systematic review and meta-analysis. Vox Sang 2022; 117:1057-1069. [PMID: 35608911 DOI: 10.1111/vox.13296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 03/23/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES There is a varied prevalence of red cell alloimmunization being reported from different parts of India. This study aimed to estimate the overall prevalence of alloimmunization in India by performing a systematic review of the literature and to establish the most suitable antigen-matching strategy to reduce the red blood cell (RBC) alloimmunization rate among transfusion recipients. MATERIALS AND METHODS A systematic search of all the original articles published in English on RBC alloimmunization among transfusion recipients from India in MEDLINE, SCOPUS, CINAHL and Google Scholar bibliographic databases was conducted. After screening the articles as per inclusion/exclusion criteria, data extraction was done independently by two sets of investigators. Meta-analysis was performed by the binary random-effects model using the restricted maximum likelihood method. RESULTS A total of 44 studies on RBC alloimmunization, with a cumulative sample size of 309,986 patients, were grouped into hospital-based and multiply-transfused patients, which yielded a prevalence of 0.5 (95% confidence interval; 0.3-0.8) and 4.8 (95% confidence interval; 3.9-5.7) per 100 patients, respectively. As many as 1992 alloantibodies were identified among the 1846 alloimmunized patients. The most common antibody identified was anti-E (127; 31.99%), followed by anti-c (75; 18.89%) in multiply-transfused patients. CONCLUSION The rate of alloimmunization was 0.5 per 100 patients tested for antibodies and 4.8 per 100 patients receiving transfusion. Considering E- and c-antigen-matched red cells along with ABO and RhD matching may significantly reduce the overall occurrence of alloimmunization among Indian population who are transfusion-dependent.
Collapse
Affiliation(s)
- Shamee Shastry
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Deepika Chenna
- Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Soumya Das
- Department of Transfusion Medicine, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
| | - Rajendra K Chaudhary
- Department of Transfusion Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| |
Collapse
|
13
|
Sahoo D, Silwal P, Basavarajegowda A. Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India. Asian J Transfus Sci 2022. [DOI: 10.4103/ajts.ajts_18_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
Nalini YC, Basavarajegowda A. Syncopal reactions in blood donors: Pathophysiology, clinical course, and features. Asian J Transfus Sci 2022. [DOI: 10.4103/ajts.ajts_167_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
15
|
Basavarajegowda A, Gopal S, Kulkarni R. Prevalence of C, c, E, e, K, and k antigens in RhD-negative blood donors in and around Puducherry. Asian J Transfus Sci 2022; 16:150-151. [PMID: 36199393 PMCID: PMC9528543 DOI: 10.4103/ajts.ajts_94_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/20/2021] [Accepted: 10/10/2021] [Indexed: 11/25/2022] Open
|
16
|
Basavarajegowda A, Balasubramanyam P, Hanumanthappa N, Ram A, Negi V. Storage lesions after irradiation: Comparison between blood stored in citrate phosphate dextrose adenine and saline adenine glucose mannitol. Glob J Transfus Med 2022. [DOI: 10.4103/gjtm.gjtm_4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
17
|
Basavarajegowda A, Das S, Kayal S, Dubashi B, Pasupala N, Kulkarni R, Dhanraju K, Pani C. Plerixafor use in autologous hematopoietic stem cell mobilization: Experience from a single center in Southern India. Asian J Transfus Sci 2022; 16:7-14. [PMID: 36199417 PMCID: PMC9528564 DOI: 10.4103/ajts.ajts_106_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND: Plerixafor is used for patients at risk of Stem cell mobilization failure based on clinical factors or low peripheral blood CD34 count. It is also added upfront to any mobilization irrespective of risk factor, but the cost-effectiveness of the approach is an issue. Data on plerixafor in different settings of autologous hematopoietic stem cell (HSC) collection from India are scant. We are hereby reporting the experience of failure/success of mobilization rate and few important significant variables (CD34+ dosage, failed collection) between plerixafor and granulocyte colony-stimulating factor alone groups among autologous hematopoietic stem cell transplantation (aHSCT) at our institute. METHODS: This was a record-based single-center study on patients who underwent aHSCT from January 2013 to June 2019 at a tertiary care hospital. Descriptive statistics were used for baseline characteristics, transplant-related factors, and peritransplant outcomes. All statistical analyses were performed at the 5% significance level. RESULTS: During the study duration, a total of 96 patients had undergone autologous hematopoietic stem cell collection (aHSCC), all by peripheral blood stem cell harvest, requiring 131 apheretic collections. Of the total 131 collections in 96 patients, plerixafor was used in 63 apheresis collections (48% of total pheresis) in 40 patients. Among the 40 patients who were administered plerixafor to augment the collection, 34 patients had upfront use of plerixafor. We did not observe any significant adverse event related to plerixafor use. CONCLUSION: A rational utilization of plerixafor can facilitate the process and logistics of aHSCC outcome.
Collapse
|
18
|
Gaonkar S, Nalini YC, Anjusha IB, Basavarajegowda A. Knowledge and practice regarding menstrual hygiene and alternatives to sanitary pad among Indian undergraduate medical students: A cross-sectional study. BLDE Univ J Health Sci 2022. [DOI: 10.4103/bjhs.bjhs_2_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
19
|
Sahoo D, Noushad S, Basavarajegowda A, Toora E, Paudel P. Effect of leukapheresis on pain reduction in leukemic priapism. Asian J Transfus Sci 2022; 16:124-127. [PMID: 36199404 PMCID: PMC9528545 DOI: 10.4103/ajts.ajts_160_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/19/2021] [Accepted: 12/19/2021] [Indexed: 11/04/2022] Open
Abstract
Priapism is a rare presentation of Chronic Myeloid Leukaemia (CML). It is also considered a medical emergency as delay in treatment may lead to impotence. Prompt medical and surgical interventions such as hydroxyurea, analgesia, phenylephrine injection and aspiration, open surgical shunting, and local radiation therapy are essential. Leukapheresis effectively reduces leukocyte count rapidly and effectively, thereby an important therapy along with other standard of care in CML-induced priapism. In the present case, priapism was the presenting symptom of CML. The same was managed with various modalities such as hydroxyurea, allopurinol, antibiotics, analgesics, sedatives, phenylephrine injection, and aspiration but failed to reduce priapism pain. With a single cycle of leukapheresis, priapism pain could be reduced significantly.
Collapse
|
20
|
Basavarajegowda A, Shivhare A, Harichandrakumar KT, Silwal P, Raj P. Factors associated with vasovagal reactions in whole blood donors: A case–control study. Asian J Transfus Sci 2022; 16:41-49. [PMID: 36199411 PMCID: PMC9528565 DOI: 10.4103/ajts.ajts_90_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/29/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Vasovagal reactions to blood donation though generally mild and account for about 1% of donations, causes embarrassment/injury to the donors, lower likely return rates for future donations etc. The workforce hours devoted to attending to those who reacted can also affect the efficiency of the blood centre. There are various factors, both modifiable and nonmodifiable, involved in the causation of such reactions. OBJECTIVES: This study sought to identify the factors associated with vasovagal donor reactions in a case–control study. MATERIALS AND METHODS: This was a descriptive comparative study between donors who had VVRs (cases) and those who did not (controls) during or after blood donation from a single center in southern India. All the biophysical and demographic variables were collected from the donor records. In addition, a questionnaire was administered to the donors after donation within half an hour, addressing the psychosocial variables. All the data were captured in Microsoft Excel and analyzed using SPSS for Windows version 20. RESULTS: A total of 178 donors who had donor reactions were included in the study with an equal number of controls who were age and sex-matched. Donors who had VVRs had an odds of 4.1 (95% confidence interval [CI]: 2.4–7.7) of admitted anxiety for blood donation. They also had an odds of 4.4 (95% CI: 2.8–6.9) of disturbed sleep the night before blood donation. Having an accompanying person to the blood center was detrimental, with an odds of 0.32 (95% CI: 0.2–0.6). Donors with local complications such as hematoma, double prick, or delayed collection had an odds of 21.2 (95% CI: 1.8–159.8) of developing VVR. CONCLUSION: The psychosocial factors such as fear of the needle, the sight of the blood, state of mind, and quality and duration of sleep seem to have an association, adversely impacting the donors resulting in VVRs after/during blood donation.
Collapse
|
21
|
Sahoo D, Anuragaa S, Basavarajegowda A, Kulkarni R. Transfusion challenges and use of best match blood transfusion in autoimmune hemolytic anemia patients: Experience from a Tertiary Care Hospital of South India. Glob J Transfus Med 2022. [DOI: 10.4103/gjtm.gjtm_39_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
22
|
Basavarajegowda A, Pichai S, Dhodapkar R. Hepatitis E virus seroprevalence and awareness about feco-oral transmission in blood donors at a single center in Puducherry. Asian J Transfus Sci 2022. [DOI: 10.4103/ajts.ajts_147_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
23
|
Basavarajegowda A, Mandal S. Can we tweak the golden number of 12.5 gm% hemoglobin for blood donation? Glob J Transfus Med 2022. [DOI: 10.4103/gjtm.gjtm_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
24
|
Remakanth R, Basavarajegowda A, Dhodapkar R. Prevalence of dengue NS1 antigenemia among healthy blood donors in a tertiary care hospital in Southern India. Asian J Transfus Sci 2021; 15:140-145. [PMID: 34908744 PMCID: PMC8628248 DOI: 10.4103/ajts.ajts_51_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION: Transmission of dengue by transfusion of blood products has been documented, although the frequency of these occurrences and the level of viremia required to cause clinical dengue are unknown. The primary objective was to assess the prevalence of dengue NS1 antigen among healthy blood donors at our blood center. METHODOLOGY: This was a cross-sectional study conducted in the Department of Transfusion Medicine, a tertiary care hospital in South-eastern India, from February 2019 to January 2020. A total of 968 donor samples were included in the study. Dengue NS1 antigen detection was done using enzyme-linked immunosorbent assay. Data regarding clinical, epidemiological, and demographic characteristics were collected from the donor questionnaire and records. RESULTS: In the study, the overall prevalence of Dengue NS1 antigen was 0.9%, with nine positive samples among the 968 samples tested. Eight of them were male, and 1 was a female donor. All of them were in the age group <32 years. Half of the positive donors were detected during December-January, the immediate post rainy season in this part of the country. Two-third of the positive donors were from rural areas. CONCLUSION: This study with a 0.9% throws light on the seroepidemiological prevalence of dengue among asymptomatic donors and gives an insight into whether dengue screening is required to be implemented in routine transfusion transmissible infection screening in blood transfusion services and shall assist in devising strategies to be adapted as to improve the blood safety.
Collapse
Affiliation(s)
- Remi Remakanth
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rahul Dhodapkar
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
25
|
Balasubramanyam P, Basavarajegowda A, Hanumanthappa N, Negi VS, Harichandrakumar KT. Irradiating stored blood and storing irradiated blood: Is it different? - A study of serial changes in biochemical parameters of red blood cell units. Asian J Transfus Sci 2021; 15:172-178. [PMID: 34908750 PMCID: PMC8628233 DOI: 10.4103/ajts.ajts_71_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/04/2021] [Accepted: 07/11/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Gamma Irradiation of blood products accentuates biochemical changes in the blood stored at 4°C. This study tried to compare the changes in potassium, sodium, glucose, lactate, and lactate dehydrogenase (LDH) levels in packed red blood cell (PRBC) units irradiated at various time points and then stored versus those stored for a particular period then irradiated. METHODOLOGY One hundred and eighty units of RBCs were randomly assigned equally to be irradiated or not. Eighteen units each were irradiated by gamma irradiator using cobalt 60 (BI 2000) on day 1, 7, 14, 21, and 28 of their storage, respectively, in the irradiation group. All the units were assessed for their plasma levels of potassium, sodium, glucose, LDH, and lactate by clinical chemistry auto analyzer Beckman coulter AU680 weekly. The values were documented and analyzed by SPSS. RESULTS Baseline values on day 1 for studied biochemical parameters were comparable between irradiated and nonirradiated groups. Mean values of potassium, lactate and LDH were higher in irradiated than nonirradiated PRBC bags. In contrast, Sodium and Glucose mean values were lower than baseline values. Maximum cumulative mean values were noted in day-21 irradiated bags when the parameters were measured on day-28 for potassium and lactate levels. This was followed by day 14 irradiated bags, followed by day 7 irradiated bags. CONCLUSION The study indicates that irradiation of red cells later in their storage period had comparatively more detrimental changes in relation to potassium and lactate than irradiation in earlier days. Consideration of irradiation to be performed as close to the issue as possible to reduce a lesser number of days of storage postirradiation is to be explored.
Collapse
Affiliation(s)
- Pramanya Balasubramanyam
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nandeesha Hanumanthappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vir Singh Negi
- Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K T Harichandrakumar
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
26
|
Cherukat J, Jacob SE, Kulkarni R, Basavarajegowda A. Seroprevalence of cytomegalovirus among blood donors at a tertiary care hospital in Puducherry, India. Is testing donated blood for cytomegalovirus a viable option? Asian J Transfus Sci 2021; 15:113-114. [PMID: 34349470 PMCID: PMC8294448 DOI: 10.4103/ajts.ajts_1_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 02/17/2020] [Accepted: 04/04/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jayasree Cherukat
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sajini E Jacob
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rajendra Kulkarni
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
27
|
Basavarajegowda A, Arjunan C, Nalini YC, Parameshwaran S, Kannan S. A comparative study of knowledge, attitude, and practices about organ donation among blood donors and nonblood donors. Asian J Transfus Sci 2021; 15:37-45. [PMID: 34349455 PMCID: PMC8294447 DOI: 10.4103/ajts.ajts_9_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/21/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION: Shortage of organs by donation is a national problem which needs a multipronged approach for its strengthening. Educating the people and increasing the awareness of the need for donation would be of the foremost priority. Identifying the target population who are more likely to respond would be very important to reap the maximum results. There is speculation that blood donors would be more amenable and likely to accept the idea and thought of organ donation. This study is being designed to study the same. METHODOLOGY: This was a cross-sectional comparative questionnaire-based study among two groups: blood donors and nonblood donors. Donors were defined as aged above 18 years and have made at least one whole blood/apheresis donation. Nondonors were the ones who were aged above 18 years and have not donated whole blood/apheresis blood products in the past. All the responses were entered in the Microsoft Excel sheets, and statistical analysis was carried out using Statistical Package for Social Sciences. RESULTS: A total of 829 participated in the study. Among the 829 participants, 416 were donors, and 413 were nondonors. There was no difference in knowledge regarding organ donation among the groups except for perceived risks of organ donation among nondonors. Concerning attitudes, they were more favorable among blood donors, and it was statistically significant at a P < 0.05. CONCLUSION: There was no difference with respect to knowledge between donors and nondonors. However, donors had a more favorable attitude toward organ donation. Factors like concerns about misuse of donated organs, lack of clarity on their religion's policy toward organ donation, and potential for harm for the organ donor seem to account for the unfavorable attitude of nondonors toward organ donation.
Collapse
Affiliation(s)
- Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Charumathy Arjunan
- Department of Transfusion Medicine, SGPGI, Lucknow, Uttar Pradesh, India
| | - Y C Nalini
- Department of Physiology, Mahatma Gandhi Medical College, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India
| | - Sreejith Parameshwaran
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sujitha Kannan
- Department of Transfusion Medicine, Blood Bank, Apollo Hospitals, Vellore, Tamil Nadu, India
| |
Collapse
|
28
|
Basavarajegowda A, Bajpai M, Arora S, Maheshwari A, Dua S, Sahoo D. Survey based cross-sectional study to analyse the variation of practices at blood centres during COVID-19 pandemic in India. Transfus Apher Sci 2021; 60:103131. [PMID: 33865716 PMCID: PMC9761931 DOI: 10.1016/j.transci.2021.103131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/14/2021] [Accepted: 03/25/2021] [Indexed: 01/28/2023]
Abstract
India has almost 3,000 blood centres collecting more than 11 million units annually. Maintaining blood supply during the COVID-19 pandemic is a huge challenge. We conducted a cross-sectional study by an online survey to analyse the variation of practices across blood centers of India during this pandemic. A total of 196 blood centers completely responded to the online survey. Most of the blood centres who responded were part of Government hospitals (60 %), part of an academic institutes (55.6 %) and were directly supporting a COVID hospital (67.5 %). Almost 95.4 % blood centers reported reduction of blood donation mainly due to lockdown (50 %) and inability to conduct camps (17.3 %). Scheduling blood donations was one of the most difficult to implement strategy for maintaining adequate blood donation (40.2 %). Blood center manpower management was also a challenge and upto 48 % blood centers operated in two batches to ensure social distancing in blood banks and reduce the risk of exposure. Hemato-oncology (36.8 %) and obstetrics (33.7 %) were major utilizer of blood during the pandemic. There were marked variations in use of PPE by blood banks staff as well as strategies adopted while conducting immunohematology tests on COVID-19 positive patients samples. This pandemic has highlighted some of the major limitations of the health services but blood services have risen to the challenge and strived to maintain the blood supply chain while ensuring blood donor and staff safety. The wide variations in the practices adopted highlights the need for uniform guidelines for blood services in future pandemics.
Collapse
Affiliation(s)
- Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Meenu Bajpai
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Satyam Arora
- Department of Transfusion Medicine, Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida, Delhi NCR, India.
| | - Ashish Maheshwari
- Department of Transfusion Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Seema Dua
- Department of Transfusion Medicine, Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida, Delhi NCR, India
| | - Dibyajyoti Sahoo
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
29
|
Mathew J, Gnanaraj J, Basavarajegowda A, Venkateswaran R. Plasmapheresis in lethal yellow phosphorus poisoning: a scope for recovery. BMJ Case Rep 2021; 14:14/4/e239676. [PMID: 33883110 PMCID: PMC8061805 DOI: 10.1136/bcr-2020-239676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 16-year-old girl presented with grade 3 hepatic encephalopathy (HE) following suicide attempt after consuming a lethal dose of yellow phosphorus containing rodenticide. Although she was a candidate for liver transplantation, it could not be done. In the absence of a specific antidote for yellow phosphorus poisoning, the patient was managed conservatively. In addition, low volume-therapeutic plasma exchange (LV-TPE) was initiated, which resulted in a dramatic improvement in HE. Although liver transplantation is the definitive treatment, this case has shown that TPE has a promising role as a 'bridge to recovery' in situations where transplantation is not feasible. We describe our experience with the above-mentioned case, along with the sequence of clinical recovery and the trend in biochemical parameters during follow-up. The patient made a full recovery and is doing well.
Collapse
Affiliation(s)
- Jithin Mathew
- Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - John Gnanaraj
- Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Abhishekh Basavarajegowda
- Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | |
Collapse
|
30
|
Umakanthan S, Chattu VK, Ranade AV, Das D, Basavarajegowda A, Bukelo M. A rapid review of recent advances in diagnosis, treatment and vaccination for COVID-19. AIMS Public Health 2021; 8:137-153. [PMID: 33575413 PMCID: PMC7870385 DOI: 10.3934/publichealth.2021011] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
COVID-19 is caused by SARS-CoV-2, which originated in Wuhan, Hubei province, Central China, in December 2019 and since then has spread rapidly, resulting in a severe pandemic. The infected patient presents with varying non-specific symptoms requiring an accurate and rapid diagnostic tool to detect SARS-CoV-2. This is followed by effective patient isolation and early treatment initiation ranging from supportive therapy to specific drugs such as corticosteroids, antiviral agents, antibiotics, and the recently introduced convalescent plasma. The development of an efficient vaccine has been an on-going challenge by various nations and research companies. A literature search was conducted in early December 2020 in all the major databases such as Medline/PubMed, Web of Science, Scopus and Google Scholar search engines. The findings are discussed in three main thematic areas namely diagnostic approaches, therapeutic options, and potential vaccines in various phases of development. Therefore, an effective and economical vaccine remains the only retort to combat COVID-19 successfully to save millions of lives during this pandemic. However, there is a great scope for further research in discovering cost-effective and safer therapeutics, vaccines and strategies to ensure equitable access to COVID-19 prevention and treatment services.
Collapse
Affiliation(s)
- Srikanth Umakanthan
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies
| | - Vijay Kumar Chattu
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G2C4, Canada
- Division of Occupational Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5C 2C5, Canada
| | - Anu V Ranade
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, PO Box 27272, USA
| | - Debasmita Das
- Department of Pathology and Laboratory Medicine, Nuvance Health Danbury Hospital Campus, Connecticut, Zip 06810, USA
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, PIN-605006, India
| | - Maryann Bukelo
- Department of Anatomical Pathology, Eric Williams Medical Sciences Complex, North Central Regional Health Authority, Trinidad and Tobago, West Indies
| |
Collapse
|
31
|
Basavarajegowda A, Gopal S, Kannan S, Kulkarni R. Prevalence of ABO blood group phenotypes and antibody titers of the blood donor population in and around Puducherry. Int J Adv Med Health Res 2021. [DOI: 10.4103/ijamr.ijamr_8_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
32
|
Gnanaraj J, Arjunan C, Basavarajegowda A. Hourglass ballooning of the apheresis kit blood filter. J Clin Apher 2020; 35:376-377. [PMID: 32682338 DOI: 10.1002/jca.21808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/05/2020] [Accepted: 06/16/2020] [Indexed: 11/05/2022]
Affiliation(s)
- John Gnanaraj
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Charumathy Arjunan
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
33
|
Das S, Priyamvada PS, Basavarajegowda A, Mathur A. Deciphering a delayed hemolytic transfusion reactions nightmare - Case of Chido/Roger antibodies. Asian J Transfus Sci 2020; 13:132-135. [PMID: 31896921 PMCID: PMC6910026 DOI: 10.4103/ajts.ajts_152_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 11/19/2018] [Indexed: 11/04/2022] Open
Abstract
Antibodies against Rh (CEce) and Kidd (Jka and Jkb) system antigens are mostly implicated in delayed hemolytic transfusion reactions (DHTR), which is a potentially life-threatening complication observed in patients receiving chronic transfusions. Here, we are describing a case of Chido/Roger antibody which presented to our laboratory as DHTR. The clinical presentation and laboratory findings including the immunohematological workups with regard to the reaction are discussed, with a special emphasis on the benefit of identifying such an antibody and obtaining blood unit for transfusion supports the patient with respect to providing a compatible unit.
Collapse
Affiliation(s)
- Soumya Das
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - P S Priyamvada
- Department of Nephrology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ankit Mathur
- Department of Transfusion Medicine, Bangalore Medical Services Trust, Rotary Bangalore TTK Blood Bank, Bengaluru, Karnataka, India
| |
Collapse
|
34
|
Basavarajegowda A, Usha KC, Mayadevi S. Self-admitted motivating factors and barriers to blood donation in a single center from Southern India. Glob J Transfus Med 2020. [DOI: 10.4103/gjtm.gjtm_67_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
35
|
Singh J, Kayal S, Dubashi B, Jadhav N, Basu D, Vijayakumar S, Basavarajegowda A, Vadivel A. Engraftment syndrome, transplant-associated thrombotic microangiopathy and hemophagocytic syndrome following autologous stem cell transplant in multiple myeloma. Transfus Med 2019; 29:290-294. [PMID: 31090118 DOI: 10.1111/tme.12600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 12/09/2018] [Accepted: 04/12/2019] [Indexed: 01/06/2023]
Affiliation(s)
- J Singh
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - S Kayal
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - B Dubashi
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - N Jadhav
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - D Basu
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - S Vijayakumar
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - A Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - A Vadivel
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| |
Collapse
|
36
|
Basavarajegowda A, Pokhrel B, Chandran S, Basu D, Rehman T. Allogenic blood transfusion requirements and effects of storage age of blood units on postoperative period in cardiac surgeries: An analytical study. Glob J Transfus Med 2019. [DOI: 10.4103/gjtm.gjtm_47_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
37
|
Das S, Kumar V, Jafa E, Basavarajegowda A, Kayal S. Complete disappearance of ABO antigen-a cause of ABO discrepancy. Transfusion 2018; 58:5-6. [DOI: 10.1111/trf.14231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/30/2017] [Accepted: 05/24/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Soumya Das
- Department of Transfusion Medicine; Jawaharlal Institute of Post-graduate Medical Education and Research; Puducherry India
| | - Vikram Kumar
- Department of Transfusion Medicine; Jawaharlal Institute of Post-graduate Medical Education and Research; Puducherry India
| | - Esha Jafa
- Department of Medical Oncology; Jawaharlal Institute of Post-graduate Medical Education and Research; Puducherry India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine; Jawaharlal Institute of Post-graduate Medical Education and Research; Puducherry India
| | - Smita Kayal
- Department of Medical Oncology; Jawaharlal Institute of Post-graduate Medical Education and Research; Puducherry India
| |
Collapse
|
38
|
Basavarajegowda A, Gente V, Kulkarni R, Basu D. Recipient hemovigilance at a tertiary care hospital in Southern India: A cross-sectional study. Int J Adv Med Health Res 2018. [DOI: 10.4103/ijamr.ijamr_33_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
39
|
Elakkumanan LB, Cherukat J, Tolson JN, Sistla S, Basavarajegowda A. Out of the blue: Blue blood.! Asian J Transfus Sci 2017; 11:212. [PMID: 28970696 PMCID: PMC5613435 DOI: 10.4103/ajts.ajts_75_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Lenin Babu Elakkumanan
- Department of Anaesthesiology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Jayasree Cherukat
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Jane Nithya Tolson
- Department of Anaesthesiology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Sarath Sistla
- Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| | - Abhishekh Basavarajegowda
- Department of Transfusion Medicine, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India
| |
Collapse
|
40
|
Basavarajegowda A, Mukherjee A, Harichandrakumar KT. Olfactory function and its association with ABO blood group in adults: A cross-sectional study. Glob J Transfus Med 2017. [DOI: 10.4103/gjtm.gjtm_20_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|