RESUMO
BACKGROUND AND OBJECTIVES: With increasing life expectancy and prevalence of thalassaemia, it has led to a greater need for safe blood, yet the current supply from voluntary donors is insufficient to meet this demand. Thalassaemia recipients face a significant risk of alloimmunization because of repeated exposure to foreign red cell antigens. Study aims to determine high prevalent Rh antigen negative donors in western India donor population along with what percentage of these donors are willing to become dedicated voluntary donors for thalassaemia patients. Study also aims to examine factors influencing their willingness and challenges faced in mobilizing dedicated donors. METHOD: 700 whole blood donors from western India, following screening for inclusion & exclusion criteria as per Drugs and Cosmetic Act (DCA) 2020 amendment guidelines & were sero-negative for transfusion transmitted infections were enrolled for the study. Red cell phenotyping was performed using Conventional Tube Technique (CTT) for "D", "C", "E", "c", "e" and "K" antigen using known antisera. Donors that were "C" AND/OR "e" antigen negative were contacted telephonically and were counseled and motivated for becoming voluntary blood donors. Statistical analysis assessed correlation between donation frequency, donor's occupation and education. RESULT: Among 700 donors, 96.6% (n = 676) were males and 3.4% (n = 24) were females. The most predominant blood group was B > O > A > AB. Rh(D) antigen was present in 91.44% (n = 640) and absent in 8.6% (n = 60). Prevalence of other Rh antigens is as follows: "e" (99%) > "C" (85.4%) > "c" (59.1%) > "E" (18.0%). Only 1.15% had "K" antigen positive. The commonest Rh phenotype R1R1 (DCe/DCe) was expressed by 40.57% (n = 283), and the least common râ³r (cE/ce), râ³râ³ (cE/cE) and r'r' (Ce/Ce) was found in 0.14% (n = 1), respectively. 'C' negative, 'e' negative, 'C' and 'e' antigen negative donors constituted 14.8% (n = 104) with 93.2% (n = 97) C-antigen negative, 1.92% (n = 2) e-antigen negative and 4.8% (n = 5) both "C" and "e" antigen negative donors. The commonest phenotypes among C-antigen and e-antigen negative donors were rr (50%) and RzR2 (1.94%) respectively. Likewise, the most common phenotype amongst both C- and e-antigens negative donors was R2R2 (3.84%). 61.5% of the donors agreed to enroll for voluntary blood donation following telephonic invitation, while 6.8% of them refused permanently. Approximately, 3.9% of the blood donors were willing to donate blood only when needed and 27.8% of them could not be contacted. CONCLUSION: Creating a database of voluntary donors with known phenotype, especially who lack very common antigens like "C" and "e" and are willing to become dedicated, regular voluntary donors for thalassemic patients can ensure timely administration of safe blood. One of the major challenges for this noble initiative was lack of awareness which can be circumvent effectively with proper counseling efforts.
RESUMO
STATEMENT OF PROBLEM: The challenges of conventional methods to measure the sagittal condylar inclination and the Bennett angle include patient discomfort and an output of averaged values calculated on the arc of mandibular movement. Programming these average values into a mechanical or mathematically simulated articulator may introduce occlusal errors. PURPOSE: The purpose of this clinical study was to compare the sagittal condylar inclination and Bennett angle measurements derived from a conventional electronic tracking device and an optical tracking device. MATERIAL AND METHODS: Fifteen dentate participants with at least 12 occluding units, 25 years old and above, participated in the study. Each participant's mandibular movements were recorded by the 2 systems for different condylar guidance values. A conventional tracking device, the Cadiax Compact 2, and an optical tracking device, the MODJAW, were used for this study. Sagittal condylar inclination was measured at 3 mm and 5 mm using protrusive records and the values of the Bennett angle at 3 mm were measured using excursive records along the path traced by mandibular condyles. The Wilcoxon signed-rank test was used to analyze the paired data from the 2 methods. RESULTS: A significant difference was found between right (P=.007) and left sagittal condylar inclinations (P=.010) measured at 3 mm with the conventional and optical tracking devices. A significant difference was found between right (P=.015) and left sagittal condylar inclinations (P=.004) measured at 5 mm with the conventional and optical tracking devices. The right and left Bennett angles measured at 3 mm with the conventional and optical tracking devices were statistically different (P=.043 and P=.035 respectively). CONCLUSIONS: The sagittal condylar inclination and Bennett angle measured at different positions along the path of movement exhibited significant differences. The sagittal condylar inclination and Bennett angle values obtained from the conventional tracking device were generally significantly less than those derived from the optical tracking device.