Enhancing clinical insight: Implementing validated questionnaires for comprehensive assessment of clinician expertise in transfusion medicine practices.

BACKGROUND: Blood transfusion is a cornerstone of modern healthcare, pivotal in saving countless lives annually. However, inadequate knowledge among healthcare providers can lead to serious complications. Despite the availability of assessment tools like the Biomedical Excellence for Safer Transfusion (BEST) test, there is a need for indigenous-validated questionnaires to address knowledge gaps effectively. This study aimed to evaluate bedside transfusion medicine knowledge among clinical residents using a validated questionnaire, focusing on knowledge gaps. STUDY DESIGN AND METHODS: A cross-sectional study was conducted at a tertiary care referral center in Northern India. The questionnaire, developed based on national and international transfusion guidelines, was validated by an expert panel, and administered to 245 clinical residents. The questionnaire covered six domains related to transfusion medicine: blood component storage, blood bank procedures, transfusion-transmitted infections, administration of blood components, transfusion reactions, and transfusion practices. RESULTS: The study revealed varying levels of knowledge across specialties and residency years. Overall, residents scored 61 % in transfusion medicine knowledge, with Pediatrics residents demonstrating the highest scores. The incremental increase in knowledge from first to third-year residents underscores the value of continuous, experience-based learning throughout the residency period. DISCUSSION: Study highlights significant knowledge gaps in bedside transfusion practices among clinical residents, emphasizing the need for structured educational interventions. Tailored programs, integrated into undergraduate and postgraduate curricula, are essential to improve transfusion safety and patient outcomes. Addressing these gaps can lead to better bedside transfusion practices, reducing risks and improving the quality of patient care.

Study of Prevalence of Gastritis Caused by H. pylori and Correlation of Urease Test with Serology (ELISA) Test.

Introduction: H. pylori are a pathogen of global importance. Gram-negative curved flagellate bacilli are implicated as one of the most trivial complaints of and are associated with peptic ulcer disease gastritis ulcer and gastric malignancy. This study was performed to find out the prevalence of Helicobacter pylori (H. pylori) infection in patients presenting the symptoms related with gastritis with or without chemically known peptic ulcer. Materials and Methods: The study was undertaken with the help of the Christensen and quotes urease test on endoscopic biopsy specimen and correlated with the detection of immunoglobulin IgG in the serum against H. pylori by an ELISA technique. Results: A total of 67 cases were analyzed in which 29 (43%) cases were positive for H. pylori. The endoscopic findings of acid peptic diseases show 21 (31.4%) cases of stomach ulcer, and 3 (4.5%) have esophagitis, whereas 43 (64.1%) have nonulcer dyspepsia. There is strong positive association between the urease tesr and ELISA test. Conclusion: The urease test is a quick and inexpensive test with high specificity and sensitivity, but since it is an invasive test, it has reduced patient compliance.

Therapeutic plasma exchange in autoimmune neurological disorders: A comprehensive evaluation of clinical outcomes, safety, and long-term disability using the modified Rankin scale.

INTRODUCTION: Autoimmune neurological diseases (ANDs) involve the immune system attacking the nervous system, leading to various symptoms. Therapeutic plasma exchange (TPE) is used to remove pathogenic autoantibodies, aiming to improve clinical outcomes. METHODS: This ambispective observational study included 99 patients with ANDs who underwent TPE from January 2018 to June 2022 at a tertiary care center in India. Clinical outcomes were measured using the modified Rankin Scale (mRS) scores at admission, post-TPE, at 3-months, 6-months, and 1-year follow-up post-discharge. Data were analyzed using Epi Info version 7.0. RESULTS: The median mRS score improved significantly from 5 (IQR 4-5) before TPE to 3 (IQR 2-4) post-TPE (p < 0.001). Complications occurred in 5.95% of procedures, with allergic reactions being the most common. The in-hospital mortality rate was 9%. CONCLUSION: TPE is a safe and effective treatment modality for autoimmune neurological diseases, especially in resource-constrained settings. It aids in both symptomatic relief and reducing long-term functional disability.

A Pilot Seroprevalence Study Suggests Silent Zika virus Transmission in Bhopal Region of Central India.

BACKGROUND: Several sporadic cases and outbreaks of Zika virus disease have been reported from different states of India. OBJECTIVES: This paper explored the possibility of any ongoing transmission of Zika virus (ZIKV) in the Bhopal region of Central India, where the last outbreak of this disease was reported in 2018. MATERIALS AND METHODS: We screened a group of 75 febrile patients who had already tested negative for the locally endemic causes of fever like dengue, chikungunya, enteric fever, malaria, and scrub typhus and two groups of asymptomatic healthy individuals represented by blood donors (n = 75) and antenatal mothers (n = 75). We tested blood samples of febrile patients for ZIKV RNA using real-time polymerase chain reaction (PCR), and for the healthy individuals, we determined anti-zika immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assay. RESULTS: ZIKV RNA was not detected in any of the 75 samples tested by real-time PCR assay. Among the voluntary blood donors and antenatal mothers, a total of 10 (15.38%) and 5 (6.66%) individuals were found to be seropositive for anti-ZIKV IgG antibodies, respectively. The seropositive group was found to have higher age 33.06 (±10.83) years as compared to seronegative individuals 26.60 (±5.12) years (P = 0.037). CONCLUSION: This study, which is the first survey of seroprevalence of anti-Zika antibodies from India, reports an overall seropositivity rate of 10% for anti-Zika antibodies among the healthy population, suggesting an ongoing, low level, silent transmission of ZIKV in the local community.

Retrospective comparison between non-treponemal and treponemal tests for screening of blood donors for syphilis and their correlation with donor history in a tertiary care teaching hospital.

BACKGROUND AND OBJECTIVES: Treponemal tests provide advantage of better detection during early, late and latent stages of syphilis with equal or higher sensitivity & specificity in comparison to non-treponemal tests. The objective of the present study was to analyse the level of concordance between treponemal and non-treponemal tests for donor screening and to correlate them with donor history. MATERIALS AND METHODS: Retrospective analysis of syphilis screening by treponemal (Chemiluminescence & TPHA) and non-treponemal tests (RPR) was done and donor history for high-risk behaviour and factors associated with false positivity were collected from post-donation counselling and collected data was coded and analysed. RESULTS: Amongst the 12,000 donors screened, reactivity rate by RPR, TPHA and Chemiluminescence was 0.45%, 0.8% and 1.17% respectively. There was discordance of 62% and 32% for reactive results by RPR and TPHA respectively when compared with Chemiluminescence. History of high-risk behaviour was present in ∼ 50% and 15% of donors with discordant results by RPR and TPHA respectively. Of 34 donors who were reactive only by Chemiluminescence and were followed up, 15% had history of high-risk behaviour and 56% had factors associated with false reactivity. CONCLUSION: Treponemal tests showed high syphilis reactivity amongst blood donors as compared to non-treponemal tests most likely due to their ability to detect early, late and latent syphilis cases. This may confer added transfusion safety in centres dependent on replacement donors without NAT testing by identifying donors with high-risk history with negligible increase in discard rate due to false reactivity.

Is coronavirus lockdown taking a toll on mental health of medical students? A study using WHOQOL-BREF questionnaire.

INTRODUCTION: The Quality of life is a broad-ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs, and their relationship to salient features of their environment. The ongoing COVID-19 pandemic has resulted in many quarantine and isolation measures and lockdown of the nation for the foreseeable future. Although these initiatives are necessary to prevent the spread of coronavirus they may be causing adverse mental health effects. Medical students are backbone and future of the health system and the general public always looks up to them as a role model of society. With this background, this study aims to assess the quality of life among medical students during the lockdown period amid the COVID-19 pandemic. MATERIAL AND METHODS: A self-administered, pretested, questionnaire based on World Health Organization Quality of Life: Brief Version (WHOQOL-BREF) standard quality of life was used. For internal reliability and structural validity, Cronbach's alpha coefficient and confirmatory factor analysis (CFA) were calculated, respectively. t-test, one way ANOVA, and Pearson Chi-square test were used. RESULTS: The mean scores of domains of the present study were highest for the environmental domain (72.10 ± 13.0) followed by physical (67.23 ± 13.74), social (57.13 ± 20.1), and lowest for the psychological domain (52.10 ± 17.45). The level of internal consistency was found to be 0.883, which is considered as sufficiently reliable. One-third of the medical students were spending >6 h on-screen, and merely 15.6% were doing physical activity >1 h. CONCLUSION: It was found that during this time of crisis medical students were weaker in the psychological domain of Quality of Life among all the four domains. Physical activity and screen time was an important factor to the QOL of students, and it is likely that students would benefit from increased physical activity and minimizing screen time.