Assessment of pre and post donation changes in hematological parameters and serum calcium and magnesium levels in plateletpheresis donors.

Background: Single donor platelet products are preferred over random donor platelet products due to several advantages. However, safety issues with regard to post procedure hematological decrements and serum calcium and magnesium levels in donors undergoing plateletpheresis have been explored minimally. Aims: This prospective study was done to analyze the effects of plateletpheresis on donor's hematological parameters and serum calcium and magnesium levels. Settings and Design: It is a prospective, cross-sectional study conducted in the department of immunohematology and blood transfusion. Material and Methods: This study was undertaken on 150 healthy plateletpheresis donors over a period of 1 year. Blood samples were collected from each donor before and after the procedure, one in ethylenediaminetetraacetic acid (EDTA) vial for estimation of hematological parameters and another in plain vial for serum calcium and magnesium levels. Statistical Analysis Used: Paired t-test was used to analyze the data. Results: This study included donors in the age group of 18 to 60 years who underwent plateletpheresis on Haemonetics model of a machine (MCS) + intermittent flow cell separator. A statistically significant increase was observed in mean post procedural Hb (0.95%), Hct (0.7%), and red blood cell (RBC) count (1.3%). There was a decrease in mean post procedural platelet count (27.5%), white blood cell (WBC) count (4.02%), mean serum calcium (1.5%), and serum magnesium (5.1%), which was statistically highly significant (P < 0.001). No significant change was observed in post procedural mean platelet volume (MPV) and platelet distribution width (PDW). Conclusion: Amid the need of increased demand for plateletpheresis, donor safety must be ensured. Failing to do so can be detrimental to blood supply chain, hence stringent programs for post donation screening of plateletpheresis donors need to be established.

Analysis of red cell alloimmunization in multi transfused patients at a Tertiary care teaching hospital.

BACKGROUND: Red blood cell (RBC) alloimmunization is an immune response against foreign RBC antigens; this generally occurs after sensitization due to multiple blood transfusions and pregnancies. Antibody detection plays a critical role in transfusion medicine as it can detect irregular or unexpected antibodies. This study was done to know the frequency and specificity of unexpected red cell antibodies in the multitransfused patients. MATERIALS AND METHODS: This prospective study was done in the Department of Immuno-Haematology and Blood Transfusion. Antibody screening of 100 multitransfused patients with initial negative antibody screen was carried out prior to compatibility testing and followed for a period of 12 months for each transfusion. Depending on the results, patients were given corresponding antigen-negative blood units. RESULTS: In this study, the rate of alloimmunization was 7%. Total number of samples that were positive for irregular alloantibodies were 4 of 54 cases of thalassemia, that is, 7.4%, whereas 3 of 40, that is, 7.5%, cases of solid malignancies developed alloantibodies. None of the patients of chronic kidney disease formed any alloantibody. Anti-K antibody was the most frequent antibody detected in 3 of 7, that is, 42.8% patients. Anti-E was the second most frequent antibody observed in 2 of 7, that is, 28.57%. However, anti-c and anti-M were detected in one each of 7, that is, in 14.28% each. CONCLUSION: It is concluded here that red cell alloimmunization should not be overlooked in multitransfused patients. To avoid the effects of alloimmunization, routine RBC antibody screening at set time intervals after transfusion should be performed.

Comparative Evaluation of Therapeutic Efficacy of Intralesional Injection of Triamcinolone Acetonide versus Intralesional Autologous Platelet-rich Plasma Injection in Alopecia Areata.

CONTEXT: Alopecia areata is a chronic non-scarring alopecia that involves scalp and/or body. Corticosteroids are the most popular drugs for its treatment. AIM: The aim of the study was to evaluate the therapeutic efficacy of intralesional injection of triamcinolone acetonide and platelet-rich plasma (PRP) in alopecia areata and to compare the efficacy of these modalities in alopecia areata. SETTINGS AND DESIGN: This was a randomized controlled comparative study. SUBJECTS AND METHODS: Forty patients were enrolled from the outpatient department and divided into two groups of 20 patients each. Group A and B randomly received intradermal triamcinolone acetonide suspension (10 mg/mL) and PRP, respectively, into the lesion using an insulin syringe in multiple 0.1 mL injections 1cm apart. The injections were repeated every 3 weeks till 12 weeks. The patients were evaluated by Severity of Alopecia Tool (SALT) score and photographically every 3 weeks till the end of 12 weeks and then at the end of 6 months. Statistical analysis used descriptive analysis along with Pearson chi-square test or Fisher exact test, paired samples, and independent samples t test or their nonparametric analogs for continuous variables. RESULTS: The reduction in SALT score at each visit with respect to baseline was greater in the triamcinolone group as compared to PRP group. This signifies greater effect of triamcinolone in alopecia areata. Around 50% patients in triamcinolone group and 5% patients in PRP group showed grade V improvement. Pain during intralesional injection was higher in the PRP group. CONCLUSION: Both intralesional triamcinolone and PRP were found to be efficacious in alopecia areata but the latter produced lesser improvement.

Cold agglutinin disease in sepsis: A rare entity.

Cold agglutinin disease (CAgD) is a type of autoimmune hemolytic anemia which generally occurs in adults and is characterized by the presence of IgM antibodies directed against polysaccharide antigens on red blood cell surface. A 16-year-old male, having clinical picture of sepsis and anemia, presented to the Emergency Department of our Institute in an Hemodynamically unstable condition. Investigation profile revealed hemolysis due to CAgD, which responded to corticosteroids, antibiotics and supportive treatment. This case highlights the importance of recognizing this entity in such type of cases presenting with sepsis and anemia.