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INTRODUCTION: The ABO blood group shows various subtypes due to the heterogeneity of A and B alleles. The frequency of these subtypes varies in different populations. Studies related to the frequency of subtypes of blood groups A and AB are lacking in this region. So, we planned this study to estimate the prevalence of A1 and A2 subtypes among the healthy blood donor population. MATERIALS AND METHODS: This was a prospective study performed in the blood center of a teaching hospital in the Chhattisgarh state. Healthy whole-blood donors were included in the study after written informed consent. The conventional test tube method was used for performing forward and reverse blood grouping. Testing with anti-A1 and anti-H lectin was performed in blood groups A and AB. Additional tests such as saliva testing for secretor status and adsorption-elution were performed if needed. RESULTS: Four thousand one hundred twelve donor samples were studied, out of which 1170 showed A antigen. Among 1170 samples, 74.6% were blood group A, and 25.4% were AB. Among blood group A, 92.3% were A1 and 3.3% A2, and the rest were other subtypes, while in AB, it was 85.2% A1B and 14.8% A2B. Two cases of anti-A1 antibodies were also noted, which were clinically insignificant. CONCLUSION: We observed a significantly higher proportion of A2B than A2 in our study population. We also found a large proportion of Aint in the study participants. Testing with anti-A1 and anti-H lectin is recommended in blood groups A and AB to determine various subtypes and prevent any incompatibility.
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Autoimmune hemolytic anemia (AIHA) is characterized by the presence of antibodies directed against self-antigens on red blood cells (RBCs) leading to progressive RBC destruction along with reduced red cell survival. Mixed-type AIHA is characterized by the presence of both warm and cold-autoantibodies. These autoantibodies may cause blood-group discrepancy or cross-match incompatibility leading to delay in arranging suitable blood unit for transfusion. The detection of autoantibodies by monospecific-direct antiglobulin test showing positive reaction on immunoglobulin G and C3d and presence of cold-agglutinins leads to the diagnosis. We report a rare case of mixed AIHA in a 15 years female showing severe anemia, blood group discrepancy, and cross-match incompatibility. She received transfusion of least incompatible packed RBCs without any untoward effect.
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INTRODUCTION: One-third of the annual hospital budget is spent on the purchase of medicines, materials, and supplies. Drug store management is a complex but critical process within the healthcare delivery system. Health supply chains, the import of active pharmaceutical ingredients, transportation, procurement, finished products have been disrupted by COVID-19. MATERIALS & METHODS: A retrospective, observational study was carried out at the Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), Raipur. Quantitative data about the pattern of consumption of 20 most commonly used drugs (10 antibiotics, three analgesics, three antipyretics, two anticoagulants, and two steroids), and 20 most frequently used consumables were sourced from existing records of the Central Pharmacy for 24 months between 1st January 2019 to 31st December 2020. RESULTS: A significant rise in the consumption pattern was seen in 25 drugs and consumables out of 40 total selected drugs and consumables. The maximum increase was observed in antibiotics followed by antipyretics, and the least increase was observed in analgesics followed by anticoagulants. Tablet Azithromycin 500 mg was the most frequently used antibiotic during the COVID-19 Period as compared to the Pre-COVID-19 period followed by injection Piperacillin + Tazobactam. The only antibiotic having a decline in consumption and also with the lowest consumption was tablet Metronidazole 400 mg. The highest increase in consumables occurs by 10088% in N95 Masks, followed by 573% in shoe covers, and 153% in face masks (three-layers), respectively. CONCLUSION: This study will enhance education to the pharmaceutical industries, policymakers to the Government, and other hospitals on how to better manage drug stores in future pandemic-like situations. Proper drug store management played a crucial role in medication usage that improved patient outcomes and prevented the misuse of medications. The pattern of changes in the consumption of drugs and consumables in the present study can be utilized by other hospitals in the third wave of the pandemic.