Association of haemoglobin levels in the first trimester and at 26-30 weeks with fetal and neonatal outcomes: a secondary analysis of the Global Network for Women's and Children's Health's ASPIRIN Trial.

OBJECTIVE: Limited data are available from low- and middle-income countries (LMICs) on the relationship of haemoglobin levels to adverse outcomes at different times during pregnancy. We evaluated the association of haemoglobin levels in nulliparous women at two times in pregnancy with pregnancy outcomes. DESIGN: ASPIRIN Trial data were used to study the association between haemoglobin levels measured at 6+0 -13+6  weeks and 26+0 -30+0  weeks of gestation with fetal and neonatal outcomes. SETTING: Obstetric care facilities in Pakistan, India, Kenya, Zambia, The Democratic Republic of the Congo and Guatemala. POPULATION: A total of 11 976 pregnant women. METHODS: Generalised linear models were used to obtain adjusted relative risks and 95% CI for adverse outcomes. MAIN OUTCOME MEASURES: Preterm birth, stillbirth, neonatal death, small for gestational age (SGA) and birthweight <2500 g. RESULTS: The mean haemoglobin levels at 6+0 -13+6  weeks and at 26-30 weeks of gestation were 116 g/l (SD 17) and 107 g/l (SD 15), respectively. In general, pregnancy outcomes were better with increasing haemoglobin. At 6+0 -13+6  weeks of gestation, stillbirth, SGA and birthweight <2500 g, were significantly associated with haemoglobin of 70-89 g/l compared with haemoglobin of 110-129 g/l The relationships of adverse pregnancy outcomes with various haemoglobin levels were more marked at 26-30 weeks of gestation. CONCLUSIONS: Both lower and some higher haemoglobin concentrations are associated with adverse fetal and neonatal outcomes at 6+0 -13+6  weeks and at 26-30 weeks of gestation, although the relationship with low haemoglobin levels appears more consistent and generally stronger. TWEETABLE ABSTRACT: Both lower and some higher haemoglobin concentrations were associated with adverse fetal and neonatal outcomes at 6-13 weeks and 26-30 weeks of gestation.

T11TS immunotherapy potentiates the repressed calcineurin-NFAT signalling pathway of T cells in Cryptococcus neoformans infected rats: a cue towards T-cell activation for antifungal immunity.

AIMS: To examine the modulation of the interacting partners of the calcineurin (CaN)-NFAT pathway in T cells during Cryptococcus neoformans fungal infection and post-T11TS immunotherapy. METHODS AND RESULTS: Wistar rats were infected with C. neoformans and followed by immunotherapy with immune-potentiator T11TS. T cells were analysed by flow cytometry, immunoblotting and nuclear translocation study. The signalling proteins LCK, FYN, LAT, PLCγ1 and CaN in T cells were regulated by C. neoformans infection resulting in reduced nuclear translocation of NFAT and IL-2 expression. Following T11TS immunotherapy, the expressions of the above-mentioned proteins were boosted and thus resulting in the clearance of C. neoformans from lung and spleen. CONCLUSIONS: The precise mechanism of suppression of the T-cell function by C. neoformans is still unknown. Previously, we have shown that T11TS positively regulates the function of T cells to abrogate glioma and other immunosuppressive conditions. T11TS immunotherapy increased the expression of the above signalling partners of the CaN-NFAT pathway in T cells and improved nuclear retention of NFAT. As a result, an increased IL-2 expression leads to activation and proliferation of T cells. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results demonstrate the role of T11TS in restoring the CaN-NFAT signalling pathway in T cells. It identifies T11TS as an immunotherapeutic agent with potential clinical outcomes to counteract C. neoformans infection.

In situ reversible redox switching of first hyperpolarizability of bimetallic ruthenium complexes.

In this article we report the reversible redox switching of first hyperpolarizability of bimetallic ruthenium complexes bridged by bipyridyl tetrazine (bptz) ligands by second harmonic light scattering experiments (SHLS). We have synthesised [RuII(acac)2(CH3CN)2] and [(acac)2Ru-bptz-Ru(acac)2] complexes and measured their first hyperpolarizabilities as a function of in situ electrochemical oxidation/reduction of the metal centres. As a result of the oxidation of ruthenium centre from Ru(ii) to Ru(iii), the molecular hyperpolarizability of the complexes went up. The mixed-valence intermediate bimetallic complex and not the fully oxidized complex exhibit the highest ß value of 780 × 10-30 esu. We also demonstrated that the hyperpolarizability is reversible with the change of the oxidation state of the metal and both the complexes are stable for several cycles of redox switching. The experimental results are also supported by calculations.

Band Structure of the IV-VI Black Phosphorus Analog and Thermoelectric SnSe.

The success of black phosphorus in fast electronic and photonic devices is hindered by its rapid degradation in the presence of oxygen. Orthorhombic tin selenide is a representative of group IV-VI binary compounds that are robust and isoelectronic and share the same structure with black phosphorus. We measure the band structure of SnSe and find highly anisotropic valence bands that form several valleys having fast dispersion within the layers and negligible dispersion across. This is exactly the band structure desired for efficient thermoelectric generation where SnSe has shown great promise.

Influence of Spin-Orbit Coupling in Iron-Based Superconductors.

We report on the influence of spin-orbit coupling (SOC) in Fe-based superconductors via application of circularly polarized spin and angle-resolved photoemission spectroscopy. We combine this technique in representative members of both the Fe-pnictides (LiFeAs) and Fe-chalcogenides (FeSe) with tight-binding calculations to establish an ubiquitous modification of the electronic structure in these materials imbued by SOC. At low energy, the influence of SOC is found to be concentrated on the hole pockets, where the largest superconducting gaps are typically found. This effect varies substantively with the k_{z} dispersion, and in FeSe we find SOC to be comparable to the energy scale of orbital order. These results contest descriptions of superconductivity in these materials in terms of pure spin-singlet eigenstates, raising questions regarding the possible pairing mechanisms and role of SOC therein.

Probing protein adsorption on a nanoparticle surface using second harmonic light scattering.

A new application of second harmonic light scattering to probe protein physisorption on a gold nanoparticle surface in aqueous buffer is reported. The free energies of adsorption, the number of protein molecules adsorbed on the surface and the binding affinity of a moderate size protein, alcohol dehydrogenase (ADH), and a small protein, insulin, have been determined using the change in the second harmonic scattered light signal as a function of binding. Four different size gold nanoparticles from 15 to 60 nm were used to determine the effect of size on the free energy change, the affinity constant and the number of protein molecules adsorbed on the surface. All were shown to increase with an increase in size. The binding can be reversed by centrifugation, and the protein molecules can be desorbed quantitatively. The application of this method for studying thermodynamic parameters of weakly interacting biomolecules with nanoparticles for nanoparticle based diagnostic and therapeutic formulations is important.

Uphill Movement of Sessile Droplets by Electrostatic Actuation.

The dynamics of uphill motion and the internal circulation of a sessile droplet by inducing asymmetric electrocapillarity were formulated and investigated numerically. We developed and analyzed a coupled electro-hydrodynamic model that includes conservative body and surface forces along with electrostatic effects. The interplay between gravity and electrostatic actuation is influenced by induction voltage, the inclination of the surface, and the droplet volume. Actuation voltage on the sessile drop causes an internal circulation which, upon increasing strength, overcomes the gravitational pull to climb uphill. As uphill droplet climbing is a spatiotemporal phenomenon, droplet volume plays a major role in accommodating the internal circulations and subsequent climb. Simultaneously, actuation due to electrostatic force behaves differently on different inclined surfaces, causing a roll down at higher inclination and an uphill climb at lower ones. A pattern map has been generated to identify favorable conditions for uphill movement based on the inclination, actuation voltage, and volume of the droplet.

Mechanism of interactions between CMC binder and Si single crystal facets.

Interactions of the active material particles with the binder are crucial in tailoring the properties of composite electrodes used in lithium-ion batteries. The dependency of the protonation degree of the carboxyl group in the carboxymethyl cellulose (CMC) structure on the pH value of the preparation solution was investigated by Fourier transform infrared spectroscopy (FTIR). Three different distinctive chemical states of CMC binder were chosen (protonated, deprotonated, and half-half), and their interactions with different silicon single crystal facets were investigated. The different Si surface orientations display distinct differences of strength of interactions with the CMC binder. The CMC/Si adhesion forces in solution and Si wettability of the silicon are also strongly dependent on the protonation degree of the CMC. This work provides an insight into the nature of these interactions, which determine the electrochemical performance of silicon composite electrodes.

Microscale investigation of thin film surface ageing of bitumen.

This paper investigates the mechanism of bitumen surface ageing, which was validated utilizing the atomic force microscopy and the differential scanning calorimetry. To validate the surface ageing, three different types of bitumen with different natural wax content were conditioned in four different modes: both ultraviolet and air, only ultraviolet, only air and without any exposure, for 15 and 30 days. From the atomic force microscopy investigation after 15 and 30 days of conditioning period, it was found that regardless the bitumen type, the percentage of microstructure on the surface reduced with the degree of exposure and time. Comparing all the four different exposures, it was observed that ultraviolet radiation caused more surface ageing than the oxidation. It was also found that the combined effect was not simply a summation or multiplication of the individual effects. The differential scanning calorimetry investigation showed that the amount of crystalline fractions in bitumen remain constant even after the systematic conditioning. Interestingly, during the cooling cycle, crystallization of wax molecules started earlier for the exposed specimens than the without exposed one. The analysis of the obtained results indicated that the ageing created a thin film upon the exposed surface, which acts as a barrier and creates difficulty for the wax induced microstructures to float up at the surface. From the differential scanning calorimetry analysis, it can be concluded that the ageing product induced impurities in the bitumen matrix, which acts as a promoter in the crystallization process.

A Retrospective Study of Covid-19 Patients: A Real-Life Experience in a Secondary Care Hospital, Jashore, Bangladesh.

Covid-19 was first detected on 8th March of 2020 in Bangladesh after the global pandemic being started. As a new virus and disease there are scarcity of data of SARS-CoV-2 and Covid-19 respectively in our country. Aim of this study is to assess the demographic characteristics, clinical profiles, underlying co-morbid conditions, treatment pattern and outcome of the SARS-CoV-2 positive patients in Jashore, Bangladesh. This retrospective study recruited 208 RT-PCR positive Covid-19 patients from 1st April 2020 to 15th May 2020 who appeared at Flu corner centre, 250 Bedded General Hospital, Jashore, Bangladesh. Data was collected online through telephone, mobile and email due to the high contagious property of Covid-19. Out of total 208 Covid-19 patients, the mean age of the participants was 37.0±15.0 years with a male and female ratio of 2.06:1. Underlying comorbidities were documented in 36.5% of total Covid-19 patents of which hypertension in 16.3%, diabetes in 14.4%, respiratory diseases in 8.7% and pre-existing coronary arterial diseases in 6.3% patients. Though 17.8% Covid-19 patients were asymptomatic, the most common symptoms were fever (68.8%), cough (30.8%), myalgia (30.8%), sore throat (22.1%), vertigo (21.6%), respiratory distress (20.7%), anorexia (17.8%), nasal congestion (16.3%), nausea or vomiting (13.9%) and diarrhoea (13.0%). Whereas, the symptomatic patients were classified as flu-like illness (77.9%), mild to moderate pneumonia (2.4%) and severe pneumonia (1.9%). Many patients (19.2%) recovered spontaneously and 22.1% patients cured by the only simple symptomatic treatment. The most commonly received antibiotics were Azithromycin and Doxycycline. Home stay management was demonstrated in 73.1% patients, whereas, 26.0% patients required general ward admission and only 0.9% patients required referral for the HDU or ICU management with an average duration of hospital stay of 16±6 days. A high satisfactory outcome was found as evident by complete recovery in 98.08% of Covid-19 patients, complications (0.48%) and fatality (1.44%) even in this secondary care center. Therefore, we can conclude that the disease was well managed with highly satisfactory outcomes even in the low resource health care setting in the early stage of Covid-19 pandemic era. Hence, the early case detection, identification of the high-risk groups and proper management may mitigate to develop complications and fatalities of Covid-19.

Effect of Diethylcarbamazine (DEC) on prostaglandin levels in Wuchereria bancrofti infected microfilaraemics.

Diethylcarbamazine (DEC) interferes with arachidonic acid metabolism for the clearance of microfilariae in Wuchereria bancrofti infected individuals. In this study, we have quantified the plasma concentrations of prostaglandin E2 (PGE2) and 6-keto-PGF1α, the end products of arachidonic acid metabolic pathway in microfilaraemics (DEC treated and untreated), and normal healthy individuals at pre- and 3,9,12,36, and 72 h of post-DEC treatment. We have also determined the microfilariae counts at pre and post day 2 (36 h) and day 3 (72 h) of DEC treatment by membrane filtration technique. Significant reduction in PGE2 and 6-keto-PGF1α concentrations was found at 12 h of DEC treatment. Rapid reduction in microfilarial counts was observed at 36 h of post-DEC treatment. Higher levels of prostaglandins were found at pre-treatment hours in microfilaraemics compared to normal healthy individuals (P < 0.05). Our findings indicate that DEC inhibits prostaglandins for the clearance of microfilariae, and increased levels of prostaglandins in microfilaraemics may be contributed by the parasite or host upon stimulation.

Troponin I Elevation after Elective Percutaneous Coronary Interventions: Prevalence and Risk Factors.

Percutaneous coronary intervention (PCI) is one of the most important modalities of treatment for coronary artery disease (CAD). Minor extents of injury to the myocardium have been observed even after successful PCI. This peri-procedural injury might therefore reduce some of the beneficial effects of coronary revascularization. The objective of this hospital based comparative observational study was to determine the prevalence of post procedural Cardiac troponin I (cTnI) elevation after elective PCI and also to find out the relation with risk factors such as age, sex, body mass index (BMI), smoking, anemia, diabetes mellitus, hypertension, dyslipidemia, family history, left ventricular dysfunction, renal insufficiency, type of stent, number of stent and length of stent. This was a hospital based comparative observational study carried out in the Department of Cardiology, Chattogram Medical College Hospital (CMCH), Chattogram, Bangladesh from July 2018 to June 2019. A total of 50 patients who underwent elective PCI were included as sampled by purposive sampling method. Serum cTnI was measured by FIA8000 quantitative immunoassay analyzer with an analytical measurement before and at 24 hours of PCI. Value >1.0ng/ml was considered elevated. Univariate and multivariate analysis were applied to assess predictors for the occurrence of post-procedural elevation of cTnI. The mean±SD age of the study population was 54.96±9.1 years (range 35-74 years) and 34(68.0%) patients were male. Regarding cardiovascular risk factors, 17(34.0%) patients had diabetes mellitus, 27(54.0%) had dyslipidemia, 30(60.0%) had hypertension, 32(64.0%) were current or ex-smokers and 20(40.0%) had a family history of CAD. Eighteen patients (36.0%) had post-procedural cTnI elevation but only 8(16.0%) had significant (>1.0ng/ml) elevation. Change of cTnI before and at 24 hours of PCI was not significant (p=0.057). Cardiac Troponin I increase was related to age, pre-procedural serum creatinine and multi-vessel stenting. Minor elevation of cTnI was common following elective PCI and associated with few risk factors such as elderly patient (more than 50 years), raised serum creatinine and multi-vessel stenting. So, early detection of these risk factors, as well as effective intervention may help to prevent injury to cardiac tissue hence stop elevation of cardiac TnI following elective PCI.

Comparison of Risk Factors and Angiographic Profile between Younger and Older Patients with Acute Myocardial Infarction.

Acute myocardial infarction (AMI) in younger adults (≤40 years) is being increasingly encountered in recent years among the South Asian population. Data regarding the presentation, risk factors and angiographic findings on this important subset of patients is lacking in our country. The aim of this study was to compare the risk factors and pattern of Coronary artery involvement in younger patients presenting with AMI with that of the older age group. This was a cross-sectional observational study conducted during the period from October 2018 to June 2019. Seventy consecutive AMI patients age ≤40 years and another 70 consecutive AMI patients age >40 years undergoing Coronary Angiogram (CAG) were included in the study. After taking informed written consent; demographic, anthropometric, risk factors, CAG findings were recorded in a pre-designed case record form. The severity of Coronary Artery Disease (CAD) was calculated by using Gensini score. The mean age of the younger and older patient groups was 36.89±4.4 years and 57.00±8.4 years respectively. Among the risk factors, smoking (67.1% versus 45.7%, p=0.017), positive family history CAD (38.6% versus 22.9%, p=0.040) and obesity (34.3% versus 20.0%, p= 0.05) were more common in younger group. Whereas, Hypertension (41.4% versus 72.9%, p=0.010) and DM (28.6% versus 50.0%, p=0.024) were more common in older patients. Younger patients mainly presented with STEMI (60.0% versus 48.6%) and predominantly had single vessel disease (42.9%), whereas older patients readily presented with NSTEMI (51.4%) and had a higher incidence of double vessel disease (32.9%) and triple vessel disease (30.0%). The Median Gensini score was significantly higher among the older patients than in the younger age group. Patients in younger age group showed a different pattern of risk factors and coronary artery involvement in comparison to the older age group. Thus, offering younger individuals to make them aware of these risk factors and their early detection, as well as an effective intervention may help to prevent AMI in younger people.

The Magneto Electron Statistics in Heavily Doped N Type-Intrinsic-P Type-Intrinsic Structures.

In this paper we study the Electron Statistics in Heavily Doped N Type-Intrinsic-P Type-Intrinsic structures of non-linear optical, tetragonal and opto-electronic materials in the presence of magnetic quantization. It is found taking such heavily doped structures of Cd3As2, CdGeAs2, InAs, InSb, Hg1-xCdxTe, In1-xGaxAsyP1-y as examples that the Fermi energy (EF) oscillates with inverse quantizing magnetic field (1/B) and increases with increasing electron concentration with different numerical magnitudes which is the signature of respective band structure. The numerical value of the Fermi energy is different in different cases due to the different values of the energy band constants.

Systemic Therapy of Dermtophytosis with Voriconaole: A Clinical Observational Study of 250 Bangladeshi Patients.

Superficial fungal infection or dermatophytosis is one of the most common dermatological problems in a tropical country like Bangladesh. For last 4-5 years this skin problem is on rise with increase in cases of recalcitrant, recurrent and chronic dermatophytosis. In place of an easy task to treat dermatophytosis recently it has evolved into difficult to treat by traditional antifungal agents. Meanwhile, voriconazole, primarily appeared as an agent for deep fungal infections, has come out as a new promising systemic antifungal drug for dermatophytosis also. In Bangladesh recently an endeavor has been made to treat superficial fungal infection with voriconazole. Two hundred and ninety four patients suffering from recalcitrant, recurrent, resistant and chronic dermatophytosis between 12 and 70 years of age and both sexes were selected for the study between August 2018 and November 2018 from different parts of the country. Two categories of therapy were designed: Group A - 200mg 12 hourly for 14 days and Group B - 200mg 12 hourly for 28 days. Patients showing full response in 2 weeks were declared apparently cured and were kept under follow up. Those who did not show significant response (less than 50% improvement) in 2 weeks were considered failed. Unresponsive cases after 28 days were considered failed. Both groups were followed up for 4 weeks. Cases not showing any activity of the disease and negative microscopy on two occasions at 2 weeks interval were considered cured. Two hundred and fifty patients completed the study. Incidence of cure rate was more in Group B (93.04%) which is statistically significant (p<0.005). Relapse rate was observed more in Group A (22.83%). Visual side effects were 4.4% while vertigo and headache were observed in 12.0% and 10.8% respectably. Voriconazole is a promising treatment option for recurrent, recalcitrant and chronic dermatophytosis in dosage of 200mg twice daily for at least 4 weeks with negligible side effects. More diversified studies with longer follow up period is required for further opinion to establish an authenticated dosage schedule for treatment of superficial fungal infection.

Multimode dynamics of a liquid drop over an inclined surface with a wettability gradient.

A liquid drop placed over a solid surface with a wettability gradient self-propels to minimize its surface energy. It can also climb an inclined plane if the applied gradient strength is high enough. We investigate the motion of liquid drops over an inclined gradient surface using a unique 3D computational technique. The technique combines diffuse interface in a smoothed particle hydrodynamics simulation to study the internal fluid structure and the contact line dynamics. Simulation results reveal that drop motion is dependent on its volume, surface inclination, and the strength of the wettability gradient. It has been demonstrated that, depending on these parameters, a drop can experience upward or downward motion or can remain stationary on the inclined plane. Finally, drop mobility maps which give an idea about the regimes of uphill and downhill movement of a drop over gradient surfaces have been proposed.

Schemes for the fragmentation and merging of droplets resting on a solid substrate using a patterned wettability gradient.

A methodology has been proposed for the breakup and joining of water drops over a solid surface by varying its wettability gradient. A computational scheme using diffuse interface based smoothed particle hydrodynamics has been employed to simulate the droplet dynamics as the proof of the concept. For both the joining and breakup of drops, Y shaped patterns with the same or different wettability gradient along its different arms have been proposed. The breakup of a drop at the junction of the Y joint may be achieved if it is subjected to pulling forces along both of the branch arms. The pulling force can be brought into existence by providing an appropriate wettability gradient along the branches. By a proper selection of the branch orientation and the wettability gradient along them, it is possible to break a drop into two droplets of equal or unequal size. It has also been demonstrated that a drop can be broken into three small droplets by a specially designed four junction pattern of wettability on the solid surface. A Y junction has also been used for the merger of two drops. For this, two water drops placed at the end of the two branches are made to move toward the junction due to the gradient of contact angle. At the junction, they collide and merge into a single drop. A scheme has also been described where a combination of Y patterns can be exploited to generate a multitude of drops of different size.

Effect of a single dose of diethylcarbamazine, albendazole or both on the clearance of Wuchereria bancrofti microfilariae and antigenaemia among microfilaria carriers: a randomized trial.

BACKGROUND: Lymphatic filariasis is a major vector-borne parasitic disease. The global programme to eliminate lymphatic filariasis was launched in 1997 and currently over 570 million people are covered under it in 48 countries. Mass annual single-dose drug administration of diethylcarbamazine (DEC), co-administrated with albendazole for 5-6 years and mass distribution of diethylcarbamazine-fortified salt are the two strategies for elimination of filariasis. METHODS: Asymptomatic volunteers residing in Puducherry, India were screened for microfilaria (mf) by examining nocturnal thick blood smears. Those testing positive were randomly assigned to receive a single dose of DEC (6 mg/kg body weight) or albendazole 400 mg or both. Participants were hospitalized for 5 days. Membrane filtration count was used to assess microfilaraemia and ELISA (Og4C3) assay to measure circulating filarial antigens (CFA). Measurements were done before treatment and at 1, 2 and 3 years post-treatment. Viability of the adult worms was assessed by looking for the filarial dance sign (FDS) using ultrasound examination of the scrotum in men with hydrocele. RESULTS: Fifty-four microfilaraemic Individuals were studied. The mf prevalence started decreasing only by day 180 posttreatment in the DEC group but much earlier in the other two groups (day 30 in the albendazole and day 90 in the DEC with albendazole group). The decrease in mfwas marginal (17.6%, 26.3% and 27.8%, respectively) by the end of year 1 posttreatment, but significant (96.7%, 78.6% and 93.3%, respectively) by the end of year 2 post-treatment (p < 0.05). By the end of year 3, the level decreased to 80% in the DEC, 90% in the albendazole and to 100% in the DEC and albendazole groups. However, the mf intensity decreased significantly (by 39%; p < 0.05) by day 7 post-treatment in both the DEC and DEC with albendazole groups, but only by day 30 in the albendazole group. In all the drug groups, the prevalence as well as intensity of CFA returned to pretreatment levels by the end of year 3 post-treatment. CONCLUSION: Annual single-dose administration of all the 3 drug regimens significantly reduced antigenaemia levels. There were no significant differences in the efficacy and overall pattern of CFA clearance between the 3 drug regimens.

Pulmonary embolism: an observational study at Narayana Hrudayalaya Institute of Cardiac Sciences, Bangalore, India.

Pulmonary embolism (PE) is extremely common and is a leading cause of death in all age groups. Unfortunately the diagnosis is most often missed than it is made. Prompt diagnosis and treatment can dramatically reduce the mortality and morbidity. This study was done to evaluate the patients with acute PE, assess the utility of laboratory tests and potential of high resolution spiral computed tomogram angiography of pulmonary arteries (sCTPA) as the confirmatory diagnostic tool. Twenty six consecutive patients with acute PE admitted to CCU of Narayana Hrudayalaya of Banglore were followed prospectively. There were 15 male and 11 female (M:F=1:3:1); age range was 32-58 yrs. (mean 45+/-13 yrs). Pre-testing probability assessment of PE was done by a combined approach of history, physical examination and presence of risk factors. D-dimer and cardiac troponin I (TnI) estimation and sCPTA done by contrast enhanced 64-slice spiral CT scanner in all patients. In addition to the typical findings of PE, sCTPA included and revealed features of cardiac and venous CT imaging. Doppler study of leg veins were done to exclude deep vein thrombosis. Trans-thoracic echocardiography assessed right ventricular dilatation and presence of pulmonary hypertension. Nineteen patients (73.0%) had sub-massive PE, 5 patients (19.2%) had non-massive and 2 patients (7.6%) presented with massive PE. A raised D-dimer (0.5mugm/ml) was found in all the cases (100.0%). An elevated a trponin I (TnI) was found in 18 patients (69.2%). RV dilatation, (i.e. RV/LV>0.9) was found in 21 patients (80.7%). All patients (100.0%) received unfractionated heparin. Thrombolysis with alteplase, without concomittent heparin was administered in 11 patients (42.3%). Inferior venacaval filter were implanted in 9 patients (34.6%) with sub massive PE and recurrent events despite anticoagulation. Embolectomy done in one patients with massive PE, offered satisfactory recovery. Pulmonary endarterectomy were undertaken in 6 patients with acute on chronic thromboembolic pulmonary hypertension. Thus sCTPA detected PE, source of PE and provided prognostic information.

Incidence and risk predictors analysis of adverse donor reactions in whole blood donation.

OBJECTIVE: Adverse donor reactions in normal healthy blood donors is not unusual. However, these unpleasant effects have a negative impact on donor retention. Adverse event due to blood donation is multifactorial in origin. Therefore, the objective of this study was to determine the frequency and type of adverse donor reactions during or after blood donation. More importantly, this study also aimed at analyzing important risk predictors of adverse donor reaction. MATERIAL AND METHODS: This was a retrospective study conducted from May 2017 to April 2019 in the department of Transfusion Medicine at a tertiary care center in eastern India. Data were stored in Microsoft excel 2016 by using a standardized format as per ISBT criteria and analyzed with software "R, version 3.5.3" to find out the various independent precipitating factor. RESULTS: Overall, 107 donors (0.98%) experienced adverse events with 10,814 whole blood donations. The first time, females, younger age donors (18-30 years), and donors with a mean arterial blood pressure of less than 90mm of Hg were the most important independent risk factors predicting the possibility of adverse donor reaction. Donors' weight, hemoglobin, and the type of donation had not affected the frequency of adverse events. CONCLUSION: Analysis of adverse donor reactions helps in selecting the blood donors who are at risk of donor reactions. Our study highlights the importance of proper predonation screening especially in terms of assessment of mean blood pressure, along with identification of first time and female blood donors in order to reduce untoward donor reaction.