Coconut Water Induces Clinical Remission in Mild to Moderate Ulcerative Colitis: Double-blind Placebo-controlled Trial.

BACKGROUND & AIMS: Coconut water (CW) is anti-inflammatory, can manipulate the gut microbiome, and is a rich source of potassium. Gut microbiome modulation improves outcomes in ulcerative colitis (UC), and potassium possesses in vitro anti-inflammatory property. We evaluated the effect of CW as an adjunct therapy for patients with mild-moderate UC. METHODS: This single-center, double-blind, placebo-controlled trial randomized patients with mild to moderate (Simple Clinical Colitis Activity Index [SCCAI]: 3-9) endoscopically active UC (Ulcerative Colitis Endoscopic Index of Severity [UCEIS] >1) in 1:1 ratio to CW + standard medical therapy (SMT) vs placebo + SMT. Four hundred mL of CW was administered for 8 weeks. Primary outcome measure was clinical remission (SCCAI ≤2), and secondary outcome measures were clinical response (SCCAI decline ≥3) and adverse events at 8 weeks. Microbiome was analyzed at baseline and 8 weeks. RESULTS: Of 121 patients screened, 95 were included for modified intention to treat analysis (CW, n = 49; placebo, n = 46) (mean age, 37.2 ± 11.2 years; males, 54.1%; disease duration, 48 months [interquartile range (IQR), 24-90 months]; pancolitis, 26.1%; SCCAI, 5 [IQR, 4-6]; UCEIS, 4 [IQR, 3-5]). Clinical response (57.1% vs 28.3%; odds ratio [OR], 3.4; 95% confidence interval [CI], 1.4-7.9; P = .01), remission (53.1% vs 28.3%; OR, 2.9; 95% CI, 1.2-6.7; P = .02), and proportion of patients with fecal calprotectin (FCP) <150 µg/g (30.6% vs 6.5%; OR, 6.3; 95% CI, 1.7-23.6; P = .003) were significantly higher in CW. The relative abundance of bacterial taxa that had a significant or trend towards negative correlation with SCCAI, UCEIS, or FCP increased at 8 weeks in CW, and this effect was independent of disease activity and dietary fiber. Adverse events were comparable, and no patient developed hyperkalemia. CONCLUSIONS: CW was more effective than placebo for induction of clinical remission in patients with mild to moderate UC. The trial was prospectively registered on Clinical Trials Registry of India (ctri.nic.in, Number: CTRI/2019/03/01827).

Functional analysis of metalloenzymes from human gut microbiota and their role in ulcerative colitis.

AIM: Metalloenzymes produced by gut microbiota play an essential role in various physiological processes, and maintains homeostasis of gastrointestinal tract. Our study includes functional analysis of microbial metalloenzymes using metagenomics and metatranscriptomics data from Inflammatory Bowel Disease Multiomics Database. METHODS AND RESULTS: The distance matrix calculated by using metalloenzymes data produced significant results for bacterial taxonomy, with higher variance compared to HMP analysis in both Western and Indian population. Differential gene expression analysis revealed altered expression of ulcerative colitis (UC)-associated enzymes, increased folds changes in Prevotella and Megamonas transcripts; whereas, low transcripts of Alistipes genera. Further, docking and simulation studies performed on screened UC-associated enzymes revealed changes in catalytic efficiency and ligand interacting residues. CONCLUSION: The ß-diversity using microbes containing metalloenzymes suggests considering small group of specific genes or enzymes for understanding the diversity between UC and healthy individuals. The docking and differential gene expression analysis collectively indicate the probable role of metalloenzymes and few UC-associated enzymes in the severity of UC.

A Dicobalt(II) Single-Molecule Magnet via a Well-Designed Dual-Capping Tetrazine Radical Ligand.

The recent years have witnessed the glory development for the construction of high-performance mononuclear single molecule magnets (SMMs) within a specific coordination geometry, which, however, is not well applied in cluster-based SMMs due to the synthetic challenges. Given that the monocobalt(II) complexes within a trigonal-prismatic (TPR) coordination geometry have been classified as excellent SMMs with huge axial anisotropy (D ≈ -100 cm-1), here we designed and synthesized a new dual-capping tetrazine ligand, 3,6-bis(6-(di(1H-pyrazol-1-yl)methyl)pyridin-2-yl)-1,2,4,5-tetrazine (bpptz), and prepared a novel dicobalt(II) complex, [Cp2CoIII][{(hfac)CoII}2(bpptz•-)][hfac]2·2Et2O (1, hfac = hexafluoroacetylacetonate). In the structure of 1, the bpptz•- radical ligand enwraps two Co(II) centers within quasi-TPR geometries, which are further bridged by the tetrazine radical in the trans mode. The magnetic study revealed that the interaction between the Co centers and the tetrazine radical is strongly antiferromagnetic with a coupling constant (J) of -65.8 cm-1 (in the -2J formalism). Remarkably, 1 exhibited the typical SMM behavior with an effective energy barrier of 69 cm-1 under a 1.5 kOe dc field, among the largest for polynuclear transition metal SMMs. In addition, DFT and ab initio calculations suggested that the presence of a strong Co(II)-radical magnetic interaction effectively quenches the QTM effect and enhances the barrier height for the magnetization reversal.

Clinical outcome of living donor kidney transplantation across simultaneous ABO and HLA incompatibility: Single center experience of first ten cases.

BACKGROUND AND AIMS: Preconditioning using different protocols has been tested to prevent antibody mediated rejection (ABMR) individually for ABO and HLA incompatibility. However, simultaneous presence of both barriers is still less explored. The aim of this study was to report outcomes of institutional desensitization protocol in renal transplant recipients with simultaneous ABO and HLA incompatibility. MATERIALS AND METHODS: This was a retrospective study conducted from October 2015 to December 2018. All patients with a clinical diagnosis of dialysis dependent chronic kidney disease (CKD), who were prospective coexistent HLA and ABO incompatible renal transplant recipients were included in the study. Patients were followed up and graft function and patient survival was assessed at 1 y from the date of transplant. RESULTS: Median and mode baseline anti-A titers were 64, while median and mode baseline anti-B titers were 256. All recipients were discharged by tenth postoperative day. None of the patients had any bleeding complications. Post transplant infection rate was found to be 20 %. A total of 54 therapeutic plasma exchange (TPE) procedures were performed before transplant and 8 were performed after transplant. Graft survival and patient survival was 100 % at 3, 6, 9, and 12 months. Range and mean follow-up period was 15-42 months and 23 months respectively. Mean glomerular filtration rate (GFR) at 1 y using the CKD-EPI equation was 85.25 ± 13.76 mL/min. Biopsy proven ABMR was observed in one case only which was managed with TPE and immunosuppression. CONCLUSION: Simultaneous ABO and HLA incompatibility in renal transplant recipients can be managed successfully with adequate preconditioning and careful monitoring.

Prospective audit of blood transfusion request forms and continuing medical education to optimise compliance of clinicians in a hospital setting.

OBJECTIVES: The aim of this study was to analyse blood requisition forms sent by clinicians in a tertiary care hospital to the transfusion service to ascertain their completeness and correctness. A secondary objective was to study the effect of continuing medical education (CME) in a hospital setting on clinician's behaviour regarding the importance of details that ought to be mentioned on blood requisition forms. BACKGROUND: Transfusion audits are useful tools in the evaluation and education of those requesting blood components. METHODS/MATERIALS: This was a prospective, observational study conducted in the department of Transfusion Medicine at a tertiary-level healthcare centre from June 2019 to December 2019. The study was divided into two phases: pre-CME (P1) and post-CME (P2). In both phases, an audit for assessing completeness and correctness of blood requisition forms, which were divided into four sections, was performed. A scoring system was devised to compare both phases. RESULTS: In the P1 phase, 45.77% of the blood requisition form entries were complete and correct; 23.45% of incomplete entries were generated by emergency and trauma. In the P2 phase, 76.75% of the blood requisition form entries were complete and correct; 35.09% of the incomplete entries were generated by obstetrics and gynaecology. Complete and correct entries increased from 45.7% (P1) to 76.75% (P2). Scores of P1 were found to be lower than scores of P2 for all four sections. Cumulative mean score for P1 (20687) was found to be significantly lower than the mean score for P2 (30870). CONCLUSION: Audit and CME regarding different aspects of transfusion medicine practices play a major role in the improvement of transfusion practices in hospitals.

Outcome of desensitization in human leukocyte antigen and ABO incompatible living donor kidney transplantation: Single center experience of first 200 incompatible transplants.

BACKGROUND AND AIMS: Although desensitization is well established, concerns about graft outcome, patient survival and rejection still exist. The present study aims at comparing outcomes of renal transplant recipients across simultaneous ABO and human leukocyte antigen (HLA) incompatibility barriers to those with ABO or HLA incompatibility alone. MATERIALS AND METHODS: This was a retrospective study conducted from October 2015 to December 2018. All patients with a clinical diagnosis of chronic kidney disease, who were prospective HLA incompatible (HLAi) and/or ABO incompatible (ABOi) renal transplant recipients were included. A total of 400 cases including 36 ABOi transplants, 154 HLAi transplants, 10 simultaneously ABO and HLA incompatible transplants, and 200 ABO (ABOc) and HLA (HLAc) compatible kidney transplants from living donors were included. RESULTS: There were significantly more number of blood transfusions, previous transplants and pregnancies in HLAi transplant recipients relative to the ABOi or the control group. Mean number of therapeutic plasma exchange procedures per patient and mean plasma volume processed per procedure were slightly higher in the ABOi + HLAi category. The incidence of graft dysfunction due to suspected antibody-mediated rejection during first year was highest in the ABOi + HLAi group, followed by ABOc + HLAi and ABOi + HLAc, lowest in the ABOc + HLAc category. Mean time to first episode of graft dysfunction was significantly shorter with incompatible transplants. There were no kidney transplant recipient deaths in the study. CONCLUSION: Patient outcome and graft outcomes observed with incompatible transplants were not worse than those observed with compatible transplants.

A Design Criteria to Achieve Giant Ising-Type Anisotropy in CoII -Encapsulated Metallofullerenes.

Discovery of permanent magnetisation in molecules just like in hard magnets decades ago led to the proposal of utilising these molecules for information storage devices and also as Q-bits in quantum computing. A significant breakthrough with a blocking temperature as high as 80 K has been recently reported for lanthanocene complexes. While enhancing the blocking temperature further remains one of the primary challenges, obtaining molecules that are suitable for the fabrication of the devices sets the bar very high in this area. Encouraged by the fact that our earlier predictions of potential single-molecule magnets (SMMs) in lanthanide-containing endohedral fullerenes have been verified, here we set out to undertake a comprehensive study on CoII -ion-encapsulated fullerene as potential SMMs. To study this class of molecules, we have utilised an array of theoretical methods ranging from density functional to ab initio CASSCF/NEVPT2 methods for obtaining reliable estimate of zero-field splitting parameters D and E. Additionally, we have also employed, for the first time a combination of molecular dynamics based on DFT methods coupled with CASSCF/NEVPT2 methods to seek the role of conformational isomers in the relaxation of magnetisation. Particularly, we have studied, Co@C28 , Co@C38 and Co@C48 cages and their isomers as potential target molecules that could yield substantial magnetic anisotropy. Our calculations categorically reveal a very large Ising anisotropy in this class of molecules, with Co@C48 cages predicted to yield D values as high as -127 cm-1 . Our calculations on the smaller cages reveal the free movement of CoII ion inside the cage, leading to the likely scenario of faster relaxation of magnetisation. However, larger fullerene cages were found to solve this issue. Further models with incorporating units such as {CoOZn}, {CoScZnN} inside larger fullerenes yield axial zero-field splitting values as high as -200 cm-1 with negligible E/D values. As these units represent a strong axiality coupled with a viable way to obtain air-stable low-coordinate CoII complexes, this opens up a new paradigm in the search of SMMs in this class of molecules.

Trigonal Prismatic Cobalt(II) Single-Ion Magnets: Manipulating the Magnetic Relaxation Through Symmetry Control.

Two mononuclear trigonal prismatic Co(II) complexes [Co(tppm*)][BPh4]2 (1) and [Co(hpy)][BPh4]2·3CH2Cl2 (2) (tppm* = 6,6',6″-(methoxymethanetriyl)tris(2-(1H-pyrazol-1-yl)pyridine; hpy = tris(2,2'-bipyrid-6-yl)methanol) were synthesized by incorporating the Co(II) ions in two pocketing tripodal hexadentate ligands. Magnetic studies indicate similar uniaxial magnetic anisotropy while having distinct dynamic magnetic properties for two complexes, of which 1 exhibits clear hysteresis loops and Orbach process governed magnetic relaxation with an effective energy barrier (Ueff) of 192 cm-1, among the best examples in transition metallic SIMs, about 10 times larger than that of 2 (Ueff = 20 cm-1, extracted by fitting the data to an Orbach relaxation process but there is no real state at this energy). Such pronounced difference is ascribed to the dominant Raman process and quantum tunneling of magnetization (QTM) in 2 owing to the structural distortion and symmetry breaking, indicated by a nearly perfect trigonal prismatic geometry (D3 local symmetry) for 1 and a more distorted configuration for 2 (C3 local symmetry). Ab initio calculations predict strong axial anisotropy for 1 with minimal QTM probability, with the transverse component of anisotropy being estimated to be much higher for 2 than 1, leading to a 10-fold lower Ueff value than 1.

Probing the Axial Distortion Effect on the Magnetic Anisotropy of Octahedral Co(II) Complexes.

Three mononuclear octahedral Co(II) complexes are reported, [Co(py)4(SCN)2] (1), [Co(py)4(Cl)2]·H2O (2), and [Co(py)4(Br)2] (3), that exhibit different distortions with compression (1) or elongation (2 and 3) of the axial positions. Easy plane magnetic anisotropy was confirmed by magnetic, HF-EPR, and computational studies for all complexes. Further analyses indicate that both the sign and magnitude of zero-field splitting parameters experience a significant change (D ≥ ±150 cm-1) by tuning of the axial and equatorial ligand field strength. Slow magnetic relaxation is observed for all compounds which is dominated by the Raman process involving both acoustic and optical phonons.

Theoretical Studies on Hexanuclear [M3(µ3-O/OH)]2 (M = Fe(III), Mn(III), and Ni(II)) Clusters: Magnetic Exchange, Magnetic Anisotropy, and Magneto-Structural Correlations.

Controlling spin Hamiltonian parameters such as magnetic exchange and magnetic anisotropy of polynuclear clusters is of great interest in the area of single molecule magnets (SMMs). Among large polynuclear clusters, hexanuclear clusters offer the best compromise in terms of size as they are often rigid, solution stable, and chemically amenable. The {M6O2} core is one of the common architectures known for many hexanuclear clusters and generally reported to possess a diamagnetic ST = 0 spin ground state, barring a few exceptions. In these clusters, there are several open questions that are poorly understood: (a) What controls the nature of magnetic exchange, which in turn dictates the ground state spin values? (b) For clusters possessing a nonzero spin ground state, what dictates the magnetic anisotropy? Here, using density functional methods, we have attempted to shed light on these two question by evaluating the exchange coupling constants in [Fe6IIIO2(OH)2{(C4N2H2SMe)2C(OH)O}2( tBuCO2)10] (1), [Fe6III(O)2(O2CH2)(O2CCH2 tBu)12(py)2] (2), [Fe6III(O2)(O)2(O2CCMe3)12(py)2] (3), [FeIII6O3(O2CMe)9(OEt)2(bpy)2]ClO4 (4), [MnIII6O2(O2CH2)(O2CPe t)11(HO2CPe t)2(O2CMe)] (5), and [NiII6(OH)4(O2C tBu)8( tBuCO2H)4] (6) complexes. We have estimated all the eight near-neighbor exchange coupling constants in these clusters. Our calculations not only agree with the experimental results but also offer insight on the origin of the spin ground state. Extensive magneto-structural correlations developed by varying M-O-M angles and M-O distances reveal that J values are extremely sensitive to small structural distortions. Correlations developed indicate that both the parameters are important for Fe(III), but for Mn(III) and Ni(II), the angles were found to play a dominant role. Quite interestingly, the computed zero-field splitting parameter D S=5 of complex 1 reveals that the exchange contribution to the anisotropy controls the sign of the ground state D value-an observation which differs from the general perception that the ground state D is controlled by the single-ion zero-field splitting parameter.

Role of (1,3) {Cu-Cu} Interaction on the Magneto-Caloric Effect of Trinuclear {CuII-GdIII-CuII} Complexes: Combined DFT and Experimental Studies.

Molecular refrigeration is found to be of great interest in the field of coordination chemistry, and GdIII ion based complexes are particularly attractive, as they exhibit a large magneto-caloric effect (MCE). As the magnetic coupling in GdIII clusters is difficult to control, other avenues to enhance the MCE values have been explored and incorporation of 3d metal ions in the cluster aggregation with GdIII yielding {3d-Gd} clusters are targeted. Among the transition-metal ions, the CuII ion is particularly attractive, as it does not possess any anisotropy, and in this regard, several di- and polynuclear {Cu-Gd} clusters are reported to yield attractive MCE values. While the role of near-neighbor {Cu-Gd} interactions in the MCE has been explored in detail, how the next-nearest-neighbor interaction influences the MCE has not been explored. To explore the importance of next-nearest-neighbor (1,3) {Cu-Cu} interaction, we have undertaken detailed density functional studies on five trinuclear {CuII-GdIII-CuII} complexes that are reported in the literature. In addition, we also report the synthesis and magnetic and EPR studies of a novel complex [(CuSALen)2Gd(NO3)3] (6; where SALen is N,N'-ethylenebis(salicylaldiminato)). Both magnetic and EPR studies reveal an S = 9/2 ground state for 6 with a very small zero-field splitting parameter (+0.01 cm-1), which aid in the achievement of a large MCE value for this molecule. Magnetization data collected for 6 yield a magnetic entropy change (-ΔSm) of 17 J kg-1 K-1 at 3.5 K by employing a 7 T magnetic field. Our calculations on all six complexes reveal that {Cu-Gd} exchange is ferromagnetic in nature, while the next-nearest-neighbor {Cu-Cu} exchange is found to vary from a weak ferromagnetic to a moderate antiferromagnetic interaction. In all of the cases studied, simulated susceptibility data are in excellent agreement with the experimental data, offering confidence in the computed J values. In addition, we have developed a mechanism of magnetic coupling for {CuII-GdIII-CuII} trinuclear complexes, where the role of formally empty 5d, 6s, and 6p orbitals of GdIII ion is established. In particular, our studies reveal that the next-nearest-neighbor {Cu-Cu} interaction is strongly correlated to Cu-Gd-Cu angle, with both smaller and larger angles yielding stronger antiferromagnetic exchange. The antiferromagnetic {Cu-Cu} interaction diminishes the gap between the ground S = 9/2 state and first excited S = 7/2 state, leading to enhancement of MCE values. In contrast to the general belief that weak interactions are desired for large MCE, our study advocates targeting a stronger antiferromagnetic {Cu-Cu} interaction to obtain larger MCE values in this class of clusters.

Can CH⋠⋠⋠π interactions be used to design single-chain magnets?

This theoretical study suggests that CH⋅⋅⋅π stacking interactions between monomeric units can be used to design novel single-chain magnets (SCMs), as the sign of coupling is predictable and such chains inherently yield negative axial anisotropy, a condition often difficult to achieve in conventional SCMs.

To Determine the Quality of Life in Indian Women After Peripartum Hysterectomy Using a Hindi Version of the SF-36 Questionnaire.

Objective: The objective of the study was to determine the quality of life in women after peripartum hysterectomy using a Hindi version of the SF-36 questionnaire. Background: There are long-term effects on quality of life in women after peripartum hysterectomy. The effects on physical, mental, and social functioning have a prolonged recovery. No studies have been done in Indian women after peripartum hysterectomy to evaluate quality of life. Methods: Patients who underwent peripartum hysterectomy from January 2017 to May 2021 were contacted to participate in the study. To determine the quality of life post-surgery, a Hindi version of the 36-item Short-Form Health Survey (SF-36) was used for a face-to-face personal interview-based assessment. The participants were divided into two groups based on the duration between surgery and the interview. The aggregate scores for the eight components of SF-36 were calculated, and responses were analyzed. Results: Out of the 138 post-hysterectomy women, 118 were enrolled in the study. Women who could not be contacted [14 (10.14%)] and those who died post-procedure [6 (4.35%)] were excluded. Out of the total, 43 assessed participants were within 2 years of surgery, and 75 were after 2 years of surgery. The group that was assessed after 2 years of surgery had a significantly lower quality of life in six, out of the eight aspects of SF-36 domains. Conclusion: Women after peripartum hysterectomy undergo a prolonged recovery phase with effects on physical, mental, and social functioning. A multi-disciplinary long-term follow-up including physiotherapy and psychotherapy is required and that should be guided by a dedicated clinical team.

Syntheses, structures, magnetic properties, and density functional theory magneto-structural correlations of bis(µ-phenoxo) and bis(µ-phenoxo)-µ-acetate/bis(µ-phenoxo)-bis(µ-acetate) dinuclear Fe(III)Ni(II) compounds.

The bis(µ-phenoxo) Fe(III)Ni(II) compound [Fe(III)(N3)2LNi(II)(H2O)(CH3CN)](ClO4) (1) and the bis(µ-phenoxo)-µ-acetate/bis(µ-phenoxo)-bis(µ-acetate) Fe(III)Ni(II) compound {[Fe(III)(OAc)LNi(II)(H2O)(µ-OAc)](0.6)·[Fe(III)LNi(II)(µ-OAc)2](0.4)}(ClO4)·1.1H2O (2) have been synthesized from the Robson type tetraiminodiphenol macrocyclic ligand H2L, which is the [2 + 2] condensation product of 4-methyl-2,6-diformylphenol and 2,2'-dimethyl-1,3-diaminopropane. Single-crystal X-ray structures of both compounds have been determined. The cationic part of the dinuclear compound 2 is a cocrystal of the two species [Fe(III)(OAc)LNi(II)(H2O)(µ-OAc)](+) (2A) and [Fe(III)LNi(II)(µ-OAc)2](+) (2B) with weights of 60% of the former and 40% of the latter. While 2A is a triply bridged bis(µ-phenoxo)-µ-acetate system, 2B is a quadruply bridged bis(µ-phenoxo)-bis(µ-acetate) system. Variable-temperature (2-300 K) magnetic studies reveal antiferromagnetic interaction in 1 and ferromagnetic interaction in 2 with J values of -3.14 and 7.36 cm(-1), respectively (H = -2JS1·S2). Broken-symmetry density functional calculations of exchange interaction have been performed on complexes 1 and 2 and also on previously published related compounds, providing good numerical estimates of J values in comparison to experiments. The electronic origin of the difference in magnetic behavior of 1 and 2 has been well understood from MO analyses and computed overlap integrals of BS empty orbitals. The role of acetate and thus its complementarity/countercomplementarity effect on the magnetic properties of diphenoxo-bridged Fe(III)Ni(II) compounds have been determined on computing J values of model compounds by replacing bridging acetate and nonbridging acetate ligand(s) by water ligands in the model compounds derived from 2A,B. The DFT calculations have also been extended to develop several magneto-structural correlations in these types of complexes, and the correlations focus on the role of Fe-O-Ni bridge angle, average Fe/Ni-O bridge distance, Fe-O-Ni-O dihedral angle, and out-of-plane shift of the phenoxo group.

Development of controlled release formulations of thiram employing amphiphilic polymers and their bioefficacy evaluation in seed quality enhancement studies.

Controlled release formulations of Thiram (Dimethylcarbamothioylsulfanyl-N,N-dimethylcarbamodithioate), a contact fungicide, have been prepared using laboratory synthesized poly(ethylene glycol) (PEG) based functionalized amphiphilic copolymers. The kinetics of thiram from developed controlled release (CR) formulations were studied in comparison with that of the commercially available 75 WS. Release from the commercial formulation was faster than with the developed CR formulations. Maximum amount of thiram was released on 35th day for PEG-2000 4d, 28th day for PEG-1500 4c, 21st day for PEG-1000 4b and 15th day for PEG-600 4a in comparison to commercial formulation (7th day). The diffusion exponent (n) of thiram in water ranged from 0.356 to 0.545 in the tested formulations. The half-release (t(1/2)) values ranged between 14.78 to 22.1 days, and the Period of Optimum Availability (POA) of thiram ranged from 7.79 to 25.15 days. An effort has also been made to identify the suitable polymers that could reduce the seed deterioration during storage and also act as an effective carrier of fungicide thiram. The results demonstrate that the seeds coated with the different formulations deteriorated at a slower pace as manifested in high germination percentage over control. Apart from the fungicidal effect of thiram, the polymers acted as barriers to moisture reducing the rate of seed deterioration and checked the degradation of thiram. The CR formulation 4d, with PEG 2000, was found to be most effective as seed coat.

An assessment of clinical and laboratory impact in a resource constraint setting: Does Rh and Kell phenotyping of donor units complement type and screen method of compatibility testing?

BACKGROUND AND AIM: Despite knowing benefits of extended phenotyping, a vast majority feel that phenotype matched units add to the cost of blood banking. The purpose of this study was to discuss advantages and disadvantages of performing Rh Kell phenotyping in Indian scenario. MATERIALS AND METHODS: This was a prospective, observational study conducted at a tertiary healthcare center between July 2014 and February 2020. All consecutive whole blood donors and all consecutive patients whose samples were sent for Rh-Kell phenotyping were included for calculating antigen, phenotype and gene frequencies. For rate of alloimmunization in patients transfused with phenotype matched units, all patients who were given Rh-Kell phenotype matched transfusions were included in the prophylactic antigen matched (PAM) category and those who were given random units were included in the non-PAM category. RESULTS: A total of 37,588 donors and 258 patients were included in the study for calculation of antigen, phenotype and gene frequencies. Percentage similarity of phenotypes between patient and donor populations was 33.8%. For rate of alloimmunization, results of a total of 31,991 patient samples revealed 0.94% prevalence of unexpected antibodies; highest against the Rh system. Three patients in the non-PAM category and one in the PAM category were alloimmunized during follow-up. Significant clinical and laboratory impact of phenotyping was observed in terms of reduced turnaround time and consumption of resources. CONCLUSION: Rh-Kell phenotyping of donors can prevent alloimmunization, reduce cost burden on the patient and the laboratory and help the laboratory personnel in smooth routine testing.

A rare case of clinically significant naturally occurring anti-Cw reported in a healthy male donor.

Anti-Cw antibody is an immunoglobulin against the red cell antigen Cw which is a low frequency red cell antigen that belongs to the Rh antigen system. It is a clinically significant antibody and may cause haemolysis on exposure to antigen positive red cells. Due to its low frequency, it is not included in routine antibody screening panels. A 32 years healthy male donor with no history of transfusion donated whole blood at the department of Transfusion Medicine & Blood Centre of our institute. As a part of routine pre-transfusion testing, the donor's samples were subjected to automated blood grouping and screening for unexpected red cell antibodies using 3 cells panel on solid-phase red-cell adherence (SPRCA) (Galileo Neo, Immucor, Norcross, USA). The antibody screening came out to be positive with a reaction in cell I of the antibody screening panel. Further the antibody was identified as anti Cw in using 16 cells panel, select cells and phenotyping. In the present case, the anti-Cw antibody was found to be reactive at 37 °C and AHG phase which could lead to haemolytic transfusion reaction. The fact that the male donor had no history of transfusion or transplant led us to the conclusion that it was a naturally occurring, but a clinically significant antibody. This case highlights the importance of performing an antibody screening for healthy donors as well and urges transfusion services to procure screening cells which incorporate Cw positive cells.

A prospective observational study to evaluate effect of heat inactivation on ABO titers performed by column agglutination technology and conventional tube technique.

BACKGROUND AND AIMS: When determining ABO antibody titers, immunoglobulin G (IgG) antibodies can be masked by immunoglobulin M (IgM) antibodies. Hence, the measurement of actual concentration of IgG requires methods like heat inactivation (HI) of plasma. This study was aimed at determining the effects of HI on IgM and IgG titers performed by conventional tube technique (CTT) and column agglutination technique (CAT). MATERIALS AND METHODS: This was a prospective, observational study conducted from October 2019 to March 2020. All consecutive A, B, and O group donors who gave consent for participation were included. All samples were consecutively tested by CTT and CAT, before and after HI (pCTT, pCAT). RESULTS: A total of 300 donors were included. IgG titers were found to be more than IgM titers. For group O, IgG titer results were higher for both anti-A and anti-B compared to group A and B. For group A, B, and O, pretreatment results were higher than posttreatment IgG titer results. Median anti-A titers were similar to median anti-B titers across all categories. Median IgM and IgG titers were higher for group O individuals than nongroup O individuals. There was reduction in IgG and IgM titers after HI of plasma. One log reduction in median titers was observed when ABO titers were performed by CAT and CTT. CONCLUSION: There is one log difference between median antibody titers estimated using heat inactivated and nonheat inactivated plasma. The use of HI for ABO isoagglutinin titer estimation can be considered in low resource settings.

Pomegranate Resembling Design of Starch Sago Beads Encapsulates Nanopyriproxyfen, Enabling Slow Release and Improved Bioactivity.

Environmental contamination by intense insecticide usage is consistently proposed as a significant contributor to major hazards; further, disturbing non-target populations provoke a grave concern worldwide as they play essential roles in ecosystems. Pyriproxyfen is one of the most widely used pesticides; however, due to its probable toxicity, its global application in large amounts may result in water concentrations that exceed regulatory pollution thresholds. Herein, we describe nanopyriproxyfen-loaded sago beads (PPX-NCB) designed for the slow release of pyriproxyfen (PPX). Our design is inspired by the composite structure of sago beads, composed of several small beads resembling a pomegranate. The microscopic beads accumulate chitosan-PPX-nanomicelles cross-linked with tripolyphosphate via physical absorption, offering adequate room for water absorption and subsequent PPX release. PPX-NCB had distinct effects on the immature egg and larva of Anopheles stephensi, limiting embryonic development in the eggs while enhancing bioactivity. It affects the integument of larvae and alters the surface hydrocarbons of eggs and larvae. In addition, PPX-NCB demonstrates an improved safety profile in non-target Daphnia magna.

Fecal microbiota transplantation refurbishes the crypt-associated microbiota in ulcerative colitis.

A crypt autochthonous microbial population called crypt-associated microbiota (CAM) is localized intimately with gut regenerative and immune machinery. The present report utilizes laser capture microdissection coupled with 16S amplicon sequencing to characterize the CAM in patients with ulcerative colitis (UC) before and after fecal microbiota transplantation with anti-inflammatory diet (FMT-AID). Compositional differences in CAM and its interactions with mucosa-associated microbiota (MAM) were compared between the non-IBD controls and in patients with UC pre- and post-FMT (n = 26). Distinct from the MAM, CAM is dominated by aerobic members of Actinobacteria and Proteobacteria and exhibits resilience of diversity. CAM underwent UC-associated dysbiosis and demonstrated restoration post-FMT-AID. These FMT-restored CAM taxa correlated negatively with disease activity in patients with UC. The positive effects of FMT-AID extended further in refurbishing CAM-MAM interactions, which were obliterated in UC. These results encourage investigation into host-microbiome interactions established by CAM, to understand their role in disease pathophysiology.