Impact of blood donor characteristics on quality of packed red blood cell concentrates.

INTRODUCTION: Impact of blood donor characteristics on quality of packed red blood cell concentrates. OBJECTIVE: To determine the impact of donor factors on the quality of packed red blood cell concentrates. MATERIAL AND METHODS: The analytical cross sectional study was conducted on 505 whole blood donors after approval by the Institutional Ethics Committee and written informed consent from blood donors. Two mL EDTA sample was collected for pre-donation haemoglobin estimation and all relevant donor details were recorded. Whole blood was collected in 350mL double blood bags. PRBCs were prepared as per the departmental SOP. Volume of each PRBC was recorded and sample from each bag was taken for estimation of total haemoglobin content and haematocrit. RESULTS: Of 505 blood donors, 459 (90.9%) were males and 324 donors (64.2%) were less than 30 years of age. The majority of the donors were repeat donors (61%, n=308 repeat donors), vegetarians (52.9%, n=267 vegetarians) and non-smokers (92.7%, n=468). Mean haemoglobin was found to be significantly higher in males (14.9 vs. 13.3; P≤0.001), donors more than 30 years of age (15 vs. 14.7; P=0.042), repeat donors (14.9 vs. 14.7), non-vegetarians (15.1 vs. 14.6; P≤0.001) and smokers (15.3 vs. 14.8g/dL; P=0.020). PRBC units prepared from male blood donors, repeat donors and non vegetarians had significantly higher mean volume and mean total haemoglobin content. Strong positive correlation was observed between haemoglobin of the blood donor and total haemoglobin content of the PRBC and volume of blood collected. CONCLUSIONS: Donor characteristics do have effect on total haemoglobin content of packed red blood cells.

Reporting of delayed adverse donor reactions in whole blood donors: Just the tip of an iceberg!

BACKGROUND AND OBJECTIVES: The study was planned to determine the incidence and analyze how various epidemiological factors tend to be associated with delayed adverse donor reactions (ADR). MATERIAL AND METHODS: The prospective observational study was conducted in Department of Transfusion Medicine of tertiary care hospital from January to December 2019. Eligible blood donors were observed for any adverse reactions after 15 minutes of removal of phlebotomy needle. Further, telephonic calls were made to each enrolled blood donor on day-2 and day-7 of the whole blood donation. For each day, two calls were made at an interval of 4 hours before declaring the participant to be non-responder. RESULTS: A total of 1540 (84.1%) blood donors responded on day-2 and 1610 (87.9%) responded on day-7 of follow-up. Total 180 (11.2%) blood donors experienced delayed ADRs. Two donors (1.1%) experienced on-site while 178 (98.89%) reported off-site delayed ADRs when followed-up telephonically. The commonest delayed ADRs reported were bruise (n=72; 30.9%), arm-pain (n=61; 26.2%) and generalised weakness (n=44; 18.9%). Female donors (27.3% vs. 11.2%; P=0.004), first time donors (15.2 vs. 9.9%; P=0.002), donors with low body-weight (range of 45-60kg; 15.9% vs. 11.5% vs. 6.1%; P=0.011) and body mass index<18.5 (24% vs. 12.5% vs. 9.7% vs. 11.3%; P=0.028) experienced more delayed ADRs. CONCLUSION: Blood donors do experience delayed ADRs but these are not reported to the blood centers as these are usually mild. However, it is important to capture these delayed adverse donor reactions and report it to National Hemovigilance Program so that strategies can be formulated to prevent their occurrence and recurrence.

Has Convalescent Plasma Therapy Hesitancy Increased COVID-19 Mortality?

We bring to you our viewpoint and a snapshot of the journey of convalescent plasma therapy (CPT) in the management of ongoing coronavirus disease 2019 (COVID-19) pandemic. We also discuss how best to use the updated data on this important treatment option and maximize benefit for our patients, thereby saving lives, especially in resource constraint settings.

Production of hand-made cloned buffalo (Bubalus bubalis) embryos from non-viable somatic cells.

Use of non-viable somatic cells for hand-made cloning (HMC) can enable production of cloned animals from tissues obtained from elite or endangered dead animals. Buffalo skin fibroblast cells were rendered non-viable by heat treatment and used for HMC. Although fusion (93.6 ± 1.72 vs 67.1 ± 2.83%) and cleavage (90.3 ± 1.79 vs 65.8 ± 1.56%) rate was lower (P < 0.001) than that for controls, blastocysts could be successfully produced. However, blastocyst rate (34.1 ± 2.43 vs 6.9 ± 2.18%, P < 0.001) and total cell number of blastocysts (TCN, 221.3 ± 25.14 vs 151.1 ± 21.69, P < 0.05) were lower and apoptotic index (4.8 ± 1.06 vs 10.9 ± 1.21) was higher (P < 0.001) than that of controls. In another experiment, ear tissue of slaughterhouse buffaloes was preserved in mustard oil at room temperature for 48 h following which somatic cells were harvested by enzymatic digestion and used for HMC. Although fusion (96.8 ± 1.48 vs 84.2 ± 3.19%), cleavage (89.6 ± 3.59 vs 77.2 ± 3.99%), and blastocyst rate (36.9 ± 7.45 vs 13.1 ± 6.87%) were lower (P < 0.01), TCN (223.0 ± 27.89 vs 213.3 ± 28.21) and apoptotic index (3.97 ± 0.67 vs 5.22 ± 0.51) of blastocysts were similar to those of controls. In conclusion, HMC can be successfully used for production of blastocysts from non-viable cells and from cells obtained from freshly slaughtered buffaloes. This can pave the way for the restoration of farm or wild animals by HMC if somatic cells could be obtained within a few hours after their death.

Evaluation of aspiration cytology of ovarian masses with histopathological correlation.

OBJECTIVES: To evaluate the efficacy and diagnostic accuracy of fine needle aspiration cytology (FNAC) in distinguishing non-neoplastic and neoplastic ovarian lesions and to determine reliable cytological criteria for typing neoplastic ovarian masses into benign and malignant tumours and their subtypes. METHODS: FNAC was performed on 50 patients diagnosed as having an ovarian mass clinically and/or ultrasonographically. Detailed history, clinical examination and ultrasound findings in each case were recorded. The cytological diagnoses were categorized as neoplastic and non-neoplastic and further into benign and malignant neoplasms. These cytological diagnoses were then compared subsequently with the histopathological diagnoses. RESULTS: The study material consisted of 57 aspirates from 50 patients. A comparison of cytological findings with the histological diagnosis was possible in 53 aspirates; in the remaining four cases (7%) the smears were acellular. On cytology, 31 lesions were diagnosed as neoplastic and 22 as non-neoplastic. The overall sensitivity of cytology in diagnosing neoplastic and non-neoplastic ovarian lesions was 93.9% and the specificity was 100%. The positive predictive value was 100% and negative predictive value 90.9%. The overall diagnostic accuracy was 96.2 %. CONCLUSION: FNAC of ovarian masses is a minimally invasive procedure that can differentiate neoplastic from non-neoplastic ovarian lesions. It may help avoid unnecessary operations and preserve the reproductive ability in young patients. Furthermore, it also enables a satisfactory sub-categorization of ovarian tumours, which facilitates the choice of appropriate therapy.

Feasibility of screening for Chlamydia trachomatis in young men attending an emergency department.

OBJECTIVE: To determine the feasibility of screening asymptomatic young men for genital Chlamydia trachomatis infection in a suburban emergency department setting. DESIGN: Prospective observational study. SETTING: Chase Farm Hospital Emergency Department in Enfield, North London. PARTICIPANTS: Asymptomatic sexually active men aged 16-24 years. METHODS: A convenience sample of men aged 16-24 years attending the emergency department was offered urine-based screening for Chlamydia at triage. Verbal consent was obtained and first pass urine specimens were tested using the strand displacement amplification technique. Participants were traced by their preferred method of contact in order to be offered treatment within 2 weeks of attendance at the emergency department. RESULTS: 67 men participated, 64 of whom were tested, 3 returning positive tests. The prevalence of Chlamydia in asymptomatic men attending the emergency department was 4.7%. CONCLUSION: Urine testing for genital C trachomatis in the emergency department can identify asymptomatic men in the community who may otherwise remain undetected. It is suggested that this is a worthwhile screening test to offer in the emergency department, providing follow-up for treatment can be arranged locally. There is no requirement for increased emergency department input into these patients over and above introducing them to the screening programme.