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BACKGROUND AND OBJECTIVES The study was planned to determine the incidence and analyze 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 2019 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. 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 45-60 kg; 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.

Protocols for transfusion therapy in transfusion-dependent thalassemia (TDT) children differ among various medical centers. In India, most centers consider only the patient's weight while calculating the volume of packed red blood cells (PRBCs) to be transfused. This study aimed to compare the efficacy of PRBC transfusions of different volumes calculated either by weight or by a formula using weight and pretransfusion hemoglobin of patient and hematocrit of PRBC.Sixty TDT patients in the age group of 3-9 years were enrolled and randomly allocated to two groups. Group A received PRBC transfusion volume based on the patient's weight, and Group B received PRBC volume calculated using a formula for 6 months.Average pretransfusion hemoglobin in Group A and Group B (9 ± 0.4 vs. 8.9 ± 0.4 g/dl) was not significantly different (p = .353). Although the average number of visits in 6 months was less for Group A compared to Group B (7 ± 1 vs. 8 ± 1; p = .001); the average volume transfused per visit was more (351 ± 78 vs. 287 ± 68 ml; p = .003). The calculated average annual pure red cell requirement of the patients was 178 ml/kg/year for Group A and 154 ml/kg/year for Group B (p = .000). Total donor exposures were significantly lower in Group B than Group A (11 ± 3 vs. 14 ± 3; p = .006).The number of donor exposures and annual pure red cell requirement was significantly lower in the formula-based group. Transfusions based on formula are recommended in TDT patients.

BACKGROUND AND OBJECTIVES The present study was planned to assess the clinical utility of reticulocyte haemoglobin content (CHr) and immature reticulocyte fraction (IRF) in the early detection of latent iron deficiency in blood donors. MATERIALS AND METHODS The prospective longitudinal observational study was conducted using the purposive sampling method. Written informed consent was obtained and donors were allocated into the first-time (FTD) and regular donor (RD) group. The enrolled blood donors (n = 205 in each group) were followed up for two subsequent whole blood donations. Haemoglobin (Hb), CHr, IRF and serum ferritin values were recorded at enrolment and two follow-ups. RESULTS The sensitivity of CHr in detecting iron-deficient erythropoiesis (serum ferritin values ≤ 26 μg/dl) was 45% and 56.7%, specificity 96.7%, positive predictive value (PPV) 85.6% and 90.8% and negative predictive value (NPV) 80.1% and 78.7%, respectively in FTD and RD cohorts. The sensitivity of IRF was 45.1% and 44.8%, specificity 93.4% and 97.1%, PPV 74.8% and 90.4% and NPV 79.6% and 74.5%, respectively in both the cohorts. The sensitivity of CHr in detecting absent iron stores (serum ferritin values ≤ 15 μg/dl) was 66.2% and 74.4%, specificity 92% and 90.6%, PPV 56.7% and 68.7% and NPV 94.5% and 92.8% among FTD and RD cohort, respectively. The sensitivity of IRF was 72.7% and 65.3%, specificity 90.3% and 94.3%, PPV 54.4% and 76% and NPV 95.4% and 90.8%, respectively in both the cohorts. CONCLUSION Reticulocyte hemoglobin content and IRF can be used along with complete blood count for early detection of iron deficiency in blood donors using the same blood sample at no extra cost.

Objectives During plateletpheresis, citrate induces hypocalcemia and hypomagnesemia, which are usually transient and self-limiting, but they can lead to significant donor discomfort. The aim of study was to determine the effect of citrate infusion on a multitude of biochemical parameters during plateletpheresis in healthy donors and to correlate changes with adverse donor reactions. Methods The study was conducted on 60 healthy plateletpheresis donors. Blood samples were drawn on three occasions, a baseline pre-donation sample, 30 min at start of procedure and 30 min post procedure. Heparinized samples were taken to measure ionized calcium and plain samples to measure serum calcium, serum magnesium, parathyroid hormone, total protein and serum albumin. Results There was statistically significant decline in mean total calcium (9.27 ± 0.66 mg/dl to 8.72 ± 0.87 mg/dl) and ionized calcium (3.8 ± 0.51 mg/dl to 2.9 ± 0.67 mg/dl) from baseline until 30 min after the start of procedure respectively. A significant fall in serum magnesium, total protein and serum albumin was observed. The mean parathyroid hormone showed significant increase from baseline levels till at the completion of procedure (19.94 ± 12.1 pg/ml to 92.08 ± 36.78 pg/ml). If the yield was set constant, there was negative correlation between ACD used and pre-donation platelet count. Majority of adverse donor reactions were hypocalcemic reactions, which were more with Amicus double yield plateletpheresis and were managed with calcium supplementation. Conclusion Plateletpheresis induces marked reduction in serum calcium and magnesium levels. Moreover, increase in parathyroid hormone levels was significant. In addition, decline in total protein and serum albumin may be a concern in donors also participating in plasmapheresis.

Stimuli modulated photophysical properties of a new asymmetric multifunctional molecular probe, 2-(pyren-1-yl)-5-(pyridin-4-yl)thiazolo [5,4-d]thiazole (PYTZ-P) bearing electron-rich pyrene and electron-deficient pyridine units linked through a π-conjugated thiazolo [5,4-d]thiazole (TTz) bridge are reported. Its sensitivity towards protons (TFA) in solution is manifested in the form of bathochromically shifted emission that spreads all over the visible region, and is related to the increased acceptor strength of pyridine upon protonation and subsequent enhanced magnitude of intramolecular charge-transfer in the probe. Similar modulation of the luminescence behaviour of the probe was also observed in the solid state. These observations are well rationalised by the theoretical calculations. The applicability of the sensitivity of the probe towards TFA has been demonstrated by developing the ready-to-use portable paper strips. Furthermore, PYTZ-P showed different acid/base induced absorption/emission switching property. Interestingly, when the response of the probe was noted in the presence of several cations, modulation of the electronic properties was observed only in the presence of Hg

Introduction and objectives Nose is considered to be a conspicuous feature of human face. Its different parameters like shape, size, nasal angles etc may indicate one's gender, age, race, adapted climatic conditions, and the environment to which one belongs to. Furthermore, it is an important component and determinant of an individual's physical outlook and appearance. The current study provides a new approach for the assistance of anthropologists and forensic experts in human identification and sex determination from the nasal angles. Methodology The study was performed on a total of 500 subjects (250 males and 250 females) belonging to north India (Mandi, Himachal Pradesh State). In comparison to the classical and manual methods for nasal angle measurements, an automated approach was followed in the present study. A Windows-based software called tpsDig2 was used for nasal angle measurements by utilization of the landmarks (nasion, pronasale, subnasale, and alare). Three nasal angles (nasal prominence angle, inter-alar angle, and nasal tip angle) were measured in all the subjects and each measurement was repeated thrice to reduce the measurement error and increase the specificity and efficiency of the results. Discriminant function statistics was used for determination of sex from different nasal angles. Results and conclusion The results of the statistical analysis (ANOVA) performed using SPSS reveal the significant difference between males and females in all the 3 repeated measurements of nasal angles. The final discriminant classification statistics show that 64% of original grouped cases have been correctly classified and the designed statistical model can be used in several forensic scenarios for the sex determination on the basis of the available nasal angles. The study may be further useful in the identification cases pertaining to facial reconstruction. The investigation may also be helpful in providing specific correlation of the nasal angles with the other parts of the face in the cases of remodelling and reformation of craniofacial alterations and reconstructions in plastic surgery and aesthetics.

Iron deficiency anaemia is the most common nutritional deficiency disorder in the world. Iron deficiency is a potential complication in repeated apheresis donation. The present study was aimed to evaluate serum iron stores in regular plateletpheresis donors.A total of 60 donors were included in this study, which included 30 regular plateletpheresis donors as cases and controls were 30 first time donors. The donor samples were collected before donation for complete hemogram, transfusion transmissible infections screening and serum iron, total iron binding capacity, percentage saturation of transferrin and serum ferritin.Out of 60 donors, more than half of the donors (56.6 %) had serum ferritin less than 30 ng/mL. Out of these 34 donors, 25 were from the case group and 9 donors in the control group. The median serum ferritin level in cases and controls was 11.86 ng/mL (Interquartile range 4.18-17.34 ng/mL) and 37.92 ng/mL (Interquartile range 27.87-86.20 ng/mL) respectively (p0.001). The mean serum iron in cases and controls was 71.23 ± 31.32 μg/dL and 93.53 ± 33.53 μg/dL respectively (p = 0.016). The mean percentage saturation in cases and controls was 20.09 ± 9.31 % and 26.26 ± 9.03 % respectively (p = 0.012). A significant decline in mean serum ferritin with increase in number of annual donations and decrease in donation interval was observed.Regular plateletpheresis donation may lead to depletion of iron stores and subclinical iron deficiency. Donors with high platelet count are more likely to exhibit iron deficiency. Periodic serum ferritin estimation in donors participating in regular plateletpheresis donation is warranted.

Treatment of atypical hemolytic uremic syndrome cases is challenging right from establishing correct and timely diagnosis to execution of management protocol. A seven-year-old male child from poor socioeconomic status was admitted with chief complaints of fever, 3 episodes of vomiting and passage of cola coloured urine. Based on clinical and laboratory findings, diagnosis was established. However, ADAMTS13 levels and genetic studies required for diagnosis could not be performed due to financial constraints and non-availability of these tests. TPE kits were arranged from charitable organizations. Six TPE procedures were performed using Cobe Spectra cell separator. Central venous catheter was placed in femoral vein. TPE kit was primed with compatible packed red blood cells before each procedure. Patient was non-cooperative and irritable in first three procedures and was sedated. A total of 1300 ml plasma was exchanged in each procedure with group specific fresh frozen plasma. After second TPE procedure, patient started improving with decrease in plasma discoloration and periorbital edema. Renal function tests along with hematological parameters became normal after 6th TPE procedure. Patient was discharged in a stable condition. On follow up, C3 levels were normal with adequate platelet count and normal renal functions suggesting complete remission.

OBJECTIVE Black emerging adult women (ages 18-25 years) are among the fastest growing demographics of HIV infection, second only to men who have sex with men. Black women account for nine of 10 new HIV cases, whereas 84% of these cases are reported to be from heterosexual contact with infected male partners. Heterosexual Black college women (BCW) have been nearly ignored in the HIV literature despite having shared (e.g., risky alcohol use, multiple and concurrent sex partnerships, and inconsistent condom use) and unique (e.g., segregating dating practices and high sexually transmitted infection rates) risk factors when compared with broader college student demographics. METHOD This conceptual paper uses a multiple risk factor framework to underscore shared and unique risk factors that may work to increase the potential HIV infection risk burden in this understudied population. CONCLUSIONS Prevention and intervention implications and recommendations for future research that have potential to impact the ways in which colleges, universities, and researchers engage this population are presented. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Introduction and objectives Face recognition plays an important role in the field of biometrics, bioinformatics, and forensic identification. Human faces appear bilaterally symmetric. However, asymmetry is a norm in the human body and careful morphological and metric examination of the human face gives an exact idea of the asymmetry present in the face of an individual. Most of the studies on asymmetry of human face have been carried out with regard to evaluation of expressions in psychology, anthropology, and biometrics. In this preliminary study, an idea of the human face symmetry has been used for complete facial reconstruction. Sometimes, in the CCTV cameras and other surveillance systems, the complete face is not visible, but only a half of the frontal face is detectable. In all such cases, the mirror image of the face can be used to reconstruct the complete face of the person in question for representation-based face recognition. In previous studies related to forensic identification and in the discipline of computer science, mirror images have only been used to overcome and deal with the problem of nonsufficient training sample and have not been used for the reconstruction of the full facial profile. Methodology In this article, we present a computerized methodology to generate the mirror image from one frontal half of the face (either left or right) and merging the both (input image and generated mirror image) halves to create the full face. The program was designed using METLAB computer program. This procedure is very simple, less time-consuming, and computationally efficient. Results and conclusion The results have been presented with regard to generate a complete face in those cases where only one frontal profile, that is, left or right sides of the face is available for examination. The scenario is commonly seen in those cases also where shadow almost hides one half of the face. The proposed methodology would also be useful for improving other facial reconstruction and recognition methods in forensic identification and in other medical fields such as plastic surgery, where creating full face still poses a technical challenge to a plastic surgeon. Some challenges, limitations, and future perspectives of the method have also been discussed in the article.

The face is an important part of the human body by which an individual communicates in the society. Its importance can be highlighted by the fact that a person deprived of face cannot sustain in the living world. The amount of experiments being performed and the number of research papers being published under the domain of human face have surged in the past few decades. Several scientific disciplines, which are conducting research on human face include: Medical Science, Anthropology, Information Technology (Biometrics, Robotics, and Artificial Intelligence, etc.), Psychology, Forensic Science, Neuroscience, etc. This alarms the need of collecting and managing the data concerning human face so that the public and free access of it can be provided to the scientific community. This can be attained by developing databases and tools on human face using bioinformatics approach. The current research emphasizes on creating a database concerning literature data of human face. The database can be accessed on the basis of specific keywords, journal name, date of publication, author's name, etc. The collected research papers will be stored in the form of a database. Hence, the database will be beneficial to the research community as the comprehensive information dedicated to the human face could be found at one place. The information related to facial morphologic features, facial disorders, facial asymmetry, facial abnormalities, and many other parameters can be extracted from this database. The front end has been developed using Hyper Text Mark-up Language and Cascading Style Sheets. The back end has been developed using hypertext preprocessor (PHP). The JAVA Script has used as scripting language. MySQL (Structured Query Language) is used for database development as it is most widely used Relational Database Management System. XAMPP (X (cross platform), Apache, MySQL, PHP, Perl) open source web application software has been used as the server.The database is still under the developmental phase and discusses the initial steps of its creation. The current paper throws light on the work done till date.

Objective: This study explores the impact racism has on the drinking behaviors of Black college women. Little is known about Black college women's experience of racism and the impact racism has on their psychological wellbeing and drinking behaviors. The current study fills a gap in our understanding of the role racism plays in the risky drinking behavior of Black college women. Participants: 469 Black college women ages 18–29 were sampled from 8 colleges and universities across the US, in 3 waves from December 2014-August 2017. Results: Findings suggest that general life stress and perceived racism are significantly associated with alcohol use among Black college women. However, only increased experiences of racism increase Black college women's engagement in risky drinking. Conclusions: The findings of this study serve as an entry point for a more nuanced assessment of stressors among Black college women that may inform drinking behaviors in this population.

The face is an important part of the human body, distinguishing individuals in large groups of people. Thus, because of its universality and uniqueness, it has become the most widely used and accepted biometric method. The domain of face recognition has gained the attention of many scientists, and hence it has become a standard benchmark in the area of human recognition. It has turned out to be the most deeply studied area in computer vision for more than four decades. It has a wide array of applications, including security monitoring, automated surveillance systems, victim and missing-person identification and so on. This review presents the broad range of methods used for face recognition and attempts to discuss their advantages and disadvantages. Initially, we present the basics of face-recognition technology, its standard workflow, background and problems, and the potential applications. Then, face-recognition methods with their advantages and limitations are discussed. The concluding section presents the possibilities and future implications for further advancing the field.

Background Blood donors are prone to have iron deficiency. The aim of this study was to determine utility of serum hepcidin as an indicator of iron deficiency in blood donors. Methods A total of 200 voluntary, healthy blood donors were included in the study. Donors were categorized into four groups according to the donation frequency. Group I: (n = 50) who donated for the first time, or those who have not donated in the past 2 years (reactivated donors). Group II: (n = 50), who donated blood for the second time and had donated once in the previous 12 months. Group III: (n = 50), who donated blood for third time and had donated twice in the previous 12 months. Group IV: (n = 50) who donated blood for the fourth time and had donated thrice in the previous 12 months. Sera of study participants were evaluated for serum ferritin and serum hepcidin levels based on enzyme linked immunosorbent assay. Results Serum hepcidin concentration ranged 2.36−15734 pg/mL. Serum hepcidin and serum ferritin were found to be lowest in group IV donors. When serum ferritin concentration of less than 15 ng/mL was considered as gold standard for diagnosing iron deficiency, AUCROC for serum hepcidin as a diagnostic test of iron deficiency was found to be 0.715. Serum hepcidin showed statistical significant correlation with donation frequency(p = 0 .005) and serum ferritin (p = 0.01). Sensitivity and specificity of serum hepcidin was found to be 77.8 %, 79.6 % respectively. Conclusion Effectiveness of Serum hepcidin as a diagnostic marker of iron deficiency still needs to be determined.

Purpose In patients with epidermal growth factor receptor ( EGFR) mutation–positive advanced non–small-cell lung cancer (NSCLC), there is an unmet need for EGFR–tyrosine kinase inhibitors with improved CNS penetration and activity against CNS metastases, either at initial diagnosis or time of progression. We report the first comparative evidence of osimertinib CNS efficacy versus platinum-pemetrexed from a phase III study (AURA3; ClinicalTrials.gov identifier: NCT02151981) in patients with EGFR T790M–positive advanced NSCLC who experience disease progression with prior EGFR–tyrosine kinase inhibitor treatment. Methods Patients with asymptomatic, stable CNS metastases were eligible for enrollment and were randomly assigned 2:1 to osimertinib 80 mg once daily or platinum-pemetrexed. A preplanned subgroup analysis was conducted in patients with measurable and/or nonmeasurable CNS lesions on baseline brain scan by blinded independent central neuroradiological review. The CNS evaluable for response set included only patients with one or more measurable CNS lesions. The primary objective for this analysis was CNS objective response rate (ORR). Results Of 419 patients randomly assigned to treatment, 116 had measurable and/or nonmeasurable CNS lesions, including 46 patients with measurable CNS lesions. At data cutoff (April 15, 2016), CNS ORR in patients with one or more measurable CNS lesions was 70% (21 of 30; 95% CI, 51% to 85%) with osimertinib and 31% (5 of 16; 95% CI, 11% to 59%) with platinum-pemetrexed (odds ratio, 5.13; 95% CI, 1.44 to 20.64; P = .015); the ORR was 40% (30 of 75; 95% CI, 29% to 52%) and 17% (7 of 41; 95% CI, 7% to 32%), respectively, in patients with measurable and/or nonmeasurable CNS lesions (odds ratio, 3.24; 95% CI, 1.33 to 8.81; P = .014). Median CNS duration of response in patients with measurable and/or nonmeasurable CNS lesions was 8.9 months (95% CI, 4.3 months to not calculable) for osimertinib and 5.7 months (95% CI, 4.4 to 5.7 months) for platinum-pemetrexed; median CNS progression-free survival was 11.7 months and 5.6 months, respectively (hazard ratio, 0.32; 95% CI, 0.15 to 0.69; P = .004). Conclusion Osimertinib demonstrated superior CNS efficacy versus platinum-pemetrexed in T790M-positive advanced NSCLC.

Objectives The present study was aimed to find out the prevalence of parvovirus B19 amongst healthy blood donors and blood transfusion recipients so as to determine the feasibility of providing seronegative blood components to vulnerable recipients. Methods A total of 1000 samples were studied which included 800 blood donors and 200 transfusion recipients.The transfusion recipients included 100 multitransfused patients and 100 non transfused controls.All samples were subjected to parvovirus B19 ELISA for IgG and IgM antibodies. Results Of the 800 blood donors,663(82.9%) were voluntary while 137(17.1%) were replacement donors.The seroprevalence of B19V IgG antibodies among healthy blood donors was found to be 34.1% whilst that of IgM antibodies was 1.4%.The seroprevalence of B19 V IgG antibodies was found to be 28.4% in the age group 18–35 years and 42.1% in donors more than 35 years of age(p ≤ 0.01). The overall seroprevalence of IgG antibodies in multitransfused patients was 34% and IgM antibodies was 7.0%.The B19 V IgG prevalence was 20% in the transfused patients aged 0–20 years and 48% in patients above 20 years of age (p ≤ 0.05). Conclusion The moderately high seroprevalence of B19 V IgG in blood donors and patients suggests endemicity of infection.However, prevalence of B19 V IgM antibodies in blood donors is low.With the widespread use of pooled plasma derived medicinal products and recognition of severe pathological effects in susceptible recipients, transfusion transmission of B19 V has become a major concern in the past few decades.We suggest screening of blood units to identify B19 V IgM negative units for transfusion to selected patients.

Background: Diffusion hypoxia is the most serious potential complication associated with nitrous oxide. It occurs during the recovery period. Hence, administration of 100% oxygen is mandatory as suggested by many authors. Aim: The aim of this study is to evaluate the occurrence/nonoccurrence of diffusion hypoxia in two groups of patients undergoing routine dental treatment under nitrous oxide sedation when one group is subjected to 7 min of postsedation oxygenation and the second group of the patients is made to breathe room air for the similar period. Materials and Methods: A total of sixty patients within the age group of 7–10 years requiring invasive dental procedures were randomly divided into two groups of 30 each using chit method. In the control group, patients were administered 100% oxygen postsedation, whereas, in the study group, patients were made to breathe room air postsedation. Various parameters (pulse rate, respiratory rate, blood pressure, and oxygen saturation [SpO2]) were recorded pre- and post-operatively. Data were collected and then sent for statistical analysis. Results: The mean postoperative SpO2 at measurement times 1, 3, 5, and 7 min in both the groups was higher than the mean preoperative SpO2. This increase was statistically significant. No significant difference was found between the Trieger test scores. Conclusion: This study proves that clinical occurrence of diffusion hypoxia is not possible while following the routine procedure of nitrous oxide sedation.

The dilution controlled aggregation enhanced emission of spherically aggregated form of a triazole based probe dies down upon detecting iodide over other inorganic anions. The sensing is realised as a dynamic quenching mechanism dominated event. Being highly selective for iodide, the probe finds application in the detection of iodide in human urine.

OBJECTIVE: A motivational drinking framework (Cooper, 1994) is utilized to understand the relationship between minority stressors (e.g., race related stress and acculturative stress) and alcohol use behaviors (risky alcohol use and coping motivate drinking) among a large sample of Black American college students. METHOD: 649 Black college students from 8 colleges and universities in the US were recruited as part of a large, multiwave, cross-sectional study investigating the stress and coping experiences of Black emerging adults. RESULTS: Results from the current investigation provide support for the independent contributions of acculturative stress and race-related stress to the risky alcohol use behavior of Black college students, while acculturative stress significantly predicted coping motivated drinking behaviors in the sample. CONCLUSION: Findings underscore the need to better understand the unique relationships between minority stress and risky alcohol use behaviors of Black college students; namely relationships not shared by their non-minority peers that increase their risk of problem drinking.

SummaryIntroduction The ABO system is the most important of all blood group systems in transfusion practice. ABO grouping is a simple, accurate, and precise procedure and to be considered valid, the results of cell grouping and serum grouping should agree. The aim of this study was to assess the cause of discrepancies and its implication in transfusion practice. Methods This study was performed between January 2010 and May 2013. We analyzed ABO discrepancies which were detected serologically in blood donors, where a result of cell grouping and serum grouping was discordant. Confirmation of subgroups was carried out by adsorption and elution technique. Saliva of these donors was also tested for A, B, and H antigens by inhibition tests. Results Twenty-eight blood group discrepancies were observed in 44 425 blood groups tested during the study period, thus giving an overall frequency of 0.06%. Technical errors leading to blood group ABO discrepancy were noticed in five cases. Sample-related problems that affect red-cell testing were observed in twenty cases, and the most common cause of ABO discrepancies in this category was subgroups of A and B. ABO discrepancies that affect the serum testing included the presence of additional antibodies other than anti-A and anti-B. Conclusion It is imperative to recognize discrepant results and resolve them. Correct blood typing and labeling of an individual are essential to prevent ABO incompatibility.

The CD19+ B-lymphocyte and CD138+ plasma cell repertoires in cerebrospinal fluid from four patients with monosymptomatic optic neuritis (ON) were analyzed by single-cell reverse transcriptase polymerase chain reaction. Amplified heavy (H)- and light (L)-chain antibody segments were sequenced and used to identify the rearranged germline and J segment of closest homology. Both the B-cell and plasma cell repertoires from ON cerebrospinal fluid demonstrated significant clonal expansion. Up to 75% of the amplified H- and L-chain sequences were contained in overrepresented populations and were somatically mutated, consistent with an antigen-targeted response. The relationship between clonal populations within the CD19+ B lymphocyte and CD138+ plasma cell populations suggests ongoing mutational pressure to refine antigen binding. Our observations demonstrate that an antigen-driven clonal B-lymphocyte and plasma cell response is prominent in the initial stages of central nervous system demyelination and suggest that detection of the disease-relevant antigens in ON may bear on the inciting antigens in chronic inflammatory disorders such as multiple sclerosis.

Structurally simple, ferrocene–pyrene imine dyad1detects Cr3+viathe metal ion triggered hydrolysis of imine functionality with subsequent ‘turn-on’ fluorescence behaviour. Furthermore, the non-cytotoxic dyad detects Cr3+in the human breast cancer (MCF-7) cells.

With the development of an insulin autoantibody (IAA) assay performed in 96-well filtration plates, we have evaluated prospectively the development of IAA in NOD mice (from 4 weeks of age) and children (from 7 to 10 months of age) at genetic risk for the development of type 1 diabetes. NOD mice had heterogeneous expression of IAA despite being inbred. IAA reached a peak between 8 and 16 weeks and then declined. IAA expression by NOD mice at 8 weeks of age was strongly associated with early development of diabetes, which occurred at 16–18 weeks of age (NOD mice IAA+at 8 weeks: 83% (5/6) diabetic by 18 weeks versus 11% (1/9) of IAA negative at 8 weeks;P< .01). In man, IAA was frequently present as early as 9 months of age, the first sampling time. Of five children found to have persistent IAA before 1 year of age, four have progressed to diabetes (all before 3.5 years of age) and the fifth is currently less than age 2. Of the 929 children not expressing persistent IAA before age 1, only one has progressed to diabetes to date (age onset 3), and this child expressed IAA at his second visit (age 1.1). In new onset patients, the highest levels of IAA correlated with an earlier age of diabetes onset. Our data suggest that the program for developing diabetes of NOD mice and humans is relatively “fixed” early in life and, for NOD mice, a high risk of early development of diabetes is often determined by 8 weeks of age. With such early determination of high risk of progression to diabetes, immunologic therapies in humans may need to be tested in children before the development of IAA for maximal efficacy.

Background and objectives In India, screening of blood for human immunodeficiency virus, hepatitis B surface antigen, and hepatitis C virus is mandatory before issue for transfusion, but donors are not informed of their reactive status. Advising donors who have reactive test results of viral markers is an essential adjunct to blood donor testing and is part of donor care. We realized that donor disclosure is an important public health issue. Therefore, we took the initiative of posttest counseling of blood donors. Materials and methods The donors reactive for any transfusion transmitted diseases by enzyme linked immunosorbent assay in duplicate as well as by rapid tests, were notified of their reactive test results and called for counseling. We tried to maintain confidentiality at each step. Counseling and information about confirmation, evaluation, early treatment and prevention of transmission were given to responding donors. Results The results were analyzed for the period from 1st April 2011 to 30th June 2012. Among 15,844 donors, 172 were found to be reactive for various infectious markers. Letters were sent to all reactive donors. Only 60 donors responded and were counseled. The counseling rate was 49%, 45.5%, 50% and 17% for HBsAg, HCV, HIV and syphilis respectively. Conclusion This study describes our experience and challenges faced in implementing the program of donor counseling in a resource poor setting.

Anti A1 antibody in the serum of A2 and A2B individuals is rare but when present can have laboratory and clinical significance. Routine subgrouping of all A and AB blood groups in blood centres in India is difficult due to economic constraints and has always been a point of debate. This study thus brings out the prevalence of anti A1 antibody and the clinical significance related to its presence. The results of the study showed a low prevalence of anti A1 antibody and when present, it had a low thermal amplitude and titre. Further, no blood group discrepancy or problems during compatibility testing were encountered with these (A1 antibody positive) blood units. Thus, it may be concluded that in India and other developing countries where resources are scarce, routine subgrouping of A and AB may not be really worthwhile unless there is a group discrepancy, problem during compatibility testing or history of a transfusion reaction.

Introduction Most anti-M antibodies are not active at 37 °C and are thus of no clinical significance. Occasionally these antibodies have a wide thermal range and can lead to hemolytic transfusion reactions or hemolytic disease of the new born. Patient and methods We describe two cases of anti-M antibodies, both of which were clinically significant. Results The first case was detected due to crossmatch incompatibility and the second presented as a blood group discrepancy. Conclusion When the antibody is active at 37 °C, M antigen negative red cell units should be issued.

Life-long red blood cell (RBC) transfusions remain the main treatment for severe thalassemia. We hereby report a case of anti S and anti Lu(a) in a β-thalassemia major patient detected incidentally on antibody screening. The patient was a known case of β-thalassemia major and was on regular blood transfusion every 3 weeks from the institute from the age of 6 months. Subsequently, on one occasion, patient's crossmatch was compatible despite positive antibody screen using microcolumn gel technique. Autocontrol and direct antiglobulin test were negative on microcolumn gel. Anti S and anti Lu(a) antibodies were identified. Blood unit found compatible was negative for S and Lu(a) antigens. Antibody titers were 1:1 for both anti S and anti Lu(a) in AHG phase using tube technique and antibodies were of IgG type. Blood unit was transfused uneventfully to the patient. Donors were traced back (last three donations) and called for repeat blood sample testing for S and Lu(a) antigen. Two out of three donors were found to be S antigen positive and one out of these two was Lu(a) antigen positive. Anti S and anti Lu(a) antibodies were again identified on patient's subsequent visit for transfusion. The present case re-emphasize the importance of antibody screening at each visit in earlier detection of antibodies in multi transfused patients. Encouraging patients to receive transfusion from one center and dedicating donors could reduce alloimmunization rate but larger studies are required.

Among the antibodies of the MNS blood group system, anti S antibody is generally IgG antibody reacting at 37 °C. It is rarely implicated in hemolytic transfusion reaction; however, it can lead to potentially severe transfusion reactions. Anti S is also capable of causing mild to severe fatal hemolytic disease of newborn [1]. We report a case of anti S antibody in a pregnant patient with complicated falciparum malaria.

Transfusion-transmitted infections continue to be a threat to safe transfusion practices. We analysed the prevalence and patterns of co-infections among voluntary and replacement donors.Blood donations collected over a 5-year period were studied for the type of donation (voluntary or replacement), number of seroreactive cases and the number, type and distribution of co-infections.Of the 42 439 units of blood collected over a 5-year period, 19 118 (45%) were from voluntary and 23 321 (55%) from replacement donors. There were 1603 seroreactive cases (3.8%). These included 250 with HIV (0.6%), 734 with hepatitis B surface antigen (HBsAg; 1.7%), 337 with hepatitis C virus (HCV; 0.8%) and 282 (0.7%) with VDRL (Venereal Diseases Research Laboratory) reactivity. Twenty-three (0.05%) of these hador = 2 seroreactive infections; 20 of these were in replacement donors and only 3 in voluntary donors and the difference was statistically significant (p0.005). Among HIV seropositive donors, there were 4 seroreactive for syphilis and 5 for HBsAg. Among HIV seronegative donors, 5 were seroreactive for HBsAg and VDRL, 4 for HCV and VDRL, and 2 for HBsAg and HCV. One person was seroreactive for HIV, HBsAg and VDRL. The multiple infection rate showed a decreasing trend over the years.Multiple infections pose a small but definite risk to the recipients of blood products. Voluntary donations are safer as compared with replacement ones and need to be encouraged.

Cold agglutinins are autoantibodies and are often present in the sera of healthy individuals. They assume importance when the thermal reactivity of these antibodies approaches body temperature. This communication describes a case of cold hemagglutinin disease with Mycoplasma pneumoniae infection detected during routine laboratory investigations. The patient was managed conservatively.

Bombay phenotype is unique in the aspect that the red cells are not agglutinated by antisera A, B and H. However the serum of such individuals contains anti A, B and strongly reactive anti H which agglutinates red cells of 'O' group individuals through a wide thermal range. The blood specimen of a 35 year old male donor who donated blood for the first time was subjected to detailed cell and serum grouping. There was a discrepancy between the results. The possibility of Bombay phenotype was considered and the sample was tested with anti H lectin. Further confirmation of blood group and secretor status was done from a reference laboratory. Family studies showed the same blood group in the elder sibling of the propositus. The present case highlights the significance of correlating cell and serum grouping results. Moreover, this blood group is very rare in North India. Family studies revealed the propositus to possess the B gene which was suppressed in the donor but expressed in the offsprings. The use of anti H in discrepant blood grouping results is recommended.

Multiple sclerosis (MS) is the most common cause of neurological disability in young adults. Since approximately 40% of the brain is devoted to vision, demyelination commonly affects visual function, resulting in a myriad of neuro-ophthalmic symptoms. In this chapter, we examine the seminal afferent and efferent neuro-ophthalmological manifestations of MS, highlighting those history and examination findings critical for the diagnosis and treatment of various visual and ocular motor disorders. Among the topics, a special emphasis will be placed on optic neuritis, the most common clinically isolated demyelinating syndrome. This chapter focuses on the evaluation and treatment of visual sensory and oculomotor disorders in MS. The objective is to provide the reader with a working model for enhancing their care of patients with demyelinating disease.

Solitary plasmacytomas are rare tumors of plasma cell origin categorized as extramedullary plasmacytoma (EP) and solitary plasmacytoma of bone (SPB). We report here a case of SPB who is off treatment for 14 years and is completely disease-free.

Endogenous anterior uveitis (AU), when untreated, may lead to vision loss. This study compared the safety and efficacy of difluprednate versus prednisolone acetate for the treatment of this condition.This phase III, double-masked, noninferiority study randomized patients with mild to moderate endogenous AU to receive difluprednate 0.05% (n = 56) four times daily, alternating with vehicle four times daily, or prednisolone acetate 1% (n = 54) eight times daily. The 14-day treatment period was followed by a 14-day dose-tapering period and a 14-day observation period. The primary efficacy end point was change in anterior chamber cell grade (range, 0 for ≤1 cell to 4 for50 cells) from baseline to day 14.At day 14, the mean change in anterior chamber cell grade with difluprednate was noninferior to that with prednisolone acetate (-2.2 vs. -2.0, P = 0.16). The proportions of difluprednate-treated patients versus prednisolone acetate-treated patients demonstrating complete clearing of anterior chamber cells at day 3 were 13.0% vs. 2.1% (P = 0.046) and at day 21 were 73.9% vs. 63.8% (P = 0.013). A significant between-group difference in the mean IOP increase was seen at day 3 (2.5 mm Hg for difluprednate-treated patients and 0.1 mm Hg for prednisolone acetate-treated patients, P = 0.0013) but not at other time points. The mean IOP values in both groups remained less than 21 mm Hg throughout the study.Difluprednate 0.05% four times daily is well tolerated and is noninferior to prednisolone acetate 1% eight times daily for the treatment of endogenous AU. (ClinicalTrials.gov number, NCT01201798.).

An indole based "ratiometric" and "turn-off" tris(N-methylindolyl)methane based chemosensor depicting a contrasting fluorescent behavior towards Hg(2+) and Cu(2+) ions, exhibited NOR and YES logic functions, and also imaged intracellular Hg(2+) in cervix cancer (HeLa) cells.

Interleukin 1 alpha and tumour necrosis factor-alpha stimulated phosphorylation of three 27 kDa phosphoproteins in MRC-5 fibroblasts which was sustained for up to 2 h after adding the cytokines. All three phosphoproteins were immunoprecipitated by a specific antiserum to the small mammalian heat shock protein, hsp 27. The three phosphoproteins from stimulated or control cells contained phosphoserine but not phosphothreonine or phosphotyrosine. Similar increases in phosphorylation of immunoprecipitable 27 kDa proteins were seen in U937 cells stimulated by TNF alpha and Hep G2 cells stimulated by IL1 alpha.

Penile involvement was seen in 19.5% of 261 patients, aged 11 to 30 years, with tinea cruris. It was more common in patients under the age of 20 years (p less than 0.05). The increased incidence is probably related to the use of langota, a semiocclusive undergarment that may favor the growth of dermatophytes.