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Chronic non-healing ulcers present significant challenges in diabetic, dermatological and surgical patients. Platelet-Rich Plasma (PRP), enriched with bioactive factors, offers promise for wound healing enhancement. The prospective observational study was done in the Department of Transfusion Medicine at AIIMS Bhopal for a period of two years, from April 2020 to 2022. This study evaluates PRP's efficacy, prepared via the single spin method, in non healing chronic ulcers. Aseptically, 100 ml of blood was drawn into CPDA (citrate-phosphate-dextrose-adenine) bags. PRP was prepared by centrifuging blood at 3400 rpm for 10 minutes, yielding PRP and buffy coat. Patient serum and 10.0% calcium gluconate were added to fibrin gel. PRP was injected around the ulcer and then dressed. Dressings were changed on the 5th, 15th and 20th days with PRP. The evaluation was done on day 30 using surface area and volume assessments. Thirteen patients aged 18-65 participated. The patients treated with single spin PRP (four females, nine males) had mean hemoglobin of 10.79±2.22gm/dL. Initial lesions (14.72cm²) significantly reduced to (8.78cm²) after application of single Spin PRP sessions (p=0.005). The PRP showed a mean platelet count of 1,527.00±192.26 × 10⁹/L. Ulcer surface area decreased from 9.87cm² to 7.56cm²; lesion volume reduced from 14.72cm³ to 8.78cm³. Platelet count differences between whole blood and PRP were significant (p<0.05). The single-spin PRP method exhibited considerable improvements in healing parameters, showcasing its potential for chronic ulcer management.

Introduction: The determination of one's blood group is dictated by the inheritance-based diversity in the presence or absence of RBC antigens on the surface. Extended Rhesus (Rh) antigens are the most clinically relevant antigens of blood group systems after the ABO blood group system in transfusion medicine. The aim of this study was to serologically assess the prevalence of extended Rh antigens across diverse blood group systems., Methods: A total of 2043 samples were tested for the ABO blood group and Rh typing with monoclonal antisera. The Rh phenotyping (C, c, E, e ) was performed on all the samples., Results: The most frequently observed ABO blood group was O (36.5%), while AB (13.6%) was identified as the least prevalent. Positive Rh D antigen was found in 91.6% of tested samples, while 8.4% were Rh D-negative. The most frequently encountered antigen was e, followed by D, while the least prevalent was E., Discussion: Establishing a Rh phenotype repository for blood donors and conducting Rh phenotype assessments as part of pretransfusion testing before initiating the initial blood transfusion for each patient could significantly lower the patients' incidence of alloimmunization., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. National Institute of Biologicals Institutional Human Ethics Committee issued approval NIB/IHEC/2010/01. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Raghuwanshi et al.)

Background: Chronic nonhealing ulcers present significant challenges in diabetic, dermatological, and surgical patients. Platelet-rich plasma (PRP), enriched with bioactive factors, offers promise for wound healing enhancement. This study evaluates PRP's efficacy, prepared via single and double spin methods in nonhealing chronic ulcers., Methods:  Twenty-two patients aged 18-65 years participated and 100 mL of blood was drawn into citrate phosphate dextrose adenine (CPDA) bags with all aseptic precautions. PRP was prepared by single and double spin methods. Patient serum and 10% calcium gluconate were added to fibrin gel. PRP was injected around the ulcer and then dressed. Dressings were changed on the fifth, 15th, and 20th days with PRP. Evaluation occurred on day 30 using surface area and volume assessments by both methods., Results: The single spin PRP group and double spin PRP group had 11 patients each with hemoglobin range of 10.79±1.88 to 12.63±2.22 g/dL. Initial lesions (16.27 cm²) significantly reduced to 14.76 cm² after double spin PRP sessions (p=0.005) and Initial lesions (9.87 cm²) significantly reduced to 7.65 cm² after single spin PRP sessions (p=0.005). Platelet count differences between whole blood and PRP were significant (p<0.05)., Conclusions: The single spin PRP method exhibited considerable improvements in healing parameters, showcasing its potential for chronic ulcer management., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Human Ethics Committee-Postgraduate Research of All India Institute of Medical Sciences, Bhopal issued approval #2020/PG/JAN/28. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dubey et al.)

As per American Society of Apheresis (ASFA) guidelines, the indication for Erythrocytapheresis for sickle cell patients is category III for preoperative management and vaso-occlusive crisis. Erythrocytapheresis, with the help of automated cell separators, has the benefit of reducing the Sickle hemoglobin (HbS) levels to <30.0% with a reduced risk of increasing blood viscosity and single procedure achieving target hemoglobin levels. A 17-year-oldfemale patient who was a known case of sickle cell disease presented to our institution with a vascular necrosis of the right femoral head. Due to the pain and limitations of her day-to-day activities, she was advised for total hip arthroplasty. This patient underwent a successful Erythrocytapheresis using an automated cell separator and was operated on. In a sickle cell patient planned for surgical intervention, the procedure of Erythrocytapheresis can help in decreasing the chances of the patient developing any vaso-occlusive crisis during surgery and in the immediate post-operative period. This technique can help in improving the chances of a successful surgical procedure for such patients.

The novel corona virus causing severe acute respiratory symptoms appeared in China at the end of year 2019 and soon spread globally resulting in Pandemic. The susceptibility to novel corona virus infection and severity of symptoms in an individual is an outcome of immune system of the host. The Human leucocyte Antigen (HLA) of an individual is responsible for regulation of immune system. Thus, genetic variability of the HLA can affect the individual's response to Novel corona virus infection in terms of susceptibility and severity. The memory B cells which persist in the body after initial infection protect by faster response to repeat infection by the virus. However viral mutations prevent recognition by memory B cells and therefore repeat infection by virus leads to slow immune response as immunity to the mutated virus is not present.

Background: Blood supply management amid the coronavirus disease 2019 (COVID-19) pandemic became a cause of concern. Blood donations in the pandemic reduced significantly because of travel restrictions and fear of contracting the virus by visiting blood banks. The WHO (World Health Organization), NACO (National AIDS Control Organization) and the SBTC (State Blood Transfusion Council) published guidelines to ensure the safety of blood donors and staff during the pandemic and to ensure correct procedures are followed. The blood centre physicians took measures for appropriate clinical use of blood and blood products, which reduced the number of transfusions and thereby safeguarded the blood supply for those who needed it the most., Materials and Methods: The study was conducted at the All India Institute of Medical Sciences, Bhopal, and 33 blood banks from 33 districts of Madhya Pradesh in collaboration with the National Health Mission and NACO. This was a retrospective study from pre-lockdown to lockdown and unlock phases 1 to 5 for nine months (February 2020 to October 2020) from 33 district-level blood centres of Central India, and the study compared the impact on blood supply from pre-pandemic time to the COVID-19 pandemic time. During the stipulated time period of 9 months, which included the pre-pandemic blood supply, the phases of lockdown when Section 144 was imposed in the country and the unlock phases, the management of transfusion services by the district blood banks of Central India during the COVID-19 pandemic was evaluated. The strategies adopted to maintain the blood supply and adequate inventory were studied., Results: The blood donation percentage in the district hospitals of Madhya Pradesh dropped drastically by 61.5% in February 2020 (pre-pandemic time) to 3.35% in April 2020 (COVID-19 pandemic). The nadir of fall in blood donations was seen in April 2020 (phase 1 of COVID-19 pandemic lockdown) with a zenith in February 2020 (pre-pandemic time). The minimum number of donations 8,037 (3.32%) in all 33 districts of Central India was seen in April, when the lockdown restrictions in the country were the strictest. In response to the reduced blood supply, the blood centres adopted strategies to maintain the inventory. Routine requests and inventory were monitored strictly for judicious and rational use of blood and its components., Conclusion: The motivation, dedication and the judicious use of blood products in addition to blood conservation strategies, first-in-first-out policy, maintaining an emergency stock of blood and strict monitoring by blood centre physicians led to the gradual upward trend of blood stocks, and hence blood supply management amid the COVID-19 pandemic could be sustained., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Family Medicine and Primary Care.)

The Health Promoting Lifestyle Profile-II (HPLP-II) is a western-developed questionnaire that assesses 52 health-promoting behaviours (HPB) over six subscales. The purpose of this research was to identify and assess all six components of the Health-Promoting lifestyle Profile among medical and nursing students in central India (AIIMS and Gandhi Medical College, Bhopal). A cross sectional descriptive study was conducted on 619 medical (MBBS/MD/MS) and nursing students of AIIMS and GMC, Bhopal. The online questionnaires were provided to them which consisted of questions from the Health-Promoting Lifestyle Profile II. Health-promoting behaviors differed by gender in MBBS students particularly with respect to Health-Promoting Lifestyle (p=0.009), Health Responsibility (p=0.021), Nutrition (p=0.046) and Physical Activity (p=0.004). Males had significantly higher scores then females. But the difference between males and females was not significant in PG (MD and MS) students. Scores of five out of six scales (except spiritual growth) were found to be higher among nursing students in comparison with medical students (MBBS, MD and MS). These results will raise concerns about lifestyle behaviours and encourage medical and nursing students to evaluate their own health-promoting lifestyles. Physical exercise and diet should be prioritised, particularly for medical students.

Background: The escalating need for blood component due to increasing accidents and surgeries are always challenging for blood banks and hospitals. In this fast and busy world, collecting blood from a healthy and voluntary donor is quite challenging due to time constraints. Many blood donors who wish to donate blood were unable to go to the blood bank because of simultaneous operational timings of the blood bank and office hours of the donors. We dealt with this concern by extending the donation hours and also started collecting blood on the weekends following LAARC (Listen, Acknowledge, Assess, Respond, Confirm) methodology as a pilot project for improving blood donor convenience and satisfaction at the blood bank., Methodology: It was a prospective observational pilot study conducted at the government tertiary care institute in the Department of Transfusion Medicine from December 2018 to June 2019. All blood donations were made as per the guidelines laid down by the Drug and Cosmetic Act. The donation timings were divided as office-hour donations (8 am to 5 pm on weekdays) and off-hours donations (5 pm to 8 pm, weekends and holidays)., Results: In this pilot project, over 7 months out of a total of 1,591 donations, 664 donations (41.73%) were done during the off-hours. The donor experiences were pleasing, and they felt extra cared due to the convenient donation timings., Conclusions: Increasing the donation base needs more donor-friendly timings for the pleasant donation experience without hampering their work. More extensive studies should be conducted to include such strategies for increasing voluntary blood donation., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Leukostasis in acute and chronic leukemias leads to increased cell burden and increased blood viscosity. Therapeutic leukocytapheresis is an automated procedure aimed at white blood cell depletion, and it thereby reduces the complications associated with increased blood viscosity, such as thrombotic events and mortality. In this report, we present the case of a 25-year-old patient with leukostasis and splenic laceration who was treated with therapeutic leukocytapheresis with symptomatic relief in leukostasis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Raghuwanshi et al.)

A case of a 45-year-old male presentation with viral pneumonia with anemia and thrombocytopenia and was admitted to COVID-19 ICU. The blood bank encountered a discrepancy in blood grouping and cross-match, which were subsequently resolved. The patient presented to the emergency room with fever and shortness of breath. He had tachycardia, fever, and had an oxygen saturation of 88% on room air. His SARS-CoV-2 RT-PCR test was positive. Total and unconjugated bilirubin was raised. Due to the anemia and falling haemoglobin, he was not started on any anticoagulation. On investigation, the patient's direct Antiglobulin test was positive. Cold agglutinin titer at 4-degree Celsius was 64. The blood sample showed auto agglutination at collection and discrepancy in blood grouping and cross-matching, which were subsequently resolved. As observed in this case report, COVID-19 infection can be associated with cold agglutinin disease and Autoimmune hemolytic anemia, and cold agglutinins should be recognized as potentially significant due to interference with laboratory investigations and complications associated with COVID 19., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Raghuwanshi et al.)

Background: The transfusions in patients with thalassemia are a double-edged sword as the patients develop complications due to inadequate transfusions and due to multiple transfusions. These complications vary from metabolic complications such as diabetes mellitus and clinical complications such as growth retardation, transfusion-transmitted infections (TTI), and iron overload. We selected Balasore district in Odisha which is a satellite center of AIIMS Bhubaneshwar and has a huge population of hemoglobinopathy patients especially thalassemia and this district in Odisha lags in terms of healthcare and health awareness., Materials and Method: In all, 123 patients with thalassemia major were included in this study for the evaluation of metabolic and clinical complications. Anthropometric measurements such as height and weight with age and gender were used for evaluation of growth parameters as per World Health Organization (WHO) reference data. Children were termed wasted and stunted if the values were below 2 standard deviation of the reference WHO median. Blood samples were collected for TTI status and fasting blood sugar levels., Result: A total of 118 (95.9%) were detected to have under nutrition, 73 (59.3%) of the patients were HCV-positive, and 54 (48.6%) had high fasting blood sugar levels. Based on the HCV status, they were classified as HCV-positive and HCV-negative to compare the anthropometric and growth status in these patients. About 98.6% of the HCV-positive cases were undernutrition and 83.6% were stunted., Conclusion: There is an increasing trend of associated metabolic derangements in patients with thalassemia. The district-level health services have an urgent need for improvement in chelation regimes and screening technologies., Competing Interests: There are no conflicts of interest., (Copyright: © Journal of Family Medicine and Primary Care.)

Context: Hepatitis C virus (HCV) is a potential cause of morbidity and mortality worldwide. It is most commonly transmitted through injecting drug use; the reuse or inadequate sterilization of medical equipment and the transfusion of unscreened blood products. Management of thalassemia requires long-term blood transfusion. Though it improves the overall survival, it carries a definite risk of infection which is expected to be higher in resource limited settings., Aims: To find the percentage of transfusion-transmitted infections (TTIs) in multitransfused patients of thalassemia in Eastern India., Settings and Design: The study was conducted to assess blood safety in rural population in India by measuring the percentage of TTIs including HCV in multitransfused thalassemia patients., Methods and Materials: One hundred and twenty three patients with major beta-thalassemia were enrolled in this study. The blood samples were tested using ELISA technique for all TTIs. HIV fourth generation kits, HbsAg, HCV third generation kits, malaria and syphilis, parbovirus IgM and parbovirus IgG kits, HEV Antigen and IgM antibody were used., Statistical Analysis Used: Proportions and means were calculated for categorical and continuous variables, respectively. Chi-square test was applied and P value of <0.05 was taken as significant., Results: The mean age of patients was 9.5 years ± 5.2 years. Among various TTIs, Hepatitis C and HIV was prevalent among 59.3% and 4.1% of the study participants, respectively., Conclusions: The causes of high prevalence of HCV may be due to donors being usually asymptomatic in early stages, despite being screened for HCV possibly due to missing early window period infections. The screening methodology of TTIs particularly HCV at the district and village level and consequent increased prevalence of HCV in multitransfused rustic population of India shows the extent of blood safety., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Family Medicine and Primary Care.)

Sickle cell trait is a highly prevalent condition. It is not a disease. However, it has been associated with few rare complications. Splenic infarction is one among them. The altitude-related hypoxia is the most common predisposing factor for this. The simultaneous occurrence of this complication in more than one member of a family is so rare that possibly, it is the only second such case report. We encountered this in two members of a family, the father and his son. They were on a religious visit to a 12,756 feet high mountain cave, when they developed pain left upper abdomen. A thorough workup including contrast-enhanced computed tomography abdomen established the diagnosis. Both recovered uneventfully on the conservative management. As it is a rare occurrence, the finding must be interpreted carefully. There is no need to screen the individuals for sickle cell trait before high-altitude travel., Competing Interests: There are no conflicts of interest.

Background and Aims: Excessive requests for cross matching blood which is more than the blood required for transfusion are usually based on worst case assumptions leading to overestimation of blood usage. We investigated the blood ordering pattern and transfusion practices so as to incorporate a blood ordering schedule for streamlining the use of blood in various hospital departments., Methods: The study was conducted over a period of 19 months in a 350 bedded tertiary teaching hospital. Source of data was blood bank requisition forms and blood bank registers of patients who underwent elective or emergency procedures in the hospital, for which blood was ordered. Data were entered in MS Excel and analysed using SPSS version 20., Results: The blood bank was requested to prepare 10,594 units of blood for 2556 patients. The blood utilised was 16.04% of total cross matched blood, leaving 83.9% of units cross matched but not transfused to patient for whom it was prepared, i.e., wasted. The surgery department had the highest number of units cross matched and transfused. The least number of units cross matched and wasted due to non-transfusion were from the Department of Oncology., Conclusion: The current deficiency of explicit maximum blood order schedule in our hospital is the major factor responsible for high cross match: transfusion ratio. Therefore, a maximal surgical blood order schedule has been suggested to the hospital transfusion committee to implement maximum surgical blood order schedules for selected procedures., Competing Interests: There are no conflicts of interest.

Introduction: The factors influencing blood donation decisions are varied and complex and one's attitude can influence this decision., Aim: To find the factors affecting the knowledge and practice of blood donation among college students and their attitude towards the same., Materials and Methods: This cross-sectional study was conducted among 399 college going students using convenience sampling from medical, nursing and engineering colleges in Bhubaneswar city, where blood donation camps were to be held. Data was collected through self-administered questionnaires and, analysed in SPSS Version 20.0., Results: Knowledge regarding blood donation was adequate among 228 (57.1%) of the students and, 221 (55.4%) students had donated blood. Knowledge was significantly better among female students, medical stream and in those whose parents were in non-medical jobs; whereas blood donation had been done significantly more by male, non-medical stream students and by those whose parents were in medical field. Most common reason for donating blood was a sense of social responsibility and most common reason of non-donation was fear of the procedure. An 85% of the students were of the view that they would donate blood if asked. Students suggested that small incentives like certificates and arranging transport for blood donation would make it easier to donate., Conclusion: Just over half of the students had adequate knowledge about blood donation and similar percentage had donated blood. There is this large pool of safe blood in college going students who are willing, but not tapped as source of blood donation.

Non-transfusion-dependent thalassemias (NTDT) encompass a group of hereditary chronic hemolytic anemia, which, as the name indicates, not require regular blood transfusion for survival. These include β-thalassemia intermedia, hemoglobin E/β-thalassemia, and Hemoglobin H disease (α- thalassemia intermedia). Individuals with structural variant of hemoglobin especially Hemoglobin S and Hemoglobin C associated with "α" or "β" thalassemia in heterozygous condition may also present with similar features of NTDT. NTDT patients are not immune to the development of transfusion unrelated complications in the long run. These hereditary chronic hemolytic anemias are still under-recognized in developing countries like India, where the disease burden might be high causing significant morbidity. The pathophysiologic hallmark that characterizes this group of disorders (ineffective erythropoiesis, hemolysis, chronic anemia) leads to a number of serious complications, similar to transfusion dependent thalassemia. So, timely diagnosis and institution of appropriate preventive/remedial measures as well as education of patient population can help decrease the morbidity to a significant extent. In the present review, focus will be on the pathophysiological mechanisms and available management options of NTDT from a developing country perspective like India.

Aim: The aim of this study was to reliably measure and define the normal wave velocity values in a healthy liver by Acoustic radiation force impulse imaging (ARFI) technology in central India., Subjects and Methods: Fifty two healthy volunteers underwent acoustic radiation force impulse imaging tissue quantification and were enrolled in this prospective study. All patients were examined clinically by a clinician and blood samples were drawn and tested for liver function test and viral markers for hepatitis B virus, hepatitis C virus. The healthy volunteers were then examined by a certified sonologist and twenty-four measurements per subject were obtained and evaluations were performed. Statistical comparison of all mean data was performed with Student's t-test was done. A valueof p < 0.05 was considered significant. A comparative analysis was performed, and interclasscorrelation coefficients were calculated., Results: The sonologist obtained 416 measurements. A statistically significant differencewas found between the mean shear wave velocity values in deep of the right lobe of the liver and the values obtained on the surface of the right lobe (1.2vs1.05 m/s) and between the mean values obtained deep in the right lobe and those obtained deep in the left lobe (1.2vs 1.0 m/s). In almost all cases, the shear wave speeds were between 1 and 2 m/s., Conclusion: Acoustic radiation force impulse imaging quantification of hepatic tissue is more reproducible when applied to the deeper portion of the right lobe of the liver.