bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Ophiocephalus striatus sp. Extract on Nitric Oxide in Ischemic Stroke Model
Authors: Nasution Iskandar , Sjahrir Hasan , Ilyas Syafruddin , Ichwan Muhammad
Published: June 2021

BACKGROUND: One of alternative medicine in stroke therapy is Ophiocephalus striatus sp. extract. The nutrients contained in the O. striatus sp. extract, namely amino acids, fatty acids, cuprum, and zinc, are useful for the process of angiogenesis in poststroke patients through increased endothelial nitric oxide synthase.

AIM: We hypothesized that there was an effect of giving O. striatus sp. extract to cerebral angiogenesis process of Sprague Dawley rats ischemic stroke models through the level of NO.

METHODS: This was evidenced by conducting experimental studies on rats ischemic stroke models which were divided into five groups, (a) K (−) group (no ligation, no treatment), (b) K (+) group (ligation, no treatment), (c) P1 group (ligation, 200 mg extract), (d) P2 group (ligation, 400 mg extract), and (e) P3 group (ligation, 800 mg extract). Then blood sample was taken on day 3 to assess levels of NO.

RESULTS: There was increased level of NO in P1 (p = 0.001), P2 (p < 0.001), and P3 (p < 0.001) groups compared to K (+) group. The level of NO increases along with the increasing dose of O. striatus sp. extract. Histological examination revealed that there was formation of new blood vessel in the P1, P2, and P3 groups compared to K (+) group.

CONCLUSION: Our study showed that O. striatus sp. extract improves cerebral angiogenesis in rat models of ischemic stroke.
Parkinson’s Disease and Gene Therapy
Authors: Amin Mustafa Mahmud , Rambe Aldy S. , Ritarwan Kiking
Published: June 2021

Since its introduction for more than a century, Parkinson’s disease has caught attention in the field of neuroscience. From the beginning of understanding its pathogenesis of dopamine pathways, many studies have grown in finding the treatment of the disease. In the beginning, medications showed promise results until each of them had its limitation in treating the disease. Another focus of attention from studies in the last decade was from gene therapy, and early phases of studies have shown some pledging moments for the disease.
Incrédulité et mystification. Réflexions sur Segalen, des Forêts et Puech
Authors: Rabaté Dominique
Published: June 2021

L’imposteur est une figure inversée du romancier, dont il met en abyme les pouvoirs d’affabulation. Mais le jeu se complique quand le rapport à la crédulité et à l’incrédulité vient au centre du récit. J’envisage donc le romanesque au bord du récit , dans la dissociation entre crédulité et incrédulité, quand le romanesque sort du roman tout en se maintenant dans cet espace critique. Je propose ainsi des lectures de René Leys de Segalen, du Bavard de Des Forêts, de l’œuvre de Puech selon un principe de réversibilité, dans un tourniquet entre mystification et démystification.
Déchiffrer, déjouer : figures de l’imposture et pratiques interprétatives
Authors: Mouton-Rovira Estelle
Published: June 2021

Le motif du lecteur dupé ou trompé, bien qu’il appartienne à une tradition ancienne, resurgit dans plusieurs récits contemporains français. Ces figures réflexives, auxquelles s’ajoute la spécificité de dispositifs textuels qui mettent en jeu le geste interprétatif, réinvestissent la relation au lecteur pour interroger ses habitudes critiques et ses pratiques de réception. Un ensemble d’exemples (Éric Chevillard, Arno Bertina, Anne F. Garréta, Christine Montalbetti, Olivia Rosenthal, Pierre Senges) permettront d’explorer ces variations autour de l’imposture qui, par la mise à distance des modèles critiques de l’herméneutique, invitent le lecteur à l’exercice d’une lecture émancipatrice.
Postures et impostures narratives dans Expiation , de Ian McEwan (2001)
Authors: Naugrette Jean-Pierre
Published: June 2021

Souvent considéré comme son chef-d’œuvre, Expiation de Ian McEwan (2001) joue savamment sur des postures narratives qui s’avèrent n’être que des impostures destinées à tromper, mais aussi happer le lecteur dans le labyrinthe métafictionnel d’un passé recomposé, à partir d’un « crime » qui n’a pas eu lieu. Entre 1935 et 1999, Briony Tallis, apprentie romancière, cherche à réparer son tort vis-à-vis de Robbie Turner, faussement accusé de viol. McEwan inclut en abyme dans son roman le roman de Briony, qui devenue auteure à succès, revendique le pouvoir de la fiction à la fois comme réparatrice, consolatrice, mais aussi libre de s’affranchir d’une soi-disant vérité historique impossible à établir.
Chant et engagement littéraire dans Le Balcon de Jean Genet
Authors: Corrado Jean-Christophe
Published: June 2021

L’article s’intéresse aux rapports entre littérature et politique chez Jean Genet tels que ces rapports se dessinent dans Le Balcon . Genet réfléchit à l’efficacité et aux limites d’une certaine littérature politique : la littérature de célébration qui se donne pour tâche de chanter régimes politiques et révolutions. Mettant en place une image héroïsée de ce qu’elle célèbre, cette littérature court le risque de s’autonomiser par rapport à la cause qu’elle prétendait défendre. L’article proposera d’opposer Chantal – figure d’une littérature révolutionnaire qui héroïse la révolte – au Saïd des Paravents – lequel représente non plus une image embellie de la révolution mais une image des humiliations qui rappellent au révolté les raisons de sa révolte.
La France, acteur stratégique ? Un questionnement
Authors: Gautier Louis
Published: June 2021

La France se veut être encore un acteur stratégique de premier rang. Or, les faits démontrent une réelle perte d’influence. La campagne présidentielle de 2022 devrait obliger à une réflexion en profondeur sur notre modèle de défense et sur la définition d’une vraie stratégie pour affronter les défis de demain et non ceux d’hier.
La France et l’Europe face aux crises du XXI e siècle
Authors: Baverez Nicolas
Published: June 2021

L’Europe n’est pas à la hauteur des changements géopolitiques actuels, accélérés par la crise sanitaire. La France, qui maintient malgré tout un effort de défense conséquent, a besoin d’une union plus forte et volontaire qui doit comprendre l’importance de la sécurité, en investissant pour préserver ses libertés.
La France face aux guerres invisibles : à la recherche d’une carte géopolitique et géoéconomique
Authors: Gomart Thomas
Published: June 2021

Dans un monde en pleine évolution géopolitique, les transformations sont devenues complexes et nécessitent une meilleure compréhension des mécanismes à l’œuvre. Cela oblige à disposer d’outils puissants permettant d’analyser la tectonique des plaques stratégiques.
Défis technologiques et compétitivité des entreprises françaises dans l’aéronautique et la défense
Authors: Caine Patrice
Published: June 2021

La défense et en particulier l’aéronautique sont des champs de compétition industrielle intense où l’Europe est confrontée aux États-Unis et à la Chine. Face à cette concurrence, les entreprises françaises et européennes disposent d’atouts évidents, à condition qu’il y ait une réelle volonté politique d’investir pour préparer l’avenir.
Emmanuel Macron, disrupteur stratégique ? Ambitions et réalité
Authors: Kauffmann Sylvie
Published: June 2021

Le président Macron a exprimé, dès le début de son quinquennat, ses ambitions stratégiques pour l’Europe. Avec cependant des difficultés à faire bouger les lignes et bousculer l’inertie européenne. La diplomatie globale ainsi souhaitée nécessite des efforts s’inscrivant dans la durée et avec des moyens conséquents.
Les instruments internationaux de gestion des conflits au défi de la crise sahélienne
Authors: Bagayoko Niagalé
Published: June 2021

Les outils traditionnels de gestion des conflits ont montré leur limite dans la crise sahélienne. Inadaptation, lourdeur administrative, concurrence stérile, autant de difficultés qu’il convient de surmonter par une nouvelle approche. Cela implique que les acteurs africains et leurs partenaires formulent un vrai projet.
Le réveil du « Béarn » ou la montée en puissance de l’A400M
Authors: Caspar-Fille-Lambie Thierry
Published: June 2021

L’escadron « Béarn » a été de tous les théâtres de guerre et d’opération depuis le début de l’aviation de transport militaire. Son réveil d’ici peu, avec la mise en œuvre de l’A400M va lui permettre d’écrire de nouvelles pages avec un avion remarquable dont les capacités ne cessent de monter en performances.
Où en est la « Vision 2030 » saoudienne cinq ans après son lancement ?
Authors: Besancenot Bertrand
Published: June 2021

L’Arabie saoudite a pris conscience de sa mauvaise image de marque et du besoin de réformes. Le prince héritier, Mohammed ben Salmane considère que des progrès ont été réalisés depuis le lancement de son plan « Vision 2030 » il y a cinq ans. Il reste cependant beaucoup de travail à réaliser pour consolider le projet saoudien.
Quelle place pour la lutte informationnelle dans les opérations navales ?
Authors: Saunois Laurent
Published: June 2021

Des exemples récents dans des opérations navales ont montré l’usage de la lutte informationnelle à des fins politiques. Il est nécessaire d’y réfléchir activement et d’intégrer l’utilisation de l’information dans la manœuvre à conduire dès la phase de conception par le commandement.
Histoire militaire
Authors: Franc Claude
Published: June 2021

La guerre d’Indochine a été très pénalisante pour l’Armée de l’air qui devait à la fois entamer une modernisation indispensable pour assurer sa mission au sein de l’Otan afin de défendre le continent européen et soutenir les troupes engagées dans la péninsule indochinoise avec du matériel dépassé et un personnel limité.
Vade in pace . La fortune littéraire et historiographique de la prison monastique du Moyen Âge au XX e siècle
Authors: Lusset Élisabeth
Published: June 2021

Attestés depuis le iv e  siècle, les cachots monastiques destinés à punir les religieux ont longtemps été occultés par les historiens du monachisme. Ils ont néanmoins survécu dans les mémoires à travers leur légende noire, celle du vade in pace ou in pace . Depuis le xv e  siècle, cette locution latine désigne le cachot obscur, souterrain et insalubre dans lequel croupiraient les moines et les moniales fautifs, enfermés à perpétuité. L’article entend retracer quelques-uns des jalons du « grand récit » historiographique forgé à propos de l’ in pace , qui s’est constitué par une sédimentation successive entre le xv e et la fin du xviii e  siècle, avant de se fossiliser au xix e  siècle. Il montre en particulier le rôle décisif du mauriste Jean Mabillon et de ses Réflexions sur les prisons des ordres religieux , parues en 1724, qui confèrent à l’ in pace une épaisseur historique. Il analyse ensuite la manière dont les Lumières, les dramaturges révolutionnaires, les romantiques, la science pénitentiaire et l’historiographie des xix e - xx e  siècles se sont saisis de l’ in pace , symbole du despotisme monastique, et l’ont investi de significations variées et renouvelées.
L’itinérance carcérale durant la guerre d’indépendance algérienne : entre logique de répression étatique et stratégie de résistance individuelle
Authors: André Marc
Published: June 2021

La guerre d’indépendance algérienne s’est déroulée non seulement sur un front militaire, avec l’envoi du contingent et le recours aux appelés, mais aussi sur un front judiciaire. Résultat, en Algérie comme en France, des milliers d’individus, Algériens, Français, hommes, femmes, militaires, civils, ont été envoyés en prison. Au lieu d’examiner la situation dans les établissements pénitentiaires, cet article opte pour une démarche au plus près des trajectoires carcérales. Grâce aux archives de la direction pénitentiaire et notamment du bureau de l’application des peines, des dossiers de détenus et des registres d’écrou, comme à de nombreux entretiens oraux, à la collecte d’archives privées et à la lecture d’autobiographies d’anciens prisonniers, on constate que la prison, parce qu’elle est une peine, est mobile. L’itinérance carcérale conduit en effet les détenus à migrer d’un site à l’autre non seulement en France et en Algérie, mais aussi entre la France et l’Algérie (dans les deux sens). Cette itinérance, qui définit un espace transméditerranéen de répression et de migration forcée, s’explique à la fois par une stratégie de répression coloniale et étatique, dont les racines remontent à la conquête de l’Algérie, mais aussi par des stratégies de résistances et de subversions individuelles. Car, si chaque détenu dessine une cartographie carcérale singulière, le trajet donne la possibilité d’alerter l’opinion sur la situation, la traversée des prisons facilite la comparaison (donc la lutte) pour une uniformisation vers le haut des conditions de détention et, finalement, le transfert permet de piéger l’État à son propre jeu répressif.
Les bénéficiaires du cursus publicus : des privilégiés ?
Authors: Crogiez-Pétrequin Sylvie
Published: June 2021

Le service de transport officiel de l’Empire romain, le cursus publicus , est pendant cinq siècles un service administratif réservé à l’État. Seul un petit nombre de personnes bénéficient de l’autorisation d’en utiliser ses infrastructures. Ces personnes sont-elles des privilégiées ? À partir des sources écrites, inscriptions, textes littéraires ou codes juridiques à notre disposition, on étudiera qui sont les bénéficiaires des voyages effectués dans ce cadre, comment ces voyages sont vécus par les utilisateurs, et enfin quel jugement porte les populations provinciales sur le service de transport et ses bénéficiaires ? Le droit de voyager par le cursus publicus est-il l’expression de la faveur impériale, la marque de l’importance du personnage qui l’utilise ou un instrument de domination et de contrôle du pouvoir politique ?
Hiérarchie sociale et classement des routes. Ce que les itinéraires royaux nous apprennent sur les déplacements au XIV e siècle
Authors: Bove Boris , Costa Laurent
Published: June 2021

L’article croise l’étude statistique et spatiale des itinéraires des rois du xiv e  siècle avec le témoignage des contemporains et les cartes des routes au xvi e - xviii e  siècle pour tenter, à travers la construction de ce référentiel, une sociologie des usages de la route dans le royaume en général, et en Beauvaisis en particulier. On constate alors que la mobilité est inversement proportionnelle au rang social et qu’à rang égal, le rayon d’action des femmes est nettement plus limité que celui des hommes, avec une correction notable à cette règle : les princes et plus encore les princesses en position de maîtriser leur patrimoine sont beaucoup plus mobiles que le roi, qui voyage ponctuellement mais sort peu de sa région de résidence francilienne au quotidien, et la reine ne quitte guère les environs de Paris. Croiser les voyages vers la Flandre avec la hiérarchie des routes permet de confirmer que les contraintes logistiques du roi en voyage le poussent à suivre les mêmes routes que les caravanes marchandes, et au même rythme – quoiqu’il ignore la voie d’eau et soit capable d’accélérations ponctuelles. L’étude sérielle des voyages du sacre permet néanmoins de nuancer cette constatation : si le voyage du sacre suppose un itinéraire stable avec comme étapes Paris, Reims, Corbeny, et dans une moindre mesure Laon et Soissons, son tracé entre ces géosymboles est extrêmement variable et emprunte même régulièrement des chemins non répertoriés sur les cartes modernes. Cette capacité du cortège royal à emprunter des chemins secondaires est confirmée par l’éloignement des étapes royales dans les itinéraires en général : entre la moitié et le tiers des étapes sont en effet situées à plus de 3 km des grands axes de circulation, ce qui suppose non seulement de faire passer des chariots sur des chemins de traverse, mais aussi de loger dans des gîtes médiocres puisque la moitié des étapes se situe dans des lieux uniques et en général obscurs. La sociologie des voies routières proposée par Philippe de Beaumanoir dans ses coutumes du Beauvaisis est donc une rationalisation en partie idéologique des pratiques contemporaines. La variété des routes empruntées par les rois s’explique par l’hétérogénéité des modelés des divers tracés qui composent chaque itinéraire.
Le genre documentaire, une forme partagée d’écriture de l’histoire
Authors: Delage Christian
Published: June 2021

Le genre du film documentaire procède-t‑il d’un partage entre les compétences de la réalisation et celles de l’écriture de l’histoire ? Les expériences inaugurales conduites dans l’Amérique de la Grande Dépression et la France du Front populaire montrent l’importance du collectif ou l’apport de chercheurs individuels dans le processus de réalisation. En France, l’implication du Comité d’histoire de la Seconde Guerre mondiale dans l’écriture du film d’Alain Resnais  Nuit et Brouillard  restera sans suite : la plupart des grands documentaristes travaillent à distance de l’expertise historienne. Si certains historiens ont développé une véritable familiarité avec l’outil audiovisuel, il faut attendre les années 1990 pour voir des chercheurs devenir eux-mêmes réalisateurs, dans un contexte où la création de la chaîne ARTE, en lien avec une politique d’aide à la création conduite par les pouvoirs publics, permet à la France d’ouvrir un espace exigeant de collaboration entre le monde de la recherche et celui de la production de films. Aujourd’hui, le passage, la translation du langage de la connaissance scientifique vers celui du film est devenu un terrain d’expérimentation davantage partagé dans l’écriture de l’histoire.
Recent advances in isolation, identification, and culture of mammalian spermatogonial stem cells
Authors: Xi Hua-Ming , Ren Yi-Jie , Ren Fa , Li Yu , Feng Tian-Yu , Wang Zhi , Du Ye-Qing , Zhang Li-Kun , Hu Jian-Hong
Published: June 2021

Continuous spermatogenesis depends on the self-renewal and differentiation of spermatogonial stem cells (SSCs). SSCs, the only male reproductive stem cells that transmit genetic material to subsequent generations, possess an inherent self-renewal ability, which allows the maintenance of a steady stem cell pool. SSCs eventually differentiate to produce sperm. However, in an in vitro culture system, SSCs can be induced to differentiate into various types of germ cells. Rodent SSCs are well defined, and a culture system has been successfully established for them. In contrast, available information on the biomolecular markers and a culture system for livestock SSCs is limited. This review summarizes the existing knowledge and research progress regarding mammalian SSCs to determine the mammalian spermatogenic process, the biology and niche of SSCs, the isolation and culture systems of SSCs, and the biomolecular markers and identification of SSCs. This information can be used for the effective utilization of SSCs in reproductive technologies for large livestock animals, enhancement of human male fertility, reproductive medicine, and protection of endangered species.
Is it an acute pain transfusion reaction?
Authors: Remakanth Remi , Abhishekh B.
Published: June 2021

A 40-year-old male patient presented to the emergency department with complaints of anasarca, mild dyspnea, orthopnea, vomiting, and decreased urine output. A provisional diagnosis of chronic kidney disease was made and planned for hemodialysis. In view of severe anemia, 1 packed red blood cell (PRBC) was requested and after pretransfusion testing one unit of buffy coat-poor, nonleucofiltered, coombs cross-match compatible, fresh (<7-days old) saline-adenine-glucose-mannitol PRBC unit was issued. After transfusion of around 20 ml of red cells patient developed sudden onset of excruciating pain in the lower back and hip joints, tachypnea, and breathlessness with oxygen saturation dropping to 82%. Vitals were normal and patient remained afebrile. After stopping transfusion, supplemental oxygen and opioid analgesic were given. Once the symptoms subsided, transfusion was completed. A complete work-up was done to rule out other adverse reactions. Thus, this patient experienced what is known as an acute pain transfusion reaction.
A case report of multiple Rh alloantibodies in a pregnant female
Authors: Setya Divya , Tiwari Aseem K. , Arora Dinesh , Mehta Swati Pabbi , Aggarwal Geet
Published: June 2021

Anti-G antibody mimics the reactivity pattern of coexistent anti-D and anti-C. Differentiating between the two is significant in antenatal females where the decision to administer RhD prophylaxis is based on the presence or absence of anti-D antibody. The aim of reporting this serological challenge is to emphasize the need for phenotyping red cells for sourcing appropriate in house red cell reagents and to help transfusion services sharpen problem-solving skills. A 26-year-old pregnant female with a complicated obstetric history and a positive indirect antiglobulin test presented to the hospital for antenatal assessment at 24 weeks. A positive antibody screen warranted identification of the implicating antibodies. Since identification was suggestive of multiple alloantibodies whose specificities could not be confirmed, step-wise sequential adsorption and elution was required. Anti-D, anti-C, and anti-E antibodies were identified in patient plasma with titers of 1024, 4, and 32, respectively. The absence of anti-G was also confirmed. Multiple alloantibodies can pose a challenge to transfusion services. However, with the help of select cells, phenotyping, adsorption elution studies, and phenotyped donor units; solving complex serological cases can be accomplished.
Postdonation information during dengue outbreaks at a single blood center in Brazil
Authors: Costa-Lima Carolina , Benites Bruno Deltreggia , Rocha Daniele Ramos , Andrade Elisabete , Alvarez Patricia , Magnus Mariana Munari , Addas-Carvalho Marcelo
Published: June 2021

BACKGROUND:

Brazilian blood banks encourage donors to report postdonation information (PDI) regarding conditions that would lead to deferral in an attempt to retrieve distributed nonconforming blood.

OBJECTIVES:

This study evaluated the profile of donors reporting PDI, the impact on transfusion safety, and the possible impact on the discard of blood products.

SUBJECTS AND METHODS:

We analyzed 115 consecutive PDIs between May 2014 and July 2015, a period comprising two dengue-like syndrome (DLS) outbreaks.

RESULTS:

These PDIs accounted for 87,780 blood donations. The average time for PDIs since donation was 4 (0–23) days and 190 blood components were discarded. DLS accounted for 21.7% of the PDIs analyzed; 11 of the 23 samples tested were nucleic acid test (NAT) positive for dengue and 2 positive for Zika virus (ZIKV). Six of these PDIs were reported after blood components have been transfused: After NAT testing, one of these recipients was diagnosed with dengue and another one with ZIKV infection, both possible transfusions transmitted but without clinical consequences.

CONCLUSION:

The high number of recovered blood components due to PDI suggests that PDI remains a great ally in the fight against transfusion-transmitted infections and may be particularly useful during outbreaks of emerging potentially blood-borne pathogens.
Evaluation of the confidential unit exclusion on Iranian blood donors
Authors: Ameli Mohammad Reza , Hosseini Seyed Hossein , Rad Fariba , Sajjadi Seyed Mehdi
Published: June 2021

BACKGROUND:

Confidential unit exclusion (CUE) was recommended by the Food and Drug Administration to permit blood donors confidentially exclude their donation for transfusion. However, its effectiveness as a safety measure to the blood supply is debated.

AIMS:

We, therefore, evaluated its benefit in identifying donors at risk of transmitting transfusion-transmissible infections (TTIs) and increasing blood safety in our population.

SETTINGS AND DESIGN:

This was a cross-sectional and retrospective study. The study was performed at the South Khorasan Blood Transfusion Center.

MATERIALS AND METHODS:

In this descriptive and retrospective study, data of CUE use and data of confirmed positive TTI markers were analyzed for the study period 2006–2016.

STATISTICAL ANALYSIS:

Data were analyzed using SPSS software version 16.

RESULTS:

Out of 165,267 donations, the CUE option was selected by 493 (0.3%) donors, most frequently by first-time blood donors, by men, by donors with <12 years schooling, and by 18–24-year-old donors. The data revealed that donations from CUE donors had no higher infection rates. Moreover, CUE showed low sensitivity (0.6%) and low positive predictive value (0.6%) in detecting TTI markers.

CONCLUSION:

The data do not provide any indication of a safety advantage from CUE; thus, we recommend that the procedure of CUE can be discontinued.
National blood donor vigilance programme of India
Authors: Bisht Akanksha , Marwaha Neelam , Arora Satyam , Patidar Gopal K. , Chhabra Reba
Published: June 2021

INTRODUCTION:

The donor vigilance program is intended to collect and assess information on unexpected or undesirable effects or reactions resulting from blood donation. In this report, we discuss the analysis of the blood donor adverse reactions (DARs) reported in the National Blood Donor Vigilance Programme of India during the first 2 years of implementation.

MATERIALS AND METHODS:

DAR reporting form prepared and approved by the National Executive Committee of the Haemovigilance Programme of India was used to capture the data by the blood centers and submitted to Donor-Vigil software prepared and hosted by the official website of the National Institute of Biologicals. Data reported for the years 2016 and 2017 were reviewed, analyzed, and validated by independent transfusion medicine experts.

RESULTS:

During this period, a total of 19,98,101 donations denominator data were reported, in which 1,622,600 (80.9%) were valid. A total of 6091 DARs were reported, out of which 3980 (65.35%) were found valid. Only validated numerator and denominator data were included in the analysis. Generalized DARs were the most common type of DARs reported (83.7%), followed by “others” type (7.7%), localized (7.6%), allergic (0.4%), and complications related to apheresis (0.4%). The overall DAR rate was 2.45/1000 blood donations, which was higher in apheresis donations (3.07/1000) as compared to whole blood donations (2.39/1000). The DARs rates were higher in females (3.5/1000) compared to male donors (2.3/1000) and in the first time (2.5/1000) compared to repeat donors (2.15/1000).

CONCLUSION:

In this report, we concluded that younger age, first time, and female donors are more prone to DARs as compared to older age, repeat, and male donors. During the analysis of the data, we found some limitations, which can be improved by upgrading the reporting form and conducting regular continuing medical education (CMEs) of participant blood centers.
Prevalance of Anti-HLA antibodies in parous female blood donors
Authors: Priyadarsini Arcot Jayachandran , Dhawan Hari Krishan , Sharma Ratti Ram , Saikia Biman , Minz Ranjana W.
Published: June 2021

BACKGROUND:

Various studies have implicated that plasma causing transfusion-related acute lung injury is from alloimmunized females. The frequency of sensitization to human leukocyte antigen (HLA) was found to correlate with their parity score. No literature on the prevalence of anti-HLA antibodies in Indian blood donors is available to date. Hence, this pilot study was done to know the frequency of HLA alloimmunization in Indian blood donors.

MATERIALS AND METHODS:

A total of 192 consenting voluntary blood donors from blood donation camps were enrolled in the study. Test group: Parous female donors (n = 96) and control group: Nulliparous female donors (n = 48) and male donors (n = 48). HLA alloimmunization was tested on the Luminex platform by screening assay to detect IgG antibodies to HLA Class I and II molecules of human origin. A mean fluoresence index of more than 2000 was considered as a positive reaction, considering the high sensitivity of Luminex assay.

RESULTS:

Sixty-three out of 192 donors (32.8%) tested positive for anti-HLA antibodies, out of which 23 donors were in the control group (23.9%), and 40 donors were in the test group (41.7%); P = 0.002. On gender-based comparison, 9 out of 48 male donors (18.7%), as compared to 54 out of 144 female donors (37.5%), tested positive for HLA antibodies (P = 0.02). Based on an increase in parity score, the frequency of HLA alloimmunization was found to be significantly correlated (P = 0.002). A decrease in the trend of HLA alloimmunization was observed as the duration from the last pregnancy increased. A higher frequency of HLA alloimmunization was observed in female donors with a history of transfusion and bad obstetric history.

CONCLUSION:

The present study substantiates that plasma from parous female donors has a higher chance of containing anti-HLA antibodies as compared to nulliparous female and male donors.
Implementation of internal quality control program for monitoring of enzyme-linked immunosorbent assay performance at a blood center
Authors: Dubey Anju , Sonker Atul
Published: June 2021

BACKGROUND:

Internal quality control (IQC) samples may be incorporated in enzyme-linked immunosorbent assay (ELISA) routinely for detection of errors occurring due to change in environmental conditions, test system, or operator performance. We have described methodology for preparation of IQC samples, monitoring of results using Levey–Jennings (LJ) charts and their interpretation. We have also described our experience of quality control in ELISA using IQC samples, identification of errors and corrections applied.

MATERIALS AND METHODS:

IQC samples for anti-HIV, hepatitis B surface antigen (HBsAg), and anti-HCV ELISA were prepared “in-house” using standard methodology. After validation of run, E-ratio of IQC sample was calculated and plotted on LJ chart. Further interpretation was done to detect the errors. LJ charts illustrating the performance of IQC samples on 180 runs for each ELISA were drawn and analyzed.

RESULTS:

For anti-HIV ELISA, violation of warning rule was found in 2 runs (1.11%). Only one run (0.55%) was rejected due to violation of rejection rule. For HBsAg ELISA, violation of warning rule was indicated in two runs (1.11%). Two runs (1.11%) were rejected due to violation of rejection rules. For anti-HCV ELISA, violation of warning rule was indicated in two runs (1.11%), whereas two runs were rejected due to violation of rejection rules. Comprehensive checks were performed for the evaluation of equipment calibration, handling, and storage temperature of reagents and operator's technique. A thorough investigation was undertaken according to the type of error.

CONCLUSION:

Inclusion of IQC with each ELISA run is valuable to check the assay performance, ensuring reliability and reproducibility of test results.
Role of therapeutic plasma exchange in acute humoral rejection patients undergoing live-related renal transplantation
Authors: Kakkar Brinda , Makroo Raj Nath , Agrawal Soma , Chowdhry Mohit , Nayak Sweta , Jasuja Sanjiv , Sagar Gaurav , Guleria Sandeep
Published: June 2021

BACKGROUND AND AIM:

Renal transplantation (RT) is the most successful and ideal renal replacement therapy for end-stage renal disease patients. Renal allograft rejection has always been one of the major barriers in successful RT. Our aim was to report the role of therapeutic plasma exchange (TPE) in acute humoral rejection (AHR) patients who underwent live-related RT (LRRT) and their renal allograft outcome at our center.

MATERIALS AND METHODS:

A prospective observational study was conducted from July 1, 2014, to December 31, 2016. Patients with biopsy-proven AHR and treated with TPE along with other lines of treatment after undergoing LRRT were included in the study. ABO-incompatible individuals, pediatric patients, and patients undergoing second transplants were excluded from the study. Clinical history, donor and graft details, management, and patient and graft survival were noted.

RESULTS:

Of the 1608 patients who underwent LRRT, 49 (37 males, 76%; 12 females, 24%; mean age 39.5 ± 13.3 years) had biopsy-proven AHR (3.04%) and were treated with TPE. A total of 281 TPEs were performed with an average of 5.7 TPE/patient (range 2–12). Of the 49 patients, 38 patients (78%) with favorable response underwent 213 (75.8%) TPEs (average of 5.6 TPE/patient; range: 2–12), whereas 11 patients (22%) with unfavorable response underwent 68 (24.2%) TPEs (average of 6.2 TPE/patient; range: 3–8). Blood urea (P = 0.012) and serum creatinine (P = 0.038) levels at the time of rejection were significant predictors of response to TPE therapy. The average length of stay in our study population was 33 ± 22 days. Six months posttransplant, the patient and graft survival were 93.3% and 89.5%, whereas at 12 months, they were 89.3% and 81.5%, respectively.

CONCLUSION:

TPE is a safe and effective adjunct therapy for treating AHR patients.
A novel observation on grouping anomaly
Authors: Joshi Sanmukh R. , Kanani Ashish N. , Senjaliya Snehal B. , Rajapara Manisha M.
Published: June 2021

BACKGROUND:

Discrepancy in “forward/reverse” grouping leads to confusion in assigning ABO group to a person. It could be genetic in nature and classified according to the presence/absent of antigen on red blood cell (RBC) vis-a-vis corresponding alloantibody in plasma.

AIM:

The aim of the study was to investigate the grouping anomaly found in a recently delivered woman who required transfusion.

MATERIALS AND METHODS:

A standard protocol for investigation was followed.

RESULTS:

A 27-year-old female, gravida 4, para 3, was grouped O on forward grouping, but her serum did not agglutinate Group B RBCs tested. Absorption-elution study gave an active eluate from her sensitized RBCs with anti-B or anti-A+B. Saliva showed H, but no B antigens indicating to her Bel phenotype. However, 2-week latter in the follow-up study, her serum revealed a presence of complement binding high titer anti-B. The problem of missing anti-B on the previous occasion was attributed to hemagglutination inhibition caused by accumulated complement macromolecules on RBCs that gave rise to physical hindrance in the formation hemagglutination clumps.

CONCLUSION:

The unusual case of erroneous reversed grouping was attributed to complement-mediated hemagglutination inhibition. The positive eluate obtained from sensitized RBCs of the mother was considered to be due to a contamination of fetal RBCs in maternal circulation entered during her postpartum phase of pregnancy. It could also be due to a conversion of H to B antigen no matter in trace amount by the fetal B group-specific transferase percolated into maternal circulation.
Red cell alloimmunization among antenatal women attending tertiary care center in Jamnagar, Gujarat, India
Authors: Dholakiya Spruha Kashyap , Bharadva Sumit , Vachhani Jitendra H. , Upadhyay B. Shweta
Published: June 2021

BACKGROUND:

The following study was conducted to measure the presence of alloantibodies of Rh and other blood group antigens produced due to fetomaternal hemorrhage in all antenatal women as well as those leading to hemolytic disease of fetus and newborn; presenting to a tertiary care center, G.G. Government Hospital, Jamnagar, Gujarat, India, between April 2014 and March 2016 (2 years).

MATERIALS AND METHODS:

All multiparous women irrespective of their period of gestation or obstetrics history were included whereas those having taken anti-D immunoprophylaxis or with a history of blood transfusion were excluded. Antibody screening and identification were done using Bio-Rad ID microtyping system.

RESULTS:

Out of total 8920 multigravida females, 8488 were D-antigen positive whereas 432 were D-antigen negative. A total of 126 antibodies among 117 females (1.31%) were found; out of them, 33 were found in D-antigen positive females (0.39%) and 84 in D-antigen negative ones (19.44%) looking at overall frequency of other antibodies such as anti-C: 9, anti-c: 9, anti-E: 13, anti-Cw: 1, anti-M: 5, anti-S: 8, anti-Fya: 3, and anti-D: 78; it was found that anti-D is the most common.

CONCLUSION:

The rate of alloimmunization in D-antigen negative women was found to be very high as compared to other studies in western region; hence, strict follow-up of immunoprophylaxis of all Rh D-negative women needs to be taken care of. Apart from this, D-antigen-positive women also show alloimmunization against various antigens giving the prevalence of 0.39%; hence, it should be mandatory that there should be one standard universal protocol for screening of all antenatal women.
Just not cosmesis! Role of low-density lipoprotein apheresis in familial hypercholesterolemia
Authors: Kaur Daljit , Negi Gita , Walia Rohit , Malhotra Sheetal , Bhatia Riti , Meinia Sushant K. , Mandal Saikat , Jain Ashish
Published: June 2021

Familial hypercholesterolemia (FH) is characterized by an increase in plasma low-density lipoprotein-cholesterol (LDL-C) levels. It presents with tendon/skin xanthomas and premature atherosclerotic cardiovascular disease. The most available treatment options for FH are lipid-lowering medications such as statins, lifestyle modification, and LDL apheresis. As per American Society for Apheresis guidelines 2019, the treatment of FH using LDL apheresis falls under Category I. Here, we are reporting an interesting case of a young patient who presented with chief complaints of progressively increasing yellowish lesions around eyes, neck, hands, and legs. She was thoroughly investigated and was diagnosed provisionally as a case of Type 2 FH. Her total serum cholesterol and LDL-C were 717.2 mg/dl and 690.6 mg/dl, respectively, at presentation. One cycle of LDL apheresis was planned for her. We found immediate post-procedural reduction of 55.8% and 55.3% for total serum and LDL cholesterol levels respectively while 70.58% and 77.41% reduction in the levels from the day of presentation to the hospital.
Extent of transfusion support in a developing country in managing a bleeding acute myeloid leukemia patient with platelet transfusion refractoriness
Authors: Chellaiya Gayathiri K. , Nair Chandran K. , Raghavan Vineetha , Pandian R. Jesu , Vinod Roshan , Murugesan Mohandoss
Published: June 2021

Conventional platelet transfusion may not be adequate to deal with platelet transfusion refractoriness (PTR), and therefore human leukocyte antigen (HLA) or human platelet antigen (HPA) matched and platelet crossmatch compatible units are recommended. However, in developing countries, finding a unit that is HLA or HPA matched or platelet crossmatch poses a challenge. Hence, easier and cost-effective alternatives such as massive platelet transfusion and continuous platelet transfusion were attempted to manage bleeding in PTR. A 31-year-old male presented with acute myeloid leukemia relapse and chloroma in bladder underwent FLAG salvage chemotherapy. Despite almost daily platelet transfusion with single donor platelets (SDPs), patient presented with hematuria and low corrected count increment at 1 h and 24 h suggesting both immune and nonimmune refractoriness to platelet transfusion. The patient received SDP transfusion twice daily from day 19 to day 21 to maintain hemostasis. The patient had persistent hematuria, so massive platelet transfusion in the form of double adult doses of SDP given every 12th hourly for three events. Despite these measures, there was persistent hematuria and refractoriness to platelet transfusion. As HLA or HPA matched or crossmatch compatible platelets were unavailable, continuous platelet transfusion was started for this patient from day 23 to day 28. After 4 days of continuous platelet transfusion, hematuria subsided. In resource-constrained clinical settings, continuous platelet transfusion can be an effective alternative to HLA/HPA-matched platelets in the management of PTR.
Evaluation of quality matrix when practice changed from triple bags to quadruple (top and bottom) bags
Authors: Bhardwaj Gunjan , Tiwari Aseem Kumar , Aggarwal Geet , Pabbi Swati , Sharma Jyoti , Luthra Aanchal , Upadhyay Anand
Published: June 2021

BACKGROUND:

As a part of continuous quality initiatives, while moving from triple bags to quadruple bags, we undertook a study to compare platelet-rich plasma (PRP) and buffy-coat (BC) methods with respect to all blood components (red blood cells [RBCs], random donor platelet concentrate [RDPC], and fresh frozen plasma [FFP]) prepared by PRP and BC methods.

MATERIALS AND METHODS:

It was a prospective analysis of different physical and quality parameters of RDPC, RBC, and FFP prepared out of 100 whole blood (WB) donations. Of these, 50 WB units were processed by PRP method using Triple bags and 50 WB units by BC method, using quadruple (top and bottom) bags, with an attached integral filter.

RESULTS:

RBC prepared by BC method had higher hematocrit (61.3 ± 1.91% vs. 56.03 ± 3.37%; P < 0.05) and lower white blood cell (WBC) contamination (6.3 × 104 ± 6.1 vs. 5.41 × 105 ± 2.5; P < 0.05) in comparison to prepared by PRP method. Higher PLT yield (7.67 × 1010 ± 1.8 vs. 6.47 × 1010 ± 1.5; P < 0.05) and lower WBC count (8.24 × 103 ± 1.1 vs. 1.5 × 104 ± 2.1; P < 0.05) was observed in RDPC prepared by BC method than PRP derived. CD62P expression was lower in RDPC prepared by BC method (31.46 ± 9.7%; P < 0.05) as compared to PRP method (43.35 ± 12.5%; P < 0.05). The BC method also resulted in increased plasma yield (210.56 ± 18.54 ml vs. 187.92 ± 12.93 ml; P < 0.05) in FFP in comparison to PRP method.

CONCLUSION:

The blood components produced from WB by the BC method have laboratory variables suggestive of superior quality than those produced by the PRP method.
A rare case of antibody against enhancement media interfering with crossmatching
Authors: Anuragaa S. , Sahoo Dibyajyoti , Abhishekh B. , Nair Revathy
Published: June 2021

Detection of clinically significant alloantibodies during pretransfusion testing is essential before any blood transfusion. Sometimes, clinically insignificant antibodies unrelated to blood group antigen may interfere with routine testing. Their interpretation is often made only after tedious immunohematology workup resulting in the exclusion of all possible clinically significant antibodies. We encountered such incidence which interfered with crossmatching. In our case, direct antiglobulin test was negative, indirect antiglobulin test and autocontrol were positive with pan-reactive antibody screening test, and group-specific units were incompatible. After meticulous workup, we could find that these antibodies were directed against the enhancement media, low-ionic strength solution in this case.
Co-Inheritance of α-Thalassemia Gene Mutation in Patients with Sickle Cell Disease
Authors: Ali Al-Barazanchi ZA , Abdulateef SS , Hassan Meaad Kadhum
Published: June 2021

Background:

Sickle cell disease (SCD) is a monogenic, phenotypically highly variable disease with multisystem pathology. The phenotypic heterogeneity of SCD is attributed to environmental and genetic factors such as fetal hemoglobin and co-inheritance of α-thalassemia.

Objectives:

To look for different types of α-thalassemia gene mutations among SCD patients and evaluate the influence of the co-inheritance of α-thalassemia on clinical and hematological variables.

Methods:

This cross-sectional analytical study included 765 SCD patients, and 150 patients (with low mean corpuscular volume (MCV), low mean corpuscular hemoglobin (MCH) and normal serum ferritin levels) were tested for α-thalassemia gene mutations. Multiplex PCR and reverse hybridization and sequencing for both α genes using the Vienna Lab Strip Assay PCR study were performed using conventional PCR technology.

Results:

Out of 150 patients tested for α-thalassemia gene mutations, 141 patients were found to have one or more of the mutational types, representing 18.4% of all studied SCD patients. The most common mutations found were the -3.7 deletion (76.6%), followed by the -4.2 deletion (12.1%), mutant α2polyA-1 (Saudi type) (9.2%), and --MED double gene deletion (7.8%). Acute painful episodes did not differ significantly in sickle cell anemia (SCA) patients with or without α-thalassemia, although the co-inheritance of α-thalassemia has a protective role against many disease-related complications. However, this role was not observed with other types of SCD. The means of red blood cell count, hemoglobin, and hematocrit were significantly higher, while the MCV, MCH, reticulocyte count, and hemoglobin A2 percentage were significantly lower in patients with α-thalassemia gene mutations than in those without α-thalassemia gene mutations (P < 0.05).

Conclusions:

The co-inheritance of α-thalassemia and SCA confers protection against many disease-related complications and is associated with improved hematological indices. However, this protection was not noticed in patients with other types of SCD.
The Efficacy of Magnesium Sulphate as an Adjunct to Local Anaesthetics for Perineal Pain Relief After Episiotomy
Authors: Garba JA , Shehu CE , Nwobodo EI , Panti AA , Tunau KA , Sulaiman B , Kadas SA , Onwudiegwu U , Aboyeji AP
Published: June 2021

Background:

Episiotomy is a deliberate surgical incision of the perineum with the aim of increasing the vulval outlet to facilitate childbirth. However, it could be associated with some complications, such as pain, hemorrhage, and wound infection. It is a surgical procedure that requires adherence to basic surgical principles of providing adequate analgesia.

Aim:

To determine the efficacy of magnesium sulphate (MgSO4) as an adjunct to local anesthetics for analgesia during episiotomy repair among women that had vaginal delivery at Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto, Nigeria.

Subject and Methods:

This was a single-blind randomized clinical trial. Pregnant women who had episiotomy during the study period were randomized into two groups. Those in Group A had xylocaine administered alone, whereas those in Group B had xylocaine + MgSO4 administered for repair of episiotomy. Pain was assessed by numeric rating scale at commencement of the repair, at 2 and 6 h after the repair. Patient's level of satisfaction, request for additional analgesia, and side effects were also assessed.

Results:

The pain score in the xylocaine + MgSO4 group was lower throughout the period of assessment. There was no significant difference in the pain scores between the two groups at 0 and 6 h. However, there was significant difference in the mean pain scores between the two groups at 2 h (P < 0.001). There was no significant difference in the level of satisfaction, request for additional analgesia, and side effects between the two groups.

Conclusion:

Both xylocaine alone and xylocaine with MgSO4 provide adequate perineal pain relief during episiotomy repair. MgSO4 improves the analgesic effect of xylocaine at 2 h after episiotomy repair without any significant side effect.