bluuebunny/crossref_metadata_2025 huggingface dataset:
Reexamining low rank matrix factorization for trace norm regularization
Authors: Ciliberto Carlo , Pontil Massimiliano , Stamos Dimitrios
Published: September 2022

Trace norm regularization is a widely used approach for learning low rank matrices. A standard optimization strategy is based on formulating the problem as one of low rank matrix factorization which, however, leads to a non-convex problem. In practice this approach works well, and it is often computationally faster than standard convex solvers such as proximal gradient methods. Nevertheless, it is not guaranteed to converge to a global optimum, and the optimization can be trapped at poor stationary points. In this paper we show that it is possible to characterize all critical points of the non-convex problem. This allows us to provide an efficient criterion to determine whether a critical point is also a global minimizer. Our analysis suggests an iterative meta-algorithm that dynamically expands the parameter space and allows the optimization to escape any non-global critical point, thereby converging to a global minimizer. The algorithm can be applied to problems such as matrix completion or multitask learning, and our analysis holds for any random initialization of the factor matrices. Finally, we confirm the good performance of the algorithm on synthetic and real datasets.
Hrvaščina in angleščina v besedilih oglasnih sporočil
Authors: Bautović Mirjana , Omrčen Darija
Published: September 2022

Na vzorcu 173 anketirancev (72 moških in 101 ženska), starih od 20 do več kot 60 let, iz Republike Hrvaške smo želeli ugotoviti, ali razumejo besedila oglasnih sporočil na jumbo plakatih in panojih, ki so pisana v celoti angleško ali pa kot kombinacija hrvaščine in angleščine. Statistično pomembne razlike med moškimi in ženskami niso zaznane, v posameznostih pa so ugotovljene razlike med starostnimi skupinami.
Pourquoi et comment Proclus commentait-il Euclide ?
Authors: Bernard Alain
Published: September 2022

Je m’intéresse dans cet article au Commentaire de Proclus de Lycie au premier livre des Éléments d’Euclide. J’en propose une interprétation qui tient compte du contexte dans lequel il a été écrit et que j’introduis en deux étapes. Dans un premier temps, je montre que cette lecture contextuelle a été le plus souvent éludée par les historiens et ceci non par négligence, mais parce qu’ils ont suivi une philosophie de l’histoire dont les origines remontent en dernier ressort à la tradition du néoplatonisme tardif à laquelle Proclus appartient. Dans un second temps, je propose à partir de quelques extraits du Commentaire1 une ébauche d’interprétation qui prend en compte l’arrière-plan scolaire dans lequel il a été conçu. Je montre en particulier que pour comprendre l’influence du texte de Proclus sur ses lecteurs et donc son importance historique, il est essentiel de tenir compte de la dimension rhétorique sous-jacente à la méthode d’exégèse à la fois suivie et explicitée par Proclus et son entourage dans leur travail de commentaire.
La réception du darwinisme en France. Un cas exemplaire : Darwin et de Quatrefage
Authors: Laurent Goulven
Published: September 2022

Le darwinisme n’a pas été accepté en France aussi facilement qu’il l’a été dans d’autres pays. On s’est posé la question de savoir la raison de ce retard. Le cas d’Armand de Quatrefages est exemplaire dans une telle recherche. Protestant libéral, d’une grande ouverture d’esprit, comme le reconnaissait Darwin, il avait une grande admiration pour le savant anglais. Il est resté cependant très critique à l’égard de ses idées, pour des raisons épistémologiques qu’il a nettement et courtoisement exposées.
Les paradoxes de la relativité
Authors: Bidal Sylviane
Published: September 2022

Par la lecture des principales questions soulevées et les réponses apportées par les deux paradoxes les plus connus issus de la théorie de la relativité, nous nous proposons, dans ce qui suit, de répondre à la question suivante. Le paradoxe des jumeaux et le paradoxe d’Ehrenfest mettent-ils en valeur, comme c’était leur vocation première, une contradiction entre les conséquences immédiates de la théorie de la relativité et le principe de relativité ?
Malakoplakia of the urinary bladder: A review of the literature
Authors: Polisini Giordano , Delle Fave Rocco Francesco , Capretti Camilla , Marronaro Angelo , Costa Alessia Mariagrazia , Quaresima Luigi , Mazzaferro Daniele , Galosi Andrea Benedetto
Published: September 2022

Objective: The aim of the study is to make a review of the literature about bladder malakoplakia. Material and Methods: We searched articles on the PUBMED web-literature database with the following keywords: “vesical malakoplakia” and “bladder malakoplakia”. In the literature we found 254 articles. At final we have excluded 219 articles, including in our study only 35 articles. Results: The overall average age found was 50.85 years. The average age of men was 43.22 years, while that of women was 53.37 years. 75% of the patient cases were women and 25% were men. Regarding comorbidities, in 5.55% of the cases were missing whereas 47.22% of the patients suffered from recurrent urinary tract infection (UTI) and 19.44% from immune system disorders. Urine culture was positive in 69.44% with E.coli being isolated in 92% of cases. Hydroureteronephrosis was present in 44.44% of the cases: left in 6.25% of cases, right in 18.75% and bilateral in 75%. The mean serum creatinine of patients with hydroureteronephrosis was 5.11 (1-21) mg/dl. The most frequent site of the lesion was the vesicoureteral junction (VUJ) (42.31%), followed by the trigone (38.46%). 30.56% of patients were treated with antibiotic and surgery (transurethral resection of bladder, partial or radical cystectomy), less frequent options were antibiotics alone and surgery alone. The recurrence rate was 15%.Conclusions: Malakoplakia is a disorder usually related to other affections, like UTI and immunodepression, and it seem to be caused by an abnormal macrophage function. In almost half of the described cases of isolated bladder malakoplakia, hydroureteronephrosis and renal failure were present.Treatment is not standardized, but both medical and surgical therapies are effective to avoid recurrence.
Generazione trap. Nuova musica per nuovi adolescenti
Authors: Buffagni Federico , Santi Sara
Published: September 2022

Non disponibile
Commento al caso clinico: Lilia
Authors: Milanesi Paolo
Published: September 2022

Non disponibile
Commento al caso clinico: Lilia
Authors: Bertoli Silvia
Published: September 2022

Non disponibile
Recurrent Inguinal Hernia Containing the Urinary Bladder
Authors: Ogbetere Friday Emeakpor , Imoisili Udoka
Published: September 2022

Inguinal bladder hernia (IBH) is an extremely rare occurrence and remains a challenge to the surgeon in the preoperative, intraoperative, and in the postoperative period. Its diagnosis requires a high index of suspicion, especially in the high-risk patients: elderly overweight/obese males with a recurrent hernia and lower urinary tract symptoms. Here, we report the case of a 78-year-old overweight male who presented with a bilateral direct inguinal hernia with the right being recurrent and irreducible. The diagnosis of IBH was made incidentally during the hernia repair. The patient was managed successfully by the replacement of the bladder in the pelvic position and inguinal herniorrhaphy done using the modified Bassini technique. The left groin hernia was also repaired using the modified Bassini technique. Our goal here is to reawaken the consciousness of the surgeons involved in inguinal hernia repair about IBH, particularly in high-risk patients.
Role of Dietary Habits and Personal Hygiene on Nutritional Status of School-Going Adolescents
Authors: Khan Mubashshera Firdous , Banerjee Sitikantha , Bandyopadhyay Kajari , Kalaiselvi S. , Akkilgunata Sujiv , Tripathy Jaya , Solanki Ranjan , Kushwaha Arvind Singh , Deshmukh Pradeep
Published: September 2022

Purpose:

Adolescence is a nutritionally vulnerable time when rapid physical growth increases nutrient demand. Addressing the nutrition needs of adolescents could be an important step toward breaking the vicious cycle of intergenerational malnutrition. Under the healthy school initiative, a baseline assessment was carried out to assess the nutritional status, dietary habits, and personal hygiene of school-going adolescents to plan the future interventions at school level.

Materials and Methods:

A cross-sectional study was conducted in two government-aided schools for 6 months among 814 students of Class VI–IX to assess their dietary habits and personal hygiene by using the GSHS (Global School based student Health Survey) -2007(Indian version) tool. Anthropometric measurement was taken by standard technique.

Results:

The study found the proportion of thinness, stunting, and overweight/obesity as 40%, 20%, and 4.2%, respectively. Male students were found more thin (61.1% vs. 38.8%) and stunted (55.6% vs. 44.4%) as compared to female students. Less than one-fourth (13.7%) of the students reported <5 servings of fruits and vegetables. In multivariable analysis, male students, children of homemaker mother, skipping breakfast on all days of week, consumption of fast food ≥3 times/week, consumption of high sugary ready to use food, and infrequent handwashing after toilet were found to be predictors of thinness.

Conclusion:

Dietary habits and personnel hygiene were found to be important factors of undernutrition; promoting health behavior through school health policy with involvement of teachers, students, and parents is highly recommended to reduce the problem of undernutrition among adolescents.
An In vitro Evaluation of Effect of Implant Abutment on Human Gingival Epithelial Keratinocytes
Authors: Bagchi Paulami , Alfawzan Ahmed Ali , Magar Swaroopkumar M , Priya Ritu , Kochhar Anuraj Singh , Agrawal Sneh , AlMutairi Faris Jaser
Published: September 2022

Background:

Abutment surfaces are being designed to promote gingival soft tissue attachment and integration. This confirms implant survival for long term by forming a seal around the prosthetics.

Objectives:

This study was done to compare the biocompatibility of three implant abutments: titanium uncoated, Ti-nitride coated, and modified polyetheretherketone (PEEK) with human gingival keratinocytes.

Materials and Methods:

The titanium-uncoated, titanium-nitride-coated, and modified PEEK discs (13 mm × 3 mm) were fabricated and compared with uncoated polyester cell culture discs, which were used as controls. These three implant abutments were evaluated for biocompatibility with respect to human gingival keratinocytes for viability, morphology, proliferation, and migration by scanning electron microscopy imaging and scratch wound healing assays. Measurements of roughness show changes between the investigated surfaces.

Results:

Keratinocytes cultured on all examined surfaces indicated adhesion and attachment. An assay of cell viability showed no substantial variances among the groups. The modified PEEK surface showed greater cell proliferation and migration among the three abutment materials.

Conclusion:

All three abutment material surface types showed similar epithelial biological responses. However, modified PEEK material showed the highest biocompatibility.
Novel Transthyretin Gene Mutation in Familial Amyloid Neuropathy in India
Authors: Rohatgi Shalesh , Nirhale Satish , Manohar Poonkodi , Rao Prajwal , Naphade Pravin , Khan Furqan Mohd. Akram , Dave Dhaval , Sravya Kotaru V.V. , Gupta Sahil , Gitay Advait , Dubey Prashant
Published: September 2022

Familial amyloid polyneuropathy (PN), also known as amyloid transthyretin (TTR)-PN is an autosomal dominant adult-onset fatal disease, if not treated. It occurs due to mutations in (TTR) gene which leads to a faulty TTR protein which folds up to form amyloid and gets deposited mainly on nerves and causes length-dependent PN and autonomic dysfunction. We report a case of a 45-year-old female who presented with symptoms of painful peripheral neuropathy for 5 months, a history of deafness for 5 years, and cardiac pacemaker implantation 2 years ago for complete heart block. She denied any symptoms of autonomic dysfunction. Her brother with similar symptoms died of cardiac arrest at the age of 50 years. Clinical examination was suggestive of symmetrical sensorimotor PN. The nerve conduction study was suggestive of axonal sensorimotor PN. Abdominal fat biopsy was negative for amyloid. Sural nerve biopsy was suggestive of amyloid neuropathy. Genetic analysis showed c. 165G > T mutation encoding amino acid p. Lys55Asn on exon-4 of TTR gene. This mutation has not been reported from India.
Health-Related Quality of Life of Persons with Diabetic Foot Ulcers in a Cosmopolitan City in Northwestern Nigeria
Authors: Habibu Raliya Aliyu , Uloko Andrew Enemako , Gezawa Ibrahim Danjummai , Ramalan Mansur Aliyu , Muhammad Fakhraddeen Yahaya , Abubakar Usman Ibrahim , Muhammad Abdullahi
Published: September 2022

Background:

Diabetic foot ulcer is one of the most serious and disabling complications of diabetes mellitus (DM). It is a major source of morbidity, mortality, and a leading cause of hospitalization. It constitutes a major burden to the patient, family, and health-care system as well as impairs quality of life (QoL). The aim of this study was to determine the QoL of persons with diabetic foot ulcers attending two major hospitals in a cosmopolitan city in northwestern Nigeria.

Materials and Methods:

We conducted a descriptive cross-sectional study at the diabetes outpatient clinics and wards of two major hospitals in Kano, Northwestern Nigeria. Sociodemographic characteristics, type of DM, duration of DM, and the presence of risk factors for foot ulcers were assessed. The QoL of patients with and without foot ulcer was determined a well-validated questionnaire for chronic diseases, short form 36 (SF 36) health-related QoL questionnaire.

Results:

We recruited 394 patients with DM (163 males and 231 females) with mean age and duration of DM of 50.8 ± 12.5 years and 7.72 ± 6.65 years, respectively. Ninety-five percent of the study participants had type 2 DM. Foot ulcers were present in 57 (14.5%) study participants. The QoL was generally poor (P < 0.001) in patients with DFU, compared with those without DFU in all domains of the SF 36, that indicated poor QoL in the physical, mental, and emotional well-being of the patients.

Conclusion:

Diabetic foot ulcers are quite common and impart significantly on the QoL of persons with DM affecting their physical, mental, and emotional well-being. Early detection and management of foot ulcers will reduce the burden of the disease and improve the QoL of affected individuals.
Prevalence and Characteristics of Rotavirus Acute Gastroenteritis among Under-five Children in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Authors: Mado Sani Malam , Giwa Fatima Jummai , Abdullahi Sakinatu Mahadi , Alfa Abdullahi Mohammed , Yaqub Yahaya , Usman Yahaya , Wammanda Robinson Daniel , Mwenda Jason Mathiu , Isiaka Ayodeji Hassan , Yusuf Kabir , Lawali Namadi
Published: September 2022

Background:

Rotavirus infection is a significant cause of gastroenteritis in developing countries and, in severe cases even leads to death. The impact of rotavirus vaccine introduction in reducing the rotavirus disease burden in children was well known. The study was aimed to determine the prevalence and clinical characteristics of rotavirus gastroenteritis before the introduction of rotavirus vaccine into Nigeria's routine immunization program.

Materials and Methods:

We conducted a cross-sectional hospital-based study involving 735 children aged 0–59 months with acute gastroenteritis hospitalized at the Ahmadu Bello University Teaching Hospital Zaria from September 2017 to August 2020. Relevant sociodemographic and clinical data were obtained and entered into the World Health Organization standardized case investigation forms. Stool specimens were tested for rotavirus Group A antigen using the ProSpecT™ Rotavirus Microplate Assay by Thermoscientific Oxoid Microbiology UK.

Results:

One hundred and fifty-three stool samples tested positive for rotavirus giving a prevalence of 20.8%. One hundred and two (66.7%) children with rotavirus gastroenteritis were infants. There were 87 males and 66 females with M: F ratio of 1.3:1. Only 30 (19.6%) children with rotavirus-associated diarrhea presented with severe dehydration. The presence of vomiting was significantly associated with rotavirus diarrhea (P = 0.001). More cases of rotavirus diarrhea occurred in September through February. None of the studied children were vaccinated against rotavirus.

Conclusion:

The prevalence of rotavirus diarrhea remains high in this study. Infants were recognized as a high-risk group, and none of them were vaccinated against rotavirus and this underscores the urgent need for implementing the rotavirus vaccine in the national vaccination program to reduce the disease burden in the country.
A Study to Evaluate the Role of Eosinophil Count as a Prognostic Marker for Assessing the Outcome in Patients with COVID-19 Infection
Authors: Krishnamurthy Vishwanath , Sujatha K. J. , Kumar T Anil , Phaniraj Priyanka , Shankar Tharanath , Raj Madhu P
Published: September 2022

Background and Objectives:

The triaging of COVID-19 patients is of paramount importance to plan further management. There are several clinical and laboratory parameters that help in categorizing the disease severity, triaging, and prognostication. Little is known about the prognostic significance of eosinopenia in predicting the severity of COVID-19 from large hospital data, especially from low- and middle-income countries. The objective of this study is to evaluate the level of eosinopenia as an early prognostic marker for assessing the outcomes in COVID-19 patients and to assess the superiority of eosinopenia as a prognostic marker for assessing the outcomes in COVID-19 patients compared to lymphopenia and neutrophil-to-lymphocyte ratio (NLR).

Methods:

The study was carried out in a tertiary care hospital. A retrospective longitudinal approach was adopted wherein the hospital records of COVID-19 patients were analyzed. In our study, two separate groups of patients were included for analysis to describe the association between initial eosinophil counts of the patients and the clinical outcomes. In the first group, the disease severity in terms of clinical and radiological parameters was compared in patients of COVID-19 presenting with and without the presence of initial eosinopenia. Commonly used markers for triage, namely lymphopenia and NLR, were compared with the presence of initial eosinopenia among the patients who progressed to moderate and severe disease. In the second group, an analysis of eosinopenia was made among the patients who succumbed to the illness.

Results:

It was seen that 29.6% of patients with eosinopenia had moderate and severe disease compared to those without eosinopenia where only 10.8% had moderate disease, none had severe disease. It was seen that 19.7% of patients with eosinopenia but no lymphopenia had more severe disease compared to patients with lymphopenia but no eosinopenia where 10.8% of the patients had moderate disease, none had severe disease. In patients younger than 60 years who died of COVID-19, it was found that initial eosinopenia was found in 86%, whereas a high NLR >17 was seen in only 25.6% of patients who died, thus implying that is eosinopenia is an important marker of disease severity in COVID-19.

Conclusions:

Eosinopenia is an important parameter in the evaluation of COVID-19 and the presence of it should alert the clinicians regarding the further progression of the disease. It is not only an important marker but also an early marker for severe disease.
Impacted Dentures in the Pharynx and Esophagus – Implication for Advocacy
Authors: Baidoo Kenneth , Blankson Paa-Kwesi , Kwakye Sally , Amoah Estella Bilson , Searyoh Kafui , Parkins Grace E. , Edem Amazing Grace , Nyamekye Evelyn , Quartey Waltraud N. O. D. , Boateng Christiana , Hewlett Sandra
Published: September 2022

Background:

Impaction of dentures has potentially significant morbidity and management challenges. This study sought to leverage on the occurrence of swallowed dentures to advance discussions on its management and prevention.

Methods:

A 5-year retrospective review of patients seen on account of impacted dentures at the Ear, Nose, and Throat Department of the Korle-Bu Teaching Hospital was done. Variables obtained included age, sex, location of impacted denture, treatment done, denture type, number of teeth, and complications. Variables were analyzed, and descriptive summaries were reported.

Results:

There was a record of 898 cases of impacted foreign bodies which presented to the department. Fifty-five (6.1%) records were on account of impacted dentures. These consisted of 25 (45%) males and 30 (55%) females. Ranging from 23 to 98 years, the mean and median ages were 55.7 (±18.1) years and 56.5 years respectively. There were no complications, and no identifiable predisposing patient conditions. All prostheses were removable acrylic dentures, and some observations included worn-out and loose dentures, while several had their prostheses dislodging in the process of swallowing tablet medications with water.

Conclusion:

Swallowed dentures are not rare occurrences in Ghana. Denture wearers should, therefore, be encouraged to get professional reviews, especially when prostheses get unretentive, while dental professionals are urged to incorporate measures in their fabrication to reduce the occurrence of swallowed dentures.
Endoscopy for Upper Gastrointestinal Bleeding in a Tertiary Hospital in Kaduna, North-West Nigeria
Authors: Yahya Husain , Umar Halima , Shekari Bulus Timothy , Sani Kalli
Published: September 2022

Background:

Upper gastrointestinal bleeding (UGIB) is a common medical emergency and upper gastrointestinal endoscopy (UGIE) makes diagnosis and treatment possible; performing this procedure within 24 h of bleeding is considered the standard of care for managing this condition. Access to upper endoscopy improves the prognosis of the disease.

Methods:

We present our experience and findings of performing UGIE in patients referred for UGIB to a new endoscopy unit in a tertiary center in North-West Nigeria. The age, gender, reasons for referral, interval between endoscopy, and last known episode of bleeding and endoscopic findings were obtained from endoscopy records.

Results:

We performed UGIE in 204 patients for UGIB over a 7-year period: Mean age 45.5 years (range 10–88 years), 61.8% male, 54.8% <50 years. Most patients (81.3%) had endoscopy seven or more days after the last known episode of bleeding and none had endoscopy within 24 h. Esophageal and gastric varices were found in almost 30% of patients while peptic ulcer disease was found in 23%. Portal hypertensive gastropathy was found in 12.7% of patients all of whom also had esophageal or gastric varices. Gastric mucosal erosions (7.4%) and gastric malignancy (6.4%) were other notable findings. No significant abnormalities were detected in 11.8% of patients.

Conclusion:

Bleeding from esophageal/gastric varices and peptic ulcer disease were the most common finding in our patients. There was delay in performing endoscopy and improving access and training for endoscopy will go a long way in addressing some of the challenges we identified.
Comparative study of quality of leukoreduced packed red blood cell units as assessed by nageotte hemocytometry and flow cytometry
Authors: Sheikh Mohd Anas , Biswas Amit Kumar , Baranwal Ajay Kumar , Kushwaha Neerja , Karade Santosh , Philip Joseph
Published: September 2022

PURPOSE:

Assessment of residual white blood cell (rWBC) count is vital to ascertain the quality of leukodepleted (LD) blood components. Automated cell analyzers lack the sensitivity for the assessment of very few leukocytes as found in LD blood components. Flow Cytometry (FC) based methods and Nageotte hemocytometer are the most commonly used techniques for this purpose. The objective of this study was to compare the use of Nageotte hemocytometer and FC for quality control of LD red blood cell units.

MATERIALS AND METHODS:

A prospective, observational study was conducted in the Department of Immunohematology and Blood Transfusion of a tertiary care center from September 2018 to September 2020. About 303 LD-packed red blood cell units were tested by FC and Nageotte hemocytometer for rWBCs.

RESULTS:

The number of rWBC (mean) detected by flow cytometer and Nageotte's hemocytometer was 1.06 ± 0.43 white blood cell (WBC)/μL and 0.67 ± 0.39 WBC/μL, respectively. Coefficient of variation was 58.37% by Nageotte hemocytometer method and 40.46% by FC. Linear regression analysis did not show any correlation (R2= 0.098,P= 0.001) whereas Pearson's correlation coefficient showed a weak relation (r = 0.31) between the two methods.

CONCLUSION:

Flow cytometric technique provides a more precise and accurate objective tool compared to Nageotte hemocytometer which is labor intensive, time consuming, and prone to errors arising out of subjectivity along with reported underestimation bias. In the absence of adequate infrastructure, resources, and trained workforce, Nageotte hemocytometer method is a reliable alternative. Nageotte's chamber could be best used in the resource-constrained setup as it offers a relatively inexpensive, simple, and viable means to enumerate rWBCs.
Prevalence of GP. Mur variant phenotype among Malaysian blood donors
Authors: Hassan Siti Nazihahasma , Mohamad Suharni , Kannan Thirumulu Ponnuraj , Hassan Rosline , Wei ShuangShi , Wan Ab Rahman Wan Suriana
Published: September 2022

BACKGROUND AND OBJECTIVE:

A number of glycophorin variant phenotypes or hybrid glycophorin variants of the MNS blood group system bear multiple immunogenic antigens such as Mia, Mur, and MUT. In the East and Southeast Asian populations, glycoprotein (GP.) Mur is the most common glycophorin variant phenotype expressing those three immunogens. The aim of this study was to detect MNS system glycophorin variant phenotypes (GP. Mur, GP. Hop, GP. Bun, GP. HF, and GP. Hut) among Malaysian blood donors.

MATERIALS AND METHODS:

In this cross-sectional study, 144 blood donors were selected under stratified random sampling. The deoxyribonucleic acid was extracted from whole blood samples, followed by a polymerase chain reaction assay. Sanger sequencing was used to identify the specific MNS variants and then validated by a serological crossmatch with known anti-Mur and anti-MUT.

RESULTS:

GP. Mur was identified among Malaysian blood donors with a prevalence of 6.94%, and no other variants of the MNS system were found.

CONCLUSION:

The present study substantiates that GP. Mur is the main variant of the MNS system glycophorin (B-A-B) hybrid in Malaysian blood donors. GP. Mur-negative red blood cells must therefore be considered in the current transfusion policy in order to prevent alloimmunization and immune-mediated transfusion reactions, particularly in transfusion-dependent patients.
Leukoreduced red cell concentrates: Are they meeting the quality standards?
Authors: Chand Sreethu , Rudrappan Raj Bharath , Gupta Debasish
Published: September 2022

BACKGROUND:

Leukocytes are responsible for producing both immune and nonimmune adverse reactions, and therefore, various methods have been developed to remove them from the blood components before transfusion.

AIM:

The aim of this study was to analyze the quality parameters in leukoreduced red cell concentrates (RCCs) and investigate the efficiency of leukocyte removal and red cell recovery in the leukoreduction methods followed in our center.

MATERIALS AND METHODS:

The study evaluated the quality parameters in 112 RCCs prepared using buffy-coat reduction by the Terumo automatic component extractor II+ system, manual saline washing, and leukofiltration using the Leucolab filter system.

RESULTS:

With analysis, leukofiltration was found to be the most efficient in reducing leukocyte content in RCCs, achieving a mean leukoreduction of 99.99%. Buffy-coat reduction and saline washing achieved a leukoreduction of 78.54% and 82.67%, respectively. While filtration showed the least red cell recovery of 81.93% compared to 90.57% in buffy-coat reduction and 91.87% in saline washing methods. An analysis of hemoglobin content showed that none of the buffy-coat removed RCCs processed from 350-ml collections and underwent poststorage leukofiltration could meet the European Standards for minimum hemoglobin content.

CONCLUSION:

Filtration is found to be the better method for leukoreduction of RCCs. It is suggested to perform a single method of leukoreduction preferably leukofiltration for maximum red cell recovery.
Prevalence of ABO, Rh (D, C, c, E, and e), and Kell (K) antigens in blood donors: A single-center study from South India
Authors: Soumee Banerjee , Devi A. M. Shanthala , Sitalakshmi Subramanian
Published: September 2022

BACKGROUND:

Although ABO and RhD are the clinically significant blood group antigens that are routinely tested for, other blood group antigens may become important in multiply transfused patients due to risk of alloimmunization. Knowledge of antigen prevalence in a population is important in the context of alloimmunization and antigen matching. This study aims to do the same in a population of voluntary blood donors of a center in South India.

AIMS AND OBJECTIVES:

To study the ABO, Rh (D, C, c, E, and e), and Kell (K) antigen and Rh phenotype prevalence in whole blood donors donating at the blood bank of a tertiary care hospital in South India.

MATERIALS AND METHODS:

One thousand and two hundred eligible whole blood donors were chosen by random sampling between November 2017 and April 2019. After administration of informed consent and routine testing for ABO grouping, RhD typing, and indirect antiglobulin test, Rh and Kell typing was done on appropriate gelcards and the data were analyzed to arrive at phenotypes.

RESULTS:

97.6% of the donors were male and 2.4% were female. They were divided into 7 different categories based on the regions of origin: Kerala, Andhra Pradesh, Tamil Nadu, Karnataka, West Bengal, North India, and others with the largest number of donors hailing from Karnataka (38.5%). The ABO distribution, in descending order, was as follows: O (38%), B (34.5%), A (20.6%), and AB (6.8%). The prevalence of the Rh antigens was as follows: D: 93.4%, C: 87.9%, c: 55.6%, E: 19.3%, and e: 98.8%. K was present in 1.4% of the population. Since genotyping has not been done, the most common “presumed” Rh phenotype among RhD-positive donors was R1R1 (46.4% of total donors and 49.5% of RhD-positive donors). The most common phenotype among RhD-negative donors was rr (5.9% of total donors and 92.2% of RhD-negative donors). The order of prevalence of the ABO, Rh, and K antigens and the Rh phenotypes remained the same irrespective of gender, ABO group, and region of origin.

CONCLUSION:

This population-based study analyzes a donor population as a whole and separately as per regions of origin and shows that antigen prevalence and thereby risk of alloimmunization does not vary markedly among the different population subsections. Hence, even where extended phenotyping and antigen matching cannot be done, risk of alloimmunization may be low. Limiting antigen matching to specific patient subsets like in multiply transfused patients with uncommon phenotypes may, therefore, be an efficient and cost-effective approach.
Serological characteristics and immunohematological difficulties in autoimmune hemolytic anemia patients: A retrospective analytical study from South India
Authors: Sahoo Dibyajyoti , Anuragaa S.
Published: September 2022

INTRODUCTION:

Autoimmune hemolytic anemia (AIHA) is a condition in which there is decreased survival of red blood cells (RBC) due to the destruction of RBC by autoantibodies. AIHA is classified into warm, cold, and mixed according to temperature sensitivity. The antibodies may be immunoglobulin G, immunoglobulin M, immunoglobulin A, or complement proteins, and hemolysis may be intravascular or extravascular. The present study was done to find out serological characteristics of AIHA patients in our population.

MATERIALS AND METHODS:

During the study, a total of 112 patients’ samples were analyzed. All immunohematology workup, including blood grouping, direct Coombs test (DCT), indirect Coombs test (ICT), monospecific DCT, and alloantibody identification, were done.

RESULTS:

A maximum number of patients were in the age group of 16–45 years (69.6%). Primary AIHA (56.25%) is more common than secondary AIHA. Females (73.2%) were more affected than men, mostly due to the prevalence of autoimmune disease more in females. Warm AIHA (58%) was more common, followed by mixed (33%) and cold (9%). Grouping discrepancy was seen in 30 (26.8%) cases.

CONCLUSION:

Warm AIHA is more common in our population followed by mixed and cold types. Blood group discrepancy seen in good proportion of AIHA patients, therefore meticulous immunohematological work up plays an essential role in these patients.
Outcome of pregnancy in sickle cell anemia patients with COVID-19 infection
Authors: Gowri Vaidyanathan , Al Dughaishi Tamima , Geetha Deepti , Al Riyami Marwa , Alburaidi Radhiya , Al Kindi Salam
Published: September 2022

Sickle cell anemia (SCA) is a multisystem disease, associated with increased risk for infection and thromboembolic disease, and pregnancy is a stressor for patients with SCA. In general, coronavirus disease 2019 (COVID-19) infection in SCA is associated with a favorable outcome. Literature of pregnancy in SCA with COVID is scarce. We report a case series study of pregnant women with SCA, who are confirmed positive for COVID-19 from May 2020 to March 2021. These patients showed generally mild-to-moderate disease and presented predominantly with fever and painful crisis. They showed a significant drop in Hb from baseline, and they received low-molecular-weight heparin prophylaxis (LMWH) and blood transfusion. The outcome of pregnancy is satisfactory, although the mean birth weight was significantly lower than that reported from the same SCA population.
Clinical significant anti-P1 antibody with wide thermal amplitude
Authors: Thulasiram Nallagondla , Sahoo Dibyajyoti , Basavarajegowda Abhishekh
Published: September 2022

The P blood group system was introduced in 1927 by Landsteiner and Levine. About 75% of the population possesses P1 phenotype. P2 simply implies P1 negative and there is no P2 antigen. Individuals with P2 may have anti-P1 antibodies in there serum are cold-reacting antibodies which are clinically insignificant and occasionally active at 20°C or higher temperatures. However, in certain cases, anti-P1 is clinically significant and may cause acute intravascular hemolytic transfusion reactions. Our case report confirms the complexity and difficulty in the diagnosis of anti-P1. In India, very few cases are reported regarding clinical significant anti-P1. Here, we report a case of IgM type of antibody anti-P1 which was reactive at 37°C and AHG phase in a 66-year-old female planned for Whipple's surgery, who had grouping discrepancies in reverse typing and incompatibility during routine crossmatch.
Syncopal reactions in blood donors: Pathophysiology, clinical course, and features
Authors: Basavarajegowda Abhishekh , Nalini Y. C.
Published: September 2022

Vasovagal syncope (VVS) in donors is a transient loss of consciousness due to short-term global cerebral hypoperfusion, which has a rapid onset and has complete spontaneous recovery. VVS may be triggered by pain, fear, anxiety, or emotional upset and loss of blood perse. It is an exaggeration of an adaptive response meant to assist in reducing the amount of bleeding/loss of blood. The four major components necessary for rapid cardiovascular adjustments to supine or upright posture, otherwise called orthostasis, are the autonomic nervous system, adequate blood volume, and intact skeletal and respiratory muscle pumps. The taxing of these autoregulatory mechanisms and their inability to compensate sufficiently results in VVS. VVR episodes can be described in 3 phases; Presyncope, Syncope, and Postsyncope. The actual syncope generally lasts for <15 s, comprising staring, muscle jerks, eye deviation/rolling, sometimes incontinence, loss of consciousness, gasping, snoring, apnea, inability to move/react, etc., The postsyncopal phase is the longest, which is generally manifested as fatigue.
A clinical audit on the utilization of group O-negative red cells and the lesson learnt
Authors: Ali Arzina Aziz , Qadir Hira , Khalid Areeba , Moiz Bushra
Published: September 2022

BACKGROUND:

Ideal blood inventory management involves guaranteeing maximal availability of blood while minimizing wastage. Benchmark for the guidance of O (Rh) D-negative red blood cells (ONEG RBCs) is not widely available. In this study, we aimed to identify the areas of improvement in blood center inventory of ONEG RBCs through a clinical audit.

MATERIALS AND METHODS:

During April 2017 to March 2018, patients who received ONEG RBCs units were studied for their demographics, primary reason for admission, location, and clinical condition. Data were collected from computerized blood center information system, online integrated laboratory data (Integrated Laboratory Management System), and patients’ medical record charts. Children at ≤18 years were included in the pediatric population as per our institutional criterion while a female between 15 and 49 years was considered as having childbearing potential according to previously published data.

RESULTS:

Overall, 807 units (2.8%) of ONEG RBCs were transfused during 577 transfusion events with a median (inter quartile range) of 2 (1–3) units per patient in each transfusion event. Recipients of ONEG RBCs were 221 unique patients including 91 females (41%) and 130 males (59%) and only 44 (20%) females had child-bearing potential. Overall, 72 of 807 red cell units (8.9%) were transfused to young females of O/non-O negative/unknown group and were classified as “obligatory.” Neonates, pediatric patients, chronically transfused, and bone marrow transplant recipients received 337 of 807 (42%) units and were marked as “acceptable.” Transfusion of 398/807 units (49%) to females of nonchildbearing potential and adult males could have been saved for those with a mandatory transfusion requirement of ONEG RBCs.

CONCLUSIONS:

This clinical audit showed that 409 of 807 of ONEG RBCs (51%) were transfused according to the guidelines while 398 of 807 of these (49%) could have been saved for other mandatory requirements. Appropriate policies, planning, education of physicians, and regular clinical audits are needed to bring the desired change in transfusion practices.
Development and validation of informed consent for blood transfusion questionnaire
Authors: Senin Mohd Hilmi , Sopian Mastura Mohd , Shaharuddin Bakiah , Nasir Muhammad Jaffri Mohd
Published: September 2022

INTRODUCTION:

Blood transfusion warrants written informed consent from the patient. However, patients have poor knowledge regarding blood transfusions as evidenced by nonstandardized information retained by patients from the informed consent discussion. The problem stems from suboptimal patient knowledge on the elements of informed consent. This study describes the development and validation of a new questionnaire to assess the knowledge on informed consent for blood transfusion from the patients’ perspective.

SUBJECTS AND METHODS:

The development phase consisted of literature review, small group discussion, expert review meeting, content, and face validity. We evaluated the psychometric properties of Informed Consent for Blood Transfusion Questionnaire (ICBTQ) using reliability test and item response theory among a sample of 95 patients in Hospital Universiti Sains Malaysia.

RESULTS:

ICBTQ was formulated to include sociodemographic and knowledge sections. ICBTQ possessed excellent content validity. The face validity index (FVI) of clarity and comprehension were both 0.97. Thus, the universal FVI was 0.96. One item was added following the advice given by one of the content experts. ICBTQ had excellent face validity. For the validation phase, ICBTQ demonstrated an acceptable Cronbach’s Alpha value. One item was omitted in view of low corrected item-total correlation. In the item response theory (IRT) analysis, ICBTQ exhibited good difficulty and discriminatory indexes. Assessments of item-fit indicated that all items of the model were well-fitted.

CONCLUSIONS:

Based on the IRT and reliability analysis, the knowledge section of the ICBTQ was psychometrically valid to be used among patients.
Severe donor reaction as a hazard of replacement blood donation
Authors: Nair Amita Radhakrishnan , Gupta Debasish
Published: September 2022

Blood donation is generally considered to be a safe procedure, but occasionally adverse reactions of varying severity may occur predonation, donation, or postdonation phases. Various studies have reported the incidence of adverse donor reaction as 0.6%–5.6%. Donor reactions are classified into mild, moderate, and severe types or immediate and delayed. Although delayed reactions account for <2% of total adverse donor reactions, 27.6% are severe with or without injury. Herein, we report a case of potentially preventable delayed Grade 2 vasovagal reaction in a 56-year-old replacement blood donor.
Hemolysin test as a tool to screen high-titer Group O platelet apheresis donors: A prospective study
Authors: Murugesan Mohandoss , Augustine Merline , Velayudhan Shibin Cherukunnuparambil , Darussalam Thahira , Nayanar Sangeetha Keloth
Published: September 2022

BACKGROUND:

Minor ABO-incompatible apheresis platelet transfusion poses a risk of hemolytic transfusion reactions in non-Group O recipients when donor’s plasma possesses unusual high titers for anti-A and anti-B. The aim was to determine whether the hemolysin test can be used as a screening tool to predict high-titer Group O platelet apheresis donors.

METHODS:

A prospective study, with Group O platelet donor’s samples, was tested for hemolysin test and antibody titration test in parallel. Antibody titration was also performed on products suspended in platelet additive solution (PAS). Hemolysin test was assessed for diagnostic accuracy against antibody titration. Chi-square test and Mann–Whitney U-test were used to determine the relationship between the hemolysin test and antibody titration.

RESULTS:

Among 107 Group O platelet donations, median anti-A and anti-B titers in donors were 32 (8–128) and 32 (4–256), respectively. High titer (≥128) for ABO antibodies was seen in 18% of donations, whereas hemolysin test was positive in 69% of donations. Hemolysin test results differ significantly with antibody titration results (P = 0.03). Hemolysin test had higher sensitivity (89%) with a strong negative predictive value (94%). None of the products suspended in PAS had high-titer antibodies.

CONCLUSION:

Adopting hemolysin test as a screening tool may label a large number of units (69%) unsuitable for ABO-incompatible platelet transfusion. Alternatively identifying donors with high antibody titer or positive hemolysin test and selectively suspending their product in PAS may be a cost-effective approach and certainly prevent high-titer antibodies in the product.
Smart approaches for encouraging the blood donation
Authors: Sharma Rakesh , Banerjee Debadri , Singh Anupama , Saharan Vikas Anand
Published: September 2022

Blood is a life saver in many emergencies like accidents or for the patients suffering from deadly diseases such as cancer and thalassemia. Conventionally, blood collection is done in five steps, i.e., recruitment, screening, physical examination, collection, and postdonation care. The huge demand of blood requires the implementation of smart approaches in the field of blood donation, which allows specific, measurable, achievable, and timely outcomes. This paper throws light on various smart approaches to motivate and attract people for blood donation. Gamification, social media, short message service, mobile applications, and other web-based applications are some of these approaches reviewed in this article. A number of platforms are also highlighted where one can seek potential donors or blood banks easily during urgency, avoiding the complex steps followed in traditional blood donation systems.
Serological comparison of weak D versus weakly reacting D by four different methods
Authors: Sahoo Dibyajyoti , Kanungo Girija Nandini , Behera Rachita , Jena Partha Sarathi
Published: September 2022

INTRODUCTION:

Weak D red cells were defined as having a reduced amount of D antigen (formerly called “Du”) that required an indirect antiglobulin test (IAT) for detection. Weakly reacting D is those which give <2+ reactions on routine methods. The present study is sharing our experience on weak D and weakly positive anti-D in various methods.

MATERIALS AND METHODS:

All the blood sample of patients and blood donor, which were RhD negative, were included in the study. Furthermore, RhD positive sample <2+ was included. We repeated blood grouping of all these samples by gel card (Tulip), tube method (two different antisera), slide method, and Solid Phase Red Cell Adherence (SPRCA) (Immucore, USA).

RESULTS:

A total number of samples were 27,245. RhD negative found out to be 945 (3.46%). Out of all, 929 (98.3%) samples were Rh D negative in gel card and IAT negative, while 16 (1.7%) were weak D positive. Rh D typing with these samples by different antisera at four platforms showed that 14 were weakly positive (<2+) in any of the four platforms. Similarly, out of 26,300 Rh D Positive samples, 21 samples (0.079%) were serologically weak (<2+). Repeat Rh D typing was done with different antisera in all four platforms. Result showed more than 50% were Rh D negative in any of four platforms.

CONCLUSION:

Above observation showed that serological tests at various platforms failed to distinguish weak D from weakly reacting D. Thus, we propose that weakly reacting D should be treated equal as weak D unless they are distinguished by genotyping.
Prevalence of hemoglobinopathies using high-performance liquid chromatography as diagnostic tool in anemic patients of tertiary care center of Western India
Authors: Singh Virender , Biswas Amit Kumar , Baranwal Ajay Kumar , Asthana Bhushan , Dahiya Tejpal
Published: September 2022

CONTEXT:

Hemoglobinopathies are the most common heterogeneous group of monogenetic disorder in the world and its prevalence varies with geographical regions. India is developing country and many studies show a significant burden of hemoglobinopathies in India.

AIMS:

The aim of the present study was to check the prevalence of various hemoglobinopathies in anemic subjects using high-performance liquid chromatography (HPLC) method in Pune region which has multiple ethnic population groups from all parts of India.

SETTINGS AND DESIGN:

The present study was conducted at the department of IH and BT on anemic patients referred from different outpatient department and Wards of the hospital and informed consent were taken from all participants.

SUBJECTS AND METHODS:

The present study included a total of 2698 individuals’ age ranging from 1.5 to 67 years. The HPLC test was performed using Bio-Rad D-10 analyzer once a week.

RESULTS:

Out of a total of 2698 cases, we found 543 (20.12%) cases with abnormal hemoglobin fractions and 2155 (79.88%) cases free from hemoglobinopathies. Out of the total hemoglobinopathies detected 250 (46%) were male and 293 (54%) were female. The major abnormality detected was beta-thalassemia trait (BTT) with 425 (15.75%) cases, followed by sickle cell disorders 58 (2.15%), HbE 38 (1.41%), hereditary persistence of fetal hemoglobin 6 (0.22%), HbD Punjab 13 (0.48%), HbD Iran 2 cases and 4 cases of compound heterozygous for HbS beta-thalassemia. Forty (1.48%) cases were detected as borderline with HbA2 level ranges from 3.6% to 3.9%.

CONCLUSIONS:

In our study, we found a high prevalence of hemoglobinopathies among anemic subjects. The most common disorder detected was BTT. Most of the hemoglobinopathies found in our study could be accurately quantified by HPLC which is a rapid, sensitive, and reproducible method for the detection of different hemoglobinopathies.