bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Neutrophils-to-Lymphocytic Ratio as a Marker for Post-operative Pain in Patients Undergoing Harmonic Cholecystectomy
Authors: Tarabay Ahmed , Mousa Ahmed Hafez , Radwan Hanin Ahmed , Khaled Islam 
Published: August 2023

Objectives:
Our study aimed to investigate the pre-operative neutrophils-lymphocytes ratio (NLR) in patients who underwent cholecystectomy and to identify whether it discriminates between chances of developing pain or not and at what interval.

Materials and Methods:
A cross-sectional study was conducted in a single center in Saudi Arabia over a period of 2 months. Analysis was conducted using SPSS 22nd edition; numeric variables were presented in mean ± standard deviation and compared using the Mann–Whitney U-test after normality testing.

Results:
The study included 69 patients diagnosed with acute cholecystitis and underwent cholecystectomy. The minimum identified NLR in our study was 0.3 and the maximum identified variable was 15.0. Highest sensitivity and specificity were found to be 93.8% and 24.5% after 36 h of performing the procedure, respectively.

Conclusion:
NLR utilization as a pain marker post-operatively has promising outcomes which will highly impact the reduction of disease burden on patients.
Hemovigilance
Authors: Mani Anila , Gupta Debasish 
Published: August 2023

Background and Objectives:
Hemovigilance is defined as a set of surveillance procedures covering the whole transfusion chain that is intended to collect and assess information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products and to prevent future occurrence and recurrence. The primary goal of the study was to reduce the incidence of adverse events among blood donors and to make blood donation a pleasant experience. Prevention of adverse reactions at the time of blood donation is an important aspect of blood donor motivation and blood donor retention for future blood donations.

Methods:
This is a one and half year's prospective study which was conducted by the department of Transfusion Medicine. The study assessed untoward blood donor reactions, as a measure to further maximize the elimination of untoward reactions encountered during or after blood donation to secure a healthy donation-transfusion chain. We analysed the causative factors that can lead to complications in blood donors at different phases of blood donation like pre-donation, during donation and post donation phases.

Results:
Out of 8180 whole blood collections, 252 blood donor complications were observed during the study period. Out of this, 8.73% (n=22) adverse reactions were observed during donation at blood centre, while 91.27% (n=230) reactions occurred in blood donation camps. Among the camp donations, 61.30% (n=141) were at outdoor camps and 38.70% (n=89) were inside Blood Mobile. We had 83.23% (n=6808) of male blood donors and 16.77% (n=1372) of female donors. Out of the 66 females who developed complications, majority were belonging to the age group of 18-25 years. We had 37.90% (n=3100) first time donors and 62.10% (n=5080) repeat donors. Among the repeat donors, 34.59% (n=1757) were regular repeat donors and 65.41% (n=3323) were irregular repeat donors. Out of 130 first time donors who developed complications, 91.5% (n=119) were systemic reactions. 57.1% (n=12) of regular repeat donors and 80.2% (n=81) of irregular repeat donors developed systemic complications.

Conclusion:
Hemovigilance reporting has reinforced our blood donor safety as well as transfusion safety. Regular reporting of the adverse donor complications helped us to improve proper documentation of all aspects of a complete blood donation sequence not only by the medical officers but also by the blood centre staff members.
Harvesting COVID Convalescent Plasma Using Latest-Generation Apheresis Systems
Authors: Das Sudipta Sekhar , Biswas Rathindra Nath , Sen Subrata 
Published: August 2023

Background and Objectives:
Transfusion of COVID convalescent plasma (CCP) has been found to be a useful and logistically feasible therapeutic strategy in COVID-19. Appropriate guidelines describing donor eligibility criteria, CCP collection and storage, and clinical transfusion of CCP have been described. In this study, we discussed the collection of CCP by plasmapheresis, quality of product obtained, and donor adverse reactions associated with CCP collection.

Methods:
This observational study included 209 screened eligible donors and 186 procedures of plasmapheresis for the collection of CCP. Donor selection and CCP collection were done as per the guidelines described by regulatory bodies. Statistical analysis was done using the SPSS statistical package.

Results:
The median age of the eligible donors was 42 years, with a male preponderance. The mean anti-severe acute respiratory syndrome coronavirus 2 immunoglobulin G value (S/Co) was 11.8 in eligible donors. The total mean whole blood volume processed to collect the targeted plasma volume, mean utilization of anticoagulant, and mean time needed to complete the procedure were significantly more in the Spectra Optia cell separator (P < 0.05). Quality of the plasma separated by Trima Accel and Spectra Optia was found to be comparable. A total of 9 (5.1%) donors experienced adverse events during or after plasmapheresis.

Conclusion:
Plasmapheresis using new-generation automated cell separators has the potential to generate CCP of optimized quality and potency. More emphasis is needed on the quality control of CCP with regard to the establishment of defined quality markers and their allowable limits. Appropriate donor vigilance, donor selection, and equipment management during the procedure may significantly prevent adverse events related to plasmapheresis.
Blood Cell Exchange in Sickle Cell Disease
Authors: Chowdhry Mohit , Agrawal Soma , Sharma Ankita , Thakur Uday Kumar 
Published: August 2023

Background and Objectives:
Red cell exchange (RCE) is a type of therapeutic apheresis procedure aimed at removing the deformed red blood cells of a patient and replacing them with those obtained from healthy donors. It is a commonly used but yet underutilized procedure for the treatment of hemoglobinopathies such as sickle cell disease (SCD) (acute or chronic), and other diseases and conditions such as ABO-incompatible hematopoietic stem cell transplantation, severe erythrocytosis, hereditary hemochromatosis, severe infection with intra-erythrocytic parasites such as malaria, babesiosis or cases of a drug overdose, poisoning and to perform envenomation. The objective of the study is to study and understand the efficacy of RCE in the management of patients in various clinical scenarios.

Methods:
This is a retrospective study carried out at a tertiary care hospital in North India over a period of 4 years (2016–2020). All the RCE were performed on Spectra Optia apheresis (System 1 P0 4552 (Terumo BCT, Lakewood, CO, USA) which comes with a built-in software (Version 11) for performing RCE.

Results:
A total of 8 exchanges were performed in five patients. Three of these patients had undergone the procedure twice. Two out of the five patients were found to be antibody screen positive. Corresponding antigen-negative units of packed red cells were issued for these patients. The targeted and final fraction of red cell remaining values which were kept at ≤30% was achieved in all cases.

Conclusion:
RCE is a safe and effective therapeutic treatment modality for patients of SCD. It is a simple and relatively safe treatment modality that provides immediate relief in acute complications and also prevents the risk of long-term complications such as iron overload and iron-induced organ damage.
RH Phenotype, ABO and Kell Antigens, Alleles and Haplotypes Frequencies in North Indian Blood Donor Population
Authors: Mangwana Sadhana , Simon Nikhil , Sangwan Lalitesh 
Published: August 2023

Background and Objectives:
ABO, RH and Kell blood group systems are clinically significant blood group systems among 36 blood group systems having total of 360 blood group antigens which cause most cases of alloimmunization following blood transfusions or pregnancy. India has regionally and ethnically very diverse population in different demographic areas. Due to different antigenic expression in different population, knowledge of antigen frequencies among their local and regional donor population is important to assess the risk of antibody formation, probability of antigen negative blood for patients having alloantibodies, inventory management and database for rare antigens thus enhancing patient safety.

Aim:
To know and compare phenotype prevalence, frequency distribution of ABO, RH and Kell antigens and Alleles in blood donors.

Methods:
A prospective study was conducted in a tertiary care hospital in North India over three years period. ABO, RH D grouping, RH and Kell phenotypes were performed on blood donors. Hardy Weinberg's equations were used to calculate ABO, RH and Kell allele frequencies and were analyzed.

Results:
During the study period, 24745 healthy individuals donated blood at Tertiary Care hospital; with 97.26% male and 2.74% female population. Prevalence of ABO antigens were B =37.74%, O = 31.38%, A = 21.77% and AB = 9.09% with allele frequency for O = 0.560, B = 0.266, A = 0.169 and AB = 0.091. The commonest RH phenotype observed was DCCee followed by DCcee, DCcEe, DccEe while commonest RH negative phenotype were ccee and Ccee. Homozygous phenotypes were absent in our population. Amongst five RH antigens phenotyped serologically, highest prevalence was of e antigen followed by D, C, c and E being the lowest. Prevalence of Kell phenotype was 2.57% (K) while that of k as 97.43% with allele frequencies of K and k as 0.0252 and 0.986 respectively.

Discussion:
Genetic variability in different population result in varied expression of red cell antigens in different races. Knowledge of varied frequency and phenotypic expression of major clinically relevant antigens and RH haplotypes in these blood groups systems would help in more rational approach for blood transfusion, decreasing alloimmunization thus enhancing blood safety.
Gray Zone Sample Testing in Enhancing Blood Safety
Authors: Kandukuri Maheshkumar , Vujhini Sudhir Kumar , Bonagiri Shanthi , Bogi Murali Krishna 
Published: August 2023

Background:
Gray zone samples with optical density (OD) lying between cutoff OD and 10% below the cutoff OD (cutoff OD × 0.9) were identified during routine Transfusion Transmissible Infections (TTI) screening. Enzyme-linked immunosorbent assay (ELISA) used for this purpose can sometimes fail to detect blood donors who are recently infected or possessing the low viremia. Estimation of a gray zone in ELISA testing and repeat testing of gray zone samples can further help in reducing the risks of TTI in countries where nucleic acid amplification testing for TTIs is not feasible.

Methods:
Repeat ELISA testing was done on gray zone samples in duplicate, the samples showing both OD values below gray zone were marked nonreactive, and samples showing one or both OD values in the gray zone were marked indeterminate. The samples on repeat testing showing one or both OD above cutoff values were labeled reactive.

Results:
Out of the 196 gray zone samples, 33 samples turned out to be reactive (as shown in the table), 39 samples were nonreactive, and 124 samples were again in the gray zone and were labeled as indeterminate.

Conclusion:
Estimation of gray zone samples with repeat testing can further enhance the safety of blood transfusion in resource-poor developing nations where more sophisticated and sensitive methods such as nucleic acid amplification test (NAT) is not available in all the blood banks.
Prevalence of Unexpected Red Cell Antibodies in Healthy Donor Population in a Tertiary Care Center in South Kerala
Authors: Gayathri AM , Gupta Debasish 
Published: August 2023

Background and Objectives:
Apart from naturally occurring red cell antibodies Anti-A and Anti-B in human plasma, there are two types of unexpected red cell antibodies: Alloantibodies and auto-antibodies. The presence of these antibodies, alone or in combination, makes difficulties with compatibility testing, thereby delaying in the issue of a compatible blood unit or may reduce posttransfusion red blood cells life span. Antibody screening is mandatory as laid down by the Drug and Cosmetic Act 1940 and Directorate General of Health Services guidelines. This goal of this paper was to study the prevalence of Unexpected Red Cell Antibodies in Healthy Donor Population in a Tertiary Care Centre in South Kerala.

Methods:
The sample size chosen for this study was 7000 randomly chosen healthy nonremunerated voluntary donors who attended in house and blood donation camps over a period between November 26, 2017, and February 15, 2019.

Results:
The prevalence of unexpected red cell antibodies was found to be 1 in 1000. Male blood donations were more than female and blood donors among 18–30 years of age were greater in number. There were no cases of direct antiglobulin test positivity encountered. Male: Female ratio is 2.5:1 and males had naturally occurring alloantibodies, whereas females had a previous history of pregnancy. Anti-M and Anti-Lewis antibodies were the most common alloantibodies followed by Anti-Rh (D and C) antibodies and Anti-IH in the current study. Benign cold agglutinins (BCA) were found predominately in the younger male population with a significant seasonal variation noted in the prevalence of these antibodies.

Conclusion:
All antibodies identified had the ability to cause immune hemolytic transfusion reactions in the recipients. BCA-positive cases were seen more during the winter season and rainy seasons when compared to hot climatic conditions.
Evaluation of Donor Demographic, Clinical, and Serological Characteristics in COVID Convalescent Plasma Donation by Plasmapheresis
Authors: Das Sudipta Sekhar , Biswas Rathindra Nath , uz Zaman Rafique , Sen Subrata 
Published: August 2023

Background and Objectives:
Passive transfusion of convalescent plasma (CCP) in coronavirus disease 2019 (COVID-19) has proven to be a winning and logistically feasible therapeutic strategy. The efficacy of plasma depends on appropriate donor screening and selection. Ours being a tertiary care hospital with dedicated COVID facility, we obtained prescriptions of CCP from clinicians for the treatment of COVID-19. Here, we discuss the clinical and serological characters of the voluntary donors who altruistically visited the blood center for plasma donation.

Methods:
The study included 683 voluntary donors who visited the blood center for mandatory eligibility screening to donate plasma. Donor eligibility criteria were applied following established guidelines. Donor details were obtained from blood center records and software. Detailed investigations on blood samples were performed as mandated and discussed.

Results:
Among 683 donors initially registered 166 (24.3%) were deferred due to various causes The median age of eligible donors was 44 years with a male preponderance. The mean anti- severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG (S/Co) was calculated to be 12.9. An upward trend in anti-SARS-CoV-2 IgG level was observed with increase in fever temperature, disease severity, and symptom-free days (P < 0.05).

Conclusion:
Donor screening and selection in CCP donation should be performed meticulously to obtain safe and potent plasma products. Based on our findings, we suggest that in addition to optimum anti-SARS-CoV-2 IgG levels, factors such as the severity of disease, fever temperature, and symptom-free days which determine antibody adequacy may be considered while selecting CCP donors.
Performance Evaluation of Blood Donor Screening Assays for Serological Detection of Hepatitis B Surface Antigen and Antibodies to Hepatitis C Virus
Authors: Bajpai Meenu , Kakkar Brinda , Gupta Ekta , Kumar Guresh 
Published: August 2023

Background and Objectives:
Screening for transfusion transmissible infections in donated blood can be done by either rapid diagnostic tests (RDTs) or enzyme-linked immunosorbent assay (ELISA) or any other available sensitive immunoassay such as chemiluminescence immunoassay (CLIA). The aim of this assay was to evaluate performance of two commercially available RDTs and CLIA against ELISA for serological screening of hepatitis B surface antigen (HBsAg) and anti hepatitis C virus (HCV). In addition, we also tested the seropositive samples by RDTs, CLIA, and/or ELISA by molecular assays (transcription-mediated amplification, transcription-mediated amplification, and quantitative polymerase chain reaction).

Methods:
In this prospective study, 1000 consecutive blood donors were screened from September 2017 to March 2018. All blood samples collected during the study period were tested by RDTs, CLIA, and ELISA, and the results obtained were compared.

Results:
On considering ELISA as a reference standard, low analytical sensitivity was noted for both RDTs (64.29%) and CLIA (71.43%) for HBsAg detection. Similar results were also noted for both RDTs (25%) and CLIA (75%). The positive predictive value of CLIA was found to be lower (HBsAg 31.25%; anti-HCV 50%) as compared to RDTs (HBsAg 90%–100%; anti-HCV 100%). High false positivity was noted with CLIA, while RDTs missed seropositive samples. The viral load for HBsAg and anti-HCV seropositive samples ranged from 29.7 IU/ml to 3.4 × 104 IU/ml and 7.56 × 106 IU/ml, respectively.

Conclusions:
Performance of CLIA as screening assay was better compared to RDTs. CLIA seems to be a suitable screening assay for emergency situations and predonation apheresis donor screening. RDTs may be used as supplemental assay prior to donor notification.
Two Sample Policy
Authors: Setia Rasika D , Dogra Mitu , Yadav Ramesh 
Published: August 2023

Background and Objectives:
Pretransfusion testing has undergone remarkable changes over the past few decades starting from manual methods to semi-automation to full automation, but sample collection from the right person is out of scope of blood center. Through this study, we tried to address this issue by introducing two-sample policy in our institute. The objective of this study is to emphasize the importance of using two different samples for type and screen and crossmatch.

Methods:
This is a retrospective study extending over a period of 3.5 years (January 2015–June 2018) in a tertiary care health center. Retrospective data collections were done for the period post implementation of two-sample policy in the institute. As per the two-sample policy, two samples of the same patient would be collected, one at the time of type and screen and other at the time of blood component arrangement request. In case of any discordance between the two samples, incident is generated.

Results:
Of total 110,949 requests, 85,326 blood/blood components were issued, 56879 of which were for packed red blood cells (PRBCs) and a total of 34,922 PRBC units were released in the study duration. A total of 22/(0.06%) errors were recorded as grouping discrepancy between type and screen sample and sample received for blood component arrangement request. Incidentally, all 22 cases were for the arrangement of PRBC. Out of 22 errors, 20 were near misses and were detected in immunohematology laboratory at the time of compatibility testing and 2/22 (9.09%) errors were actual no harm events.

Conclusion:
The problem of wrong blood in tube (WBIT) is still a challenge faced by many laboratory persons. The issue can be resolved by training dedicated staff for sample collection. Although this policy has many drawbacks, such as added costs of sample collection and double testing, inconvenience to the patient, delay in providing blood, and increased type O blood use, we would like to emphasize that it would be helpful in error reduction.
Blood Component Therapy in Coronavirus Disease-2019 Patients Hospitalized in a Tertiary Care Center in Eastern India
Authors: Das Sudipta Sekhar , Biswas Rathindra Nath 
Published: August 2023

Background and Objectives:
Most patients with coronavirus disease-2019 (COVID-19) do not need blood transfusion, and only a subset of critically ill patients requires transfusion. Here, we describe the pattern of blood usage in COVID-19 patients in our hospital with regard to indications, clinical and laboratory evaluations, and blood and blood component transfusions.

Methods:
This is a retrospective study that included 34 hospitalized transfused patients admitted with clinical features and diagnosis of COVID-19. Demographic, clinical, laboratory, and blood transfusion details were obtained from patient files and blood bank software. Statistical analysis was done using the IBM SPSS statistical package.

Results:
Among the 419 hospitalized COVID-19 patients, 34 (8.1%) received blood transfusion. Levels of D-dimer, serum ferritin, and interleukin-6 as high as 8545 ng/mL, 8486 ng/mL, and 256 pg/mL, respectively, were observed in few patients. Comorbidity was demonstrated in 91.2% of transfused patients. A total of 6 (17.6%) patients succumbed to disease. Packed red blood cell was the main blood component transfused to COVID-19 patients followed by platelet (PLT) and plasma products. A rise in trend in blood utilization was demonstrated from March to June 2020 with a dip in July 2020. Compared to other months, more patients required PLT concentrates in June 2020.

Conclusion:
Blood utilization in COVID-19 patients is usually low and does not affect the blood inventory significantly. Most transfused patients have been critically ill, and the trend in blood utilization in COVID-19 patients may be difficult to ascertain.
Justification of Blood Requisition
Authors: Kesarwani Nitika , Bahadur Shalini , Mahajan Saurabh , Kumar Anand 
Published: August 2023

Background:
The purpose of this study is to compile and review the blood utilization in various surgical departments in a tertiary care trauma center. To monitor and improve transfusion practices, analysis of effective usage of blood and its components is necessary.

Methods:
A retrospective cross-sectional study was done in the department of pathology in our center for a period of 6 months. Data from blood requisition forms, transfusion forms, and issue register were compiled and reviewed. The number of units requested cross-matched and transfused for every patient was collected. Statistical Analysis: The data were entered in SPSS version 20 and analyzed through the calculation of blood transfusion parameters: (i) cross-match to transfusion ratio (C/T), (ii) transfusion probability (T%), and (iii) transfusion index (TI).

Results:
2724 units of blood was cross-matched and 2108 units of blood was transfused. The overall C/T ratio calculated was 1.29, TI was 0.77, and T% was 88.2%. All these figures are under the desirable range.

Conclusion:
The study concluded that though the trauma center in our hospital meets the parameters required for blood transfusion, yet the departments requiring blood should critically analyze the blood requisitions to minimize the blood bank load and cost.