bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract:
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.
Syncopal reactions in blood donors: Pathophysiology, clinical course, and features
Authors: Basavarajegowda Abhishekh , Nalini Y. C. 
Published: September 2022

Abstract
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

Abstract

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

Abstract:

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

Abstract:
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

Abstract

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

Abstract
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

Abstract

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.