Effect of double dose plateletpheresis on target yield and donor platelet recovery

Abstract Introduction The demand for apheresis platelets has increased in the recent past and the shrinking donor pool has shifted the trend to collection of double-dose or higher yield of platelets. Objective The present study aimed to determine the effect of double-dose plateletpheresis on the target yield and donor platelet recovery. Methods The study was conducted on 100 healthy plateletpheresis donors, 50 of whom were in the study group, which underwent double-dose plateletpheresis (DDP), and 50 of whom were in the control group for single-donor plateletpheresis. Pre- and post-procedure samples of donors were subjected to a complete blood count. The DDP product was sampled for platelet yield and then split into two parts. Platelet yield, collection efficiency, collection rate, recruitment factor and donor platelet loss were calculated. Results The mean platelet yield in the SDP was 4.09 ± 1.15 × 1011 and in the DDP, 5.93 ± 1.04 × 1011. There was a significant correlation between the pre-donation platelet count and platelet yield. The total of platelets processed for the SDP were 5.42 ± 1.08 × 1011 and for the DDP, 7.94 ± 0.77 × 1011. The collection efficiency was 71.93 ± 25.14% in the SDP and 72.94 ± 16.28% in the DDP, while the collection rates were 0.78 × 1011 and 0.94 × 1011 per minute, respectively. The average recruitment factor observed was 0.98 in the SDP, while it was 0.99 in the DDP. The mean platelet loss observed in the SDP was 35.55 ± 8.53% and in the DDP, 37.76 ± 8.65%. Conclusion The double-dose plateletpheresis supplements the platelet inventory in developing countries where the apheresis donor pool is limited. It is prudent to ensure stringent donor selection criteria for donors donating high-yield platelet products, thus enhancing donor safety and retention.

Laproscopic evaluation in primary female infertility

Background: Infertility is defined as inability to conceive within one or more years of regular unprotected coitus. Infertility has now a days not only a medical but a social problem as well. Ignorance and illiteracy, coupled with hesitancy to discuss the problem, complicates the matter further. WHO has listed infertility as a global health issue.Methods: The present study was conducted on 64 patients with female factor primary infertility admitted in department of obstetrics and gynecology at Rajendra Hospital, Patiala over a duration of 1 year (December 2013- November 2014). All the patients had normal semen study of their partner.Results: In our study mean age was 27.87±4.57. No patient was above 40 years of age. Duration of infertility between 1-5 years was in 47 patients (73.43%), nine patients (14.06%) were infertile for 6-10 years. Out of 64 patients of primary infertility, majority of patients were of endometriosis 15(23.43%), followed by pelvic inflammatory disease14(21.87%), tubal blockade in 7(10.9%), PCOD in 6(9.37%). 14.08% patients had normal laproscopic study. 34 patients (53.12%) had bilateral spill while no spill was seen in 12 patients (18.75%). Unilateral spill was seen in seven patients (10.93%) while six patients (9.37%) had delayed spill.Conclusions: Prevalence of infertility is increasing, so is the awareness and treatment seeking behavior. The present study assures that in evaluation and workup of primary infertility patients, after baseline noninvasive investigations, endometrial sampling and HSG, the diagnostic and operative laproscopy is an excellent tool for evaluation of tubal factor. Least expected conditions like endometriosis on clinical evaluation, can be diagnosed and treated with ease on laproscopy. Although tubal factor has been considered to be responsible for a large percentage of cases with female secondary infertility since decades, but in present study laproscopic evaluation confirmed tubal factor in 85.01% cases with female factor infertility.

An analysis of the pattern of blood requisition and utilization in a tertiary care center.

Background: Blood utilization audit helps to formulate guidelines for improving transfusion practice in a health care centre. With increasing demand for blood components being unable to meet the supply particularly in developing countries, there is a need to implement strategies for rational use of blood and its components. The present study aims to evaluate the transfusion practices in a hospital based blood centre. Material and Methods: A retrospective audit was conducted on 1000 blood requisitions and 300 requisitions for fresh frozen plasma and platelets. The requisitions were reviewed for pre transfusion hematological values, utilization trends and appropriateness. Results: Out of 1000 requisitions, 67.8% were for packed red cells and 32.2% were for whole blood. Pre transfusion hemoglobin values were available for 11.1%. The urgency for transfusion and indication was mentioned on 18.1% of requisition forms. The maximum cross match to transfusion ratio was for Department of Obstetrics and Gynaecology. The blood utilization was 41.3%. Out of 300 requisitions for fresh frozen plasma/platelets, 67.33% were for fresh frozen plasma and 32.6% were for platelets. Only 25.66% of requisitions had prothrombin index/platelet count mentioned. Over ordering was seen in 37.33% of requisitions. Conclusion: Retrospective audits help to identify key areas that need interventions to change local guidelines for transfusion. There is need for regular audit to improve transfusion practices in a health care set up. A type and screen policy for routine surgeries and obstetric patients should be implemented to save valuable time and resources in developing countries.

Patterns of infections among blood donors in a tertiary care centre: A retrospective study.

Background. Transfusion-transmitted infections continue to be a threat to safe transfusion practices. We analysed the prevalence and patterns of co-infections among voluntary and replacement donors. Methods. Blood donations collected over a 5-year period were studied for the type of donation (voluntary or replacement), number of seroreactive cases and the number, type and distribution of co-infections. Results. Of the 42 439 units of blood collected over a 5- year period, 19 118 (45%) were from voluntary and 23 321 (55%) from replacement donors. There were 1603 seroreactive cases (3.8%). These included 250 with HIV (0.6%), 734 with hepatitis B surface antigen (HBsAg; 1.7%), 337 with hepatitis C virus (HCV; 0.8%) and 282 (0.7%) with VDRL (Venereal Diseases Research Laboratory) reactivity. Twenty-three (0.05%) of these had >2 seroreactive infections; 20 of these were in replacement donors and only 3 in voluntary donors and the difference was statistically significant (p<0.005). Among HIV seropositive donors, there were 4 seroreactive for syphilis and 5 for HBsAg. Among HIV seronegative donors, 5 were seroreactive for HBsAg and VDRL, 4 for HCV and VDRL, and 2 for HBsAg and HCV. One person was seroreactive for HIV, HBsAg and VDRL. The multiple infection rate showed a decreasing trend over the years. Conclusion. Multiple infections pose a small but definite risk to the recipients of blood products. Voluntary donations are safer as compared with replacement ones and need to be encouraged.

Bombay phenotype in two North Indian brothers: a case report.

Bombay phenotype is unique in the aspect that the red cells are not agglutinated by antisera A, B and H. However the serum of such individuals contains anti A, B and strongly reactive anti H which agglutinates red cells of 'O' group individuals through a wide thermal range. The blood specimen of a 35 year old male donor who donated blood for the first time was subjected to detailed cell and serum grouping. There was a discrepancy between the results. The possibility of Bombay phenotype was considered and the sample was tested with anti H lectin. Further confirmation of blood group and secretor status was done from a reference laboratory. Family studies showed the same blood group in the elder sibling of the propositus. The present case highlights the significance of correlating cell and serum grouping results. Moreover, this blood group is very rare in North India. Family studies revealed the propositus to possess the B gene which was suppressed in the donor but expressed in the offsprings. The use of anti H in discrepant blood grouping results is recommended.

Transfusion-transmitted infections: existing and emerging pathogens.

In general, the risk of transfusion-transmitted infections has been greatly reduced today. However, blood-borne bacterial and parasitic infections and emerging infections transmitted through transfusion are an area of increasing concern. Implementation of stringent donor eligibility criteria, improved donor screening and more sophisticated as well as sensitive methods of antibody, antigen and viral genome detection, have virtually eliminated transfusion transmitted infection in developed countries. In developing countries like India, the risk of transfusion-transmitted infections is still considerable. A comprehensive MEDLINE search and review of relevant transfusion medicine literature were carried out and the data extracted and studied with particular reference to emerging pathogens transmitted through blood transfusion and posing a huge threat.

Solitary plasmacytoma of bone: fourteen years disease-free survival.

Solitary plasmacytomas are rare tumors of plasma cell origin categorized as extramedullary plasmacytoma (EP) and solitary plasmacytoma of bone (SPB). We report here a case of SPB who is off treatment for 14 years and is completely disease-free.