Predicting donor-related factors for high platelet yield donations by classification and regression tree analysis

Introduction Collecting high-dose (HD) or double-dose (DD) apheresis platelets units from a single collection offers significant benefit by improving inventory logistics and minimizing the cost per unit produced. Platelet collection yield by apheresis is primarily influenced by donor factors, but the cell separator used also affects the collection yield. Objectives To predict the cutoff in donor factors resulting in HD and DD platelet collections between Trima/Spectra Optia and MCS+ apheresis equipment using Classification and Regression Trees (CART) analysis. Methods High platelet yield collections (target ≥ 4.5 × 1011 platelets) using MCS+, Trima Accel and Spectra Optia were included. Endpoints were ≥ 6 × 1011 platelets for DD and ≥ 4.5 to < 6 × 1011 for HD collections. The CART, a tree building technique, was used to predict the donor factors resulting in high-yield platelet collections in Trima/Spectra Optia and MCS+ equipment by R programming. Results Out of 1,102 donations, the DDs represented 60% and the HDs, 31%. The Trima/Spectra Optia predicted higher success rates when the donor platelet count was set at ≥ 205 × 103/µl and ≥ 237 × 103/µl for HD and DD collections. The MCS+ predicted better success when the donor platelet count was ≥ 286 × 103/µl for HD and ≥ 384 × 103/µl for DD collections. Increased donor weight helped counter the effects of lower donor platelet counts only for HD collections in both the equipment. Conclusions The donor platelet count and weight formed the strongest criteria for predicting high platelet yield donations. Success rates for collecting DD and HD products were higher in the Trima/Spectra Optia, as they require lower donor platelet count and body weight than the MCS+.

Comparison of abo antibody levels in apheresis platelets suspended in platelet additive solution and plasma

ABSTRACT Background Transfusion of platelets (PLTs) with high ABO antibody titres can pose a risk of hemolysis if the unit crosses the ABO type. The PLTs stored in the platelet additive solution (PAS) remove asubstantial fraction of plasma and replace it with an isotonicbuffered solution.We aimed to assess the difference in anti-A/B antibody levels in Groups O, A and B apheresis platelets (APs) suspended in plasma and PAS. Methodology Apheresis donors are categorized into two groups, Plasma (Group I) and PAS (Group II), each blood group (A, B and O) had 20 samples. The anti-A/B(IgM)antibody levels were recorded from the AP donor (Group II) and from the AP units for both groups. The reduction in the anti-A/B(IgM) antibody levels in the APs suspended in the PAS for each blood group was determined. Results The median anti-A titres in blood Groups B (p = 0.009) and O (p = 0.005) was significantly lower in Group II. However, the difference in anti-B levels was not significant in the blood groups A (p = 0.057) and O (p = 0.205). The median level of reduction in IgM antibody titres across donor samples and the PAS-stored platelets was two-fold. The regression showed a level of reduction in antibody titres which can be explained by baseline donor antibody titres in blood groups A and B compared to blood group O. Conclusion The medianABO antibody titres were lower in APs suspended in PAS than in plasma. Addition of the PAS significantly lowered the IgM antibody titres by twofold, compared to plasma.

Screening Aids for Oral Squamous Cell Carcinoma.

Oral cancer is the sixth most common cancer seen worldwide out of which squamous cell carcinoma accounts for 94% of oral cancer. Squamous cell carcinoma is found to be a more prevalent in south Asia because of habits like betel quid, tobacco chewing, and areca nut. Th ese along with alcohol are considered as the major risk factors. Th e mutagenic eff ects produced by these are dose and duration dependent. Some cases of squamous cell carcinoma were found in persons without habits. Early detection of oral cancer is the key factor which helps in the faster treatment and improves the survival rate of patients. A brush biopsy is the simple and inexpensive cytological technique in which an OralCDx Brush is used to collect the cells by scrubbing the mucosal site followed by spreading the sample into the glass slide which is then stained. Veloscope is a device which measures the alteration of autofl uorescence of the oral mucosa. Th e patients, in many cases, may be unaware initially as many of these lesions are asymptomatic during the initial stages and might be fi rst detected by a dentist. Th us, proper knowledge on the clinical features and eff ective use of the screening aids are essential to produce the best possible long-term outcome.

A study of aerobic bacterial pathogens associated with vaginitis in reproductive age group women (15-45 years) and their sensitivity pattern.

Background: Aerobic vaginitis (AV) is caused by a displacement of the healthy vaginal Lactobacillus species with aerobic pathogens such as Enterococcus faecalis, Escherichia coli and Staphylococcus aureus that triggers a localized vaginal inflammatory immune response. AV if it is not diagnosed and treated early, especially during pregnancy can place the health of both the mother and the foetus at risk as it is associated with preterm birth, premature rupture of membranes (PROM) and chorioamnionitis. Hence the present study aims at analysing the prevalence of aerobic vaginitis in females in the reproductive age group (15-45 years) with special reference to pregnancy, pathogens involved and their antibiogram. Methods: Over one year period, high vaginal swabs were collected from 125 women with clinical suspicion of vaginitis. They were then subjected to Gram’ staining and culture was made onto blood agar, chocolate agar and MacConkey agar and incubated aerobically at 37 0c for 24 hours. The AV score was determined and the organisms were then identified and antibiotic sensitivity test of isolates were performed. Results: The prevalence of Aerobic vaginitis in this study was 20.8% (26/125) and the most common age group affected was between 26-30 years. Out of the 26 positive cases, 21 samples yielded monobacterial growth and 5 cases polybacterial growth. The most common organism isolated was Enterococcus faecalis (32.26%), followed by Escherichia coli (25.8%), Staphylococcus aureus (19.35%) and β-hemolytic streptococci (9.68%). Antibiotics like β–lactams/ β–lactamase inhibitor combinations, vancomycin and linezolid were found to be more effective against all Gram positive isolates whereas the Gram negative isolates were more sensitive towards β–lactams/ β–lactamase inhibitor combination, aminoglycosides and meropenem. Conclusions: This study emphasized on the need to identify the aerobic vaginal pathogens associated with vaginitis especially in reproductive age group women which can go a long way in preventing the adverse outcomes associated with pregnancy and also ensures the necessity to determine the antibiotic sensitivity pattern of the pathogens which can aid in making a suitable therapeutic choice for 'aerobic vaginitis' by considering an antibiotic that is characterized by an intrinsic activity against the majority of bacteria of faecal origin, bactericidal effect and without any interference with the vaginal microbiota.

Cerebral Venous Thrombosis Due to Abrin Toxicity: A Case Report.

Abrus precatorius (jequirity bean) is a common cause of accidental or intentional poisoning in the tropics. The data on exact incidence of abrus poisoning is largely insufficient in our country, due to lack of reporting. The estimated lethal dose for humans is 0.1-1 μg/kg. The toxic component is the protein abrin that causes widespread endothelial damage. Abrin causes a variety of manifestations like hemorrhagic gastroenteritis with erosions, hemolysis, acute renal damage, dyselectrolytemia, hepatotoxicity with elevated liver enzymes and seizures. Apart from the common manifestation of hemorrhagic gastroenteritis, patients experiencing mental status perturbations have been identified and documented earlier. There have been previous reports of elevated intracranial tension (ICT) in abrus poisoning, however, the exact cause for this phenomenon had not been elucidated. We herein report a case of intentional A. precatorius poisoning in a young girl that caused cerebral venous thrombosis (CVT).

Prune belly syndrome (sequenze): a case report.

The Prune Belly syndrome (PBS) also known as Eagle Barret syndrome is a rare disorder. It is an abdominal muscles deficiency syndrome characterized by a Triad syndrome i.e. deficiency of abdominal wall muscles, failure of testicular descent and dilation of the urinary tract. This syndrome has derived its name from the wrinkled prune appearance of the abdominal wall. Prune Belly syndrome is a rare anomaly seen in one in 35,000-50,000 live births. It occurs in all races. Prune Belly syndrome almost exclusively occurs in males (M:F, 20:1). The diagnosis can be made in utero by ultrasonography at 21 weeks of gestation or in the Neonate with characteristic clinical findings. The present case was a dead male fetus of 20 weeks of gestation sent to Anatomy department after Medical termination of pregnancy, due to congenital anomalies identified in routine ultrasound examination during antenatal checkup.