Guidelines on Covid-19 for Blood Banks.

General measures for infection prevention and control should be followed by the health care workers as the world struggles to control Covid-19 spread. Medical professionals and researchers continue to fight with the recent global outbreak of Covid-19 and its potential impact on blood transfusion services is real and a cause of concern for transfusion medicine experts. The 2002 - 03 SARS outbreak saw 8098 reported cases resulting in 774 deaths, and a 9% mortality rate.(1) The mortality rates for the same spiked to 50% for individuals over the age of 60. It is accepted that the present Covid-19 outbreak originated in bats. As per the American Association of Blood banks (AABB).(2) There is no reported or suspected case of transfusion transmitted Covid-19.(3,4,5) Similarly, in India there is no reported case of transfusion transmission. Social distancing of blood donors is of paramount importance for blood donors while blood collection. Similarly, organizing of blood donation camps by organisers and blood bank staff should ensure the same. Facilities for hand washing for blood donors and use of mask should be ensured. Blood donation by blood donors with travel history should be deferred for 28 days.

Do cytokines correlate with disease activity in tuberculous meningitis?

Background: Tuberculous meningitis (TBM) remains to be one of the most fatal central nervous system infections. The exact pathogenesis of TBM at cellular level remains unclear. In this study, we assessed the cytokine levels in the serum and cerebrospinal fluid (CSF) of TBM patients and determined their correlation with the disease activity. Methods: The levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were measured by enzyme linked immunosorbant assay (ELISA) in both serum and CSF of 38 patients at baseline, and in 17 of these patients at 1 and 6 month of follow-up. Clinical examination and imaging was performed at baseline and on follow-ups. Results: There was a remarkable rise in the levels of serum and CSF TNF-α and IL-1β in TBM patients as compared to age and sex matched controls (p<0.05). A significant correlation was found between cytokine levels and stages of TBM (p< 0.05). TNF-α levels in both serum and CSF and IL-1β levels in serum were found to be significantly higher in those patients who died than those who survived and had better outcome. TNF-α was higher in patients who developed tuberculoma on follow-up than those who did not (p<0.05). The cytokine levels progressively declined over time but remained detectable till 6 months in most patients. Conclusions: The higher levels of TNF-α and IL-1β were associated with poor outcome in TBM. The higher cytokine levels in patients developing tuberculoma on antituberculous therapy and steroids suggests that these patients may benefit from immunomodulation agents like anti-TNF-α antibody.