The prevalence of markers for hepatitis B and human immunodeficiency viruses, malarial parasites and microfilaria in blood donors in a large hospital in south India.

Blood donors (35,395) were screened at the CMC Hospital, Vellore, in South India during the 2-year period from July 1986 to June 1988. They were either relatives of patients (referred to as replacement donors) or volunteers. Paid or professional donors were not accepted. Of the replacements 21.5% and of the voluntary donors 9.7% were rejected. Mean donor age was 32.2 years and the commonest blood group was O (39.46%), Rh positive (93.93%). Hepatitis B surface antigen was found in 1.37% and 2.96% of voluntary and replacement donors respectively. Anti-HIV antibodies were found in 1.9/1000 donors. This shows an increasing prevalence of HIV infection in the Indian donor population not reported earlier. The prevalences of malarial parasites and microfilaria in replacement donors were 0.02 and 1.62% respectively. In voluntary donors, malarial parasites were not found and microfilaria were found in only 0.15%. All rejection criteria except low haemoglobin were significantly more frequent among replacement donors than among voluntary donors. In the light of these results, screening of all donor blood for HBsAg and Anti-HIV by the most sensitive techniques and for malarial and filarial parasites in endemic areas is essential.

Glanzmann's thrombasthenia. A review and report of 42 cases from South India.

In the 14 year period from June, 1966 to June, 1980, 42 cases of Glanzmann's thrombasthenia have been diagnosed, all fulfilling the criteria of prolonged bleeding time, with normal venous platelet count, defective clot retraction and decreased platelet aggregation, associated with a lifelong bleeding tendency. Few cases have been reported from India though it is the fourth most common congenital bleeding disorder among the patients seen at the Christian Medical College Hospital, Vellore. The large number of such cases found in South India as compared with reports from other parts of the world may be due to the high degree of consanguinity which is part of the accepted culture in this area. Reliable diagnosis of this condition is possible with fairly simple laboratory procedures.

Essential athrombia. A report on 4 cases from South India.

Four cases of essential athrombia have been diagnosed in the 14 year period from June, 1966 to June, 1980 at the Coagulation Laboratory of the Christian Medical College Hospital, Vellore. All cases fit Inceman's description of the original case and fulfill the diagnostic criteria of prolonged bleeding time, decreased platelet aggregation, normal platelet count, normal morphology and normal clot retraction. No cases have been reported from India in the past 15 years.

Renal failure following snake bite. A clinicopathological study of nineteen patients.

Clinical, hematological, and renal biopsy findings in 19 unselected patients with renal failure following snake bite, including eight bitten by Russell's viper, are presented. Hematological findings were variable and did not influence treatment. Renal histology was a good guide to prognosis; patients with normal histology recovered with conservative management, those with tubular necrosis responded well to dialysis, while those with cortical necrosis responded only partially. Peritoneal dialysis was found to be an adequate form of treatment in the majority of patients.

Hepatitis B antigen and viral hepatitis type B in India.

Surveys were conducted to determine the occurrence of overt hepatitis manifested by jaundice in groups of hospital patients who had survived their initial illness. Of those who had been given blood that had not been screened for the presence of hepatitis B antigen (HB Ag) 9.4% reported that they had had jaundice during the 6 months following transfusion. During a similar period jaundice was reported by only 1.1% of those who had received blood found to be negative for HB Ag by the cross-over electrophoresis test. This difference is highly significant. Jaundice was reported by 25.5% of recipients of HB Ag-positive blood. Of a control population of hospitalized but non-transfused patients 2.2% reported jaundice within 6 months of hospitalization. The risk of overt hepatitis from HB Ag in transfused blood is high in southern India and is similar to that in temperate countries where the occurrence of antigen carriers, and presumably of immune status, are lower than in the tropics.