Detection of ABO Blood Groups From Dentin and Pulp by Using the Absorption-Elution Technique: A Forensic Cross-Sectional Study Among the Population of the Al Jouf Province, Saudi Arabia.

Background and objective Human teeth have a significant forensic importance. As they are the hardest of all human tissues, they are not just chemically stable but also their characteristics are maintained for a long time after death even in the most harsh environmental conditions. Despite the advances made in DNA analysis, fingerprinting, etc., ABO blood grouping still plays a significant role in the forensic practice in the field of personal identification, paternity disputes, and several other scenarios including the identification of mass disaster victims. The term blood groups refers to inherited antigens on the surface of red blood cells (RBCs) detected by specific antibodies. Since tooth pulp contains numerous blood vessels, blood group antigens are most certainly bound to be present in tooth pulp. Various studies have shown that blood group antigens in the pulp and dentin are preserved as long as up to two years after the demise of an individual. Absorption-elution technique has been proven to be the most sensitive, reliable, and consistent method to determine the ABO blood group from both the pulp and dentine. This study aimed to ascertain the ABO blood group from both the hard (dentin) as well as the soft tissue (pulp) of the tooth by using the absorption-elution (AE) technique and also to determine if there are any variations in identifying the blood groups from the teeth based on age and gender. Material and methods After obtaining due consent, we included patients of both genders aged between 16-60 years visiting the outpatient department (OPD) clinics at the College of Dentistry for periodontal or orthodontic extractions. One patient's blood type was determined by using the slide agglutination technique before any capillary blood extraction was performed; this patient served as a control. For this investigation, we used the pulp and powdered dentin samples taken from the dental extractions to test for the presence of ABO and Rhesus (Rh) factor antigens by using the AE method. The study samples were compared with the control for blood group determination. Statistical analysis was carried out using the chi-square test with Monte Carlo (MC) simulation to check for any correlation of blood grouping with age and gender. Results The dentin and pulp were shown to have positive blood group antigens for the ABO and Rh factors. While neither pulp nor dentin performed significantly differently in identifying the blood group antigens, pulp showed marginally higher accuracy. There was no discernible difference regarding gender or age in the dentin or pulp of any of the 45 samples studied. Conclusions For determining an individual's blood type and Rh factor, both the hard (dentin) and soft (pulp) tissues of a tooth are valid sources. This is particularly helpful in forensic medicine cases where teeth are the only remains that can be viably used to find out a person's identity.

Association of blood group with COVID-19 disease susceptibility and severity in Saudi Arabia.

BACKGROUND: Novel SARS-CoV-2 (COVID-19) virus has rapidly spread worldwide and was declared a pandemic, making identifying and prioritizing individuals most at risk a critical challenge. The literature describes an association between blood groups and the susceptibility to various viral infections and their severity. Knowing if a specific blood group has more susceptibility to COVID-19 may help improve understanding the pathogenesis and severity of the disease. We aimed to assess the association between ABO/RhD and COVID-19 susceptibility and severity, and to compare results with similar studies in Saudi Arabia. STUDY DESIGN AND METHODS: This study was conducted between March and October 2021 on 600 patients confirmed positive for COVID-19 infection. Patients' data were collected and analyzed. As a control, 8423 healthy blood donors were enrolled as a sample representative of the population for blood group distribution. RESULTS: More individuals had blood group B in the COVID-19 group in comparison with the control group (24.2% vs. 18%), The opposite was observed among individuals of group O (39.5% vs. 47.3%). The B blood group was predictive of higher risk of mortality. No significant difference in the distribution of RhD was observed between the COVID-19 and the control groups. Neither ABO nor RhD was significantly associated with the severity of COVID-19. DISCUSSION: Although there was no significant association with the disease severity, the B blood group may be associated with a higher risk for COVID-19 infection. Further studies with a larger sample size are necessary to evaluate this correlation.

An Insight Into the Distribution of Allele Frequency of ABO and Rh (D) Blood Grouping System Among Blood Donors in a Tertiary Care Hospital in Chengalpattu District of South India.

Introduction The distribution of ABO and Rh (D) blood groups and their allele frequencies vary from one population to another worldwide. The objective of the study is to estimate the distribution of ABO & Rh (D) blood groups among all the blood donors in a tertiary care hospital in Chengalpattu district of Tamilnadu in South India and to determine their allele frequencies. Methods This was a retrospective observational study carried out in the blood bank of Karpaga Vinayaga Institute of Medical Sciences and Research Centre from January 2015 to December 2021. ABO and Rh (D) blood grouping of all the blood donors were carried out by tube agglutination method. Allele frequency of the blood group genes was calculated based on Hardy-Weinberg equilibrium. Results Out of total a of 7598 blood donors, 7576 (99.71%) were males and 22 (0.29%) were females. The most common blood group was O positive (37.67%) while AB negative (0.18%) was the least common blood group. The phenotypic frequency of blood group O (39.17%) was the highest and that of blood group AB (7.88%) was the least. A majority (95.96%) of the blood donors were Rh (D) positive. The allele frequencies of ABO and Rh (D) blood groups were 0.1628 for IA, 0.2177 for IB, 0.6259 for IO, 0.7991 for ID, and 0.2009 for Id. Conclusions The distribution of the two major blood group systems namely ABO and Rh (D) systems show considerable heterogeneity in different populations of the world. Information about allele frequencies of blood groups among different populations worldwide will help in framing policy decisions to face future challenges in healthcare services.

Relationship Between Helicobacter pylori Infection, Serum Vitamin D3 Level and Spontaneous Abortion.

BACKGROUND: The effects of vitamin D3 (VD3) on pregnancy outcomes remain obscure. Thus, this study aims to investigate the relationship between maternal H. pylori infection, low VD3 level, and spontaneous abortion. METHODS: This research is conducted in Shahid Ali Qader Consultant Clinic in Sulaimaniyah city in which 100 women with a history of abortion and 100 women with no history of miscarriage were included. Serum detection of anti-H. pyloriIgG, IgA, and VD3 were done using enzyme-linked immunosorbent assay (ELISA) technique. RESULTS: The mean of VD3, H. pylori IgG, and IgAin patients and control group cases was determined and analyzed statistically. CONCLUSION: H. pylori infection and VD3 play a significant role in early pregnancy loss. Blood group A and O are more prone to spontaneous abortion.

Human errors in manual techniques for ABO/D grouping are associated with potentially lethal outcomes.

AIMS/OBJECTIVES: To review if ABO/D grouping errors are more likely to occur with manual intervention compared to automation. BACKGROUND: Human errors in manual pre-transfusion testing may result in ABO/D-incompatible transfusions and catastrophic outcomes. Accurate ABO/D grouping is a critical part of pre-transfusion testing. METHODS: This was a retrospective analysis of reports made to Serious Hazards of Transfusion (SHOT) between January 2004 and December 2016 where ABO/D grouping errors led to the transfusion of an incorrect blood component to review if errors are more likely to occur with manual intervention compared to automation. RESULTS: In 148 of 158 (93%) ABO/D grouping errors, manual intervention took place. In the remaining 10, causes were not reported. No errors occurred with full automation. Interpretation errors occurred in 86 of 148 (58%) and 42 of 148 (28%) transcription errors, and in 20 of 148, wrong or no samples were selected. Of 148 errors, 21 (14%) resulted in ABO-incompatible transfusion, with one death in 2004 due to an interpretation error in a manual ABO group. In 30 of 148 (20%), D-positive red cells were given to D-negative recipients, where three women of child-bearing potential became sensitised and developed anti-D. ABO grouping errors have reduced from 18 of 539 (3%) of total reports analysed in 2004 (3·3%) to 3 of 3091 (0·10%) in 2016. CONCLUSIONS: Where manual testing cannot be avoided, results should be confirmed using automated techniques as soon as possible, and a back-up process should be available 24/7. SHOT data confirm that manual interventions are prone to human error, especially in transcription and interpretation, and demonstrate a continuing need for appropriate serological knowledge and understanding by transfusion laboratory staff to underpin safety provided by automation and information technology (IT).

Rapid rare ABO blood typing using a single PCR based on a multiplex SNaPshot reaction.

BACKGROUND: ABO subgroups would be considered when discrepancies in ABO grouping occur. Serological methods including adsorption-elution test, salivary ABH inhibition test, and anti-A1 (lectin) saline method could be used. However, these serological methods are laboring and obscure. Therefore, reliable and affordable method to assess the ABO subgroups is of particular interest. METHODS: To solve this problem, the multiplex SNaPshot-based assays were designed to determine rare A and B subgroups. Primers used as probes for determination of rare ABO blood groups known in Taiwanese population were designed. Many ABO subtype samples were used to validate the accuracy and reproducibility of our SNaPshot panel. RESULTS: A panel of primer probes were successfully designed in determining 8 SNP sites (261, 539, 838, 820, 745, 664, IVS6 +5, and 829 in exon 6 and 7) for A phenotype and 6 SNP sites (261, 796, IVS3 +5, 247, 523, and 502 in exon 2, 6 and 7 and intron 3) for B phenotype. SNaPshot analysis for defining blood group A alleles (A1, A2, A3, Am and Ael) and blood group B alleles (B1, B3, Bw and Bel) was therefore available. CONCLUSION: SNaPshot analysis could be used in reference laboratories for typing known rare subgroups of A and B without DNA cloning and traditional sequencing. Moreover, this method would help to construct databases of genotyped blood donors, and it potentially plays a role in determining fetal-maternal ABO incompatibility.

Evaluation of new indigenous "point-of-care" ABO and Rh grouping device.

BACKGROUND: Erycard 2.0 is a "point-of-care" device that is primarily being used for patient blood grouping before transfusion. MATERIALS AND METHODS: Erycard 2.0 was compared with conventional slide technology for accuracy and time taken for ABO and Rh forward grouping result with column agglutination technology (CAT) being the gold standard. Erycard 2.0 as a device was also evaluated for its stability under different storage conditions and stability of result till 48 h. In addition, grouping of hemolyzed samples was also tested with Erycard 2.0. Ease of use of Erycard 2.0 was evaluated with a survey among paramedical staff. RESULTS: Erycard 2.0 demonstrated 100% concordance with CAT as compared with slide technique (98.9%). Mean time taken per test by Erycard 2.0 and slide technique was 5.13 min and 1.7 min, respectively. After pretesting storage under different temperature and humidity conditions, Erycard 2.0 did not show any deviation from the result. The result did not change even after 48 h of testing and storage under room temperature. 100% concordance was recorded between pre- and post-hemolyzed blood grouping. Ease of use survey revealed that Erycard 2.0 was more acceptable to paramedical staff for its simplicity, objectivity, and performance than conventional slide technique. CONCLUSION: Erycard 2.0 can be used as "point-of-care" device for blood donor screening for ABO and Rh blood group and can possibly replace conventional slide technique.

Report on External Proficiency Testing for the ABO and D Blood Group Typing Tests in Blood Centers (2014) / 대한수혈학회지

BACKGROUND: Korean Blood Safety Commission has implemented external proficiency testing (PT) for blood grouping test (BGT) to help improve the quality of blood centers since 2011. We analyzed the results of 2014 PT for BGT to help in planning the future PT for BGT and to improve the quality of blood centers. METHODS: Whole blood survey samples including three panels for ABO grouping and three panels for D typing were sent to 69 institutes. Evaluation criteria for BGT were as follows: 'Good' for answers matched with intended results, 'Acceptable' for correct answers other than that of 'Good', 'Unacceptable' for answers other than those of 'Good+acceptable' as correct answers; and 'Not graded' for answers in case of different answers in the two standard laboratories. RESULTS: All of the answer rates of 'Good' for D typing were 100%. However, the answer rates of 'Good' for cell typing, serum typing and interpretation for 14-ABO-2 samples with discrepant result between cell typing and serum typing were 39.1%, 29%, and 47.8%, respectively. Those of 'Unacceptable' for cell typing and interpretation for 14-ABO-2 samples were 2.8% and 1.4%. CONCLUSION: Because the answer rates of ABO grouping for samples with discrepant result between cell typing and serum typing were not high, education for this case is needed. Diversity of materials for PT would be necessary for more accurate evaluation of the performance of BGT in blood centers.

Report on External Proficiency Testing for the ABO and D Blood Typing in Blood Centers in 2012 and 2013 / 대한수혈학회지

BACKGROUND: It was reported that a continuous education program and external proficiency testing (PT) for blood grouping test (BGT) might be necessary because some blood centers of medical institutions could not correctly examine ABO subtype and D variant, according to the results of the first year project in 2011. Therefore, the results of PT for BGT in blood centers in 2012 and 2013 were compared to those in 2011 in order to assess the impact of projects during a period of three years and to help in planning the future PT for BGT. METHODS: Whole blood survey samples composed of three panels for ABO grouping and three panels for D typing were sent to 74 and 71 institutes in 2012 and 2013, respectively. Evaluation criteria for BGT were as follows: 'Good' for the answers matched with intended results, 'Acceptable' for the correct answers other than that of 'Good', and 'Unacceptable' for the answers other than those of 'Good+acceptable' as correct answers. RESULTS: The answer rates of 'Unacceptable' for ABO subtype were 1.4% in 2012 and 4.2% in 2013. However, the answer rate of 'Good' increased from 44.6% in 2012 to 83.1% in 2013. The answer rate of 'Unacceptable' for D variants showed a marked decrease, from 16.2% in 2012 to 1.4% in 2013. CONCLUSION: Projects for PT for BGT during a period of three years have improved laboratory quality in blood centers. However, the acquisition and change of the materials for PT would be necessary in order to continuously and practically provide help to blood centers.

Report on External Proficiency Testing for Blood Grouping Tests in Blood Centers (2011) / 대한수혈학회지

BACKGROUND: To ensure safety of blood transfusion, accuracy in performance of blood grouping tests (BGT) is essential. External proficiency testing (PT) for BGT has not been conducted in Korea. The first PT for BGT in domestic blood centers was conducted in order to evaluate the domestic status of accuracy of BGT in blood centers and to aid in improving the quality of blood centers. METHODS: Whole blood survey specimens consisting of three panels for ABO grouping and two panels for Rh typing were sent to 81 blood centers. Evaluation criteria for BGT were as follows: 'Good' for answers with 100% referee consensus, 'Acceptable' for correct answers other than those of the referee, and 'Unacceptable' for answers other than those of 'Good+acceptable' as correct answers. RESULTS: Rates of correct answers on three panels for ABO grouping were all 100%; however, that of cell typing for the panel with BW was 61.7%, and 31 blood centers incorrectly reported normal 'B' type as an answer. The rate of correct answers for the Rh negative panel was 100%; however, that for the weak D panel was 84%, and 13 blood centers incorrectly reported Rh negative type as an answer. CONCLUSION: Findings from this study demonstrated that some hospital blood centers were not able to correctly detect blood groups with weak antigens. Therefore, to improve the quality of blood centers, intensive education for blood center staff and continued PT for BGT should be required.

Annual Report on External Quality Assessment in Blood Bank Tests in Korea (2004) / 임상검사와정도관리

We report here the results of surveys for external quality assessment of blood bank tests performed in 2004. Response rates for the 1st, 2nd and 3rd trial were 96.4%, 96.8%, and 96.8%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 100% and 100%, respectively. In crossmatching test, the accuracy rates were 96.2-97.8% for the compatible samples, 75.5-90.6% for the incompatible samples, and 75.5-90.6% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.8-100% for negative samples and 87.3-98.8% for positive samples. The correct results were reported by 98.8-100% of the surveyed institutions for antibody screening test and 100% for identification test. Forty six institutions gave repeatedly incorrect answers for crossmatching. Nine institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.