Blood Grouping Research Articles

HPB SO39 - Incidence for the need of blood transfusion for Laparoscopic Cholecystectomy :Is a group and save always needed ?

Abstract Background Major bleeding is rare but among the most serious complications of laparoscopic surgery. As low as 1.3% of patient undergoing laparoscopic cholecystectomy may require a blood transfusion. We propose that not all patients undergoing laparoscopic cholecystectomy require a valid group and save sample, as the risk of bleeding is minimal. Method Health records of 458 patients who underwent cholecystectomy at our two hospital sites were reviewed for blood transfusion up to 30 days post-operatively. This review included elective and emergency procedures from January 2023 till March 2024. Demographics and surgical outcomes, including preoperative Haemoglobin (Hb) levels, need for transfusion, reason for transfusion and amount of units transfused were recorded. We analysed nominal values in proportions and percentages. Results Average pre-operative Hb levels were 13.38 g/dl. 7 patients required peri-operative blood transfusion. Three patients requiring transfusion had conversion to open cholecystectomy. Three patients requiring transfusion underwent emergency procedures. Time to transfusion ranged from 2 hours-5 days. All patients requiring transfusion were at our main hospital site (Watford General Hospital). Our yearly cost of ordering routine group and save sample throughout the audit period was £12,824 Conclusion Routine group and save is not required prior to Laparoscopic Cholecystectomy. In case transfusion is required sufficient time to process a group and save samples is present. High risk patients i.e those with known haematological malignancies, coagulopathy, concurrent use of blood thinner, higher ASA grades can be identified and selective blood grouping performed.

Genetic analysis of a blood donor with combined FUT1 and ABO dual blood group gene variants resulting in para-Bombay and A2 subtype blood types and a literature review

To investigate the serological and molecular genetic characteristics of a voluntary blood donor with combined FUT1 and ABO blood group gene variants causing para-Bombay and A2 subtype, and to review relevant literature on para-Bombay blood types carrying alleles such as FUT101W.37 and FUT101W.23. A blood donor with para-Bombay and A2 subtype who participated in voluntary blood donation at the Dongguan Blood Center in August 2023 was selected as the study subject. Serological tests were performed to identify the ABO blood group, Lewis blood group antigens, and unexpected serum antibodies in the donor. Adsorption-elution test was conducted to detect trace antibodies in the blood donor's plasma to trace the A, B and H antigens on the red blood cell surface. Sanger sequencing was carried out to analyze the sequences of the FUT1 and ABO genes. Using keywords such as "para-Bombay" "FUT1*01W.37" and "FUT1*01W.23" both in Chinese and English, relevant literature on para-Bombay blood type subjects carrying FUT1*01W.37 and FUT1*01W.23 alleles was retrieved from the CNKI, Wanfang Data Knowledge Service Platform, and PubMed databases, and the retrieval time was set as from the establishment of database to December 2022. This study has been approved by the Ethics Committee of Dongguan Blood Center (No. 2022005), and informed consent of blood donation was obtained from the blood donor. Serological testing of the blood donor revealed inconsistent results between forward and reverse ABO blood typing, negative H antigen on the red blood cell surface, Le(a-b+) secretor type for Lewis blood group, and unexpected anti-H antibodies in the plasma, indicating a suspected para-Bombay type. Absorption-elution test suggested the blood type of the blood donor to be para-Bombay and A subtype. Sanger sequencing showed that the donor has harbored homozygous FUT1*(c.35T+c.803A)/(c.35T+c.803A) variant, with the FUT1*(c.35T+c.803A) allele containing a dual nucleotide variant unrecorded by the International Society of Blood Transfusion (ISBT) FUT1 gene variant database, which was similar to the weakly functional allele of FUT101W. 37(c.803G>A) as recorded by the ISBT database. The ABO genotype was heterozygous ABOA2.05/O.01.02. Combining the results of serological and genetic testing, the blood type of the blood donor was determined to be para-Bombay and A2 subtypes. Literature review has identified a pregnant women from Qingdao carrying the FUT1*01W.37 allele and 2 individuals carrying a heterozygous FUT1*01W.23 allele. This study has discovered a blood donor with coexisting para-Bombay and ABO subtype blood groups. Based on the characteristics of red blood cell surface antigens, the FUT1*01W.37 as classified as an FUT1 null allele.

Reliability of the documented blood group in motor vehicle driving license in Kerala, India - A public health concern?

ABSTRACT Introduction: Blood groups documented in motor vehicle driving licenses can provide quick information during emergency transfusion requirements and imbibe self-awareness about one’s blood group. The tendency of applicants to mention blood groups without verification during the application may result in incorrect documentation of blood groups in their driving license. The study aims to assess the reliability of the blood groups in driving licenses and their association with sociodemographic variables. Methods: This was a single-center cross-sectional study conducted over 6 months. Donors who were accepted for donation and willing to participate were included. Donors without a valid driving license were excluded. The blood group details and sociodemographic variables were collected and analyzed. Cross tabulation and Chi-square test were done for bivariate analysis. Results: In our study, 33 out of 446 (7.39%) participants had incorrect documentation in their driving licenses. Out of 33, 30 were ABO and three were Rh discordant results. Blood group was not mentioned in the case of 37 donors (8.3%). Incorrect documentation was significantly higher for individuals of younger age and those who acquired a license before 2018. Conclusion: Eight out of 100 individuals had incorrect documentation in their driving license, which is a concern, especially in the situation of emergency transfusion requirements. Approximately 19% of participants revealed that they did not undergo blood grouping during the application process. License issuing authorities should ensure proper blood group verification during the application process.

Research on Correlation between DNA Typing and Trace Characteristics of Blood after Thermal Exposure

The identification of biological evidence is particularly important for criminal detection, and the deoxyribonucleic acid (DNA) analysis plays a significant role in reconstructing events. However, bloodstains after thermal exposure in fires are quite unique compared to those in other scenes. Previous results regarding DNA recovery in bloodstains after heating are inconsistent with each other, which limits guidance for forensic science. In order to confirm the influence of heat on DNA recovery, the important physical evidence, bloodstain, was selected for its common occurrence, and a standard heat source, the Cone Calorimeter, was used to simulate high temperatures in fire scenes. A series of bloodstains were prepared under different heating conditions, and the results of short tandem repeat (STR) typing were systematically correlated with the trace characteristics of bloodstains. The findings indicate that heating bloodstains below 150oC for less than 10mins has minimal effect on DNA testing. After heating bloodstains at 150oC for 20mins or at 180oC for 5mins, partial DNA profiles were obtained, accompanied by blackening and cracking of the bloodstains. After exposure to 180oC for 20mins or 200oC for 10mins, no DNA profiles were obtained with bloodstains exhibiting metallic lusters and black bulges. Furthermore, from the perspective of chemical bond energy, the C-N, C-O, C-C, and P-O bonds in DNA molecules are prone to breaking during heating. The C-N bond serves as the primary connection between the four bases and the strand, while the C-O, C-C, and P-O bonds are significant connections within the DNA strand. It is thus hypothesized that the breakage of any bond aforementioned during heating results in the failure of DNA typing. Understanding the correlation between trace characteristics of bloodstains and DNA typing results after thermal exposure is crucial for comprehending DNA recovery from physical evidence collected from fire scenes.

Common Contaminants Of Blood Group Factors And Its Effect On Blood Groups In Blood Samples, Collected At Scene Of Crime

For detection of crime in Forensic medicine blood group studies& its application plays an important role. The study of blood grouping gives important information regarding identification and details of Crime Investigation. The most common trace evidence is blood which is obtained from the crime scene. Blood grouping & typing can point to a group of people that have the same blood type rather than pointing particular person. When blood is properly collected and preserved, blood as an evidence can establish a strong link between a criminal and the criminal act. We can trust the blood grouping of blood stains in detection of crime. Randomly A, B, AB, Rh positive blood samples were taken in duplicates and rusted pins, dust particles, detergent, staphylococci are added to it respectively. The common contaminants in blood stains are dust, rust, bacteria and detergent. So an effect of these on blood groups was studied in detail.

Association of ABO blood group with blood pressure in healthy adults of districts Hyderabad Pakistan

BackgroundIncreased blood pressure is called a “silent killer” as it is often asymptomatic and can persist without the knowledge of the sufferer. It is one of the most prevalent and strong predictive factors for cardiovascular diseases.MethodologyThis cross-sectional study was conducted to find out any association of the ABO blood group with blood pressure and includes 581 randomly selected subjects from the different organizations of district Hyderabad including Universities, colleges, Hospitals, their students, faculty members, and their employees. This study was conducted from February 2021 to January 2022. Informed consent was obtained from volunteers. A detailed history was taken followed by a thorough clinical examination. Blood pressure was recorded with a mercury sphygmomanometer in sitting position. Blood grouping was done by ABO typing. Data obtained were analyzed by SPSS version 23.0.ResultsIn this study, the B blood group participants were 205 (34.22%) was found more prevalent in district Hyderabad, the mean systolic blood pressure was 119.10 ± 16.57, and the mean diastolic blood pressure was 78.89 ± 29.85. and in blood group B participants systolic blood pressure was found 46.82% and diastolic blood pressure was found 43.90% also in B blood group participants followed by A, O, and AB.ConclusionThe incidence of hypertension is high in Pakistan as found in other developing countries. In this study, the evidence is suggestive of the association of the B blood group with increased blood pressure in young healthy adults of district Hyderabad Pakistan.

Prevalence of a Subtype in Iraqi Donations of National Blood Transfusion Center

General Background: The ABO blood group system is essential in blood transfusion, with subtypes of A and B groups influencing clinical outcomes. Specific Background: Subtypes A1 and A2 differ in the amount of antigen on red blood cells, impacting blood typing accuracy. Knowledge Gap: The prevalence of A2 and A2B subtypes in Iraqi donors remains underexplored, and their detection in routine screening can be challenging. Aims: This study aimed to determine the prevalence of A2 and A2B subtypes among Iraqi blood donors and evaluate the necessity of Anti-A1 reagent in accurate subtype identification. Results: In 2022, type O blood donors were the most prevalent, followed by B, A, and AB. A routine screening identified 0% A2 and 0.7% A2B subtypes, but 5% and 14.2% were A2B. Novelty: This study highlights the limitations of routine serological testing in detecting A subtypes, demonstrating that the use of Anti-A1 reagent significantly improves accuracy. Implications: Given the low rate of discrepancy between forward and reverse grouping, the Anti-A1 reagent should be routinely used for detecting A subtypes in clinical settings. Additionally, molecular techniques may be required to distinguish between rarer A subtypes such as A3, Ax, and Am. Highlights: ABO subtypes A1 and A2 are vital for precise blood transfusion typing. Routine tests miss A2; Anti-A1 reagent ensures accurate subtype detection. Molecular techniques help identify rarer subtypes like A3 and Ax. Keywords: ABO system, blood subtypes, Iraqi donors, Anti-A1 reagent, blood typing

Serologic investigation and management of an antibody screen negative para-Bombay phenotype during pregnancy

Abstract Introduction/Objective Individuals with the Bombay and para-Bombay red blood cell (RBC) phenotypes express anti- H antibodies associated with acute hemolytic transfusion reactions. The rarity of compatible donor units creates unique logistical challenges. However, para-Bombay individuals have been shown to tolerate transfusion of non- Bombay RBCs without acute hemolysis. Therefore, accurate serologic identification and judicious management of blood products are crucial when planning to transfuse patients with anti-H. This is especially true during pregnancy, as early onset of labor and fetal distress can occur without warning. Methods/Case Report A 24-year-old gravida 2 para 1 (G2P1) at approximately 38 weeks gestation with the fetus in breech position was transferred to our hospital after anti-H antibodies were detected. Although our in-house antibody screen was negative on automated solid-phase red cell adherence (SPRCA) testing, manual tube testing revealed the presence of anti-H antibodies, and forward typing with Ulex europaeus lectin confirmed the absence of H-antigen. Further, Lewis B phenotyping and saliva neutralization demonstrated the presence of H-antigen in secretions, consistent with the O-para-Bombay phenotype. Finally, differential adsorption ruled out other clinically significant allo- antibodies. An external cephalic version (ECV) was initially planned since vaginal delivery carries lower bleeding risk than cesarean section (CS). Three frozen Bombay RBC units were obtained, with one possibly compromised before arrival. Four pre-warmed, cross-match compatible units of O-positive RBCs (non-Bombay) were also prepared. Acknowledging the unpredictability of ECV, the challenge of timing thawed frozen units, and the possibilities of massive hemorrhage versus wasting rare donor blood, our transfusion service ultimately recommended an elective CS with only one Bombay unit deglycerolized. The patient underwent an uneventful procedure without transfusion. Results (if a Case Study enter NA) NA Conclusion Overall, this case highlights key diagnostic and management considerations for patients with Bombay and para-Bombay phenotypes. First, automated SPRCA testing may provide false negative results for anti-H antibodies. Second, backup transfusion strategies for para-Bombay patients may include non-Bombay RBCs. Finally, the procurement, preparation, and use of rare donor blood products requires multidisciplinary clinical decision-making to optimize patient outcomes, especially for high-risk labor when unexpected acute bleeding events can occur.

Red Blood Cell (RBC) Antigen Confirmation Workflow – A Positive Impact at an Academic Medical Center

Abstract Introduction/Objective Introduction: Blood group antigens, present on the surface of red blood cells (RBCs), play a crucial role in transfusion medicine. These antigens are recognized serologically and form the basis of RBC phenotyping. Understanding the significance of antigen-negative RBCs is essential for mitigating the risk of hemolytic transfusion reactions and hemolytic disease of the fetus and newborn (HDFN). This study aims to assess the impact of implementing a new RBC antigen confirmation workflow on transfusion service efficiency and patient outcomes. Methods/Case Report Method: The study involved collaboration between our Transfusion Services Department (TS), the Blood Center supplier, and the Apheresis department. A comprehensive review of historical practices and FDA recommendations regarding RBC antigen labeling was conducted. Changes were implemented to streamline antigen confirmation testing and labeling processes. The impact on TS workload, turnaround time, and patient care metrics was evaluated. Results (if a Case Study enter NA) Results: Implementation of the new RBC antigen confirmation workflow led to a significant reduction in antigen confirmation tests performed by TS, with a 607% decrease observed from 2020 to 2023. Concurrently, the workload for reference lab workups increased by 337% over the same period. This shift in workload distribution allowed TS staff to focus more on patient reference workup cases and case review. The improved workflow efficiency resulted in enhanced turnaround times for providing patients with antigen-negative RBCs, ultimately improving the patient experience. Conclusion Conclusion: The adoption of the new RBC antigen confirmation workflow has resulted in compliance with FDA labeling requirements, efficient utilization of TS staff resources, and decreased turnaround times for blood delivery. These improvements have positively impacted patient care by ensuring timely access to compatible blood products. Future steps include developing reports to track turnaround time for patients with special blood product needs and continuing collaboration with the blood supplier and the Apheresis department to optimize inventory management and transfusion processes.

Lost in the Ds: Unexplained Loss of Rh(D) Antigen Expression By Serological Testing In Two Patients

Abstract Introduction/Objective While the loss of ABOH antigens has been well documented, reduced-to-absent expression of the RHD antigen is comparatively rare. Here, we describe two cases with D antigen loss presenting associated clinical settings, smear results, and red blood cell (RBC) genotyping findings to elucidate this unusual phenomenon. Methods/Case Report Cases (n=2) were retrospectively reviewed based on discovery during routine serological testing in our Blood Bank. RhD blood typing was performed via gel methods [Grifols, Los Angeles, CA]. Clinical information and laboratory data were extracted via the electronic medical record. Case 1 is a 79-year-old female with metastatic breast cancer. She initially typed as D positive (4+) in at least two separate analyses, but her D front type progressively became weaker until turning entirely negative after several weeks. Spherocytes and stomatocytes were present on her peripheral blood smear. This patient received 10 D+ red blood cell (RBC) units without anti-D formation. RBC genotyping revealed traditional “dce” by standard polymerase chain reaction (PCR). Case 2 is a 61-year-old male with a history of pre-B acute lymphocytic leukemia post-stem cell transplant, myelodysplastic syndrome, and progressive loss of D antigen expression (4+ to 0). Standard RBC genotyping revealed “Dce” by PCR. The peripheral blood smear was significant for RBC anisopoikilocytosis with increased stomatocytes, spherocytes, and ovalocytes. Results (if a Case Study enter NA) NA Conclusion The disappearance of the D antigen is rare, and our experience suggests an association between malignancies (both hematopoietic and non-hematopoietic) and D antigenic loss. Beyond these disease associations, however, loss of RhD is not otherwise readily explained in either case. Further analysis to test for other RHAG and RHCE mutational variants is an ongoing area of investigation in these cases, as more sensitive testing may reconcile the traditional PCR results with our initial detection of the D antigen.

Evaluating RhD Assessment By Automated Methodology: A Potential ‘Blind Spot’ For RhD Variant Identification

Abstract Background Automated blood typing platforms are ideal for blood donor centers, given their broad recognition of RhD antigen variants, resulting in products from such donors to be labeled as RhD positive. However, this ‘blind spot’ for variants may be problematic for hospital-based transfusion services, since RhD variants may require provision of RhD- RBC units and Rh immune globulin. The extent to which automated methods accurately characterize variant D antigen expression is not known. As such, the objective of our study was to assess D typing results, as well as RHD genotyping, among two automated testing platforms at our facility. Methods The study site is a single tertiary care center with analysis done from 12/2020-1/2024. At our facility, all females <60 years of age with RhD antigen testing results of ≤2+ agglutination (0-4+ scale) via automated methods [solid phase testing 12/20-4/22 (Neo, Immucor, Norcross, GA) and gel testing 5/22-1/24 (Erytra, Grifols, Emeryville, CA)] are assessed by a tube RhD antigen test (Grifols reagents). If tube testing confirms a ≤2+ result (0-4+ scale), molecular variant D analysis is performed (Versiti, Milwaukee, WI). Patients typed as Rh negative with anti-D antibodies, or those with inconsistent D typing, are also subjected to genetic D testing. The Wilcoxon matched pairs signed rank test was employed for comparative data (P< 0.05 was deemed significant). Results Amongst tested patients, 73 demonstrated ≤2+ agglutination via an automated typing method, leading to variant D genetic analysis. Of these, 71% (n=52) harbored variant D antigens. Within this subgroup, 29 (56%) subjects exhibited variants associated with potential allo-anti-D development (n=5 partial D variants; n=24 weak D variants). Notably, 4 patients with partial D and 1 with weak D demonstrated allo-anti-D antibodies. Of 23 patients with variant D who underwent automated gel testing, 20 concurrent tube testing results were available. Gel testing revealed significantly stronger agglutination compared to tube testing (p < 0.001). In contrast, for paired solid phase and tube testing (n=11), there was no statistically significant difference in agglutination strength (p = 0.28). Conclusion Automated testing, particularly gel-based platforms, exhibits reduced sensitivity to RhD antigen variant identification when compared to tube testing, placing subsets of patients potentially at risk for forming allo-anti-D. Implementing protocols for verification of D status could enhance the sensitivity of variant D detection for facilities that largely rely on automated methods for antigen typing.

Forensic identification of abo blood grouping from teeth under different conditions using absorption elution method

Forensic identification of abo blood grouping from teeth under different conditions using absorption elution method

A cross-sectional pilot study to estimate the frequency of minor blood group alleles and phenotypes in RhD-negative North Indian blood donors by DNA microarray analysis

Abstract: INTRODUCTION: There are scarce data on Indian blood donors with respect to blood group phenotypes using molecular diagnostic modalities. Hence, we planned to estimate frequencies of blood group alleles/phenotypes using DNA microarray analysis in the north Indian RhD-negative blood donor population. With this initial pilot study, we plan to expand it to our entire donor population. METHODOLOGY: The cross-sectional prospective study was conducted on 50 Indian blood donors (O RhD negative), to study the blood group genotype frequency. Genotyping for the most relevant red blood cell antigens (Rh, Kell, Duffy, Kidd, MNS, Lutheran, and Dombrock) was done using Bioarray Precise TypeHM Human Erythrocyte Antigen BeadChip kit containing probes directed to polymorphic sites. RESULTS: In the Rh system, the most common alleles were RHCE*e/RHCE*e (98%) and RHCE*c/RHCE*c (80%). Phenotype K-k+ (genotype- KEL*02/KEL*02) was seen in 98% of samples, Js(a-b+) (KEL*02.07/KEL*02.07) was detected in 98% (49/50) of the samples tested. Jk(a + b+) (JK*01/JK*02) was the most common phenotype (48%) in the Kidd blood group system. In MNSs system, M+N+ (GYPA*01/GYPA*02) 44% and S+s+U+ (GYPB*03/GYPB*04) 34% were the most common phenotypes detected. CONCLUSION: This pilot study shows the feasibility of genotyping a Northern Indian donor population. To the best of our knowledge, it is the first study on molecular blood grouping in Indian blood donors using the Bioarray platform.

B-052 Celiac Disease Risk Assessment of HLA-DQ Typing in IgA Deficient Patients

Abstract Background Celiac disease (CeD) is a chronic autoimmune disorder triggered by the ingestion of gluten in persons with the genetic risk factors human leukocyte antigens (HLA)-DQ2 and DQ8. Diagnostic evaluation of patients with suspected CeD often includes serology tests for tissue transglutaminase (tTG) antibodies. While the presence of HLA-DQ2 or DQ8 is required for the initiation and development of CeD, the genetic risk associated with the various alleles is not equivalent. Previous studies in patients with normal total IgA demonstrated the risk gradients of various HLA-DQ2 and DQ8 heterodimers in CeD. However, the impact of both gene variants in IgA deficient patients has not been investigated. In this study, HLA-DQ2 and HLA-DQ8 as risk factors for tTG-IgG positivity in IgA deficient patients were evaluated. Methods Retrospective data was collected from a cohort of individuals (n=3,515) with IgA concentrations below the age-dependent reference interval with suspicion for CeD who were tested for HLA-DQ genotyping and tTG-IgG (reference interval < 6 U/mL) at Mayo Clinic Laboratories. Total IgA was measured using quantitative nephelometry (Siemens BN™ II System); HLA typing was performed using the reverse SSO DNA typing assay (LABType SSO kits). tTG-IgG was determined by enzyme-linked immunosorbent assay (QUANTA Lite R h-tTG, Werfen Diagnostics) on the Dynex Agility System. The prevalence and frequency distribution of HLA-DQ2 and DQ8 haplotypes were determined and the odds ratio (OR) was calculated to evaluate the risk gradient for tTG-IgG positivity based on different HLA-DQ variants. Results Among IgA deficient patients, 58% (n=2,041) expressed HLA-DQ2 or DQ8 haplotypes. Relative to patients without permissive alleles, patients homozygous for HLA-DQ2.5 exhibited a significantly increased risk for tTG-IgG positivity (OR = 10.98, 95% CI: 6.56-18.18, p < 0.001) while those homozygous for HLA-DQ2.2 and DQ8 did not (DQ2.2/DQ2.2_OR = 0.72, 95% CI: 0.04-3.44, p = 0.75; DQ8/DQ8_OR = 0.96, 95% CI: 0.05-4.64, p = 0.97). Patients heterozygous for HLA-DQ2.5 (DQ2.5/x) displayed a lower odds ratio relative to homozygous patients (OR = 3.31, 95% CI: 2.29-4.82, p < 0.001); however, the risk for tTG-IgG positivity increased in the presence of HLA-DQ2.2 (DQ2.5/DQ2.2_OR = 7.59, 95% CI: 4.48-12.65, p < 0.001) or HLA-DQ8 (DQ2.5/DQ8_OR = 6.26, 95% CI: 3.55-10.73, p < 0.001) alleles. Conversely, in the absence of HLA-DQ2.5, HLA-DQ2.2 heterozygotes (DQ2.2/x_OR = 2.80, 95% CI: 1.77-4.39, p < 0.001) and HLA-DQ8 heterozygotes (DQ8/x_OR = 0.99, 95% CI: 0.52-1.77, p = 0.99) displayed lower correlations with tTG-IgG positivity, suggesting a potential risk elevation for tTG-IgG positivity is associated with the combination of DQ2.5 and DQ2.2 or DQ8. Conclusions Our study indicates the risk gradient of HLA-DQ genes in IgA deficient patients. Overall, compared to patients without HLA-DQ2 or DQ8 haplotypes, the homozygous HLA-DQ2.5 genotype had the highest correlation with tTG-IgG positivity, followed by HLA-DQ2.5/DQ2.2 and HLA-DQ2.5/DQ8 heterodimers. The results suggest that HLA-DQ2.2 or HLA-DQ8 alone does not confer risk, but when in the presence of HLA-DQ2.5 these alleles may increase the risk for tTG-IgG positivity. Results from this study shed light on the risk of CeD in patients with IgA deficiency.

Clinical assessment of ectopic pregnancy in a tertiary care hospital: An observational study

Background: Ectopic pregnancy is defined as pregnancy that occurs outside normal uterine cavity that occurs due to implantation of fertilized ovum in an aberrant site which is conducive to its growth and development. In developing countries like India, late presentations with tubal rupture and hemodynamic instability, late presentations with tubal rupture causes first trimester maternal morbidity and mortality. For early diagnosis, a clinician should be well aware about the various presentations of ectopic pregnancy. Aims and Objectives: (a) To estimate the incidence, risk factors, clinical manifestations and outcome following different management protocol. (b) To estimate the morbidity and mortality with respect to different types of presentation and management. (c) To understand the need for clinical assessment in order to diagnose early and provide urgent intervention and also to lean toward the possibility of conservative approach in order to preserve fertility. Materials and Methods: The current study was a time bound, Observational descriptive study with Longitudinal design. It was conducted in the Department of Obstetrics and Gynecology, R. G. Kar Medical College and Hospital, between March 2021 and August 2022. One hundred and thirty-eight participants, suspected to have ectopic pregnancy were enrolled for the study. Data collection was done by detailed history taking and physical examination. The basic investigations including hemoglobin, ABO and Rhesus typing, urine pregnancy test, and ultrasound (USG) examination were done. All data were collected on a structural data form and analyzed for descriptive statistics. Post-operative histopathological examination (HPE) reports were collected and final diagnosis was made. Results: About 63.8% of the study population belonged to 21–30 years of age. About 63.7% patients presented with >5–8 weeks of amenorrhea. About 18.1% of the study population were sterilized and the duration between the sterilization and the occurrence of ectopic was 4–10 years in 64% patients. The most common risk factor was h/o Previous C-section (31.8%). The most common clinical symptom was abdominal pain present in 131 (94.9%), 44 (31.9%) participants had all the three classical symptoms with 100% specificity. On examination, forniceal fullness/tenderness was the most specific finding. The most common USG finding was Adnexal mass with empty Uterine cavity with Free fluid (49.2%). Most of the patients were managed with Partial Salpingectomy (30.4%). The final diagnosis of ectopic was made in 129 patients, which was confirmed by HPE reports in 124 patients. Five patients underwent medical treatment. Conclusion: Early diagnosis before rupture and referral are the key factor in reducing the maternal morbidity and mortality.

Establishment and discussion of autoverification rules for transfusion compatibility testing.

To develop an automated verification workflow for transfusion compatibility testing (TCT) based on the AUTO10-A guidelines and blood group serology characteristics and to conduct a simulated validation of the test and subtest results by assessing the appropriateness of the autoverification rules. The accuracy of TCT results is a fundamental prerequisite for ensuring the safety of blood transfusions. However, the verification of these results still requires manual intervention. Five autoverification rules and their standards were determined: agglutination intensity, normal results, logical relationships, delta checks and interlaboratory test comparisons. The established categories and standards for the five rules were retrospectively validated using 13 506 samples (requests) that had been manually verified in our laboratory from January 2020 to June 2023. A total of 66 638 test items were involved in the autoverification, with 3844 items violating the verification rules, resulting in a pass rate of 96.10%. Considering individual test items, four tests had a pass rate of more than 90% in both the test item result table and the test subitem result table. However, there were significant differences in the pass rates between different tests. The same conclusion can be drawn when the unit is requests. The different standards set for the agglutination intensity and the delta check in the ABO typing testing subitems showed significant differences in pass rates. The incorporation of manually verified results into the automated verification simulation indicated that the five rules established in this study have good applicability, and appropriate standards can lead to reasonable pass rates.

Rapid parallel blood typing on centrifugal microfluidic platform by microcolumn gel immunoassay

Microcolumn gel immunoassay (MGIA) has the ability to meet the requirements of clinical diagnosis due to its reliable sensitivity and accuracy. However, traditional MGIA exhibits limitations including inadequate portability, low throughput, and extended analysis time. To address these challenges, we combined MGIA with microfluidic technology, demonstrating a centrifugal microfluidic-based microcolumn gel immunoassay (μMGIA) platform for blood typing of clinical samples. Experimental results indicate that the μMGIA platform can simultaneously detect six blood group antigens in five clinical blood samples within 2 min. Notably, it offers comprehensive detection of ABO blood group antigens and Rh blood group antigens with 100 % accuracy, outperforming the traditional slide method. The integration of microfluidic technology with MGIA circumvents the constraints of traditional methods, providing a new avenue for blood typing and immunoanalysis of clinical samples.

Dog Blood Type DEA 1 in Two Municipalities of Luanda Province of Angola (Sub-Saharan Africa).

In dogs, the risk of an acute hemolytic transfusion reaction at the first transfusion is negligible; however, mismatched transfusions may produce alloimmunization. To avoid fatal acute hemolytic reactions in subsequent blood transfusions, it is important to recognize blood groups and to blood type both the donor and the recipient. Prevalence of dog blood groups varies geographically and between breeds. Our aim was to determine DEA 1 prevalence in a canine population in Luanda (Angola) and to assess alloimmunization risk after a mismatched blood transfusion. Blood samples were typed using an immunochromatographic strip technique. Of the 112 dogs tested (59 males; 53 females), 52.68% were DEA 1 positive and 47.32% DEA 1 negative. Females tended to be DEA 1 positive, and males DEA 1 negative (p = 0.0085). In a first-time mismatched blood transfusion, the calculated probability of a dog becoming sensitized was 24.9% and the probability of an acute hemolytic reaction following a second incompatible blood transfusion was 6.21%. DEA 1 prevalence obtained was similar to that reported worldwide, but differs from other African countries. The risk of alloimmunization and acute hemolytic transfusion reactions in mismatched blood transfusions is higher than that in other African regions. Blood typing is recommended prior to transfusion.

Impact of Type and Screen Method on Turnaround Time and Man-Hour Utilization Compared to Conventional Coomb's Crossmatch: A Cross-Sectional Analytical Study.

Background Blood component transfusion is vital for various medical conditions, requiring thorough pretransfusion testing to ensure safety and compatibility. The Type and Screen (T and S) method allows for efficient detection of clinically significant antibodies while reducing unnecessary crossmatching. This study evaluates T and S's impact on turnaround time and man-hour utilization compared to conventional crossmatching. Methodology The study included 835 elective crossmatch requests. Blood grouping, antibody screening, and antihuman globulin (AHG) crossmatching were performed using column agglutination technology, while immediate saline crossmatching was done by tube technique. Turnaround time (TAT), man-hour utilization, and saved rates were calculated for both the T and S protocol and routine AHG crossmatch. Results In this study, 835 elective blood samples underwent antibody screening and immediate saline phase crossmatching, with validation by AHG phase crossmatch. The T and S protocol significantly reduced TAT for both first (51.24 vs. 71.56 minutes) and subsequent transfusions (17.47 vs. 39.67 minutes) compared to AHG crossmatching, with reductions being statistically significant (p < 0.0001). T and S also saved 279.28 man-hours (11.6 man-days), equating to 0.33 man-hours saved per sample. Conclusion Our study shows that the T and S protocol significantly enhances blood bank efficiency by reducing TAT and man-hour utilization compared to conventional AHG crossmatching. This improvement not only optimizes manpower but also makes the process more cost-effective.

Blood Groups and their Correlation with Physical Traits Affecting 100-Meter Performance

Background. Sport training has an impact on other sciences. Among these sciences is physiology, in which emerged to form what is called sports physiology. The recent development in the science of physical education is one of the important factors in measuring and determining the nature of athletes' physical, physiological and biochemical adaptations and responses. The blood circulatory system is important as manifested in finding the relationship between some blood groups and the basic physical characteristics and the completion of the 100-meter race. Objectives. The aim of this study is to identify the types of blood groups and their relationship to some physical traits, and the completion of the 100-meter race for some student athletes. Methods. the descriptive approach was used for its suitability to the research problem. The sample consisted of the students of second stage in the Department of Physical Education and Sports Sciences at Al-Mustaqbal University in Iraq. It was 143 students (35%) of the original research sample. With the a 143 sample size , the calculated confidence is 34.95 with standard deviation of ±3.87. Results. The study finds out a positive correlation between blood groups and some physical traits. There is also a positive correlation between blood groups and 100-meter sprint achievement as indicated from the statically data analysis and supported by the mean values 5.6 for O blood grouping. Conclusion. the blood group of athletes can take a role and impact on the speed and muscular strength tests. according to the results of this study the athletes who have AB and O blood group are more likely to win in 100 sprint races.