1.
Evaluation of the role of novel aprotic dimethyl sulfoxide in cutaneous antisepsis rotocols prior to blood donor phlebotomy with isopropyl alcohol, povidone iodine or chlorhexidine
Sachdev S, Sethuraman N, Gautam V, Pahwa D, Kalra A, Sharma R R, Marwaha N, Ray P
Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion. 2018;34((1)):132-137.
Abstract
The study was planned to measure the reduction of the load of bacterial flora on the blood donor's arm quantitatively using a three step protocol of donor arm cleansing incorporating either 70% isopropyl alcohol (IPA) or 5% w/v povidone iodine (PVI, 0.5% w/v available iodine) or 4% chlorhexidine gluconate (CHG) with or without the addition of 5% dimethyl sufloxide (DMSO). Single blind randomized study after obtaining ethical clearance, using the Miles and Misra technique for quantification and matrix assisted laser desorption ionization-mass spectrometry for identification of colony morphotypes on blood donor's skin. The mean pre-cleansing colony forming units (CFUs) was 89,318 and mean post-cleansing CFUs was 132, with a mean reduction of 99.85% with a mean log reduction of 3.24 (95% CI 2.01-4.47) at a P value of <0.0001. The post-cleansing CFUs was reduced to zero in all 34 samples in the protocol using CHG with DMSO, in 23 of 31 samples in the protocol using PVI with DMSO and 19 of 29 samples in the protocol using IPA with DMSO. The difference in means of the reduction of CFUs in protocols using CHG with DMSO compared with protocols using PVI or IPA with DMSO and PVI or IPA without DMSO was statistically significant with P value of 0.006, 0.0009, 0.015 and 0.05 respectively. The enhanced cutaneous antisepsis effect of CHG when complimented with DMSO in presence of IPA using the three step protocol of donor arm cleansing could stimulate more research and utilization of this as an additional safety towards the prevention of the problem of bacterial contamination of blood and blood components.
2.
Factors affecting the quality of cryoprecipitate
Subramaniyan R, Marwaha N, Jain A, Ahluwalia J
Asian Journal of Transfusion Science. 2017;11((1)):33-39.
Abstract
BACKGROUND Many variables affect the quality of cryoprecipitate (CRYO). We investigated the effect of freezing techniques and ABO blood groups on the quality of CRYO with respect to factor VIII C and fibrinogen levels. MATERIALS AND METHODS Ninety-six whole blood units each collected from in-house (Group I) and blood donation camps outside the hospital premises (Group II) were processed for CRYO preparation. Within each group, half the number of plasma units was frozen using blast freezer and another half using the conventional freezer. The CRYOs from blood groups A, B, and O were equally distributed, i.e. 32 within each of the Groups I and II. The fibrinogen and factor VIII C levels in CRYO were analyzed using single-stage clotting assay. RESULTS In Group I, the mean +/- standard deviation percentage recovery of factor VIII levels in CRYO prepared using the conventional freezer and blast freezer were 58.5% +/-16.2% and 66.7% +/-16.4%, respectively, and in Group II, it was 55.3% +/-17.6% and 70.4% +/-13.4%, respectively. Recovery of factor VIII was higher in CRYO prepared using blast freezer than that of CRYO prepared using conventional freezer (P < 0.000). In Group II, CRYOs prepared using blast freezer had higher percent recovery of fibrinogen than that of Group I. In both the groups, the mean factor VIII levels in blood group A were higher than that of factor VIII levels in the blood group O CRYO. CONCLUSION The factor VIII recovery in CRYO improves significantly with higher baseline factor VIII C levels, blood group A donor, and rapid freezing using blast freezer. Rapid freezing also increases the fibrinogen yield.
3.
A randomized control study to evaluate effects of short-term oral iron supplementation in regular voluntary blood donors
Dara RC, Marwaha N, Khetan D, Patidar GK
Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion. 2016;32((3)):299-306.
Abstract
Regular blood donation can lead to iron deficiency anaemia. Early recognition and reversal of excessive iron loss by iron supplementation may avoid symptomatic iron store depletion in blood donors. The aim of this study was to assess the efficacy of iron supplementation in maintaining the iron stores of voluntary blood donors. A total of 200 regular volunteers who donated twice in previous year were randomly divided into two groups. Iron: oral iron supplementation tablets of elemental iron as ferrous fumarate. Placebo group: glucose containing capsules, to be taken once daily for 21 days after one unit of blood donation. Their hemogram, serum ferritin, red cell indices and red cell distribution width were determined at baseline and after 1 month and at the time of next blood donation. Out of 200 volunteers enrolled 98 were assigned to iron group and rest 102 into placebo group. Total of 37 % donors dropped out, yielding a dropout rate of 35 % in iron group and 39 % in the placebo group. The haemoglobin and ferritin levels showed significant improvement in iron group compared to placebo group (p < 0.05). Three weeks of oral iron therapy (98.6 mg elemental iron/day) was able to maintain iron stores at 1 month after donation but was not sufficient to sustain the iron stores over a period of 3 months. Thus there is need to evaluate increased dosage or duration of iron supplementation in maintaining the iron stores.
4.
Platelet-rich plasma prevents blood loss and pain and enhances early functional outcome after total knee arthroplasty: a prospective randomised controlled study
Aggarwal AK, Shashikanth VS, Marwaha N
International Orthopaedics. 2014;38((2):):387-95.
Abstract
PURPOSE The purpose of this study was to determine whether platelet-rich plasma (PRP) might prevent blood loss and postoperative pain and expedite wound healing following total knee arthroplasty (TKA). METHODS Forty consecutive patients with knee arthritis who were matched for age, sex and body mass index (BMI) were randomly allocated to either receive or not receive PRP application over the wound, including capsule, medial and lateral recesses, during TKA. Postoperative haemoglobin, blood loss, blood transfusion, visual analogue scale (VAS) score, wound score, Knee Society Score (KSS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded and evaluated. RESULTS The platelet-rich plasma and control groups comprised 17 and 23 patients, respectively. The PRP group recorded significantly less reduction in haemoglobin and need for blood transfusion (p=0.00 and p=0.001, respectively), experienced less pain (p=0.00) and required fewer narcotics than the control (p=0.00). There was significant difference in range of motion (ROM) at three months (p=0.01), no significant difference in wound scores (p=0.311) and significant difference in KSS and WOMAC scores at 12 weeks (p=0.00, 0.00). However no significant difference was found at six months. CONCLUSIONS PRP has significant effect in preventing blood loss, postoperative pain and need for narcotics after TKA and has a positive effect on short-term clinical outcome.