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1.  Wrong Sample Dispensing May Cause False Positive Malaria Test 
Both false positive (FP) and false negative are known limitations of any diagnostic test. Malaria parasite (MP) rapid diagnostic tests (RDTs) may give FP results due to interference by substance in blood sample. We detected a FP in a MP RDT for first time in 36-year-old female whole blood donor due to incorrect sample dispensing technique. As per manufacturer’s instructions, while allowing all kit components and blood specimen to come to room temperature before testing, blood samples usually separate into lower layer of red blood cells (RBC) and upper layer of plasma. Technician performing the test took the sample from the bottom of the vacutainer thus taking RBC instead of whole blood (WB-recommended by manufacturer). This test showed reactive result and as per our standard protocol was re-tested to confirm the result. This second test was performed after re-mixing the same sample, which now tested as non-reactive sample, buffer and other kit component mix-up were ruled out. Repeated test on another sample of same donor produced same results. Thick and thin peripheral blood smear examination for malaria was found negative. This case highlights wrong MP RDT result due to wrong sample dispensing.
PMCID: PMC4437078  PMID: 26023564
Malaria parasite; Rapid diagnostic tests; Rheumatoid factor
2.  The need to label red blood cell units with their haemoglobin content: a single centre study on haemoglobin variations due to donor-related factors 
Blood Transfusion  2014;12(4):520-526.
Red blood cell (RBC) transfusions are given as “number of units” without considering the haemoglobin (Hb) content of these units. Donor factors influencing Hb level in whole blood donors and, ultimately, in RBC units have not been studied.
Materials and methods
Donor data for a period of 1.5 years were retrospectively analysed and the effects of age, gender and weight on the Hb level of the donors were determined. The correlation between donor’s Hb concentration with total Hb in the RBC unit was analysed. Additionally, actual Hb content of 125 RBC units was determined. The total Hb content of these RBC units was also mathematically calculated based on the blood donors’ Hb. The ability of this mathematically calculated Hb to predict actual Hb content per RBC unit was then analysed.
The mean Hb level in female donors was 1.79 g/dL lower than in the male donors (p<0.001). Increasing age was associated with a lower mean Hb in the donors (p<0.01), while a higher body weight correlated weakly (r=0.06) but significantly with increased mean Hb (p<0.01). Logistic regression analysis showed that in blood donors, female gender had a stronger influence on lowering the mean Hb than either older age or lower weight. A variation of nearly 100% (42.3–80.8 g Hb per unit) was seen in the total Hb content of the RBC units tested. Mathematically calculated Hb content correlated well (r=0.6; p<0.01) with the actual Hb content of the RBC units.
We demonstrated the effect of gender, age and weight on Hb levels in whole blood donors. Dissimilarities in the donor Hb caused nearly 100% variations in the Hb content of the RBC units. It would, therefore, be prudent to label RBC units with their total Hb content. This total Hb content can be predicted fairly accurately from the donor’s pre-donation Hb level.
PMCID: PMC4212032  PMID: 24960649
pre-donation Hb; blood transfusion; Hb increase; RBC overtransfusion; Hb content
3.  Turbid plasma donations: Need for quantification 
PMCID: PMC4140067  PMID: 25161342
4.  Transfusion associated circulatory overload 
Transfusion associated circulatory overload (TACO) is an established, but grossly under diagnosed and underreported complication of blood transfusion. We present the case of a 46-year-old diabetic and hypertensive patient admitted to our hospital for recurrent episodes of urinary retention. Over initial 3 days of the admission, the patient received multiple units of packed red blood cells (RBC) and fresh frozen plasma, uneventfully. However, the patient developed signs and symptoms suggestive of TACO with only small amount of the 4th unit of RBC. The patient had to be shifted to the Intensive Care Unit for further management of this complication. Etiology of TACO is more complex than a mere circulatory overload and is still not completely understood. TACO leads to a prolonged hospital stay and morbidity in the patients developing this complication. TACO thus needs to be suspected in patients at risk for this complication.
PMCID: PMC4071685  PMID: 24987240
Blood transfusion; blood transfusion reaction; risk factors; transfusion associated circulatory overload
5.  A suspected transfusion transmitted malaria case 
PMCID: PMC3943152  PMID: 24678179
6.  Analysis of adverse events and predisposing factors in voluntary and replacement whole blood donors: A study from north India 
Lack of awareness and community motivation, compounded with fragmented blood transfusion services in our country, Often leads to shortage of blood. Donor recruitment and retention are essential for ensuring adequate blood supply. However, adverse events (AEs) in donors have a negative impact on donor return.
Aims and Objectives:
The present study was aimed to assess the frequency of AEs in whole blood donors and analyze the predisposing factors for AEs.
Material and Methods:
The study was conducted on allogeneic whole blood donors over a period of 14 months, i.e., from January 2002 to February 2003. A total of 37,896 donors were monitored for any AEs: 22587 (59.6%) were voluntary donors (VD) and 15,309 (40.4%) were replacement donors (RD).
Overall reaction rate was 2.5% with vasovagal reactions constituting 63.5% and hematomas 35.0% of all reactions. Vasovagal reactions showed a significant association with young age, lower weight, first time donation status, female gender, and nature of blood donation camps. Amongst male donors, RDs had more reactions (P=0.03) than VDs. Majority of donors (85%) with vasovagal reactions admitted to some fear or anxiety prior to donation. Hematoma formation occurred significantly more when less trained staff performed phlebotomy.
Donor safety is an essential prerequisite to increase voluntary blood donation. AE analysis helps in identifying the blood donors at risk of donor reactions and adopting appropriate donor motivational strategies, pre-donation counseling, and care during and after donation.
PMCID: PMC3439755  PMID: 22988381
Adverse events; donors; vasovagal reactions
7.  Whole blood donor deferral analysis at a center in Western India 
Deferrals lead to loss of precious whole blood donors (WBD) and blood units available for transfusion purposes. Knowledge of rate and causes of donor deferral can guide the recruitment strategy for WBD.
To find the incidence and causes of deferral in Indian WBD and apply relevant findings to modify recruitment strategy for blood donors.
Materials and Methods:
Data for WBD presenting for donation in a blood center and outdoor camps over one and half year were analyzed retrospectively. National guidelines were used for selection and deferral of WBD.
736 (11.6%) WBD were deferred out of 6357 presenting for donation during the study period. Most (69.8%) of the donors were deferred on physical examination and hemoglobin (Hb) testing. Most common reasons for deferral were low Hb (55.8%), abnormal blood pressure (11.1%), medication (6.9%) and underweight donors (2.9%). Significantly more volunteers were deferred than relative donors (13.97% vs 5.80%; P<0.000). Females were found to have higher deferral rate than males (53.5% vs 6.9%; P=0.000) and higher odds ratio for deferral (15.4). Donors older than 40 years of age had significantly higher chance of being deferred (P<0.05).
Discussion and Conclusion:
It is important to determine the rate and causes of WBD deferral to guide the recruitment and retention efforts at local, regional, and national level.
PMCID: PMC2937288  PMID: 20859512
Anemia in blood donors; blood donor deferral; deferral criteria; deferral reasons; donor rejection; hypertension in blood donors; medication history in blood donors

Results 1-7 (7)