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1.  Post-prandial paradoxical filling of gall bladder in patients with acute hepatitis: Myth or reality? 
Background
A minority of patients of acute hepatitis may exhibit edematous GB walls with no visible lumen despite fasting and may also exhibit paradoxical GB response in the post-prandial state.
Methods
Patients of acute hepatitis underwent routine upper abdominal sonography after overnight fasting. Patients who demonstrated contracted GB with edematous and coapted walls without any visible lumen despite overnight fasting were studied in the post-prandial phase after having breakfast. Serial ultrasonography was carried out at 10–15 min interval for an hour and changes in GB morphology was noted at each stage.
Results
A total of 77 patients of acute hepatitis underwent USG of hepatobiliary system between Sept 2008 and Aug 2009. Contracted gall bladder with edematous and coapted walls without any visible lumen despite overnight fasting was noted in 11 patients and were studied in the post-prandial phase. Post-prandial paradoxical filling of GB was observed in all such cases. Serial post-prandial ultrasonography demonstrated onset of filling of GB as early as 10–15 min post-prandial. Maximal GB distension was observed between 30 and 60 min. USG at 60 min post-prandial showed slight reduction in GB volume. As the GB distended in the post-prandial state, the lumen became increasingly visible with marginal reduction in wall thickening.
Conclusion
We have observed transient paradoxical filling of GB on serial USG in early post-prandial state, in a subset of patients of acute viral hepatitis who had contracted GB with coapted walls in the initial USG after overnight fasting.
doi:10.1016/j.mjafi.2012.04.021
PMCID: PMC3862963  PMID: 24532902
Ultrasonography; Acute hepatitis; Gall bladder; Post prandial paradoxical filling
2.  Analysis of efforts to maintain safe donor in main donor pool after completion of temporary deferral period 
Background:
Voluntary blood donation is not satisfactory all over India. In India, about 55% of donation is through voluntary non-remunerated blood donors (VNRBD). However, about one third already motivated blood donors are deferred due to stringent screening criteria, either temporarily or permanently. The temporarily deferred donors could be a good source of blood donation after deferral period.
Aims:
The present study is carried out to know retrieval of blood donors those who are deferred temporarily.
Design:
The present study is carried out in the Regional Blood Transfusion Centre of Western India. All donors screened as per the guideline and deferred donors are categorized as temporary and permanently deferred donors.
Materials and Methods:
From temporarily deferred donors, reason for deferral is considered. As per reason of deferral, time duration for recalling the donor is defined. Based on this, donor is called back to donate again.
Statistical Analysis:
Chi-square test is applied.
Result:
A total of 33% donors were deferred either temporarily or permanently. In the repeat donors (5.32%) deferral rate was significantly higher than first time (1.32%) donors. Significant female preponderance was observed (15.05% vs 2.51%). Majority of temporarily deferred donors were less than 40 years of age (80.80%), graduate (82.90%), from low income group (62.90%) and profession was service (48.10%).
Conclusion:
Low hemoglobin (78.30%) was the most common reason of temporary deferral, both in first time and repeat donors (71.00%). Efforts to increase the hemoglobin in the repeat donors will improve the donor retention and overall blood safety can be increased.
doi:10.4103/0973-6247.106742
PMCID: PMC3613667  PMID: 23559769
Donor return; hemoglobin; retrieval; temporary deferral; voluntary non-remunerated blood donors/ blood donor
3.  True positivity of anti-Hepatitis C Virus Enzyme-linked immunosorbent assay reactive blood donors: A prospective study done in western India 
Background:
A significant number of safe donations are removed from the blood supply, because of the reactive anti-HCV screening test results. This study aimed to assess if the HCV (Hepatitis C Virus) seropositive donors were confirmed positive or not.
Materials and Methods:
More than 68,000 blood donors’ samples were routinely screened and 140 samples were found to be anti-HCV ELISA reactive. These 140 samples were tested by NAT. The NAT negative samples were tested by RIBA. Analysis of samples reactive in single ELISA kit vs. two ELISA kits was done.
Results:
Out of 140 anti-HCV ELISA reactive samples, a total of 16 (11.43%) were positive by NAT. The results of 124 RIBA showed 6 (4.84%) positive, 92 (74.19%) negative, and 26 (20.97%) indeterminate results. None of the sample which was reactive in only single ELISA kit was positive by NAT or RIBA.
Conclusion:
Only a minority of blood donors with repeatedly reactive anti-HCV screening test is positive by confirmatory testing, but all these blood units are discarded as per existing legal provisions in India. Efforts should be made to retain these donors and also donor units.
doi:10.4103/0973-6247.98927
PMCID: PMC3439757  PMID: 22988383
Anti-Hepatitis C Virus Enzyme-linked immunosorbent assay; nucleic acid amplification test; recombinant immuno blot assay
4.  Deferral pattern in voluntary blood donors on basis of low hemoglobin and effect of application of digital hemoglobinometer on this pattern 
Background:
One of the responsibilities of blood center is to provide safety to blood donors. It is mandatory to screen a blood donor for hemoglobin (Hb) or hematocrit which should not be less than 12.5 g/dl or 38% Hct. Most commonly applied method for hemoglobin estimation is copper sulphate method, but this method has chances of false acceptance as well as false deferral. In order to avoid this chance of error, digital hemoglobinometer is used. This study was planned to analyze effect of application of digital hemoglobinometer for detection of Hb on donors, who are deferred by copper sulphate method.
Materials and Methods:
Total 35,339 voluntary non renumareted altruistic donors were included in this study between the periods of September 2005 to July 2006. Total deferred donors were 8622 (24.39%) and donors deferred due to hemoglobin by copper sulphate method were 4391 (50.92%). Digital hemoglobinometer was applied on 3163 deferred donors (72.03%). Results of digital hemoglobinometer were validated by known controls.
Result:
Digital hemoglobinometer was applied on 3163 donors who were deferred by copper sulphate method. Out of this, donors accepted by digital hemoglobinometer were 1196 (37.01%). Total repeat donors were 629 (52.50%) and first time were 567 (47.40%). Male donors were 891 (74.44%) and females were 305 (25.50%). Donors deferred with digital hemoglobinometer were 2135, out of them 1097 (51.14%) were repeat, 1038 (48.38%) were first time, 1349 (60.79%) were male, 786 (34.47%) donors were female donors. Range of hemoglobin in deferred donors was 7.0 to 12.4 and in accepted donors 12.5 to 16.4.
Conclusion:
By the application of digital hemoglobinometer 37.81% donors were found hemoglobin >12.5 which were deferred with copper sulphate method and unnecessary deferral of donors can be reduced to a great extent. In country like India, where blood supply is always less than the requirement, this new technique may be helpful to increase donor population but cost benefit ratio should be analyzed.
doi:10.4103/0973-6247.98939
PMCID: PMC3439760  PMID: 22988386
Copper sulphate; digital hemoglobinometer; hemoglobin
8.  Serial follow-up of repeat voluntary blood donors reactive for anti-HCV ELISA 
Background:
Voluntary non-remunerated repeat blood donors are perceived to be safer than the first time blood donors. This study was planned for follow-up of previous hepatitis C virus (HCV) test results of anti-HCV enzyme-linked immunosorbent assay (ELISA) reactive repeat blood donors. The aim was to suggest a protocol for re-entry of the blood donors who are confirmed HCV negative by nucleic acid test (NAT) and recombinant immunoblot assay (RIBA). A group of repeat voluntary donors were followed retrospectively who became reactive on a cross sectional study and showed HCV reactivity while donating blood regularly.
Material and Methods:
A total of 51,023 voluntary non remunerated blood donors were screened for anti-HCV ELISA routinely. If anybody showed positivity, they were tested by two ELISA kits (screening and confirmatory) and then confirmed infection status by NAT and or RIBA. The previous HCV test results of repeat donors reactive by anti-HCV ELISA were looked back from the records. Data of donors who were repeat reactive with single ELISA kit (in the present study) were analyzed separately from those reactive with two ELISA kits (in the present study).
Results:
In this study, 140 (0.27%) donors who were reactive by anti HCV ELISA were included. Out of them, 35 were repeat voluntary donors and 16 (11.43%) were reactive with single ELISA kit. All 16 donors were reactive by single ELISA kit occasionally in previous donations. Their present ELISA positive donations were negative for HCV NAT and RIBA. A total of 19 (13.57%) donors were reactive with two ELISA kits. In their previous donations, the donors who were reactive even once with two ELISA kits were consistently reactive by the same two ELISA kits in their next donations also.
Conclusion:
Donor sample reactive by only single ELISA kit may not be considered as infectious for disposal as they were negative by NAT and or RIBA. One time ELISA positivity was found probably due to ELISA kit specificity and sensitivity. Donors reactive with two ELISA kit should be discarded as there is a high positivity with NAT/ RIBA. However, donors reactive by two ELISA kits and negative by NAT and RIBA should be followed up and may not be deferred permanently.
doi:10.4103/0973-6247.75979
PMCID: PMC3082711  PMID: 21572711
Anti-HCV ELISA; repeat voluntary blood donor; occult infections; donor follow-up; nucleic acid test; recombinant immunoblot assay
9.  Visual detection of hemolysis in a blood bag before issue 
doi:10.4103/0973-6247.76013
PMCID: PMC3082726  PMID: 21572725
10.  Contralateral hyperinflation: Computed tomography demonstration of an unusual complication of unrecognized endobronchial intubation 
Endobronchial intubation (EBI) is an important complication of endotracheal intubation. In a case of unrecognized EBI, usually, the intubated lung gets hyperinflated while the contralateral lung collapses. We report a case of unrecognized right main stem EBI with ipsilateral normal aeration and contralateral hyperinflation detected during computed tomography scan of the chest for trauma work up in a case of severe head injury.
doi:10.4103/0972-5229.78229
PMCID: PMC3097545  PMID: 21633549
Contralateral hyperinflation; endobronchial intubation; computed tomography

Results 1-10 (10)