Determination of rate and analysis of reasons for discarding blood and blood components in a blood bank of tertiary care hospital:a retrospective study

Background: The transfusion of blood and blood components has become an integral part of patient management in modern medicine. There are no substitutes for human blood. Thus, proper utilization of blood is necessary with minimal wasting.Methods: A total of 15,333 donors donated blood during the study period of 3 years in blood bank of a tertiary care hospital, south Maharashtra from 1 st of January, 2013 to 31 st December 2015, which were screened.Results: Of the total 3355 whole blood collection, 615 blood bags were discarded. Out of these 615 bags 544 (88.45%) were discarded because of date expired, 41(6.66%) blood bags were discarded due to seropositivity for TTI and 22 (3.5%) blood bags were due under collection and leakage and other reasons contributed for 1.3%. A total of 4026 blood components were discarded against 29,715 blood components prepared during the study period. Among blood components discarded, most common units were platelets. The most common cause of discarding the blood components was expiry of date due to non-utilization were 3475 (86.31%).Conclusions: Properly implemented blood transfusion policies, training of staff as well as implementation of automation will also help to improve process and output of BTS. This would reduce the discarding of blood components and wastage due to non-conformance. These discarded bags, because they are unutilized are both financially as well as socially harmful to the blood bank

Adverse blood transfusion reactions at tertiary care hospital

Background: The goal of hemovigilance is to increase the safety and quality of blood transfusion. It is necessary to recognize and prompt response to adverse transfusion reactions, which will help in taking appropriate steps to reduce their incidence and make blood transfusion process as safe as possible. The aim of the study was to determine the frequency and type of transfusion reactions (TRs) occurring in patients, reported to the blood bank at our institute.Methods: A retrospective review of all TRs reported to the blood bank Krishna Hospital, between January 2011 and July 2013 was done. All the TRs were evaluated in the blood bank and classified using standard definitions.Results: During the study period a total 13126 units of blood and components were issued by our blood bank and total of 45 (0.3%) adverse reactions were reported to blood bank. The most common reaction observed was allergic reaction 25(55.6%) followed by FNHTR 15 (33.3%).Conclusions: Not a single case of anaphylactic reactions, TRALI, acute immune hemolytic transfusion reaction, and Sepsis was observed. This can be an underestimation of the true incidence because of under reporting which can be improved by proper hemovigilence system to provide better patient care.

Insights into Insect Resistance in Pulse Crops: Problems and Preventions

Globally, insect pests cause considerable damage to pulse crops. Hence developing broad-spectrum resistance against insect pests has been a major challenge to pulse growers and scientists. Traditionally, cultural practices and synthetic insecticides are being utilized for effective control of insect pests since ages. Apart from these, other strategies such as host plant resistance, insect-resistant transgenic crops, and IPM are also being used to manage the infestation in pulse crops. Though screening of genetic resources for insect resistance has been promising in some pulse crops, fertility barriers and linkage drag minimize the effective utilization of identified resistance in commercially viable crop breeding programs. In parallel, insect-resistant transgenic plants have been developed using various insecticidal proteins from various sources including Bacillus thuringiensis endotoxin, plant protease inhibitors, chitinases, alpha-amylase inhibitors, secondary metabolites, and vegetative insecticidal proteins (VIPs). Deploying transgenic plants with high levels of toxin expression by gene pyramiding is another practical option to delay the resistance development in insects. Nevertheless, the success achieved so far in managing insect pests is limited mainly due to the complex mechanisms underlying the defense strategies together with the lack of precision in screening techniques. Here, we discuss the recent progress and current status of studies toward developing resistance to the most common insect pests of pulses. This chapter points the lack of detailed molecular studies exploring the insect resistance that can advance our knowledge on plant resistance mechanisms and the genes involved. Therefore, a step forward now will be on exploiting natural variations with novel technologies in combination of eco-safe management practices to develop durable insect-resistant pulse crops. Despite technical and regulatory difficulties, developing insect resistance should be the major priority area for future breeding and genetic engineering studies aiming at pulse crop improvement