Trend of Hepatitis B Surface Antigen (HBsAg) among blood donors at the blood bank of a tertiary care referral teaching hospital in Southern India

Background: Blood is a scarce, but lifesaving resource; it is also the most efficient vehicle for the transmission of Hepatitis B virus (HBV). Hence there is a need for accurate screening of hepatitis B surface antigen (HBsAg) among blood donors. The present study was designed to assess the seroprevalence of HBsAg, among the voluntary and replacement blood donors in the blood bank of a tertiary care referral teaching hospital in Andhra Pradesh.Methods: This is a prospective cross sectional analytical study conducted over a period of one and a half year. A total of 9909 donor blood samples were screened for HBsAg status using enzyme linked immunosorbent assay (ELISA). The reactive samples have been tested in duplicate using different kit. The samples reactive in all three times were considered positive. The samples which were reactive only in first test were labeled as false positive.Results: Out of 9909 blood donors screened, 255 (2.6%) were initially reactive and 219 (2.2%) were reactive after triple testing.Conclusions: Our study showed similar HBsAg seroprevalence as that reported by World Health Organization (WHO) statistics in intermediate zone. But there was a mild increase in HBsAg seroprevalence among donors belonging to rural areas in our region compared to the urban donors.

A maternal "near-miss" case

The term maternal "near-miss" refers to women who have escaped death either due to chance or due to good health care after experiencing severe life-threatening problems during pregnancy, labour or after termination of pregnancy. A "nearmiss" event involving a third gravida with placenta praevia leading to severe antepartum and postpartum haemorrhage, disseminated intravascular coagulation, shock, and respiratory failure managed succesfully by team consisting of obstetricians, anaesthetists, transfusion medicine specialists and critical care experts is reported here. The aim of the report is to stress the need of patient education, importance of emergency transportation and availability of multidisciplinary team and adequate blood for transfusion at all levels of health care system

Para-Bombay phenotype: report of a rare blood group

The blood sample of a 54-year-old male patient who presented with signs and symptoms suggestive of anaemia was submitted to the Blood Bank for blood grouping and cross-matching. In forward grouping, no agglutination was observed with A, B and AB antisera, but agglutination was noticed with D antiserum (Group O). In reverse grouping, there was agglutination in tube labelled A and no agglutination in tubes B and O (Group B) resulting in discrepancy between forward and reverse grouping. Further testing confirmed that the individual's blood group was Para-Bombay B (Para-BH), which is a rare entity. The Para-Bombay phenotype is very rare. Only a few cases of Para-Bombay were reported in India till now and none from Andhra Pradesh. This entity is characterized by the absence of H, A and B antigens on the red cells but their presence in saliva and secretions of gastrointestinal and genitourinary tracts. Proper identification of this phenotype is very important; otherwise this particular blood group may be mislabelled as group O