A retrospective analysis of trends of HIV and syphilis among blood donors in north India

Background: In India, it is mandatory to screen blood donors for HIV, hepatitis B, hepatitis C, syphilis and malaria. The donor screening strategies include taking the elaborate medical history, performing preliminary clinical examination and screening for infectious markers. The infectious markers include anti-HIV (1 and 2) antibodies, hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibodies, and malaria antigens, such as histidine rich protein (HRP) and pan-aldolase. National adult (15-49 years) HIV prevalence is estimated at 0.26% (0.22%-0.32%) in 20155 (0.30% among males and 0.22% among females). The objective of this study was to be carried out with the aim to find out the seroprevalence of HIV infection and its trend among the blood donors a hospital based blood transfusion service set up in north India over a period of six years.Methods: It was record based retrospective study from 2010 to 2015. Before donation "blood donation form" had been filled by every donor and this form had particulars about age, gender, address, and occupation, date of previous donation, any illness and medical treatment taken. The donor blood samples were collected at the time of blood donation from the primary bag and tested for the presence of HIV using enzyme linked immunosorbent assay (ELISA). All donors were subjected to a pre-test counselling which was done by qualified staff trained to screen donors for blood donation.Results: A prevalence of 0.21% of HIV was seen among the donors from the period 2010-2015. The trend of HIV prevalence among donors has been fluctuating while ranging from 0.13% to 0.34%.Conclusions: HIV remains the major threat for transfusion transmitted infections in India. For a safe blood service in our country, where comprehensive laboratory tests are neither possible nor pragmatic, it is best to switch over to 100% voluntary donations, as it is now established that only voluntary non-remunerated regular donation is the safest. Thus, one of our key strategies to enhance blood safety is to focus on motivating non-remunerated blood donors and phasing out even replacement donors

Patterns of voluntary and replacement blood donors in a tertiary care center: a retrospective study

Background: Blood donor base is the foundation of any blood transfusion system. In India any able-bodied individual between the age of 18 and 60 years can donate blood. Blood donors are of two types: voluntary donors and replacement donors. Blood donation should be done by low risk population otherwise there is high risk of transfusion transmissible infections like HIV, hepatitis B, hepatitis C and malaria. The present study was conceived to see the patterns of blood donation among voluntary and replacement blood donors in tertiary care centre.Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured.Results: Of the total 340078, 298421(87.75%) collections were voluntary and 41657(12.25%) were replacement collections. A total of 2810 camps were held to gather blood through voluntary donors. Number of blood camps held show an increasing pattern as we progress in time. Also, the trends in voluntary blood donations increased over the period and more donors donated blood whereas replacement donors decreased over the period and eventually vanished in time.Conclusions: For a safe blood service in our country, where comprehensive laboratory tests are neither possible nor pragmatic, it is best to switch over to 100% voluntary donations, as it is now established that only voluntary non-remunerated regular donation is the safest. Thus, one of our key strategies to enhance blood safety is to focus on motivating non-remunerated blood donors and phasing out even replacement donors

Structural Changes and Ferroelectric Properties of BiFeO₃-PbTiO₃ Thin Films Grown via a Chemical Multilayer Deposition Method

Thin films of (1-x)BiFeO3-xPbTiO3 (BF-xPT) with x ~ 0.60 were fabricated on Pt/Si substrates by chemical solution deposition of precursor BF and PT layers alternately in three different multilayer configurations. These multilayer deposited precursor films upon annealing at 700{\deg}C in nitrogen show pure perovskite phase formation. In contrast to the equilibrium tetragonal structure for the overall molar composition of BF:PT::40:60, we find monoclinic structured BF-xPT phase of MA type. Piezo-force microscopy confirmed ferroelectric switching in the films and revealed different normal and lateral domain distributions in the samples. Room temperature electrical measurements show good quality ferroelectric hysteresis loops with remanent polarization, Pr, of up to 18 {\mu}C/cm2 and leakage currents as low as 10-7 A/cm2.Comment: 14 Pages and 6 figure

Foundations of mechanism design: a tutorial Part 1- Key concepts and classical results

Mechanism design, an important tool in microeconomics, has found widespread applications in modelling and solving decentralized design problems in many branches of engineering, notably computer science, electronic commerce, and network economics. Mechanism design is concerned with settings where a social planner faces the problem of aggregating the announced preferences of multiple agents into a collective decision when the agents exhibit strategic behaviour. The objective of this paper is to provide a tutorial introduction to the foundations and key results in mechanism design theory. The paper is in two parts. Part 1 focuses on basic concepts and classical results which form the foundation of mechanism design theory. Part 2 presents key advanced concepts and deeper results in mechanism design

Osmotically Regulated Two-Compartment Asymmetric Membrane Capsules for Simultaneous Controlled Release of Anti-Hypertensive Drugs

In the present study, asymmetric membrane capsules (AMCs) with two compartments were successfully developed for simultaneous delivery of two poorly water-soluble drugs, Atenolol and Amlodipine Besylate, by using solubility modulation approach. Scanning electron microscopy (SEM) before dissolution showed presence of outer dense region and inner porous region for the prepared asymmetric membrane and the pore size increased after dissolution for both outer and inner layer. Diffuse reflectance spectroscopy (DRS) showed no incompatibility between the drug(s) and the excipients used in the study. The developed system was able to control the release of ATN and AMB by increasing the solubility through buffering agents of different strengths (0.25N to 1.0N). As the level of buffering agent was increased, the solubility of drugs also increased inside the asymmetric membrane capsule. The developed system was independent of the agitation intensity of the dissolution fluid but was dependent on the polymer diffusibility and osmotic pressure of the media, which clearly stated that osmotic pumping was the primary mechanism of drug(s) release from AMCs. The results of in-vitro demonstration of effect of membrane thickness on dissolution fluid entering AMCs showed that as the membrane thickness increased the volume of dissolution fluid entering into AMC decreased. The release kinetic studies of different formulations of AMCs showed that formulation code six, which consists of the highest amount of osmotic agents and optimum amount of buffering agents, was the best formulation, and it followed zero order release kinetics (r2=0.9990 for ATN and r2=0.9988 for AMB)

Flap and finger-tip blood glucose level monitoring to predict venous thrombosis in free flaps: a simple and effective method

Background: Rapid detection and early re-exploration is the key to salvage congested flap. Various methods have been described in literature to monitor flaps in post operative period. We evaluate the efficacy of measurement of flap and fingertip blood glucose level and its role in predicting the flap congestion and salvage. Methods: prospective observational study conducted in a tertiary care centre in North India between December 2020 to December 2022. A total of patients 500 underwent 507 free tissue transfer were included in this study. Flap congestion was noted clinically in 41 flaps. In these 41 flaps, flap and fingertip blood glucose level were measured. Results: Congested appearing flaps divided into 2 groups. Group A consist of 8 flaps out of 41. The difference in flap and fingertip blood glucose level is less than 10%. Out of 8, 5 does not required re-exploration and were successfully salvaged. In 3 flaps, difference in flap and fingertip glucose level rises with time and were taken for re-exploration. Out of these 3, 2 were successful salvaged. Group B consist of 31 flaps. In these 31 flaps, 41. the difference in flap and fingertip blood glucose level is more than 10%. All these flaps were re-explored and 21 were salvaged. Conclusions: Flap and body glucose level monitoring is a simple and reliable method for flap monitoring and it can be performed by residents as well as nursing staff

Assessment of clinical, functional and radiological outcomes in young patients with grade 3 and 4 osteoarthritis of the knee joint undergoing knee joint distraction with and without arthroscopic debridement and chondroplasty-a prospective, comparative and randomized controlled study

Background: Treatment of severe osteoarthritis (OA) in relatively young patients is challenging. Although successful, Total knee arthroplasty (TKA) has a limited lifespan, with the risk of revision surgery, especially in active young patients. Our study aims to assess the comparative clinical, functional and radiological outcomes of knee joint distraction (KJD) with and without arthroscopic debridement and chondroplasty in OA of knee in the young, in a randomized controlled trial. Methods: Our study was a prospective randomized trial with equal allocation. A total of 160 patients needing intervention for knee arthritis, in the age group of <55 years were included as per the inclusion criteria, and were randomized into 2 groups. Group A included 80 patients who underwent KJD alone. Group B included 80 patients who underwent KJD with arthroscopic debridement and chondroplasty. All patients were followed up to 24 months post intervention. Clinical (Visual analogue scale-VAS), functional (Western Ontario and McMaster universities OA index-WOMAC) and radiological (Joint space width-JSW) outcomes were then compared and assessed. Results: Both the groups showed statistically significant improvement of clinical, functional and radiological outcome scores compared to baseline levels. The mean improvement in KJD+SCOPY group was statistically superior to that of KJD group with regard to clinical and functional outcome scores; however, the radiological improvement though being statistically significant in both groups compared to baseline levels, but one group was not superior to that of other. Conclusions: KJD in patients with OA of knee (Kellegren Lawrence grade 3-4) aged <55 years results in improvement of clinical, functional and radiological parameters at 2 year follow up. Addition of arthroscopic debridement and chondroplasty to KJD makes it superior to KJD alone in terms of improvement in clinical, functional and radiological outcomes. We recommend arthroscopic debridement and chondroplasty coupled with KJD for compliant patients of less than 55 years with grade 3-4 OA of the knee