RETROSPECTIVE ANALYSIS OF PACKED RED BLOOD CELL TRANSFUSION IN TERTIARY CARE HOSPITALIN SOUTHERN INDIA

Introduction: Packed Red cells (Packed RBC) forms an important element in the treatment of various medical conditions. RBC transfusions are generally done to treat hemorrhage and also to enhance oxygen delivery to tissues. Transfusion of RBCs should be based on the patient's clinical condition. Our present study was aimed at analyzing the appropriateness of usage of packed red blood cell usage in our tertiary care hospital. Materials and Methods: This present study was a retrospective analysis of 3000 packed red blood cells issue request forms over the period from august 2017 to October 2017 were analyzed. The appropriate use of packed RBC was assessed by AABB revised guidelines 2016. The transfusion was considered inappropriate if it does not follow these guidelines. Results: The maximum packed red blood cells were transfused in the department of nephrology no 918 units (19.58 %) followed by department of CT surgery no 793 units (16.91 %) and department of General Medicine no 710 units (15.14 %).Maximum number of packed red blood cells were utilized for elective surgeries i.e. 1323 units (28.2 %) followed by malignancies 1012 (21.6%). Commonest indication in electric surgeries is for Percutaneous Nephro Lithotomy, where as in malignancies commonest indication being the acute myeloid leukemia. Conclusion: The overall prevalence rate of appropriate usage of packed RBC in our hospital is 62.4%, which is quite lower and also we found out increasing number of single unit transfusions which could have been avoided with proper implementation of guidelines. These retrospective studies are useful to identify the critical areas requiring intervention so that inappropriate usage of blood and components can be minimized

Paediatric hodgkin's lymphoma: A study of 3 cases

Of all the pediatric malignancies, lymphomas account for about 10-15% of the cases with half of them diagnosed as Hodgkin's lymphoma. Remarkably, this malignancy has a high cure rate with a 5-year survival rate approaching 95%. Hodgkin's lymphoma has an overall incidence rate of 14 per 100,000 less than 15 years of age. It has a typical bimodal distribution with respect to age. In developed countries, the peak incidence is seen in young adults and the elderly. While, in developing countries the incidence is higher among children and young adults with a male preponderance. Histologically, mixed cellularity subtype of classical Hodgkin's lymphoma occurs commonly in the children and in developing countries. We report three typical cases of classical Hodgkin's lymphoma, mixed cellularity subtype with early-stage unfavorable disease presenting as a slightly painful right cervical mass and “B” symptoms. Erythrocyte sedimentation rate was elevated. Ultrasound neck scan suggested tuberculous lymphadenitis. Other laboratory and radiological findings were normal. Fine needle aspiration smears and histopathology helped in arriving at diagnosis of classical Hodgkin's lymphoma, mixed cellularity subtype

Fibroadenoma with spontaneous infarction: An unusual case

Fibroadenomas are the most common benign breast tumors in young women. Infarction is rarely observed in fibroadenomas and when present, it is usually associated with pregnancy or lactation. Spontaneous infarction is an uncommon complication of fibro adenoma of the breast. Although infarction following fine needle aspiration (FNA) has been reported in the literature, infarction encountering on first time aspiration is very rare. Lack of knowledge of this entity may lead to a false diagnosis of inflammatory lesion like mastitis and carcinoma on cytology smears. In young patients with breast lumps, if the aspirated material is necrotic, the probable diagnosis of spontaneous infarction should always be kept in mind. Viable fibroadenomatous tissue should be searched for in the FNA smears

Prevalence of transfusion transmissible infections in a hospital attached blood bank

Background: Screening of transfusion-transmissible infections (TTIs) among blood donors is a cost-effective approach to monitor the prevalence, distribution, and trends of the infections among healthy-looking individuals. The study aimed to determine the seroprevalence of four TTIs, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis, among blood donors in a hospital attached blood bank , suraram , hyderabad. Objectives: The present study was conducted to estimate the prevalence of transfusion transmitted infections in blood donors in a small scale hospital attached blood bank. Methods: All the donors reporting to the blood bank were screened for HBsAg, Hepatitis C Virus (HCV), HIV by using the appropriate enzyme-linked immunosorbent assay (ELISA).The Venereal Disease Reference Laboratory (VDRL) test / Rapid Plasma Reagin Test was used for estimation of syphilis infection. Results: The study was designed for duration of two years from January 2012 to December 2013. A total of 2039 blood donors were screened, of which voluntary donors were 644 (33 %) replacement donors were 1369 (67 %). Seroprevalence in 2012 prevalence rate for HIV, HBV, HCV and Syphilis were 0.62%, 2.04%, 1.53%, and 1.47% respectively. In 2013 prevalence rates for HIV, HBV, HCV and Syphilis were 0.66%, 2.47%, 1.70% and 1.15%. Blood is still one of the main sources of transmission of infections. HIV, hepatitis B, hepatitis C viruses and syphilis are prevalent among blood donors. Conclusion: Voluntary donations are safer when compared to replacement donors. Replacement donations are to be discouraged and promotion of voluntary blood donation should be done. Our study shows is an increase in HBV prevalence, especially among replacement males above 30 years of age

Malignant gastrointestinal stromal tumors (GISTs) of the duodenum occurrence: Case report Malignant gastrointestinal stromal tumors (GISTs) of the duodenum -A rare occurrence: Case report

Abstract Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Most of the cases are located in the stomach followed by the small intestine. They arise from the interstitial cells of cajal, which are loc Malignant GISTs are rare type of tumors in GIT. Small intestine GIST is more likely to be malignant compared to stomach. Here we reported such a rare case of malignant GIST in a 54 y patient who came to the hospital with complaints of pain and mass in abdomen. Ultrasound revealed a mass originating from the duodenum. Provisional clinical diagnosis of duodenal carcinoma was considered preoperatively. Patient underwent complete surgical excision of the tumor. Histopathological examination confirmed the diagnosis of malignant GIST. As the recurrence rate for malignant GIST is high, patient was kept on follow up

Cysticercosis in the axillary region: A case report

Cysticercosis, a systemic illness and a major public health problem is caused by dissemination of the larval form of the pork tapeworm. Taenia solium. A high prevalence has been reported from the developing countries because of the co-existence of poor sanitary conditions and domestic pig raising. Cysticercosis is a preventable faeco-oral transmitted infection and it is possible to prevent infection by avoiding undercooked food, and water contaminated with human faeces. In this unusual form of infection man becomes the intermediate host. The skeletal muscle, subcutaneous tissue, the eyes and CNS are the most frequently affected tissues. Other reported sites are heart, lungs, peritoneum, kidney, liver, and pancreas. The involvement of axillary region, although not unusual is a rare. We present a case of axillary cysticercosis in an 18 year old female

FNAC diagnosis of pleomorphic adenoma of palate

Pleomorphic adenoma also called benign mixed tumor, is the most common salivary gland tumor. Most of these tumors occur in major salivary glands; Parotid gland happens to be the commonly involved one (about 90 %) and about 10 % of these occur in the minor salivary glands. The most common sites for pleomorphic adenoma of minor salivary glands are the palate, followed by the lips, the cheeks, floor of the mouth, tongue, tonsil, pharynx, the retromolar area and the nasal cavity. FNAC of intraoral swellings is rarely advised. Here, we are reporting a rare case of pleomorphic adenoma arising from the palate diagnosed on FNA Cytology. We conclude that FNAC is a useful diagnostic tool before surgery even in intraoral swellings

A retrospective analysis of donor deferral characteristics for plateletpheresis in a tertiary care hospital, South India

Background: There is an increasing demand for platelets in the recent years due to increase in cancer cases, dengue fever, and other platelet-related diseases. Blood bank plays a vital role in supplying platelet units which have better yield and fewer complications. Single donor platelet (SDP) unit is a useful platelet product in many diseases for raising the platelet count. For better yield, a healthy and young donor is required which is a great challenge for the blood bank staff. Materials and Methods: This retrospective study was carried out for a period of 4 years from January 2014 to December 2017. Data were collected from the records maintained by the Department of Transfusion Medicine and Immunohematology in a Tertiary Care Hospital, Hyderabad, India. Results: Out of 860, a total of 705 Plateletpheresis donors were selected for SDP donation, and the remaining 155 (18.02%) donors were deferred for various reasons. The predominant age range of the deferred donors was 25–34 years (50.32%). Among the deferred donors, males were 90.32% and females were 9.68%. Temporarily deferred donors account for 98.07% and permanently deferred donors were 1.93%. The most common causes for deferral were low platelet count (31.61%), low hemoglobin (27.09%), and poor venous access (20.64%) and the least common cause was dermatitis at the venipuncture site (1.29%). The most common reason for permanent deferral was seropositivity for HBsAg. Conclusion: Selection of plateletpheresis donor with utmost stringency will give good yield of platelets. Temporary deferred donor should be counseled properly so as to encourage them for the future donations when they become eligible, and this bridges the gap between the demand and supply of apheresis platelets