Efficiency of blood utilization and characteristics of patients receiving blood transfusion at an associated hospital in North India

Background: Blood is the liquid connective tissue composed of cells and plasma. It is the most precious and unique gift that one person gives to another. Blood banks are not the manufacturing factories. It can only be available on replacement basis. Periodic review of blood components usage is essential to assess the blood utilization pattern in hospitals. This study was conducted to analyse the efficiency of blood utilization and to minimize the inappropriate use of blood.Methods: A retrospective cross-sectional study was conducted in the department of blood transfusion and immunohematology, government medical college and associated hospital, Rajouri for a period of one year with effect from November 2019 to November 2020. Data was collected using blood bank record. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (T%) and transfusion index (TI) indices.Results: A total of 974 patients were requested to prepare 1270 crossmatched units. Of these 1141 blood units were transfused for 664 patients. The total donations during that period were 1197. 998 donors were replacement donors and 199 were voluntary non-remunerated blood donors donated at various blood donation camps. The overall values of C/T, T% and TI were 1.1:1, 68.1% and 1.1 respectively.Conclusions: Blood utilization indices show efficient usage of blood. However, a blood ordering policy (MSBOS) must be developed to guide the clinicians regarding blood usage which can decrease overordering of blood thereby reducing unnecessary usage of reagents, manpower and also wastage of blood due to outdating.

Pattern of blood component cross-matching and their utilization in a tertiary care hospital of Jammu region

Background: Transfusion of donated blood remains the mainstay of treatment for a wide range of medical and surgical conditions. Although it can save life, but transfusion of blood is not without risk. Clinicians should cautiously assess the appropriateness of indications before requesting various blood components thereby preventing misuse of blood and unnecessary exposure of patient to various transfusion transmitted infections and antibodies production. This study was conducted to determine the pattern of whole blood (WB) and blood component cross-matching and their utilization and to minimize the inappropriate use of blood and its components.Methods: This cross-sectional prospective study was performed at SMGS Hospital Blood Bank, Jammu from April 2016 to September 2016. The requisition forms were analysed at the reception counter and inside the pre-transfusion testing laboratory for any error. The department wise utilization of blood and its components, Crossmatching to transfusion (C/T) ratio, transfusion probability (T%) and transfusion index (TI) were calculated.Results: A total of 14376 requests for cross-matching of blood and its components were received. All the units were cross-matched. Out of these, 12766(88.8%) units of blood and its components were issued to various departments. The most common indication for using packed red cells and whole blood was anemia and bleeding (APH/PPH/Trauma). The total C/T Ratio, transfusion probability (T%) and Transfusion index(TI)  of various blood components were 1.12:1, 88.8% and 0.88 respectively.Conclusions: Our study indicates efficient usage of blood and its component. However, awareness is still needed amongst the clinicians and residents to ensure the appropriate use of blood and its components in the future as well. Hospital transfusion committee has to develop transfusion guidelines and subsequent implementation of such guidelines to assure effective blood utilization. MSBOS (maximum surgical blood ordering schedule) should be formulated for elective procedures with regular auditing, feedback, and modifications to improve blood ordering and utilization

Does starting with the behavioural component of cognitive behavioural therapy (CBT) increase patients' retention in therapy?

This study examined whether starting with the behavioural component of cognitive behavioural therapy (CBT) decreases the drop-out rate in outpatients with comorbid anxiety and depression. Retrospective data were collected on 60 patients with anxiety and depression. Mean values of different psychosocial assessment scales during screening, mid-session and discharge session were compared between the patients receiving and not receiving any type of behavioural interventions and among the patients receiving different types of behavioural interventions. A significant relationship was found (p < .05) between behavioural interventions and retention in therapy. Patients who did not receive any sort of behavioural intervention showed a greater rate of drop-out than those who received behavioural interventions. In the group of patients receiving different types of behavioural interventions, there was significant improvement in mental health scores between the screening and discharge sessions in those who received exposure therapy. The study findings will be helpful to retain patients with comorbid anxiety and depression in an outpatient therapy setting. If patient retention is increased, CBT can be more effectively delivered and thereby achieve better health outcomes for patients, more effective use of therapy service resources, and decrease the socioeconomic burden of anxiety and depression on the community

Lean Implementation in Jordanian Pharmaceutical Industry: The Case of Hikma Company

The purpose of this paper was to investigate the effect of lean practices on productivity at process industries; the case of Hikma Pharmaceutical Company.  A quantitative approach based on survey questionnaire was used to evaluate the impact of lean tools on productivity. The paper showed that visual management, 5S, and work standards had a significant impact on productivity, whereas, waste reduction did not have a significant effect. Keywords: Lean practices, productivity, pharmaceutical industry. DOI: 10.7176/EJBM/13-10-08 Publication date:May 31st 202

Distribution of RH and Kell (K) blood group antigens among blood donors in a tertiary care hospital of Jammu region, India

Background: Knowledge about the frequency of red cell antigen phenotype is very important for the creation of donor data bank and to minimize the risk of alloimmunization. This requires the determination of immunological characteristics of blood products and blood recipients by performing phenotyping of clinically significant blood group antigens. The aims and objectives were to study the distribution of Rh and Kell (K) antigen among blood donors of different ethnic groups in a tertiary care hospital.Methods: This was prospective observational cross sectional one-point analysis study which was carried out over a period of one year with effect from November 2015 to October 2016 in the Postgraduate Department of Immunohematology and Blood Transfusion Medicine, Shri Maharaja Gulab Singh (SMGS) Hospital, Government Medical College, Jammu and Kashmir, India. It comprised of voluntary and replacement donors and categorized into different ethnic groups i.e Dogras, Gujjar Muslims, Non-Gujjar Muslims, Kashmiri Pandits, Sikhs and Christian. Donors selection criteria was as per Drug and Cosmetic Act.Results: A total of 500 (Five hundred) blood samples from the donors of all blood groups were typed for the presence of Rh (D, C, E, c, e) and Kell (K) antigens. Out of these 500 samples, 420 were antigen typed by conventional tube technique and 80 samples were typed by column agglutination technique using glass beads. As per ethnicity, maximum donors were Dogras (74%) followed by Non-Gujjar Muslims (9.4%), Gujjar Muslims (9%), Sikhs (5.6%), Kashmiri Pandits (1.4%) and Christians were the least in frequency (0.6%). On phenotyping for Rh and Kell antigens ‘e’ antigen have the ubiquitous distribution and was found to have the highest frequency 486 (97.2%) followed by ‘D’ antigen 472 (94.4%), ‘C’ antigen 426 (85.2%), ‘c’ antigen 320 (64.0%) and ‘E’ antigen 103 (20.6%). Overall frequency of Kell (K) antigen was 2.6%.Conclusions: Knowledge of red cell antigen phenotype frequencies in a population with different ethnic groups can help in creating donor data bank and database for the distribution of blood groups for preparing inhouse cell panels and providing proper antigen compatible blood for patients with multiple alloantibodies and also reduce the risk of RBC antigen alloimmunization along with their complications

Lean Implementation in Jordanian Pharmaceutical Industry: The Case of Hikma Company

The purpose of this paper was to investigate the effect of lean practices on productivity at process industries; the case of Hikma Pharmaceutical Company.  A quantitative approach based on survey questionnaire was used to evaluate the impact of lean tools on productivity. The paper showed that visual management, 5S, and work standards had a significant impact on productivity, whereas, waste reduction did not have a significant effect. Keywords: Lean practices, productivity, pharmaceutical industry

El Lazarillo de Tormes en árabe: la traducción de paremias y locuciones

This paper studies the phraseological translation considered as one of the challenging pitfalls for translators. The error that the translator commits in any of the phases of the translational process, from the identification of the phraseological unit and the interpretation of it, to the search of equivalents in the target language and the establishment of correspondences in the target text, can produce a meaning that is different than the one presented in the source text. This study analyzes the translation of proverbs and idioms in the three Arabic versions of Lazarillo de Tormes, focusing on the translation techniques managed by the translators.Este artículo estudia la traducción fraseológica considerada como uno de los escollos desafiantes para los traductores. El error que el traductor comete en cualquiera de las fases del proceso traslativo, desde la identificación de la unidad fraseológica y la interpretación de la misma, hasta la búsqueda de equivalentes en la lengua meta y el establecimiento de correspondencias en el texto de llegada, puede producir un sentido totalmente diferente del presentado en el texto de origen. En este estudio se analiza la traducción de paremias y locuciones en las tres versiones árabes del Lazarillo de Tormes, prestando especial atención a las técnicas de traducción manejadas por los traductores

The performance of integrated ultrasonic membrane anaerobic system (IUMAS) in treating sugar cane wastewater

Sugarcane mill effluent (SCME) causes severe environmental pollution due to its high concentration in term of pollutants. Conventional methods of treating SCME have disadvantages from both environmental and economic perspectives. Most of the treatment methods used the membrane as a solution to wastewater pollution problems but suffering from membrane fouling. In this study, the potentials of Integrated Ultrasonic Assisted Membrane Anaerobic System (IUMAS) in treating sugarcane mill effluent was investigated. In this research different organic loading rates were used as a fed to the system, which operated semi-continuously at mesophilic temperature 30°C to 35°C and pressure ranges of 1.5–2 bars. Seven steady states were accomplished as a part of a kinetic study that considered concentration ranges of 2500 mg/L to 6000 mg/L for mixed liquor suspended solids (MLSS). The aim was to obtain optimum operating conditions and maximum methane production as well as the performance of IUMAS comparing with membrane anaerobic system (MAS) in treating SCME. IUMAS depicted better performance as compared to MAS in treating the sugarcane mill effluent (SCME) as it achieved higher percentage removal efficiencies for COD, BOD, turbidity and TSS which were 96.12%, 67%, 94%and 98.8%, respectively. While higher percentage removal efficiencies for MAS were 93.8%, 66.3%, 73.8% and 97.4%. The highest methane percentage was 80.9 % for IUMAS compared with MAS was 77.3%. The SCME characterized to investigate by using a different analytical approach such as SEM/EDX, and FTIR. SEM morphology analysis for IUMAS, the permeate flux for the membrane filtration of SCME increased while for MAS decreased the permeate flux due to fouling problem. For FTIR in both methods obtained 5 identified peaks before treatment. However, after treatment indicated 6 and 5 identified peaks for IUMAS and MAS. Kinetic equations from Monod, Contois and Chen and Hashimoto were employed used IUMAS to describe the kinetics of SCME treatment. The correlation coefficient was 54% for Monod, 85% for Contois model and 91% for Chen and Hashimoto model. From the highest, R2 the best fitting in Chen and Hashimoto model. The growth yield coefficient Y and the specific microorganism decay rate b were determined as 0.23 g VSS/g COD and 0.0214 day-1 respectively. An optimization study for the preparation conditions of the selected optimum parameters for maximum methane gas was investigated using Response Surface Methodology (RSM). The determining factors such as pH, OLR, COD, and HRT were initially screened using 2 level factorial approach. The screening revealed that the effect of the above parameters was significant. Furthermore, the impact of these four operating parameters were investigated using the central composite design (CCD) techniques. The results presented the optimum conditions for methane yield from SCME were pH 7.1, OLR 8 kg COD/m3/day, COD HRT 5.65 day with CH4 84.7%. The results obtained in this study have exposed the capability of ultrasonic-assisted membrane anaerobic system (IUMAS) in treating SCME wastewater. Thus, this method can be a promising source for treating all industrial wastewater

Socio-demographic profile and mode of attempt of suicide among suicide attempters in Kashmir: a hospital-based study

Background: Suicide is an important and serious public health problem. It is one of the major emergencies in psychiatry. This study was carried out to assess the socio-demographic profile and mode of attempt of suicide among suicidal attempters attending emergency.Methods: This study was a cross sectional, observational study conducted at Institute of Mental Health and Neurosciences-Kashmir, an associated hospital of Government Medical College Srinagar, among the suicide patients attending the outpatient service and inpatient services fulfilling inclusion and exclusion criteria over a period of one and a half year. Each patient was informed about the purpose of interview; his/her consent was obtained in a simple and easily understandable unambiguous language.Results: A total of 221 cases who had been admitted following unsuccessful suicide attempts to the emergency and psychiatry department were taken up for the study. Out of which 161 (72.9%) were females and 60 (27.1%) were males, the mean age was 24.61±8.9 years. Lower middle and upper lower classes occupied an equal percentage of 34.4% of the suicide attempters, while 24% belonged to upper middle class and only 5.9% belonged to lower class .The least no. of cases (1.4%) were from the upper classes. The most common mode adopted was poisoning whereas the least common mode was self- immolation. Poisoning and self-mutilation were proportionally high in females as compared to males with a significant p value.Conclusions: There should be a robust system in place which takes care of future management and follow up of this group of population.