A positive direct Coombs test (DCT) is the hallmark of diagnosis of immune hemolytic anemias. The reagent used for the test is the Antihuman globulin (AHG), which may be either 'Polyspecific' or 'Monospecific'. The advent of the Gel card systems has made the procedure and interpretation of DCT simpler. Aim of this study is to evaluate three of the various techniques used for the performance and interpretation of DCT. A total of 96 EDTA samples were included in the study. DCT was performed by (i) polyspecific AHG manual tube method (ii) polyspecific AHG Gel card method and (iii) monospecific AHG (Anti IgG and Anti Complement) manual tube method. In our study we considered positivity by monospecific AHG as the standard for diagnosis. Of the total 96 samples evaluated, 44 cases positive by Gel card method, were also positive for either one or both the monospecific AHG reagents. 17 cases positive by Gel card were negative by all manual methods. These false positive cases were attributed to reasons such as increased ESR, macrocytosis and marked leucocytosis. Nine cases were negative by Gel card but were positive with the Monospecific AHG. The sensitivity of DCT done by the Gel card technique was 83.01% and the specificity was 60.46%. Use of Gel card technique to perform and interpret DCT is easier than manual tube methods, but positivity by Gel card needs to be correlated with clinical presentation of the patient and other laboratory findings. Monospecific antisera can be used to confirm cases that are positive by the Gel card systems.

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Dear Editor, Hb D is a b chain haemoglobin variant. It was first described by Itano in 1951 [1]. It differs in structure from Hb A at 121 position on b chain where glutamine replaces glutamic acid [2]. Hb D is known variously as Hb D Punjab, Hb D Los Angeles. It is the fourth most frequently occurring Hb variant [3].Hb D Punjab occurs with greatest prevalence (2 %) in Sikhs of Punjab and in Gujarat (1 %). It is also found sporadically in blacks and Europeans, the latter usually seen in countries that have close association with India in the past [3].HbD heterozygotes are clinically normal and homozygotes have a clinically mild phenotype. Hb D attains clinical significance in association with either b thalassemia or HbS.We describe 12 patients, 9 from South Indian population (three cases of Hb D trait and six cases of Hb SD) and 3 from West Bengal (one case homozygous HbDD, one case of HbD b thalassemia and one case of HbD trait).Blood samples collected in EDTA were subjected to complete blood counts, reticulocyte count and red cell indices on the Sysmex XT 1800i/XT 2000i/XT 4000i. Peripheral blood smears were prepared stained with Leishman's stain and examined. Sickling test was done where indicated by using 1 % sodium metabisulphite. G6PD screening was done using dye reduction test. The HPLC was done on BioRAD Variant II. The clinical data was retrieved from the medical records department.HPLC was done on 1,460 cases over a period of 2 years from September 2009 to February 2012. Five hundred and eighty-nine cases of haemoglobinopathies were detected. b Thalassemia trait was most common with 373 cases (63 %) being detected. b Thalassemia major was seen in 36 cases (6.1 %) and b thalassemia intermedia in 13 cases (2.2 %). Sickle cell disease was the next common with 28 cases of Sickle cell trait (4.7 %), 25 cases of sickle cell anemia (4.2 %) and 18 cases of sickle b thalassemia (3 %). HbE was seen significantly in the migrant population from Bengal with 24 cases of HbEE disease (4 %), 27 cases of HbE trait (4.5 %) and 14 cases of HbE b thalassemia (2.3 %). Twelve cases (2.0 %) showing Hb D were detected of which six cases were double heterozygous HbSD, one case of homozygous HbDD, one case of HbD b thalassemia and four cases of HbD trait. Eleven cases (1.8 %) of hereditary persistence of foetal haemoglobin (HPFH), four cases (0.6 %) of HPFH trait and four cases (0.6 %) of a thalassemia were also seen.

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Background:  In the twenty-first century, Caesarean section is the most frequent operation in obstetrics. Throughout the twentieth century, Caesarean sections have proven to be one of the most efficient abdominal procedures. Over the last three decades, the number of caesarean sections has risen considerably. Around the world, the number of caesarean sections performed is on the rise. From 2003 to 2018, it is more than doubled, reaching a peak of 21% and is growing at a rate of 4% every year. Today’s student nurse will become future nurse, so it’s vital create them competent while providing care to the mothers after lower section caesarean section. Objective: To assess current competencies among students on postnatal care of mothers who underwent lower section caesarean section in study group , to assess the impact of the skill training programme on the competencies of students in focused group & to find out the association between post-test competencies with the demographic variables of students of study group. Methods and Materials: The quasi-experimental with non-equivalent pre-test post-test design study was conducted on 30 students in each of experimental and control group by convenient sampling technique in two nursing institutions at Gurugram, Haryana. Results: Experimental group subjects enhanced the level of knowledge from 11.6 to 17.8 and their skill from 11.7 to 35.5 after implementing the skilled training programme, while the control group showed no improvement. There is a statistically significant transformation between the pre-test and post-test scores. Paired sample ‘t’ test was used to observe differences between pre and post-test mean scores. Students with prior knowledge were more competent, which is statistically noteworthy with a P value of < 0.001. Age, sex, religion, parents' education, and home location are not significant demographic characteristics. The Pearson chi square test was used to determine statistical significance. Conclusion: Skill training not only enhance knowledge in a specific field, but then also clarifies students how to network, accomplish to timeline, and connect efficiently with people. A competent student nurse can become a competent staff nurse by developing skill through effecting skill training program during study period.