Several changes occur during whole blood (WB) storage in the blood banks. The structure of erythrocytes and thrombocytes changes, and their viability decreases. Leukocyte degradation causes the release of cytokines and enzymes that can trigger a transfusion reaction. In addition, a decrease in pH will damage the WB components. The coagulation factors will be degraded during the storage process. All of these changes will impact the WB quality and the recipient. Therefore, this study aims to analyze the effect of storage time on WB quality. This research employed an analytical study with a time series design conducted at the Clinical Pathology Installation and Blood Bank at Dr. Soetomo General Hospital, Surabaya, on February-June 2020. The researchers utilized a sample of sixteen WB bags. The sample will be tested with several examinations, including a complete blood count examination (to determine the number of erythrocytes, leukocytes, thrombocytes, and hemoglobin), the coagulation examination (to determine PPT and APTT), and a BGA examination (to determine pH, pO2, and pCO2). All parameters were checked on day 0, day 5, day 10, day 20, and day 30.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with various clinical manifestations. Lupus nephritis isthe most common severe manifestation with a poor prognosis. Hematuria is included in the Lupus Activity Criteria Count(LACC) and SLE Disease Activity Index (SLEDAI). Phase Contrast Microscope (PCM) availability as a recommended instrumentfor dysmorphic erythrocytes evaluation is exclusive, thus causing this examination to be performed rarely. This study aimedto investigate the diagnostic value of dysmorphic erythrocytes in SLE patients with hematuria using Low Condenser LightMicroscope (LCLM), PCM, and UF-500i. This research was a cross-sectional study with consecutive sampling; 58 fresh urinesamples were examined with UF-500i during May-July 2019. Percentage of dysmorphic erythrocytes were evaluated usingLCLM and PCM. Difference percentages of dysmorphic erythrocytes were analyzed using the Wilcoxon Signed Ranks test,degree of agreement by Kappa coefficient, cut-off, sensitivity, and specificity by ROC curve. Dysmorphic erythrocytepercentage in LCLM and PCM showed a significant difference (p < 0.001) and a low degree of agreement (Kappa=0.373).Dysmorphic erythrocyte cut-off with LCLM was 7.5% (sensitivity 70%, specificity 68%) and PCM was 6.5% (sensitivity 74%,specificity 65%). Dysmorphic? flagging from UF-500i showed a sensitivity, specificity, PPV, NPV of 78%, 52%, 58% and 73%,respectively. LCLM can be considered a substitute for PCM for evaluating dysmorphic erythrocytes with its cut-off, so theclinician will be more alert to abnormalities that cause hematuria. Further research with larger samples and definitediagnosis with a kidney biopsy is needed to obtain more accurate results.

Heparin-derivative anticoagulants include unfractionated heparin (UFH), low molecular weight heparin (LMWH), pentasaccharide (fondaparinux), and ultralow molecular weight heparin (ULMWH). Heparin contains an active pentasaccharide sequence that binds to antithrombin (AT). This bond produces conformational changes that accelerate its binding with AT and inactivation of coagulation factors XIIa, XIa, Xa, and IXa and thrombin (IIa). Thrombin and factor Xa are the most sensitive to inhibition by the heparin-AT complex, and the strength of inhibiting thrombin is ten times more sensitive than factor Xa. The UFH anticoagulant response is monitored using activated partial thromboplastin time (APTT), a measurement that is sensitive to inhibition of thrombin and factor Xa. Protamine titration examination is the standard for measuring UFH concentrations in plasma. Recommendations from the American College of Chest Physicians (ACCP) suggest that the APTT target range for the UFH therapy is equivalent to 0.2-0.4 IU/mL with protamine titration or 0.35-0.7 IU/mL with an anti-Xa examination. A new examination is thrombodynamics (TD), measuring the level of development of clots. This method is considered most able to mimic the coagulation process that occurs in vivo compared to other examinations.

We summarized the various serological and molecular examination modalities for COVID-19. RT-PCR instrument selection is important. Closed system has the advantage of automatic RNA extraction, thereby reducing the risk of contamination and false negatives results, but the cost is high. In contrast, open system has lower cost, but the RNA extraction must be performed manually. Thus, it requires additional facilities and expert laboratory staff. In addition, it has a higher false negative rate and the risk of contamination towards laboratory staff. Among several number of gene targets, it is recommended to use specific gene targets according to WHO and CDC. Although the current gold standard diagnosis of COVID-19 is the RNA examination using RT-PCR, but the availability of this instrument is not evenly distributed. Therefore, alternative examination is needed. Serology is a quick and easy examination, thus it can be used for screening and helping diagnose COVID-19. However, several aspects are needed. The detected target is antigen or antibody. The detected antigen is a specific protein from the virus, but the antigen is only detected when the virus is actively replicating and more effective at acute phase. Antibodies are more effective because they can last for a long time. Total antibodies have the highest sensitivity and can increase the sensitivity of RNA tests when combined. The time of collection and specimen type used are also important because some specimens have low sensitivity.