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Background: Corticosteroids are extremely effective drugs and are used extensively in the management of asthma. Inhaled corticosteroids may offer some benefit in patients with mild to moderate obstruction in acute exacerbation and also offer the advantage of administration directly to the lungs. Hence this study was done to evaluate the efficacy of nebulized budesonide as compared to oral prednisolone in the management of moderate exacerbation of acute asthma.Methods: A total of 80 children attending pediatric emergency of SMGS Hospital Jammu aged 1 to 18 years with a moderate exacerbation of asthma despite three salbutamol nebulizations were enrolled and randomized into two groups. First group recieved nebulized budesonide (800 mcg) at hourly intervals for three doses followed by twice a day (n=37) while second group recieved oral prednisolone 2 mg/kg/day in two divided doses (n=43). Both groups continued to receive oxygen inhalation and nebulized salbutamol (0.15 mg/kg/dose) initially at hourly intervals for 3 doses followed by 6 hourly. The pattern of response as observed by the pulmonary scores in the two groups was compared.Results: The pulmonary scores were significantly improved at 1, 2 and 6 hours after starting treatment in the budesonide group as compared to prednisolone group (p < 0.01) although the difference was not significant after 12 hours. Oxygen saturation also showed a significant early improvement.Conclusions: This early demonstrable significant improvement in the clinical parameters of the inhaled budesonide group apparently suggests that inhaled budesonide may be efficacious in treating moderate exacerbations of asthma.

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Background: There is a high incidence of alloimunization in many patients with diseases that require repetitive blood transfusions. One such group is chronic renal failure patients as majority of them have severe anemia due to deficiency of erythropoietin. As many such patients are unable to afford erythropoietin, they are treated with blood transfusions. This study was thus undertaken to study alloimunization in such patients at our center.Methods: A total of 96 patients found eligible were enrolled in this cross-sectional study that was carried out from June 2016 to august 2016. After detailed history, antibody screening was done by using Immucor Panoscreen three vial set and if screening came out to be positive antibody identification was then done by using Immucor Panocell-10.Results: 96 patients including 76 male and 20 female patients recieved a total of 912 transfusions. Alloantibodies were detected in a total of 12 patients (12.5%). Of these 12 patients 8 patients had a single antibody whereas 4 patients developed two antibodies. The antibodies developed at a rate of 1.8% per transfusion (16/912). On alloantibody type identification, the most common type found was anti E (4/16) followed by both anti D and anti C in 3 patients each.Conclusions: Alloimmunization to minor erythrocyte antigens occurs in many patients of chronic renal failure. This results in frequent pre-and post-transfusion complications. Inclusion of antibody screening test in routine pretransfusion testing protocol for the patients who are at higher risk of alloimmunization and require long-term transfusion dependence is desirable.

Background: The COVID-19 pandemic has major implications for blood transfusion. There are uncertain patterns of demand, and transfusion institutions need to plan for reductions in donations and loss of crucial staff because of sickness and public health restrictions. A range of strategies need to be planned to maintain ongoing equitable access to blood for transfusion during the pandemic, in addition to providing new therapies such as convalescent plasma. The main role of transfusion institutions during this period, is the monitoring of supply and demand so that sufficient blood stocks are maintained to support ongoing critical needs. The main aim of our study was to study the impact of COVID-19 outbreak on blood transfusion services (BTS) and to identify the challenges faced by our blood center and mitigation strategies adopted to combat it.Methods: Total number of donations and total number of blood and its components issued were noted from the donor and issue registers respectively, both during the pre-COVID and COVID-19 pandemic and the results were compared thereafter. Various strategies were adopted during the COVID pandemic in order to maintain balance between demand and supply of blood and its products.Results: There has been sudden decrease in the number of blood donations in the month of April 2020 (35%) in the COVID pandemic as compared to pre-COVID time with percentage difference of 65%. This was followed by gradual decrease in the no. of donations in COVID pandemic when compared with donations in the pre-COVID time. The percentage difference in blood donation gradually improved over a period of time from 65% in April 2020 to 7% in April 2021. Similarly, no. of blood units issued also decreased from 1147 in April 2019 to 553 units in April 2020.Conclusions: The BTS need to provide an uninterrupted blood supply, and this stays true even in the face of a pandemic. The plan of action has to be started early so that the supply can be maintained and monitored effectively. Health-care workers being one of the main pillars in the fight against COVID-19 have to be supported and protected.

Background: Thalassemia is one of the most common genetic disorder of hemoglobin synthesis in Jammu region. Although RBC transfusion is life saving for these patients, it may be associated with some complications like RBC alloimmunization. Thus, alloimmunization against red blood cell antigens increases the need for transfusion and can significantly complicate transfusion therapy. Therefore, screening for unexpected antibodies should be a part of all pretransfusion testing, with antibody identification in the event of a positive result. The aim of the study was to determine the frequency of alloimmunization and autoimmunization and the most common alloantibodies involved.Methods:This was a descriptive study involving a total of 146 thalassemic patients in the age range of 2-32 years receiving regular blood transfusions, registered at SMGS blood bank, Jammu. Antibodies screening, antibody identification, and cross matching was done on all patient samples included in the study, during the period between November 2014 and October 2015.Results: At the start of the study, 8 patients who tested positive for alloantibodies 3 patients had more than one antibody subtype. Anti-E was the commonest antibody found in 4 (50%) patients. Similarly, at the end of study, antibody screening and then identification revealed presence of antibodies in 10 patients. Only 1 patient had more than one antibody subtype. Anti E was again the commonest antibody found in 5 (50%) patients.  Conclusions:The most common alloantibodies identified were anti Rh system antibodies (anti-E and anti-D) followed by Kell antibodies. In order to reduce alloimmunization, a policy for performing extended red cell phenotyping of these patients is essential and at least antigen E and Kell negative blood should be provided for transfusion to these patients.

Background: SARS‑CoV‑2 emerged in China and spread throughout the world due to its rapid transmission. The exposure rate in the healthy population is unknown, mainly in resource‑limited countries. Herein, we estimated the seroprevalence of anti‑SARS‑CoV‑2 antibodies and risk factors among blood donors at our blood bank and to describe some characteristics of those that test positive. The objective of the study was to measure the levels of IgG antibodies targeting the SARS-CoV2 during the peak period of the COVID-19 pandemic in Jammu State, India to know the magnitude of SARS-CoV-2 exposure, the prevalence of herd immunity in the population.Methods: This is prospective observational study of COVID-19 seroprevalence among blood donors that complied with blood donation protocol. Participation in study was voluntary after taking proper consent on the consent form.Results: A total of 750 random blood donors who voluntarily participated, were enrolled in this study after obtaining their proper consent on the consent form. Out of 750 donors, 287 (38.2%) were positive for IgG antibodies and 463 (61.7%) were negative for IgG antibodies. In our study, male donors (745) outnumbered the female donors but on the other hand female donors showed a higher prevalence of covid antibodies i.e., 60% as compared to male donors i.e., 38% which is a statistically significant difference (p<0.005).Conclusions: A high prevalence of SARS-CoV-2 antibodies was detected among blood donors which indicated a high level of exposure to the virus within the population and development of innate immunity against the virus. This could help us to introduce a protocol of antibody testing in the screening of blood donors to enhance the number of plasma donation cases for the treatment of serious COVID patients.

Background: Blood transfusions have always been associated with a number of adverse outcomes which have steadily decreased over years owing to new discoveries and technical advancements. Thalassemic patients are more prone to transfusions related complications owing to repeated transfusions. Study of these reactions and correlating them with the leucodepletion status of the transfused packed red blood cells (PRBCs) reduces transfusion complications due to the transfused leukocytes.Methods: This is a prospective study carried out on 1750 transfusions in 138 thalassemic patients at our institute between August 2015 and March 2016. The total transfusions were classified into four categories depending on the leucodepletion status of the PRBC’s. The clinical records and the reaction workup done to rule out the hemolytic reactions were recorded.Results: Reactions were recorded in 17 (0.97%) out of a total of 1750 transfusions. 14 (4.1%) reactions were recorded on transfusions of non-leukoreduced PRBCs whereas only 2 (0.16%) reactions were recorded in leucoreduced (buffy coat) PRBCs. 1 (0.8%) reaction was recorded on transfusion of leucodepleted PRBCs done by bedside filter. No reaction was documented when buffy coat leucoreduced PRBCs were used along bedside filter.Conclusions: Elimination of WBCs from donor packed cells results in reduction of adverse reactions following blood transfusion. Various methods of leucoreduction have been successfully employed in the past and shown to reduce transfusion reactions in multi transfused thalassemic patients. In resource limited settings, leukoreduction using the buffy-coat method is an effective intervention in reducing the transfusion reactions.