Weaker subgroups of ABO blood group system give rise to discrepancies between forward and reverse grouping and cause diagnostic difficulties in routine blood banking. Weaker subgroups of A blood group that have been reported so far include A3, Aend, Ax, Am, Ay, and Ael. We report a case of a 54-year-old patient whose red cells showed a discrepancy between cell and serum grouping on initial testing. Serological investigation included absorption elution tests and saliva testing after performing initial blood grouping. Molecular genotyping of the ABO gene was performed by DNA sequencing of exons 6 and 7 of the ABO gene. The serological characteristics of the patient's red cells were similar to Ax subtype. The patient was a secretor and only H substance was present in the saliva. Serum did not show the presence of anti-A1. Molecular genotyping confirmed the ABO status as Aw06/O13. The weak A phenotype identified in the propositus had serological characteristics similar to Ax and showed the ABO genotype Aw06/O13. Although Aw06 allele has been previously reported in the Indian population, this is the first study to report O13 allele in the Indian population.

Background Quality indicators in Transfusion Medicine are critically important aspects that can be measured and utilized to design interventions for continuous quality improvement. Interventions for improvement in bedside transfusion practices are required to check the adherence to standard protocol for safe transfusion. Study design and methodsA prospective study was conducted with a structured checklist survey of 4 key elements, to collect data for baseline assessment phase I survey, subsequently phase II survey repeated after introduction of Transfusion Monitoring Form and Telephonic reminders from blood bank. Pre-and Post-intervention data collected, tabulated and analysed using Statistical Package for Social Sciences (SPSS version 23). Results Identification of Patient, Transfusion initiation within 30 min of issue, Vitals monitoring during transfusion and completion of transfusion within time limit are the four key elements of quality indicators were checked pre-and postintervention. Mean composite score of quality indicators before intervention was 2Á3 AE 1Á3 and increased to 3Á2 AE 1Á3 (P value < 0Á001) after implementation of the Transfusion Monitoring form and Reminder calls from Blood Bank. Conclusion Manufacturing good quality blood components alone does not ensure good transfusion services. Active interventions by Transfusion specialist ensure good bedside transfusion practices. Introduction of blood transfusion monitoring form and Telephonic reminders from the blood centre brought in significant changes in the existing bedside transfusion practices and safer transfusion at our centre.

Adverse events of variable severity may occur occasionally following whole blood donation. We are reporting a case of severe donor reaction leading to grievous injury. A first-time male voluntary blood donor donated blood in our blood donation camp. The donation was uneventful, and he left the premise after 20 min of postdonation observation and advice. Several minutes later, he fell on the road and injured himself complicated with severe delayed vaso-vagal reaction. The donor had lacerated wound over the chin, fracture neck of the left mandible, fracture left lower incisor and left lower molar tooth. Appropriate medical care was catered to the donor with full medical support from Department of Transfusion Medicine and was fully recovered from the injury. Blood collection team must take up the responsibility of the management of all complications related to blood donation.