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Background and Objectives The coronavirus disease 2019 (COVID‐19) pandemic has impacted blood systems worldwide. Challenges included maintaining blood supplies and initiating the collection and use of COVID‐19 convalescent plasma (CCP). Sharing information on the challenges can help improve blood collection and utilization. Materials and Methods A survey questionnaire was distributed to International Society of Blood Transfusion members in 95 countries. We recorded respondents' demographic information, impacts on the blood supply, CCP collection and use, transfusion demands and operational challenges. Results Eighty‐two responses from 42 countries, including 24 low‐ and middle‐income countries, were analysed. Participants worked in national (26.8%) and regional (26.8%) blood establishments and hospital‐based (42.7%) institutions. CCP collection and transfusion were reported by 63% and 36.6% of respondents, respectively. Decreases in blood donations occurred in 70.6% of collecting facilities. Despite safety measures and recruitment strategies, donor fear and refusal of institutions to host blood drives were major contributing factors. Almost half of respondents working at transfusion medicine services were from large hospitals with over 10,000 red cell transfusions per year, and 76.8% of those hospitals experienced blood shortages. Practices varied in accepting donors for blood or CCP donations after a history of COVID‐19 infection, CCP transfusion, or vaccination. Operational challenges included loss of staff, increased workloads and delays in reagent supplies. Almost half of the institutions modified their disaster plans during the pandemic. Conclusion The challenges faced by blood systems during the COVID‐19 pandemic highlight the need for guidance, harmonization, and strengthening of the preparedness and the capacity of blood systems against future infectious threats.

Ocimum sanctum (OS) is tropical herbal plant which is easy to find and widely used as a vegetable food in Indonesia. In last decade, lung adenocarcinoma was in top position as male cancer disease in Indonesia. Recently, emerging data showing the extracts of different species of Ocimum exhibiting the anti-tumor properties. Further studies on lung lewis carcinoma demonstrated pro-apoptosis effects after the treatment with Ocimum extracts. However, the effect of OS of Indonesian origin in human alveolar pulmonary adenocarcinoma A549 cells remain unclear. Therefore, we aimed to investigate effects of ethanolic extract OS (EEOS) in A549 cell culture systems. Cell adhesion and viability assays revealed that EEOS significantly decreased the attachment into extracellular matrix of A549 cells. Morphological examination AO/EB and DAPI staining indicated that EEOS induced the cells shrinkage, DNA fragmentation and condensation of A549 cells. Further, EEOS treatment induced the apoptosis rate followed by up-regulation of reactive oxygen species (ROS), caspase-3 expression and decreased anti-apoptotic protein Bcl-2. This condition also suppressed the expression of SOD2 as well as the GPx. In conclusion, our findings indicate that EEOS suppressed the viability of A549 cells, which may result from the activation of ROS promoting the apoptosis signaling via mitochondrial intrinsic pathway. Taken together, EEOS might be a good therapeutic potential to further understand its properties in the treatment of lung carcinoma.

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BackgroundOccult hepatitis B infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the serum and/or liver in HBsAg-negative individuals. OBI is associated with the risk of viral transmission, especially in developing countries, and with progressive liver disease and reactivation in immunosuppressive patients. The objective of this study was to evaluate the relation of OBI to HLA-DP single nucleotide polymorphisms (SNPs) encoding antigen-binding sites for the immune response to HBV infection. As HLA-DP variants affect the mRNA expression of HLA-DPA1 and HLA-DPB1 in the liver, we hypothesised that high levels of HLA-DPA1 and HLA-DPB1 expression favour OBI development.MethodsThe study enrolled 456 Indonesian healthy blood donors (HBsAg negative). OBI was defined as the presence of HBV-DNA in at least two of four open reading frames (ORFs) of the HBV genome detected by nested PCR. SNPs in HLA-DPA1 (rs3077) and HLA-DPB1 (rs3135021, rs9277535, and rs2281388) were genotyped using real-time Taqman® genotyping assays.ResultsOf 122 samples positive for anti-HBs and/or anti-HBc, 17 were determined as OBI. The minor allele in rs3077 was significantly correlated with OBI [odds ratio (OR) = 3.87, 95% confidence interval (CI) = 1.58–9.49, p = 0.0015]. The prevalence of the minor allele (T) was significantly higher in subjects with OBI than in those without (59% and 33%, respectively). The combination of haplotype markers (TGA for rs3077–rs3135021–rs9277535) was associated with increased risk of OBI (OR = 4.90, 95%CI = 1.12–21.52 p = 0.038). The prevalence of OBI was highest in the isolated anti-HBc group among the three seropositive categories: anti-HBs <500 mIU/ml, anti-HBs ≥500 mIU/ml, and isolated anti-HBc (29.41%, p = 0.014).ConclusionGenetic variants of HLA-DP and the presence of anti-HBc are important predictors of OBI in Indonesian blood donors.Trial registrationRef: KE/FK/194/EC; registered 01 March 2013. Continuing approval Ref: KE/FK/536/EC; registered 12 May 2014.Electronic supplementary materialThe online version of this article (10.1186/s12985-017-0865-7) contains supplementary material, which is available to authorized users.

In developing countries, like Indonesia, apheresis is still a relative new procedure. Nowadays, therapeutic apheresis procedures are performed in the field of hematology and neurology, especially in the teaching hospitals in Indonesia. Therapeutic apheresis procedure, that is, leukocytapheresis, therapeutic plasma exchange (TPE), and thrombocytapheresis are already performed. In the period 2009-2013, 204 apheresis procedures in 137 patients to reduce the leukocytes, 72 TPE procedures in 17 patients, and 14 thrombocyte reductions were performed in the Sardjito hospital, Yogyakarta, Indonesia. In the future, to improve the therapeutic apheresis implementation, it is important to increase the insurance coverage and also should be considered to introduce the apheresis medicine into the curriculum of appropriate physician programs in Indonesia. Especially in Indonesia, a lot of efforts are still being needed to improve implementation of therapeutic apheresis.

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Therapeutic platelet transfusions are often performed in pediatric patients with various indications. However, the platelet transfusion has potentially induced more harm than good for some patients. Therefore, its effectiveness needs to be evaluated. This study aimed to evaluate the clinical risk factors namely sepsis, splenomegaly, DIC (disseminated intravascular coagulation), severe bleeding and the history of platelet transfusion in the incidence of platelet refractoriness. This was a casecontrol study conducted over a 13-month period from August 1 st , 2010 until September 30 th , 2011 in Department of Pediatrics, Dr. Sardjito General Hospital, Yogyakarta. From a total of 1403 platelet transfusion episodes in 464 patients, 86 incidences of refractoriness and 86 of nonrefractoriness were observed. Bivariate analysis showed that sepsis [OR= 5.91 (2.90-12.05); p = 0.000], splenomegaly [OR= 2.82 (1.32-6.04); p = 0.006], severe bleeding [OR= 8.41 (4.19-16.871); p = 0.000], DIC [OR = 22.96 (6.73-78.35); p = 0.000] and the history of platelet transfusions [OR= 5.33 (2.78-10.23); p = 0.000] increased the risk of platelets refractoriness. Furthermore, multivariate analysis showed that sepsis (OR= 2.96; 95%CI: 1.19-7.32; p = 0.019), splenomegaly (OR=3.94; 95% CI: 2.21-16.00; p = 0.000), severe bleeding (OR = 3.53; 95% CI : 1.40-8.89; p = 0.008), DIC (OR = 5.54; 95% CI: 1.29-22.75; p = 0.021) and the history of platelet transfusion (OR = 2.84; 95% CI: 2.74-9.77; p = 0.001) were the independent risk factors for the occurrence of platelet refractoriness. In conclusion, sepsis, splenomegaly, severe bleeding, DIC, and the history of platelet transfusion are the risk factors of platelet refractoriness in pediatric patients.