Austrian Karl Landsteiner(1901) discovered –
Human blood possess different antigenic and immune properties
Blood clumping was an immunological reaction.
Nobel Prize in Physiology and Medicine in 1930.
Adriano Sturli and Alfred von Decastello who were working under
Landsteiner discovered type AB a year later in 1902.
Janský is credited with the first classification of blood into the four types
(A, B, AB, O)in 1907, which remains in use today
• A blood group also called a Blood Type.
• Classification of blood is based on the presence or absence
of inherited antigenic substances on the surface of red blood
cells (RBCs).
• These antigens may be proteins, carbohydrates,
glycoproteins, or glycolipids, depending on the blood group
system.
Red cell and platelet storage lesions and their effect in transfusion practiseArjuna Samaranayaka
Bio mechanical and metabolic changes that occur in red cell concentrates and platelets during ex-vivo storage, their effect in transfusion practise and strategies to minimize them.
• A blood group also called a Blood Type.
• Classification of blood is based on the presence or absence
of inherited antigenic substances on the surface of red blood
cells (RBCs).
• These antigens may be proteins, carbohydrates,
glycoproteins, or glycolipids, depending on the blood group
system.
Red cell and platelet storage lesions and their effect in transfusion practiseArjuna Samaranayaka
Bio mechanical and metabolic changes that occur in red cell concentrates and platelets during ex-vivo storage, their effect in transfusion practise and strategies to minimize them.
Blood is a body fluid in humans and other animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells. In vertebrates, it is composed of blood cells suspended in blood plasma.
Blood is a body fluid in humans and other animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells. In vertebrates, it is composed of blood cells suspended in blood plasma.
It consists of slides about blood, various blood groups , pre-transfusion testing , blood products , conditions where blood transfusion is indicated and the various complications of blood transfusion in the field of oral and maxillofacial surgery.
Thyroid Gland and Disease of Thyroid GlandRanadhi Das
The thyroid gland is one of the largest endocrine glands.
The thyroid gland is located immediately below the larynx and anterior to the upper part of the trachea. It weighs about 15-20g.
It consists of 2 lateral lobes connected by a narrow band of thyroid tissue called the isthmus.
The isthmus usually overlies the region from the 2nd to 4th tracheal cartilage.
Regulation of temperature of Human bodyRanadhi Das
Homoeothermic (WARM blooded)- Humans capable of maintaining their body temperatures within narrow limits inspite of wide variations in environmental (ambient) temperature.
Poikilothermic- (Cold blooded) eg.-fish, reptiles
Neutral zone temperature/ Comfortable temperature/Critical / ambient temperature- at which there is no active heat loss and heat gain mechanism operated by body.
So it is the lowest ambient temperature at which mammals can maintain its body temperature at the basal metabolic rate.
Normally it is 27 ± 2º C
Living tissues can function optimally only within a very narrow range of temperature. Therefore accurate regulation of body temperature is a great boon: it enables the animal to be physically active all round the year, and in different geographical locations.
Largest part of hind brain.
Called “ silent area/Little Brain ”
Weight- 150 gms.
Cerebellar cortex is a large folded sheet, each fold is called Folium.
Connected to brain stem by 3 pairs of peduncles- Superior (Brachium conjunctiva), Middle (Brachium Pontis) & Inferior (Restiform body) peduncle.
Deep sea diving and physiological response to high barometric pressure Ranadhi Das
Sea water is approximately 800 times more dense than air. Therefore, it exerts much greater pressure on the body of a diver.
The weight exerted by the atmosphere on an area of 1m2, is approximately 10,000kg at sea level. This value of pressure (10,000 kg m-2) is thus referred to as 1 atmospheric absolute (1 ATA), or 1 atmospheric pressure.
For every 10m(~32feet) below the surface a person dives, he is subjected to an additional pressure of 1ATA. Therefore, at 30m, a diver will experience a pressure of 4 ATA (1 ATA exerted by the atmosphere, & 3 ATA exerted by the 30m of water above him).
Barometric pressure falls with increasing altitude, but composition of air remain same.
Study is important for:Mountaineering
Aviation & Space flight
Permanent human settlement at highlands
Thalamus-Anatomy,Physiology,Applied aspectsRanadhi Das
Thalamus is a very important relay station.
All general and special sensory impulses (except smell) & afferent impulses from RAS are integrated here.
Thalamus however is the center of pain and protopathic sensations.
It has other non sensory functions as well, like motor control, sleep, wakefulness.
It is the largest structure deriving from the embryonic diencephalon, the posterior part of the forebrain situated between the midbrain and the cerebrum.
The thalamus is part of a nuclear complex structured of 4 parts, the hypothalamus, epithalamus, prethalamus (formerly called ventral thalamus) and dorsal thalamus.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
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This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
2. Austrian Karl Landsteiner(1901) discovered –
•Human blood possess different antigenic and immune properties
•Blood clumping was an immunological reaction.
•Nobel Prize in Physiology and Medicine in 1930.
•Adriano Sturli and Alfred von Decastello who were working under
Landsteiner discovered type AB a year later in 1902.
•Janský is credited with the first classification of blood into the four types
(A, B, AB, O)in 1907, which remains in use today.
Introduction
3. They are group specific substrate on the surface of RBC and enable the different
individual to be identified from each other just like fingerprints.
CLASSIFICATION-
Major blood group system- ABO system, Rh system, MNS system
Minor blood group system- Kell, Duffy, Lutheran, Lewis, Deigo, kidd Etc.
Thirty-five major blood group systems were recognized by the International Society
of Blood Transfusion (ISBT) in October 2012.
Blood Group System
5. • Karl Landsteiner(1901) classified human blood into A,B,O groups.
• Von Decastello and Sturli (1902) discovered AB blood group.
• Von Dungern and Hirszfeld(1911) divided group A into 2 subgroups A1 and A2.
Discovery
6. • Appear in the sixth week of fetal life.
• Present on red cell membrane and in other tissues like salivary glands, pancreas, kidney,
liver, lung, semen, testes, amniotic fluid.( EXCEPT CNS)
• Antibodies formed in children after few months of birth.
Antigens
8. Formation of the B antigen
Glucose
Galactose
N-acetylglucosamine
Galactose
RBC
Fucose Galactose
D-galactosyl Transferase(product of B gene- GENES at 19 q13.2)
9. • Mostly IgM type.
• Produced by bone marrow and lymph gland cells .
• Known as cold antibodies.
Anti-A and Anti-B agglutinins
11. LANDSTEINER’s LAW-
1.If an agglutinogen (antigen) is present on red blood cell membrane ,the corresponding
agglutinin (antibody) must be absent in the plasma.
2.If an agglutinogen (antigen) is absent on red blood cell membrane, then corresponding
agglutinin (antibody) must be present in the plasma.
2nd law doesnot hold good for Rh factor (Rh factor absent anti D absent)
12. Inheritance of ABO blood group
Follows Mendelian Law.
In 1924, Felix Bernstein
proposed presently accepted theory.
Heterozygous: AO or BO
Homozygous: AA or BB
Mom Dad Offspring
Blood Group
AA BB 100% AB
BO OO 50% each of
B or O
OO OO 100% O
OO AO 50% each of
A or O
13. If baby is Parents must
have
Mother blood
group
Father
would not
be
O O+O No matter which AB
AB A+B No matter which O
A A+O
A+A
B or O B or O
B B+O
B+B
A or O A or O
PaternityDispute
14. The Rhesus Blood Group System
I. Discovery of Rh system
II. Antigen and antibodies
III. Inheritance
IV. Haemolytic disease of newborn
15. •History of the Rh System
• Levine and Stetson(1939) described a hemolytic transfusion reaction in an
obstetric patient following delivery of stillborn infant.
• An antibody was isolated from the mother’s serum. It was postulated that the fetus and the
father possessed a common factor that the mother lacked.
•While the mother carry the fetus, the mother was exposed to this factor and developed
antibody against the transfused red cells from the father and resulted in transfusion reaction.
•At that time ,the responsible antibody was not named.
16. • Landsteiner and Wiener(1940) injected RBC’s of rhesus monkeys in rabbits
developed antibodies.
• The antibody was named as anti-Rh.
• When resulting antiserum was mixed with human RBC’s, then agglutination occurred.
•The RBC antigen responsible for this reaction was called as Rh factor.
•The antibody discovered by Levin and Stetson in the mother was subsequently re-
examined and found identical in activity as the anti-Rh antibody found by Landsteiner
and Weiner.
•So this work led to discovery of Rh system.
17. •Anti-rhesus formed by the animals was renamed anti-LW (Landsteiner and Wiener).
•Fisher and Race(1943 and 1944) discovered C, E, c, e Ag and their corresponding antibodies
anti-C , anti -E ,anti- c ,anti -e.
18. Rh Antigens
• Rh system involves 6 Rh
antigens D,d,C,c,E,e
Rh positive
Presence of rh D
85% occurrence
Rh negative
Absence of rhD
15% Occurrence
•Integral membrane proteins with an active phoshpholipid component.
•Present on red blood cells.
•D antigen is commonest and most immunogenic.
19. • IgG type.
• Known as warm antibodies.
• Produced by exposure to foreign Rh antigen .
Rh Antibodies
20. • D Ag is inherited as a dominant gene D.
• Genotype of individual may be:
DD
Dd
dd
Inheritance
22. • ABO Incompatibility- immediate reaction as antibodies are naturally present.
• Rh Incompatibility-
First exposure-
Primary response
Immunological memory
Second exposure-
Immediate and severe response.
Incompatibility
23. • Transfusion reactions are the adverse reactions in the body, which occur due
to transfusion error that involves transfusion of incompatible (mismatched)
blood.
• The reactions may be mild causing only fever and hives (skin disorder
characterized by itching) or may be severe leading to renal failure, shock and
death.
Transfusion Reactions Due To ABO Incompatibility
24. • Erythroblastosis Fetalis (“Hemolytic Disease of the Newborn”)
Erythroblastosis fetalis is a disease of the fetus and newborn child
characterized by agglutination and phagocytosis of the fetus’s red blood
cells.
In most instances of erythroblastosis fetalis, the mother is Rh negative and
the father Rh positive.
• The baby has inherited the Rh-positive antigen from the father, and the
mother develops anti-Rh agglutinins from exposure to the fetus’s Rh antigen.
• In turn, the mother’s agglutinins diffuse through the placenta into the fetus
and cause red blood cell agglutination.
25. I.Erythroblastosis fetalis-
• Erythroblastosis
Mechanism- Rapid production of red blood cells by haematopoeitic tissues of baby in order
to replace haemolysed RBC’s.
• Anaemia
• Hydrops fetalis- Grossly edemataous, Intra uterine fetal death usually occurs.
II.Icterus gravis neonatorum-
1. Infant born at term
2. Jaundice within 24 hrs
3. No anemia ( compensated by normoblastic response in bone marrow)
4. Nucleated RBC in circulation
5. Severely damaged liver
6. splenomegaly
7. Kernicterus- unconjugated bilirubin is deposited in basal ganglia
Manifestations
27. I. Anti-D Prophylaxis –
• Based on principle antibody mediated immunosuppression.
• Inject anti-D antibody in mother soon after child birth within 72 hrs.
• RhoGAM –Ɣ glodulin rich in anti D
• Fetal Rh typing by amniocentesis or chorionic villi sampling, then give
Rh immunoglobulin to expectant mother between 28 to 30 weeks.
II. Exchange transfusion –
About 400 ml of Rh – ve blood is transfused over a period of 1.5 hr or
more while the neonates taking out the Rh +ve blood.
III. Phototherapy –
Any new-born with a total serum bilirubin greater than 18mg/dL
should receive phototherapy.
Prevention And Treatment
28. • THE Ii SYSTEM-
Weiner et al (1956)
2 antigens –I and i
Difference-
• At birth , RBC’s are rich in i Ag ,not I Ag.
• In first second years of life, gradual changeover from i to I.
• THE DUFFY SYSTEM
Cutbush , Mollison and Parkin(1950).
System has 3 blood groups-Fya ,Fyb and Fyab.
Fyab blood groups are resistant to plasmodium vivax whereas Fya and Fyb are susceptible to
vivax malaria.
Other Blood Group Systems
29. • KELL SYSTEM-
Coombs ,Mourant , Race(1946).
Antigen - K
Rare In India(.3 To .7%)
• MN SYSTEM -
Landsteiner and Levine(1927).
Required for-
• Paternity tests
• Anthropological and genetic studies.
• Bombay Blood Group-
Dr.Y.M. Bhenda(1952)
Also known as HH blood group. They do not express H antigen, as a result they cannot form A Ag
or B Ag on their RBC.
They can donate blood to anybody but can receive blood only from Bombay blood group people.
30. I. In blood transfusion.
II. In preventing Hemolytic Diseases of Newborn due to Rh Incompatibility.
III. In paternity disputes.
IV. In medicolegal cases.
V. Anthropological study
VI. In knowing susceptibility to diseases.
A group- Gastric cancer, Pancreatic cancer, Diabetes mallitus
B group- Gastrointestinal disorder
O group- Peptic ulcer, Rheumatic fever
Clinical Implications
32. Richard Lower pioneered the first blood transfusion from animal
to human in 1665 at the Royal Society( Banned in 1668).
Proper transfusion done by Landsteiner and Weiner
In 1840 Dr. Blundell, performed the first successful whole blood
transfusion to treat haemophilia.
In 1914 Lewisham brought the concept of transfusion during
1st world war
Introduction
33. I. Blood loss ( Hemorrhage, Surgery)
II. For quick restoration of Hb.
III. Exchange transfusion ( erythroblastosis fetalis)
IV. Bone marrow failure (aplastic anaemia, leukaemia )
V. To correct clotting factor deficiency-hemophilia, purpurae,clotting defects.
VI. Restore plasma volume- Burn
VII. Acute poisoning (carbon monoxide)
VIII. Acute infections or fever when gamma globulin is needed.
IX. Shock
X. To improve oxygen transport to tissue- severe anemia
Indications
34. • Donor selection-
I. Healthy and age between 18 to 60 years.
II. Hemoglobin > 12 gm%
III. Weight more than 45 kg.
IV. Females should not be Pregnant, lactating and menstruating.
V. No diseases like AIDS, Viral Hepatitis ,Malaria, Syphilis.
VI. No past H/O jaundice , HTN,TB, and cardiac diseases.
Jehovah Witnesses (1870,Pittsburgh,Pennsylvania,USA)- Christian community which
refuses blood transfusion.
Donor And Recepient
35. Blood transfusion-who can receive
blood from whom?
Blood
Group
Antigens Antibodies Can give
blood to
Can
receive
blood from
AB
(universal
recipient)
A and B None AB AB, A, B, O
A
A B A and AB A and O
B B A B and AB B and O
O
(universal
donor)
None A and B AB, A, B, O O
36. • For safe and compatible blood transfusion-
• ABO and Rh typing
• Cross matching
• Antibody screening
Investigations
37. • Processing and Testing of Blood
Donated blood is usually subjected to processing after it is collected, to make it suitable for use in
specific patient populations.
Collected blood is then separated into blood components by centrifugation:
red blood cells, plasma, platelets, albumin protein, clotting factor
concentrates, cryoprecipitate, fibrinogen concentrate and immunoglobulins (antibodies)
All donated blood is tested for infections like HIVs, Hepatitis B, Hepatitis C, Syphilis
All donated blood is also tested for ABO and Rh groups, along with the presence of any red blood cell
antibodies.
Pathogen Reduction treatment done.
39. Under Microscope
Human RBC before (left) and after (right) adding serum containing antibodies.
No agglutination Agglutination
40. II. Cross Matching-
Major cross matching -Donor’s RBCs are mixed with recepient’s plasma.
Minor cross matching- Recepient’s RBC’s are mixed with donor’s plasma.
When no agglutination then only donors blood can be transfused.
Cross Matching
42. IV. Rh positive blood should never be transfused to Rh negative blood.
V. Check blood bag for correct label.
VI. Transfuse blood at slow rate(not >20 drops/min) under proper aseptic measures.
VII. Careful watch on recipient's condition.
VIII. Stop transfusion if reaction occurs.
43. Transfusion reactions
• Hemolysis- Massive destruction of RBC of donor release of Hb in blood
hemolytic jaundice.
• Renal vasoconstriction- Due to release of toxic substances from hemolysed RBC.
• Circulatory Shock- Loss of RBC and release of toxins from hemolytic RBC lead to
fall of BP. Decrease renal blood flow oliguria
• Hemoglobinuria- Free Hb binds with haptoglobin present in plasma pass through
glomerular membrane and passed through urine.
• Renal tubular damage- Free Hb precipitate in tubules as acid hematin.
• Anuria- Absence of urine due to vasoconstriction, shock, hypotension, renal tubular
damage.
• Uremia- increased nitrogenous substances and K⁺ renal failure coma death.
• Transmission of blood borne diseases- AIDS, Hepatitis, Malaria, Syphilis
• Fever, Chill, Rigor
• Hyperkalemia
• Hypocalcemia
• Tightness of chest
44. • Replacement of more than 50% of circulating blood volume in less than 3 hrs
Or, transfusion @ >150ml/min Or, > 10 units of blood within 24 hrs.
• Blood loss-
• < 20% of total blood volume - well tolerated by the body
• 20%-40% of total blood volume - changes in vital signs
• > 40% of total blood volume - Hemorrhagic shock
Massive Blood Transfusion
46. • Safely given- 1:1:1 protocol- ‘O’ negative packed cell : FFP : Random donor
platelet.
• Advance trauma centre equipped with – Thromboelastography (gives idea
about the amount of blood loss and efficiency of blood coagulation).
Blood loss-Unknown amount
47. • It is a centre where blood gathered as a result of blood donation, stored and
preserved for later use in blood transfusion.
• Equipped with proper testing for blood and blood
products.
• 1unit = 450 ml of CPD mixed blood.
• Stored at 4°C with 63 ml of anticoagulants.
• CPD – Citrate(anticoagulant by chelating calcium),
Phosphate(synthesize ATP),
Dextrose(nutrition).
• Blood can be kept 21 days at 4°C in blood bank.
• Blood donation-
Weight- 45-55 kg 350ml/ 49 ml anticoagulant
Weight- > 55 kg 450ml/ 63 ml anticoagulant
Blood Bank
48. • RBC- with CPD 35 days,
with SAGM (saline, adenine, glucose, manitol) 42 days
• Platelet- 5 days
• Plasma- 1 year
• Clotting factors Cryoprecipitate- 1 year
Drawback in old blood- (Lesion of storage)
• Na+K+ ATPase pump stops working leading to
Hyperkalemia
• Fall in serum Calcium level swelling of the RBC
• Build up of lactic acids
• Decrease in glucose consumption
• Decrease in ATP level
• Decrease in pH.
• Diminish activity of 2,3 DPG reduce the ability to deliver oxygen
• Decrease platelet.
Storage