This document provides an overview of crossmatching procedures in blood banking. It discusses the types of crossmatches (major vs minor), methods (manual vs electronic), and steps involved. It also covers incompatible crossmatches and potential causes such as incorrect blood grouping, presence of alloantibodies, or autoantibodies. Solutions for incompatible crossmatches include verifying the identity of samples, performing additional tests like antibody identification, and using antigen-negative blood units. The document also discusses concepts like rouleaux formation, different types of Coombs tests (direct vs indirect), and antibody titration.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
4. Is the minor cross match
unnecessary?
⚫Donated units are tested for antibodies
⚫Most blood is transfused as packed cells, having
little antibodies
⚫The plasma volume is small, and Abs will be diluted
in recipient circulation
⚫This applies for packed cells. For whole blood and
FFP, minor cross match is significant
5. Types of tests
Manual (IS and AHG)
Gel Technology
Electronic (Computerized) Cross match
Solid Phase Adherence Assays (SPAA)
6. ⚫For major cross match: 2 drops of patient’s
serum + 1 drop of 5% suspension of donor red
cells
⚫For minor cross match: 2 drops of donor’s
serum + 1 drop of 5% suspension of patient’s red
cells
7. Immediate spin cross matching
⚫ When no clinically significant unexpected
antibodies are
detected and there are no previous records of such
antibodies,
a serologic test to detect ABO incompatibility is
sufficient.
⚫ This is accomplished by mixing the recipient’s serum
with
donor RBCs and centrifuging immediately (i.e..,
immediate
spin).
8. Steps
⚫Label one tube for each donor unit to be cross
matched
⚫ Add 2 drops/100μl of patient serum to each tube.
⚫ Add 1 drop/50μl of 5% donor red cell suspension
to each tube
⚫Centrifuge immediately at 1000 rpm for 1 min.
⚫ Issue the units if compatible, continue with
detailed procedure as per routine cross match.
9. Cross match using tube method
⚫Incubate both test tubes at 37oC for 45-60 min
⚫Centrifuge and observe for agglutination
⚫If there is no agglutination, give three cell wash
with saline
⚫Add 2 drops of AHG serum
⚫Centrifuge at 1000 rpm for 1 min.
⚫Look for agglutination macroscopically and
microscopically
10.
11. Precautions
⚫Tubes (gel cards, etc.) should be carefully
labeled so that the contents can be identified at
any stage of the procedure.
⚫After centrifugation of tubes, the supernatant
should be examined for hemolysis, which, if
present, must be interpreted as a positive result.
⚫Results should be read against a white or lighted
background,
12. Gel card method
⚫ Prepare 0.8 – 1% red cell suspension of donor cells
by adding 10µl of packed washed red cells to 1 ml
LISS .
⚫ Pipette 50μl of red cell suspension in micro tube of
the gel card
⚫ Add 25 µl of serum in that micro tube of gel card
⚫ Incubate for 15 min at 37 degree and then centrifuge
for 10 min at 3000rpm. Read and record the results
14. Role of LISS
LISS contains glycine in an albumin solution. In addition
to lowering the zeta potential, LISS increases the
uptake of antibody onto the
RBC during the sensitization phase. This increases the
possibility
of agglutination.
15. Electronic cross matching
⚫Donor blood is issued based on blood bank
information (computer).
⚫ The Electronic Cross match (Electronic Issue)
allows for donor blood to be issued to a patient
instantaneously
16. Criteria for electronic cross matching
1.Two Concordant blood groups of the recipient
which have been recorded electronically
2.The patients serum/plasma does not contain,
and has not been known to contain clinically
significant red cell alloantibodies reactive at 37°C
17. Solid phase adherence assays
⚫Solid phase testing system uses microtiter plates,
with wells coated with stroma from reagent RBCs
of known phenotype
⚫Patient plasma and LISS added to the RBC well
then incubate at 37 degree for 15min
18.
19. ⚫ If antibody present, will bind
to the target antigen present
on the RBCs coating the well
⚫ Plate washed to remove
unbound antibodies, and
indicator RBCs coated with
anti-IgG are added,
⚫ Spin and read:-
⚫ Positive: Uniform layer of
indicator RBCs at the bottom
of the well
⚫ Negative: Indicator RBCs
from a tight bottom at centre.
24. Possible
solutions
Causes
⚫Incorrect ABO
grouping of patient or
donor
⚫Patient’s serum may
contain an ABO
antibody
⚫Alloantibody in
patient’s serum
reacting with antigen
donor’s red cells but
not present on
screening cells
⚫ Verify identity of
sample. Repeat ABO
grouping
⚫ Check patient’s sample
for subgroups; check
patient’s transfusion
and transplantation
histories.
⚫ Perform antibody
identification tests on
patient’s serum and
repeat cross match
using units negative for
the corresponding
antigen
26. Causes
Possible
solutions
⚫Donor unit may have
a positive DAT
⚫Alloantibody in
patient’s serum
reacting with antigens
on donor’s cells and
screening cells
⚫Perform DAT on
donor unit; if
positive, do not use
the unit.
⚫Perform antibody
identification
studies on patient’s
serum and repeat
cross match using
units negative for the
corresponding
antigen.
28. Common alloantibodies
Most common- anti-E, anti-Le(a), anti-K, anti-D, and
anti-
Le(b) (variable)
Always Clinically
significant
Rarely or never
considered Clinically
significant
ABO (A, B) Lewis (Lea, Leb),
Rh (D, C, c, E, e) Lutheran (Lua)
Duffy (Fya, Fyb) P1
Kidd (Jka, Jkb) Xga
Kell (K, k)
MN
Ss (S, s)
Lutheran (Lub)
30. Causes
Possible
solutions
⚫Both an autoantibody
and alloantibody may
be present in the
patient’s serum
⚫Abnormalities in
patient’s serum due to
imbalance of A/G ratio
⚫Plasma expanders
⚫Contaminants
⚫ Perform auto
adsorption of patient
serum to remove
autoantibody, perform
antibody identification
tests, repeat
compatibility tests using
auto adsorbed serum.
⚫ If rouleaux are seen,
use saline
replacement
technique.
⚫ Obtain new specimen.
⚫ Repeat tests using
fresh saline, new bottles
32. Rouleaux formation
⚫Seen in patients with abnormal A:G ratio
⚫Will affect all tests, including the auto-
control.
⚫Strong rouleaux may mimic true
agglutination; however, agglutination
clumps are refractile when viewed under
the microscope.
⚫Rouleaux are usually strongest after
37C incubation but do not persist
through washing before the AHG test.
34. Causes
Possible
solution
⚫Passively acquired
autoantibody (e.g.,
intravenous immune
globulin) is present.
⚫Cold- or warm-
reactive autoantibody
is present
⚫ Cold-AIHA – not a
major challenge as long
as all testing and cross
matching is performed
at 37ºC
⚫ Warm AIHA:-
⚫Best matched blood
(least incompatible)
⚫Phenotypically matched
RBCs
⚫Auto/Alloadsorbed
compatible RBCs
35. Autoantibodies
⚫Warm reactive autoantibodies (usually IgG) :
antibodies attach to red cells with maximal reactivity
at 37c
⚫Cold reactive autoantibodies (usually IgM):
antibodies bind to RBCs only at low body
temperature (28-31c)
⚫Drug-induced autoantibodies
38. ⚫The direct coombs
test detects
antibodies or
complement bound to
a patient’s RBC i.e.
previously sensitized
cells
⚫The indirect coombs
test detects
antibodies against
RBCs present
unbound in the
patients serum
39. Direct coombs tests
⚫To one drop of the 5% suspension of patients red
cells, add 2 drops of AHG reagent
⚫Mix and centrifuge at 1000rpm for 1 min
⚫If agglutination is absent, add 1 drop of IgG
coated red cells
⚫Mix and centrifuge at 1000rpm for 1 min.
40. Indirect coombs test
⚫Make 5% suspension of pooled O cells in a clean
test tube
⚫Add 1 drop of this to 2 drops of patients serum
⚫Incubate at 37c for 30-45min
⚫Mix and centrifuge at 1000rpm for 1 min.
⚫Check for agglutination
⚫Give 3 cell wash of the suspension and add 2
drops of AHG
⚫Mix and centrifuge at 1000rpm for 1 min.
⚫If agglutination is not present, validate by adding
1 drop of IgG coated red cells
41. Gel card methods
ICT
⚫ To 1000ul LISS, add
10ul of washed O+
pooled cells
⚫ Add 50ul of this 0.8%
suspension at 45o angle
⚫ Add 25ul of patient’s
serum in gel card at 90o
angle
⚫Incubate at 37oC for 15
min.
⚫ Centrifuge for 10 min.
and look for
DCT
⚫To 1000ul LISS, add
10ul of patient's
sample
⚫Add 50ul of this 0.8%
suspension at 45o
angle
⚫Centrifuge for 10 min.
and look for
agglutination
43. Procedure
⚫Using 0.5ml volumes, prepare serial two-fold
dilutions of serum in saline.
⚫Initial tube contains undiluted serum and the
doubling dilution range should be from 1:2 to
1:2048 i.e.12 tubes in all.
⚫Add 0.1ml of 2% suspension of red cells to each
test tube and gently agitate. Incubate at 37C for 1
hour.
⚫Following 3 cell wash, decant the final
supernatant
⚫Add AHG to the red cell buttons obtained
⚫Centrifuge and observe for agglutination.
Validate with IgG coated red cells
45. Interpretation of results
The titer is reported as the reciprocal of the
highest dilution of serum at which 1+
agglutination is observed.
46. • Titer level studies are useful in monitoring
the obstetric patient who has an IgG
antibody that may cause HDN.
• An increase in antibody titer level during
pregnancy suggests that the fetus is antigen-
positive and therefore at risk of developing
HDN.
• An increasing titer level may indicate the
need for intrauterine exchange transfusion