The summary provides an overview of the key points and mysteries surrounding RhD typing. It begins with the complex nature and confusing nomenclature of RhD, explaining there are over 150 variants and 50 ways to be RhD negative. Case studies are presented that show weak and partial D can present as normal D, and variants only detected if they make anti-D. Guidelines are discussed for RhD typing of patients and donors. The importance of detecting very weak D expression in donors to prevent immunization is highlighted.
AJS: a lethal weapon to combat with cancers Treatment of Human Cancers Using...gan-navi
Cdc6 is essential in the initiation of DNA replication:
A). Assembling pre-replication complex (pre-RC) with ORC, and loading MCMs to replication origins;
B). Licensing DNA replication to ensure one round DNA replication per cell cycle.
AJS: a lethal weapon to combat with cancers Treatment of Human Cancers Using...gan-navi
Cdc6 is essential in the initiation of DNA replication:
A). Assembling pre-replication complex (pre-RC) with ORC, and loading MCMs to replication origins;
B). Licensing DNA replication to ensure one round DNA replication per cell cycle.
Two Case Reports of Rare Weak ‘B’ Subgroup Detected During Routine TestingApollo Hospitals
Apart from the usual A, B, AB and O groups, there also exist many variant phenotypes. Variants of Type B blood, with weak expression of the B antigen, have been previously described and are known to be rare. These usually require advanced techniques like ‘Adsorption and Elution’ for their detection. We present 2 similar cases of rare B subgroups identified at our department.
01.09.09(a): Blood Banking Theory and Component TherapyOpen.Michigan
Slideshow is from the University of Michigan Medical
School's M2 Hematology / Oncology sequence
View additional course materials on Open.Michigan: openmi.ch/med-M2Hematology
Humanization by CDR-grafting consists in transferring parental (commonly rodent) complementarity determining regions (CDR) into human framework (FR) regions. Parental antibody specificity and affinity are conserved thanks to the preservation of residues implicated in antigen binding. BIOTEM uses a validated and modernized version of the classical CDR-grafting technology.
Two Case Reports of Rare Weak ‘B’ Subgroup Detected During Routine TestingApollo Hospitals
Apart from the usual A, B, AB and O groups, there also exist many variant phenotypes. Variants of Type B blood, with weak expression of the B antigen, have been previously described and are known to be rare. These usually require advanced techniques like ‘Adsorption and Elution’ for their detection. We present 2 similar cases of rare B subgroups identified at our department.
01.09.09(a): Blood Banking Theory and Component TherapyOpen.Michigan
Slideshow is from the University of Michigan Medical
School's M2 Hematology / Oncology sequence
View additional course materials on Open.Michigan: openmi.ch/med-M2Hematology
Humanization by CDR-grafting consists in transferring parental (commonly rodent) complementarity determining regions (CDR) into human framework (FR) regions. Parental antibody specificity and affinity are conserved thanks to the preservation of residues implicated in antigen binding. BIOTEM uses a validated and modernized version of the classical CDR-grafting technology.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
- 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
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Session 3 - Reasons behind RhD Myth & Mystery
1. The myth and
mystery of RhD
Quotient Biodiagnostics Industry Workshop
AABB San Diego 2011
Joyce Poole
International Blood Group Reference Laboratory
Bristol UK
2. Objectives of my talk
• Reasons why myth and mystery surround
RhD!
• Case studies with learning points:
pregnancy, transfusion, donor-related
• IBGRL approaches and use of ALBAclone
anti-D panel
• UK typing protocols for D typing and
treating D variant patients
4. The mystery of RhD
Why is D difficult
• Not a simple antigen Complex
• Nomenclature is confusing
• D typing is not straightforward
• Controversial
Clinically significant!
5. The mystery of RhD
• Huge molecular diversity
• >150 variant D antigens
• >50 ways of being D
negative/Del
6. The mystery of RhD
Complexity
• Not derived from an amino acid
polymorphism but from presence of RhD
protein
• D expression dependent on different
epitopes along the RhD protein
• Epitopes are conformation-dependent
• Antigen expression varies quantitatively
and qualitatively
7. The mystery of RhD
Confusing Nomenclature
• D+ D category D mosaic
Partial D Weak D
Weak partial D D variant
• D-
8. The mystery of RhD
Controversial
D+ or D- ?
Do we treat the patient
as D+ or D-?
9. The myth of RhD
Widely held but
false notion
D typing is routine test and
should therefore be straightforward!
12. GUIDELINES
Compatibility procedures in blood
transfusion laboratories
BCSH British Committee for
Standards in Haematology/
Blood Transfusion
(Transfusion Medicine 2004:14:59-73)
Patients
13. D typing patients (1)
UK GUIDELINES
• Test in duplicate with IgM monoclonal
anti-D
• [Two anti-D or same one twice]
• Exception for full automation - single
anti-D
• Anti-D should not detect DVI
14. D typing patients (2)
UK GUIDELINES
• The IAT should not be used
• Anti-CDE is of no value and is not
recommended
[Misinterpretation of r’ and r’’ as D+]
15. Non-compliance with guidelines!
Patient D typing in UK
• 24% not performing duplicate D typing are using
manual systems
• 5% using IAT anti-D for D neg pre-transfusion
samples (3% in 2002) [recommended against]
• 6% include an anti-CDE reagent (10% 2002)
• 9 labs using one anti-D that detects DVI
• <1% diluting anti-D! (5% in 2002)
Data from UK NEQAS exercise late 2005
17. D typing donors
• Adopt procedures to maximise
detection of weak D and partial
D as D positive
• Determined on each donation
• D group in doubt?
Safer to classify as D+
18. Case Study
Pregnant Woman (SR)
• Typed as normal D+ (Ro) but with
allo anti-D in plasma
• All anti-D’s positive with her cells
• No Ig anti-D given
• Referred for RHD sequencing
19. 609 654 667 674 807
RHD Psuedogene
10 exons of RHD
Novel DIII
186 602 667 819
Patient SR - mutations in RHD
609 654 667 674 807
RHD Psuedogene
10 exons of RHD
Normal RHD
Twin son and daughter of SR - mutations in RHD
20. Case Study
Transfusion Recipient
• Elderly male patient - normal D+ with allo
anti-D
• Transfused in 1975 with 4 units of D+
• RHD sequence – exon 4 mutation G520A
(V174M)
• Characteristic of weak D type 33
• Transfused D negative from now on
21. Case Study
Blood Donor
• Female donor typed as D- (r’’r)
• Transfused to a D- recipient who made
anti-D!
• Referred to IBGRL for elucidation
• Very weak expression of D
• Rh genotype D+
RHD sequence: No mutations in RHD (or CE or RHAG)
22. Case Studies
Learning points
• Partial D and weak D can both
present as normal D
• Some variants will only be detected
if they have made anti-D
• Weak D’s can make allo anti-D
• Important to detect very weak
expression of D on donor cells to
prevent immunisation
23. IBGRL referrals
Overseas reference
UK hospitals
labs
Blood Centre
IBGRL
We do not do routine patient or donor typing
24. IBGRL referrals
Reasons for referral
• Pregnant female - do we give antenatal
immunoglobulin anti-D?
• Patient is D+ with anti-D - is it allo or
auto?
• Is this a weak D or partial D?
• Do we treat as D+ or D-?
25. IBGRL referrals
• 4 routine anti-D reagents that
1
detect weak D + most partial D
between them (+ C, Cw, c, E, e)
• ALBAclone IgG anti-D panel (12)
2
Clear-cut pattern Not clear
Refer for
molecular analysis
Report (RHD sequence)
26. 411 RhD referrals in 5 years
• Variants that gave clear patterns
of reactivity vs the ALBAclone panel
– DHK/DAU-4 : 17
– DVII : 12
– DVI : 9
– DFR : 7
– DMH : 6
– DOL : 6
– DAU-5 : 12
– DAR-E : 6
– Plus many others of even lower
27. • Variants that can give
ambiguous patterns of
reactivity vs the ALBAclone
panel
High
– Weak D type 1 : 74 referral
– Weak D type 2 : 79 rate
– Weak D type 4.2.2 (DAR) : 50
• Why the variation?
– Different individuals express different
amounts of the RhD protein
– C in trans (R1*r’ and R2*r’) weakens
expression of RhD
28. A novel finding
The variants DAU-5 and DV type 1
gave an identical serological pattern
DII & DNU
Type 1 & 2
(+)/
+ + + + +/- + - + + + + + - - -
DAR-E
DAU-4
DHK /
Kit ID
D VII
DMH
-
ROHar
WkD
DAR
DOL
D III
D IV
D VI
DBT
DFR
DCS
+ + + - + DV + + + + + + + + + - -
A (+)/- + + - - + - + - - + - - - - -
B + + + + + + - + + + + + + + - -
C + + + - - + - + + + + - - - - -
D + + + - + + + + + + + + + + - -
E + + + - + + + + + + + + + + - -
F + - + - + + + + + + + + + +/- - -
G (+)/
+ + - - - - + - - - - - - - -
H -
I + + + + + + - - - - (+) - (+) + + -
J + + + + + + - + + + + + + - - -
K + + + + + - - + + - + + - - + -
L
29. Diagrammatic representation of RhD
DAU-5: Phe223Val Glu233Gln Thr379Met
DV type 1: Phe223Val Glu233Gln
Phe223Val Glu233Gln
Extracellular
Trans-
membrane
Intracellular
Thr379Met
30. RhD model
DAU-5: Phe223Val, Glu233Gln, Thr379Met
DV type 1: Phe223Val, Glu233Gln
Extracellular
Glu233 Phe223 Glu233
Phe223
90° rotation
Thr379
D Thr379
CE
Intracellular
RhAG
31. Does the similarity in reaction NO
profile matter?
• The clinical care of a patient with a
DAR-E or DV type 1 is same
• Clear cut positive and negative
reactions indicate loss of epitopes
(partial D)
• Anti-D production possible
• Treat as D-
• Identifying weak D 1, 2 and 3 is
important……………
32. UK Blood Service Policy
Patients
• Identified weak D types 1,2 and 3
treat as D+
• Weak D type 4 onwards treat as
D-
• Partial D treat as D-
33. Transfusion to D variants
RISK
D- D+
D- blood D+ blood
Ig anti-D No Ig anti-D
prophylaxis prophylaxis
May be
Inadequate rr
immunised
blood supply
to make anti-D
Inappropriate
use Unlikely in weak D types 1,2 and 3
of Ig anti-D