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CONTEXT: Structured Feedback is a learning and assessment tool designed to provide feedback to students and educators to adjust learning and teaching during the training. Lack of provision of structured feedback to postgraduate (PG) medical students prompted us to plan a study to introduce a structured feedback module into the existing monthly assessment schedules in the Department of Transfusion Medicine. AIM: This study aims to introduce a structured feedback module and evaluate its efficacy after incorporation into the existing monthly assessment schedules for the PG students in the Department of Transfusion Medicine. DESIGN AND SETTING: A quasi-experimental study was commenced after obtaining clearance from the Institutional Ethics Committee in the Department of Transfusion Medicine for the students pursuing postgraduation in Transfusion Medicine. METHODOLOGY: A peer-validated feedback module was designed and implemented for MD students by the core team faculty. The students underwent the structured feedback sessions after each monthly assessment for of 3 months. One on one, verbal feedback was conducted using Pendleton's method, for monthly online assessment for the learning that happened during study period. DATA COLLECTION AND STATISTICAL ANALYSIS: The data were collected from the open-ended and closed-ended questions using Google form-based Student/Faculty perception and students' pre-post self-efficacy questionnaires on 5-point Likert Scale and the quantitative data analysis was done using percentage of Likert scores, median values for each item for pre-and post-responses and comparison using nonparametric test - Wilcoxon signed-rank test. The qualitative data analysis was done using thematic analysis from the open ended questions. RESULTS: All (n = 9; 100%) the PG students strongly agreed and agreed (median score of 5 and 4) that the feedback they received made them aware of their learning gaps, enabled them in bridging those gaps and provided ample opportunity to interact with faculty. Both students and faculty agreed that the feedback session should be an ongoing and continuous process in the department. CONCLUSION: Both the students as well as faculty were satisfied with the implementation of the feedback module in the department. Students reported awareness about the learning gaps, identification of appropriate study resources, and ample opportunity to interact with faculty, after taking the feedback sessions. The faculty felt satisfied on the acquisition of new skill for delivering structured feedback to students.

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BACKGROUND: Convalescent plasma has been used to provide passive immunotherapy to patients with COVID-19 with a high level of safety. Very few efficacy studies were available, and due to COVID being a relatively new disease, its exact therapeutic role was unclear. This observational study on the impact of COVID convalescent plasma (CCP) on clinical outcomes attempts to evaluate the effectiveness of convalescent COVID-19 plasma therapy in the treatment of COVID-19 patients at the tertiary care center in the Uttarakhand state of India. METHODS: CCP was collected by plasmapheresis/whole blood from willing COVIDrecovered donors who underwent pre-donation testing including ABO and RhD grouping, mandatory blood screening tests for HIV, HBV, HCV, syphilis and Malaria, Haemoglobin estimation and COVID IgG assay. Hospitalized patients with severe COVID-19 pneumonia who received these CCP units were followed up and the outcome (Recovery/death) was observed. RESULTS: A total of 63 patients who received CCP were included in the study. Out of the total, 13 (20.7%) were females and 50 (79.3%) were males and their ages ranged from 24 to 80 years with a median age of 53 years. The period between the start of symptoms and hospitalization ranged from 1 to 14 days with an average duration of 4.7 days. Symptoms on presentation included Fever 53/63 (84.1%), Tachypnoea 60/63 (95.2%) and Cough 42/63 (66.7%). Among these patients, 22/63 (34.9%) were on non-invasive ventilation (NIV), 6/63 (9.5%) on non-rebreather mask (NRBM) and 32/63 (50.8%) were on Ventilator support. The infused convalescent plasma had a Mean IgG value of 57.3 AU with a range of (10-142 AU). A total of 37 (58.7%) patients were lost to COVID-19 infection and 26 (41.3%) were discharged from the hospital in a healthy state. CONCLUSION: The use of convalescent plasma in addition to standard treatment in our study on patients with severe pneumonia due to COVID-19 did not demonstrate reduced mortality of COVID-19 patients amidst numerous variables. The results showed that the use of convalescent plasma as a treatment option in the present conditions needs a serious re-evaluation. Studies on a strictly defined recipient group and transfusion of CCP units, with adequate antibody titer and/or neutralization activity, must be analyzed for future works.

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BACKGROUND: Coagulation factors are essential to maintain normal hemostasis. Plasma for transfusion can be obtained from whole blood donation or plasma apheresis. Plasma obtained from whole blood donation is termed as fresh frozen plasma (FFP). The quality of FFP can be influenced by several factors including donor variables (such as age, gender, diet, genetic profile), environmental factors, collection methods, processing methods, storage temperature, etc. This study was done to assess the association of donor characteristics such as donor age, blood group, and smoking with coagulation factor levels in FFP units. MATERIALS AND METHODS: The screening of donors for collection of whole blood units was done as per the national guidelines. A total of 144 FFP units were assessed for coagulation factors. The FFP units were tested for prothrombin time (PT), activated partial thromboplastin time, fibrinogen, coagulation factor VIII, and coagulation factor IX (CF IX) on coagulation analyzer. RESULTS: A total of 144 FFP units were tested for coagulation parameters. The value of PT was highest in units prepared from donors in more than 45 years of age group. The value of CF IX was significantly lower in O blood group as compared to non-O blood group. The value of fibrinogen was significantly higher in smokers as compared to nonsmokers. CONCLUSION: The findings of the present study further add evidence to the fact that donor factors such as age, blood group, and smoking have an impact on coagulation factor levels in FFP units.

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Herein, we report a case of naturally occurring anti-Leb alloantibody identified in the plasma of a first time voluntary blood donor. The immunohematology workup was done on the pilot sample tubes collected during blood donation by the conventional tube technique and using ID-Micro Column System Glass Beads card (anti-IgG, C3d; Ortho-Clinical Diagnostics, Raritan, New Jersey, USA). Blood group of the donor was confirmed to be B RhD positive, and the alloantibody in his plasma was identified as anti-Leb, having clinically significant characteristics. Since in this particular case, anti-Leb was IgM and IgG in nature, it was clinically significant and can lead to hemolytic transfusion reaction, especially if such fresh frozen plasma unit is transfused to Leb negative patients.

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Subclinical Iron deficiency appearing in blood donors after blood donation is a recognized problem. Donors at an increased risk of iron deficiency need to be identified. Blood donors meeting national selection criteria were included in the study. Complete blood counts were done using Sysmex XP-100 three part hematology analyzer. Differences in RBC indices among donor groups defined by previous donations were then analyzed statistically. Six hundred and seventy three males and ninety six females were studied. In males, Kruskal-Wallis test showed significant differences between groups defined by number of donations for MCH and MCV (P value < 0.001), but not for MCHC (P value = 0.09) and RDW (P value = 0.6). Post-hoc tests showed statistically significant difference between donors having six or more donations compared to donors having no previous donations for both MCH as well as MCV. No significant difference was found between donor subgroups in females for any of the indices; however, no female donated blood more than three times in the study. There is increased risk for iron deficiency in donors having six or more previous donations, and evidence for starting an iron screening and supplementation programme for these donors.

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There is scant documentation of the stability of common haematological parameters on storage of blood samples under tropical conditions. K2EDTA samples in multiple vials were taken from 20 healthy blood donors, baseline readings taken, and stored at 33°C and 37°C. Readings from the stored vials were taken after 1, 3 and 6 h. The percent change against the baseline readings at each time point for each storage temperature was calculated. Platelet counts showed an unacceptable shift within 1 h at 37°C and 3 h at 33°C; red cell volume related parameters showed an unacceptable shift within 3 h at 37°C and 6 h at 33°C. Haemoglobin, red blood cell count, white blood cell count and mean corpuscular haemoglobin remained stable for 6 h at both temperatures. The unacceptable change for many parameters on storage at ≥33°C demonstrates the importance of ensuring pre-analytical control in regions experiencing such climatic conditions.

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INTRODUCTION: This study aimed to investigate the analytical bias in haematological parameters induced by storage at 33 ºC. MATERIALS AND METHODS: Blood from the diversion pouch of 20 blood donors were collected in K 2 EDTA vials and stored at 33 ºC. Readings from each vial were taken at 0, 4, 6, 12, 24, 48 and 72 hours after collection on the Sysmex XP-100 analyser (Sysmex Corporation, Kobe, Japan). The percent difference from the baseline readings were calculated and subjected to a Wilcoxon signed rank test at a Holm corrected significance level of 0.05. A median percent difference, which was statistically significant and greater than the maximum acceptable bias (taken from studies of biological variation), was taken as evidence of unacceptable shift. If the median shift was lesser than the maximum acceptable bias, two one-sided Wilcoxon signed rank tests for equivalence were used to determine whether the percent differences were significantly lesser than the maximum acceptable bias. RESULTS: Haemoglobin, red blood cell count, white blood cell count, mean corpuscular haemoglobin and lymphocyte count showed acceptable bias after storage for at least 24 hours at 33 ºC. Haematocrit, mean corpuscular volume, mean corpuscular haemoglobin concentration, platelet count and mean platelet volume showed unacceptable shift in less than 4 hours when stored at 33 ºC. CONCLUSIONS: Since many haematological parameters show unacceptable bias within 4 hours of sample storage at 33 ºC, the recommended limit of time from collection to processing should be revised for areas where high environmental temperatures are common.

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