Shamee Shastry

• MBBS, MD
• Professor at Manipal Academy of Higher Education

Background The longevity of scrub typhus IgM and IgG are not clear. A region-specific diagnostic cut-off for enzyme-linked immunosorbent assay (ELISA) is a necessity for improved diagnosis. Objectives To determine a region-specific optical density (OD) value cut-off for scrub typhus IgM and IgG ELISA and to study the persistence of these antibodie...

It is well documented that platelet disorders can result from various causes and can lead to different disease conditions such as cardiovascular diseases (CVDs), thrombocythemia, thrombocytopenia, Autoimmune diseases, Alzheimer’s disease (AD), and even cancer, to name a few. The diagnosis of many of these diseases mainly depends on imaging examinat...

ABO‐incompatible transplantations are increasingly gaining relevance with advancements in therapeutic modalities, thus allowing patients to receive timely solid organ transplants. Therapeutic apheresis (TA) procedures remain instrumental as a preconditioning measure to enable such transplants. This survey was undertaken to find out current trends a...

BACKGROUND Hepatitis E virus (HEV) stands out as a significant transfusion-transmissible infection, yet it is not included in the screening protocols of many countries. The present study was conducted to assess the cost-benefit implications of incorporating HEV screening among blood donors which is one of the preventive strategies in reducing trans...

Background As set out in Sustainable Development Goal 3.3, the target date for ending the HIV epidemic as a public health threat is 2030. Therefore, there is a crucial need to evaluate current epidemiological trends and monitor global progress towards HIV incidence and mortality reduction goals. In this analysis, we assess the current burden of HIV...

Background Hepatitis E Virus is a major cause of acute and fulminant hepatitis, particularly in developing countries. While the virus is commonly spread through the fecal-oral route, numerous cases of transfusion transmitted Hepatitis E Virus (TT-HEV) have been reported, raising concerns about its transmission via blood transfusions, especially in...

BACKGROUND Leptospirosis is among transfusion transmissible infections but is not screened routinely among blood donors and is endemic in Southern India. The presence of carrier state and the donors being asymptomatic may lead to transfusion transmission in the absence of screening. We aimed to study the prevalence of leptospirosis among blood dono...

Background and Objectives: To develop key performance indicators (KPI) for use in quality assessment of our institutional goal-directed massive transfusion (GDMT). Materials and Methods: A team comprising our transfusion and emergency medicine departments carried out a cross-sectional data analysis of GDMT in adult patients from January 2021 to Dec...

BACKGROUND AND OBJECTIVE Blood transfusion is an essential component of health care. However, several issues can hamper the promotion and sustainability of voluntary blood donation programs. This article is about a hackathon in the field of transfusion medicine that was designed to stimulate original ideas to promote voluntary blood donation. MATE...

• Written in a conversational tone, this memoir delves into the life of an iconic Indian Pathologist and a Transfusion medicine specialist Professor (Dr.) Sudha S Bhat (Ex-Head of the Department, of Transfusion Medicine from KMC Manipal, Karnataka, India). • Herein, we share her life journey, her profound dedication to teaching, her experiences, a...

BACKGROUND AND OBJECTIVE We compared the overall clinical outcome in formula-based protocol (1:1:1) and thromboelastogram (TEG)-guided goal-based massive transfusion (MT) in the resuscitation of patients with hemorrhagic shock. MATERIALS AND METHODS This was a retro-prospective case–control study conducted over a period of 2 years among the patien...

Autoimmune hemolytic anemia (AIHA) is a common term for several disorders that differ from one another in terms of etiology, pathogenesis, clinical features, and treatment. Management of patients with AIHA has become increasingly evidence-based in recent years. While this development has resulted in therapeutic improvements, it also carries increas...

Introduction: Anti-D detection and titration plays a major role in RhD negative antenatal cases both, for monitoring maternal as well as fetal status as well as initiation of early therapeutic interventions, such as intra-uterine transfusions (IUT) to improve maternal as well as fetal morbidity and mortality and reduce the adverse effects of haemo...

Background Raman tweezers spectroscopy (RTS) is a powerful tool that combines optical tweezers and Raman spectroscopy to study single living cells. RTS has become increasingly popular in biomedical and clinical research due to its high molecular specificity and sensitivity, which enable the study of cell viability, cell deformation, cell-protein, c...

Background Acute liver failure (ALF) following yellow phosphorous (YP) ingestion is similar to acetaminophen‐induced ALF and it has become a public concern in our region. This study assessed low volume therapeutic plasma exchange (LV‐TPE) efficacy in improving the transplant free survival in YP poisoning. Methods Adult patients with toxicology rep...

Developing KPIs is an integral part of process control. KPIs need to be scientifically sound, measurable and easy to capture. Assessing KPIs of Massive Transfusion will help us to understand scope of improvement. This study was an attempt to validate the KPIs that were developed in our centre.

Background and Objectives Repeated blood donation is a well‐known cause of iron deficiency among donors. However, present scientific literature lacks comprehensive evidence regarding the impact of regular plateletpheresis procedures on body iron reserves. In this study, we aimed to detect and correlate iron deficiency (using iron indices) with the...

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandati...

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandati...

Poster Number: P433 ❖ Acute liver failure due to poisoning is an emerging global burden and acetaminophen poisoning is the leading cause in the western world (Bernal et al, NEJM, 2013). ❖ Indian burden of Yellow phosphorous (YP) is 75:1 to acetaminophen poisoning and can be considered equivalent to acetaminophen induced toxic liver necrosis in the...

Background and objectives: The antigen frequencies vary across different regions and ethnic groups. Hence, we aimed to study the prevalence of blood group antigens in our population and to systemize the zone-wise prevalence of the same across India. Materials and methods: Regular voluntary O group blood donors were screened for 21 blood group an...

Red cell exchanges (RCE) help in the treatment of complications of sickle cell anemia (SCA) by reducing the viscosity of blood and improving the oxygen-carrying capacity. We present a case of sickle cell crisis (SCC) managed with automated RCE and also reviewed the literature to assess the utilization and clinical efficiency of this therapy in Indi...

Introduction and Aim: Platelets are precious blood components with a very short shelf life of only 5 days. Appropriate usage is essential for judicial utilization of these components. Blood utilization metrics help in assessing the demand and understanding the utilization pattern of blood components and in improving transfusion practices. This stud...

Background: Hepatitis E is a fecal orally transmitted disease and an emerging transfusion transmissible infection with potential transfusion safety implications. Hepatitis E Virus screening among blood donors is not routinely done despite the fact that it is endemic in India. As there are very few reports and evidence, the justification for mandati...

Background: The assessment of ADAMTS13 factor activity and inhibitor levels was conducted in severe COVID-19 patients as an observational study. Results: A total of 14 patients were included and the average ADAMTS13 activity level at the time of admission was 28.54±30.74% (range 1.83-86.67%) which was reduced compared to controls (88.09±14.77)....

Background: Autoimmune haemolytic anaemia (AIHA) is a decompensated acquired haemolysis caused by the host's immune system acting against its own red cell antigens.The aim of this national survey is to capture real-world data of clinical practices in AIHA by collecting responses from clinical haematologists across India. Methodology: In this cro...

Background Thromboembolic incidents are a rare but an often-fatal complication that occurs in thalassemia. Assessment of the hypercoagulable state is not done regularly, and we have assessed the utility of Thromboelastography (TEG) in thalassemia. Methodology A prospective single-center cohort study was conducted in a tertiary care set-up. Transfu...

Atypical hemolytic uremic syndrome (aHUS) is a rare and life-threatening disease that is associated with high mortality and morbidity. The incidence of aHUS is about 1 or 2 cases per 1,000,000 per year. Etiology can be either familial or sporadic. The pathogenesis of aHUS involves dysregulation of the alternative complement pathway, with predisposi...

Introduction Knowledge, Attitude and Practices (KAP) surveys prove beneficial to the transfusion services by providing an insight into the donors and, thus, aiding in mobilizing and retaining voluntary blood donors. We aim to study the knowledge, attitude and practices of donors towards blood donation in a pandemic setting. Methods A cross-section...

Neutrophils display functional heterogeneity upon responding diversely to physiological and pathological stimulations. During type 2 diabetes (T2D), hyperglycemia constitutively activates neutrophils, leading to reduced response to infections and on the other hand, elevated metabolic intermediates such as homocysteine induce bidirectional activatio...

COVID 19 is caused by Severe Acute Respiratory Syndrome Corona Virus-2 which results in wide range of manifestations. Systemic hypercoagulation is a typical feature of COVID-19. We present a case of COVID-19 in whom TEG was performed on admission and hypercoagulability was diagnosed and hence patient was started on Enoxaparin sodium 6000 IU twice d...

Background: COVID-19 associated coagulopathy (CAC) can either be localized or systemic hypercoagulable state with increased risk of thromboembolism. This study looked into the usefulness of Thromboelastography (TEG) and the velocity curve (V-curve) derivative from TEG in diagnosing and differentiating different stages of CAC. Materials and Methods:...

Introduction: Transfusion transmissible syphilis is caused by Treponema pallidum; blood donors are traditionally screened with non-treponemal antibody tests to ensure transfusion safety. Detection of specific antibodies against T.pallidum is employed in reverse algorithm screening. We aim to analyze the utility of reverse algorithm screening strate...

Unmanageable bleeding is one of the signifcant causes of mortality. Attaining rapid hemostasis ensures subject survivability as a frst aid during combats, road accidents, surgeries that reduce mortality. Nanoporous fbers reinforced composite scafold (NFRCS) developed by a simple hemostatic flm-forming composition (HFFC) (as a continuous phase) can...

Background and objectives: There is a varied prevalence of red cell alloimmunization being reported from different parts of India. This study aimed to estimate the overall prevalence of alloimmunization in India by performing a systematic review of the literature and to establish the most suitable antigen-matching strategy to reduce the red blood...

Blood grouping discrepancy in patients with hematological disorders can occur due to red cell sensitization following transfusion, transplantation, and pregnancy or pre-analytical errors. Prompt initiation of root cause analysis is vital to avoid complications of wrong blood transfusion. We present an unusual case of Rh mismatched grouping report o...

Background Platelets should be transfused appropriately, based on the cause of thrombocytopenia. The practice and policies of transfusion vary among institutions and even among clinical practitioners, leading to inappropriate use of platelets, which might increase the risk of transfusion-related complications to recipients, and lead to a shortage o...

Objectives: Adverse donor reactions (ADR) may often go unreported due to donor related or blood center related factors. Possible donor related factors are self-ignorance of the adverse reaction, inertia to notify blood centre and non-compliance to follow-up. A better understanding of the self-ignored adverse donor reaction (SIADR) helps in early de...

Optical techniques are becoming increasingly popular for the analysis of body fluids, particularly so after the onset of the COVID-19 pandemic. Raman spectroscopy has found special significance among them due to its ability to perform label-free investigations of biological solutions with high sensitivity and specificity. The integration of Raman s...

Snakebite in India is often attributed to the "big 4," for which polyvalent anti-snake venom is effective. Also significant and less known is the burden of other venomous snakes, one of which is Trimeresurus malabaricus. We report a bite to the face of a tree climber by Trimeresurus malabaricus in the Western Ghats of India, which caused severe loc...

Introduction : With the outbreak of COVID-19 and its containment measures, blood centers faced a huge challenge in balancing blood demand and supply and devising a preparedness plan to withstand the uncertain situation. This study assesses the effect of the COVID-19 pandemic on blood transfusion services and discusses the appropriate mitigation str...

Background - We decided to conduct this study because of the severe infections in 2021 compared to 2020 to understand the Coagulopathy in COVID-19 among our population using Thromboelastography (TEG) and V curve. Materials and methods - All adult patients with a confirmed COVID-19 and TEG report were recruited in the study for one month period. Cit...

Background: Blood donors with high Hb are often deferred for the presumed risk of polycythemia vera (PV). However, adequate data to substantiate or refute this hypothesis is lacking. Methodology: We conducted an observational study on blood donors found to have high hemoglobin (Hb ≥18 g/dl) during the pre-donation screening process using a portable...

Background: According to the American Society for Apheresis (ASFA) guidelines, thrombocytapheresis is a Category II indication in symptomatic patients and is a Category III indication when used as secondary or prophylactic treatment. The role of thrombocytapheresis is to prevent untoward complications that might occur even before the cytoreductive...

Hepatitis E virus (HEV) usually causes self-limiting acute hepatitis, but the disease can become chronic in immunocompromised individuals. HEV infection in pregnant women is reported to cause up to 30% mortality, especially in the third trimester. Additionally, extrahepatic manifestations like neuronal and renal diseases and pancreatitis are also r...

Background In an ethnically diverse country like India, establishing a national rare donor registry is a massive challenge. We aimed to establish a regional rare donor registry at our center by screening the local donor population for rare phenotypes. Methods Serological testing of O blood group donors was done using monoclonal antisera from Bio-R...

A 42-year-old male with aplastic anemia admitted for management of anemia with a recent history of blood transfusion was noted to have a hematocrit of 19.7% which necessitated packed red blood cell (PRBC) transfusion. His pre-transfusion typing demonstrated A1 Rh (D) positive group on forward testing. However, his serum showed varying grades of agg...

Naturally occurring anti‐Kpa antibody is extremely rare and was first reported in 1957, named after the first producer ‘Penney’. However, the subsequent anti‐Kpa reports presented were all anti‐Kpa due to isoimmunization. Individuals with severe bacterial infections particularly Gram‐negative bacteria are known to be capable of producing cross‐reac...

Para-Bombay is a rare phenotype with a homozygous nonfunctional FUT1 gene and a normal FUT2 gene leading to H-deficient red blood cells (RBCs) with or without ABH substances, depending on inheritance of the ABO gene. This case is about a 5-day-old male baby suffering from sepsis who required a 45-mL packed RBC transfusion. The baby’s sample tested...

BACKGROUND: Outcomes in childhood cancer has dramatically improved in the West due to intensification of chemotherapy along with improved supportive care, however in LMIC like ours, deaths in remission secondary to MDR sepsis and viral infections is alarming and has drastically reduced cure rates. Very few IV antibiotics have been FDA approved late...

Background Rh D expression varies with population and ethnicity. Accurate typing of Rh D antigens among blood donors is important to prevent development of anti D among recipients of blood transfusion. We aimed to screen blood donors for variant D phenotypes and accurately characterize them by genotyping. Material and methods We have done prospect...

Background: Prediction of transfusion requirement is part of preoperative management in a surgical case. We aimed to develop one such tool for patients undergoing cardiac surgery. Methods: A retrospective study for a period of 3 years was done to develop the scoring tool, Transfusion Requirement Prediction Score for Cardiac Surgery (TRPS), and i...

Crystalloid fluids, a subset of intravenous (IV) fluid solutions are commonly used in clinical settings. The influence of these fluids on the functions of blood components are least explored. Raman spectroscopy combined with optical trapping has been widely used to evaluate the impact of external stress agents on red blood cells. The present study...

Hyperhemolysis syndrome is one of the life threatening complications of packed red cell transfusion characterized by the destruction of both allogenic transfused cells and autologous red cells. One of the main features of hyperhemolysis syndrome is the drop of hemoglobin level lower than that prior to transfusion(Eberly et al. 2015). The purpose of...

Background: Biomaterials containing platelets have been used to promote healing of ulcers and burns, as well as in implantology and maxillofacial and plastic surgery to achieve wound healing and tissue repair. Commercial devices to prepare autologous biomaterials involve diverse preparation methods that can have high production costs and low yield...

The positive antibody screen during pre-transfusion testing helps in the detection of clinically significant antibodies. However, sometimes clinically insignificant antibodies might perplex the serologic workup and can cause a delay in transfusion. Prompt recognition and timely resolution of these discrepancies in pre-transfusion testing, although...

Background and Aims: Outcomes in childhood cancer has dramatically improved in the west due to intensification of chemotherapy and improved supportive care. In LMIC like India, infections related deaths brings down the overall childhood cancer outcome. Also, there is an alarming rise in MDR infections among pediatric cancer patients in India and th...

Background: Overordering of blood has been a challenge faced by the blood bank staff. The present study addresses the role of maximum surgical blood ordering schedule (MSBOS) in optimizing the blood inventory management. Methods: The blood requests for elective surgical procedures from various surgical departments were reviewed to constitute MSBOS...

Purpose Donor deferral results in loss of potential, motivated blood donors, and thereby, availability of blood for needy patients. This study analyses the frequency and reasons for donor deferral, including high hemoglobin deferral, which is underreported in India. Methods Retrospective analysis of the deferral record of whole blood donors from J...

Objective: We aimed to assess the frequency distribution of of ABO haemolytic disease of newborn (ABO-HDN) and to know the predictive value of immunohaematological tests in identifying at risk neonates. Background: ABO incompatibility, although a common cause of haemolytic disease of newborn, has several unaddressed issues related to it. Materi...

Hydroxyethyl starch (HES) is a commonly used intravenous fluid in hospital settings. The merits and demerits of its application is still a debatable topic. Investigating the interaction of external agents like intravenous fluids with blood cells is of great significance in clinical environments. Micro-Raman spectroscopy combined with an optical twe...

Fibrinolysis activity in various acquired clinical conditions were diagnosed using thromboelastography (TEG) and Thrombin Gneration Assay (TGA) by TEG.

Hemoglobin (Hb) estimation is a critical investigation in prospective blood donors. There are numerous techniques for Hb estimation, choosing an appropriate method is essential. Point of care devices (POC) have made quantification of Hb possible even in the field or community settings. Validation against a standard measure is necessary before imple...

Background: For appropriate management of hemolytic disease of the fetus and newborn (HDFN), it is important to detect irregular red cell antibody in the antenatal period. Though it is a simple one-step method, it is not part of routine antenatal screening in many developing countries. To reiterate the importance of antenatal antibody screening, w...

Background: Variation in the reactivity on Rh D typing may pose challenges in interpretation and ambiguity in further patient management. Materials and Methods: A prospective study was conducted in the department of transfusion medicine for a period of 18 months. Blood grouping was performed by fully automated equipment employing column agglutinati...

Objective: Refractoriness to platelet transfusion is defined as Corrected Count Increment (CCI) <5000 after two sequential ABO identical transfusions. Immune causes include alloimmunization to HLA and/or platelet-specific antigens. Analysis of various factors leading to platelet refractoriness would help in the management of the patient in a timely...

Extracellular tonicity has a significant influence on human red blood cell deformation capability. Advancements in the area of laser physics and optical trapping have opened up a plethora of applications for understanding cell structure and dynamics. Here, Raman Tweezers technique was employed to investigate the impact of extracellular tonicity by...