Alpha thalassemia is a common inherited blood disorder worldwide, with varying prevalence among different populations. This study investigates the prevalence and spectrum of alpha thalassemia deletions in the Oraon tribe, one of the largest indigenous populations in central-eastern India. Two hundred and twenty-seven Oraon individuals were genotyped using multiplex PCR for seven common alpha-globin gene deletions and triplications. Hematological profiling was performed on automated cell counter. A high frequency of alpha globin gene deletions was observed in the Oraon population, with the -α3.7 deletion being predominant. The homozygous -α3.7/-α3.7 genotype was found in 32.6

BACKGROUND:Accurate species identification of Plasmodium falciparum and Plasmodium vivax is essential for appropriate malaria treatment, particularly in endemic regions where both species co-exist. Current molecular methods, while sensitive, often require nested PCR protocols that are time-consuming and prone to contamination. METHODS:We developed and validated a single-tube multiplex PCR assay targeting species-specific regions of the 18S rRNA gene, incorporating a human β-globin gene as an internal control. The assay was evaluated using 162 malaria-positive samples from four geographical regions in India (Mumbai, Surat, Manipur, and Mangalore) and 80 malaria- negative controls. Performance was compared against nested PCR and microscopy-based techniques. RESULTS:The single-tube assay demonstrated 100% sensitivity (95% CI: 97.75-100%) and 100% specificity (95% CI: 95.49-100%) compared to nested PCR. The assay successfully identified P. falciparum (n = 42, 25.93%), P. vivax (n = 12, 7.41%), and mixed infections (n = 108, 66.67%) with a detection limit of 0.2 parasites/μL. The assay required approximately 3 h total time compared to 6-8 h for nested PCR, with reduced contamination risk. Five microscopy-negative samples were PCR-positive, indicating submicroscopic parasitemia. CONCLUSION:This single-tube multiplex PCR assay provides a rapid, sensitive, and specific method for Plasmodium species identification and differentiation suitable for clinical diagnostics and epidemiological studies in resource-limited settings.

Background:To investigate the occurrence of Plasmodium vivax infections in Duffy-negative individuals, challenging the long-held belief that P. vivax requires the Duffy antigen receptor for chemokines to infect human erythrocytes. Materials and Methods:In the present study, 365 samples were screened using serological techniques, PCR-RFLP analysis, and DNA sequencing of the ACKR1 gene promoter region mutation to identify Duffy-negative individuals. P. vivax infection was detected using PCR targeting the 18S rRNA gene and microscopic examination of Giemsa-stained blood smears. Results:Five individuals (1.36%) were confirmed Duffy-negative (Fy(a-b-)). Surprisingly, 3 out of these 5 Duffy-negative subjects (60%) were infected with P. vivax, as confirmed by both microscopy and PCR. Various parasite stages were observed in infected Duffy-negative samples, with parasitaemia ranging from 0.01% to 0.5%. Discussion:Our findings provide compelling evidence that P. vivax can infect Duffy-negative individuals, suggesting the existence of alternative invasion pathways or adaptations. This has profound implications for P. vivax biology, evolution, and global distribution. The burden of vivax malaria may be underestimated, particularly in regions with a high prevalence of Duffy negativity. This study highlights the need to reevaluate P. vivax epidemiology, diagnostic approaches, and control strategies, especially in areas previously considered at low risk. Further research is needed to elucidate the mechanisms enabling P. vivax invasion of Duffy-negative erythrocytes and to assess the clinical and epidemiological consequences of these infections.

Atypical chemokine receptor 1 (ACKR1), formerly known as the Duffy antigen/receptor for chemokines (DARC), has been primarily recognized for its role in Plasmodium vivax invasion of erythrocytes. Recent research has unveiled its diverse functions beyond malaria like susceptibility in inflammation, cancer biology, hematopoiesis, and several diseases. This perspective highlights these emerging roles and their potential therapeutic applications.

INTRODUCTION:Atypical chemokine receptor 1 (ACKR1) which carries the Duffy antigens, is not just a blood group antigen but serves many more functions. It is a receptor for various pro-inflammatory and inflammatory chemokines and for Plasmodium vivax. Genetic variations in ACKR1 are the basis for Duffy blood group antigens. METHODS:Routine serological Fya/Fyb typing and ACKR1 genotyping by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism was employed in a population study that included 331 samples from the Agri community. RESULTS:Weak Fyb expression was detected by serological findings in five unrelated samples, which prompted further investigation by molecular means. By Polymerase Chain Reaction an aberrant pattern was demonstrated on polyacrylamide gel electrophoresis, which led to the identification of an alteration by sequence analysis. This study describes a 3-bp insertion, present in the FY*B allele (c.144_146dupTGC), resulting in the insertion of the amino acid alanine (p.A49dup) within the full-length protein. CONCLUSION:The 3-bp in-frame insertion (c.144_146dupTGC, p.A49dup) (rs765671589) in the ACKR1 gene was identified in five individuals from the Agri community. Despite apparently carrying an FY*B allele, a very weak Fyb antigen expression was found in association with this genotype. This insertion may also have implications for some physiological roles of ACKR1 and be of interest in malaria research and population genetics.

Background ACKR1 blood group genes exhibit a high degree of polymorphisms with varying allele distribution seen among different populations and ethnic groups. The study aimed to genotype ACKR1 antigens and to establish FY allele frequency among the individuals with the Bombay (Oh) blood group phenotype. Materials and Methods ACKR1 phenotype and genotype frequencies were estimated on 160 individuals typed as Oh and were compared with 100 non-oh blood donors from Mumbai, India by molecularly genotyping via PCR-RFLP. Results The allelic and genotypic frequency of T(-67)C polymorphism showed the dominance of T allele and TT genotype [OR=3.26 (0.59-17.99)] in both the study groups. The ACKR1 null (Fya-b-) phenotype was not found in the tested group. While the genotypic combination among the Oh group individuals was FYA/FYB (45.3%), FYA/FYA (42.7%), and FYB/FYB (12%), in the non-Oh group donors, it was observed as FYA/FYB (53.3%), FYA/FYA (39.1%), and FYB/FYB (7.6%).The haplotype TGGGC occurred in 38.4% of the Oh group, but in non-Oh donors, it was found to be 50.9% [OR = 1.820 (1.196-2.771)], and the difference was statistically significant (p =0.005). Similarly, the TGGGT haplotype was found at a frequency of 12.7% in non-Oh donors and 27.1% in Oh group [OR=0.411 (0.234-0.722)] (p =0.001). Conclusions This study shows the prevalence of ACKR1 gene polymorphisms, including weak ACKR1 antigens in Oh individuals with a high frequency of haplotype TGGGC. The present study demonstrated for the first time the genotypes FyBweak, FyAweak and Fy Aweak/FyBESon RBC membranes in Indian subjects with Oh phenotype.

Background Prompt malarial treatment and surveillance is crucial for accurate diagnosis of Plasmodium Sp. Gold standard microscopic examination has been widely applied for diagnosis of malaria in most part of the endemic areas. But in case of submicroscopic and asymptomatic microscopic diagnosis is questioned. The study aims to develop a simple, cost effective & robust nucleic acid amplification technique for the detection of malaria parasite. Methods Study population included 50 clinically diagnosed positive malaria patient samples from various pathological laboratories. Microscopy by preparing thick film was carried out of every sample for primary screening in the available facility of Surat Raktadan Kendra & Research Centre- Blood Bank. The conventional PCR (Polymerase Chain Reaction) was applied for genus-specific amplification targeting the 18 S rRNA gene of Plasmodium. Agarose gel electrophoresis was used to separate and analyze the amplified PCR product using 2% Agarose gel. Results and Conclusion The study shows that nested PCR not only detected all microscopic positive samples, but also detected submicroscopic infections that were missed or misread by microscopy. Hence, the sensitivity of molecular based detection technique is proved to be more compared to microscopic examination.

Plasmodium vivax malaria poses a major global health challenge, fueled by the parasite’s ability to establish chronic infections via dormant liver hypnozoites that enable immune evasion and show transmission resilience. A key virulence determinant of P. vivax blood-stage infection is the ligand-receptor interaction of infected erythrocytes mediated by the Duffy Binding Protein (PvDBP) ligand. Gene duplication events leading to increased PvDBP copy numbers have been documented in parasite populations in Cambodia, Brazil, and Sudan, but whether such changes exist in Indian isolates is not known. India shoulders a disproportionately high P. vivax burden in the world. DNA extracted from malaria-positive samples from a multisite survey was subjected to diagnostic PCR to evaluate PvDBP duplication. We identified PvDBP duplication at 18.6

Transfusion of blood and its components form an important component in obstetric care. Almost 5% of pregnant mothers require some sort of red cell and/or component transfusion as part of their obstetric management. Although red cell usage in large parts of developed countries are coming down, its usage in obstetric care is increasing. About 27% of maternal deaths in the world are due to hemorrhage. There are many causes where transfusion with different blood components is required in obstetric practice; to name a few are – accidental hemorrhage, placenta previa, hemoglobinopathies, pre-eclamptic toxemia, postpartum hemorrhage, amniotic fluid embolism, disseminated intravascular coagulation, malaria, etc. Certain complications and challenges of transfusion such as transfusion related acute lung injury, microangiopathy, Thrombotic thrombocytopenic purpura, isoimmunization, and transfusion-associated cardiac overload occur with increased frequency in pregnant mothers. Transfusion requirement around peripartum period is uncertain and sometimes could be massive. Hence, both obstetrician and transfusion experts should remain prepared for this eventuality. Transfusion of blood products even though has never been safer than it is today; yet, this procedure carries with it many immunological, infectious, and other complications, hence, should be used judiciously and very cautiously. Several procedures such as apheresis and intraoperative cell salvage are being increasingly used nowadays for various facets of management and obstetric care. Present review condenses on the knowledge of usage of blood and blood products in obstetric care.

Objectives: Hepatitis E virus (HEV) infection is growing worldwide and presents a new threat to the blood transfusion services across the world. The present review tries to explore how the transfusion medicine community is responding to the threat. Materials and Methods: The major papers and important case reports were culled from PubMed, Science Direct, Embase related to this infection, and transfusion medicine since 2005 were explored and relevant articles were discussed with emphasis on epidemiology, infection, prevalence in donor population, susceptible recipients, prevention, and future development. Results: There are eight genotypes of this virus with different host, transmission biology, and clinical infection. Chronic infections are more common with Genotype 3 and Genotype 4 which are prevalent in Europe and transmitted by pig and meats cooked from this animal. Genotype 5 and 6 has not yet been linked to human transmission. Genotype 1 and Genotype 2 cause epidemic form of this infection and are common in developing countries. Immunosuppressed and chronic liver disease patients get chronic or severe infection. Pregnant ladies develop fulminant hepatitis with high mortality. The virus is transmitted by blood products but severe infection is uncommon. Many European countries, USA, Canada are using Nucleic Acid Testing (NAT) based technology to screen their donors as Individual Donor-NAT or Minipool NAT with varying efficiency. Large part of the world as yet has not taken any active measure to contain this infection through transfusion. A vaccine is available, effective but is not widely used as more studies are needed. Cross immunity does happen between genotypes and presence of immunoglobulin G antibody in blood protects against serious infection. Alanine transaminase level corresponds with viremia in asymptomatic but infected individuals. Conclusion: The HEV is an emerging but important threat to transfusion medicine service. Important information regarding this infection is still lacking. However, there is a need to develop robust safety algorithm to counter this threat and make transfusion safer.

Bone marrow fibrosis represents an important structural change in the marrow that interferes with some of its normal functions. The aetiopathogenesis of fibrosis is not well established except in its primary form. The present review consolidates current understanding of marrow fibrosis. We searched PubMed without time restriction using key words: bone marrow and fibrosis as the main stem against the terms: growth factors, cytokines and chemokines, morphology, megakaryocytes and platelets, myeloproliferative disorders, myelodysplastic syndrome, collagen biosynthesis, mesenchymal stem cells, vitamins and minerals and hormones, and mechanism of tissue fibrosis. Tissue marrow fibrosis-related papers were short listed and analysed for the review. It emerged that bone marrow fibrosis is the outcome of complex interactions between growth factors, cytokines, chemokines and hormones together with their facilitators and inhibitors. Fibrogenesis is initiated by mobilisation of special immunophenotypic subsets of mesenchymal stem cells in the marrow that transform into fibroblasts. Fibrogenic stimuli may arise from neoplastic haemopoietic or non-hematopoietic cells, as well as immune cells involved in infections and inflammatory conditions. Autoimmunity is involved in a small subset of patients with marrow fibrosis. Megakaryocytes and platelets are either directly involved or are important intermediaries in stimulating mesenchymal stem cells. MMPs, TIMPs, TGF-β, PDGRF, and basic FGF and CRCXL4 chemokines are involved in these processes. Genetic and epigenetic changes underlie many of these conditions.

Arterial thrombosis (AT) originates through platelet-mediated thrombus formation in the blood vessel and can lead to heart attack, stroke, and peripheral vascular diseases. Restricting the thrombus growth and its simultaneous monitoring by visualisation is an unmet clinical need for a better AT prognosis. As a proof-of-concept, we have engineered a nanoparticle-based theranostic (combined therapy and monitoring) platform that has the potential to monitor and restrain the growth of a thrombus concurrently. The theranostic nanotool is fabricated using biocompatible super-paramagnetic iron oxide nanoparticles (SPIONs) as a core module tethered with the anti-platelet agent Abciximab (ReoPro) on its surface. Our in vitro feasibility results indicate that ReoPro-conjugated SPIONS (Tx@ReoPro) can effectively prevent thrombus growth by inhibiting fibrinogen receptors (GPIIbIIIa) on the platelet surface, and simultaneously, it can also be visible through non-invasive magnetic resonance imaging (MRI) for potential reporting of the real-time thrombus status.

Fermented papaya preparation (FPP) is the source of antioxidants that may help in reducing the complications associated with oxidative stress and may improve the quality of life in sickle cell disease patients. In this study, we assessed the in vitro effect of FPP on sickled red blood cells (RBCs) using oxidative stress markers and observed that FPP has the potential to reduce the oxidative stress. Scanning electron microscopy (SEM) and eosin 5 ' malaemide (E5 ' M) dye test showed that FPP protects red cell morphology against the oxidative stress. Liquid chromatography mass spectrometry (LCMS) analysis of FPP suggests the presence of essential amino acids, vitamin D3, and its derivatives. Fermented papaya preparation can be of benefit either in reducing oxidative stress parameters or in preventing pathophysiological events in the sickle cell disease patients.

AbstractFactor XIII deficiency is an inherited bleeding disorder, which is rare, ∼1 in 5,000,000, while its combination with an intellectual disability is seldom. It is mostly a result of genetic mutation caused due to consanguineous marriage. Due to deficiency of fibrin stabilising factor, a clot formed is weak and leads to fibrinolysis, which is evident as unstoppable bleeding from umbilical cord stump, epistaxis and bleeding from various organs. The condition is made worst due to intellectual disability as the patient is more prone to injuries due to lack of knowledge of impending dangers. The latest provision of gene therapy is yet to be achieved in such cases and therefore the biggest challenge lies in keeping these patients fit and functional with optimum quality of life. The anxiety of parents is intensified due to the overall condition of the patient. This case report presents homoeopathic management of one such case. The patient was under treatment for almost a decade. Acute homoeopathic medicines efficiently managed acute haemorrhagic episodes. Constitutional medicine Bufo Rana was prescribed in the asymptomatic phase, which helped to reduce the frequency and intensity of bleeding and also helped to improve social quotient of the patient. The social quotient was assessed employing the Vineland Social Maturity Scale, and the result shows that the social quotient of the patient has improved from 8.3 to 41.66. The anxiety of parents also reduced, which was measured using the Family Interview for Stress and Coping in Mental Retardation Scale. The case analysis was done using a paired t-test. The p-value is less than 0.0001 and highly significant. The evaluation of the homoeopathic treatment was done using modified Naranjo criteria for homoeopathy. Homoeopathy medicines efficiently managed the acute episodes of bleeding and also showed improvement in the intellectual disability.