Publications by authors named "Urvershi Kotwal"

9 Publications

  • Page 1 of 1

Role of Automated Therapeutic Red Cell Exchange in the Setting of Acute Methemoglobinemia: Our Experience.

Indian J Hematol Blood Transfus 2018 Jan 22;34(1):143-145. Epub 2017 May 22.

Department of Transfusion Medicine, Artemis Hospitals, Sec-51, Gurgaon, Haryana 122001 India.

Methemoglobinemia, an altered state of hemoglobin resulting in impaired oxygen delivery to the tissues can be congenital or following exposure/ingestion of various oxidant drugs or toxins. One of the earliest signs of methemoglobinemia is generalized cyanosis not improved on oxygen supplementation and presence of normal PO on acid blood-gas analysis. Here, we report two cases of acquired methemoglobinemia following poisoning and our experience of managing them with automated therapeutic red cell exchange.
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http://dx.doi.org/10.1007/s12288-017-0832-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786626PMC
January 2018

Growth Factor Variation in Two Types of Autologous Platelet Biomaterials: PRP Versus PRF.

Indian J Hematol Blood Transfus 2017 Jun 6;33(2):288-292. Epub 2016 Sep 6.

Department of Transfusion Medicine, Dr Ram Manohar Lohia Hospital, New Delhi, India.

Autologous platelet biomaterials represent a key source of cytokines and growth factors extensively used for clinical and surgical applications involving tissue regeneration; wound healing and tissue repair. In this communication we discuss the growth factors released by activated platelet rich plasma (PRP) and platelet rich fibrin (PRF) releasate. Our study highlights that significantly higher growth factors (TGF-ß1) are released by activated PRP as compared to releasate of PRF. The various growth factors released by both platelet products are significantly higher than the baseline concentration in the whole blood and have different bio-mechanism hence should be individualized as per the clinical indication.
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http://dx.doi.org/10.1007/s12288-016-0721-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5442062PMC
June 2017

Quantification of platelets and platelet derived growth factors from platelet-rich-plasma (PRP) prepared at different centrifugal force (g) and time.

Transfus Apher Sci 2016 Feb 3;54(1):103-10. Epub 2016 Feb 3.

Department of Transfusion Medicine, Dr Ram Manohar Lohia Hospital, New Delhi, India.

Introduction: Platelet derived biomaterials represent a key source of cytokines and growth factors extensively used for tissue regeneration; wound healing and tissue repair. Our study was to quantify platelets and growth factors released by PRP when prepared at different centrifugal force (g) and time.

Material And Methods: Our study was approved by the institutional ethical committee. One hundred millilitres of whole blood (WB) was collected in bag with CPDA as the anticoagulant(AC); (14 mL for 100 mL WB ratio). Nine aliquots of 10 mL each were made from the bag and set of three aliquots were made a group. PRP was prepared at varying centrifugal force (group A: -110 g, group B: -208 g & group C: -440 g) & time (1: -5 min, 2: -10 min & 3: -20 min). Contents of each PRP prepared were analysed. Commercial sandwich ELISA kits were used to quantify the concentrations of CD62P (Diaclone SAS; France), Platelet derived growth factors-AB (Qayee-Bio; China), transforming growth factor-β1 (DRG; Germany) and vascular endothelial growth factor (Boster Immuno Leader; USA) released in each PRP prepared.

Results: Eight volunteers were enrolled in the study (24-30 years). The baseline blood counts of all the volunteers were comparable (p ≥ 0.05). Mean ± SD of platelet yield of all nine groups ranged from 17.2 ± 4.2% to 78.7 ± 5.7%. Each PRP was activated with calcified thromboplastin to quantify the growth factors released by them. Significantly higher (p < 0.05) transforming growth factor-β1 and vascular endothelial growth factor were released compared to the baseline.

Conclusion: Our study highlights the variation in both force (g) and time results in changes at cellular level and growth factor concentrations.
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http://dx.doi.org/10.1016/j.transci.2016.01.028DOI Listing
February 2016

Hemolysis: A positive agglutination reaction while studying titration of anti A/B antibody for ABO-incompatible solid organ transplants.

Asian J Transfus Sci 2015 Jul-Dec;9(2):115-6

Department of Transfusion Medicine, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

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http://dx.doi.org/10.4103/0973-6247.162682DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562127PMC
September 2015

Rapid plasma reagin test: High false positivity or important marker of high risk behavior.

Asian J Transfus Sci 2015 Jan-Jun;9(1):109

Department of Blood Bank, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

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http://dx.doi.org/10.4103/0973-6247.150979DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339923PMC
February 2015

Maternal anti-M induced hemolytic disease of newborn followed by prolonged anemia in newborn twins.

Asian J Transfus Sci 2015 Jan-Jun;9(1):98-101

Department of Paediatrics, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Allo-anti-M often has an immunoglobulin G (IgG) component but is rarely clinically significant. We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. The aim was to diagnose and successfully manage hemolytic disease of newborn (HDN) due to maternal alloimmunization. Direct antiglobulin test (DAT), antigen typing, irregular antibody screening and identification were done by polyspecific antihuman globulin cards and standard tube method. At presentation, the newborn twins (T1, T2) had HDN with resultant low reticulocyte count and prolonged anemia, which continued for up to 70 days of life. Blood group of the twins and the mother was O RhD positive. DAT of the both newborns at birth was negative. Anti-M was detected in mothers as well as newborns. Type of antibody in mother was IgG and IgM type whereas in twins it was IgG type only. M antigen negative blood was transfused thrice to twin-1 and twice to twin-2. Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. Anti-M is capable of causing HDN as well as prolonged anemia (red cell aplasia) due to its ability to destroy the erythroid precursor cells. Newborns with anemia should be evaluated for all the possible causes to establish a diagnosis and its efficient management. Mother should be closely monitored for future pregnancies as well.
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http://dx.doi.org/10.4103/0973-6247.150968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339947PMC
February 2015

Blood donor notification and counseling: Our experience from a tertiary care hospital in India.

Asian J Transfus Sci 2015 Jan-Jun;9(1):18-22

Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Aims: To evaluate the response rate of transfusion-transmissible infection (TTI)-reactive donors after notification of their abnormal test results for the year 2012.

Materials And Methods: This study is an observational descriptive study performed in our department over a period of 1 year. We evaluated the response rate of TTI-reactive donors after notification of their abnormal test results over 1 year as per the existing strategy (three telephonic and two postal communications).

Results: During the study period, among the annual donation of 15,322 units, 464 blood donors were found to be seroreactive. Of these 464 seroreactive cases, 47 were HIV positive, 284 were reactive for Hepatitis B surface antigen (HBsAg), 49 were Hepatitis C (HCV) positive and 84 were VDRL reactive. The TTI-reactive donors (464) for various markers were contacted: 229 (49.4%) telephonically and the remaining 235 (50.6%) not contacted on phone were informed by post. Of the 229 contacted donors, the response rate was 98.2% as only 225 donors reported (221 on the first, three on second and one on the third call) for one to one counseling. The remaining four non-responders were - one HIV and three HBsAg reactive. The remaining 235 (50.6%) reactive donors did not respond to any communication.

Conclusion: Donor notification and post-donation counseling are an essential aspect of the blood bank that entails provision of information on serological status, assess the impact of test results on the donor and finally referral for medical care. As in our data only 49.4% of the blood donors could be contacted successfully, incomplete demographic details was the major limiting factor in communicating with rest. Of the 229 contacted donors, the response rate was 98.2%. A large majority (94.75%) of the notified donors in our study contacted their health care provider when given clear instructions to do so. These results are encouraging because they indicate that a major element of the notification message is acted upon when it is worded clearly. The very high response rate of the contacted donors ensured their concern for knowing their test result status.
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http://dx.doi.org/10.4103/0973-6247.150941DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339925PMC
February 2015

Reactive donor notification: First error reported.

Asian J Transfus Sci 2014 Jul;8(2):135-6

Blood Bank, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Donor notification and post-donation counseling is an essential role of blood bank. If a donor is reactive for any marker, the blood bank counselor, informs the donor and advices him/her to report to the blood bank for further counseling and management. The counselor at our blood bank informed a young female voluntary donor to be reactive for HIV both with ELISA as well as NAT. When the donor reported to blood bank, the repeat testing was negative and no history of high risk behavior could be elicited. The hospital information system (HIS) records were checked again immediately for clarification and showed consistency with her demographic profile. But when her manual records and donor questionnaire were retrieved, showed information displayed in the HIS system was wrongly interpreted by the counselor. In this era of information technology being highly advanced, the role of manual record keeping is still the gold standard.
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http://dx.doi.org/10.4103/0973-6247.137456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140059PMC
July 2014