I make a difference....

A day at the Red Cross blood drive.....

It was my first day at the Red Cross blood drive as a volunteer. Despite the rainy morning, many were walking in to help out with the cause of saving many lives. Some of them were first time donors and about to pass out at the very thought of a needle pricking in. It is an incredible feeling to walk them through their fear of donation and help save someone's life.

I could see the disappointment on those who were deferred from donating either due to medical reasons or recent travel out of US.  It was interesting to learn that people who have been in Germany and some other European countries in the 1980's and early 90's are not allowed to donate due to the risk of getting Creutzfeldt Jakob Disease (CJD). Unfortunately, I couldn't donate my blood though; since you can't donate if you were out of US or Canada in the past 12 months.

It is indeed a great satisfaction to be a part of the American Red Cross in their mission; to make a difference in someone's life.

Angel dust .... to ...snake bite..

"As the Chennai mail screeches to a lazy halt, a six-foot tall Nigerian walks out along with the restless passengers and was nabbed and ........." Reading the news felt much similar to a crime thriller. The story was about two men  trying to smuggle cobra venom and the dangerous rise in the use of it as a substance of abuse in different parts of the world. Snake venom, in highly diluted form, is emerging as a designer narcotic drug in many parts of the world. Reports suggest that it gives tremendous high and works well for long-heroin users. This is shocking and seemingly dangerous.

The cases of snake bite for abuse have been reported in Substance Abuse Journal. The abusers, both long term addicts of various substances, received snake bite with the help of nomadic snake charmers. Both of them felt dizzy and had blurred vision followed by a sense of heightened arousal and sense of well being lasting for a few hours. They felt sort of grandiosity than  given by a regular narcotic drug. 

Cobra venom is made of enzymes and lipids. The neurotoxic venom can cause paralysis and respiratory arrest. Cobratoxin, a component of the venom prevents acetylcholine molecules from binding receptors blocking synaptic transmissions, resulting in a temporary relaxation of the muscles similar to certain common drugs of abuse. 

So keep in mind of another emerging substance abuse scenario  you may have to deal with in the near future.

References: Wikipedia

Sleep and lose ten pounds instantly.....

Yummy cheesy pizza and a diet coke ....(sounds funny,but to save me from the guilt of extra calories)....I can't resist eating but only with the strong resolution to start exercising from tomorrow morning  itself...... but tomorrow never comes ...as i always look forward to another auspicious day.. I always wished if there could be something to wash away the fat ...... 

And I was wonderstruck to  read about Harvard's new research innovation... a new hormone injection.....Irisin.... the ultimate dream of obese people and weight watchers across the world.

Researchers from the Dana-Farber Cancer Institute, Massachusetts, Harvard Medical School, University of California and Denmark’s Odense University Hospital, among others, have found that some of the most widely recognized effects of exercise on muscle are mediated by irisin. The study has been published in the latest issue of the scientific journal 'Nature'. Except for that it doesn't build muscles, all the other good things that happen after exercise can be reproduced with the drug...Another miracle from the great research happenings...

The hormone has been found to act in two ways. It promotes the conversion of inert yellow fat to the metabolically more active brown fat, and facilitates insulin action, thus decreasing blood glucose levels(great for diabetics... wow!!!). The researchers found irisin to be present in the blood of human volunteers who had undergone 10 weeks of exercise. 

The researchers are continuing to explore irisins possible health benefits, including potentially even being used in the treatment of Parkinsons disease because the process appears to have protective effects on mitochondrial metabolism as well. The researchers  again advocate strongly....... there is no substitute for toiling in the gym....

References: http://en.wikipedia.org/wiki/Irisin

Image Courtesy: http://www.bestantisnorepillowreviews.com

Chilled to death ....

Microbiology class started with a question...Suppose you are  in charge of doing a lumbar puncture for a 2 year old child with signs and symptoms of meningitis. You took the sample and labelled it, when you realized there is some delay in transporting the CSF sample to the lab. Where would you store the sample before it is transported ?
....The Refrigerator (What a silly question?) screamed the whole class  .... except for one (Yes, he was right)

Usually whenever there is  an  extra samples of CSF or there comes some delay in transporting it, we have the habit of keeping it in refrigerator  ..... Just read this .....

2 year old child presented  all symptoms  and signs of meningitis. Lumbar puncture was done, and three samples of CSF were taken. One sample was taken immediately for processing, and the rest two were refrigerated. The  first sample report came positive for H.Influenza, and the rest two when send for reconfirmation came as negative.

H.Influenza dies as soon as it is refrigerated ...It cannot withstand  less than 4 degree C of temperature. So keep it at room temperature if there is any delay in transporting the sample. So we can avoid the potential risk of missing the correct diagnosis and therefore the treatment given .....

Courtesy: microbiologyinpictures.org

The A2B blood group

It was a very long day at work. After 60 hours of continuous duty arrived the most longed for moment in the past two days.....yes exactly,  to go home and sleep like a baby...( the only dream any intern has). While climbing down the stairs to the way out I rechecked my 'TO-DO' list one more time, to make sure am done for the day. Then it came to my notice of the pending job of arranging blood for a patient posted for surgery the early morning next day. To avoid the delay of nursing staff collecting the report, I went to check the report of grouping and typing sample given and order for a unit of blood. The person at the blood bank told me that I was supposed to meet the pathologist on duty before collecting the reports (meeting pathologist is indeed a nightmare lest I would have sent some partially filled blood bank orders or have forgotten to sign an order form both of which are punishable offences an intern does). With great fear, I entered her room only to find there was greater news in store for me. The patient posted for the surgery next day has A2B blood group (OMG!! does such a group really exist??), and it shows cross reactivity. So the patient should be transfused the same group.

I was surprised to learn about the new blood group. I went to the patient and tried to find out from him if he was aware of his blood group. He had checked his blood group before and reported as AB negative. Thus, came the greatest difficult in convincing the patient about the existence of an A2B blood group about which I have learned  no earlier than him (indeed I had some quick review and talks with seniors before meeting him). Luckily someone in his family had the same blood group, and the surgery was done though it had to be postponed for two days before blood group was reconfirmed and arranged. So let me share with you what I have a learned from various sources.

The ABO system of blood grouping comprise of four major groups. A (A1 and A2), B, AB (A1B and A2B) and O. A2B is one of the rare subgroups of ABO comprising less than 1% in the total population and even lesser in the Asian population. But there as many as other 100  subgroups which may complicate transfusion. The difference between the A1 and A2 group is attributed to the genetic variation in the coding regions. The coding region of A2 allele differs from A1 in two ways: 

1. by a single nucleotide substitution that creates a single amino acid change (proline at position 156 is changed to leucine 
2. by a deletion mutation resulting in frameshift, extending the reading frame by 64 nucleotides

These two mutations create an enzyme whose activity is significantly weakened but not completely abrogated.

But there are several other studies suggesting that the difference is attributed to the quantitative difference in A2 antigen in the RBC and some going in favor of qualitative differences as well. Studies are still on regarding this group.

The complications of transfusions mainly arise when it is done under hypothermic conditions as in cardiopulmonary bypassing. Hemolytic reactions are less under normothermic conditions. So this poses a risk when organ transplants are done. Considering autologous transfusions avoid this risk in such cases.

So medicos... please keep in mind of the potential risks that can be encountered while transfusing blood to an A2B person.

Image Courtesy: Environmental Graffiti

References:

1. www.madsci.org/posts/archives/2007-05/1179846995.Me.r.html
2. www.meja.aub.edu.lb
3. www.ncbi.nlm.nih.gov/pubmed/2264401