Background: The timely availability of safe and quality blood is a lifesaving decisive factor. Maintaining a stable and adequate blood supply has become a huge challenge amidst COVID 19 pandemic, especially in developing countries like India. Impact of this pandemic on blood transfusion services and potential challenges faced are discussed in the present study which helps planning acute blood shortage even in future pandemics. Objective: 1. To know the impact of COVID-19 pandemic on Blood bank service; 2. To suggest strategy to tackle acute crisis of blood in future disasters. Materials and Methods: In the present study six month's data pertaining to blood bank following, COVID 19 outbreak in district was compared with that of pre-COVID19 state. Donor attendance register, blood issue register, blood stock-component register, Voluntary blood donation camps, reagents and consumables stock inventory records are analyzed statistically. Mitigative measures adopted are discussed for smooth functioning of Blood bank services. Results: During COVID-19 outbreak there was drastic reduction in total number of voluntary blood donors visiting blood bank, cancellation of Voluntary blood camps, decreased number of blood components and discard rate of blood components was increased. Disruption of inventory stock maintenance was also seen. Conclusion: COVID 19 pandemic had a negative impact on Blood transfusion services. A multi-centric approach with evidence based emergency preparedness plan helps to overcome acute crisis of blood supply and in future disasters.

Background: Human Blood is essential and life saving in certain medical and surgical conditions and considered as "liquid of life" as it is not replaced by any artificially prepared medicine, though there are tremendous advances in medical sciences. Though Safe blood practice is emphasised since many years, yet there are many side effects of blood transfusion, of which temporary and reversible are easily recognised and treated. Whereas others especially few transfusion transmitted infections which have long term morbidity and mortality needs attention. Recognising these dreaded transfusion transmitted infections in donated blood will help to procure safe blood and help to treat the reactive donors at the earliest. Indirectly reducing the prevalence of transfusion transmitted infections (TTIs) in the community. Tracing the reactive donors and initiating treatment at the earliest, which often would be a window period of transfusion transmitted disease, helps to formulate the strategy to curb the economic burden besides reducing morbidity and mortality. Objective: 1)To know the seroprevalence of transfusion transmitted infection among healthy blood donors; 2)To study reactive donors response to counselling; 3) To suggest strategy to collect and issue safe blood with aim to reduce TTIs. Materials and Methods: A retrospective study of 6.5 years done by review of blood donor registry maintained in blood bank from 2014 to June 2020. All the blood donors were clinically examined, and were asked fill up questionnaire and consent form as per standard guidelines. Mandatory screening tests suggested by WHO like for HIV, HBV, HCV and Syphilis were done and prevalence among both voluntary and replacement donors were calculated. Counselling for reactive donors done and they were directed to undergo advice and treatment by respective department concerned. SPSS software and MS excel sheet were used to analyze the data. Results: Analysis of data revealed replacement blood donors outnumbered voluntary donors. TTIs were more common among replacement donors compared to voluntary. Most number of reactive donors were among men aged between 26 to 35 years. Prevalence of HIV, HBV, HCV, Syphilis and Malaria were 0.062%, 0.655%, 0.006%, 0.146% and0.006% respectively in our study. Among reactive donors responders were 108(85.71%) as compared to non-responders 18(14.28%). Conclusion: Following strict measures to select donor and to counsel donor before donation with appropriate privacy will help to decrease seroprevalence of Transfusion Transmitted Infections. Counselling reactive donors help to seek treatment at the earliest along with unnoticed ongoing blood donations by them. By knowing seroprevalence rate and response of reactive donors, Government and health administration should make and implement policy for safe blood collection and transfusion.

Introduction: Coronary slow-flow phenomenon (CSFP) is a frequent angiographic finding with obscure pathophysiology. Although recognized for decades, the incidence of such a clinical entity is rare in aviation environment and poses unique aeromedical challenges in disposition of the aircrew. Case Details: A 53-year-old asymptomatic pilot from a helicopter stream was detected to have ECG abnormality during a routine medical examination. His treadmill test was borderline positive for inducible myocardial ischemia, whereas angiography revealed proximal ectasia with a slow flow. He was diagnosed as a case of “Coronary Slow-Flow Phenomenon,” started on antiplatelets and was observed on ground for 36 weeks. A comprehensive cardiological evaluation following that revealed an asymptomatic status, controlled modifiable risk factors and no progression of ECG changes. Echocardiography, 24 h Holter, and stress MPI were essentially normal. Based on an evidence-based approach, the aircrew were reflighted back to flying in a multicrew aircraft. Discussion: This case study discusses our approach to aeromedical evaluation and disposition of a helicopter pilot with CSFP, which is unique, yet rarely encountered disability among aircrew.

Introduction: Modern generation fighter aircraft has expanded the escape envelope for a fighter aircrew. With the ejection occurring at very high airspeeds, windblast is a cause of major injuries and fatalities. Flying helmet, before its induction into operational usage, must be tested in simulated windblast conditions to ensure that they provide adequate safety. Material and Methods: Windblast tests were conducted on a newly designed/procured helmet in a standard windblast test facility as per Mil Std MIL-V-29591/1. A large instrumented Hybrid III male dummy was used for the tests. The test conditions were: Wind speed 600 ± 60 KEAS, rise time of 125 ± 20 ms, time at peak wind velocity of 300 ± 50 ms, and total exposure time of ≥3 s. Structural integrity, retention with the headform, and recorded neck loads were assessed for interpretation of test results. Results: Helmets could withstand the windblast conditions without any significant structural failures and were retained with the headform during the entire duration of test conditions. However, analysis of the neck loads resulted in a significant dilemma in aeromedical decision-making, there being no laid down criteria in the Mil Specification. The neck tension forces were more than the acceptable limits and found to have the potential for significant neck injuries as per the Injury Assessment Reference Values specified in AGARD-AR-330 specifically in the tests where blast was head on and outer visor in up configuration; however, these values were within the acceptable limits as per the other proposed criteria. Similarly, analysis of the neck tension extension combined effects revealed conflicting outcomes for Nij performance limits specified in various standards. This paper discusses the critical analysis of neck loads vis-à-vis the neck injury criteria to understand the neck loads generated during windblast conditions and its implication on aircrew safety. Conclusion: Neck loads assessment is critical in predicting aircrew safety during windblast testing. In the absence of a clearly defined criteria in the Mil Specification, critical ananlysis of neck loads vis-à-vis recommended standards in scientific literature be done to make meaningful conclusion.

Introduction: Sleep inertia, a detrimental effect of daytime nap, may affect cognitive functions following awakening. The present study aimed to assess the effects of sleep inertia on cognitive and psychomotor tasks following short nap of 30 min taken in the afternoon hours, a realistic probability in the aerospace operational environment. Material and Methods: In a repetitive measure design, 30 healthy male volunteers having adequate sleep the previous night, were tested for changes in cognitive and psychomotor performance following 30 min of nap after lunch at the Sleep-cum-Group confinement lab. Post nap longitudinal testing for dual task (DT) test and Stroop test was carried out in periodic intervals for 40 min. DT response time (DTRT), DT lag error (DTLE), DT correct clicks (DTCC) and response time difference (Stroop Effect [SE]) were analyzed as performance measures. Results: There was a significant increase in DTRT (χ2 =11.13, P = 0.011) in the post-nap period as compared to pre-nap baseline values. No significant changes were observed in other parameters vis DTLE, DTCC, and SE. Post-hoc analysis revealed that the increase of DTRT was significant at 6 min post-nap session; following which the changes were not statistically significant. Conclusion: Sleep inertia was found to affect speed component of the task rather than accuracy in a post-nap period of 30 min. The effect was significant at 6 min following awakening and after that, the effects got dissipated. Although nap can be an effective strategy for sleep-alertness management, the effects of sleep inertia have to be borne in mind, especially during sustained military operations.