Background: Autoimmune hemolytic anemia (AIHA) is an immune hemolytic disease characterized by hemolysis and anemia which results from increased red cell destruction due to auto antibodies directed against self-antigens on red cells. Clinical characteristics and potential associated hemolysis in AIHA can greatly depend on the serological characteristics. Aims and Objectives: This study was done to find out the association of Grade of polyspecific Direct Antiglobulin test (DAT), complement involvement and immunoglobulin G (IgG) subclass with severity of hemolysis in an AIHA patients. Materials and Methods: This was a cross-sectional study conducted for a period of 18 months from March 1, 2012, to August 31, 2013. Fifty consecutive AIHA patients diagnosed by a positive DAT in EDTA anticoagulated blood samples using poly specific anti human globulin reagent were followed up and results of various immunohematological tests such as polyspecific and monospecific DAT, IgG subtyping, and thermal amplitude were performed. Hematological and biochemical parameters such as hemoglobin, percentage of reticulocyte, total serum bilirubin, and serum lactate dehydrogenase also were recorded. Data were analyzed using SPSS v17. Results: Majority of patients were belonging to 31–40 year age group and there was a remarkable female predilection. Secondary AIHA was more common (56%) than primary. SLE was identified as the most common underlying disorder in secondary AIHA. Majority (46%) were Grade 4 DAT positive. Predominant autoantibody identified was IgG (52%). Of the total IgG positive cases, IgG1 was the predominant subclass. C3d alone was detected in 18% of cases and C3d and IgG together in 30%. About 48% of our patients were of warm type, 32% mixed type, and 20% cold type. About 80% of the study population were treated with steroids alone. A small percentage of cases (16%) needed immunosuppressant in addition to steroids and still a smaller percentage (4%) needed splenectomy. Higher grades of DAT positivity were associated with more severe degree of anemia and hyperbilirubinemia. The study also demonstrated a positive correlation between DAT grade and severity of hemolysis. Conclusion: AIHA patients in this study were predominantly of Warm AIHA with more of IgG1 involvement. A significant association is found between higher grades of DAT results and severity of anemia and jaundice in this study group. A positive correlation exists between grades of DCT and hemolysis as well.

BACKGROUNDABO incompatibility can cause neonatal jaundice and haemolytic disease of foetus and newborn (HDFN). The aim of this study is to describe the clinical profile of ABO HDFN in a tertiary care centre. Settings and Design-This was a descriptive study conducted in neonates suffering from ABO HDFN. Setting for the research was

BACKGROUND Haemolytic Disease of Fetus and Newborn (HDFN) is characterised by lysis of red blood cells resulting in anaemia and its hypoxic effects thereafter. Following anaemia, the production of fetal red blood cells is drastically increased. This is followed by extramedullary haematopoiesis in a widespread manner and erythroblastosis characterized by nucleated red cells in the circulation. Since this is an illness affecting many a newborn, assessing the patterns of anaemia in both ABO and Rh-D HDFN may help in effective planning and implementation of better management protocols. METHODS This is a cross sectional study with comparative analysis. The study was performed among 154 neonates who were diagnosed to have HDFN. Setting for this study was Department of Transfusion Medicine and Pediatrics of Government Medical College, Trivandrum. During the time of delivery, 5 mL umbilical cord blood was collected. That sample was used for analyzing haemoglobin levels of the neonate. Duration of treatment of the neonate was noted down during follow up. Statistical analysis was done using SPSS software version 16. RESULTS The mean cord blood haemoglobin value in ABO haemolytic disease was 17.1 ± 2.7 g %. The mean cord blood haemoglobin value in Rh-D haemolytic disease was 14.5 ± 1.9 g %. In infants with ABO haemolytic disease, 53 (48.2 %) had undergone no treatment in ICU. Remaining 51.8 % had undergone 3 - 10 days of treatment in neonatal ICU. Infants with Rh-D HDFN 20 (45.5 %), had undergone no treatment in ICU. Remaining 54.5 % has got 3 - 9 days of treatment in neonatal ICU. Mean treatment duration in infants with ABO haemolytic disease was 3.1 ± 3.3 days. Mean treatment duration in infants with Rh-D haemolytic disease was 2.9 ± 2.9 days. A comparison of mean values of cord blood haemoglobin in neonates with both categories of haemolytic disease was performed. The p value was 0.00 and it was significant. Mean values of duration of treatment of neonates with ABO and Rh-D haemolytic anaemias were compared statistically. No significant difference was observed. CONCLUSIONS Mean haemoglobin levels in Rh-D HDFN showed a significant decrease as compared to ABO-HDFN. Duration of treatment in ABO HDFN and Rh-D HDFN presented no significant difference. KEYWORDS Haemolytic Disease of Fetus and Newborn, Umbilical Cord Haemoglobin, Anaemia, ICU Stay, ABO HDFN, Rh-D HDFN

BACKGROUNDThe potency of anti-A and anti-B was determined by racial and environmental factors. With respect to ethnic groups, the prevalence and intensity of maternal-newborn ABO incompatibility varied in different populations. The aim of this study is to describe the immunological profile of ABO HDFN. Settings and Design-This was a descriptive study conducted in neonates with ABO HDFN. Research was conducted in Depts. of Transfusion Medicine and Neonatology division of Paediatrics in Govt. Medical College, Trivandrum. MATERIALS AND METHODSThose neonates who fulfilled the inclusion criteria were enrolled in this study. Demographic details, maternal details, bilirubin and haemoglobin levels were recorded. Investigations such as maternal blood grouping and antibody titration were done. In infant's blood sample direct antiglobulin test, blood grouping and elution was performed.Statistical Analysis-All statistical data were analysed using SPSS software version 16. RESULTSAmong mothers of infants with ABO HDFN 25 (22.7%) had a titre of 128, 34 (30.9%) had 256, 35 (31.8%) had 512 and 16 (14.6%) had 1024. Among 110 infants 34 (30.9%) were DAT positive, while the rest 76 (69.1%) were DAT negative. While DAT positive was graded 13 (11.8%) fell in grade 1, 16 (14.6%) in grade 2, 3 (2.7%) in grade 3 and 2 (1.8%) in grade 4 categories. Eluate from 59 (53.6%) of infants with ABO HDFN gave a positive result, while the rest 51 (46.4%) gave a negative result. Out of that 59 (53.6%) elution positive infants, 34 (30.9%) had a positive DAT and 25 (22.7%) had a negative DAT; 51 (46.4%) of infants were negative for both elution and DAT. CONCLUSIONMothers of infants with ABO HDFN had an antibody titre of 128 -1024. Almost one-third of infants were DAT positive and majority fell in grade 1 or 2. Eluate from half of infants gave a positive result.

BACKGROUNDAccumulating evidence suggests that Helicobacter pylori (H. Pylori) infection account for many unexplained cases of Iron Deficiency Anaemia (IDA), which may benefit from testing and treatment for H. pylori infection. This study attempts to evaluate the role of anti H. pylori treatment in management of iron deficiency anaemia among patients treated at a tertiary care centre in North India. MATERIALS AND METHODSThis was a prospective study which included 60 patients with IDA, proven positive for H. pylori by Rapid urease test and histopathological staining. They were divided into three groups (n= 20) and received different treatments, i.e. only anti-H. pylori therapy/ oral iron therapy plus anti-H. pylori therapy/ only oral iron therapy. Haemoglobin, RBC indices, Reti count, S. iron and S. ferritin were compared at the end of treatment with One-Way ANOVA.