Introduction The distribution of ABO and Rh (D) blood groups and their allele frequencies vary from one population to another worldwide. The objective of the study is to estimate the distribution of ABO & Rh (D) blood groups among all the blood donors in a tertiary care hospital in Chengalpattu district of Tamilnadu in South India and to determine their allele frequencies. Methods This was a retrospective observational study carried out in the blood bank of Karpaga Vinayaga Institute of Medical Sciences and Research Centre from January 2015 to December 2021. ABO and Rh (D) blood grouping of all the blood donors were carried out by tube agglutination method. Allele frequency of the blood group genes was calculated based on Hardy-Weinberg equilibrium. Results Out of total a of 7598 blood donors, 7576 (99.71%) were males and 22 (0.29%) were females. The most common blood group was O positive (37.67%) while AB negative (0.18%) was the least common blood group. The phenotypic frequency of blood group O (39.17%) was the highest and that of blood group AB (7.88%) was the least. A majority (95.96%) of the blood donors were Rh (D) positive. The allele frequencies of ABO and Rh (D) blood groups were 0.1628 for I A , 0.2177 for I B , 0.6259 for I O , 0.7991 for I D, and 0.2009 for I d . Conclusions The distribution of the two major blood group systems namely ABO and Rh (D) systems show considerable heterogeneity in different populations of the world. Information about allele frequencies of blood groups among different populations worldwide will help in framing policy decisions to face future challenges in healthcare services.

Aim The objective of this study was to compare the efficacy of immunoadsorption (IA) with conventional therapeutic plasma-exchange (cTPE) in ABO-incompatible (ABOi) renal transplant. Methods Data of patients from July 2015 to June 2017 (category-I, number of patients (N) = 11; IA±cTPE) on the average length of stay (ALOS), number of cTPE/IA, antibody-titers (AT), creatinine, patient and graft survival at one year were compared retrospectively with patients in period from February 2012 to June 2015 (category-II, N = 29; cTPE only). AT of patients not decreasing to less than one fold after two cTPE were shifted for IA. For patients undergoing IA, real-time AT was done and IA stopped after target titer (TT <1:8) was achieved. Post-transplant cTPE was done if, titers rebounded to ≥1:8. Intravenous immunoglobulin (IVIG) was given after every cTPE/IA. Cost comparisons were made. Results In category-I, seven patients (63.63%) were shifted to IA from cTPE. The mean cTPE procedures in category I and II are 3.5 ± 2.4 and 4.8 ± 2.5, respectively ( p = 0.206). The mean IA procedures in category-I are 1.6 ± 0.5. The number of patients requiring post-operative TPE was less in category-I than category-II, i.e., N = 5, 45.5% vs N = 20, 69%, respectively ( p = 0.171). The expense of IA in category-I vs cTPE in category-II was statistically not significant ( p = 0.422) but had significant lesser ALOS ( p = 0.044). Expenses, when a patient undergoes both cTPE and IA (category-I), are significantly higher to category-II ( p = 0.003). The two groups were comparable in AT, creatinine value, graft and patient survival rates at one year. Conclusion Contrary to the general judgment of IA being expensive than cTPE, this study shows equivalent expenditures with comparable therapeutic outcomes.

Neurological syndromes associated with voltage-gated potassium channels (VGKC) affect the nerve and muscle physiology. Presence of antibodies to VGKC are associated with three main neurologic syndromes namely neuromyotonia (NMT), limbic encephalitis (LE) and Morvan's syndrome(MVS) LE is a variably treatable neurologic syndrome associated with high levels of antibodies to the voltage-gated potassium channel (VGKC) complex. These antibodies are directed against protein antigens that bind to the VGKC complex. These antigens are usually leucine-rich, glioma inactivated 1 (LGI1), and contactin associated protein-like 2 (CASPR2). Case description: A 58-year-old female and with a known case of auto immune encephalitis (voltage gated potassium channel) and steroid induced diabetes mellitus presented with progressive worsening of vertigo, recurrent myoclonic jerks and post ictal confusion for last 7 days. She had memory impairment since last few months. She was on treatment with steroids which were gradually tapered off 11 months back. CSF was tested for presence of VGKC antibodies and the test was positive for LGI (leucine-rich glioma inactivated 1) antibody. Therapeutic plasma exchange (TPE) was scheduled every day for 6 consecutive days based upon the recommendations from the ASFA guidelines for the treatment of neurologic syndromes. Conclusion: TPE done every day in patient diagnosed LE with VGKC antibodies had shown rapid improvement in controlling the symptoms.