Divya Setya | Medanta Medicity , Gurgaon, NCR (original) (raw)
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Papers by Divya Setya
PubMed, May 16, 2023
Background and aims: When determining ABO antibody titers, immunoglobulin G (IgG) antibodies can ... more Background and aims: When determining ABO antibody titers, immunoglobulin G (IgG) antibodies can be masked by immunoglobulin M (IgM) antibodies. Hence, the measurement of actual concentration of IgG requires methods like heat inactivation (HI) of plasma. This study was aimed at determining the effects of HI on IgM and IgG titers performed by conventional tube technique (CTT) and column agglutination technique (CAT). Materials and methods: This was a prospective, observational study conducted from October 2019 to March 2020. All consecutive A, B, and O group donors who gave consent for participation were included. All samples were consecutively tested by CTT and CAT, before and after HI (pCTT, pCAT). Results: A total of 300 donors were included. IgG titers were found to be more than IgM titers. For group O, IgG titer results were higher for both anti-A and anti-B compared to group A and B. For group A, B, and O, pretreatment results were higher than posttreatment IgG titer results. Median anti-A titers were similar to median anti-B titers across all categories. Median IgM and IgG titers were higher for group O individuals than nongroup O individuals. There was reduction in IgG and IgM titers after HI of plasma. One log reduction in median titers was observed when ABO titers were performed by CAT and CTT. Conclusion: There is one log difference between median antibody titers estimated using heat inactivated and nonheat inactivated plasma. The use of HI for ABO isoagglutinin titer estimation can be considered in low resource settings.
Transfusion and Apheresis Science, May 1, 2023
Global journal of transfusion medicine, 2023
Recent advances in anti-infective drug discovery, Apr 7, 2023
PubMed, May 16, 2023
Background: Therapeutic plasma exchange (TPE) has been advocated as an adjunct to steroids and cy... more Background: Therapeutic plasma exchange (TPE) has been advocated as an adjunct to steroids and cytotoxic drugs in treating patients suffering from vasculitis and presenting with active disease, but we still have insufficient evidence on its effectiveness in improving the clinical response, especially in India. This study was planned to study the clinical outcome in severe vasculitic presentations treated with TPE as an adjunctive therapy. Materials and methods: A retrospective analysis of TPE procedures performed from July 2013 to July 2017 in the department of transfusion medicine at a large tertiary care hospital was done. All consecutive patients admitted with new diagnosis of systemic vasculitis presenting with active disease and severe presentations such as advanced renal failure or severe respiratory abnormalities or life-threatening vasculitis affecting the gastrointestinal tract, neurological and musculoskeletal system; who needed TPE for removal of preformed antibodies, were included in the study. Results: There were a total of 31 patients in whom TPE was performed for severe systemic vasculitis; 26 adults and five pediatric. Six patients tested positive for perinuclear fluorescence, 13 for cytoplasmic fluorescence (cANCA), two for atypical antineutrophil cytoplasmic autoantibody, seven for anti-glomerular basement membrane antibodies, two for antinuclear antibodies (ANA), and one patient tested positive for ANA as well as cANCA before the augmentation of TPE. Out of 31, seven patients showed no clinical improvement and succumbed to the disease. At the end of desired number of procedures, 19 tested negative and five tested weak positive for their respective antibodies. Conclusion: Favorable clinical outcomes were observed with TPE in patients with antibody-positive systemic vasculitis.
Journal of Clinical Apheresis
Indian Journal of Transplantation
Indian Journal of Transplantation
Indian Journal of Transplantation
Transfusion Clinique et Biologique
Global Journal of Transfusion Medicine
Polish Journal of Surgery, Apr 30, 2022
Transfusion Clinique et Biologique
Transfusion Clinique et Biologique
Global Journal of Transfusion Medicine
Journal of Virological Methods, 2019
Indian Journal of Pathology and Microbiology
Several blood banks use grey zone (GZ) phenomenon (defined as samples with optical density within... more Several blood banks use grey zone (GZ) phenomenon (defined as samples with optical density within 10% below the cut off in enzyme immuno-assay [EIA]/chemiluminescence immunoassay [CLIA]) to further augment blood safety. There is paucity of data regarding usefulness of GZ sample and its application in Transfusion Transmissible Infection (TTI) screening procedures in blood transfusion services. We looked at our GZ sample results and their confirmatory test results to verify if it adds to blood safety in our set-up? We performed a prospective analytical study on blood donors' samples over two years. All the donors' samples were screened for TTI using CLIA. Samples with signal/cut-off ratio between ≥0.90 and <1.00 were classified under GZ. They were re-tested in duplicate and submitted to confirmatory testing: Neutralization Test for HBsAg, Immunoblot for HCV, and Western blot for HIV. Among the 50,064 blood donors donating the blood during study period, 573 (1.14%) donors were reactive for HBsAg, HCV, and HIV. Forty-seven (0.1%) TTI samples were GZ, but none was “confirmed positive.” The utility of GZ testing seems to be limited. However, this may be continued for sake of “erring on the side of caution” and since this only results in negligible wastage (0.1%) of blood units.
Indian Journal of Hematology and Blood Transfusion
ISBT Science Series, 2021
PubMed, May 16, 2023
Background and aims: When determining ABO antibody titers, immunoglobulin G (IgG) antibodies can ... more Background and aims: When determining ABO antibody titers, immunoglobulin G (IgG) antibodies can be masked by immunoglobulin M (IgM) antibodies. Hence, the measurement of actual concentration of IgG requires methods like heat inactivation (HI) of plasma. This study was aimed at determining the effects of HI on IgM and IgG titers performed by conventional tube technique (CTT) and column agglutination technique (CAT). Materials and methods: This was a prospective, observational study conducted from October 2019 to March 2020. All consecutive A, B, and O group donors who gave consent for participation were included. All samples were consecutively tested by CTT and CAT, before and after HI (pCTT, pCAT). Results: A total of 300 donors were included. IgG titers were found to be more than IgM titers. For group O, IgG titer results were higher for both anti-A and anti-B compared to group A and B. For group A, B, and O, pretreatment results were higher than posttreatment IgG titer results. Median anti-A titers were similar to median anti-B titers across all categories. Median IgM and IgG titers were higher for group O individuals than nongroup O individuals. There was reduction in IgG and IgM titers after HI of plasma. One log reduction in median titers was observed when ABO titers were performed by CAT and CTT. Conclusion: There is one log difference between median antibody titers estimated using heat inactivated and nonheat inactivated plasma. The use of HI for ABO isoagglutinin titer estimation can be considered in low resource settings.
Transfusion and Apheresis Science, May 1, 2023
Global journal of transfusion medicine, 2023
Recent advances in anti-infective drug discovery, Apr 7, 2023
PubMed, May 16, 2023
Background: Therapeutic plasma exchange (TPE) has been advocated as an adjunct to steroids and cy... more Background: Therapeutic plasma exchange (TPE) has been advocated as an adjunct to steroids and cytotoxic drugs in treating patients suffering from vasculitis and presenting with active disease, but we still have insufficient evidence on its effectiveness in improving the clinical response, especially in India. This study was planned to study the clinical outcome in severe vasculitic presentations treated with TPE as an adjunctive therapy. Materials and methods: A retrospective analysis of TPE procedures performed from July 2013 to July 2017 in the department of transfusion medicine at a large tertiary care hospital was done. All consecutive patients admitted with new diagnosis of systemic vasculitis presenting with active disease and severe presentations such as advanced renal failure or severe respiratory abnormalities or life-threatening vasculitis affecting the gastrointestinal tract, neurological and musculoskeletal system; who needed TPE for removal of preformed antibodies, were included in the study. Results: There were a total of 31 patients in whom TPE was performed for severe systemic vasculitis; 26 adults and five pediatric. Six patients tested positive for perinuclear fluorescence, 13 for cytoplasmic fluorescence (cANCA), two for atypical antineutrophil cytoplasmic autoantibody, seven for anti-glomerular basement membrane antibodies, two for antinuclear antibodies (ANA), and one patient tested positive for ANA as well as cANCA before the augmentation of TPE. Out of 31, seven patients showed no clinical improvement and succumbed to the disease. At the end of desired number of procedures, 19 tested negative and five tested weak positive for their respective antibodies. Conclusion: Favorable clinical outcomes were observed with TPE in patients with antibody-positive systemic vasculitis.
Journal of Clinical Apheresis
Indian Journal of Transplantation
Indian Journal of Transplantation
Indian Journal of Transplantation
Transfusion Clinique et Biologique
Global Journal of Transfusion Medicine
Polish Journal of Surgery, Apr 30, 2022
Transfusion Clinique et Biologique
Transfusion Clinique et Biologique
Global Journal of Transfusion Medicine
Journal of Virological Methods, 2019
Indian Journal of Pathology and Microbiology
Several blood banks use grey zone (GZ) phenomenon (defined as samples with optical density within... more Several blood banks use grey zone (GZ) phenomenon (defined as samples with optical density within 10% below the cut off in enzyme immuno-assay [EIA]/chemiluminescence immunoassay [CLIA]) to further augment blood safety. There is paucity of data regarding usefulness of GZ sample and its application in Transfusion Transmissible Infection (TTI) screening procedures in blood transfusion services. We looked at our GZ sample results and their confirmatory test results to verify if it adds to blood safety in our set-up? We performed a prospective analytical study on blood donors' samples over two years. All the donors' samples were screened for TTI using CLIA. Samples with signal/cut-off ratio between ≥0.90 and <1.00 were classified under GZ. They were re-tested in duplicate and submitted to confirmatory testing: Neutralization Test for HBsAg, Immunoblot for HCV, and Western blot for HIV. Among the 50,064 blood donors donating the blood during study period, 573 (1.14%) donors were reactive for HBsAg, HCV, and HIV. Forty-seven (0.1%) TTI samples were GZ, but none was “confirmed positive.” The utility of GZ testing seems to be limited. However, this may be continued for sake of “erring on the side of caution” and since this only results in negligible wastage (0.1%) of blood units.
Indian Journal of Hematology and Blood Transfusion
ISBT Science Series, 2021