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Alkhateb R, Prajapati V, Daniels J, Greebon L. RhD negative women transfused RhD positive blood: Alloimmunization prophylaxis protocol and experiences. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
Preventing allomiunization from D-mismatched transfusions, i.e., transfusion RhD positive (RhD+) red blood cells (RBC) to an RhD negative (RhD–) individual, is not well established. We describe our hospital protocol and experiences managing RhD– young women who received emergency release D-mismatched transfusions.
Methods/Case Report
The pathologists evaluate all patients who received D-mismatched blood transfusions. The inclusion criteria for alloimmunization prophylaxis protocol include: RhD– females; <50 years old; No current or historical Anti-D; and received ≥1 unit of RhD+ blood.
The prophylaxis protocol depends on the RBC volume (RBCV) transfused. Patients who receive RBCV <20% of their total blood volume (TBV) are eligible to receive high dose RhIg, calculated based on the volume transfused. Those who received RBCV ≥20% of TBV would be eligible for red cell exchange (RBCX) followed by RhIg.
Results (if a Case Study enter NA)
Since 2016, four eligible patients received RhIg prophylaxis protocol and none met the criteria for RBCX. All the patients started the prophylaxis protocol within 24 hours of transfusion and completed it within 72 hours. One patient developed post treatment hemolysis and significant drop in hemoglobin requiring blood transfusion. Passive anti-D post treatment was confirmed in three patients, and one had passive anti C. Three of the four patients had follow up antibody screens >6 months post treatment that were negative for RhD alloimmunization.
Conclusion
Our therapeutic plan, the first well established protocol, involves identifying eligible patients based on set criteria and protocols. Our experience demonstrates that this protocol is effective in reducing/preventing RhD alloimmunization.
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Affiliation(s)
- R Alkhateb
- Pathology, University of Texas San Antonio, San Antonio, Texas, UNITED STATES
| | - V Prajapati
- Pathology, University of Texas San Antonio, San Antonio, Texas, UNITED STATES
| | - J Daniels
- Pathology, University of Texas San Antonio, San Antonio, Texas, UNITED STATES
| | - L Greebon
- Pathology, University of Texas San Antonio, San Antonio, Texas, UNITED STATES
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Jalota L, Allison DR, Prajapati V, Vempilly JJ, Jain VV. Ability of Exhaled Nitric Oxide to Discriminate for Airflow Obstruction Among Frequent Exacerbators of Clinically Diagnosed Asthma. Lung 2018; 196:455-462. [PMID: 29916097 DOI: 10.1007/s00408-018-0132-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/11/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Fraction of exhaled nitric oxide (FENO) has been proposed as a non-invasive biomarker for allergic inflammation seen in asthma. Many asthmatics in clinical practice have never had spirometry and recent data report misdiagnoses in patients with physician diagnosed (PD) asthma. The aim of this study was to assess the ability of FENO to discriminate between those with and without airflow obstruction (AO) among patients with PD-asthma. METHODS Frequent exacerbators of PD-asthma (with 2 or more asthma exacerbations leading to emergency room visit or hospitalization within last 12 months) were enrolled. All patients underwent diagnostic evaluations including spirometry, FENO testing and serum immunoglobulin (IgE) and eosinophils. Serial spirometry and methacholine challenge testing (MCT) were performed as indicated. AO was defined by a decreased FEV1/FVC ratio (< 70% and/or < LLN), or a positive MCT. RESULTS Of the 222 patients with PD-asthma, AO was found in 136 (vs. 86 without AO). 81.6% of patients with AO and 66.2% without AO completed FENO testing. There was no significant difference in the mean FENO levels among patients with or without AO (40.8 vs. 30.4 ppb, P = 0.10). Likewise, there was no difference in the serum IgE levels and serum eosinophils. CONCLUSIONS Our analyses suggest that FENO levels do not help discriminate between those with and without AO in patients with PD-asthma. Patients who experience symptoms of asthma may have elevated FENO levels above the suggested cut points of 20-25 ppb. Objective confirmation of AO should be considered in all patients with PD-asthma, irrespective of FENO levels.
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Affiliation(s)
- Leena Jalota
- Division of Pulmonary and Critical Care, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
- Department of Internal Medicine, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
| | - D Richard Allison
- Division of Pulmonary and Critical Care, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
- Department of Internal Medicine, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
- Community Regional Medical Center, Fresno, CA, USA
| | - Vinisha Prajapati
- Division of Pulmonary and Critical Care, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
- Department of Internal Medicine, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
| | - Jose J Vempilly
- Division of Pulmonary and Critical Care, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
- Department of Internal Medicine, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA
| | - Vipul V Jain
- Division of Pulmonary and Critical Care, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA.
- Department of Internal Medicine, University of California, San Francisco-Fresno, 155 N Fresno St, Fresno, CA, 93701, USA.
- Community Regional Medical Center, Fresno, CA, USA.
- Chronic Lung Disease Program, University of California, San Francisco, Fresno, 2823, Fresno St, Suite A, Fresno, CA, 93721, USA.
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Prajapati V, Mazurek A, Haws J, Joseph K, McKinnon JG. A retrospective analysis of Merkel cell carcinoma in Alberta from 1980 to 2006. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Prajapati V, Mydlarski PR. Advances in pemphigus therapy. Skin Therapy Lett 2008; 13:4-7. [PMID: 18506357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The pemphigus variants represent a group of potentially life-threatening autoimmune mucocutaneous blistering diseases. Though systemic corticosteroids have dramatically reduced the rate of disease mortality, current therapeutic options are limited by their toxicity profiles. Advancements in our understanding of the molecular mechanisms involved in the pathogenesis of pemphigus have translated into the development of novel therapies. However, few treatments have been subject to randomized controlled trials to firmly establish therapeutic efficacy. Herein, we focus on the new and emerging therapies in the management of pemphigus.
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Affiliation(s)
- V Prajapati
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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Prajapati V, Mydlarski PR. Rituximab: a B-cell depletion therapy for dermatologic disease. Skin Therapy Lett 2007; 12:6-9. [PMID: 17762903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Rituximab (Rituxan, Genentech/ Biogen Idec) is a genetically engineered chimeric murine/human monoclonal antibody directed against CD20, a B lymphocyte-specific antigen. Initially approved for the treatment of relapsed or refractory low-grade or follicular non-Hodgkin's lymphoma (NHL), rituximab has been increasingly used to treat a variety of immune-mediated and autoimmune diseases. While anecdotal case reports recommend its "off-label" use in dermatology, randomized clinical trials are required to firmly establish the safety and efficacy of this emerging biologic therapy.
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Affiliation(s)
- V Prajapati
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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Bond A, Fleming A, Kelleher F, McGinley J, Prajapati V. Corrigendum to “Reactions of 1,4-bis(tetrazole)benzenes: formation of long chain alkyl halides”. Tetrahedron 2007. [DOI: 10.1016/j.tet.2006.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fleming A, Kelleher F, Mahon M, McGinley J, Prajapati V. Corrigendum to “Reactions of bis(tetrazole)phenylenes. Surprising formation of vinyl compounds from alkyl halides”. Tetrahedron 2006. [DOI: 10.1016/j.tet.2006.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Tripathi AK, Prajapati V, Verma N, Bahl JR, Bansal RP, Khanuja SPS, Kumar S. Bioactivities of the leaf essential oil of Curcuma longa (var. ch-66) on three species of stored-product beetles (Coleoptera). J Econ Entomol 2002; 95:183-189. [PMID: 11942755 DOI: 10.1603/0022-0493-95.1.183] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Essential oil extracted from the leaves of turmeric, Curcuma longa L., was investigated for contact and fumigant toxicity and its effect on progeny production in three stored-product beetles, Rhyzopertha dominica F. (lesser grain borer), Sitophilus oryzae L. (rice weevil), and Tribolium castaneum Herbst (red flour beetle). Oviposition-deterrent and ovicidal actions of C. longa leaf oil were also evaluated against T. castaneum. The oil was insecticidal in both contact and fumigant toxicity assays. The adults of R. dominica were highly susceptible to contact action of C. longa leaf oil, with LD50 value of 36.71 microg/mg weight of insect, whereas in the fumigant assay, adults of S. oryzae were highly susceptible with LC50 value of 11.36 mg/liter air. Further, in T. castaneum, the C. longa oil reduced oviposition and egg hatching by 72 and 80%, respectively at the concentration of 5.2 mg/cm2. At the concentration of 40.5 mg/g food, the oil totally suppressed progeny production of all the three test insects. Nutritional indices indicate >81% antifeedant action of the oil against R. dominica, S. oryzae and T castaneum at the highest concentration tested.
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Affiliation(s)
- A K Tripathi
- Central Institute of Medicinal and Aromatic Plants, Lucknow, India
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Tripathi AK, Prajapati V, Aggarwal KK, Kumar S. Toxicity, feeding deterrence, and effect of activity of 1,8-cineole from Artemisia annua on progeny production of Tribolium castanaeum (Coleoptera: Tenebrionidae). J Econ Entomol 2001; 94:979-83. [PMID: 11561861 DOI: 10.1603/0022-0493-94.4.979] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
1,8-Cineole isolated from Artemisia annua was tested against Tribolium castaneum (Herbst) for contact toxicity, fumigant toxicity, and antifeedant activity. The adults of T. castaneum were more susceptible than larvae to both contact and fumigant toxicity of 1,8-cineole, and LD50 and LC50 values of 108.4 microg/mg body weight of adult insect and 1.52 mg/liter air were found, respectively. Furthermore, 14-d-old T. castaneum larvae were more tolerant than 16- and 18-d-old larvae and adults to the contact toxicity of 1,8-cineole, but the 16- and 18-d-old larvae have similar susceptibility. In contrast, all the larvae (14-18 d old) of T. castaneum were much more tolerant than the adults to the fumigant action, but larvae of different ages had similar susceptibility. The compound 1,8-ciineole applied to filter paper at a concentration of 3.22-16.10 mg/cm2 significantly (P < 0.05) reduced the hatching of T. castaneum eggs and the subsequent survival rate of the larvae. Adult emergence was also reduced by 1,8-cineole. Feeding deterrence of 81.9% was achieved in T. castateum adults by using a concentration of 121.9 mg/g food, whereas larvae showed 68.8% at the same concentration.
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Affiliation(s)
- A K Tripathi
- Genetic Resources and Biotechnology Division, Central Institute of Medicinal and Aromatic Plants, Lucknow, India
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Abstract
Sesamin, a major lignan of Piper mullesua of Manipur origin, exhibited significant antifeedant activity and moderate growth inhibition towards 4th instar larvae of Spilarctia obliqua. No larval toxicity of sesamin could be established in topical bioassay experiments. Its effective dose for 50% feeding deterrence (ED(50)) and growth inhibition (GI(50)) were found to be 3856 and 6212 ppm, respectively.
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Affiliation(s)
- S Srivastava
- Central Institute of Medicinal and Aromatic Plants, P.O. CIMAP, Lucknow - 226015, India
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Tripathi AK, Prajapati V, Aggarwal KK, Khanuja SP, Kumar S. Repellency and toxicity of oil from Artemisia annua to certain stored-product beetles. J Econ Entomol 2000; 93:43-7. [PMID: 14658510 DOI: 10.1603/0022-0493-93.1.43] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The essential oil of Artemisia annua L. was tested for its toxic repellent and development inhibitory activities against 2 economically important stored product insects: Tribolium castaneum (Herbst) and Callosobruchus maculatus (L.). Adult beetles of T. castaneum were repelled significantly by oil of A. annua at 1% concentration (vol:vol) and above in filter paper arena test. Dose-response relationship of A. annua oil revealed a significant negative correlation between larval survival; pupal survival and adult emergence of T. castaneum (i.e., increase in dose caused decrease in survival and adult emergence). Effective concentration (EC50) to reduce F1 progeny by 50% was calculated to be 2.6 and 4.1 microl/ml solvent against both the insect species, C. maculatus and T. castaneum, respectively. The relationship between bioactivity of oil from A. annua and responses of T. castaneum and C. maculatus is discussed. We found that oil from A. annua was largely responsible for both repellent (behavioral) and toxic (physiological) actions on 2 species of insect tested.
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Affiliation(s)
- A K Tripathi
- Central Institute of Medicinal and Aromatic Plants, P.O. CIMAP, Lucknow 226015, India
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Shukla YN, Srivastava R, Tripathi AK, Prajapati V. Characterization of an ursane triterpenoid from centella asiatica with growth inhibitory activity against spilarctia obliqua. Pharm Biol 2000; 38:262-267. [PMID: 21214472 DOI: 10.1076/1388-0209(200009)3841-aft262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A new triterpenoid glycoside 3-O-[a-L-arabinopyranosyl] 2 a, 3 ß , 6 ß , 23-a tetrahydroxyurs-12-ene-28-oic acid ( 1 ) accompanied by 6ß-hydroxyasiatic acid and asiatic acid were isolated from Centella asiatica . The structure of 1 was established by physicochemical data. Compound 1 exhibited dose-dependent growth inhibitory activity against larvae of Spilarctia obliqua but was not as active as azadirachtin.
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