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Vasovagal syncope (VVS) in donors is a transient loss of consciousness due to short-term global cerebral hypoperfusion, which has a rapid onset and has complete spontaneous recovery. VVS may be triggered by pain, fear, anxiety, or emotional upset and loss of blood perse. It is an exaggeration of an adaptive response meant to assist in reducing the amount of bleeding/loss of blood. The four major components necessary for rapid cardiovascular adjustments to supine or upright posture, otherwise called orthostasis, are the autonomic nervous system, adequate blood volume, and intact skeletal and respiratory muscle pumps. The taxing of these autoregulatory mechanisms and their inability to compensate sufficiently results in VVS. VVR episodes can be described in 3 phases; Presyncope, Syncope, and Postsyncope. The actual syncope generally lasts for <15 s, comprising staring, muscle jerks, eye deviation/rolling, sometimes incontinence, loss of consciousness, gasping, snoring, apnea, inability to move/react, etc., The postsyncopal phase is the longest, which is generally manifested as fatigue. [ABSTRACT FROM AUTHOR]

A novel concept is described concerning the possible effect of right ventricular pacing stimulation being detected by the cardiac autonomic nervous system and through its afferent neuronal connection to the central autonomic nervous system (spinal cord) causing reversal or attenuation of the vasovagal reflex. This could be a direct effect of electrical stimulation or may occur by the known adverse consequences on ventricular synchrony induced by stimulation which could be right ventricular site and timing in the evolution of the vasovagal reflex dependent. [ABSTRACT FROM AUTHOR]

BACKGROUND: Vasovagal reactions to blood donation though generally mild and account for about 1% of donations, causes embarrassment/injury to the donors, lower likely return rates for future donations etc. The workforce hours devoted to attending to those who reacted can also affect the efficiency of the blood centre. There are various factors, both modifiable and nonmodifiable, involved in the causation of such reactions. OBJECTIVES: This study sought to identify the factors associated with vasovagal donor reactions in a case–control study. MATERIALS AND METHODS: This was a descriptive comparative study between donors who had VVRs (cases) and those who did not (controls) during or after blood donation from a single center in southern India. All the biophysical and demographic variables were collected from the donor records. In addition, a questionnaire was administered to the donors after donation within half an hour, addressing the psychosocial variables. All the data were captured in Microsoft Excel and analyzed using SPSS for Windows version 20. RESULTS: A total of 178 donors who had donor reactions were included in the study with an equal number of controls who were age and sex-matched. Donors who had VVRs had an odds of 4.1 (95% confidence interval [CI]: 2.4–7.7) of admitted anxiety for blood donation. They also had an odds of 4.4 (95% CI: 2.8–6.9) of disturbed sleep the night before blood donation. Having an accompanying person to the blood center was detrimental, with an odds of 0.32 (95% CI: 0.2–0.6). Donors with local complications such as hematoma, double prick, or delayed collection had an odds of 21.2 (95% CI: 1.8–159.8) of developing VVR. CONCLUSION: The psychosocial factors such as fear of the needle, the sight of the blood, state of mind, and quality and duration of sleep seem to have an association, adversely impacting the donors resulting in VVRs after/during blood donation. [ABSTRACT FROM AUTHOR]

Background: Plateletpheresis procedures are generally safe and associated with low adverse reactions. Although donor reactions and injuries are self-limited events, they may discourage donors from future platelet donations. Aim: The purpose of this study was to determine the prevalence and predictors of adverse donor reactions in plateletpheresis donors, which could serve as targets for interventions to reduce reactions. Materials and Methods: The study included 106 platelet donors over a period of 2 years. The demographic, biometric, and clinical parameters were noted. The data were analyzed for predictors of adverse donor reactions. Statistical Analysis Used: The data were analyzed using independent sample t-test to correlate donor variables such as gender. To correlate other variables such as age, weight, and whole blood processed, Chi-square test was used. Results: A total of 106 plateletpheresis donations were performed and 13.2% of vasovagal reactions were observed. The significant predictive factors for reactions were young female donors with low body weight in which more than 2.5 L volume of whole blood was processed and more than 250 ml of acid, citrate, and dextrose-A was infused and with single venous access procedures. Conclusions: The results of this study are encouraging and helpful in identifying donors at risk for developing adverse reactions during plateletpheresis so that proper and close observation during and after donation as well as timely intervention can prevent most of the unpleasant events of plateletpheresis donors. [ABSTRACT FROM AUTHOR]

Context: Whole blood donation is generally considered a safe procedure; however, a small percentage of donors could develop vasovagal reactions (VVRs) during or after completion of blood donation. Aims: This study was undertaken to establish the prevalence of VVR among whole blood donors in Hospital Pulau Pinang and to investigate factors that lead to its occurrence. Settings and Design: A cross-sectional study was conducted involving 27,890 whole blood donations in 2016. Subjects and Methods: For each donation, donor's demographic and blood donation-related information was extracted from the blood bank database. Statistical Analysis Used: Qualitative data including age group, sex, race, frequency, and location of donation were analyzed using Chi-square tests, while blood pressure was analyzed using t-test. Results: Overall, 425 cases of VVRs were reported, resulting in a VVR rate of 1.5% (one event in every 65 donations). We found a statistically significant association (P < 0.05) between the occurrence of VVRs with the young age group, female gender, Indian race, first-time donor, lower predonation blood pressure, and donation performed in a mobile donation campaign. The most common vasovagal symptoms are lightheadedness (88%), followed by nausea (5.4%), muscle twitching (3.5%), vomiting (1.4%), loss of consciousness <30 s (1.4%), and paresthesia (0.2%). Conclusions: The prevalence of VVRs among whole blood donors in Hospital Pulau Pinang appeared to be low. Our study reaffirms that blood donation is a relatively safe process, and the incidence of VVR can be further reduced by ensuring strict screening procedure before blood donation. [ABSTRACT FROM AUTHOR]

Adverse events of variable severity may occur occasionally following whole blood donation. We are reporting a case of severe donor reaction leading to grievous injury. A first-time male voluntary blood donor donated blood in our blood donation camp. The donation was uneventful, and he left the premise after 20 min of postdonation observation and advice. Several minutes later, he fell on the road and injured himself complicated with severe delayed vaso-vagal reaction. The donor had lacerated wound over the chin, fracture neck of the left mandible, fracture left lower incisor and left lower molar tooth. Appropriate medical care was catered to the donor with full medical support from Department of Transfusion Medicine and was fully recovered from the injury. Blood collection team must take up the responsibility of the management of all complications related to blood donation. [ABSTRACT FROM AUTHOR]

Context: Vasovagal reactions (VVRs) in blood donors. Aim: To find an association of age, sex, donation status, weight, total blood volume and volume of blood collected with occurrence of immediate VVR. Settings and Design: Retrospective single-centre study. Materials and Methods: The study was conducted from March 2000 to November 2010 at a tertiary care blood transfusion centre. All VVRs with or without syncope occurring during or at the end of donation were noted. Statistical Analysis Used: For qualitative association, c2-test was used. Unpaired 't' test was used for assessing difference between two groups with respect to VVR status. Simultaneous impact of all risk factors was assessed using multivariate logistic regression analysis. The data entry software SPSS (version 17.0) was used for statistical analysis. A P-value <0.05 was considered statistically significant. Results: Overall 1085 VVRs were reported in relation to 88,201 donations, resulting in an overall VVR rate of 1.23%, that is, an incidence of 1 in every 81 donations. Donors with low blood volume, first-time donors, with low weight and female donors had higher absolute donation VVR rates than other donors. Conclusions: Donation-related vasovagal syncopal reactions are a multifactorial process determined largely by weight, age, first-time donor status and total blood volume. Our study reinforces the fact that blood donation is a very safe procedure, which could be made even more event-free by following certain friendly, reassuring practices and by ensuring strict pre-donation screening procedures. [ABSTRACT FROM AUTHOR]

Background: Lack of awareness and community motivation, compounded with fragmented blood transfusion services in our country, Often leads to shortage of blood. Donor recruitment and retention are essential for ensuring adequate blood supply. However, adverse events (AEs) in donors have a negative impact on donor return. Aims and Objectives: The present study was aimed to assess the frequency of AEs in whole blood donors and analyze the predisposing factors for AEs. Material and Methods: The study was conducted on allogeneic whole blood donors over a period of 14 months, i.e., from January 2002 to February 2003. A total of 37,896 donors were monitored for any AEs: 22587 (59.6%) were voluntary donors (VD) and 15,309 (40.4%) were replacement donors (RD). Results: Overall reaction rate was 2.5% with vasovagal reactions constituting 63.5% and hematomas 35.0% of all reactions. Vasovagal reactions showed a significant association with young age, lower weight, first time donation status, female gender, and nature of blood donation camps. Amongst male donors, RDs had more reactions (P=0.03) than VDs. Majority of donors (85%) with vasovagal reactions admitted to some fear or anxiety prior to donation. Hematoma formation occurred significantly more when less trained staff performed phlebotomy. Conclusion: Donor safety is an essential prerequisite to increase voluntary blood donation. AE analysis helps in identifying the blood donors at risk of donor reactions and adopting appropriate donor motivational strategies, pre-donation counseling, and care during and after donation. [ABSTRACT FROM AUTHOR]

We present the electroencephalographic and electrocardiographic tracing obtained in an 8-year old boy who experienced malignant vasovagal syncope during the recording. This tracing illustrates the highly specific "slow-flat-slow" sequence described in cases of syncope induced by severe cerebral hypoperfusion. [ABSTRACT FROM AUTHOR]

The article present case study of a 68‑year‑old male presented to the hospital with a 4‑day history of right‑sided otalgia and upper respiratory tract infection. Right facial paralysis started after 2 days accompanied by hoarseness, slight choking, hearing loss and tinnitus on the right side after 4 days. Vesicular eruptions manifested itself in the right ear auricle, behind the ear and on the face on the second day of admission.

Guillain–Barre syndrome (GBS) is the most common cause of acute flaccid paralysis worldwide both in adult and pediatric population. Although flaccid paralysis is the hallmark of this disease, there are some rare variants which may be easily missed unless suspected. Here, we present a very rare variant of GBS ‑ acute bulbar palsy plus syndrome in a pediatric patient. A 13‑year‑old female child presented with right‑sided lower motor neuron type of facial palsy and palsy of bilateral glossopharyngeal and vagus nerve of 2 weeks duration. On detailed neurological examination, motor and sensory system were normal, but the deep tendon reflexes were absent universally. Nerve conduction study showed demyelinating motor neuropathy. Based on typical clinical course and electrophysiological studies, the diagnosis was made. To the best of our knowledge, this is the first pediatric case of unilateral facial palsy with bulbar involvement without any motor abnormality. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 19-year-old male blood donor who experienced delayed vasovagal reaction loss of consciousness, followed by fall, after blood donation.