The Scientific Journal of Iranian Blood Transfusion
Year:2017 | Volume:13 | Issue:4|Papers Count:12

Background and Objectives: Patients with thalassemia are one of the at risk groups for acquiring Hepatitis C virus (HCV) infection. They need to be transfused regularly. High prevalence of this virus in thalassemia population, complications of HCV infection and the important effect of HCV genotype determination in treatment of the virus were the reasons for performing this research. The aims of the present study were to detect thalassemia patients with chronic infection and determinate the HCV subtypes distribution in this group.Materials and Methods: The study was concluded on 120 specimens for HCV antibody from thalassemia patients in Tehran and Amol cites. After sequencing of PCR products, determination of HCV subtypes was performed by construction of phylogenic trees.X2, t, Fisher exact test and SPSS 22 have been used for data analysis.Results: The results showed that 67 (55.8%) of the 120 specimens were positive for HCV RNA, 34 (28.3%) from Tehran and 33 (27.5%) from Amol.65 specimens could be genotyped. Subtype 1a accounted for 53.8% (n=35), 3a for 30.7% (n=20), 1b for 13.8% (n=9) and 4a for 1.7% (n=1) of infected cases.Conclusions: Implementation of effective strategies for detection of thalassemia patients, with HCV chronic infection in thalassemia centers is necessary. The predominance of genotype 1 among thalassemia patients is important in treatment of these patients because genotype 1 indicates lower rate of sustained viral response to current therapy (Interferon and Ribavirin) compare to HCV genotype 2 and 3.

Background and Objectives: Blood consumption and request are the major challenge in the patient blood management program in hospitals at the present time. Blood request and consumption data for each part are important to estimate the amount of transfusion and blood ordering. In this study, transfusion and cross-matching status were evaluated in different wards of the two biggest hospitals in northwest of Iran.Materials and Methods: In the present descriptive, retrospective study, the data of cross matching and blood transfusion were collected from hospitals of Tabriz, and the C/T ratio was calculated. Data were analyzed using descriptive statistics using SPSS software version 18.Results: Of the 36210 blood units cross-matched, 19329 units had been transfused and about 46.6% were left unused. In total the C/T ratio was 1.9. The C/T ratio was the highest in the maxillofacial ward (10.4) and the lowest in ICU (1.3).Conclusions: The C/T ratio is above compared with MSBOS tables in the world. Blood ordering is more than required; therefore, it is suggested that the policy be reassessed for hospital blood ordering and the patient blood management programs be implemented to reduce the transfusion ratio.

Background and Objectives Religious beliefs are one of the positive motivations for blood donation. The present study aimed to compare blood donation on religious days and normal days with respect to donor pattern and safety of donors.Materials and Methods This retrospective, cross-sectional study was conducted on individuals who referred to the main centres and portable teams of Shiraz Blood Transfusion Centre, Iran for donation on two days Tasua and Ashura days and three days 19th, 21st, and 23rd of Ramadan (2009-2013) and on similar dates one month before these religious days.Afterwards, the donors’ characteristics (age, sex, marital status, and donation status), donor deferral rate, and the prevalence rates of hepatitis B, Hepatitis C, and HIV in blood donors were compared among them. The comparisons were made through proportion tests using Med Calc software (v.8.0).Results The results revealed significant increase in the number of blood donors on Tasua and Ashra days (1.4fold). Most of the donors who referred on the religious days were male (p<0.001).No significant difference was observed regarding marital status and donation status. The prevalence rates of hepatitis B and hepatitis C were lower in the blood donors who referred on religious days and compared to those referring on similar dates (p<0.001).Conclusions Higher numbers of blood donors and lower prevalence rate of Hepatitis B and hepatitis C on religious day shows the importance of recruiting blood donors and providing possibilities for blood donation on these days can improve blood adequacy and blood safety.

Background and Objectives FVIII activity (FVIII: C) is measured by clotting or chromogenic methods. The results of these methods may be different in some cases of hemophilia A that can cause misdiagnosis. The Aim of this study is to assess the results of two methods of F VIII: C assay in patients with hemophilia A Materials and Methods In A descriptive survey research, FVIII: C level was measured using one-stage and chromogenic assays in 73 hemophilia A known patients. The data were analyzed by t-test and SPSS 22 statistical method.Results From 73 patients in this study, the range of FVIII: C assay by one-stage method was 4% to 81% (mean=22.7, SD=14.8) and the range of FVIII: C assay by chromogenic method was 1% to 123 % (mean=16.5, SD=21).Conclusions For prevention of misdiagnosis, it is recommended to use two methods of FVIII: C assays for diagnosis of patients with hemophilia A.

Background and Objectives: The current survey aims at determining the frequency of prophylaxis usage against deep vein thrombosis (DVT) according to ACCP instruction among the patients hospitalized in surgical wards of Imam Khomeini teaching hospital in Ilam.Materials and Methods: This study is descriptive and retrospective and the sampling was carried out amongst the cases of patients who were hospitalized and underwent operation in the period between March of 2012 to September of 2013 in Imam Khomeini Hospital in Ilam. The type of receiving Prophylaxis was determined by ACCP (The American College of Chest Physicians) Guidelines. After investigating the input and output criteria, patients’ data were extracted according to the dependent variables. Eventually the information gathered from the cases were analyzed by SPSS software version 17.Results: There were 169 qualified cases out of whom 46.2% (78 participants) were female. Out of 132 patients in need, only 39 persons (29.5%) were offered Prophylaxis. ACCP Guidelines with respect to the appropriate type, dose, and duration of thromboprophylaxis were followed completely only in 30 individuals (22.5%). The maximum rate of thrombo-prophylaxis happened to be in ICU (46.6%) and neurosurgery section (47.5%) and the least utilization of that was in the kidney and urinary tract section (0%).Conclusions: This study shows that there is a considerable difference in the clinical performance recommended by ACCP in prophylaxis against DVT; in 75% of DVT affected patients, thrombo-prophylaxis was not offered according to ACCP Guidelines. Thus, new strategies must be implemented to operate thrombo-prophylaxis against DVT in Ilam hospitals.

Background and Objectives The decrease in mesenchymal stem cells (MSCs) survival rate after transplantation is a major challenge in MSC-cell-therapy. Hence, it is promising to employ some proper strategies for addressing this problem. This study was conducted to assay the therapeutic effects of MSCs treated with Nrf2 -manipulated-MSC conditioned medium in acute kidney injury (AKI) -induced animal models.Materials and Methods In an experimental study, recombinant plasmid pcDNA3.1-Nrf2 was transfected into bone marrow-derived MSCs and the resulted conditioned medium was harvested. The MSCs was cultivated with Nrf2 -manipulated-derived conditioned medium. The conditioned mediumtreated-MSCs were transplanted to AKI-induced rats (each group containing 10 rats) and the therapeutic potentialities of these MSCs were evaluated using biochemical and pathological methods.Results Fourteen days after MSCs transplantation, there was a significant difference in BUN decreasing in rat groups injected with conditioned medium-treated-MSCs (48±3.5 mg/dL) in comparison with those injected with normal MSCs (100±9.9 mg/dL) (p<0.001). The number of observed casts (0.26) in kidney tissue sections of these rat groups were also less than (0.51) the groups transplanted with normal MSCS.Conclusions Cultivation of MSCs in the presence of Nrf2 -manipulated-derived conditioned medium increase the therapeutic effects of these cells in AKI-induced models.

Background and Objectives Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. The side effects of chemotherapeutic drugs have primarily lead to the increased use of natural products for cancer treatment. Juniperus excels a, a medicinal herb, was reported to show antiproliferative effects on various cancer cells. In this study, cytotoxic and apoptotic effects of extract from aerial parts of Juniperus excels a plant were investigated on acute lymphoblastic leukemia cell lines, Nalm-6 and Reh.Materials and Methods In this basic research, Nalm-6 and Reh were cultured and then they were treated with various concentrations of J. excels a extract for 48 and 72 h and then the cell viability was evaluated by using MTT assay. Apoptosis also was assessed by caspase 3 activity assay and flow cytometry following Annexin V and Propidium iodide staining. Statistical analysis was assessed by one way ANOVA test and SPSS 23.Results MTT assay results show that J. excels a extract concentrations of 3, 4 and 5 mg/ml significantly reduce percentage of alive cells (p<0.001). Flow cytometry results also show that J. excels a extract significantly increase percentage of apoptotic cells compared with control groups (p< 0.001). Caspase 3 activity assay results show that caspase 3 activity was significantly increased in treated cells (p<0.05).Conclusions Our study shows that extract from aerial parts of J. excels a has cytotoxic and apoptotic effects on Nalm-6 and Reh cells.

Background and Objectives: As the role of telomerase in unlimited proliferation is a common feature of the majority of human cancers including hematological malignancies, thus inhibition of this enzyme has been proposed as a novel strategy in cancer therapeutics. This study was performed to investigate the effect of BIBR1532, a synthetic inhibitor of hTERT, on metabolic activity, DNA synthesis rate, cell cycle activity, and expression of pro-apoptotic genes such as p21, p73, Bax, and Bad in Nalm-6 pre-B ALL cells.Materials and Methods: In an experimental study, to investigate the effect of BIBR1532, Nalm-6 leukemic cells were cultured in the presence of various concentrations of the inhibitor and consequently MTT assay, BrdU cell proliferation assay, flowcytometeric cell cycle analysis, and quantitative realtime PCR were applied.Results: Our results revealed that BIBR1532 induces an inhibitory effect on metabolic activity and DNA synthesis rate of Nalm-6 cells in a dose- and time-dependent manner. Moreover, we found that BIBR1532 exerts an inductive effect on mRNA expression level of Bax, Bad, p73, and p21, which in turn leads to G1 cell cycle arrest and increased sub-G1 cell population.Conclusions: Since treatment with BIBR1532 could arrest the cell cycle activity in Nalm-6 cells and activate cellular apoptotic pathway, anti-telomerase-based therapy may be regarded as a novel promising strategy for ALL treatment.

Background and Objectives: ASXL1 gene has been recently considered as an important mutant gene in myeloid leukemias including Chronic Myelogenous Leukemia (CML). Mutation in this gene is associated with disease aggressiveness and poor clinical outcome, so its evaluation would guide us to remarkable conclusions in estimating disease prognosis. Considering that there are only a few known prognostic factors for CML and that the study of this gene has never been accomplished in Iranian population, we decided to study this mutation in our CML patients.Materials and Methods: In this experimental study 66 diagnosed CML patients were evaluated for the presence of ASXL1 mutation. For this reason a portion of exon 12 from ASXL1 gene (site that most mutations take place at), was amplified. This area was further studied by nucleotide sequencing.Results: Mutations in ASXL1 were detected in 4 CML patients (2 men and 2 women) with mean age of 44 years and SD of 17.85 (6%). Mutations were of two different types including frame shift mutation (c.1394DupG) and deletion (1900-1922del) and both were reported in previous studies. No significant difference was detected in patients with and without mutations, according to sex, age, WBC count, Platelet count and Hemoglobin levels.Conclusions: ASXL1 gene mutation is considered as a genetic abnormality in CML. According to the presence of this mutation in our patients at the time of diagnosis, it could be regarded as one of the primary genetic distortions in CML.

Background and Objectives Umbilical cord blood for the treatment of various diseases including types of cancer is important. The purpose of this study was to survey the knowledge and attitude of midwifery nursing personnel in prenatal clinics and emergency obstetric affiliated to Tehran University of Medical Sciences towards cord blood donation in 1390 (Iranian calendar).Materials and Methods In this descriptive survey research, A self-made questionnaire consisting of three parts of personal and job characteristics (11 questions), knowledge (13 questions), and attitudes (25 questions) were completed by 149 Midwifery-Nursing personnel. The score of the knowledge part was divided into three groups (less than 8), medium (8-15) and good (above 16) and the score of attitude part was divided into three parts of negative attitude (less than 25), indifferent or neutral (26 to 50) and positive (greater than 51). Data analysis was performed using SPSS statistical software (version 16) and descriptive and inferential statistics (Spearman Correlation Coefficient).Results About half of the participants had a medium knowledge (45.9%) and the majority of them (87.9%) had a positive attitude. The mean score S of knowledge and attitude were 12.36±5.49 and 74.23±18.29, respectively. There was no statistically significant association between knowledge and attitude (p=0.084).Conclusions Educational planning and awareness raising about cord blood donation are necessary for knowledge improvement.

Background and Objectives: Since all of our blood donors are volunteer and unremunerated and our country is a young society, we aimed to evaluate the motivation and the effective motivating factors for blood donation in the youth.Materials and Methods: This study was a cross sectional descriptive study. In this study, 1000 questionnaires were completed by donors during 2010-2011. Chi-square test and SPSS 11.5 software were used in analyzing data.Results: The most common motivation of our donors was altruism (89.2%); 18.4% from these donors donated for the purpose of free of charge check up and 21.8% for HIV testing. The average age of studied cases was 24.6 with 82.1% of donors being male and the others 179 (17.9%) female.71.1% of donors were single and 33.4% had bachelor and upper degrees. Out of the participants, 84.1% had awareness of donation while 12.4% had no information about window period of infectious diseases.Conclusions: The present study showed that donors had little awareness about blood transfusion and transfusion transmitted diseases. It is necessary to pay more attention to educational programs to change the youth into safe and regular blood donors.

Background and Objectives Factor XIII (FXIII) deficiency is an extremely Rare Bleeding Disorder (RBD) with estimated incidence of 1 per 2 million in the general population. All routine coagulation tests including Bleeding Time (BT), Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and platelet count are normal in FXIII deficiency (FXIIID) and this makes the diagnosis of disorder difficult. In this study, we presented a practical approach for laboratory diagnosis of FXIIID.Materials and Methods For this review article, all relevant articles were searched using appropriate keywords.Results Clot solubility test is the most common diagnostic test of FXIIID that has low specificity and sensitivity and also can be affected by several factors including clotting and solubilizing agents. Although this test is not further recommended by experts for diagnosis of FXIID but due to expanded use of this method, it cannot be abolished and we can use it to screen the disease with some modifications. FXIII activity assay should be considered as a screening test of FXIIID. FXIII activity is performed by several methods among them photometric assay is the most common. Without a serum blank, photometric assay overestimates FXIII activity that in patients with severe FXIIID can be accompanied by life threatening bleeding.Conclusions FXIIID is a rare disease with lethal outcomes. A best clinical examination, family history as well as a suitable laboratory approach led to timely diagnosis of FXIIID and prevented misdiagnosis of the disease and the arising consequences. Thus, this study is to give a proper laboratory approach for diagnosis of FXIIID.