THE SCIENTIFIC JOURNAL OF IRANIAN BLOOD TRANSFUSION ORGANIZATION (KHOON)
Year:2008 | Volume:5 | Issue:3 (20)|Papers Count:12

Background and Objectives: A current serological screening test for blood-borne hepatitis viruses has reduced the risk of post-transfusion hepatitis dramatically. Occult hepatitis B virus (HBV) infection might allow the release of viremic units into the blood supply if blood is tested only for hepatitis B surface antigen (HBsAg). Screening for anti-HBc has been shown as an alternative for detection of HBV infection. The aim of this study was to evaluate the prevalence of HBV infection markers in HBsAg negative blood donors.Materials and Methods: In this descriptive cross-sectional study, 2000 HBsAg negative samples were collected from blood centers in Tehran. All HBsAg negative samples were tested for anti-HBc using ELISA method. Then, all HBsAg negative and anti-HBc positive samples were tested for anti-HBs by the same method. All data were analyzed statistically using Chi-square test.Results: One hundred ninety nine (9.95%) out of the 2000 HBsAg negative blood donors were anti- HBc positive (confidence interval of 7.66%-12.24%). Out of the 199 anti-HBc-positive samples tested for anti-HBs, 149 (75%) were anti-HBs-positive (confidence interval of 65.5%- 85.5%), and 102 (50.3%) had an antibody titer greater than 100 IU/ml. Conclusions: In our study, the prevalence rate of anti-HBc in HBsAg negative blood donors was high. While anti-HBc-positive blood may be a potential source of HBV transmission, routine application of anti-HBc screening is not feasible in our country as it would seriously affect the blood supply adequacy. Therefore, more sensitive techniques such as minipool PCR testing after virus enrichment are essential for detecting HBV DNA in HBsAg-negative chronic HBV carriers.

Background and Objectives: Thrombus formation may form enhanced coagulation or impaired fibrinolysis. An increased tendency for the blood to clot is referred to as the hypercoagulable state or thrombophilia which includes various inherited and acquired clinical disorders or mixed conditions. There are many studies suggesting that elevated factor VIII may be a common and independent risk factor for thrombotic events. We tried to assess the level of factor VIII in patients with idiopathic thrombosis.Materials and Methods: Our cases were the patients with idiopathic venous thrombosis having referred for hypercoagulable studies to Coagulation Lab in Iranian Blood Transfusion Organization. The inclusion criterion was the occurrence of thrombotic event confirmed by objective diagnostic methods coupled with three months of follow-up without any other disorder. Our controls were from healthy blood donors and matched with the cases on sex, ethnicity, and age. Plasma of a healthy person was used to establish the normal reference range according to which our patients are compared. Factor VIII levels were measured using a one-staged assay, the PTT based Diagonistica Stago on the STA compact automated coagulation factor analyzer. SPSS and Chi-square were finally used for data analysis.Results: One hundred fifty two cases and 130 controls enrolled. The mean factor VIII level for cases was 157.26 IU/dl (SD±53.8) with the minimum level of 66 and maximum of 364 IU/dl. For controls, the mean factor VIII level was 111.78 IU/dl (SD± 29.68) with the minimum level of 42 and the maximum of 195 IU/dl. These levels were statistically significant and higher in the case group. The elevated FVIII level was higher in females than males (35.3%vs 23.8%) and increased with age. The normal range in the control group varied within 52-171 IU/dl, which is higher than the normal level of 50-150 IU/dl.Conclusions: There are many studies showing that increased FVIII level may be an independent risk factor for thrombosis. Our results suggested elevated FVIII level in 28.9% of the patients with thrombosis compared to 3.1% in the control group. So, factor VIII measurement is recommended to be practiced in routine thrombophilia screening programs.

Background and Objectives: Rearrangement of V, D, and J segments of immunoglobulin heavy chain gene with inserted or deleted nucleotides within rearranged segments makes unique hypervariable regions (CDR-3). These regions can be used for evaluation of B cell clonality for the purpose of molecular diagnosis of Non-Hodgkin Lymphoma (NHL) and for confirmatory diagnosis in suspicious cases.Materials and Methods: In this study, samples of 42 patients were collected from Taleghani, Baqhiyatalah, and Aliasghar hospitals; out of this number, there were 22 patients with diagnosis of B cell NHL, 10 with reactive hyperplasia, and 10 with malignant lymphoma. After DNA extraction from formalin fixed paraffin embedded tissues, PCR was done using consensus primers for amplification of CDR-3 region. PCR products were analyzed after heteroduplex analysis using polyacrylamide gel electrophoresis and silver stain.Results: Clonal patterns in group 1 (B cell NHL), 2 (reactive and follicular hyperplasia), and 3 (morphological diagnosis without immunohistochemistry) were observed in 77.2%, 0%, and 70% of patients, respectively.Conclusions: Our findings are compatible with other international studies with minor differences. The diagnosis of B-cell lymphoid malignancy can frequently be substantiated by detecting clonal immunoglobulin heavy chain (IGH) gene rearrangement.

Background and Objectives: Provision of adequate and safe blood is the main purpare of Iranian Blood Transfusion Organization. One of the most important and vital strategies to deal with the issue is to replace once donors by repeat donors. Psychological effects of blood donation on frequent and infrequent clients having referred to different blood collection centers in Tehran were considered to be the aim of this study.Materials and Methods: In the course of this analytic cross-sectional study the standard questionnaire of GHQ was utilized to measure mental health of the participants. All of the donors who had referred to blood collection centers in Tehran during 2004-2005 formed the participants of this research. Data were analyzed with Chi-square, t-test and Man Withney test.Results: Nine hundred thirty five frequent and 749 infrequent donors filled the questionnaire. The level of anxiety and depression in repeated donors was also lower than the other group.Conclusions: The individuals who attempt on blood donation for the first time report their health and physical conditions at a completely acceptable level in order to be accepted as an eligible candidate; however, it is not the same for constant donors, as they do not benefit from this. The return rate of blood donors is very low in case of individuals suffering from high stress. Religious beliefs and the feeling of being beneficial to the society are considered to be important factors both in motivating people to repeat blood donation and protecting against depression. The results of the present study upon publication will also encourage donors to repeat their behavior.

Background and Objectives: In Acute Normovolemic Hemodilution (ANH) which is practiced in operating room, whole blood is removed from a patient (while restoring the circulating blood volume with simultaneous infusions of suitable volume) shortly before or after the induction of anesthesia. This method is devoid of the major complications of homologous transfusion especially infectious diseases, except for the risk of bacterial contamination. This study aimed to evaluate the rate of blood contamination in ANH autologous transfusion.Materials and Methods: In a cross sectional study, prevalence rates of bacterial contamination at ANH autologous transfusions on 71 patients in two separate centers in Tehran were compared. From each patient, 1-3 blood bags were taken from arterial line. Before transfusion, 10ml of the blood was sampled and cultured in “Brain Heart Infusion Broth”. After inspecting the cultures, the bacterial contamination rate was calculated.Results: There were 96 samples but no positive culture was reported. The mean peri-operation bleeding of 7 patients (9.8%) was 2457 ml and their Hb counts was low (<10).It is while they received on average only 1.4 bags of homolougus blood, The mean Hb counts before operation and after were 14.53 and 12.44, respectively.Conclusions: In this study which was performed at two separate medical centers no bacterial contamination due to ANH transfusion was observed showing ANH safety as far as bacterial contamination is concerned.

Background and Objectives: One of the main steps in reducing bacterial contamination of blood and blood components is the correct use of appropriate disinfectants at blood collection sites and blood processing areas.Virkon is one of the most effective disinfectants consisting of a high percentage of surfactant. The purpose of the present study was to test the bactericidal effect of Virkon on native species of bacteria seen in Iran by selecting a suitable concentration of Virkon.Materials and Methods: This was an interventional study. 169 samples were taken from laboratory benches, instruments and outer surfaces of blood bags. After the growing bacteria were identified, their CFU/ml was also determined. Later, all the laboratory benches and instruments involved in the preparation of platelet components were disinfected using (1%) Virkon solution; 101 samples were taken from disinfected areas and swabs were plated on to standard bacteriological media and plates were read. 1100 segments from platelet bags were also separated and the platelet contents were plated and any bacterial growths were assessed using quality control department guidelines. Finally, all the data were analyzed using SPSS, Chi-square and Fischer exact test.Results: Out of 169 samples which were plated before disinfection by Virkon, 96 were 56.8% gram positive b., 101 were 59.8% gram positive cocci, 159 were 94.8% gram negative b., and 139 were 82.2% gram negative cocci. Out of 101 samples post-disinfected by virkon solution, 25 came out to be 24.8% gram positive b., 17 were 16.8% gram positive cocci, and 6 were 5.9% gram negative b. Out of 1100 segments separated from platelet bags, 4 showed bacterial growth (0.0036%), 2 had gram positive b. growth, and 2 had staph.Conclusions: By using correct concentration of Virkon solution and following the exact manufacture's instruction for use, we were able to observe log reduction in bacterial contamination of the areas where blood components were prepared. The reduction of bacterial contamination in platelet components prepared after disinfection of the working areas by Virkon solution should be emphasized.

Background and Objectives: Major b thalassemia has been reported as a high prevalence genetic disorder in Iran with some oromaxillofacial complications. The aim of this study was to evaluate the prevalence of oromaxillofacial disorder in thalassemia patients at Kerman province.Materials and Methods: In this research, 208 patients with major b thalassemia were under study. Data were obtained by oral examination and analyzed by statistical programs of SPSS 13.5, t- test, and X² test.Results: Out of 208 patients with major b thalassemia, 103 were male and 105 female. The mean age was 12.48 with the range of 1-26 years. The most prevalent facies appearance in these patients was pale face (47.3%) and lower jaw protrusion had the minimum prevalence. From data analysis, it was found that 46.6% of patients had protrusion of maxilla. Results of the present study showed that the most prevalent location with pigmentation into oral cavity was gingival of labial and the locations with less prevalence were lateral border of tongue, soft palate, and floor of mouth.Conclusions: This study showed that about 84.2% (175 cases) of all patients under consideration complained from changes in oral and Maxillofacial complications including upper and lower jaw protrusion, saddle nose, space between anterior teeth, anterior teeth protrusion, posterior malocclusion and frontal bossing. Also, it was revealed that the rate of prevalence for oral and Maxillofacial complications decreases when patients receive blood at younger ages.

Background and Objectives: Entrance of unaware and high risk donors into blood donation cycle can endanger blood safety. Therefore, the importance of educating blood donors as safe blood resources can be one of the most important goals of any blood service. This study was designed to evaluate the awareness level of Zanjan Universities students about blood donation criteria.Materials and Methods: In this descriptive study, 600 students were selected from Zanjan University of Medical Sciences, Zanjan University, and Zanjan Azad University by randomized sampling method, and they were then interviewed using especially formatted questionnaires. Data were finally analyzed by SPSS 11.5 and Chi-square test.Results: Out of 600 students, 221 were medical and 379 non-medical students with 63.2% being female and 36.8% male. The age average was 21.43 ± 2.34. Most of the students (83.5%) had never donated blood, 10.3% had donated once, and 6.2% were regular donors. About 30.8% of medical students had a very low level of awareness about blood donation criteria, 28.1% a low level of awareness, 27.6% an intermediate level, and 13.6% a high level of awareness. Out of non-medical students, 35.6% had a very low level of awareness, 37.2% a low level, 21.6% an intermediate level, and 5.5% had a high level of awareness about blood donation criteria. There was not any statistical difference between student level of awareness and demographic findings and education levels.Conclusions: It seems that awareness-raising activities about blood donation are necessary for culture building purposes to be promoted. Inclusion of topics relevant to safe blood donation in school curricula at different educational grades is also highly recommended.

Background and Objectives: Blood and blood components are used inappropriately in surgery and non surgery procedures. In medical settings, blood transfusion is important and its appropriate practice requires adequate expertise and knowledge; thus, this study is designed to assess the knowledge level of health care workers regarding appropriate use of blood and blood components in hospitals of Zabol.Materials and Methods: This is a descriptive study conducted on 122 nurses and health care workers. Data were collected by a questionnaire including 30 questions; they were then analyzed by SPSS version 11 software and Chi-Square.Results: Findings showed that 26.2% of health care workers had a low level, 22.1% a moderate, and51.6% an acceptable level of knowledge about appropriate use of blood. We did not find any significant correlation between the knowledge level of health care workers and their years in profession, age, gender, university degree, etc.Conclusions: Results strongly emphasized the need for a curriculum to promote knowledge of health care workers regarding blood transfusion because we found a low and moderate level of knowledge in approximately half of the participants.