فصلنامه خون
سال یازدهم شماره 1 (پیاپی 43، بهار 1393)

Background Deferral for travel to malaria-endemic areas has excluded many blood donors in the Iran. To determine the effect of these deferrals on blood availability and safety we designed this study. Materials and Methods In cross sectional and retrospective study deferred donors due to malaria related risk factors from 2005-2010 in Tehran Blood Transfusion Center were sampled to enroll for analysis. Data were extracted from MAK data base by two different grouped keywords. 2827129 record of blood donor volunteers were surveyed for the study. Results 23462 out of all volunteers were deferred due to malaria`s risks from 2005-2010 in Tehran Blood Transfusion Center. The most frequent deferral causes related to malaria was shown travel to malaria endemic areas. The trend of deferral volunteers due to malaria''s risks was shown descending pattern after relaxing application of the present guideline for travel to very low-risk areas such as Karbala. Conclusions We estimated that the wastage of more than 7000 units of blood were prevented annually by accepting volunteers who travelled to very low malaria''s risk areas، but according to other similar studies it seem wiser to defer them for a short period (e. g. 3 months)، instead without deferral period. If cost permits، The introduction of a malarial screening test in the assessment of malaria''s risk blood donor eligibility would be an ideal strategy.

The effect of Baicalin، a PPARy activator، was investigated on erythroid differentiation of CD133+ cord blood hematopoietic stem cells. The effect of PPARγ agonists (Baicalin and Troglitazone) were evaluated in erythropoiesis. CD133+ cells were isolated from human cord blood using MACS technology and cultured in the medium containing PPARγ agonists in a dose-dependent manner with SCF (20 ng/mL) and Epo (4. 5 u/mL). The morphology of CD133+ cells، cell surface markers (Transferrin receptor and glycophorin A)، and the formation of erythroid colony were assessed with microscopicanalysis، flow cytometry، and colony forming assay، respectively. Microscopic and flow cytometric analysis revealed the differentiation of CD133+ cord blood hematopoietic stem cells to erythroid lineage. Flow cytometry showed that both of the PPARγ agonists were able to diminish significantly Transferrin receptor and glycophorin A positive cell population. The inhibitory effect of PPARγ agonists on erythroid differentiation was dose-dependent. The colonies formation of erythroid was suppressed by both of PPARy agonists; hence، the effect of troglitazone was markedly higher. The inhibitory effect of Troglitazone on colonies formation of Erythroid was also markedly higher than Bicaline. Our findings demonstrated that PPARy agonists modulates erythroid differentiation of CD133+ hematopoietic stem cell; therefore، they might play an important role in regulating normal erythropoiesis in vivo. The inhibitory effect of Baicalin on erythropoiesis should be noted because this herbal remedy mostly is used to treat a wide range of diseases.

Platelet function disorders are common in the world population but in our country except for severe cases، they are not well investigated due to limited diagnostic tools. In recent two years we aimed to assess platelet function tests in referral patients suspected of platelet function disorders، in the special reference coagulation laboratory of Iranian Blood Transfusion Organization، as the center equipped with lumi-aggregometer. We have investigated 195 referral patients during a seven-month period، from November 2011 to May 2012، for platelet aggregation and ATP release response for highly suspected patients with four platelet agonists ADP، collagen، arachidonic acid and ristocetin and a luciferin-luciferase reagent. Results were analyzed by SPSS version 16. Among 195 referred patients، 90 cases (46. 1%) had an abnormality in platelet count or function. Abnormal cases fall within the categories of low platelet count with normal function (8. 2%)، ATP release (secretion) defect (6. 7%)، Glanzman''s thrombastenia (4. 6%)، Bernard Solier Syndrome (2%)، acquired platelet defect (1. 5%)، afibrinogenemia (0. 5%)، and uncategorized platelet function disorders (22. 6%). The other 105 remaining patients showed a quiet normal result. The present study is the first simultaneous analysis of platelet function and secretion disorders. In order to guess the true prevalence of these disorders، more wider and comprehensive studies، the use of more complete panels of agonists and ATP release assessment in all patients with an abnormal aggregometry pattern have been suggested for future studies.

Several hereditary and acquired risk factors for thrombosis are known. Among the genetic factors، PAI-1 4G/5G polymorphism can be noted. This study was done to investigate the association of 4G/5G polymorphism in PAI-1 gene and thrombosis in coronary arteries. Sixty one patients with the history of thrombosis in coronary arteries and 92 healthy blood donors participated as the control in our study. After DNA extraction from leucocytes based on the selective detergent-mediated DNA precipitation from crude lysate، PCR was performed using ARMS technique. Single and multivariate analyses were applied to adjust for potentially confounding factors using SPSS 19 software. The data were also compared with those of the other similar studies. The results showed 61 patients with history of coronary artery thrombosis for PAI-1 with the values of 24. 6%، 45. 9%، and 29. 5% for 4G/4G، 4G/5G، and 5G/5G، respectively; the values for 92 healthy blood donors were evaluated to be 20. 7%، 42. 2%، and 37% in order. The polymorphism studied was not significantly different between cases and controls. Single and multivariate analyses show a significant difference for the conventional risk factors for coronary artery disease between patients and healthy controls (P value: 0. 001). We found no association between arterial thrombosis and the 4G/4G genotype for PAI-1 gene in Iranian population of the current study.

Iron deficiency anemia might appear in donors particularly in women following blood donation. The present study compared the efficacy and consequences of iron intake compared with iron plus vitamin C supplements. One hundred thirty eligible female donors were included in the study. The iron supplement group (IS) receiving 150 mg/day in a 10-day course of oral ferrous sulfate، divided in 3 doses were compared with the group who received iron supplement plus vitamin C (750 mg/day) in a 10-day course، divided in 3 doses، orally (AIS group). Ferritin، hemoglobin، hematocrit، serum iron، and total iron binding capacity (TIBC) were checked in both groups at the first visit before donation and 4 months after donation. TIBC levels increased in both groups of donors (p< 0. 01). Ferritin level in IS group decreased (p= 0. 036) from 25 ± 24 (ng/ml) to 22 ± 21، and in AIS group (p= 0. 031) from 16. 5 ± 17 to 13. 5 ± 13 after donation. Iron storage levels were similar in the both groups (p> 0. 05). Gastrointestinal disturbances was seen in 9% (12) of supplement consumers. There are no differences between the two groups (p< 0. 05). Addition of Vitamin C to ferrous sulfate supplements neither had any impact on body iron load nor placed any adverse effects on blood donors. Moreover، the decline of ferritin level in all volunteers might be due both to the time duration between the first and the second sampling and the menstural period.

Fibrinogen، coagulation factor 1، is a soluble plasma glycoprotein which converts thrombin to fibrin fibers in the coagulation cascade. Various polymorphisms located on beta chain gene، FGB، have been studied. The promoter – G455A (rs1800790) polymorphism had been shown to be significantly associated with fibrinogen plasma levels. In this study، the frequency of rs1800790 polymorphism has been assessed and the correlation was evaluated between this variant and fibrinogen plasma levels. Whole blood samples were collected for DNA isolation. To perform rs1800790 genotyping، the region encompassing the HaeIII restriction site was amplified using specific primers. The plasma levels of fibrinogen were measured and the obtained data were analyzed by SPSS software. The levels of plasma fibrinogen has shown a significant correlation with FGBrs1800790 genotype (p-value = 0. 021; CI = 0. 347 - 3. 253). Minor allele frequency was estimated to be 0. 28 which was consistent with the predicted value. The significant correlation between fibrinogen and FGBrs1800790 genotype emphasizes the importance of this variant in the modulation of fibrinogen plasma concentrations. Since FGBrs1800790 contributes to the gene expression and environmental risk factors، it is important to be noticed in the cardiovascular disease.

According to our national standards، whole blood units are stored at 22 ± 2 ° C prior to processing. Since there has been no study about the quality of RBCs prepared after the storage of whole blood units at 22 ± 2 ° C in Iran، we decided to investigate the quality effect of whole blood stored for 8 and 24 hours at this temperature. Twelve whole blood units in pediatric bags were collected and placed in the cooling plate box. After 8 and 24 hours، RBCs were produced from these stored units. Then، the bags were analyzed for hemolysis، 2، 3-diphosphoglycerate، lactate dehydrogenase، glucose، and sodium. Although a higher percentage of hemolysis، lactate dehydrogenase levels، and lower 2،3-DPG، sodium and glucose levels were determined in RBCs prepared after the 24-hour WB storing time، no significant differences، except for 2،3 DPG، were observed between 8-hour (205 ± 12) and 24-hour (113 ± 13) WB storing time periods. Although storing whole blood at 22 ± 2 ° C for 24 hours prior to RBCs production had an impact on its quality، the property of prepared components is defined to be within an acceptable range of quality control.

Blood is a valuable product whose storage، distribution، and utilization requires great attention. Overprescription of blood decreases blood quality and makes blood less fresh. Overprescription of blood is one of the important problems of clinical centers; so we decided to assess blood ordering and utilization in hospitals of Babol city. This retrospective-descriptive study was carried out at university hospitals in Babol; 690 patients in operational wards of 3 hospitals were included in this study. Data were retrieved during 9 months from blood banks of these centers. C/T ratio and TI were calculated for each ward and hospital. Out of 690 patients، 304 were from Shahid Beheshti Hospital، 115 from Yahyajejhad Hospital and 271 from Rohani Hospital. Out of the total number، 396 (57. 4%) were female and 294 (42. 6%) male. C/T ratio and TI were 1. 05 and 1. 73، respectively. With regard to these findings، the C/T ratio and TI of these hospitals were in the standard range. We suggest that the same study is done in all hospitals regularly. If these indices aren’t proper in a certain center، Type and Screening (T&S) and MSBOS program should be performed.

Blood transfusion is a modality of knowledge important for health care personnel to know about its different aspects. The aim of this study was to assess the knowledge of health care personnel in two hospitals of Zahedan about blood products، blood use، and adverse reactions. In a study in two hospitals of Zahedan، 170 randomly selected employees from the hospital wards with the highest level of blood use participated. Data were collected via a questionnaire. For data analysis، SPSS، chi-square tests، t-test، ANOVA، and Pearson correlation coefficients were used. The average knowledge score of the personnel of Khatam Hospital was estimated to be 11. 13 ± 3. 68 and Ali ibn Abi Talib Hospital 13. 31 ± 2. 19. The average knowledge score of the two hospitals was 12. 34 ± 3. 13 with one hospital being significantly more knowledgeable than the other. But there was no correlation between age، gender، education، and work experience with the knowledge level (p > 0. 01). The results showed that the average knowledge score of health care personnel about blood transfusion is low at the two hospitals in Zahedan. Therefore، an academic course about blood transfusion should be dedicated to medical students in universities.

According to the World Health Organization، about 2 billion people (over 30%) of the world population have anemia. This rate in students is about 25. 4 %. Iron deficiency anemia is one of important nutritional problems among female teenagers which causes reduced concentration and impaired learning. Because of the effects of iron deficiency، enzymes and neurotransmitters affect brain and results in a decreased concentration and learning ability. The population of this study are third-year guidance school female students in Garmsar. A sample group of 45 volunteer students underwent laboratory testing. According to the results of laboratory tests، students were divided into anemic and non-anemic groups. GPA was used for scaling educational performance and evaluating the numerical ability; three components of Math scores، numerical memory، and numerical calculation of Wechsler test were used. Outcome scores were compared with the lab tests. Pearson and ANOVA were used in SPSS 19 software. The correlation between GPA and indicators of HB، HCT، MCV، Serum iron، and Ferritin، the correlation between math scores and indicators of Ferritin and HCT Serum Iron، the correlation between the numerical calculation and Ferritin، MCH، HCT، and HB، and finally the correlation between short-term memory and Ferritin were all estimated to be significant (p< 0. 05). According to the results، anemia especially iron deficiency anemia has a negative effect on educational and mathematics performance of students.

The unexpected alloantibodies are usually found in the sera of those patients who have a history of blood transfusion and pregnancy. These alloantibodies cause many complications in patients with post-transfusion delayed hemolytic transfusion reactions. Case: A 24-year-old man with melana، blood vomiting، and the history of discopathy and consumption of moleksicam was observed. In laboratory tests، incompatibility of the cross-match test and discrepancy of blood grouping were observed. In the analysis of the antibody screening، positive reactions were observed with all of the cells in different phases of panels 3 and 11. On the next visit، similar results were obtained after 6 months. If indicated for blood transfusion، only autologous blood is recommended to be administered to prevent hemolytic transfusion reactions.