فصلنامه خون
سال سیزدهم شماره 4 (پیاپی 54، زمستان 1395)

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.
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. c2, t, Fisher exact test and SPSS 22 have been used for data analysis.
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.
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.

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.
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.
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).
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.

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.
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).
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 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.

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.
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.
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 ).
For prevention of misdiagnosis, it is recommended to use two methods of FVIII:C assays for diagnosis of patients with hemophilia A.

Annually a large number of patients are hospitalized for benign diseases, but some die due to pulmonary embolism. However, with the proper prophylaxis can be avoided death. The current survey aimed to determine the frequency percentage of prophylaxis usage against deep vein thrombosis (DVT) according to the American College of Chest Physicians ACCP Guidelines.
This study is a retrospective descriptive study. The sampling was done and the participants were selected among the patients hospitalized in surgical wards of Imam Khomeini hospital in Ilam during the March of 2012 to September of 2013. The appropriate type, dose, and duration of thromboprophylaxis were determined by ACCP Guidelines. After investigating the inclusion and exclusion criteria, necessary data were extracted. Finally, data were analyzed by SPSS software version 17.
A total of 169 patients (78 female) entered this survey. Findings showed that from 132 patients needed to receive prophylaxis, only 39 (29.5%) received prophylaxis. According to ACCP Guidelines, prophylaxis in 30 patients (22.7%) was operated correctly. The maximum rate of thrombo-prophylaxis happened to be in ICU (46.6%) and neurosurgery section (47.5%) and the minimum utilization pertained to the kidney and urinary tract surgery wards (0%).
This study showed a considerable difference in clinical practice versus ACCP recommendations in prophylaxis against DVT. About 75% of patients had risk of DVT and thrombo-prophylaxis according to ACCP Guidelines was not operated. Thus, new strategies must be implemented to operate thrombo-prophylaxis against DVT.

Background and ObjectivesThe 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 MethodsIn 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 medium-treated-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.
ResultsFourteen 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 ConclusionsCultivation of MSCs in the presence of Nrf2-manipulated-derived conditioned medium increase the therapeutic effects of these cells in AKI-induced models.

Background and ObjectivesAcute 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 excelsa, 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 excelsa plant were investigated on acute lymphoblastic leukemia cell lines, Nalm-6 and Reh.
Materials and MethodsIn this basic research, Nalm-6 and Reh were cultured and then they were treated with various concentrations of J. excelsa 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.
ResultsMTT assay results show that J. excelsa extract concentrations of 3, 4 and 5 µg/ml significantly reduce percentage of alive cells (p Conclusions Our study shows that extract from aerial parts of J. excelsa has cytotoxic and apoptotic effects on Nalm-6 and Reh cells.

Background and ObjectivesAs 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 MethodsIn 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 real-time 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.
ConclusionsSince 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 ObjectivesASXL1 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 MethodsIn 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.
ResultsMutations 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 ObjectivesUmbilical 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 MethodsIn 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).
ResultsAbout half of the participants had a medium knowledge (45.9%) and the majority of them (87.9%) had a positive attitude. The mean scoreS 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).
ConclusionsEducational planning and awareness raising about cord blood donation are necessary for knowledge improvement.

Background and ObjectivesSince 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 MethodsThis 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.
ResultsThe 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 ObjectivesFactor 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 MethodsFor this review article, all relevant articles were searched using appropriate keywords.
ResultsClot 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.
ConclusionsFXIIID 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.