فصلنامه خون
سال پانزدهم شماره 4 (پیاپی 62، زمستان 1397)

  Long-term preservation of the records requires a standard archive space. The purpose of this study is to examine the recent implementation of archival records in Iranian blood transfusion centers (BTCs) and to define effective corrective actions to improve current conditions.

In this descriptive cross-sectional observational study, a questionnaire consisting of 60 questions in four areas of infrastructure design, environmental control, archiving and health and safety was developed and was sent to 31 BTCs within the time frame from February to March 2017. Data analysis was performed using descriptive statistics (average and percentages) and SPSS 17.

The average frequency of positive responses in accordance with the requirements and standards was 73.13%. The monitoring of archive room temperature was carried out in 90.47% of BTCs. Nearly 73% of BTCs responded positively to compliance with relative humidity and ventilation control requirements. The average frequency of positive response of BTCs to establish the requirements of archival process was about 72.72%. Establishment of health and safety related parameters had the highest score among the four subjects (83.36%).

Despite the good state of implementation of requirements in the archive rooms for the infrastructure and health and safety, there are challenges in the field of temperature control and the archival process and document traceability, which resulted in effective corrective actions such as preparing the guideline for design requirements and archiving, defining the temperature and humidity limits and training BTCs to establish the necessary standards.

The goal of Iranian Blood Transfusion Organization (IBTO) is to provide safe blood and blood components that are necessary for patients. Blood donors are interviewed and selected in order to providing safety of blood donors and recepients, so a number of potential blood donors to be deferred. The aim of this study was to determine the rate of donors return after temporary deferral in the center of East Azerbaijan province.

In this study, temporary deferred donors in Tabriz in 2013 were included. Temporary deferred donors were analyzed by the reasons of deferral. The return rate during 3 years after deferral were calculated and compared between different blood donors.

Of all the 66176 volunteers, 20% were deferred from blood donation and 80% were found eligible. Of those deferred, 92% were temporarily deferred. The most frequent causes of temporary deferral were abnormal finding in physical examinations (25%), a history of medication use (23%), and a history of bloodletting or tattooing (8%). Of the potential fisrt time donors deferred, only 1.5% returned for blood donation during the three years following the temporary deferral. However, 54% and 94% of the repeat and regular donors returned, respectively.

The present study showed that first-time blood donors who were deferred have a less return rate than regular and repeat donors who were deferred.

  Thalassemia major is an autosomal recessive disease with serious morbidity, mortality and pathology. Due to today’s therapeutic advances, the life expectancy of thalassemia patients has significantly increased. As a result, thalassemia patients need lifelong care, but caring for patients with thalassemia causes a lot of costs. Therefore, being aware of the costs and effectiveness of the treatments is essential for controlling the costs and providing effective treatments.

In this cross-sectional descriptive study, a bottom-up method was used to estimate the treatment costs for thalassemia patients and all the costs were estimated over a one-year period (2015). The number of QALYs created by treatment was also extracted using the EQ5D questionnaire, and eventually, the Markov model was used to calculate the costs and effectiveness for patients’ longevity.

Treatment for any patients with thalassemia major costs $ 8,321.8 per year. Applying a 3% discount rate, we estimated that each patient lifelong treatment costs $ 147,098.4, which would results in 11.8 QALYs. Hence, the cost per QALY would be $ 12,466,0.

Treating the patients with thalassemia major, despite its cost effectiveness, might cost a lot so that the treatment of the patients in the fourth decade of their lives may even reach the cost-effectiveness threshold. Therefore, increasing the costs in the field of patient screening and prevention of the birth of patients with thalassemia major seems to be useful.

  Estimation of the frequency and causes of immunization to red blood cells in transfusion dependent thalassemia (TDT) patients can help us know the limitations of current practice and plan specific measures to reduce it. This study aimed to evaluate the frequency and causes of immunization in TDT patients.

This case control study was conducted on 732 (TDT) patients between 20 November 2015 to November 2016 in Dastgheib Hospital, Shiraz, Iran. Direct coombs test, antibody screening, and antibody identification were performed for every TDT patient. Then, the frequency and type of antibodies were surveyed. Clinical and laboratory data of immunized and non-immunized patients were compared.

All of the case group had positive results in direct or indirect coombs tests. Indirect coombs test (ICT) was positive in 59 patients (63.4%) while direct coombs tests (DCT) was positive in 41 (44%) of immunized patients. In addition, 7 patients (7.52%) showed positive results for both DCT and IAT. The most frequent antibodies were against Kell (48.6%), D (22.7%) and E (18.2%). Our results reflected that lower age of starting transfusion and splenectomy had an impact on higher immunization rate.

Antbodies against Rh and Kell system were the most frequent antibodies. It seems that extended RBC matching at least for ABO/Rh/Kell antigens must be performed for thalassemia patients with its effect on RBC immunization rate to be then surveyed.

  Glasses and glass-ceramics are a group of biological substances that form hydroxyapatite against a simulated solution of the body and can be used in many clinical cases that require the production and repair of bone. The purpose of this study was to create a 45S5 bioactive glass nanoparticle and evaluate its impact on staining and differentiation of mesenchymal stem cells into bone cells.

In this experimental research, the nanocomposite of the bioaccuminant 45S5 was synthesized by the fusion method and planetary mill was converted to the nanoscale structure; then, its physicochemical and structural properties were investigated. The bioactivity was evaluated using a simulated body solution. The growth, amplification and differentiation of mesenchymal stem cells in the vicinity of nanoparticles were investigated.

Biomedical evaluation indicated the formation of hydroxyapatite on nanoparticles after zinc immersion in the body was simulated. Cell experiments also confirmed the lack of toxicity of the glass nanoparticles and its stimulating effect for the growth, proliferation and differentiation of mesenchymal cells in bone cells. In the bone differentiation, the activity of alkaline phosphatase in the glass nanoparticle was expressed after 14 days of differentiation (0.55 ± 0.07), while it was the control sample (0.15 ± 0.03).

According to the progenies, mesenchymal stem cells can propagate and grow on the nanoparticles of the synthesized bioactive glass and, in addition to not being toxic, stimulate and stimulate cell growth.

  Immune abnormalities are the fourth leading cause of death in thalassemia major patients. These patients are affected by stimulating chronic immunosuppression and immune deficiency following repeated blood transfusions and iron overload. Considering the role of chemokine network in immunosuppression, we examined the role of CCL-5 chemokine and its receptor CCR-5 in β-Thalassemia major patients.

In the present case/control study, 45 β-thalassemia patients having referred to Kerman Special Health Center and 45 healthy subjects as controls participated. For the expression of CCR-5 and CCL5 receptor expression, flow cytometry and ELISA were used, respectively. After the tests, T-test and SPSS software version 22 were used for analysis and p < 0.05 was considered as a significant difference.

Our results indicated that both CCR5 and CCL-5 were induced in β-thalassemia patients compared to the control (p< 0.05).

This study showed the increase of CCL5/CCR5-receptor chemokine-centered axis in patients with thalassemia major compared with healthy subjects and similarly the very increase in patients with spleen compared with those without. Due to the fact that a study on this chemokine network has not been done so far, it is necessary to repeat this study with more samples and to carefully examine the role of the spleen.

  Recurrent abortion is referred to a condition that 2 or 3 consecutive pregnancies are affected by abortions before the 20th week of gestation, which is likely to occur in 2-5% of pregnancies. There are some etiologic factors such as anatomical, infectious and immunological elements. One of these immunological factors is the polymorphism of the HPA-1 gene as a factor able to cause FNAIT and its related complications; besides it contributes to abortion as a thrombophilic gene. This study was conducted to evaluate the prevalence of HPA-1 incompatibility in Iranian couples with a history of recurrent abortions.

In this cross-sectional descriptive study, totally 75 couples with at least two recurrent pregnancy losses without any specified causes (according to the medical records obtained from the infertility center) were entered to the study. Four-ml blood samples were collected in EDTA tubes and the allelic frequency of HPA-1 was determined by PCR-SSP. Gene frequency was calculated using the Hardy Weinberg equation. The p< 0.05 was considered significant.

Totally 75 couples were included with the average age of women being 32 ± 7 years and the mean number of abortions 2.5 ± 0.9. HPA-1a was found in 100% of the under study population, and HPA-1b was absent in this population.

Conclusions
This study revealed that HPA-1a gene polymorphism does not have the likelihood of being involved in the recurrent abortion in Iranian couples, and other factors need to be investigated to determine the possible causes of recurrent abortion.

  Viral hepatitis B and C are considered to be a medical problem for people with HIV infection. The importance of these infections is in the shared route of their transmission, and liver disease as a result of infection with HCV, HBV and HIV infection that can lead to death.

In this cross-sectional descriptive study, a total of 31 serum samples were prepared from patients referring to the Behavioral Diseases Counseling Center in Chaharmahal and Bakhtiari province who were diagnosed with HIV infection by Western blotting method; their consent was taken. The coinfection with HBV and HCV was investigated by PCR method. Data were analyzed by fisher exact test and prism7 software.

The results of this study on serum samples of HIV-infected people showed the prevalence of HCV/HBV coinfection in HIV-positive individuals to be %3.22, the prevalence of HBV infection in HIV-positive individuals %4.45, and the prevalence of HCV infection in HIV infected ones %22.5.

According to the common routes of transmission of HCV, HBV, and HIV viruses, it is essential that all people who are HIV-positive or HIV-infected be screened for hepatitis B and C viruses by highly sensitive diagnostic methods.