مجله دانشکده پزشکی اصفهان
پیاپی 721 (هفته اول امرداد 1402)

Transfusion of blood components is one of the therapeutic measures that today has a special place in the treatment and saving of the lives of patients. However, the adverse effects caused by blood components transfusion may harm patients and impose high costs on patients and the health care system.

In this cross-sectional descriptive-analytical study, the data related to adverse reactions following blood transfusion such as: time of onset of symptoms, type of symptoms, severity of symptoms, hemolytic reaction or type of complication were collected among 55839 patients who were admitted to Al-Zahra Hospital in Isfahan city, and had been received blood products during the years 2020-2021. The results were compared with the American Association Blood Bank (AABB) standards.

The total number of patients who suffered complications after receiving blood components is 48 patients, 32 patients (62.7%) are women and 16 patients (33.3%) are men. The average age of the patients is 59.70 ± 18.68. Allergic reactions with 26 cases (54.16%) and Febrile Non-Hemolytic Transfusion Reactions (FNHTR) with 17 cases (35.4%) are the most common reactions found.

Allergic reaction and FNHTR are the most common complications after receiving blood components. The incidence of these complications in this study is lower than the statistics announced by AABB. The most common clinical symptoms manifested in patients are chills, hives, itching, restlessness, and fever.

Autosomal dominant cerebral arteriopathy with subcortical infarction and leukoencephalopathy (CADASIL) is a genetic vascular disorder that is clinically characterized by migraine, (TIA) and cognitive deficits and is caused by mutations in the NOTCH3 gene. transient ischemic attacks.

Case Report: 

The presented case is a patient with magnetic resonance imaging (MRI) and atypical clinical findings, which was mistakenly diagnosed as multiple sclerosis (MS) for several years, the patient was referred to our service due to recurrent neurological deficits. MRI examinations and gene analysis were done for them. MRI showed extensive hyperintensity in T2 and fluid-attenuated inversion recovery (FLAIR) and multiple small hemorrhages in susceptibility-weighted imaging (SWI) in the periventricular region, external capsule, and anterior temporal lobe. The diagnosis of CADASIL was confirmed by genetic analysis of the NOTCH3 gene. Once CADASIL was confirmed, MS-related treatments were discontinued.

The presented case highlights the importance of careful evaluation of clinical findings and neuroimaging in suspected MS patients and emphasizes the importance of CADASIL as an overlooked differential diagnosis.

The aim of this study is to compare the effect of high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on body composition in adults with overweight and obese.

A systematic search of English and Persian articles published in PubMed, Web of Science, SID, and Magiran databases was conducted up to November 2022. A meta-analysis was performed to compare the effect of HIIT and MICT on body composition in adults with overweight and obese. Weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using fixed effect model.  Also, I2 test was used to determine heterogeneity, and Funnel plot test and Egger test were used for publication bias.

The results of 36 studies with 1096 subjects showed that HIIT did not significantly change in body weight [WMD = 0.37, (-1.12 to 0.24), P = 0.3], body fat percentage [WMD = 0.31 (-0.19 to 0.83), P = 0.2], and body fat mass [WMD = -0.43 (-1.12 to 0.24), P = 0.2], compared to MICT in adults with overweight and obese. But HIIT causes a significant increase in body free fat mass [WMD = 0.82 (0.07 to 1.58), P = 0.03], compared to MICT in adults with overweight and obese.

The results of the present study show that HIIT has similar benefits to MICT on body composition, and body fat reduction, although HIIT is a time-efficient training method.  However, neither of the short-term HIIT nor MICT results in a clinically significant reduction in body fat. HIIT leads to an increase in body free fat mass in obese adults compared to MICT.