فصلنامه خون
سال هفدهم شماره 4 (پیاپی 70، زمستان 1399)

The most important aim of all blood transfusion centers is to motivate and recruit young blood donors from low-risk population to donate blood voluntarily and regularly to ensure a safe and continuous blood supply. There is a paucity of studies on awareness and attitude among university students on voluntary blood donation in Yazd. The aim of this study was to determine the knowledge, attitude and practice about blood donation among university students.

A cross-sectional study was conducted among university students. The data were obtained during 2014 through questionnaire. Data were coded in SPSS18 software and analysis was done by using of Chi square, T-test, and ANOVA statistical tests.

Totally 1329 cases were selected and asked by trained individuals to fill a specially formatted questionnaire. Mean age of cases was 22.7±4.4. Knowledge levels of 694 (52.2%), 449 (33.8%), and 186 (14%) students were estimated to be weak, moderate, and good, respectively.  Attitude levels of 422 (31.8%), 693 (52.1%), and 214(16.1%) were stimated weak, moderate, and good, respectively. 77 students had good knowledge and attitude towards blood donation. Totally, 226 (17%) students, including 83 (12%) female and 143 (24%) male and in the case of 409 (30.7%) students, one of their family members donated blood at least once. 
 Conclusions  

According to the results of this study, studentschr('39') knowledge, attitude and practice about blood donation were not desirable and need improvement.

Hepatitis B virus (HBV) infection remains a serious global health challenge. Hepatitis B infection is one of the major diseases transmitted by blood transfusion. Infection with the virus can cause extensive liver damage.  So far, 10 genotypes have been identified for hepatitis B. The aim of this study was to do Hepatitis B virus genotyping in asymptomatic HBV blood donors in Tehran.

In this cross-sectional study, 20 HBsAg positive blood donors tested by ELISA were examined. After viral DNA extraction, the pres gene was amplified by Nested-PCR method and the virus genotype was aligned with the references sequence by Clustal w software.

Samples were sequenced after Nested-PCR was done. Hepatitis B virus genotype was determined in all 20 blood donors with hepatitis B to be genotype D. 

Prevalence of genotype D in study subjects was 100%.  This result can be used in preparation of hepatitis B diagnostic kits. Identifying genotypes can also help physicians identify patients at higher risk for disease progression and adopt better treatment strategies.

Acute lymphoblastic leukemia is a hematological malignancy of lymphoid lineage. Side effects of chemotherapy drugs is a major reason for the tendency to use Herbal medicines. Previous studies on Juniperus excelsa (J.excelsa) have shown anti-cancer properties on some cancer cell lines. This study aimed to investigate the effect of three fractions of J.excelsa on acute lymphoblastic leukemia cells (Nalm-6) and normal mononuclear cells (PBMC), and find a more toxic fraction.

In this experimental study, the cytotoxic activity of these fractions in Nalm-6 was determined using Viability and MTT assay. By these tests, the more toxic fraction was selected and apoptosis was assessed and confirmed with Annexin-V/propidium iodide staining by flow cytometry. Each test was repeated at least three times. Statistical analysis was assessed by one-way ANOVA and SPSS 23.

The results showed that concentrations of 2.5 and 4 µg/ml of chloroform and etherdopetrol fractions of J.excelsa, without considerable effect on PBMC (p > 0.05), reduced significantly the cell viability and metabolic activity of Nalm-6 (p < 0.01). Also, aquae fraction had no cytotoxic effect on Nalm-6 and normal cells (p > 0.05). The more toxic fraction, which was chloroform fraction, was selected by these tests. According to the flow cytometry test, treated Nalm-6 cells with chloroform fraction demonstrated a 13-fold increase in the number of apoptotic cells compared with control (p < 0.001).

Our study showed that chloroform and etherdopetrol fractions have cytotoxic and antiproliferative effects on leukemic cells (Nalm-6) and induce apoptosis.

Education has an essential role in the community awareness that could increase the blood donation tendency and reduce the risk of unsafe blood donation. The present study assessed the role of education and removal of blood donation barriers in increasing blood donation and promoting blood safety among students of Zahedan universities.

This Descriptive-interventional study was conducted in five universities and high education centers in Zahedan City. At the beginning, the questionnaire was used to identify the main barriers of blood donation among these students. Then we tried to resolve the studentschr('39') major concerns through education. Finally, the mobile blood collection teams were sent to these universities. The percentage of first-time blood donors and the safety of donated blood units were compared with those of the main blood transfusion center.

The main reasons for lack of blood donation among the 2744 students were fear of endangering their health (44.8%) and lack of enough time (26.7%). After the education was provided, 1211 individuals including 1039 (85.8%) men and 172 (14.2%) women donated blood, The number was much higher than that in the main blood transfusion center of Zahedan City (p < 0.01). The number of the first-time donors as well as the rate of blood safety were significantly higher (p < 0.001) among these donors than those in the main blood transfusion center of Zahedan (p < 0.001).

The present study showed that education plays a very important role in increasing blood donation rate and promoting blood safety

Following incompatible blood transfusions, anti-HLA and  anti- HPA antibodies may develop and cause various disorders such as post-transfusion purpura, platelet refractoriness, and thrombocytopenia leading to bleeding. The aim of this study was to investigate platelet antigens and antibodies in multi-transfused patients.

In this descriptive study, platelet antigens and presence of platelet antibodies were tested by PCR-SSP and PIFT flowcytometry in 30 Thalassemia major and 30 oncohematologic patients with one hour post transfusion platelet counts in the range of 150000-450000/µl. χ2  test was employed for comparing the results of the study.

Molecular genotyping of HPA-1in thalassemia major patients and patients with oncohematologic disorder in this study revealed that HPA-1a/1a was the most and HPA-1a/1b and  HPA-3b/3b  were the least frequent genotypes. No homozygous cases of 1b/1b, 2b/2b and  5b/5b  were detected. HPA-4b allele was not detected in any patient.  Flow PIFT results revealed platelet antibodies in 10(30%) patients with hematologic disorders and 1(3.3%) thalassemia major patients.

Conclusions  

According to %100 frequency of HPA-4a and total absence of HPA-4b allele and absence of homozygous b/b genotype for HPA-1/-2/-5 alleles in the patient polulation of this study, the prevalence of platelet alloimmunization due to antibodies against these antigens seems to be low. Although further studies in the field are nessessary.

Coronary artery bypass grafting is common in coronary artery disease. Some patients will need a blood transfusion. Despite the known complications of blood transfusions, there are different conclusions about the clinical significance of fresh and non-fresh red blood cells transfusion.

In this Cohort study, patients were divided in two groups of fresh blood recipients-less than two week blood bag storage- including 744 people and non-fresh-more than two weeks of storage- including 1259 people. Variables including demographic factors, hours of ventilator connection, hours of ICU hospitalization, LVEF, arrhythmia, renal failure, tamponade, neurological deficit, wound infection, septicemia, pneumonia, MI, stroke, pulmonary emboli, and in-hospital mortality were examined in two groups.

Of the 2003 subjects, 715 (35.7%) were female and 1288 (64.3%) were male. According to the Kaplan-Meier curve, the in-hospital survival rate of patients receiving fresh blood was 95.8% and in non-fresh blood 96.5%, which did not show a statistically significant difference. In other mentioned variables, no significant difference was observed.

Conclusions  

Due to the absence of significant differences between mortality and the lifespan of red blood cells in patients undergoing CABG at Tehran Heart Center, it seems that prioritizing fresh blood for the transfusion should be reserved for patients in whom the benefits of  fresh blood injections have been proven.

Vitamin K-dependent clotting factor deficiency (VKCFD) is usually an acquired problem due to liver disease, malabsorption, and overdose of warfarin.  In the present paper the significance and role of vitamin K-dependent coagulation factors in menorrhagia were evaluated.

 Case

We present a rare case of 43 year woman with acquired vitamin K deficiency and severe menorrhagia without any gynecological problem. The level of all Vitamin-K dependent coagulation factors, Fctor II, Factor VII, Factor IX, and Factor X decreased. Furthermore, even after multiple administration of Vitamin K  and its oral consumption, still the level of coagulation factors and menorrhagia did not ameliorate.

Conclusions  

Acquired VKCFD is one of the rare situations that can be life-threatening.

Platelet refractoriness can be caused by immunological and non-immunological factors. In non-immunological cases, the source which is usually a disease, should be eliminated. In immunological cases antibodies produced against foreign platelet antigens play a significant role. The aim of this review was to investigate the strategies involved in identifying and preventing immunological platelet refractoriness .

This article reviews the tests used to identify platelet refractoriness for selection of compatible platelets, as well as prevention and management of the disease. This was done by using keywords; Platelet Transfusion, Platelet Refractory, Corrected Count Increment and Alloantibody and their Persian equivalents through scientific database including  Science Direct, PubMed Medline, SID, Scopus and Magiran, and finally among 100 related articles, 66  were selected.

Since the main immunological cause of platelet refractoriness is production of anti-HLA antibodies, screening for these antibodies is very important. Cross-matching and antibody-specificity prediction can also be performed for these patients. In emergencies, plasma replacement, intravenous immunoglobulin injection, and use of certain medications and compounds could be helpful.

Investigating the efficacy of different methods in diagnosis of platelet refractoriness and detection of compatible platelets has a great impact on prevention, treatment and better management of the disease.