فصلنامه خون
سال نوزدهم شماره 3 (پیاپی 77، پاییز 1401)

HIV virus and its subsequent disease is one of the most important challenges of the world health system. Although antiretroviral therapy (ART) is a breakthrough in patients’ life quality, it has complications like side effects. The side effect causes are diverse. One of the factors considered about side effects is genes polymorphism. This study investigates the relationship between rs2712816 and rs949096 polymorphisms on SLCO2B1 gene which is one of the most important antiretroviral drugs transporters.

In this Cross-sectional study, the two variants, rs2712816 and rs949069 were genotyped on 161 samples of HIV-1 infected patients. Consequently, the records of patients in Imam Khomeini Behavioral Diseases Center were reviewed and necessary data were collected. Statistical analysis was done by chi-square, exact Fisher test, and Mann Whitney U test using SPSS 26.0.

The results show that there is a significant relationship between AA genotype in rs949069 polymorphism and dizziness and urticaria in patients (p< 0.05). The rs2712816 polymorphism and side effects did not show any significant relationship.

There are different factors involved in antiretroviral therapy side effects. According to the results of this study, the rs949069 is one of the factors.

Histocompatibility antigens (HLAs) have high genetic diversity and their frequency can be diverse in different ethnicities. Therefore, the determination of these antigens in different ethnicities can provide data used in the expansion of centers for the registration of stem cell donors.

In this descriptive study, donor DNA was extracted and qualified. Then, the allele groups of HLA-A were determined at low resolution level by PCR-SSP method. Ethnic and HLA information of Gilak (n= 150), Lor (n= 465), Kurdish (n = 719) and Arab (n = 370) were analyzed and the relationship between the allele and ethnicity was examined and a significant relationship between the frequencies of alleles in the studied ethnicities were evaluated by chisquare statistical method. In this study, a statistically significant level of 0.05 was considered. In order to determine in which of the ethnicities the frequency of the studied alleles was higher than the expected values under the assumption of independence, the standardized residual values were determined.

Allelic frequencies in the studied ethnic groups were obtained for HLA-A*23 and HLA-A*31, <3% . In allelic groups of HLA-A*25, HLA-A*34, HLA-A*36, HLA-A*43, HLA-A*66, HLA-A*69 and HLA-A*74, this frequency was less than 1 %. The frequency of rare HLA-A allelic groups, including HLA-A*34, HLA-A*69 and HLA-A*74, showed a significant difference in the ethnic groups (p-value less than 0.05).

Identifying the frequency of HLA alleles in different ethnicities can identify similarities and differences in allelic groups in those ethnicities.

Although blood transfusion is the most important method to control thalassemia major, this method leads to the iron accumulation in various tissues and organs of patients. The aim of this study was to compare the effect of Deferasirox with new formulations and other iron chelator drugs on serum ferritin level and gastrointestinal effects in thalassemia major patients in thalassemia center of Kashan University of Medical Sciences during a two-year period.

This semi-experimental study was performed on 45 thalassemia patients. In 2018, these patients were treated with a drug other than Defrasirox with a new formulation. In 2018, all patients were treated with the new Defrasirox. Serum ferritin level was measured once every three months, compared with the previous year, and analyzed by Kolmogorov smirnov, Anova and SPSS 19.

In 2018 and 2019, there was no significant difference in terms of serum ferritin level. In 2019, with the use of the new drug Deferasirox, a total of 11.1% of patients have suffered from complications of drug use, which is a significant decrease compared to the previous year (p = 0.004).

The effect of the Deferasirox with new formulation in reducing serum ferritin level in patients with thalassemia major is similar to previous drugs (old Deferasirox, deferiprone and desferrioxamine). However, patients recieving this drug have less gastrointestinal effects such as pain, nausea, vomiting and diarrhea. At the same time, the satisfaction with the drug has increased significantly.

Mortality is one of the common consequences of non-trauma patients (NTP) admitted to the intensive care unit. In this study, hemoglobin concentration and its relationship with clinical outcome in NTP was investigated

This cross-sectional study was performed on the records of 400 non-trauma patients admitted to the General Intensive Care Unit of Besat Hospital in Hamadan during 2020-2022 in terms of hemoglobin concentration and its relationship with clinical outcome. Study data were analyzed using SPSS software version 23 and Student t-tests, one-way analysis of variance, and Pearson correlation coefficient.

In this Cross-sectional study, cancer (18.8%), drug poisoning (14.8%), poisoning (14.5%), and DKA (8.8%) were the most common causes of non-trauma hospitalization. The incidence of in-hospital death was 18.8%. Sepsis, pulmonary embolism, myocardial infarction, meningitis and DIC with 46.7%, 22.7%, 18.7%, 6.7% and 5.3% were the most common causes of death, respectively. There was a significant relationship between hemoglobin concentration with age, sex and duration of hospitalization (p<0.05). A significant relationship was observed between lower hemoglobin concentration before and during hospitalization with increased mortality (p<0.001).

In the present study, the hemoglobin of non-trauma patients decreased during hospitalization compared to pre-hospitalization period and this decrease in hemoglobin level was associated with increased mortality of non-trauma patients in the hospital.

HNAs are glycoprotein antigens on the surface of neutrophils. Antibodies against these antigens are produced in patients with repeated blood transfusions. We here study the HNA-1a, HNA-1b and HNA-1c gene frequencies in regulary transfused patients suffering from hemolytic transfusion reactions as well as the risk of alloimmunization of these individuals based on the genotype pattern.

As the study population, 99 thalassemia patients were included in the descriptive study. Sampling lasted from July 2019 to March 2020 at Zafar Thalassemia Center. Patients were administered low-leukocyte blood. Three mL of blood was collected in tubes containing EDTA and DNA was extracted. HNA-1 gene was analyzed by PCR-SSP method. Allelic frequency of neutrophil antigens was calculated using Hardy-Weinberg equation. Chi-square and T-test were used to analyze the data.

The frequency rates of observed alleles were 52.7% for HNA-1a, 44.3% for HNA-1b, 3% for HNA-1c, which was in accordance with Hardy-Weinberg's law with a 5% confidence interval. The highest risk of alloimmunization to HNA-1b, HNA-1a, and HNA-1c were 22%, 18%, and 3%, respectively.

The frequency of HNA-1 neutrophil antigen allele in thalassemia patients with febrile blood transfusion was consistent with previous findings in different Iranian populations. Patients still have a risk of alloimmunization and blood transfusion based on neutrophilic genotype pattern.

Beta thalassemia major patients suffer from psychological problems in dealing with its complications. The aim of this study was to evaluate the effectiveness of spiritual therapy based on positive thinking on spiritual health, psychological hardiness and death anxiety in women with Beta thalassemia major in Khorramabad.

The design of this study was quasi-experimental and pre-test/post-test with a control group. The statistical population of this study was women with beta thalassemia major referred to Shahid Madani Hospital in Khorramabad in 2021. Using the convenience sampling method, 40 people were selected and randomly assigned to the experimental (20) and control group (20). The experimental group received 12 sessions of spiritual therapy based on positive thinking. In order to collect data, Palutzin and Ellison's spiritual Well-Being, Kobasa's psychological hardiness, and Templer 's death anxiety were used.

The results of multivariate and univariate covariance analysis showed that spiritual therapy based on positive thinking had a significant effect on improving spiritual health (41.50 ± 6.64), psychological hardiness (50.15 ± 8.38), and death anxiety (6.45 ± 0.91) in women with beta thalassemia major in the experimental group (p < 0.001).

According to the results of the research, spiritual therapy intervention based on positive thinking has improved spiritual health, psychological hardiness, and death anxiety of women with beta thalassemia major.

Exercise can cause various hematological changes and affect some blood parameters; among these, yoga exercises are one of the most practical exercises in this field. So the present study was conducted to compare Asana and Pranayama exercises on the hematological characteristics of women climbers.

The present study was semi-experimental with pre-test and post-test design and 2 experimental groups. For this purpose, 16 healthy women climbers with an age range of 20 to 45 years were purposefully selected and randomly divided into two groups of Pranayama and Asana exercises. The Asana and Pranayama protocol were performed for 8 weeks (3 days a week). At the end, the hematologic parameters were measured. The collected data were analyzed using ANCOVA test at the significance level of p < 0.05.

There was a significant difference between the two groups only in RBC (Asana: 5.69 ± 0.76, Pranayama:4.86 ± 0.62) while it was increased in Asana compared to Pranayama (p = 0.015). However, no statistically significant difference was observed in other indices (MCV, MCH, MCHC, leukocytes, hemoglobin and Percentage of hematocrit).

There was little difference between the two training exercises of Asana and Pranayama in hematologic parameters. Maybe since the abdominal breathing is included in Asana exercise, it presented similarly to Pranayama in hematologic indices. However, Asana was superior in RBC number calculation.

ABO-incompatible allo-HSCT leads to complications like pure red cell aplasia (PRCA), which involves 7-16% of ABO-incompatible recipients. In this condition, albeit the development of other hematopoietic lineages in the bone marrow engraftment is successful, erythroid precursors are missing; thus, patients may require blood transfusions because of severe anemia. An extensive variety of treatment strategies has been introduced for treating PRCA patients. This study reviewed the various PRCA treatments following allo-HSCT.

In this Review study, keywords including Pure Red-Cell Aplasia, Hematopoietic Stem Cell Transplantation, and ABO Blood-Group System were searched in PubMed and Google Scholar databases. Sixty-four articles were reviewed, and related data were extracted.

There are three main approaches for treating PRCA: erythropoiesis with erythropoietin, reducing isoagglutinin levels, and immunomodulatory therapies/graft versus plasma cell effect.

Monoclonal antibody drugs targeting plasma cells have shown unprecedented results. Overall, PRCA management ways incorporate: individual patients’ evaluation in order to select the proper treatment management for each case, a thorough monitoring approach from the first day of hospitalization, and predicting the possibility of PRCA as indicated by blood group antibodies’ levels.