فصلنامه خون
سال نهم شماره 3 (پیاپی 37، پاییز 1391)

One of the factors known to cause thrombophilia in women with unexplained recurrent spontaneous abortion (RSA) is the 4G/5G polymorphisms in the promoter region of the plasminogen activator inhibitor-1(PAI-1). This study aimed to determine the association between RSA and this polymorphism in Iranian patients. In this case-control study, 30 patients with the background of two or more consecutive unexplained abortions and 10 women with at least two live births without a miscarriage who referred to Baqiyatallah hospital and Avicenna Infertility Clinic were analyzed for the PAI-1 4G/5G promoter polymorphism by the PCR-RFLP method. Results achieved from estimating the genotype of this polymorphism were analyzed by the SPSS16 and Chi Square. 4G allele frequency was 46.7 % in the patient group and 40% in the control group. Frequency of the PAI-1 4G/5G promoter polymorphism was 76.7% in patients and 80% in controls. For PAI-1 4G/5G promoter polymorphism, 60% of patients and 80% of controls were heterozygote. Furthermore, 16.7% of patients were homozygote, though there were not any homozygote in controls. These findings failed to support the relationship between PAI-1 4G/5G promoter polymorphism and the increasing risk of RSA in evaluated Iranian women.

The identification of the genetic diversity and evolution of HIV-1 in the country needs constant molecular survey which could represent useful information to design new diagnostic and therapeutic strategies. Gene cloning strategy was used to evaluate the distribution and genetic diversity of the HIV-1 circulating forms. Overal, 50 HIV-1 seropositive subjects were enrolled in the study. All of them were IDUs and had no history of antiretroviral therapy. The reverse-transcriptase genes of HIV-1 were amplified by nested RT-PCR using specific primers. Then, the RT gene of HIV-1 was cloned into a cloning vector PTZ-57R. Multiple clones from each patient were sequenced. The obtained sequences were aligned with the reference sequences, retrieved from the GenBank database. Multiple sequence alignments were performed by using the ClustalW 1.8 software package. Phylogenetic trees were generated by using the neighbor-joining plot. Of 50 serum samples, 30 were HIV RNA positive by nested RT-PCR. The nucleotide sequence analysis was performed on the RT genes from multiple clones. All samples were of HIV-1 CRF35-AD strains. Data showed that CRF35-AD strain is the most prevalent in HIV infected patients. Information on the genetic diversity of viruses in patients and also viruses circulating in the community can be useful in design of diagnostic procedure, infection control programs and treatment.

Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for certain individuals diagnosed with high risk acute myeloid leukemia (AML). Several recent studies have described a significant correlation between transplantation outcome and three single nucleotide polymorphisms (SNPs) in the NOD2/CARD15 gene. This study was conducted to evaluate the association of NOD2/CARD15 gene polymorphisms with the occurrence of mortality in AML patients who underwent HSCT. NOD2/CARD15 genotypes were analyzed by using PCR-SSP in 124 patients diagnosed with AML and their full match donors who underwent an allogenic HSCT; then, the association of NOD2/ CARD15 gene polymorphisms with the occurrence of mortality in AML patients and their donors was evaluated. The median time of follow up of survived recipients in the cohort was 40 months (28-77). Analysis was performed by using SPSS 11.5, the Kaplan-Meier method, and Long Rank test. Sci J Iran Blood Transfus Organ 2012; 9(3): 290-299 Mutation frequency of the NOD2/CARD15 gene was found in 27 pairs (21.8%). The estimated 3-year OS (Overal Survival) in wild type pairs was 74.7% (SE = 4.5) as compared with OS of 55.6% (SE = 9.6) in NOD2/CARD15 SNP pairs (P = 0.04). There was no significant difference between survival rate without a 3-year relapse in wild type patients (73.6%, SE = 4.5) and those with polymorphisms (61.7% SE = 10.3). This study showed that polymorphism in the NOD2/CARD15 gene has an effect on survival rate and transplantation outcome after HSCT.

Myocardial infarction (MI) is one of the most important causes of death in the world. The platelets play an important role in ischemic myocardial disease in many ways; after a brief episode of ischemia, oxygen-derived free radicals are generated in several pathological processes. Oxidation of platelet enzymes such as xanthine oxidase and lipid peroxidation may increase after MI. In this cross-sectional study, we have studied 20 patients with MI (group1) and 10 voluntary healthy people as the normal control (group 2) for 10 months. Group1 just recieved routine drugs (β -blockers) and aspirin, while group 2 received an extra vitamin E for 6 days. We collected 10 ml coagulated blood from patients and controls. After preparation of the platelet-rich plasma (PRP), xanthine oxidase and lipid peroxidase of platelets were detected. Data were analyzed by using SPSS16, paired T- test and ANOVA test. Findings showed that the administration of vitamin E along with aspirin after 6 days brought about a good antioxidant drugs effect as evidenced by the activity reduction of platelet xanthine oxidase (p< 0.001) and decrease of lipid peroxidase metabolite (p< 0.001). Using vitamin E along with the other β -blocker drugs would protect patients with MI from oxidant and further heart failure.

Importance of hemoglobin (Hb) screening for blood donors persuades blood centers to try to estimate hemoglobin via faster, simpler, and more reliable methods. This study evaluated the diagnostic value of the methods for blood donor selection. In this cross-sectional study, 256 non-selective whole blood donors entered the study after written consents were obtained. Three drops of capillary blood and 2 ml of venous blood mixed with EDTA were collected from blood donors before donation for the purpose of Hb screening by the use of colour scale (HCS) and photometric methods and blood cell analysis. Data were analyzed by using t-paired test, Pearson correlation, and SPSS17. Mean Hb values in cell analyzer, capillary and venous photometric methods were 15.5 ± 1.4, 16.5 ± 1. 4, and 16.1 ± 1.4, respectively. Hb screening using venous photometric method had the highest correlation with cell analysis (r = 0.933) while the correlation of capillary photometric method was the second highest (r = 0.823). Bias was estimated 0.2-0.6 mg/dl at Hb range of 11 g/dl and lower. The sensitivity and specificity using the capillary photometric method were 100 and 97 at Hb level of 12.5 g/dl, respectively. The more the level of Hb of blood donors, the less the values of specificity and sensitivity. The best sensitivity and specificity values in capillary HCS at Hb level of 12 g/dl were 97.3% and 66.7%, respectively. The photometric method is reliable and accurate for Hb screening of first time donors, female donors, and those exposed to anemia. Blood centers could use nonexpensive methods such as HCS and microhematocrit in testing donors.

The global prognosis of renal cell carcinoma (RCC) remains poor; about 40% of patients will develop metastasis after nephrectomy. There is a strong need to identify the early metastasis. The present study aimed to test if analysis of the CA9 gene in peripheral blood can provide useful information to predict micro metastasis. In this experimental study, patients (n=30) with RCC were evaluated for peripheral blood CA9 expression non-randomly. Data of tumor grade were received from the pathologist. Total RNA extraction and cDNA synthesis were performed. CA9 expression levels of patients were compared with the normal group (n=16) by real - time PCR. The Mann-Whitney U test and Kruskal-wallis test were used to compare CA9 expression levels with tumor grades. SPSS13 was used for data analysis. Six of patients show high CA9 expression (3 in grade I, 2 in grade II, and 1 in grade III) but no significant difference was found between CA9 expression level and tumor grade. After one year follow up, 4 patients were found to have a metastasis but no significant difference was found between CA9 expression level and metastatic patients. On the basis of the results of this study, CA9 is a tumor-specific marker for RCC with a high degree of expression in the conventional RCC. At the same time, the detection of CA9 gene expression in the peripheral blood of patients with RCC may predict increasing risk of micro metastasis.

Background and Objectives The complex nature of hemophilia and negative effects on patient body, mind and spiritual state can affect their quality of life. The aim of this study was to compare the different dimensions of quality of life between healthy and hemophilia teenagers. Materials and Methods In this descriptive-comparative study, 64 teenagers with similar demographic characteristics like age, sex, and socioeconomic status were randomly divided in two groups of case and control in Seyed Al-Shohada hospital. Data were collected through questionnaires filled out at two times by the researcher. Data were analyzed by using SPSS15, paired t-test, independent t-test and Man Whitney. Results Average scores of physical, psychological and environmental aspects for quality of life and average total score of quality of life in the control group were significantly different from the case group (p> 0.001). The average scores of social dimention of quality of life in both groups in the first and second evaluation were not significantly different. Conclusions Regarding the poor quality of life in teenagers with hemophilia compared with healthy teenagers, measures to improve the quality of life in all its aspects seem to be essential.

Nurses play an important role in safe use of blood and blood products. Blood safety and effectiveness of transfusion somehow pertain to the knowledge and skills of the nurses who are responsible for. The purpose of this study was to evaluate nurse's knowledge and practice of blood transfusion in hospitals of Arak in 2010. In this descriptive cross-sectional study, all nurses in hospitals of Arak participated. Information was collected through questionnaires. Scores of knowledge and practice were arranged to three levels of weak, average and good after recoded in terms of accepted scores. Data were analyzed by statistics-descriptive analysis using SPSS16, Chi Square correlation test and Spearman correlation coefficient. Most people were women (92.9%) and had bachelor degree (99.3%). Average and standard deviation of age and work history were 29.79 ± 5.14 and 6.15 ± 4.76, respectively. Knowledge measurement showed that 50.9% of participants are at good level, 33.5% at the intermediate and 15.6% at the weak level. Self-evaluation of nurses about their practice showed that the majority of subjects (63.9%) have good practice and the rest are at average. There was a significant correlation between knowledge and practice of the nurses (p< 0.001). In this study the majority of nurse's knowledge and performance is satisfactory; but there is still the need for more learning about the complications of blood transfusion and care improvement. Therefore, holding educational programs and monitoring managers seem to be necessary.

Cost analysis of blood transfusion centers and their products is a very important tool for policy makers to manage and plan for future. The aim of this study was to develop a model for estimating costs related to blood transfusion centers and their products. In this descriptive and retrospective study, we have evaluated the following costs during the financial year of March 2009 to 2010: capital costs (values of buildings, vehicles, unusable materials and equipment) and recurrent costs (costs of buildings’ repairs, usable materials, drugs, salaries of employees and other consumables and office expenses). A checklist was used for data collection and analysis was done by SPSS 17. Initially the costs were calculated in Iranian Rials and then converted to USD (1 USD = 9600 Rial) during 2009 -2010. Mean total costs for a fixed blood transfusion center without no blood component preparation was 48059$, for a mobile blood center 336445$, and for a fixed blood transfusion center with both blood collection and blood component preparation ranged from 1599256 to 268361$. It is also calculated to be 1581488$ for a blood transfusion center where blood collection, blood component preparation, and laboratory screening tests are done. Overall, the service charge of the preparation of whole blood unit, packed cell, FFP, and random donor platelet were 72, 62, 77 and 226$, respectively. Since blood components are provided free of charge and there is no insurance coverage over production costs, the management of resources is of prime importance for blood centers.

Delayed puberty is a great problem of thalassemia patients. Zinc is antioxidant and is available in red blood cell (RBC) membrane and plays an effective role in survival of RBC. Some part of growth retardation in thalassemia seems to be related to zinc deficiency. The aim of this study was to investigate correlation of serum copper and zinc concentration with prooxidant-antioxidant balance (PAB) in thalassemia major patients. In this cross-sectional study, 140 thalassemia major patients (79 male and 61 female) reffered to Sarvar Center in Mashhad. Serum copper and zinc levels were measured by atomic absorption (Spectrophotometer) and results were compared with 140 sex and age matched healthy subjects. Data were analyzed by SPSS18 and t-test. Thalassemic patients had significantly lower serum zinc (60.11 ± 19.01 vs. 87.09 ± 23.68 (µg/dl)) and copper levels (90.45 ± 29.8 vs. 105.59 ± 32.5 (µg/dl)) compared with healthy subjects (p<0.001). In thalassemia patients PAB value was very increased compared with healthy subjects (70.2 ± 19.9 vs 78.764 ± 25.583 HK)(p<0.003) Because of the high prevalence of low serum zinc and copper levels in thalassemic patients, use of zinc and copper supplementation in thalassemic patients was strongly recommended.