فصلنامه خون
سال یازدهم شماره 3 (پیاپی 45، پاییز 1393)

Brucellosis is an infectious zoonotic disease that continues to be of public health and economic concerns in many parts of the world. Since Iran is an endemic area for brucellosis, this study was conducted to look into the sero-prevalence of brucellosis in blood donors in Khuzestan province, South West of Iran. In the cross-sectional study, 3000 sera were obtained from blood donors having referred to transfusion centers of Khuzestan cities in 2011. Sera were screened for serological evidence of brucellosis using the Rose Bengal Plate Test (RBST), Standard Tube Agglutination Test (STAT), and the 2-Mercapto ethanol (2ME) test. A titer of ≥ 1/80 for STAT and a titer of ≥ 1/40 for 2ME were taken as criteria of brucellosis. Data were analyzed by SPSS 18 software and Chi test. Seropositivity rates of brucellosis in blood donors were 1.7%, 1.46%, and 0.56% by RBPT, STAT, and 2ME, respectively. There was no statistical correlation between brucellosis and sex or age groups (p = 0.26 and p = 0.56, respectively). The highest rates of brucellosis sero-prevalence was found in Izeh (1.7%) and the lowest in Ahvaz (0.2%). The area of living and season were significantly associated with brucellosis (p = 0.032 and p = 0.019, respectively). Based on the results, the Seroprevalence of brucellosis in blood donors at Khuzestan province is greater than expected.

Clopidogrel is one of the most commonly prescribed drugs to prevent ischemic events following coronary syndromes or stent placement. The objective of this study was to evaluate the prevalence of the cytochrome P450 (CYP450) 2C19 enzyme (CYP2C19) genotypes in the Iranian population. CYP2C19 (*1/*2/*3) variants were analyzed using Polymerase Chain Reaction-Restriction Length Polymorphism (PCR–RFLP) assays in a representative sample of 154 Iranian patients with ischemic heart disease in Peyvand Laboratory. In this study, out of 154 Iranian patients the frequency rates of CYP2C19 *2 were 36 (23.4%) in heterozygous and 6 (3.9%) in homozygous forms; 112 (72.7%) patients had the normal genotype. FDA recommendations are more useful to be practiced in our country than other countries. Physicians should identify patients and advise them to consider other antiplatelet medications or alternative dosing strategies in poor metabolizers.

Blood is a scarce and valuable human resource and must be prescribed wisely and based on international and regional standards. Considering the importance of blood and blood components, we carried on this study to evaluate the discard rate of blood components and the attributed causes in Ahvaz hospitals in 6 months of 2010; both the total and the individual hospital rates were estimated. This cross-sectional study was conducted for the first time in Khuzestan province; all the blood components return forms of all hospitals in Ahvaz city during the six months were analyzed with SPSS 14 software. The total amount of blood waste in our study was 12% (3124/30211). The highest rate of wastage pertained to PC (58.1%) and the lowest to WB (0.2%). The main cause of discard was attributed to being close to the expiry date (86.4%) and the minor cause was the detection of clot in blood units (0.1%). The highest discard rate of blood occurred in April (23.5%) and the lowest in July (16.1%). Shafa Hospital had the highest rate of blood waste (35.3%) and Golestan the minimal loss (0.5%). The 12% waste rate of blood and blood products in our study shows the necessity of training about blood ordering and cold chain during transportation with the participation of the hospitals with the low level of wastage, the establishment of efficient hospital committees, and counseling with professionals. Further study of blood wastage in hospitals with seemingly high discard rate of blood is recommended.

Arterial thrombosis, with MI as the severe complication, represents the most frequent cause of death in the world. Although there is no doubt that genetic factors contribute significantly to the prothrombotic state, the data on polymorphisms in candidate genes are still inconclusive. We investigated if T13254C polymorphism in the platelet GPVI gene confers an increased risk of premature acute myocardial infarction (MI). We conducted a case-control study of 100 young males with premature acute MI and 100 inpatient controls of the similar age, without any known heart diseases. Genotyping was done using PCR-RFLP. The significance of differences between cases and controls with respect to the variables was tested using student’s t test and Chi square. Logical regression model was used to control confounding variables. The allele frequencies of T13254C polymorphism did not differ between patients (30%) and controls (33%), and this polymorphism was not associated with premature acute MI (p < 0.05). Logistic regression analysis also indicated no association between these polymorphisms and premature MI. Compatible with our study, the T13254C polymorphism of platelet collagen receptor did not play a significant role in the development of premature MI.

The knowledge of physicians and nurses concerning blood transfusion has a significant impact on the optimal use of blood and blood products. The aim was to survey their knowledge regarding transfusion medicine and the effect of education thereof. An interventional semi-experimental study was conducted on physicians and nurses who worked in Shiraz hospitals. The questionnaire included demographic characteristics, previous education records, and their experience regarding blood transfusion, transfusion indications, blood administration, and adverse reactions. The mean knowledge of the participants before and after education was calculated. T test, Pair T test, and Chi-squared test were used for data analysis with SPSS 18. The mean knowledge scores of physicians and nurses regarding transfusion medicine were 15.3 ± 6.9 and 9.5 ± 5.2 out of 24, respectively. The mean knowledge score of physicians and nurses who received education regarding transfusion medicine during their medical and nursing courses was more than those who did not (p < 0.01); 98.6% of physicians and 97.1% of nurses believed that their education was not adequate. The mean knowledge score after education increased significantly in physicians (20.8 ± 4.3) and nurses (18.2 ± 3) out of 24 (p < 0.001). The knowledge of physicians and nurses regarding blood transfusion was low. The education can improve their knowledge. It seems necessary for educational courses regarding transfusion medicine to be held and for academic transfusion medicine courses to be added to medical and nursing curriculua.

There are several evidences that show lipoproteins especially Low Density Lipoprotein (LDL) and platelets play an important role in the pathogenesis of atherosclerotic plaque and thrombosis. The important issue is how lipids induce primary clot formation and detect primary thrombosis. The present cross-sectional study evaluated 42 of hyper-cholesterolmias who had serum cholesterol levels above the normal range (200 mg/dL; based on the Iranian serum cholesterol reference) and 14 healthy volunteers as the normal control. The serum LDLs of the samples were isolated and oxidized; then, the function of platelet after being affected by natural LDL (N-LDL) and oxidized LDL (OX-LDL) was observed. Finally, the data were statistically analyzed using SPSS version 16 software and the student T-test. The serum ox-LDL was detected in 234 nm, the absorbance from 0.45 in LDL turned to 0.98 in OX-LDL, (p < 0.0008). Results in our study indicated that, in contrary to N-LDL, OX-LDL induced increased platelet aggregation in aggregometry method, respectly 11% platelet agggragation with N-LDL and 45% with OX-LDL. Flowcytometry analysis of platelet function indicated that; in the vicinity of N-LDL confirm the only 8% of platelets were binding with fibrinogen, whereas 82% of platelets binding with 20 mg/mL of OX-LDL. The study shows that LDLs modified by serum lipooxidants and exposed to OX-LDL may induce platelet activity and aggregation followed by the increase risk of thrombosis and cardiovascular diseases.

Neutropenia is the strongest factor associated with infection in neutropenic patients with immunodeficiency and under immunosuppressive medication with fever being the most important indicator of infection in neutropenic patients. Since infections are the commonest cause of death in these patients, this study was performed to determine the causes of fever in neutropenic patients. This cross-sectional study was performed on 63 patients hospitalized with febrile neutropenia, admitted in the oncology ward of Imam Sajjad Hospital during 2006-2011. Sampling was performed by available sampling techniques and data collection was performed by checklist. The data were analyzed using statistical software SPSS 16. The significance level was considered to be less than 0.05 in this study.Out of the total number of patients, 39.7% were male and 60.3% female. The mean age of patients was 51.83 ± 17.06 years. Culture was positive in 54% patients (33.36% F, 20.64% M). The most common types of infection were urinary tract (14.3%) and respiratory infections (7.9%). The most common isolated microorganism was Escherichia Coli (26.5%). The findings of most studies show that gram-positive bacteria are the most common cause of fever in neutropenic patients.

Recognizing people's attitudes has a pivotal role in the process of their attraction to voluntary blood donation. This study compares the effectiveness of three-fold Theory of Planned Behavior and two-fold Theory of Rational Action beliefs on voluntary blood donation among Tehran women. The present research was descriptive-correlative. A group of 425 Tehran women was selected by stratified sampling method. The data were collected using a questionnaire based on TRA and TPB, and t-test and Chi-square statistical indexes were applied for the analysis and model fitness using LISREL software. Findings expressed an equal ability in both patterns to predict blood donation behavior. The significance index was obtained to be 0.34 (t = 5.83) for TRA, and 0.30 (t = 4.96) for TPB in the relationship between behavioral attitude and intention, respectively. This index was obtained to be 0.55 (t = 9.69) for TRA and 0.51 (t = 8.63) for the other pattern in the relationship between normative beliefs and intention. It was also obtained to be 0.14 (t = 2.42) in the relationship between perceived behavioral control and intention. The impact of normative ethics was greater than the impact of people's behavioral attitudes on their intention. Behavioral and normative ethics were effective on people intention towards blood donation, and the utility of normative beliefs is more than the other type in this respect. Thus, the reinforcement of this belief through the mass media can be an appropriate technique to create a social value called "Blood Donation".

The aim of this study was to evaluate the prevalence of acute blood transfusion reactions in Nemazee Hospital as one of the biggest in the south of Iran. In a descriptive study during 2010-2011, a total of 57902 patients (including 33462 male and 2440 female, age range 11-86 years old) that underwent blood transfusion in Nemazee Hospital were evaluated for acute transfusion reactions. In total 52 (0.09%) cases of acute transfusion reactions (34 male and 18 female) were recorded including fever (25 cases), allergy (15 cases), back pain (9 cases), chills (8 cases), hypotension (5 cases), chest pain (1 case), hematuria (1 case), and cold sweat (1 case). Although the acute reactions were not so high, it is important to educate nurses and physicians to prevent severe and life threatening reactions.

β -thalassemia is the most common monogenic autosomal recessive all over the world. Therefore, identifying carriers and performing prenatal testing can prevent the birth of a new patient. Case: The young couple resident in Bandar Abbas with their son were referred to the Genetic Laboratory with hematological parameters that indicated minor thalassemia and implicated a symptom of an unknown hemoglobin in the father. Based on the genetic study, the father carried a rare mutation in CD56 (GGC > CGC) leading to Hb-Hamadan. In this study seems that Hb-Hamdan has no pathological effect and. This point is very important particularly in prenatal diagnosis (PND).

Views on population increase, more access to physician are causes to increase the referral to health care center. By progress of medical sciences, some disease is going to new treat. One of new treatment is bone marrow transplantation with three sources, Umbilical cord blood (UCB) stem cell, Bone marrow and peripheral blood stem cell. UCB is available source of haemopoietic stem cells that can be an alternative to peripheral blood or bone marrow stem cells in treatment of the malignant and non malignant children and also in adults. The number of cord blood units stored by public and private banks are large, for much possible autologus engraft. This review will concentrate on procedure of collection, clinical use, advantages, limitation and storage of umbilical cord bloods. The data of this article was obtained through a literature search via Pubmed, websites and individual experiences. Establish of cord blood banks are necessary to support bone marrow transplantation center for improve social welfare. In countries which governments support the cord blood bank, establish public cord blood bank have more priority than private or familial cord blood bank.