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  Abstract

 Background and Objectives

 Bacterial contamination of blood products, especially platelets, may lead to bacterial sepsis or death and therefore is of concern. Many techniques have been explored to detect bacteria in blood products in order to prevent transfusion-related bacteria contamination and transmission. In the present study, four different methods were employed to detect 12 platelet units precontaminated with known bacteria.

 

 Materials and Methods

 Ten units of platelet concentrates were inoculated at three levels (150, 15, and 1.5 CFU per ml) with Escherichia coli and Staphyococcus epidermidis. All of the platelet concentrates and two control units of platelet concentrates were stored at 20 to 24 ° C for five days. Every morning during storage, platelet concentrates were tested for platelet pH, plasma glucose, quantitative plate culture, and gram staining on platelet centrifuged smears.

 

 Results

 Escherichia coli with 150 and 15 CFU per ml and staphylococcus epidermidis with 150 CFU per ml grew on culture medias after two days but staphylococcus epidermidis with 15 CFU per ml did after three days. The sensitivity rate of bacteria detection in platelet concentrates through gram staining was lower than quantitative culture. Despite lower plasma glucose level in platelet concentrates (as measured by hexokinase enzymatic method) inoculated with microbial staines, pH level in platelet concentrates (as measured by pH meter) contentiously increased during five days of storage.

 

 Conclusions

 The sensitivity rate of bacterial detection in platelet concentrates through measuring extra cellular pH was estimated to be higher than that of plasma glucose, culture and gram staining methods.

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 Key words : Platelet, Glucose,�Culture techniques�

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Prevalence of anti-HBc and anti-HBs in HBsAg negative blood donors in Tehran Alizadeh Z.1( MS), Sharifi Z. 1( PhD), Samiei Sh. 1( MS) 1Iranian Blood Transfusion Organization-Research Center, Iran Abstract Background and Objectives Current serological screening tests for blood-borne hepatitis viruses has reduced the risk of post-transfusion hepatitis dramatically. Occult hepatitis B virus (HBV) infection might allow the release of viremic units into the blood supply if blood is tested only for hepatitis B surface antigen (HBsAg). Screening for anti-HBc has been shown as an alternative for detection of HBV infection. The aim of this study was to evaluate the prevalence of HBV infection markers in HBsAg negative blood donors. Materials and Methods In this descriptive cross-sectional study, 2000 HBsAg negative samples were collected from blood centers in Tehran. All HBsAg negative samples were tested for anti-HBc using ELISA method. Then, all HBsAg negative and anti-HBc positive samples were tested for anti-HBs by the same method. All data were analyzed statistically using Chi-square test. Results One hundred ninety nine (9.95%) out of the 2000 HBsAg negative blood donors were anti-HBc positive (confidence interval of 7.66%-12.24%). Out of the 199 anti-HBc-positive samples tested for anti-HBs,149 (75%) were anti-HBs-positive (confidence interval of 65.5%-85.5%), and 102 (50.3%) had an antibody titer greater than 100 IU/ml. Conclusions In our study, the prevalence rate of anti-HBc in HBsAg negative blood donors was high. While anti-HBc-positive blood may be a potential source of HBV transmission, routine application of anti-HBc screening is not feasible in our country as it would seriously affect the blood supply adequacy. Therefore, more sensitive techniques such as minipool PCR testing after virus enrichment are essential for detecting HBV DNA in HBsAg-negative chronic HBV carriers. Key words: HBsAg, ELISA, Iran, Blood donors SJIBTO 2008 5(3): 139-147 Received: 16 Feb 2008 Accepted: 25 Aug 2008 Correspondence: Sharifi Z., PhD in Virology. Iranian Blood Transfusion Organization Research Center. P.O.Box: 14665-1157, Tehran, Iran. Tel: (+9821) 88601501-30 Fax : (+9821) 88601555 E-mail: z-sharifi@ibto.ir

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Abstract Background and Objectives Iron overload especially in heart is one of the most important causes of death among patients with major thalassemia. Chelation therapy is one of the main therapeutic methods in these patients. This study was done to compare the therapeutic effects of deferoxamine (DFO) and deferiprone combination therapy with deferoxamine alone in the patients of Mazandaran, Iran. Materials and Methods In this clinical trial, major thalassemia patients with serum ferritin >3000 ng/ml were divided into two groups and matched based on age, sex, serum ferritin levels and cardiac systolic function (LVEF). First group received DFO alone and second group received combination therapy of deferiprone and deferoxamine. The patients were physically examined every month serum ferritin, mean Hb, AST, ALT, and LVEF also started to be measured 6 months prior to the study and subsequently at every visit. Data were analyzed using t-test and χ² test. Results There were fifty patients in each group in single and combination therapy groups. Duration of F/U was 28.5 ± 6.2 months. Serum ferritin levels in single and combination therapy groups were 4100 ± 1400 and 4500 ± 1700 ng/ml during 6 months before the study, respectively the levels decreased to 4600 ± 2200 and 3800 ± 1400 ng/ml at the end of treatment, respectively (p<0.05). Only 3 patients had leukopenia and 10 had nausea in combination therapy group. Conclusions The study showed that the combination therapy has a better effect on decreasing the serum level ferritin. Moreover, it can improve LVEF. Keywords: Deferoxamine, Deferiprone, Thalassemia major, Ventricular ejection fraction, Ferritins

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Abstract Background and Objectives Sport hematology is a new branch in the field of exercise physiology with a history of not more than 30 years in the world in Iran, it is even shorter with just a brief literature available. Thus, the aim of this study is to make a brief and accurate review of the previous studies about “Complete Blood cells Count (CBC)” in sport. Materials and Methods In this study, a brief review on 81 articles published either in Persian or English was done. The sources were either local (2 books and 16 articles) or foreign (10 Wikipedia texts and 38 articles) publications. Results The results show that an acute exercise causes an increase in red blood cells destruction and a transient sport anemia due to hemolysis generated by mechanical impact, oxidative stress, and hematuria. Moreover, an increase in leukocytic and thrombocytic indexes was observed after a single session of physical exercise the increase is due to hormonal changes, elevated blood flow, and escape of cells from spleen, bone marrow, and lungs. Despite the above changes, adaptation to regular physical training may not be altered however, any little alteration would be attributed to plasma volume changes which should be considered in interpretation. Conclusions Physical activity and exercise can seriously change CBC indexes however, the impact of such changes can be highly reduced through appropriate recovery measures followed by getting back to regular training and the related adaptation schedule. Key words: Erythrocyte, Leukocytes, Thrombocytes, Blood count, Physical activity, Sports

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  Abstract

 Background and Objectives

 The high rate of anemia in pregnancy is associated with complications of pregnancy and delivery therefore, to assess the level of hemoglobin (Hb) in women who are at risk can prevent these complications .

 

 Materials and Methods

 In this descriptive study, 108 pregnant women referred to a medical and educational center in Shiraz in 2006. They were enrolled in three different occasions: first trimester (10-14 weeks), second trimester (25-30 weeks), and third trimester (37-40 weeks). The correlation of blood hemoglobin concentration with the risk of severe nausea, vomiting, and iron supplementation in pregnant women was estimated . Statistical analysis was done with SPSS11.5 and Pearson correlation.

 Results

 The mean age of the participants is 25.74 ± 5.66. In the first trimester of pregnancy 71.9% had normal hemoglobin level and 28.1% higher than normal with no case being anemic. In the second and third trimester of pregnancy, 29.2% of the subjects were anemic. The level of hemoglobin had positive correlation with the total amount of iron intake in the second trimester (p= 0.001 and r= 0.44), also in the third trimester (p< 0.001 and r= 0.46) and the whole pregnancy (p< 0.001 and r= 0.38).

 

 Conclusions

 This study indicated that despite regular intake of iron, %29.2 of the subjects had anemia. These findings emphasize the importance of treating these groups of patients and measuring levels of hemoglobin in each trimester together with reviewing other risk factors which are effective on anemia .

 

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  Abstract

 Background and Objectives

 Studies on the relationship between maternal hemoglobin (Hb) level and adverse pregnancy outcomes have been inconsistent. The aim of this study was to examine the birth outcomes in pregnant adolescents as high risk mothers.

 

 Materials and Methods

 In this cross sectional study, 312 healthy pregnant women with GA=37-40 weeks were selected by random sampling. After their medical records were taken and clinical investigation done, Hb tests were conducted. After birth, the correlation between the levels of Hb concentration during pregnancy and birth outcomes was estimated. Statistical analyses were performed with SPSS software using t-test, chi-square, and ANOVA.

 

 Results

 The prevalence rate of anemia was 23.2 % . The average birth weight was 3197.8 ± 398.25 g and it was higher in mothers with Hb=10.5-12.5 g/dL than others (10.5 > Hb > 12.5 g/dL) (p< 0.01). Apgar score less than 8 was higher in the anemic group.

 

 Conclusions

 Our findings demonstrated that abnormal Hb concentrations increased the risk of adverse birth outcomes in pregnant adolescents. Thus, the intensive care is recommended for them.

 

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  Abstract

 Background and Objectives

 Echis carinatus venom is a complex mixture of toxins. This venom contains metalloproteinases which convert prothrombin to meizothrombin. The prothrombin activator leads to the formation of small blood clots inside the blood vessels throughout the body. To understand the effect mechanism of Iranian Echis carinatus venom, in this study we investigated the effect of EV on human plasma proteins (prothrombin and fibrinogen) and on blood coagulation. The aim was the purification and characterization of procoagulant factor from the Iranian Echis Carinatus venom and the evaluation of the procoagulant activity on human plasma.

  

 Materials and Methods

 Crude venom from the Iranian snake species E. carinatus was selected. The prothrombin activator was purified from the crude venom of Echis carinatus by combination of the procedures by gel filtration, ion-exchange chromatography , and reverse phase HPLC. Electrophoresis on 12.5% polyacrylamide gel was performed.

 

 Results

 The Iranian E. carinatus venom was able to coagulate human plasma very rapidly. The coagulation time was reduced from 13.4 seconds (SD= ±0.59) to 8.6 seconds (SD= ±0.64) when human plasma was treated with crude venom (concentraion of venom was 1 mg/ml).

  

 Conclusions

 The venom of Iranian Echis carinatus contains procoagulant factors. It seems the fraction F1B4 isolated from IEc to be like coagulation proteins which coagulate human plasma very rapidly in vitro.

  

 

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  Abstract

 Background and Objectives

 Factor XIII deficiency is one of the rarest bleeding disorders with an estimated prevalence of 1 in 1-3 million in the general population. The main clinical manifestations of the disease are delayed wound bleeding, recurrent miscarriage, intracranial bleeding, and umbilical cord bleeding. The prevalence of the disease in the regions such as Sistan and Baluchistan with consanguinity marriages is higher. The aim of this study was to assess the diagnosis and treatment of factor XIII deficiency in Sistan and Baluchistan province.

 

 Materials and Methods

 This descriptive study was performed on 205 patients with the severe factor XIII deficiency. The diagnosis of the disease was done by a wide spectrum of characteristics including family history, clinical manifestations, laboratory tests, clot solubility in 5 M urea or monochloroacetic acid 1% environments.

 

 Results

 It seems that Khash city has the highest prevalence of the disease worldwide. The molecular analysis of the patients showed that an identical homozygote mutation TGG —› CGG at codon 187 in exon 4 of catalytic A subunit is responsible of this deficiency. The common manifestations of the disease at time of diagnosis were umbilical bleeding (84.4%), deep soft tissue haematoma (54.4%), and less frequently gum bleeding and finally ecchymosis.

  

 Conclusions

 It seems that Sistan and Baluchistan province has the highest prevalence of factor XIII deficiency worldwide with a dramatic increase of 46 cases in 2008 to 205 patients in 2012 that alarmed the absence of a screening test in this region.

 

 

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  Abstract

 Background and Objectives

 Hemophilia is a hereditary bleeding disorder associated with multiple complications. Adolescents are a wide population of hemophilia patients. The appropriate management of chronic diseases requires an adequate knowledge about their complications. The aim of the present study is to assess the knowledge of hemophilia affected adolescents on the prevention of its complications.

  

 Materials and Methods

 In this descriptive study, the adolescents affected with hemophilia were selected from 11 hemophilia centers during 9 - month period between 2011-2012 by the available sampling method. For data collection, a questionnaire developed by researchers as the self report method was used. Data were analyzed using SPSS (version 13).

 

 Results

 From 108 participating hemophilic adolescents, 35.3% were not aware of hemophilia complications, 43.7% of the preventive methods of hemophilia complications, and 47% of the causes of the complications. Out of the total number, 69.5% had not received any information about the prevention of complications. In the assessment of the adolescents' knowledge of hemophilia complications, 67.6% were not aware of viral infections, 56.1% of threatening bleeding, 60.6% of the complications of dentistry procedures, 68.2% of threatening drugs, and 22.4% of threatening exercises. As far as the other aspects of the prevention of complications are concerned, the adolescents were either unaware or modestly aware.

 

 Conclusions

 There is a need to promote the preventive knowledge of complications among hemophilia adolescents. Faced with the scarcity of resources, it is the education that plays an important role in organizing hemophilia services in developing countries.

 

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  Abstract

 Background and Objectives

 Excessive consumption of iron supplement during pregnancy may increase in Hb level and adverse pregnancy outcome. The aim of this study was to examine the effect of iron supplementation in pregnant women with high hemoglobin.

 

 Materials and Methods

 In a randomized, double-blind, placebo-controlled trial, 83 healthy pregnant women who had a hemoglobin concentration more than 13.2 g/dL and a serum ferritin level higher than 15 μg/L between the 16^th and 20^th week of pregnancy took either one 50 mg tablet of ferrous sulfate daily or placebo during their pregnancies. Markers of iron status (Hb, ferritin) were measured at 37-39 weeks of pregnancy.

  

 Results

  The mean of maternal age and prepregnancy BMI were 26.11 ± 5.13 and 23.9 ± 2.32 kg/m², respectively. After intervention, the mean levels of hemoglobin concentration were 12.05 ± 0.9 g/dL and 38.5 ± 9.3 µg/L in iron supplementation and 11.94 ± 0.65 g/dL in placebo groups and those of ferritin levels were and 27.22 ± 12.96, respectively. The differences were significant (p = 0.03) in both groups but the incidence of anemia did not show any differences.

 

 Conclusions

 Not using iron supplementation did not increase the risk of anemia in women with hemoglobin concentration more than 13.2g/dL during pregnancy thus, the intensive care and control of iron status markers are recommended for the groups without supplementation.

  

  

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Abstract

Background and Objectives

Alloimmunization is one of the side effects of regular blood transfusion in thalassemic patients. We studied the frequency of Kell antigen in donor blood bags used in Adult Thalassemia Clinic in Tehran.

Materials and Methods

Our aim was to screen Kell antigen on the blood bags which came for use in Adult Thalassemia Clinic. First, we recorded the bag number with which we could access the characteristics of the blood donors such as sex, age, number of donation, and so on. Then, for Kell study, we used anti Kell kit on each cord detached from the blood bags. The results were collected and analysed by SPSS18.

Results

In our one year cross sectional study, we checked Kell antigen for 11557 blood bags 98.7% were for male and 1.3% for female. The minimum age of our donors was 17 years old and maximium 65. Out of the total number of blood donors, 19.6 % were first time, 27.4% had the history of prior donation, and 52.9% were repeated donors. In our kell study for K or  KEL1 antigen, we had 96.2% Kell negative bags and 3.8% were Kell positive.

Conclusions

We had the rate of less than 4% positivity of Kell antigen on our donors showing more than 96% Kell negativity. However, for the reduction of the risk of alloimmunization in chronically transfused patients, it is better to check all bags for Kell antigen and prevent the use of Kell positive bags.

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Abstract

Background and Objectives

SR-B1 acts as the main receptor for HDL and plays an important role in reverse cholesterol transport. In contrast to LDL level which causes Atherosclerotic plaque in artery, plasma concentration of HDL correlates inversely with the incidence of coronary artery disease and atherosclerosis. This study investigates the expression of Scavenger Receptor-B1 and its role on the function of platelets in patients with atherosclerotic disease.

Materials and Methods

The present case-control study evaluated the SR-B1 receptor of 24 patients with atherosclerotic plaque and 24 healthy volunteers as the normal control. After separation of platelet, the expression of SR-BI was detected using western blotting. Platelet function in response to agonists was examined by aggregometry. Finally, the data were statistically analyzed using SPSS version 16 software and the student T-test.

Results

The western blotting assay showed a significant reduction of SR-BI protein expression in AD patients (0.4 AU) compared with the healthy control (1.4 AU), (p < 0.001). The platelet aggregation in response to ADP showed a significant increase in patients (85%) compared to the control (51%), (p < 0.001).

Conclusions 

The levels of SR-B1expression correlate inversely with platelet aggregation.

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