Scientific Journal of

  Abstract

 Background and Objectives

 Globin chain synthesis and DNA analysis are among complementary tests for thalassemia diagnosis. Nowadays, DNA analysis is the only definitive method for diagnosis of suspected carriers. Despite the complexity of this heterogenic disease which is attributed to mutations in gene regulation sites or unknown mutations, globin chain synthesis has maintained its significant role in identifying different kinds of thalassemia. As a result, besides the routine application of this method , we decided to determine the ranges of α/β ratio values in different kinds of thalassemia.

 Materials and Methods

 In this experimental study 214 cases were divided into the control (51 cases), minor β thalassemia (24 cases), mild α (α thal. 2) thalassemia (68 cases), severe α (α thal. 1) thalassemia (44 cases), Hemoglobin H disease (6 cases), silent β ( type II) thalassemia (14 cases), δβ thalassemia (5 cases), and αδβ thalassemia (2 cases) groups. CBC, hemoglobin electrophoresis using acetate cellulose paper in alkaline pH, hemoglobin A2 measurement by column chromatography, reticulocytes percentage, hemoglobin H, RBC morphology, and globin chain synthesis were performed on each group.

 Results

 Significant differences were observed in mean values of RBC, hemoglobin, hematocrite, MCV, MCH, MCHC, α/β ratio in α and β thalassemia cases as compared with the control group. High prevalence of α thalassemia was observed among suspected individuals (55.2% of different kinds of α thalassemia vs. 9.8% of different kinds of atypic β thalassemia) as compared with atypic β thalassemia.

 Conclusions

 The mean value of α/β ratio achieved in this study was similar to the others, but with a greater standard deviation. Because of this, there exists a wider range of α/β ratio. This width of range made overlaps in different and adjacent groups. Therefore, α/β ratio cannot be used by itself to firmly diagnose the type of thalassemia. As a result, for accurate diagnosis to be made, besides considering patient's ethnicity and clinical features, it is necessary to assess the results of CBC, hemoglobin electrophoresis pattern analysis, globin chain synthesis, familial tests, and DNA analysis.

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 Key words : β Thalassemia, α thalassemia, Globin

  Abstract

 Background and Objectives

 Clinical use of blood components seems to be inappropriate in Iran. The aim of this study was to evaluate blood utilization patterns in Rasht.

 Materials and Methods

 This was a cross-sectional descriptive study. Data about blood orders issued at day 20 of each month during the year 2007 were obtained from 5 hospitals. Data were analyzed by T-test with SPSS 15 descriptively for 491 cases. For all hospitals and wards, crossmatch/transfusion ratio (C/T) was calculated and compared separately.

 Results

 C/T=1/9 compared to the expected ratio was normal but significant differences were observed among different centers. The highest and lowest orders were from surgery (42.8%) and internal wards (7.1%), respectively. In surgical ward, the mean hemoglobin concentration of recipients was 9.03 ± 2.19 g/dl.

 Conclusions

 Packed cell utilization in Rasht was normal but not ideal. In this study, blood utilization model in obstetrics and gynecology ward was appropriate. This may suggest an active and effective blood transfusion committee in hospitals. It seems that the lack of hospital blood transfusion committees with no experienced doctors attending, lack of executive support and external audit of hospital blood bank agenda, the lack of software integration between blood centers and hospitals, the lack of type and screening for patients, and importantly free of charge blood dispensation are major obstacles in reforming blood utilization patterns, running haemovigilance system, and raising quality.

 Key words : Blood, Blood Grouping and Crossmatching, Iran

  Abstract

 Background and Objectives

  Blood transfusion is one of the routes of Human T-Lymphotropic virus (HTLV1/2) transmission. Considering that Mashhad (located in Khorasan province) is one of the areas where the virus is endemic, it seems necessary to investigate its prevalence on Mashhad blood donors.

 Materials and Methods

 In this descriptive study, all eligible blood donors who were anti-HTLV positive based on Elisa and confirmatory tests were considered as HTLV infected individuals and a group of healthy donors was selected as the control through 2006-2008. Data were analyzed with Chi-square by SPSS17.

 Results

 In this study, 250582 volunteers embarked on blood donation. Among them, 1011 (0.4 %) HTLV⁺ cases were confirmed. The prevalence rates of the virus were 0.47% , 0.39% and 0.35%, respectively.

 Conclusions

 The results of this study shows a decreasing trend in the prevalence of HTLV among blood donors. In fact blood donors are regarded as people who have less risk behaviors. To further improve blood safety, measures should be taken to identify the prevalence rate in general population and the related risk factors so that high risk donors would be excluded effectively.