Scientific Journal of

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  Abstract

 Background and Objectives

 High blood pressure is one of the causes of blood donor rejection therefore, detection and treatment of the mild hypertension in donors have an important role in increasing the health level of blood donors and decreasing their hypertension-attributed mortality and morbidity rate and finally in preventing their rejection from blood donation.

 

 Materials and Methods

 It is a cross-sectional descriptive study conducted on 1854 donors of Kurdistan Blood Transfusion Center during a 6-month period. Blood pressure of donors is controlled by the physician two times with a 15-minute interval. Demographic data were collected through questionnaire and were analyzed by SPSS and Chi-square test.

 

 Results

 80.9% and 19.1% of the donor population were male and female respectively. Age average was 35.53 ± 11.19 years. Averages of systolic and diastolic blood pressures were 123.02 ± 13.23 mmHg and 77.35 ± 8.88 mmHg respectively. Isolated systolic hypertension was detected in 7.5% and isolated diastolic hypertension in 4.5% of blood donors. 3.4% had mild systolic and diastoic hypertension. There was a significant correlation between sex, age, education status, blood donation and systolic hypertension (p<0.05) and also between age, education status and diastolic hypertension (p<0.005) but there was no correlation between donation, sex and diastolic hypertension.

 

 Conclusions

 There was a low prevalence rate of hypertension in blood donors it can be attributed to blood donor population being young and middle aged, good attention in donor selection, and careful physical examination.

  

 Key words : Blood donor, Hypertension, Iran 

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  Abstract

  Background and Objectives

  Diversity of IgH and Ig κ molecules is generated during B and T Lymphocyte differentiation through the rearrangement of variable, diversity, junction and constant gene segments. Additionally, random insertion and deletions of nucleotides between gene segments make unique sequences which are cell or clone specific. Similar IgH and Igκ genes rearranged in normal cells of lymphoid leukemia cases can be used as a marker of clonality and for evaluation of minimal residual disease (MRD). The purpose of this study is to evaluate the pattern of IgH chain and Igκ gene rearrangements using polymerase chain reaction (PCR) in B-precursor acute lymphoblastic leukemias (ALL) to follow the MRD at day 14, day 28 (end of remission induction), week 10 , 3-6 months and 6-12 months after the initiation of treatment.

  Materials and Methods

  In our prospective study bone marrow aspirates of 183 children at the mean age of 63.6 months with diagnosis of acute leukemia were collected at admission before any chemotherapy. After reviewing cytomorphology and immunophenotyping, only 140 cases with diagnosis of B-precursor ALLs were selected for study. Mononuclear cells including leukemic blasts were isolated by density gradient. After DNA extraction, IgH and Igκ ( Vκ I-IV / Kde) were amplified by consensus primers using PCR. PCR products were analyzed after heteroduplex analysis and polyacrylamide gel electrophoresis (silver stain). The DNA sequences were compared and aligned with the sequences homologous for IgH and IgK published by Gene Bank. The follow up specimens were collected at day 14, day 28 (end of remission induction), day 45-month 3 , and 3-6 months and 6-12 months after initiation of treatment. After routine cytomorphologic analysis, similar PCR was done on follow up extracted DNAs in parallel with diagnosis DNA. MRD was considered to be approved positive if bands similar to those at the time of diagnosis were present. Statistical analysis using SPSS software (version 11.5) was performed.

  Results

  90.5% of patients had clonal IgH gene rearrangements. Monoclonal, biclonal and oligoclonal patterns were observed in 57.8%, 34.9% and 5.5% of patients with IgH (CDR III) rearrangement, respectively. Clonal patterns of Igκ-Kde were detected in 59 (67% n: 88) of BP-ALLs. According to cytomorphology about 92% of patients were in complete remission. MRD positivity decreased from more than 90% to 20% using different gene rearrangements in defined time points. Four patients who relapsed during follow up were MRD positive using 1-3 rearrangements and all except one were in clinical remission.

  Conclusions

  Clonal rearrangement of IgH had a pattern similar to other populations. IgK was slightly more frequent than previously reported and the VKI (25%) was the most common type. These differences can be explained by different techniques, DNAs and clonality markers. According to the results, these clonal markers can be used in diagnosis and follow up of MRD.

  Key words: Gene rearrangement, Minimal residual disease (MRD), Acute lymphoblastic leukemia

 

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  Abstract

 Background and Objectives

 Malignant lymphoma may be very difficult to be diagnosed through routine histopathological methods because they may mimic reactive architecture or contain reactive infiltrates. Detection of the monoclonal lymphocyte population is one of the best methods of diagnosis since a monoclonal proliferation is strongly suggestive of neoplasia. By means of a PCR method it is possible to detect the immunoglobulin heavy chain (IgH) gene rearrangement and consequently the lymphocyte clonality.

 

 Materials and Methods

 We evaluated formalin-fixed, paraffin-embedded biopsies, and bone marrow aspiration of 12 cases with non definite or suspicious histopathological diagnosis of non Hodgkin B cell lymphoma. After DNA extraction and quality control, semi-nested PCR was performed using consensus primers for amplification of CDR-3 region. PCR products were analyzed after heteroduplex analysis using polyacrylamide gel electrophoresis and silver staining.

 

 Results

 75% and 16.6% of patients showed clonal and polyclonal patterns respectively. One case showed weak monoclonal band in smear background and remained suspicious after duplicate PCR.

 

 Conclusions

 Our findings are comparable with other international studies and support the concept that molecular techniques such as PCR provide a helpful approach in detection of monoclonal immunoglobulin rearrangements in malignant lymphoma. This is especially true for suspicious cases, but always in combination with clinical and histopathological information.

  

 Key words : B-cell Lymphoma, Immunoglobulin Heavy Chain, Gene rearrangement 

 

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  Abstract

 Background and Objectives

 Blood donors awareness about AIDS and hepatitis is of importance. The aim of this research is to determine the level of awareness, study the attitude, and assess practices towards AIDS and hepatitis infections and their transmission and prevention modes among blood donors of Kurdistan Blood Transfusion Center before and after education programs.

 

 Materials and Methods

 In this quasi experimental study (before-after study design), simple random sampling was used and a sample size of 200 blood donors was selected. Reliability of the questionnaire was confirmed by Cronbach's alpha ( a =0.86) its validity was approved by two infectious disease specialists and the scientific adviser of the study. The questionnaires were filled out before and after education programs. Data were analyzed with SPSS software and paired t tests.

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 Results

 The majority of donors were male (82.5%) and 93% were urban. 6.6% were illiterate, 68.7% diploma or lower, and 24.8% higher diploma. 28.6% were new donors, 24.6% experienced, and 46.7% repeat. There was a significant difference between general awareness, attitude and practices towards AIDS and hepatitis infection before and after educational intervention (p<0.05).

 

 Conclusions

 This study showed that promotion of education will improve the level of awareness, attitude and practices towards blood donors. The important point is the elimination of misconceptions about AIDS and hepatitis transmission modes in blood donors. More use of the media, particularly radio and TV, for awareness raising and practice improvement of blood donors seems imperative

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  Key words : Awareness, Attitude, AIDS, Hepatitis, Blood donors, Iran.

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  Abstract

 Background and Objectives

 Somatic point mutation in JAK2 gene is characterized by G to T transversion at nucleotide 1849 in exon 12 in the JAK2 gene and results in autonomous activation of JAK2 protein. JAK2 mutation leads to independent cytokine signaling and clonal proliferation of hematopoietic cells in MPNs. Due to absence of any reports for JAK2 V617F mutation in Iranian MPNs patients and its important role in diagnosis, we decided to carry out this study.

 

 Materials and Methods

 In this experimental study, we evaluated JAK2 mutation in 100 MPNs patients with diagnosis of PV (n=44), PMF (n=31) and ET(n=25) by simple randomized sampling. After extraction of genomic DNA from whole blood buffy coat, detection of mutation was done using allele specific PCR. Agarose gel electrophoresis was used for observation of PCR products. For confirmation of results, PCR-RFLP using BsaXI was applied.

 

 Results

 Using allele specific PCR and PCR-RFLP, frequency of JAK2 V617F mutation was evaluated to be 89%, 61%, and 56% in PV, PMF and ET, respectively.

 

 Conclusions

 Frequency of JAK2 mutation in our study is compatible with previous reports. According to WHO criteria, allele specific PCR can be applied for detection of JAK2 mutation in Iranian patients with diagnosis of MPNs.

 

 Key words : JAK2, Protein Tyrosine Kinase, Polymerase Chain Reaction, Mutation, Neoplasms

 

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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

 Blood transfusion is a modality of knowledge important for health care personnel to know about its different aspects. The aim of this study was to assess the knowledge of health care personnel in two hospitals of Zahedan about blood products, blood use, and adverse reactions.

 

 Materials and Methods

 In a study in two hospitals of Zahedan, 170 randomly selected employees from the hospital wards with the highest level of blood use participated. Data were collected via a questionnaire. For data analysis, SPSS, chi-square tests, t-test, ANOVA, and Pearson correlation coefficients were used.

 

 Results

 The average knowledge score of the personnel of Khatam Hospital was estimated to be 11.13 ± 3.68 and Ali ibn Abi Talib Hospital 13.31 ± 2.19. The average knowledge score of the two hospitals was 12.34 ± 3.13 with one hospital being significantly more knowledgeable than the other. But there was no correlation between age, gender, education, and work experience with the knowledge level (p > 0.01).

 

 Conclusions

 The results showed that the average knowledge score of health care personnel about blood transfusion is low at the two hospitals in Zahedan. Therefore, an academic course about blood transfusion should be dedicated to medical students in universities.

 

 

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  Abstract

 Background and Objectives

 To organize blood donors, promote blood donation, predict the future, and detect possible intervening factors, we must monitor and evaluate the trend of blood donation.

 

 Materials and Methods

 In this cross-sectional study, all blood donors during the 5-year period from 2009 to 2013 in Kermanshah entered the study. The data analyzed using Excel, statistical package of Stata (version 12), and independent T-test were used to compare the means in different groups Poisson regression was used to investigate the significant trend during the time.

  

 Results

 During 2009 to 2013 (5 years), 295925 potential donors referred to blood centers in Kermanshah province 249420 (84.2%) were eligible for blood donation out of whom 216563 (87.8%) were men. The trend of blood donation during the years of study showed to be downward among females but upward among males. Moreover, among blood donors 117080 (46.9%) were regular donors whose number was growing.

 

 Conclusions

 Findings show that most blood donors in the West of Iran are regular donors with an ascending trend. Given the fact that regular donors are safer than first-time donors for infections such as HBV, HCV and HIV, it can be concluded that over time the quality and safety of blood donations would be at a better position.

  

 

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Abstract

Background and Objectives

Among the key issues in the blood supply chain design, the location of blood collection centers is essential to ensure the easy access of donors for blood donation and distribution of blood products to hospitals. The aim of this study was to calculate the optimal number and location of blood collection and processing centers, blood collection centers and mobile teams based on clinical demand, cost of construction and operating cost of these centers in East Azerbaijan province.

Materials and Methods The study was a mathematical calculation modeling on the population of East Azerbaijan province. Three six-month periods with the first and the second in 1393 and the third in 1394 were used for calculating cost. GAMZ mathematical model was implemented and the results were extracted.

Results

The results of the GAMZ application showed that a suitable locations for the establishment of a blood collection and processing center were in Maragheh and Mianeh, and the optimal locations for blood collection center were in Tabriz and Ahar. What is more, one mobile team could move among Marand, Tabriz, Ajabshir, Bonab, Malekan, Maragheh and Hashtrood cities in alternation with the cost of transport to be reduced.

Conclusions

The optimal determination of number and locations of blood collection and processing centers, blood collection centers and mobile team decreased the cost of blood collection services. In future, to plan for any changes in order to increase or decrease the number of blood centers in all provinces, the mathematical modeling in other conditions should be considered.