بشیر حاجی بیگی

Developing a vision without understanding the organizational culture is a failed attempt. The purpose of this research is to understand organizational culture for understanding expectations in order to prioritize issues and compare work groups by managers for greater productivity.

This study was carried out in Iranian Blood Transfusion Organization between 2020 and 2022. The statistical population for this research was the employees of the central headquarters and the general administrations of blood centers, and 384 of them were included in the study using stratified random sampling. To collect the required data, a 60-question organizational culture questionnaire based on Denison's model was used. For data analysis, descriptive statistics (frequency distribution, mean, standard deviation) and inferential (independent t, analysis of variance, Tukey and Pearson's coefficient) according to demographic variables, SPSS22 and Excel 2013 software were used.

The findings show that Iranian Blood Transfusion Organization has a medium/strong organizational culture with a score of 179.31 and the highest impact after mission with a score of 46.60. Also, the indicators of "customer orientation and development of capabilities" need to be improved.

Conclusions  :

According to the findings, most employees have understood the vision, strategic intentions and mission of the organization, but their capabilities are not well seen. According to the score of customer orientation, the skills and abilities of the employees should be developed by using retraining courses, while motivating the personnel, respecting the clients, and the provinces should take advantage of the experiences.

Constant control of electrical panels is effective in ensuring the safety of users. This study was conducted during the years 2022-2023 to evaluate their structure in blood transfusion centers by ETBA method.

In this descriptive-analytical study with the ETBA method, the performance and quality of the grounding system, capacitor bank, connections, the location of the panels, the arrangement structure of the components, and their cleanliness and safety in the centers of Kermanshah, Hamadan, Ilam, Sanandaj, Arak, Karaj, Semnan, Bandar Abbas, Sari and Yazd were investigated. The obtained information was analyzed statistically with SPSS 25 software.

The results showed 74.3% electrical panels with unprincipled volume and distribution of connections, 72.4% due to the selection of inappropriate location and distance from tools and devices, deployment in users' traffic area without provision of fence and safety devices, 70.5% not equipped with warning devices, 43.3% non-standard arrangement, 51.4% insufficient cleaning, 66.3% not having an active earth connection, and 60.3% not having a capacitor bank did not have reliable electrical safety.

Based on these results, the regular and continuous establishment and implementation of the medical equipment maintenance management system can be a fundamental and effective factor in identifying risks and the pertinent degree of risks and damages in the process of activity.

Today, despite scientific developments and important medical advances, the supply of healthy and sufficient blood is still one of the biggest concerns of the health system, and one of the most important needs of health and treatment centers and many victims of accidents, war wounded, and needy patients. The issue of supplying blood and blood products in the important wars of the contemporary era has been a big challenge for the countries involved in the war and many injured people have lost their lives due to the lack of timely supply of blood. With the beginning of the invasion of the Iraqi Baath army on 31st of September 1359 against the land of dear Iran, the need for blood for the treatment of the wounded increased greatly, and in addition to the Iranian Blood Transfusion Organization, the Red Crescent Society has also made significant efforts in this field. By forming a joint relief and treatment committee, this population played a significant role in providing blood in addition to medical and relief measures. However, the main role of blood supply at this time was the responsibility of the blood transfusion organization, and practically, the centers of the Red Crescent population alone were not able to respond to the significant reception of the people. This study was conducted using the method of reviewing and analyzing the content of the published papers and official reports by related bibliography and websites.

To the opinion of psychologists, job satisfaction has been defined as the action of coordination between individual needs and professional values. Therefore, evaluating the rate of job satisfaction is one the concerns of the professionals. The objective of this survey was to assess the rate of job satisfaction among the staff of IBTO headquarters (HQ) and Tehran Blood Transfusion Center (TBC).
The study is a descriptive-analytical and cross- sectional study which was done voluntarily on 120 staff of the IBTO HQ and 94 staff of TBC. To gather the data, JDI questionnaire was used. The data was analyzed by MANOVA test. P The average rate of job satisfaction in IBTO headquarters was measured as standard deviation. This rate was 21.32 in Tehran Blood Transfusion Center. The results indicate the higher job satisfaction of the staff of TBC compared to IBTO HQ. The highest unsatisfactory variables pertained to job promotion, supervisors and the colleague relationship.
Job satisfaction is an indicator for the performance improvement of the staff leading to success of an organization. While the highest unsatisfactory variables pertained to job promotion, supervisors and the colleague relationship, the necessary interventions have to be made in order to clarify and revise the ways of job promotion and to establish a competent inter-sectorial relationship between the staff.

For screening and selecting healthy volunteer blood donors, it is important how to face with the minor risk factors. In a cohort study during the 2005-2011, minor risk factors for transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Tehran, Iran, were evaluated. Data for the study were obtained from the database of MAK-SYSTEM International Group. Odds ratio and relative risk were calculated. To calculate the incidence among repeated donors, the number of seroconverters was divided to person-years at risk. From 19,044 blood donor volunteers entered the study in 2005, 10,696 people were in the unexposed group (no risk) and 8,348 in exposed group to the minor risk factors. They were followed until 2011. The odds ratio was 2.7 for donors exposed group and 2.9 in cupping, 1.4 in dentistry, 1.5 in endoscopic plus biopsy, and 7.8 in household subgroups. Calculated relative risk for HBV was 6.9 in exposed group to the minor risk factors and 9.9 in cupping subgroup. The results of this study show while in the country, more accurate screening tests such as nucleic acid-based tests (NAT) or polymerase chain reaction (PCR) methods has not been used routinely for blood donors, deferral strategy applying in cases of exposure to minor risk factors, especially in the cupping exposed cases, is essential.

Background Deferral for travel to malaria-endemic areas has excluded many blood donors in the Iran. To determine the effect of these deferrals on blood availability and safety we designed this study. Materials and Methods In cross sectional and retrospective study deferred donors due to malaria related risk factors from 2005-2010 in Tehran Blood Transfusion Center were sampled to enroll for analysis. Data were extracted from MAK data base by two different grouped keywords. 2827129 record of blood donor volunteers were surveyed for the study. Results 23462 out of all volunteers were deferred due to malaria`s risks from 2005-2010 in Tehran Blood Transfusion Center. The most frequent deferral causes related to malaria was shown travel to malaria endemic areas. The trend of deferral volunteers due to malaria''s risks was shown descending pattern after relaxing application of the present guideline for travel to very low-risk areas such as Karbala. Conclusions We estimated that the wastage of more than 7000 units of blood were prevented annually by accepting volunteers who travelled to very low malaria''s risk areas، but according to other similar studies it seem wiser to defer them for a short period (e. g. 3 months)، instead without deferral period. If cost permits، The introduction of a malarial screening test in the assessment of malaria''s risk blood donor eligibility would be an ideal strategy.

Mannose Binding Lectin (MBL) is a major initiator of the lectin pathway (LP) of complement System. MBL produced by the liver and involved in the innate immunity response. We have analyzed three SNPs of mbl2 gene at the exon 1 individuals of a random population residing in Tehran (N=143)، and have correlated genotypes with respective MBL serum concentration. Polymorphisms in exon 1 of the MBL are reported to be associated with impaired MBL function and in response of the body to infection. Three different mutations within exon 1 of the MBL gene have been described، each causing MBL deficiency. Three SNPs in exon 1 were genotyped using PCR amplification. Plasma level of MBL were quantified using ELISA. Our research showed 3 variant polymorphisms at codon 52 (D Allele)، 54 (B Allele)، 57 (C Allele) of mbl2 gene affecting the protein level in plasma. B allele was significantly correlated with the lowest MBL level.

Pre-transfusion inactivation of donor T-cells by irradiation is the method of choice for prevention of TA-GVHD. This study reviewed the usage of irradiated products in one year period in Tehran Blood Transfusion Center. There were 1333 requests for irradiated blood products to be evaluated. The data including the quantity and type of irradiated products، patients’ age and indications were gathered. Descriptive statistical analysis was performed by SPSS 18 software. The requested irradiated products in the one-year period of time include platelets (71. 3%)، packed RBCs (28. 1%)، FFP (0. 4%)، paediatric bags (0. 2%)، and whole blood (0. 1%). The age groups of patients having received irradiated products were adults (59. 6%)، children (25. 9%)، infants (6. 5%)، and neonates (3. 3%). Indications of prescription consist of leukaemia/lymphoma and Hodgkin (49. 6%)، allogeneic and autologous bone marrow transplantation (17. 7%)، immunosuppressive therapy (9. 6%)، congenital immunodeficiency (8. 6%)، premature birth (7. 6%)، aplastic anaemia (6. 5%)، relatives designated donation (0. 3%)، and HLA matched plateletphaeresis (0. 1%). The increasing trend in the quantity of requests of irradiated products and requesting hospitals was observed. It is recommended that a higher number of hospitals and their staff be informed about irradiated products and their indications and the roles they have on the prevention of TA-GVHD.

The most important factor for blood donor loyalty is the staff attitude and blood center approach. Blood donor return rate is associated with donor satisfaction and complaint follow up rates. In a retrospective study from 2005 to 2010, we evaluated all complaints in Tehran Blood Transfusion Center. SPSS version 19.5 was applied for statistical analysis. A total number of 468 complaints were evaluated; 43(9%) and 425 (91%) cases pertained to female and male blood donors, respectively. The most frequent complaint was about blood donor rejection. Blood donation department was the target of the highest percentage of complaints. In 91.5% of cases, complaints were followed. The highest level of follow up was seen for blood donation complications (98%). Since the highest percentage of complaints was addressed to blood donation department and pertained to the donor rejection, awareness raising attempts about eligibility criteria would remove most complaints.

Blood transfusion committees supervise the blood quality, preparation process of blood transfusion, blood transfusion indications, appropriate use of blood products, and report on blood transfusion complications. The aim of the present study was to evaluate hospital blood transfusion committees in Tehran (2008-2009). In this retrospective study, 143 hospital blood transfusion committees were reviewed. Received reports from hospital committees were the basic data for evaluation. According to the hospital blood bank regulations, appropriate data were extracted from their reports. Statistical analysis was performed by SPSS 19 software. Out of 143 hospitals, 38(27%) submitted their performance reports of the blood transfusion committees to the Tehran Blood Transfusion Center. Committees’ reports were studied based on six performance indicators. The most frequent reported indicator was about reports of the number of committees formed (76%) and the least frequent reported indicator was about transfusion complications (4%). Other reported indicators in descending order included preparation process of blood transfusion (66%), report statistics for the number of blood transfusions (42%), reports about blood transfusion indications (34%) and reports about training programs (28%). Mean scores of monthly transfusions in public and private hospitals were 5.7(2.5-9) and 7.1(4.3-10), respectively with significant differences (p<0.01). None of military hospitals had submitted their reports of monthly transfusion when we were conducting the present study. Findings show an increase in activities of Tehran hospital blood transfusion committees by 20% compare d with the last study in 2005-2006, but more training programs should run to improve the performance quality of the committees.

Leukocyte filters are effective for WBC reduction but they cannot inhibit passing plasma proteins and as a result repeated protein entry may produce allergic transfusion reactions. To deal with this problem, washed RBC method is used. The traditional wash method is an open system through which waste products are carried away in sewers with the risk of environmental pollution. Newly introduced approach for washed RBCs consists of a closed system whereby waste products enter into a bag. In this study, the two methods were compared. The Two open and close wash methods were compared in terms of health system, leukoreduction, risk of transmission of infection and quality control. In each method, 100 bags were washed, coded and then transmitted to different units of blood culture, flowcytometry as well as quality control. The data were collected and analyzed by SPSS14. 200 bags (100 for each method) were studied. Microbiologically, there were no positive results for any of the methods. In quality control also there was not any significant difference in the two methods. In flowcytometry, we didn’t observe any significant correlation in leukocyte count in the two methods before washing (p=0.072), however.there was correlation between them after washing (p<0.0001), demonstrating that the new method was better for leukoreduction. The new washing system method was a superior way because it involves a close system where waste products are discharged into a side bag and disposed as hospital waste. Meanwhile, this approach is more convenient for leukoreduction. In our country, since we still need a washing system for some transfusions, this method is deemed to be a decent and practical one because it impedes environmental pollution.

Background and Objectives Thalassemia is the most common hereditary anemia in Iran. Considering the recent treatment protocols and comprehensive data about clinical status of thalassemic patients, their survival rate has improved. The aim of this study was to investigate the clinical condition of patients in Adult Thalassemia Clinic. Materials and Methods This cross sectional analysis was done on 695 patients having referred to Adult Thalassemia Center in 2008. We reviewed the medical files for some demographic and lab data about serum ferittin, hepatitis B, C, and HIV. The results were analyzed with Chi Square and Pearson correlation tests by SPSS version16. Results We had 695 patients: 358 (51.5%) male and 337 (48.5%) female with mean age of 26.26 years. Out of the total unmber of patients, 501 (72%) were major thalassemia and 170 (24.5%) intermedia. The mean ferritin level was 1755.16 ng/ml. Moreover, 423 (59.2%) of patients were spelenectomized. Out of our major and intermedia patients 24.5% were HCVAb positive out of which 66% were HCV PCR positive. For HBV, 565 (81.2%) of our patients were HBsAb positive after vaccination; 90 (12.9%) were immune to HBV from past infections (HBcAb+). Totally, 655 (94.2%) were immune to HBV. We didn’t have any HIV positive patient. Conclusions In our study, the quality of treatment is evaluated to be good as compared with other centers. We advise regular periodic control of patients for early dignosis and treatment to decrease mortality and morbidity rate of patients.

Background and ObjectivesTransfusion transmitted infection is one of the most important transfusion reactions. In this study, we tried to find new cases of HCV in thalassemic patients having referred to Adult Thalassemia Clinic after 1996 and to trace them back for sources of infection. Materials and MethodsThis was a descriptive study in which all patients were studied; census method of data collection was used. Those patients with no test record before 1996 that appaeared to be positive in their first test attempt were not considered a new HCV positive case. The new cases were just those whose past negative HCV Ab test results changed into positive in new test. For data analysis, SPSS version 14 was used. ResultsOut of 395 file records, 274(69.4%) were thalassemia major, and 110 (27.8%) intermediate. We had 109 HCV positive cases (27.5%) out of whom 21 were those infected after 1996. Out of the latter, 5 had complete medical records by which 54 blood donors were identified; however, only 37 (68.5%) were traced and found to be negative for HCV Ab. Noteworthy that 81% of these safe donors were shown to be repeated donors. ConclusionSince there had been one or more donors whose donations had been administered to each patient with no possibility for them to be traced, we were not able to prove the transmission of HCV from donors to recipients. Other possibilities including hospital transmission, patient to patient transmission, and transmission by nurses involved in blood administration should be taken into account.

Background and Objectives Thalassemia is a hereditary anemia requiring lifelong transfusion treatment with thromboembolism as one of its side effects. In the present study, we tried to determine the activity of anticoagulant proteins in thalassemic patients. Materials and Methods This descriptive study was conducted in Adult Thalassemia Clinic in Tehran. Measurement of protein C, S, and anti thrombin III levels were done. At the same time, we did these tests on 110 normal people who were matched by age and sex as the control group. The data were analyzed with Chi-Square, Pearson and T-test by SPSS 16. Results Out of 127 patients with the mean age of 29.4 year (SD ± 10.6), 114 (89.8%) were spelenectomized. Seven patients (5.5%) had history of thrombosis with 2 of them being diagnosed as major and 5 intermedia; all of them were spelenectomized. In 61.1%, 67%, and 22.5% of thalassemic patients, the levels of protein C, protein S, and anti thrombin III decreased, respectively. We did not observe any correlation between these results and the type of thalassemia except antithrombin III (p= 0.001). Conclusions In our study, we observed significant decreased activity of protein C, S, and antithrombin III in comparison to the normal population which shows that thalassemic patients are prone to the thromboembolic events.

Hepatitis B vaccine is in national vaccination programs. In healthy individuals the immune response is complete d by three-dose injections in 95% of cases and remains complete with time. However, in patients with chronic transfusion this immune response may be incomplete. In such patients, it is advised to check HBs antibody periodically, and use booster dose in cases with low titer of HBs antibody. In the present study we studied the immune status of thalassemic patients for Hepatitis B Virus (HBV) and the booster effects of vaccine. Patients and Our cross-sectional study was conducted in Adult Thalassemia Clinic in Tehran.We checked Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (HBsAb),and Hepatitis B core antibody (HBcAb). We classified the immune status of patients into four categories: 1) immune to HBV via the vaccination (positively vaccinated) if HBsAg:negative, HBsAb:positive, HBcAb:negative2) immune to HBV via the natural disease (past infection) if HBsAg:negative, HBsAb:positive, HBcAb:positive3) non-immune to HBV (negative) if all three parameters were negative4) carrier of HBV (carrier state) if HBsAg was positive and HBsAb and HBcAb were both negative. We had grading of immunity to HBV vaccine through antibody (HBsAb) titration as below: positive if antibody level was more than 100 IU/mL,negative if antibody level was less than 10 IU/mL, and weakly positive if antibody level was 10-100 IU/mL. SPSS statistical software (version 10) was used for the analysis. We analyzed and compared variables using Pearson and Chi-square tests and p-value for meaningful correlations. We studied 416 patients including 302 (72.5 %) thalassemia major, 104 (25 %) thalassemia intermediate, 7 sickle thalassemia, and 3 Hb H disease. There were 247 (58.4 %) males and 169 (40.6 %) females with a mean age of 25.6. According to our classification, 289 (69.4%) were positively vaccinated, 80 (19.2 %) were immune to HBV from past infection, 40 (10.5 %) were negative and 3 (0.7 %) were carrier state of HBV. We had 319 (76.6%) cases of HBsAb level more than 100 IU/ml (positive), 77 (18.5 %) between 10-100 IU/mL (weakly positive) and 20 (4.8 %) less than 10 IU/mL (negative). HBV is one of transfusion transmmitted infections with a high rate of infectivity via tear, saliva, urine, semen, in addition to blood transfusion. HBV vaccination is obligatory for thalassemics and has been in national vaccination program since 1993. Response rate with vaccination is complete and it is not needed to use booster in healthy people, but for thalassemics it is advised to check the antibody level and administer booster dose for patients with low titer of HbsAb.This protocol can maintain immunity and prevent the decrease in antibody titer in the patients.

Pain is a significant aspect of post-operative patient morbidity. In this study, we evaluated the efficacy of oral gabapentin administration as premedication in the management of postoperative pain in patients undergone local anesthesia for cataract surgery. Patients and The study was a randomized, double–blind, controlled trial. Sixty-one patients who were candidates for eye surgery under local tetracaine anesthesia were enrolled in this study and divided into two gabapentin (n=32) and placebo (n=29) groups. In gabapentin group, the patients received oral gabapentin (300 mg) the night before surgery and the morning of surgery before operation. The pain and sedation scores were evaluated 20, 40, 60 and 120 minutes after surgery by visual analogue scale (VAS) and Ramsay score, respectively. In gabapentin group,the pain score (VAS) during follow-up period was significantly lower than the patients who received placebo (p<0.001). Ramsay score increased significantly in gabapentin group during the follow-up period (p<0.001). Our study showed that gabapentin could reduce postoperative pain. In addition, total amount of opioid consumption for relieving pain in patients undergone local anesthesia for eye surgery was reduced.

Hepatitis C is a major cause of chronic liver disease and hepatocellular carcinoma. Hepatitis C infection also has extrahepatic manifestations, including cryoglobulinemia and lichen planus. Lichen planus is a relatively common mucocutaneous disorder, and, due to its chronic pattern and increased incidence of malignancy, diagnosis and treatment of this disease are very important. The aim of the present study was to investigate the prevalence of oral lichen planus in HCV-infected patients.In this cross sectional–descriptive study, the prevalence of oral lichen planus was evaluated by means of observation, clinical examination, questionnaire and evaluation of the medical records of 150 patients

Background and ObjectivesHospital blood transfusion committees supervise blood transfusion in hospitals. These committees could save time and cost by prevention of blood loss. This study was conducted to assess the performance of hospital blood transfusion committees in Tehran in 2005-2006. Materials and Methods In this retrospective study, 46 reports from 13 hospitals (9 community and 4 private) being sent to Tehran Blood Transfusion Center in 2005-2006 were assessed. All reports were assessed from the perspective of duties entrusted by Iranian Ministry of Health. These duties were classified as (1) report of blood transfusion complications, (2) statistical report of blood transfusions, (3) statistical report of blood orders from different wards of hospitals, (4) report of blood transfusion indications, (5) report of educational programs, and (6) assessment of personnel problems and equipment of blood banks. ResultsReport of blood transfusion complications (77%) and report of blood transfusion indications (23%) were the most and the least reported duties, respectively. The most and the least relative frequencies for all hospitals, community, and private hospitals were 23%-77%, 33%-78% and 0%-75%, respectively. Committee reports in community hospitals were better than private ones, though the difference was not statistically significant (p>0.05). Cross match to transfusion ratio was considerable only in one hospital (3.05). ConclusionsThis study showed that reports of hospital blood transfusion committees in Tehran in 2005-2006 are in a relatively poor condition. This condition in private hospitals was worse than community ones. More focus on reports of blood transfusion indications seems to be necessary. Since cross match to transfusion ratio is an important performance indicator for hospitals, it should receive a higher level of attention of hospital committees.

Background and objectivesBlood transfusion organizations screen blood donors by conducting interviews and serological tests to ensure blood safety. This study was conducted to study donor deferral, blood-borne infections, and related variables in Tehran Blood Transfusion Center (TBTC) during an 8- month period in 2003. Materials and MethodsIn this cross-sectional study, 34823 volunteer blood donors were selected randomly from all clients of Tehran Blood Transfusion Center over a period of 8 months (from June 2003 to January 2004). The prevalence of HBV, HCV and HIV was studied in 26645 eligible blood donors. Correlation of donor deferral with blood-borne infections, demographic (gender, age, marital status, job, educational level) traits and donation-related variables (regular donation) was studied. ResultsDeferral rate was 22.5% in the study period. Risk of blood transfusion transmitted diseases, disease/ exposure, medication, and other factors leading to blood deferral came out to happen in 43.36%, 34.02%, 13.91% and 15.42% of cases respectively. The age range less than 40, female gender, single status, low level education, non-regular donation and some job categories correlated with lower deferral rate. The prevalence rates of HBV, HCV and HIV were 0.6%, 0.2%, and 0.003%, respectively. Higher prevalence of HBV was significantly correlated with the age range over 40 years old (p=0.000), lower educational levels (p=0.002), and married status (p=0.001). HCV was not significantly correlated with any of these variables (p>0.05). ConclusionsThis study highlights that the recruitment of males, those with age range below 40, singles, those with higher educational level, and regular donors in Tehran will increase the supply of blood components. Moreover, recruitment of females, those with age range below 40, those with higher educational levels, and regular donors will provide safer blood products. Such studies are recommended for all blood transfusion centers in all provinces of Iran.

There are no data on the frequency and biochemical expression of the hemochromatosis associated mutations, C282Y and H63D, in Iranian adult population. This is the first study among Iranians that may advocate a screening program. We investigated the frequency of the C282Y/H63D HFE gene mutations in a group of 1029 randomly selected Iranian blood donors as well as transferrin saturation (TS), serum iron and serum ferritin levels. DNA extraction with salting-out method was performed on blood samples and the analysis of HFE gene mutations was performed by PCR amplification followed by digestion with RsaI and BclI restriction enzymes. The mean age of donors was 40±11 years and 92.7% were male. No homozygosity was detected for the C282Y mutation. Heterozygosity for the C282Y mutation was 0.2%, while homozygosity and heterozygosity for the H63D mutation were 1.6% and 19.6%, respectively. There was no compound heterozygote for the C282Y/H63D mutation. These data resulted in allele frequencies of 0.1% and 11.3% for C282Y and H63D mutations, respectively. Serum iron and TS were not influenced by the type of C282Y and H63D mutation. There was no difference in ferritin levels according to type of HFE mutations among blood donors. This study shows low allele frequency for C282Y and H63D mutations in Iran. These results also suggest that there is not any association between HFE gene mutations and iron, TS and ferritin level among Iranian population. The genetic screening for the HFE gene mutation in Iran is not recommended until the true prevalence of other mutations in all hemochromatosis genes could be established.