فصلنامه خون
سال بیست و یکم شماره 4 (پیاپی 86، زمستان 1403)

During chronic hepatitis B virus infection, the dynamic balance between virus replication and the host immune response is crucial in developing liver disease. In this study, the level of expression of programmed death type 1 in asymptomatic donors infected with hepatitis B during the natural course of the infection was investigated.

In this case-control study, 120 blood donors were divided into two groups. The first control group included 60 healthy individuals who tested negative for HBsAg and anti-HBc. The second group, known as the case group, comprised 60 asymptomatic HBV-infected blood donors who tested positive for HBsAg and anti-HBc. All participants were entered from the Tehran Blood Center in 2018. To check gene expression after RNA extraction and cDNA synthesis, a Real-Time PCR test was performed for the PD-1 gene and β-actin reference gene, then using REST software, gene expression changes compared to the healthy group were checked.

All the samples of asymptomatic HBV-infected blood donors were 100% positive for total anti-HBc, anti-HBe, and negative for HBe Ag. The gene expression levels were analyzed using REST software, utilizing Cycle Threshold  values obtained from Real-Time PCR tests for the PD-1 gene and a reference gene. The analysis revealed 1.5 times increase in PD-1 gene expression in asymptomatic HBV-infected donors compared to healthy donors. However, this increase was not found to be statistically significant.

Conclusions  :

PD-1 gene expression does not change during the normal course of chronic HBV infection in asymptomatic HBV-infected donors and is similar to healthy individuals.

Hemoglobin screening is one of the requirements before donating blood, which is performed on all donors. Hemoglobinometer devices are one of the conventional methods for performing this screening in blood transfusion centers. The purpose of study is to evaluate the quality control of a hemoglobinometer device produced by a knowledge enterprise company before being used in blood transfusion centers.

In this cross sectional study, venous and capillary blood samples from donors referred to the Blood Transfusion centers of Tehran, Qazvin, Alborz and Fars were used to measure hemoglobin. A comparative evaluation of the study device with Reference was performed on 135 samples. Then a comparative evaluation of study device with hemoglobinometer devices was done on 194 samples. Bland-Altman analysis, sensitivity, specificity, PPV, NPV, accuracy and ICC were evaluated by R.4.4.1.

The mean and standard deviation of hemoglobin concentration with reference and study device were 12.55 ± 2.32 and 12.42 ± 1.60 g/dL, respectively, Based on the Bland-Altman curve, no significant difference was observed between the readings of the two study device and the reference devices (p= 0.1) and the ICC between the two devices showed an almost complete agreement with a confidence factor of 95% (0.8˂ICC˂0.89). The sensitivity, specificity, PPV, NPV and accuracy of the study device compared.

According to the results of this study and examination with a Reference, the knowledge enterprise device can be used to screen the hemoglobin of blood donors according to the permissible range of blood donation in blood transfusion centers.

Excessive blood product transfusions increase morbidity, mortality, and healthcare costs. To address this issue, we investigated the cost savings of implementing patient blood management strategies to reduce unnecessary transfusions.

We conducted a cross-sectional study at Shahid Lavasani Hospital from 2016 to 2018, analyzing laboratory service costs in the blood bank before and after adopting patient blood management. Statistical analyses included Friedman repeated measures tests for three-year trends and Wilcoxon signed-rank tests for two-year trends, using SPSS version 21 for comparison.

In 2016, the average cost of red blood cell transfusions was 209,336,820 Rials, which dropped to 185,857,980 Rials in 2017 and it decrease by 71% to 53,494,250 Rials in 2018. Total laboratory service costs decreased by 6.81% from 2015 to 2016 and 21.56% from 2017 to 2018. The average cost of plasma in 2016, before the establishment of patient blood management, was 95,155,368 rials. In 2017, this cost decreased by 79%, bringing the average down to 19,880,784 rials. In 2018, it fell further by 56.21% compared to the previous year, resulting in an average cost of 8,537,760 rials.

Conclusions  :

Patient blood management reduces costs, making it a financially advantageous strategy for hospitals.

The presence of media attachment in crises is necessary to prevent any anxiety of public opinion and misunderstanding about the performance of organizations. We intend to investigate and identify the factors affecting the media attachment in the public relations of IBTO for the proper and optimal management of public opinion through the media.

The research method carried out in this study is mixed, and the data of the quantitative part is presented. It has been done in a descriptive-survey way. The total number of participants was 483 from the general managers and employees of  IBTO; using stratified random sampling, a researcher-made questionnaire was sent to 140 people in person and by e-mail. SPSS software version 26 and  R software version 4.3.3, and confirmatory factor analysis tests, t test and Friedman test were used.

The findings showed that the media attachment factors in the public relations of  IBTO in crises are: information (factor load 0.92), management (factor load 0.72) and education (factor load 0.59). We found that the factors and indicators of the media attachment model are generally average; although the information agent had a more important role than management and education.

Conclusions : 

To improve the performance of the public relations of  IBTO, it is necessary to improve the managerial and educational factors in order to align with the current information standards.

Transfusion of blood and its products is one of the necessary and life-saving interventions for patients, and errors in any of its steps can be life-threatening. The aim of this study was to identify operational errors according to the voluntary reported errors compared to the guidelines of the Global Trigger Tool.

The study is of a descriptive-analytical and applied type and was conducted retrospectively at one of the Hospital in Tehran on 88 cases with a history of blood transfusion and its products with a checklist. Comparison of the average number of errors by section was done using the Kruskal-Wallis rank test as well as chi-square analysis using SPSS22 software. A significant level p value <0.05 was considered.

From the 88 cases, 346 errors were obtained from the checklist, which was much higher compared to 2 cases of voluntarily reported errors.The reported error was unique to category B and C, in which the accident related to blood transfusion and its products was not reported.

Conclusions:

  Identification of errors using the global clue tool was significantly higher than voluntary reporting of errors, indicating that it is a more accurate tool for identifying adverse events. The use of this tool and planning and preventive measures can improve the safety of patients and improve the quality of care in hospitals.

Antibodies are glycoprotein molecules that play a significant role in both diagnosis and treatment. Various methods exist for their production, with laboratory immunization being one of them. This study aims to investigate the laboratory immunization method and the factors influencing the optimization of immunization to achieve antibody-producing immunized lymphocytes in a laboratory setting.

A literature review was conducted using the databases in PubMed and Google Scholar, employing the keywords immunization, in vitro technique, and antibodies, covering the period from 1985 to 2023. About 50 articles were found with these keywords, 34 of which are used in this article.

The studies reviewed indicate that in vitro immunization offers several advantages over in vivo immunization, including shorter immunization time, high reproducibility, and the ability to obtain IgM-producing clones. However, this method is not universally applicable for producing antibodies against all antigens. Numerous factors influence laboratory immunization, including the type and concentration of the antigen, the type and number of lymphocytes, the removal of immune-suppressing cells, the use of adjuvants and cytokines, the physiological conditions of the culture environment, the incubation duration, and the variability in immune responses among donors.

Conclusions  :

For the production of antibodies in vitro, it is essential to consider the effective factors to enhance the efficiency of laboratory immunization.

Cupping therapy (Hijama), as a common method of treatment in the world, could carry a significant risk of infections by bloodborne pathogens. We aimed to review systematically scientific reports on the relationship between cupping practices and bloodborne infections.

In this systematic review, international and local databases were searched using relevant keywords. All original citations published in English or Persian up to March 2024 were included. No limitations were applied to study design, sample size, publication date, or cupping techniques.

After screenintg the titles and abstracts of 630 studies retrieved from the initial search, the full texts of 67 non-duplicate documents were reviewed. Of these, 42 articles were excluded for various reasons. A manual search of the references from the retrieved papers yielded 6 additional articles, resulting in a total of 29 studies that fulfilled the inclusion criteria after excluding two overlapping citations. Among the 15 surveys that assessed HBV infection, only 3 demonstrated a positive association between a history of cupping  and this infection using multivariate analysis; the reported odds ratios ranged 3.8 to 7.3. Regarding HCV infection, 2 of 13 investigations confirmed a positive correlation with cupping therapy in multivariate regression analysis; the reported odds ratios were 2.3 and 2.4. No reports indicated a significant relationship between cupping therapy and HDV, HIV, or HTLV-1 infections.

Conclusions  :

This systematic review revealed that there is insufficient evidence regarding the role of cupping in the spread of bloodborne infections. It is recommended to conduct large-scale and longitudinal studies to find if this traditional practice is a significant risk factor for infection.