Developing a databank for multiple transfusion patients: Rh antigen and phenotype distribution among 3000 regular blood donors in Iran

BackgroundRhesus (Rh) blood group system is clinically the most significant protein-based grouping system. The Rh system is of vital importance in blood transfusion, and incompatibility between the donor and recipient leads to alloimmunization. Alloimmunization is commonly seen in multiple-transfusion recipients (e.g. thalassemia patients). There are a few studies about the prevalence of Rh antigens, except for D, in Iran; and regarding the high prevalence of thalassemia in the country, in this study we have determined antigens and phenotypes of the Rh among population of regular blood donors with the aim of developing a detailed Rh databank.Materials and methodsThis cross-sectional study randomly enrolled 3000 regular blood donors from three provinces of Sistan-Balouchestan, Khuzestan and Gilan in Iran, from September 2018 to May 2019. A fully automated system, based on hemagglutination, was used to Rh typing of blood samples.ResultsThe prevalence of Rh antigens were as follows: D: 88.9 %; E: 30.9 %; C: 74.1 %; e: 96.2 %; and c: 72.8 %. The most common antigen and phenotype were "e" and R₁r (DCcee), respectively.ConclusionDue to the high rate of alloimmunization incidence against Rh blood group antigens among multiple transfusion recipients, development of regular blood donor's Rh databank can facilitate extensive matching for the Rh antigens and it likely reduces the risk of alloimmunization.     

Protective effect of pomegranate seed oil against mercuric chloride-induced nephrotoxicity in rat

Purpose: Heavy metals such as mercury can induce the generation of free radicals and oxidative stress which are associated with tissue injury. The present study was designed to evaluate the protective effect of pomegranate seed oil against HgCl₂-induced nephrotoxicity. Methods: Twenty-four W/A adult rats were randomly divided into four groups. Group I received corn oil (1?mL/kg). Group II received HgCl₂ (5?mg/kg) for 3 days. Group III and IV received PSO 0.4?mL/kg and 0.8?mL/kg, respectively one hour before HgCl₂ administration for 3 days. Blood samples were taken by cardiac puncture and used for the measurement of urea and creatinine concentration. Twenty-hour-hour urine samples were collected to measure protein and glucose. The right kidney was fixed in formalin for histological examination and the left kidney was homogenized for measuring malondialdehyde (MDA) and total sulfhydryl groups. Results: Significant elevation of serum creatinine and urea levels as well as urine glucose and protein concentrations, a significant decrease in total thiol content and a significant increase in MDA levels in kidney homogenate samples were observed after administration of HgCl₂ as compared with control group. PSO pretreatment resulted in a significant decrease in serum creatinine and urea levels as well as urine glucose and protein concentrations when compared with HgCl₂ treated (group II). PSO also significantly reversed the HgCl₂-induced depletion in thiol content and elevation in MDA content. Histological studies revealed milder kidney lesions in PSO treated groups (groups III and IV) compared to HgCl₂ treated group. Conclusion: Our results suggest that PSO has a protective effect against HgCl₂-induced nephrotoxicity in rats.     

Satisfaction and Problems Experienced With Transfemoral Suspension Systems: A Comparison Between Common Suction Socket and Seal-In Liner

Objective

To compare a seal-in liner with the common suction socket with regards to patient satisfaction and problems experienced with the prosthesis.

Design

Retrospective survey.

Setting

A medical and engineering research center and a department of biomechanical engineering.

Participants

Men (N=90) with traumatic transfemoral amputation who used both suspension systems participated in the study.

Intervention

Two prosthetic suspension systems: a seal-in liner and common suction socket.

Main Outcome Measures

Two questionnaires were completed by each subject to evaluate their satisfaction and problems experienced with the 2 suspension systems. Satisfaction and problems with the prosthetic suspension systems were analyzed in terms of fitting, donning and doffing, sitting, walking, stair negotiation, appearance, sweating, wounds, pain, irritation, pistoning, edema, smell, sound, and durability.

Results

The study revealed that the respondents were more satisfied with a seal-in liner with regards to fitting, sitting, and donning and doffing. Overall satisfaction increased with the use of a seal-in liner compared with the suction socket (P<.05). However, satisfaction with the prosthesis showed no significant differences in terms of walking (flat and uneven surfaces), appearance, and stair negotiation. Furthermore, problems experienced differed significantly between the 2 suspension systems (P<.05). Sweating, wounds, pain, irritation, pistoning, edema, smell, and sound were less problematic with the use of a seal-in liner, whereas durability was significantly better with the suction socket.

Conclusions

The results of the survey suggest that satisfaction and problems with prosthetic suspension in persons with transfemoral amputation can be improved with a seal-in liner compared with the suction socket, provided that the durability of the liner is enhanced.     

Ondansetron in patients with tinnitus: randomized double-blind placebo-controlled study

The aim of this study was to assess the effect of ondansetron on symptoms of patients with subjective tinnitus accompanied by sensorineural hearing loss or normal hearing. Sixty patients with a chief complaint of tinnitus (with duration of more than 3 months) were equally randomized to ondansetron or placebo for 4 weeks. The dose of ondansetron was gradually increased from 4 mg/day (one tablet) to 16 mg/day (4 tablets) during 12 days and then continued up to 4 weeks. The exact number of tablets was prescribed in the placebo group. Patients underwent audiologic examinations and filled questionnaires at baseline and after 4 weeks of treatment. Our primary outcomes were changes in Tinnitus Handicap Inventory questionnaire (THI), Tinnitus Severity Index (TSI) and visual analog scale (VAS) scores. Our secondary outcomes were the changes in depression and anxiety based on Hospital Anxiety and Depression (HADS) questionnaire, side effects, tinnitus loudness matching, tinnitus pitch matching, pure tone audiometry and speech recognition threshold (SRT). In the ondansetron and placebo groups, 27 and 26 patients completed the study, respectively. The changes in VAS (P = 0.934), THI (P = 0.776), anxiety (P = 0.313) and depression (P = 0.163) scores were not different between the groups. TSI score decreased significantly in the ondansetron compared with the placebo group (P = 0.004). Changes in tinnitus loudness matching (P = 0.75) and pitch matching (P = 0.56) did not differ between the two groups. Ondansetron, but not placebo, decreased the SRT threshold (right, P < 0.001; left, P = 0.043) and mean PTA (right, P = 0.006; left, P < 0.001). In conclusion, ondansetron reduces the severity of tinnitus hypothetically through cochlear amplification.     

Occult hepatitis B virus infection: A major concern in HIV-infected patients: Occult HBV in HIV

Human immunodeficiency virus (HIV)- infected patients are at risk of acquiring viral hepatitis, due to common routes of transmission. As the introduction of highly active antiretroviral therapy (HAART) reduced the frequency of opportunistic infections and improved survival, viral hepatitis emerged as an important cause of morbidity and mortality in HIV-infected cases. Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection without detectable hepatitis B surface antigen (HBsAg). There are conflicting reports on the impact of occult HBV infection on the natural history of HIV disease. In this review, we described the findings of studies on HIV and hepatitis B co-infection with focus on the prevalence of occult HBV infection. The results of this review demonstrated the importance of prevention, diagnosis and treatment of occult HBV infection in HIV-positive patients.     

Pharmacokinetics of doxorubicin in pregnant women

Purpose

Our objective was to evaluate the pharmacokinetics (PK) of doxorubicin during pregnancy compared to previously published data from non-pregnant subjects.

Methods

During mid- to late-pregnancy, serial blood and urine samples were collected over 72 h from seven women treated with doxorubicin for malignancies. PK parameters were estimated using non-compartmental techniques. Pregnancy parameters were compared to those previously reported non-pregnant subjects.

Results

During pregnancy, mean (±SD) doxorubicin PK parameters utilizing 72 h sampling were: clearance (CL), 412 ± 80 mL/min/m²; steady-state volume of distribution (Vss), 1,132 ± 476 L/m²; and terminal half-life (T_1/2), 40.3 ± 8.9 h. The BSA-adjusted CL was significantly decreased (p < 0.01) and T_1/2 was not different compared to non-pregnant women. Truncating our data to 48 h, PK parameters were: CL, 499 ± 116 ml/min/m²; Vss, 843 ± 391 L/m²; and T_1/2, 24.8 ± 5.9 h. The BSA-adjusted CL in pregnancy compared to non-pregnant data was significantly decreased in 2 of 3 non-pregnant studies (p < 0.05, < 0.05, NS). Vss and T_1/2 were not significantly different.

Conclusions

In pregnant subjects, we observed significantly lower doxorubicin CL in our 72 h and most of our 48 h sampling comparisons with previously reported non-pregnant subjects. However, the parameters were within the range previously reported in smaller studies. At this time, we cannot recommend alternate dosage strategies for pregnant women. Further research is needed to understand the mechanism of doxorubicin pharmacokinetic changes during pregnancy and optimize care for pregnant women.