Transfusion Medicine and Molecular Genetic Methods

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180603Transfusion Medicine and Molecular Genetic Methods19171917ENSchool of Health Sciences, Health Campus, Universiti Sains Malaysia, KelantanSchool of Health Sciences, Health Campus, Universiti Sains Malaysia, KelantanSchool of Health Sciences, Health Campus, Universiti Sains Malaysia, KelantanSchool of Biological Sciences, Victoria University of Wellington, WellingtonSchool of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan20180523Transfusion procedures are always complicated by potential genetic mismatching between donor and recipient. Compatibility is determined by several major antigens, such as the ABO and Rhesus blood groups. Matching for other blood groups (Kell, Kidd, Duffy, and MNS), human platelet antigens, and human leukocyte antigens (HLAs) also contributes toward the successful transfusion outcomes, especially in multitransfused or highly immunized patients. All these antigens of tissue identity are highly polymorphic and thus present great challenges for fnding suitable donors for transfusion patients. The ABO blood group and HLA markers are also the determinants of transplant compatibility, and mismatched antigens will cause graft rejection or graft‑versus‑host disease. Thus, a single and comprehensive registry covering all of the signifcant transfusion and transplantation antigens is expected to become an important tool in providing an effcient service capable of delivering safe blood and quickly locating matching organs/stem cells. This review article is intended as an accessible guide for physicians who care for transfusion‑dependent patients. In particular, it serves to introduce the new molecular screening methods together with the biology of these systems, which underlies the tests. Keywords: Blood groups, genetic marker, human platelet antigen and human leukocyte antigen, transfusion http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1917http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1917/717717742

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180603Implementing Tuberculosis Close‑contact Investigation in a Tertiary Hospital in Iran19201920ENClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, TehranMycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, TehranChronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, TehranLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran20180603Background: Close contact investigation is the essential key in tuberculosis (TB) case fnding and an effective strategy for TB control program within any society. Methods: In this prospective study, 1186 close family contacts of hospitalized TB patients (index) in a referral TB hospital in Tehran‑Iran were passively studied. These people were studied to rollout TB infection and disease. Demographic characteristics, clinical and laboratory data of these individuals were reviewed and summarized for analysis. Results: A total of 886 (74.4%) close‑family contacts completed their investigation. The index TB patients of these individuals were sputum smear negative for acid‑fast bacilli in 137 cases (11.6%) and the rest were smear positive. A total of 610 (68.8%) close‑family contact ruled out for TB infection or disease (Group I). A total of 244 cases (27.5%) had latent TB infection (Group II) and active TB (Group III) was confrmed in 32 cases (3.6%). A signifcant difference was shown for female gender, signs and symptoms, family size, and positive radiological fnding between Group I and Group II. The study of index parameter including positive sputum smear/culture did not reveal any signifcant difference, but positive cavitary lesion signifcantly more has seen in active TB group (P = 0.004). Conclusions: This study emphasizes on sign and symptoms and radiological fnding in TB contact investigation, where index parameters including positive smear/culture, does not implicate any priority. Although cavitary lesions in index patient have more accompanied by active TB, close contact study should include all of TB indexes. This investigation should include chest radiography for these individuals. Keywords: Contact investigation, passive case fnding, tuberculosis http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1920http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1920/717717745

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180603Iran’s Struggling Health System: An Increase in Natural Childbirth: A Case Study19191919ENHealth Management and Economics Research Centre, Isfahan University of Medical Sciences, IsfahanHealth Management and Economics Research Centre, Isfahan University of Medical Sciences, IsfahanHealth Management and Economics Research Centre, Isfahan University of Medical Sciences, Isfahan20180603Background: The 7th package of health reform in Iran has been implemented in May 15, 1393, is concerned with the “promotion of natural childbirth.” It has been focusing on reducing cesarean section (CS) and promoting normal vaginal delivery (NVD) as broadly as possible. This study evaluated the changes in the vaginal delivery and cesarean before and after implementation of the 7th package of health reform in public and private hospitals of Isfahan Province in 2014.Methods: This was a quasi‑experimental research. The population of this study contained all public and private hospitals in Isfahan Province covered by the Health Reform Program. It included 22 public and 6 private hospitals. The data collected from the vice chancellor of treatment in 6 months before and after the implementation of the program have been analyzed. SPSS software version 18.0 (SPSS Inc., Chicago, IL, USA) and independent t‑test have been employed for data analysis.Results: It was demonstrated that the increasing rate of NVD (P = 0.001) and decreasing rate of CS in public hospitals (P = 0.027) after the implementation of the plan were signifcant. On the other hand, the increasing rate of CS in private hospitals was signifcant (P = 0.026).Conclusions: Although this scheme has achieved its targets in public hospitals of Isfahan Province, it has not met its objectives in private hospitals. It seems CS operations were shifted from public hospitals to private ones, which is conﬂict with the objectives of the health reform plan.Keywords: Cesarean section, health reform, Iran, Isfahan, normal vaginal deliveryhttp://ijpm.mui.ac.ir/index.php/ijpm/article/view/1919http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1919/717717744

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180603Seroprevalence of Hepatitis B Infection and Associated Risk Factors among Drug Users in Drop‑in Centers of Isfahan, Iran19181918ENInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, IsfahanInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, IsfahanInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, IsfahanAcquired Immunodefciency Research Center, Isfahan University of Medical Sciences, IsfahanInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, IsfahanInfectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, IsfahanIntegrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, IsfahanNosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan20180603Background: Scientists perceive drug users (DUs) as a high‑risk population for hepatitis B virus (HBV) infection. Effective strategies aiming at the reduction of HBV infection can be depicted when its epidemiological status is clearly defned. The present study provides new insight into associated risk factors of HBV infection and its seroepidemiological status among DUs attending drop‑in centers (DICs). Methods: This was a cross‑sectional study, which was implemented in 7 DICs of Isfahan province. The sample size included 539 participants. Demographic data and risk factors for HBV infection were obtained by a trained social worker using a self‑made structured questionnaire. Venous blood sample was obtained and tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody, and total hepatitis B core antibody (HBcAb) using enzyme‑linked immunosorbent assay. Results: Mean age of the participants was 31.76 ± 8.4 years. They were generally male, Iranian, urban, with an education level of high school or less. The prevalence of HBV infection (HBsAg and/or HBcAb) was 18% (88.490). Regression analysis showed that age, bloodletting, and drug injection, being the sexual partner of injecting DU (IDU), as well as frequency and duration of imprisonment positively correlated with HBV infection.Conclusions: Drug injection bloodletting, and being the sexual partner of IDU, as well as frequency and duration of imprisonment could be considered as contributing factors in HBV infection. Keywords: Drug users, hepatitis B, hepatitis B surface antigens, prevalence http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1918http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1918/717717743

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180603The Use of Laypersons to Support Tuberculosis Screening at a Kenyan Referral Hospital19161916ENCenter for Global Health Research, Kenya Medical Research Institute, KisumuKenya Medical Research Institute, Center for Global Health Research, KisumuDivision of Leprosy Tuberculosis and Lung Diseases, The former Nyanza province of Kenya20180523Background: The former Nyanza Province of Kenya bore the brunt of HIV‑driven tuberculosis (TB); 62% of the 19,152 cases in 2010 were HIV co‑infected. The use of laypersons to improve TB case fnding in community settings has shown rewarding results in other countries. We have no documented Kenyan experience in health facility settings. We evaluated the beneft of using laypersons to support TB screening and referrals at the former Nyanza Province of kenya province’s largest regional referral facility. Methods: In 2010, fve high school graduates were trained on symptomatic recognition of TB suspects and assisted sputum production by the region’s District’s TB and Leprosy Coordinator. They then identifed and referred TB suspects (from hospital patients and visitors) at waiting‑areas and wards to clinicians and documented their TB screening and referral outcomes. We describe results from one waiting‑area with complete documentation between January and December 2011. Results: Of the 217 TB suspects identifed, majority were male (55%); their median age was 36 (range 1–70) years. 11% (23) were aged <15 years; 65% (15) were diagnosed with TB by, a combination of sputum microscopy and chest X‑rays (5) followed by chest X‑ray alone (50), then sputum microscopy alone (1), and TB score chart (4). Of those aged 15+ years, 72% (140) were diagnosed with TB by a combination of sputum microscopy and chest X‑rays (75) followed by sputum microscopy alone (38), and chest X‑ray alone (27). Excluding cases that transferred out, this process contributed to 33% of Jaramogi Oginga Odinga Teaching and Referral Hospital’s annual TB case burden. Conclusions: TB case detection in high TB burden regions can be supported the use of laypersons in hospital settings. Keywords: Cough monitors, referrals, tuberculosis identifcation http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1916http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1916/717717740http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1916/717717741

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180603Human Immunodefciency Virus and Hepatitis B Virus Infection Prevention Following Occupational Exposure among Staff at a Regional Referral Hospital in Western Kenya19151915ENCenter for Global Health Research, Kenya Medical Research Institute, KisumuCenter for Global Health Research, Kenya Medical Research Institute, KisumuJaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu20180523Background: Postexposure prophylaxis (PEP) with antiretroviral therapy (ART) and vaccination against hepatitis B virus (HBV) aides in preventing human immunodefciency virus (HIV) infection and HBV, respectively, from accidental or occupational exposure. We assessed compliance to guidelines for HIV and HBV prevention after occupational exposure among hospital staff at a referral Kenyan hospital.Methods: We reviewed PEP registers for hospital staff reporting an occupational injury at a referral hospital in Western Kenya between January 2011 and December 2012. Proportions were used to summarize number of participants receiving the recommended services, Kaplan–Meier curves were used to describe time to ART initiation, and Chi‑square statistics was used to describe the association between participant characteristics and PEP completion rates. P < 0.05 was considered statistically signifcant. Results: Majority of documented hospital staff (n = 52) were health workers (63%) and students (27%) and had high HIV risk exposures (97%). All had timely PEP initiation with 50% completing PEP. Completion rates did not vary by gender (P = 0.78), exposure type (P = 1.0), or department of exposure (P = 0.75). Retesting for HIV and negativity rates at months 1.5, 3, and 6 were 96%, 25%, and 17% and 100%, 100%, and 100%, respectively. At the time of exposure, 17% (9) of staff were HBV vaccinated and HBV status of sources was unknown; no intervention was provided for HBV prevention.Conclusions: Low rates of completion and follow‑up negate intended benefts of PEP. Efforts should be directed to enforce universal precaution practices and completion of PEP. Low rates of HBV testing and vaccination illustrate the need for support for the implementation of HBV prevention guidelines.Keywords: Hepatitis B, human immunodefciency virus/AIDS, workplace injuries <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1915http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1915/717717739

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180513Neck Circumference as an Indicator of Central Obesity in Healthy Young Bosnian Adults: Cross‑sectional Study19141914ENDepartment of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, SarajevoDepartment of Family Medicine, Health Centre Bosanska Krupa, Bosanska KrupaDepartment of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, SarajevoDepartment of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, SarajevoDepartment of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, SarajevoDepartment of Human Physiology, Faculty of Medicine, University of Sarajevo; Cekalusa, Sarajevo20180512Background: Neck circumference (NC) is an index of subcutaneous adipose tissue distribution in an area of the upper part of the body. The aim of this study was to assess whether NC can be used as an indicator of central obesity and to determine the prevalence of central obesity in apparently healthy Bosnian young adults.Methods: Participants for this cross‑sectional study were recruited using the snowball method. NC was measured in horizontal straight position by placing the top edge of a plastic tape only below the laryngeal prominence and perpendicular to the longitudinal axis of the neck, with the head positioned in the Frankfort horizontal plane. Body mass index, waist circumference (WC), and waist‑to‑hip ratio were taken following the WHO guidelines. Results: The study included 111 second year University of Sarajevo Dentistry students (49 students of male gender and 62 students of the female gender). Determined the optimal cutoff value of NC in the detection of central obesity based on WC values in healthy young participants of male gender was ≥37.45 cm (P < 0.001), while in healthy young participants of the female gender, it was ≥32.75 cm (P < 0.001). Based on the WHO guidelines for WC, central obesity was determined in 24.49% (n = 12) of male patients, and in 29.03% (n = 18) of female participants included in our investigation (P < 0.05). Conclusions: The results of the present study indicate that NC may be used as a screening tool for central obesity in healthy young adults. Prevalence of central obesity observed among student population suggests that there is a justifed need for an implementation of healthy lifestyle programs in this population that would have preventive purposes. Keywords: Anthropometry, central obesity, gender difference, metabolic syndrome, young adults http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1914http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1914/717717738

International Journal of Preventive Medicine (Int J Prev Med)2008-78029520180513Five Years after Implementation of Urban Family Physician Program in Fars Province of Iran: Are People’s Knowledge and Practice Satisfactory?19131913ENHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, ShirazHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, ShirazHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, ShirazHealth Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, ShirazDepartment of Health, Larestan School of Medical Science, LarestanDepartment of Health, Larestan School of Medical Science, LarestanDepartment of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz20180512Introduction: Urban family physician program (UFPP) was launched in Fars province of Iran in 2012. We aimed to assess the knowledge and practice of people toward this 5‑year‑old program. Methods: In this population‑based study, through a multistage random sampling from 6 cities of Fars province, 1350 people older than 18 years were interviewed. For data collection, a questionnaire consisting of sociodemographic characteristics and items about knowledge and practice toward UFPP was used. Results: The mean age of the interviewees was 42.4 ± 14.2 years; male (674; 49.9%)‑to‑female (651; 48.2%) ratio was 1.03. Mean score of knowledge was 4.2 ± 1.7 (out of 14), while 961 (71.1%) had <50% of the desirable knowledge. Mean score of practice was 4.4 ± 1.3 (out of 9), while only 443 (32.8%) had a good performance toward this program. Knowledge and practice did not show a signifcant correlation (r = 0.06, P = 0.05). Among cities, the highest and the lowest mean of knowledge belonged to Pasargad (5.6 ± 2.1) and Lar (3.0 ± 1.0) (P < 0.001), respectively. Pasargad (4.8 ± 1.4) had also the highest level of practice compared to Farashband (3.8 ± 1.4) which had the lowest score (P < 0.001). Multivariable analysis showed that supplemental insurance coverage (odds ratio [OR] = 2.5, %95 confdence interval [CI]: 1.6–3.9), female gender (OR = 1.9, %95 CI: 1.2–2.9) and higher level of education (OR = 1.7, %95 CI: 1.1–2.5) were the signifcant determinants of knowledge, while practice in those who were not covered by supplemental insurance was better (OR = 1.6, 95% CI: 1.2‑2.5). Conclusions: After 5 years of implementation of UFPP, knowledge and practice of people toward UFPP are not satisfactory. This fnding calls for a serious revision in some aspects of UFFP.Keywords: Family physician program, knowledge, practice, urban population <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;" />http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1913http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1913/717717737