Search

Background: Evaluation of complications after transcatheter ventricular septal defect (VSD) closure in long-term follow-up and large samples of children is limited. Objectives: We compared the residual shunt after transcatheter closure in VSDs with a single hole and multiple holes, a new task that has not been done so far. Methods: This retrospective study included all patients who underwent transcatheter device closure for VSD in a tertiary cardiovascular center from 2009 to 2020. Follow-up evaluation using transthoracic echocardiography (TTE) and electrocardiogram (ECG) was performed at 1,6,12 months, and annually after the procedure. Results: A total of 409 patients underwent transcatheter VSD closure. The mean age was 7 years (2-15 years), and the median follow-up duration was 48 months (1 - 10 years). The number of patients with a singular VSD was 259 (63.4%), and those with multiple exit holes were 150 (36.6%). The incidence of a residual shunt immediately after implantation was significantly higher in VSDs with multiple holes than those with a single hole (P = 0.008). During the follow-up, the residual shunts decreased in the group of VSDs with a single hole. Forty-five patients (11%) and 16 patients (4%) had a new-onset of mild and moderate tricuspid regurgitation (TR), respectively, and it decreased dramatically over time. Only 1 patient showed a new-onset mild aortic regurgitation (AR). The most crucial complication shown in 2 patients was a persistent complete heart block. Conclusions: Ventricular septal defects with multiple exit holes are a risk factor for a residual shunt. After transcatheter VSD closure, the residual shunt in patients with a multiple-hole VSD was significantly higher (P = 0.008). Although TR may increase during the procedure, it decreases dramatically over time. Interestingly, patients who had pre-procedure tricuspid or aortic regurgitation disappeared after 2 years of the procedure. The most important complication was a complete heart block in 2 patients. [ABSTRACT FROM AUTHOR]

Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme deficiency of the human red blood cells . Most of G6PD deficient individuals are asymptomatic, but acute hemolytic anemia may be presented with nausea, vomiting, abdominal pain, headache, jaundice, pallor, discoloration of the urine, chills, and fever. Seizure is reported as a rare symptom, as well. The present study aimed to investigate seizure following acute hemolysis caused by Glucose-6-phosphate dehydrogenase deficiency. Material and Methods: This analytic cross-sectional study was conducted on all consecutive patients aged 1- 12 years with G6PD deficiency hospitalized for hemolysis in 17 Shahrivar children hospital, Rasht, Iran, in 2016. Demographic characteristics and other variables such as place of inhabitants, type of drinking water, history of seizure in the patients and family, cause of hemolysis, hemoglobin level and hemoglobinuria on admission, and infection history prior to hemolysis were recorded. Data were analyzed by Mann-Whitney U test and Fischer Exact Test. P-value < 0.05 indicated statistical significance and data were assessed by SPSS (version 20). Results: The youngest patient was one year old and the oldest was 11 years old. Most of them were males (68.9%). Out of 244 patients, 8 ones (3.3%) experienced seizure. There was a significant correlation between seizure occurrence and family history of seizure (p=0.03) as well as fava bean consumption (p=0.019) as the causes of hemolysis; but not with infection as the cause of hemolysis, hemoglobin or hemoglobinuria level on admission, types of drinking water, place of living, and gender. Methemoglobinemia was considered as the main cause of the seizure. Conclusion: Although the rate of seizure was not so high (3.3%), it seems that seizure can be a critical and potentially life-threatening complication in these patients. Environmental factors may also play a role in the pathogenesis of the seizure in these patients. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate chemical composition of PM10 (particulate matter with aerodynamic diameter ≤ 10 μm) during dust storm and inversion in Tehran and hemolysis effects. Methods: PM10 was sampled in Tehran, Iran, during dust storm and inversion conditions. Water soluble ions (F¯, Cl¯, NO2¯, NO3¯, SO4¯2, Na+, K+, NH4+, Ca+2, Mg+2) and elements (Al, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Pb, Se, Sn, Sr, V, Zn, Pt, Rh, Pd, As and Si) were analyzed by ion chromatograph (IC) and inductively coupled plasma optical emission spectrometer (ICP-OES), respectively. Hemolysis was examined as in vitro at PM10 concentrations of 50–300 μg/ml. Results: Daily average of PM10 concentrations in dusty and inversion days were 348.40 and 220.54 μg/m3, respectively. Most prevalence ionic components were NO3¯, Cl¯, SO4¯2 and Ca+2 during dust storm and SO4¯2, NO3¯, Cl¯ and NH4+ during inversion. Si, Fe and Al had the maximum values in both conditions. Particles associated with both conditions induced hemolytic responses. PM10 from dusty day showed a higher hemolysis percent (10.24 ± 4.67%) than inversion (9.08 ± 5.47%), but this difference was not significant (p = 0.32). Hemolytic effects were significantly intensified by increased PM concentrations (p < 0.001) in a dose-response manner. Conclusions: As the results, chemical composition of sampled particles from inversion days and dust storm was different from each other. Hemolytic effects of particles during dust storm were more than inversion days. However, this difference was not statistically significant. [ABSTRACT FROM AUTHOR]

Objectives: Uropathogenic Escherichia coli (UPEC) are the major cause of urinary tract infections (UTIs). Here, we determined whether sensitivity to antibiotics was related to the prevalence of iron scavenging genes, or to biofilm and hemolysis formation. Methods: A total of 110 UPEC and 30 E coli isolates were collected from the urine of UTI patients and feces of healthy individuals without UTI, respectively. The presence of iron receptor genes and phenotypic properties were evaluated by polymerase chain reaction and phenotypic methods, respectively. Susceptibility to routine antibiotics was evaluated using the disc diffusion method. Results: The prevalence of iron scavenging genes ranged from 21.8% (ireA) to 84.5% (chuA) in the UPEC. Resistance to ceftazidime and cefotaxime was significantly correlated with the presence of fyuA and iutA iron genes. Biofilm production was significantly associated with the prevalence of fyuA and hma iron genes. A higher degree of antibiotic resistance was exhibited by isolates that produced biofilms than by their non-biofilm producing counterparts. Conclusion: Our study clearly indicates that biofilm production is associated with antibiotic resistance, and that iron receptors and hemolysin production also contribute to reduced antibiotic sensitivity. These results further our understanding of the role that these virulence factors play during UPEC pathogenesis, which in turn may be valuable for the development of novel treatment strategies against UTIs. [ABSTRACT FROM AUTHOR]

Introduction: Glucose-6-phosphate dehydrogenase deficiency (G6PD) is an X-linked genetic disorder with a relatively high frequency in malaria-endemic regions. It is an obstacle to malaria elimination, as primaquine administered in the treatment of malaria can cause hemolysis in G6PD-deficient individuals. This study presents information on the prevalence of G6PD deficiency in Sistan and Balouchetsan province, which hosts more than 90% of Plasmodium vivax malaria cases in Iran. This type of information is needed for a successful malaria elimination program. Methodology: A total of 526 students were randomly recruited through schools located in southeast Iran. Information was collected by interviewing the students using a structured questionnaire. Blood samples taken on filter papers were examined for G6PD deficiency using the fluorescent spot test. Results: Overall, 72.8% (383/526) of the subjects showed normal G6PD enzyme function. Mild and severe G6PD deficiency was observed in 14.8% (78) and 12.2% (64) of subjects, respectively. A total 193/261 males (73.9%) and 190/265 (72%) females had normal enzyme activity. Mild G6PD deficiency was observed in 10.8% (28) and 18.9% (50) of male and female subjects, respectively. However, in comparison with females, a greater proportion of males showed severe enzyme deficiency (15.3% versus 9.1%). All these differences were statistically significant (p < 0.006). Conclusions: G6PD deficiency is highly prevalent in southeast Iran. G6PD-deficient individuals are susceptible to potentially severe and life-threatening hemolytic reactions after primaquine treatment. In order to achieve malaria elimination goals in the province, G6PD testing needs to be made routinely available within the health system [ABSTRACT FROM AUTHOR]

Search results show that numerous primary studies have been carried out in different parts of Iran regarding prevalence of G6PD deficiency; if results of these studies are combined, a reliable estimation of prevalence of this factor will be achieved in Iran. Thus, present study, aimed to determine the prevalence of G6PD deficiency by combining findings of qualified primary studies using meta-analysis and taking into account heterogeneity considerations. Searching the relevant keywords in Iranian and International databases, primary studies were selected. After quality appraisal and applying inclusion and exclusion criteria, relevant primary studies were selected. In each study, standard error of prevalence of G6PD was calculated according to binominal distribution formula. Finally, heterogeneity index was determined among studies using Cochran's test. Prevalence of G6PD in Iran was estimated by STATA software ver 11 using fixed or random effect model based on heterogeneity results. 148916 subjects in 36 primary studies which entered this meta-analysis were examined. G6PD deficiency prevalence was 6.7% in Iran (men: 8.8% and women: 2.2%). Also, this deficiency in the present study was four times higher in men than in women. Its prevalence was adjusted in different parts of Iran and it was shown that it was between 0.8 and 15.2 using Bayesian analysis. This meta-analysis showed that Iran is among countries with high frequency of G6PD deficiency and there is a significant difference in prevalence of G6PD in different parts of Iran. According to these results, screening newborn children seems very vital. Carrying out other primary studies regarding prevalence of G6PD seems unnecessary [ABSTRACT FROM AUTHOR]

Background and Objectives According to our national standards, whole blood units are stored at 22 ± 2°C prior to processing. Since there has been no study about the quality of RBCs prepared after the storage of whole blood units at 22 ± 2°C in Iran, we decided to investigate the quality effect of whole blood stored for 8 and 24 hours at this temperature. Materials and Methods Twelve whole blood units in pediatric bags were collected and placed in the cooling plate box. After 8 and 24 hours, RBCs were produced from these stored units. Then, the bags were analyzed for hemolysis, 2, 3-diphosphoglycerate, lactate dehydrogenase, glucose, and sodium. Results Although a higher percentage of hemolysis, lactate dehydrogenase levels, and lower 2,3-DPG, sodium and glucose levels were determined in RBCs prepared after the 24-hour WB storing time, no significant differences, except for 2,3 DPG, were observed between 8-hour (205 ± 12) and 24-hour (113 ± 13) WB storing time periods. Conclusions Although storing whole blood at 22 ± 2°C for 24 hours prior to RBCs production had an impact on its quality, the property of prepared components is defined to be within an acceptable range of quality control. [ABSTRACT FROM AUTHOR]

Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme disorder in human. The aim of this study was to determine the prevalence of G6PD deficiency among children and evaluate its association with ABO/Rh blood groups. Method: Blood samples of 3401 asymptomatic children were analyzed and compared with 317 children who were admitted to hospital because of hemolysis resulted from G6PD deficiency. Results: Among asymptomatic children 375 (11%) were G6PD deficient. Male to female ratio for this group was 4.2:1 and for the hemolytic group was 2.5:1 (P=0.004). Two hundred and sixty-seven (84.2%) of the patients with hemolysis were younger than 2 years, with the peak age of hemolysis between 2 and 3 years (27.7%). The overall rate of hemolysis caused by G6PD deficiency was 12.3% during the 3 consecutive months of fresh Fava bean consumption. Blood groups O+, A+, and B+ together constituted 87.1%, 87.7%, and 84% of the blood groups among normal children, asymptomatic G6PD deficient subjects, and those with G6PD deficiency related hemolysis respectively (P=0.367). Seven percent of the normal children and asymptomatic G6PD deficient subjects were Rh- vs 9.7 % of G6PD deficient children with hemolysis (P=0.16). Conclusion: The prevalence of G6PD deficiency among the children was 11%. Male to female ratio was greater in nonhemolytic vs hemolytic group so that the female share was higher in hemolytic group than in the other two groups (P=0.004). The distribution of ABO blood groups was similar among asymptomatic non-G6PD deficient, asymptomatic G6PD-deficient, and G6PD-deficient children with hemolysis. The distribution of Rh- types among the G6PD-deficient children with hemolysis and the other two groups was similar (9.7% vs 7%, P=0.16). [ABSTRACT FROM AUTHOR]

Glucose 6-phosphate dehydrogenase (G6PD) deficiency is an enzyme deficiency of the red blood cells and the most important disease of hexose monophosphate pathway. The role of hemolysis in the pathophysiology of neonatal jaundice due to G6PD deficiency is in contencious. Our aim is to study the role of hemolysis in neonatal jaundice associated with G6PD deficiency. This prospective descriptive study has been done on 244 neonates who were admitted with the symptoms and signs of icter to the Ali-Asghar Children Hospital, affiliated to Iran University of Medical Sciences, Tehran, Iran, during April 2006 to April 2007. Two groups of the babies, G6PD-defcient with neonatal jaundice and G6PD-normal with neonatal jaundice, were compared based on the parameters related to hemolysis such as hemoglobin, reticulocyte count and bilirubin level. The criteria of hemolysis in our study were reticulocyte count more than >5% and hemoglobin less than <14 mg/dl. Our data have shown that 14 (5.7%) of 244 neonates with the chief complain of icter suffered G6PD-deficiency with high male to female ratio (3.6 to 1). The mean hemoglobin levels and reticulocyte counts (16.72 vs. 16.97 and %2.48 vs. %2.79 respectively) did not differ significantly between both groups (P>0.05). The present study indicate, G6PD- deficiency as a major cause of neonatal jaundice and hemolysis is not a main determinant of neonatal jaundice in G6PD-deficient babies and most of them have non hemolytic jaundice. [ABSTRACT FROM AUTHOR]

Please note that the corresponding author's correct affiliation is "Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. [ABSTRACT FROM AUTHOR]

Methemoglobinemia and hemolysis are rare findings following phosphine poisoning. In this paper, a case of aluminum phosphide (AlP) poisoning complicated by methemoglobinemia and hemolysis with a successful treatment is reported. A 28-year-old male patient presented following intentional ingestion of an AlP tablet. In this case, hematuria, hemolysis and methemoglobinemia were significant events. A methemoglobin level of 46% was detected by CO-oximetry. The patient was treated with ascorbic acid and methylene blue and he also received supportive care. Two weeks after admission, the patient was discharged from the hospital. Hemolysis and methemoglobinemia may complicate the course of phosphine poisoning. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To collect comprehensive information about the features of favic patients in Ahvaz (Capital of Khouzestan, Iran) and analyze the extent of the differences with their corresponding in other regions. Methods: A total of 103 patients with acute hemolysis admitted to pediatric division of Abouzar Hospital located in the city of Ahvaz, Iran during 21st of June 2008 to 20th of June 2009 were analyzed retrospectively. Results: 95.14% of the patients had favism while 4.86% of them underwent hemolysis due to other reasons. These patients were male (68.93%) and female children (31.06%) admitted mostly during the spring season. The three main symptoms were urine discoloration, jaundice and vomiting. At the admission time, the main hematologic findings were as follows: G6PD sufficient status (45.63%), G6PD deficient status (54.36%) and hemoglobin concentration: 2.5–11.8 (mean±SD: 6.45 ±2.12) g/dL. Conclusions: In conclusion, Ahvaz was determined as a black zone for favism in which the disease can be considered a life threatening health problem. Moreover, slight differences were observed in the three main symptoms compared with favic patients in other regions. [Copyright &y& Elsevier]

Focuses on a case of hemolysis in an infant in Tehran, Iran, which was caused by ingestion of watery extraction of Viola tricolor. Infant's history of glucose-6-phosphate-dehydrogenase (G6PD) deficiency; Viola's usefulness in the treatment of certain skin problems; Need for improved information about the adverse effects of some herbal drugs.