Geographic heterogeneity of cytogenetic characteristics of acute myeloid leukemia in the early detection: a comparative study of Iranian and Indian adult patients

Acute Meyloid Leukemia [AML] in adults is known to be a heterogeneous disease with diverse chromosome abnormalities. Some of these chromosome abnormalities are found with a high incidence in populations from specific geographical areas and ethnic societies. Therefore, we studied the cytogenetic features of AML cases in contrasting societies of Iran and India. Cytogenetic investigation was performed in various subtypes of AML with unstimulated short-term culture and High Resolution Cell Synchronization with some modification. Cytogenetically, Iranian M3 displayed a higher frequency of t[15;17] than Indian M3 [33.8% vs 19.3%] followed by M2 [t[8;21] [27.7% vs 16.2%]] and M1 [t[9;22] [16.0% vs 11.3%]]; whereas, inv[16]11q23 and numerical chromosomal aberrations in chromosome 5,7,8 occurred more frequently in Indian than Iranian. These findings represented different cytogenetic characteristics of t[15;17] between the two populations. This is the first systematic cytogenetic study of an ethnic Iranian population. Extensive biological studies of AML in Iran and India and various countries to be needed to clarify the role of genetic as well as geographic heterogeneity in the pathogenesis of AML

[Patient satisfaction and its related factors in Ayatollah Taleghani Hospital in 2006]

Patient satisfaction survey is an instrumental component in monitoring the hospital's quality of care, in relation to cost and services. Many studies have been conducted throughout the world to determine the patient satisfaction and its related factors. This study was carried out to evaluate patient satisfaction and its related factors. A cross sectional study was based on in-hospital patient who attended the Taleghni hospital between April 2006 and August 2006. Sample size was determined as 476 from 5021 by randomized sampling. Sample sizes in each ward were according to the proportion of hospitalized patient. Participants were interviewed privately face to face in the hospital at discharge time. Interviews were conducted by trained interviewers using pre tested questionnaires [Verona Service Satisfaction Scale- VSSS 32]. Correlation between total satisfaction and Patient's age, education] was estimated by using Pearson's Correlation. Prevalence and confidence interval [CI] of unsatisfied patient was calculated. In majority, 83% of patients were quite satisfied with their care and 1.5% was dissatisfied [CI=0.7-2.2]. 93% of patient was most satisfied with physician communication and treatment. Only 49% of patients were satisfied with nutrition status. There was no relationship between age, educational status and total satisfaction. Percentage of patient-faithfulness was 66%. 65% of admitted subjects were recommending this hospital to their friends. Patients whose in-hospital course was between 11-15 days were more satisfied with hospitalization among both sexes. In general, patients were quite satisfied with their hospital care. Further studies similar to this survey is offer to improve the quality of care and overall health-care outcomes

[Effects of leukocyte-depletion filters on alluimunization derived reactions of platelet transfusion in acute leukemic patients]

Leukemia is the most common malignancy among adults and children which may develop several side affects such as anemia, infection and thrombocytopenia-related hemorrage. Many modalities have been suggested for prevention of Alluimunization and one of them is using of leukocytes free products. In fact, platelets could not solely stimulate immune reaction. This study is conducted at two hospials of "Shohada" and " Taleghani" to demonstrate the usefulness of such products. This research is a single- blinded clinical trial. All the patients had acute leukemia. In control group [24 subjects] we used a routin infusion set for transfusion and in experimental group [20 subjects] a biofilter was applied during the transfusion, platelet were counted one hour and 24 hr after transfusion. CCI formulate was used to represent a signs for Alluimunization. If CCI was less than 10x10 L/M[2] after transfusion or it became below 5-7x10 L/M[2] after 18-24 hr, the subject was considered alluimmune. After one hour, 21 cases out of 24 were alluimmuned in control group whereas in experimental group 13 cases from 20 patients became alluimmune. After 24 hours, 5 cases in control group and 5 ones in experiments were found to be Alluimmune. We did not prove any preventive properties from leukocyte-depletion filters in reducing the risk factors of Alluimunization amongs patients with acute leukemia

External evaluation: a requirement for accountability and responsiveness

Quality assurance as a comprehensive term encompasses all policies, processes and actions maintaining and developing higher education quality. Quality assurance emphasizes on external goals of evaluation, one of which is to assure learners, public and government that each unit, department, program or institution manages its quality, thus quality assurance focuses on accountability. This article first describes importance of external evaluation and necessity to conduct it, then considering the fact that two educational programs leading to bachelor degrees of nursing and obstetrics, which their internal evaluation have already completed, are volunteers to go under external evaluation. Explains steps of external evaluation and focuses on the external aspect of evaluation to assure quality of educational programs following internal evaluation

preliminary study on the effect of two therapeutic procedures on the expression of BCR-ABL gene in CML patients

Chronic myelogensis leukemia [CML] is a chronic myeloproliferative disorder resulting from a specific mutation in a pluripotent stem cell. The association of Philadelphia chromosome with this disorder was described in 1973. Subsequently, the BCR-ABL fusion gene and its product which is a tyrosin kinase inhibiting apoptosis were introduced. The treatment of choice for these patients is BMT as well as the new molecular treatment of imatinib mesylate. The present study was designed in order to compare the rate of expression of the BCR-ABL gene in patients who had undergone treatment by bone marrow transplantation with those treated by imatimib. Expression of BCR-ABL gene was measured in 34 patients 17 patients were treated with BMT and 17 with imatinib mesylate using quantitative PCR on a light cycler instrument. The results obtained in this preliminary study demonstrates that rate of gene expression patients treated with imatinib mesylate for more than 8 month was similar to that found in patients treated with 8 BMT who were in relatively stable conditions. This finding may be an indication that imatinib mesylate as a molecular inhibitor can have the same effect as BMT but with less adverse effects. Clearly definite conclusions require more extensive studies on larger number of patients