ABSTRACT
BACKGROUND: Fresh frozen plasma (FFP) is a major source of coagulation factor replacement therapy for patients with clotting factor deficiency. Although FFP is readily available for use in clinical practice its administration isn't without risk. Studies on the use of FFP reveal that it is often overused or inappropriately used. We undertook an audit to assess the appropriateness of FFP transfusion in Gorgan's hospitals. METHODS: This was a retrospective, audit done at 5 hospitals in Gorgan city regarding the use of 1592 units of FFP issued to 346 patients from March 2006 to March 2007. The appropriateness of FFP transfusion was analyzed according to British Council for Standardization in Hematology (BCSH) Guidelines 2004. RESULTS: In this audit we identified a high rate of inappropriate FFP usage (53% of transfusion episodes). Most 'Inappropriate' FFP usage occurred when there was active bleeding, with normal (or unmeasured) coagulation tests (30% of transfusion episodes). In only 66% of FFP-transfused patients were coagulation variable measured at any point in the hospital episode. CONCLUSION: Inappropriate usage of FFP is often seen in medical facility and the right solution is needed to curb the misuse of this component. Regular utilization audit can identify correctable errors in transfusion practices. Formal education programs and existing information on FFP use should be directed to professionals ordering FFP.
Subject(s)
Blood Coagulation Factors/therapeutic use , Medical Audit , Plasma , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Guideline Adherence , Humans , Infant , Iran , Male , Middle Aged , Practice Guidelines as Topic , Retrospective Studies , Young AdultABSTRACT
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a common cancer in Southeast Asia and is frequently associated with Epstein-Barr virus (EBV). Human papilloma virus (HPV) is an epitheliotrophic oncogenic virus that has been detected in a variety of head and neck tumors including NPC. This retrospective study was undertaken to investigate the prevalence of EBV and HPV infection subtypes 6/11 and 16/18 in 20 patients with NPC. METHODS: In situ hybridization for EBV-encoded RNA (EBER) and tyramid signal amplification of ISH for HPV DNA subtypes 6/11 and 16/18 was performed to evaluate the prevalence of EBV and HPV latency infection among Iranian Patients with NPC. RESULTS: 16 cases were classified as WHO type III (undifferentiated carcinoma) and 4 as WHO type II (non-keratinizing SCC). EBER-ISH was positive in 19 (95%) of NPCs evaluated and in one metastases from cervical primary, included in this series. Two of 20 NPC (10%) contained HPV 6/11 sequences and two of 20 NPC (10%) contained HPV 16/18 sequences, and combined EBV and HPV infection was detected in 3 of the 20 (15%) patients. CONCLUSION: Our data indicated that EBV is closely associated with NPC in Iran. In addition, a low percentage of EBV positive NPC contained HPV sequences. The significance of coexistence of EBV and HPV in NPC requires further study.
