The Frequency and Risk Factors of Human T-cell Lymphotropic Virus Type I among Blood Donors in Khorasan-e Razavi, Iran, from 2002 to 2013.

INTRODUCTION: Human T-cell lymphotropic virus (HTLV-I) is the causative agent for adult T-cell lymphoma/leukemia (ATLL) and HTLV-I-associated myelopathy/tropical spastic paraparesis. The virus is endemic in the parts of Iran. This study is conducted to determine the trends in the frequency of HTLV-I in Mashhad, a city in Khorasan-e Razavi province, Iran, over 11 years. MATERIALS AND METHODS: Blood bank records of blood donors positive for HTLV-I were collected from different blood banks across Mashhad between 2002 and 2013. Obtained data were first entered into paper versions and then were analyzed by SPSS version 11.5. HTLV-I antibody was firstly measured by enzyme-linked immunosorbent assay (ELISA) method and later confirmed by the Western Blot (WB). RESULTS: During the study period, 983,000 donors were examined by ELISA and WB, among whom 2921 cases (0.297%) were positive HTLV-I carriers. The highest and lowest frequency of carriers was 0.451% and 0.098%, respectively. The most significant factor was related to marital status (85.2%) and the smallest significant factor was associated with the history of acupuncture (0.3%) according to the different risk factors. CONCLUSION: The frequency of HTLV-I carriers among blood donors was significantly decreased in this period. Screening of blood donors for HTLV-I infection played a significant role in this reduction.

Application of methylene blue -vitamin C -N-acetyl cysteine for treatment of critically ill COVID-19 patients, report of a phase-I clinical trial.

COVID-19 is a global catastrophic event that causes severe acute respiratory syndrome. The mechanism of the disease remains unclear, and hypoxia is one of the main complications. There is no currently approved protocol for treatment. The microbial threat as induced by COVID-19 causes the activation of macrophages to produce a huge amount of inflammatory molecules and nitric oxide (NO). Activation of macrophages population into a pro-inflammatory phenotype induces a self-reinforcing cycle. Oxidative stress and NO contribute to this cycle, establishing a cascade inflammatory state that can kill the patient. Interrupting this vicious cycle by a simple remedy may save critical patients' lives. Nitrite, nitrate (the metabolites of NO), methemoglobin, and prooxidant-antioxidant-balance levels were measured in 25 ICU COVID-19 patients and 25 healthy individuals. As the last therapeutic option, five patients were administered methylene blue-vitamin C-N-acetyl Cysteine (MCN). Nitrite, nitrate, methemoglobin, and oxidative stress were significantly increased in patients in comparison to healthy individuals. Four of the five patients responded well to treatment. In conclusion, NO, methemoglobin and oxidative stress may play a central role in the pathogenesis of critical COVID-19 disease. MCN treatment seems to increase the survival rate of these patients. Considering the vicious cycle of macrophage activation leading to deadly NO, oxidative stress, and cytokine cascade syndrome; the therapeutic effect of MCN seems to be reasonable. Accordingly, a wider clinical trial has been designed. It should be noted that the protocol is using the low-cost drugs which the FDA approved for other diseases. TRIAL REGISTRATION NUMBER: NCT04370288.

Lack of FLT3-TKD835 gene mutation in toxicity of sulfur mustard in Iranian veterans.

OBJECTIVES: Sulfur mustard (SM) was used by the Iraqi army against the Iranian troops in the Iran-Iraq war from 1983-1988. This chemical gas affects different organs including the skin, lungs and the hematopoietic system. Any exposure to SM increases the risk of chromosomal breaking, hyperdiploidy and hypodiploidy. Studies have shown that the risk for acute myeloblastic and lymphoblastic leukemia increases in veterans exposed to SM. FLT3 mutations including ITD and TKD mutations had been observed in some cases of leukemia. Therefore, we aimed to investigate the frequency of FLT3-TKD835 mutations in the veterans exposed to SM agent. MATERIALS AND METHODS: We studied 42 patients who were exposed to SM during the war in Khorasan Razavi province, Mashhad, Iran in 2012. As control group, 30 healthy males were selected from first-degree relatives of the patients. For assessment of TKD835 mutation, DNA was extracted and RFLP-PCR was performed. RESULTS: Analysis of RFLP-PCR data showed no FLT-3 TKD mutation in any of the patients. CONCLUSION: Although contact with SM can increase the risk of malignancy especially hematologic neoplasms, results of the study show that another mechanism of leukemogenesis, other than FLT3-TKD mutation, may be the reason for increased risk of leukemia in SM toxicity.

Differentiation of adipocytes and osteocytes from human adipose and placental mesenchymal stem cells.

OBJECTIVES: Mesenchymal stem cells (MSC) can be isolated from adult tissues such as adipose tissue and other sources. Among these sources, adipose tissue (because of easy access) and placenta (due to its immunomodulatory properties, in addition to other useful properties), have attracted more attention in terms of research. The isolation and comparison of MSC from these two sources provides a proper source for clinical experimentation. The aim of this study was to compare the characteristics of MSC isolated from human adipose tissue and placenta. MATERIALS AND METHODS: Adipose and placental MSC were isolated from the subcutaneous adipose tissues of 10 healthy women (25 to 40 years) and from a fresh term placenta (n= 1), respectively. Stem cells were characterized and compared by flow cytometry using CD29, CD31, CD34, CD44, CD45, CD105, CD166 and HLA-DR markers. Osteocytes and adipocytes were differentiated from isolated human mesenchymal stem cells (HMSC). RESULTS: Adipose and placenta-derived MSC exhibited the same morphological features. ADSC differentiated faster than placenta; however, both were differentiated, taking up to 21 days for osteocyte and 14 days for adipocyte differentiation. About 90% of PLC-MSC and ADSC were positive for CD29, CD44, CD105, and CD166; and negative for CD31, CD34, CD45, and HLA-DR. CONCLUSION: The two sources of stem cells showed similar surface markers, morphology and differentiation potential and because of their multipotency for differentiating to adipocytes and osteocytes, they can be applied as attractive sources of MSC for regenerative medicine.

Effectiveness of oral Tranexamic acid administration on blood loss after knee artroplasty: a randomized clinical trial.

INTRODUCTION: Some studies have proved that Tranexamic acid infusion is associated with a decrease in blood loss during and after surgery. Due to the availability of an oral form of the drug, the rapid and complete absorption of it and ease of administration without need for specific instruments, we evaluated the effectiveness of the oral form in decreasing blood loss after total knee arthroplasty. MATERIALS AND METHODS: In this double-blind, randomized, parallel clinical trial study, we evaluated 53 patients undergoing knee arthroplasty admitted to Ghaem hospital, Mashhad in 2012. Patients with any history of severe ischemic heart diseases, renal failure, cirrhosis, history of bleeding disorders or thromboembolic events, were excluded from the study. The patients were randomly allocated into 27 patients with and 26 patients without Tranexamic acid. Blood loss (mL) at 12 and at 24h and hematocrit at 24h were measured postoperatively. The results were analyzed with SPSS software (11.5 version) using independent and paired sample t-tests. A p-value ≤ 0.05 was considered to be significant. RESULTS: The average blood loss after 12h of surgery in the control and Tranexamic acid groups were 462.9 (± 147.4) and 274.6 (± 139)mL, respectively (p<0.001) and after 24h of surgery they were 588.8 (± 193)and 364 (± 165.1)mL, respectively (p<0.001). The mean decrease in the hematocrit after surgery was 4.7% in the Tranexamic acid group and 6.8% in the control group (p=0.016). CONCLUSION: Prescription of oral Tranexamic acid before knee arthroplasty can cause remarkable decrease in blood loss after surgery and also less decrease in hematocrit. The advantages of the oral route of the drug versus the intravenous form is that it can be used routinely as a safe and effective way to decrease bleeding after surgery.