Online ISSN: 2515-8260

Keywords : Thalassemia

Serum ferritin and liver function test response to oral versus subcutaneous iron chelating agent

Aymen Abd. Albakaa; Faris M. Al- Haris; Alaa Jumaah Mnaji Nasrawi; Jassim Mohammed Al Musawi; Talib Abdul Jalil Al Madany

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 130-135

Thalassemias are group of inherited autosomal recessive blood disorder. The genetic defect, which could be either mutation or deletion, results in complete absence or reduction synthesis of one of the globin chain that make up hemoglobin. This cause reduction of haemoglobin molecules production ,resulting in decreased of oxygen carrying capacity of the circulation thus causing anemia, the characteristic presenting symptom of the thalassemia. Good chelation therapy and regular blood transfusion protocol have increased the life expectancy.
Objectives : is to compare serum ferritin level and liver function test in a group of patients with beta thalassemia major in response to subcutaneous and oral chelating agent .
Patients and Methods: Prospective analytic study design done on group of 60 patients with beta thalassemia major diagnosed by hemoglobin electrophoresis registered in thalassemia center in AL – Zahra Teaching Hospital for Maternity and Children in AL- Najaf AL- Ashraf , during a period from
1st of February 2019 to 1st of February 2020, aged 2.5 to 17.9 years with serum ferritin levels above 1000 ng/ml and liver transaminases below 5 folds the normal upper limit .
The patients divided into 2 groups, 30 patients were on Deferasirox {Exjade} therapy and 30 patients were on Deferoxamine {Desferal} therapy .
Base line S. Ferritin value as well as LFT (S. GOT , S. GPT , ALP and TSB) value, were taken as base line level and then every (8-12) weeks and were used to assess the changes that occurred in response to subcutaneous and oral chelating agent .
Results : Our study show significant decline in SF (P value <0.05) in both groups after 1 year of treatment with oral or subcutaneous chelating agent. Patients on Exjade show more rate of decrement of serum ferritin (11%) compared to patients taken Desferal who a rate of decrement (6%). Patients on Exjade and Desferal therapy show increment in liver enzymes after 1 year of treatment with statistically significant results, p-value < 0.05 .
We found superiority in oral iron chelating agents (Exjade) to subcutaneous iron chelating agents (Desferal). Serum ferritin level is suitable for long term monitoring as an indicator of efficacy than liver biopsy .

Estimate Viral RNA Of Hepatitis C Of Β-Thalassemia Patients In Nineveh Province

Ali Adel Dawood; Asmaa Mohammed Khaleel; Ahmed Mohammed Hayawi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 1-8

Hepatitis C infection is the main occasional agent of chronic liver disease and might lead to cirrhosis and hepatocellular carcinoma. β-thalassemia and hemodialysis patients are most susceptible to HCV as a result of the continuous blood transfusion. Aim of the study: This study aimed to estimate the quantitative of HCV-RNA in the serum of β- thalassemia patients in Nineveh province using RT-PCR in the GeneXpert system. Methods: We detected anti-HCV using ELISA. Determine the viral RNA using Xpert® HCV viral load technique. Result: The positive detection result of anti-HCV is 48 out of a total of 752 thalassemia patients. Only 12 out of 48 enrolled HCV Ct value with a rate of 1.59% of the total β- thalassemia patients. Conclusions: The prevalence of HCV in thalassemic patients in Nineveh province is less than those found in the other Iraqi provinces or adjacent countries. The routine using of immunobiological and biochemical tests for hepatic enzymes should be the routine pursuit in thalassemia and dialysis clinical centers.

Prevalence of Hepatitis B and C in Thi-Qar Province - Iraq from 2015-2019

Rana A. Othman; Yahya A. Abbas

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 43-48

Background: Hepatitis B virus and hepatitis C virus are two of the most commonly
transmitted infectious agents by Blood transmitting so it is still remains a considerable
global health problem, this prospective cross-sectional study was conducted
between 2015 and 2019 at the directorate of main Blood Bank, dialysis center,
thalassemia center and public health laboratory in Thi-Qar Province -Iraq, during that
period a total of 1323 patients, 948 (71.7%) males and 375 (28.3%) females, they
suffering from signs and symptoms of liver diseases.
The aim of study: There were no adequate epidemiological studies on the prevalence
of viral hepatitis, especially in last years and there were no national solutions to limit
it’s, we conduct this study to determine the prevalence of both types at Thi-qar
Sampling and methods: This study was conducted in January 2015 to December 2019,
on main blood bank, patients referred to the thalassemic center, renal dialysis unit and
public health laboratory at Thi-Qar province, the study was conducted on 176848
individuals, from those (1323) cases, (515) blood donors, (45) thalassemic patients, (91)
renal failure patients and public health laboratory (672), the following data were
recorded: Age, sex, date, resident, type of infection, data were collected by from
statistical units. Data were analyzed using SPSS for windows (version 23.0, SPSS lnc,
Chicago, III), for comparison between groups as appropriate; P ≤ 0.01 was considered
statistically significant.
The results: The results of infection were found 1323(0.7%), its distributed as :672
(50.8%) were public health laboratory patients, 515 (38.9%) blood donors, 91 (6.9%)
renal dialysis patients and 45(3.4%) thalassemic patients, the results was showed
higher infection in males more than females, with high prevalence in age groups (31-
40) and (41-50) years, with significant difference (P<0.01) .
Conclusions: despite the findings revealed that Thi-Qar is acceptable percentage rate
of prevalence of infection, but may be increased the infection by Immigration from
endemic areas, especially for business , transfusion of blood, a major roots of
infections by renal dialysis, thalassemic patients were a risk groups because
administration of blood.