Complications in patients with transfusion dependent thalassemia: A descriptive cross-sectional study.

Background and Aims: One of the most common hemoglobinopathies globally related to blood transfusion and iron overload in the body is thalassemia syndrome. Increasing ferritin levels can cause severe damage to the patient's body organs. This study aims to evaluate the complications of iron overload on vital body organs in patients with transfusion-dependent beta-thalassemia. Methods: This descriptive cross-sectional study was performed in Iran University of Medical Sciences Hospitals on patients with a beta-thalassemia major with frequent blood transfusions. To evaluate the effect of iron overload on vital body organs, hematologic and blood analysis, echocardiography with measurement of pulmonary artery pressure (PAP) and ejection fraction (EF) tests, bone densitometry, and audiometric tests were performed for all patients. Results: Of the 1010 patients participating in this study, 497 (49%) were males, 513 were (51%) females aged 5-74 years, and the majority of participants (85%) were over 20 years old. This study demonstrated that increasing ferritin levels had no notable correlation with sex, cholesterol, low-density lipoprotein, parathyroid hormone, T4, and aspartate aminotransferase. However, elevating ferritin levels had significant correlations with increasing triglyceride, phosphorus, thyroid stimulating hormone, alkaline phosphatase, alanine transaminase, and PAP levels, age, hearing disorders, splenectomy, osteoporosis, and decreasing high-density lipoprotein, body mass index, calcium, and EF levels. Conclusion: Improvement in beta-thalassemia patients' survival and quality of life can be due to multidisciplinary care in a comprehensive unit through regular follow-up and early complication detection.

Dextranase enzyme and Enterococcus faecium probiotic have anti-biofilm effects by reducing the count of bacteria in dental plaque in the oral cavity of dogs.

OBJECTIVE: Periodontal disease is a common clinical complication and has a negative impact on the quality of life and the welfare of companion dogs. Periodontal disease occurs when pathogenic bacteria are accumulated in the gingival sulcus, which favors biofilm formation. The oral health of dogs can be significantly compromised by dental plaque accumulation. Thus, this investigation demonstrates the effect of Enterococcus faecium probiotic, dextranase enzyme, and their combination on dental biofilm in the oral cavity of dogs. ANIMALS: The 30 dogs were referred to Polyclinic with no oral ulcers, severe periodontitis, and internal diseases. PROCEDURES: Dextranase enzyme, E faecium probiotic, and their combination were administered in the oral cavity of dogs. Microbiological samples were obtained from tooth surfaces and gums before and after intervention with the substances. Bacterial colonies were enumerated by using a colony counter. Also, Porphyromonas gingivalis hmuY gene expression was evaluated by reverse transcription quantitative real-time PCR analysis. RESULTS: The total colony count of the bacterial culture indicated that the dextranase enzyme, E faecium probiotic, and their combination significantly reduced the total bacteria count in the oral cavity. Moreover, in the reverse transcription quantitative real-time PCR analysis it was observed that using the combination of E faecium probiotic and dextranase enzyme decreases the hmuY gene expression of P gingivalis bacteria. CLINICAL RELEVANCE: The results clearly indicated that the dextranase enzyme and E faecium probiotic could be used as preventive agents to reduce oral biofilm in dogs. Furthermore, no side effects were observed while using these substances.

Evaluation of immune system in patients with transfusion-dependent beta-thalassemia in Rasoul-e-Akram Hospital in 2021: A descriptive cross-sectional study.

Background and aims: Thalassemia syndromes are the most common hemoglobinopathy globally related to blood transfusion and iron overload in the body. Splenectomy, excessive iron overload, and repeated exposure to antigens in blood transfusions can cause severe damage to the patient's immune system making the patient prone to frequent infection. This study evaluates the immune system status and infection rate in beta-thalassemia major patients receiving iron chelators. Methods: This descriptive cross-sectional study was performed in Rasoul-e-Akram Hospital on patients with a beta-thalassemia major who had iron overload due to frequent blood transfusions. The percentage of lymphocyte markers was determined by flow cytometry. Serum levels of immunoglobin were measured by nephelometric assay. Also, Nitro blue tetrazolium and dihydrorhodamine assays were used to evaluate the phagocytic function. Results: Of the 106 patients participating in this study, 59 (55.7%) and 47 (44.3%) are male and female, respectively. The mean age ± SD of participants was 24.7 ± 12.1 years with 4 to 55 years. There was no significant correlation between sex, the C3 and C4 complements, the lymphocyte markers, and the immunoglobulin levels. Furthermore, all of these variables increased significantly over 30 (p < 0.05). Moreover, there was a strong positive correlation between splenectomy and IgG immunoglobulin (p < 0.001) and CD16 (p = 0.005) lymphocyte marker. Conclusion: Iron chelator agents effectively improve patients' immune system with thalassemia major. The increase in IgG and IgM immunoglobulins levels is due to frequent blood transfusions, which stimulate the immune system.