Print ISSN: 2790-0207

Online ISSN: 2790-0215

Keywords : Thalassemia

Pretransfusion Hemoglobin F Level in Thalassemia Patients: Effect of Well-Balanced Versus Poor Transfusion

Mustafa Zuhair Jasim; Mohammad Ahmed Ali; Mohammad Faiq Aziz; Avan Ahmed Ramadan

Kirkuk Journal of Medical Sciences, 2018, Volume 6, Issue 1, Pages 111-116
DOI: 10.32894/kjms.2021.169419

Background: Thalassemia is a common condition in Iraq. More than ten thousand patients registered in Iraq. If well-balanced hypertransfusion regimen to maintain pretransfusion hemoglobin level above the internationally agreed 9.0 gm/ dL could suppress the patients‘ bone marrow and shutdown the hematopoiesis to the extent of not producing any hemoglobin F. Patients and Methods: One hundred well-balanced transfusion-dependant thalassemia patients were evaluated for Hemoglobin F level prior to their scheduled transfusions. Hemoglobin level must have been more than 9.0 gm/ dL to qualify the patient to be entered into this group. All such patients must have showed minimal skeletal changes of thalassemia. Another hundred patients with frank features of thalassemia and poor history of blood transfusion were also enrolled in the study. We aimed at knowing whether HbF is significantly different in the two groups. It could indicate that patients‘ bone marrow could be totally turned off and no abnormal hemoglobin will be allowed to be produced. Results: Seventy nine percent of our enrolled transfusion-dependent thalassemia patients who fulfilled the criteria and were well managed showed correction of their HbF level to near zero! Thirty five percent of the poorly transfused patients also corrected their abnormal HbF level. Conclusions: This study showed that marrow micromilieu could be manipulated in patients with thalassemia in such a way so as to totally shutdown production of abnormal hemoglobin F as a result of provision of normal hemoglobin through blood transfusion. The fact that even one third of poorly transfused patients could show the same results indicates that any degree of transfusion support will have its impact on the marrow.

The Prevalence of Viral Hepatitis B and C among Multitransfused Thalassaemic Patients in Azadi Teaching Hospital in Kirkuk City

DilshadSabir Mohammed; Amanj Mohammed Salih; Mohammed FatihHaseeb

Kirkuk Journal of Medical Sciences, 2014, Volume 2, Issue 1, Pages 1-6
DOI: 10.32894/kjms.2021.169496

Background: Patients with thalassemia major are at high risk of hepatitis C and B due to the blood transfusion from donors infected by HCV and HBV. Hepatitis C virus (HCV) is the major cause of post-transfusion hepatitis infection (PTH). Objective: The aim of this study is to detect the prevalence of anti-HCV antibodies and HBs Ag and risk factors in multitransfused thalassemic patients in Kirkuk city to establish better preventive strategies. Patients and Methods: This study is conducted in Kirkuk city from Nov 2012 to March 2013 for HCV and HBV infection. A structured interview questionnaire is developed by the trained researcher to collect the demographic and risk factors. Statistical analysis was done by Chi-square test. Results: The prevalence of HCV is estimated to be (17.8%) and this is increased with increasing the requirement for blood transfusion in splenectomized patients while only (2.0%) is positive for HBV infection. Conclusion: The study shows a higher prevalence of HCV infection among multitransfused thalassemic patients with increasing requirement for blood transfusion in splenectomized patients.

Prospective Study of Total Splenectomy Among Thalassemic Major Patients Attending Azadi-Teaching Hospital in Kirkuk City During Three Years Study From 2008- 2011

Amanj Mohammed Salih

Kirkuk Journal of Medical Sciences, 2013, Volume 1, Issue 1, Pages 1-8
DOI: 10.32894/kjms.2013.169484

Background: This prospective study was conducted for Thalassemic major patients with huge enlargement of spleen attending Azadi-teaching hospital in Kirkuk city during (January 2008- December 2011) on 53 cases (48males and 5 females with mean age 13.3 years; operated on selective basis by open splenectomy through midline or left subcostal incision. Objective: To determine the role of splenectomy in reducing postoperative blood requirement, the efficacy of prophylactic vaccination and post operative penicillin in reducing the incidence of post-splenectomy infection. Methods: Patients with ages <5 years were excluded as with associated other disorders. Results: (81.2%) of the patients were below 10 years old, male preponderance (90.6%), abdominal mass were founded in all patients. Preoperative Hb below 10gm/dl (90.6%), Left sub-costal incision done in (84.9%).Postoperatively, all the patients had an Hb above (8gm/dl.) Seven patients (13.2%) suffered from recurrent URTIs during follow-up. Conclusion: Splenectomy reduced blood requirements, Left sub-costal incision offers good exposure, prophylactic vaccination definitely needs to prevent postoperative infection.