Iranian Journal of Blood and Cancer
Volume:5 Issue: 4, Summer 2013

The purpose of the present study was to assess the efficacy of non-pharmacological interventions on the anxiety among thalassemic children undergoing venipuncture. Patients and This was a clinical trial on 60 thalassemic children aged 6-12 years undergoing venipuncture. Children were randomly divided into three groups: control, bubble making and regular breathing exercise. The anxiety level was assessed by anxiety self-reported scale before and after of catheter insertion. Kruskal-Wallis and Mann-Whitney U tests were used to compare the mean score of anxiety between groups. The mean anxiety score before venipuncture in control, bubble making, and regular breathing exercise groups was 31.7, 30.78, and 29 respectively. After venipuncture, the mean anxiety score was 41.50, 29.45 and 20.55, respectively. These findings indicated a significant difference in the mean anxiety scores between the three studied groups after the venipuncture. However, there was no significant difference between the mean anxiety score in the two distraction groups (bubble making and regular breathing exercise). Needle-related procedural anxiety can be significantly reduced by using distraction. Bubble making and regular breathing exercise can be effective on the anxiety during venipuncture and might be considered for other minor invasive procedures in children. These non-pharmacological interventions require minimum effort and time and may be cost-effective and convenient nursing interventions that could be used easily in clinical settings.

The aim of the present study was application of haemoglobin absorption spectroscopy as a distinguishing tool for identification of two haemoglobin types-HbA and HbS. Millimolar absorptivities of normal adult haemoglobin (HbA) and sickle cell haemoglobin (HbS) were monitored at pH values of 7.2 and 5.0, within the ultra violet and visible spectral range (250-650 nm) in the presence of varying concentrations of hydrogen peroxide (4.00-20.00 mM). The absorption spectra of HbA and HbS exhibited the characteristic Soret band with maximum absorptivities at wavelenght (λmax) = 415 nm. Maximum absorptivities of HbA and HbS treated with H2O2 showed hypochromic red shift of the Soret band from (λmax) = 415 to 420 nm regardless of changes in pH values. In addition, increasing concentrations of H2O2 at the two pH conditions caused differential distortion and obliteration of the Soret band. Whereas pH = 7.2, [H2O2] > 14.28 mM caused obliteration of the Soret band of HbA, 20.00 mM H2O2 at lower pH = 5.0, obliterated the Soret band. In contrast to the absorption spectra of HbA, at experimental pH values of 5.0 and 7.2, maxima absorptivities of HbS were 1.8 and 2.3 mmol-1•cm-1 respectively. The spectra patterns of HbA and HbS treated with H2O2 were non-identical under the two experimental pH conditions. Therefore, these spectra absorptivity patterns can serve for the identification of HbA and HbS and to distinguish between the two haemoglobin types.

The purpose of this study was to evaluate long-term changes in bone density profile among survivors of childhood acute lymphoblastic leukemia. Patients and This was a 5 year prospective study comprised of thirty-one survivors of childhood acute lymphoblastic leukemia with a mean age of 11.8 (4.6) years, who completed therapy at least 1 year previously (according to the ALL-6 therapeutic protocol), and remained in complete continuous remission. BMD was measured from the lumbar spines (L2 to L4) and femoral neck, at baseline (2006) and after 5 years (2011), using dual energy x-ray absorbtiometry. Bone mineral density Z score and bone mineral content were calculated for both lumbar spine and femoral neck. The mean femoral bone mineral density was 0.69 in 2006 and 0.82 in 2011 (p=0.005). The mean femoral Z score was -1.38 in 2006 and -0.55 in 2011 (p=0.006). For the lumbar spine, the mean bone mineral density was 0.71 in 2006 and 0.88 in 2011 (p=0.000); and the mean Z score was -2.08 in 2006 and -0.93 in 2011 (p=0.000) respectively. All three indices significantly changed through-out the study period. The general linear regression analysis revealed that daily calcium intake was an important predictor of lumbar spine BMD Z score. Femoral neck BMD Z score was correlated with the serum vitamin D level. Osteopenia in survivors of childhood acute lymphoblastic leukemia constitutes an important health risk. Patients and their families should be encouraged to take sufficient amount of calcium and vitamin D during chemotherapy and afterward. Keywords: Acute lymphoblastic leukemia, bone mineral density, bone mineral content, dual energy x-ray absorbtiometry (DXA), Iran.

Sickle cell disease occurs due to a mutation in β chains and the substitution of valine instead of glutamate in the sixth position of the ß-chain that causes polymerization and vascular blockage. The aim of this study was to compare the serum C, S proteins and factor V Leiden between sickle cell patients and the control group. In this case-control study, performed in Khuzestan province, Iran, from 2008 to 2009, C and S proteins as well as factor V Leiden activity were measured in 100 patients with sickle cell disease and compared with 50 patient in the control group that matched in age, gender and race. The type of sickle cell disease, hydroxyurea intake, blood transfusions, the level of HbF, age and gender were also analyzed. Out of 100 sickle cell patients entering the study 47 patients were males and rests of them were females. The mean age of patients was 20.2± 1.03 years (Range 3 to 58 years). The level of protein C and S were low in 35% and 24% of patients respectively, but in controls both were normal (P<0.0001). Factor V Leiden was increased in 27% of patient and 4% of controls (P=0.001). A significant relationship was detected between protein S levels and patients’ age (P=0.02). Among patients with sickle cell disease, protein C and S levels are reduced and factor V Leiden activity is increased compared to controls, which might cause hyper-coagulation state among these patients.

Neuroendocrine tumors are most often located in the intestine and lungs but they can arise from other areas of the body. Limited data is available on epidemiology and clinical patterns of neuroendocrine tumors in Iran. We analyzed medical records of 34 patients from 2 cancer centers (Emam Khomeini hospital and Omid Charity Cancer Center) in west Azarbaijan province of Iran with neuroendocrine tumors to identify origins of the disease and the demography of the patients.

Synchronous cancer is referred to two or more histological distinct malignancies diagnosed during the same hospital admission. Globally more than 1 million people get colorectal cancer yearly resulting in about 0.5 million deaths. Vulvar cancer is the fourth most common gynecologic cancer (following the corpus uterine cancer, cancer of ovary and cervix) and comprises only 4 percent of malignancies of the female genital tract. Here we report a 63 year old female with diagnosis of synchronous vulvar carcinoma colorectal carcinoma. To our knowledge this patient is the only reported case with these two synchronous cancers without any special risk factor. Key words: Vulvar neoplasms, colorectal neoplasms, treatment.