Iranian Journal of Pediatric Hematology and Oncology
Volume:6 Issue: 4, Autumn 2016

Candidemia is the main cause of fungal nosocomial bloodstream infections and is related to meaningful mortality specially, in pediatrics. Mortality rate range from 5% to 71%, and it can reach as high as 81%. Delays in beginning of treatment have also been linked to intensified mortality. The epidemiology of Candida infection is changing from region to region. Regional surveillance of the epidemiology of candidemia is necessary to identify patients at highest risk. The aim of this study is rapid and precise detection of Candida species isolated from blood stream by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique.
This cross sectional study was conducted during October 2013 to January 2015. Sixteen Candida strains were isolated from 36 patients with positive blood culture in Milad hospital, Resalat Lab., Tehran, Iran. All isolates were identified by PCR-RFLP patterns after digestion with the restriction enzyme HpaII.
Candida albicans (72.2%) and Candida glabrata (22.2%) were the most prevalent species among isolates. Male to female ratio was 9/7, ranging in age from 4-16 years.
Candida albicans remains the most frequently isolated species in the present study; however nonalbicans Candida species are increasing. Precise identification of Candida spp. can lead to a better management of candidemia.

Children suffering from cancer frequently use complementary and alternative medicine (CAM). Most of people do not disclose using CAM to their physicians as they fear to be blamed or prohibited using them. Some of these products may interfere with the conventional remedies. The aim of this study was to investigate the frequency and characteristics of CAM use in pediatric oncology patients in 2 referral centers in south of Iran.
In this cross-sectional study, all pediatric cancer patients (from 5 months to 18 years old) registered at two referral center (n=135) were investigated from January to July 2015 in Shiraz, southern Iran. Interview with their parents and completing the specific check list were done. Data were analyzed by SPSS v. 21 using Chi-square and Student t- test.
From 150 families approached, 135 (90%) completed the questionnaires. Overall, 114 (84.4%) children ever used a kind of CAM product while 92.6% sought faith healing. Concurrently, 81.1% of the CAM admitted users applied them with their conventional treatments. The most common used CAM products were Zinc (43.7%) and multivitamins (31.9%). None of the evaluated variables significantly influenced CAM use in the patients. Most of the patients (77%) introduced their physicians as the source of knowledge about CAM which was the most trusted source as well. About half of the patients (50.9%) did not inform their physicians to use these products.
Oncologists should be aware of highly prevalent use of CAM among their patients. They should discuss with the families about the possible interactions of these products may have with chemotherapy drugs. A filled diary at regular intervals may help the physicians to monitor CAM use in their oncology patients.

Varicella is a highly contagious and dangerous disease especially in immunocompromised patients. Children with cancer are at increased risk of severe illness and may fatal cases occur. Vaccination from VZV ( varicella zoster vaccine) infection can be safe, immunogenic, and effective in children with leukemia who meet the criteria and are at the risk of serious disease or death. The aim of this study was investigate the efficacy of vaccines VZV on pediatric patients with Acute Lymphoblastic Leukemia
The study was performed on 46 ALL children aged between 1to15 years old who underwent chemotherapy. Considering the efficacy of vaccines on pediatric patients the title serum sample of IgG-anti-VZV avidity was determined using a test kit before and after the injection of vaccines VZV.
A total of 46 patients were included analysis. Their title serum sample IgG were negative before the injection of vaccines VZV and after receiving VZV vaccine with respect to title serum sample IgG atatus, 31 (67.4%) patients were positive and 15 (32.6%) patients were negetive. No significant was observed association between either title of IgG-anti-VZV after receiving of VZV vaccine and gender (P = 1.0) title of IgG-anti-VZV and age groups (P =0.387).
Regarding the obtained results, it can be concluded that varicella vaccination can have an acceptable effectiveness on pediatric patients with ALL. Varicella vaccination can be recommended for protecting these patients against VZV in order to decrease the morbidity rate caused by this infection.

In addition to child, families can be influenced traumatically by the leukemia and hospitalization. Adopting the philosophy of a family-centered care approach can maximize the well being of pediatric patients and their family. The philosophy is based on the collaboration of the family, nurses and hospital staff to plan, provide and evaluate care to establish the best plan of care for leukemic child and improve family stability as well, nurses should support the family. The current study was conducted to compare the opinions of mothers with nurses regarding the availability of nursing support for mothers of hospitalized leukemic children in a pediatric oncology ward.
This comparative descriptive study was conducted on all mothers with leukemic children who were hospitalized in a pediatric oncology ward (n=89) of Shahid Sadoughi Hospital, Yazd, Iran and all nurses (n=21) in this ward during 2015. Data were collected through the NPST( Nurse-parent Support Tool) and demographic questionnairs. The obtained data were analyzed with SPSS (version 22).
The most important dimensions in terms of mother's opinions were "emotional" (3.34±0.56) and "quality of care" (3.26 ±0.55) and considering nurse's opinions were "emotional" (3.22± 0.47) and "informational-communicational" (3.22± 0.43). Mann-Whitney test showed no significant differences between mother's and nurse's opinions regarding four subscales of nursing support (p The opinions of mothers and nurses in the pediatric oncology ward did not differ regarding the availability of nursing support. However with respect to the overall mean of nursing support from mother's perspective, it is necessary to provide further support for mothers by the nurses. The results of this study may be useful for improving nursing care in oncologic wards.

Hereditary red cell enzyme disorders are a group of Non-immune/Spherocytic Hemolytic Anemia, although these disorders are rare and they have not public health problems, the detection of these defects could help to physician in treatment and differential diagnosis. This study evaluated 5 enzymopathies in patients with Hereditary Non –immune/Spherocytic Hemolytic Anemia (HNSHA) during one year.
This cross-sectional study, evaluated 5 erythrocyte enzymes in 22 patients (mean age of 10 ± 9.3) with Hereditary Non-immune/ Spherocytic Hemolytic Anemia in Southern Iran from Jan 2014- Feb 2015. Evaluated erythrocyte enzymes consisted of pyruvate kinase (PK), G6PD, Catalase, Glutathion Proxidase( GP) and Glutathion Reductase( GR), all of these enzymes checked by quantitative assay except G6PD that evaluated by qualitative activity assay. The clinical and para clinical data were gathered from patient’s documents.
Results showed that 2 patients were PK deficient (9.1 %), 4 patients were G6PD deficient (18.2%), 1patient was GP deficient (4.5%), 1 patient was Catalase deficient (4.5%) and there is no patient with GR deficiency.
This study showed that enzymopathies should be into consideration in patients with non-immune hemolytic anemia, if other common causes of hemolysis such as hemoglobinopathies and membranopathies have been excluded.

Thalassemias are the most common inherited blood disorders caused by some mutations which can reduce the synthesis of globin chains. Iron overload and its organ deposition are responsible for functional abnormalities and tissue injury in patients who affected by β-thalassemia major. The aim of this case-control study was evaluation of hematological parameters, oxidative stress and some serum liver and kidney risk factors which play crucial role for early prediction and prevention of patients to end-stage tissue failure and mortality.
Present study consisted of Fifty young adult subjects with β thalassemia major (β- TM) (aged Urea, Creatinine and Uric Acid were significantly decreased in patients group (P 0.001); in spite of, serum ferritin, liver biomarkers AST, ALT, ALP and risk factor biomarker PAB were statistically increased in patients versus control group(P0.05) was not significantly difference in study groups. Exception hs-CRP and PAB (P>0.05), liver risk factors had a positive correlation with ferritin and serum Urea, Creatinine and Uric Acid tests had negative meaningful with hematological parameters (P0.05).
Higher level of risk factors PAB values and key liver enzyme profiles are able to involve in the prognostic pathological consequences in patients with β-thalassemia major. Even so, they contribute toward the gradual development of tissue injuries.

The present study aimed to determine the prevalence of hypothyroidism, hypoparathyroidism and the frequency of regular chelation therapy in patients with thalassemia major in Iran. Searching process was performed by two independent researchers using valid keywords in the national and international database, including: Magiran, Iranmedex, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library and google scholar search engine. All studies were searched until 2016 with no time limit. All articles met inclusion criteria were evaluated and the data were analyzed by using SATA Software Ver.11.1. Twenty-seven studies about hypothyroidism (sample size of 4851, the mean age of 16.36±5.5) and 19 studies related to hypoparathyroidism (sample size of 3219, the mean age of 17.44±6.5) were examined. The prevalence of hypothyroidism was calculated 5.7% (95% CI: 4.7-6.8) in patients with thalassemia major in Iran (P=0.000; I2 index=93.9%). The prevalence of overt and subclinical hypothyroidism was estimated 3.1% (95% CI: 1-4.7) and 6.7% (95% CI: 3.3-10), respectively. The prevalence of hypoparathyroidism was calculated 10% (95% CI: 7-12) in patients with thalassemia major in Iran. In reviewing 5 studies, the frequency of regular chelation therapy was estimated 54.6% (95% CI: 28-81.2) in these patients. The prevalence of hypothyroidism and hypoparathyroidism is high in patients with thalassemia major in Iran. Thus, new planning and supervising seem to be essential to minimize endocrine complications in these patients. There is no connection between serum ferritin level and developing hypoparathyroidism. A high percent of Iranian patients with thalassemia major perform the chelation therapy irregularly. It's been recommended to adopt the necessary measures such as educating and enhancing awareness of the patients about its complications.

B-cell lymphoblastic lymphoma (B-LBL) is an uncommon subtype of pediatric non-Hodgkin Lymphoma (NHL) which rarely involves the skin primarily. The positron emission tomography with 2-deoxy-2-[fluorine- 18] fluoro-D: -glucose integrated with computed tomography (18F-FDG PET/CT) scan findings of a 8-year-old boy with cutaneous B-LBL were presented. PET/CT scan demonstrated mild FDG uptake in the lesion located on the scalp and also multiple bone metastases with increased FDG uptakes in several areas. The importance of 18F-FDG PET/CT scan in primary staging of the patients with primary cutaneous B-LBL. due to its impact on planning of therapy via the determination of unexpected malign infiltration sites was emphasized.