Iranian Journal of Pediatric Hematology and Oncology
Volume:2 Issue: 2, Spring 2012

The present randomized clinical trial evaluated the efficacy of a topical lidocaine-prilocaine cream (EMLA) to relief pain during spinal puncture in pediatric oncology patients.Sixty patients with malignancy candidate for spinal puncture were selected for this study. The patients were randomly allocated to two groups. Group A had topical EMLA cream and group B had placebo, which they received 60 to 90 minutes before spinal puncture. Pain score was rated using the Wong-Baker Faces rating score (0: no pain to 10: worst pain).Pain score does not reduce significantly in the topical EMLA cream in compared with placebo (p-value=0.126). No signs of infection were noted at the spinal puncture sites 24 or 48 hours after the procedure.Results obtained from this study represents that the EMLA cream has not more analgesic effect than placebo in reducing the pain for spinal puncture.

Autologus platelet gel is easy to prepare and is relatively low cost. The aim of this study was to prepare and evaluate in vitro efficacy of autologus platelet gel.In this experimental study, platelet concentrate and platelet poor plasma were prepared with aphaeresis method. Thrombin was prepared by mixing the plasma with calcium. Thrombin activity level was determined by spectrophotometric method. The platelet gel was obtained by adding thrombin and calcium to the platelet rich plasma. The concentration of growth factors was measured using the enzyme-linked immunosorbent assay technique.Platelet rich plasma contained a total average of 1×1011 platelet in the 100 ml product. The highest activity of prepared thrombin was achieved at a ratio of 5 vol (5ml) platelet poor plasma to 1 volium (1ml) calcium gluconate (p=0.02). Produced thrombin was stable for two hours at 24ºC, six hours at 4ºC, and more than three months at -20ºC (p=0.04). Concentration of platelet derived growth factor and transforming growth factors-β in platelet gel supernatants were generally high (23.2 ± 6 ng/ml, 18.2 ± 5ng/ml respectively), whereas epithelial growth factor and fibroblast growth factor were present at low concentration (870 ± 110 pg/ml, 24.7 ± 3 pg/ml respectively).With proper production, large numbers of platelets in the platelet rich plasma will be activated, hence high concentration of growth factors will be produced.

The aim of the present study was to determine the endocrine dysfunction in patients with major thalassemia, who receive hyper transfusion.This cross sectional study was performed during one year, which included 65 major thalassemia patients (31 females and 34 males), aged between 14 month to 27 years old (median 10,3). Growth assessment was measured by height and weight according to age and BMI. For all patients serum ferrites concentration, serum calcium and phosphorus, alkaline phosphates, fasting blood sugar, thyroid stimulating hormone, free thyroxin, FSH, LH, dehydroepiandrosterone sulfate, testosterone, estradiol were measured.In this study, 44.9% of patients were found to be shorter than the height of 5th percentile for their age. Diabetes mellitus and impaired fasting glucose were seen in 16% and 28.6% of patients respectively. There was significant correlation between serum ferritin level and impaired glucose tolerance test (p-value =0.043) in them. Frequency of hypocalcaemia and hyperphosphatemia were 36.9% and 10.7% respectively. Frequency of hypogonadism was 54.8%. Fourthy percent of the patients had no endocrine abnormalities.Endocrine dysfunctions are extremely frequent in patients with thalassemia, but chelating therapy can prevent or limit these complications. Impaired glucose tolerance was one of the most frequent endocrine complications, which were related to ferritin level.

Prolonged P-wave duration and P-wave dispersion indicate interatrial conduction disturbance and early predict arrhythmia especially atrial fibrillation. Iron deposition in the atrial tissue might prolonged the atrial conduction time, and this study evaluated the P-wave prolongation and increased P-Wave dispersion in these patients.Fifty patients with major thalassemia and fifty healthy controls were studied, which age and sex matched between cases and controls. All patients and the controls were examined and had an ECG. The P-wave dispersion defined as the difference between the maximum and minimum P-wave duration. P-wave dispersion was compared between two groups. T-test and s correlation were used as needed.There was a significant difference between the P-wave dispersion of the 2 groups (P=0.019). Maximum P-wave duration and P-wave dispersion in patients had strong correlation with age (disease duration). P-wave duration and P-wave dispersion had no correlation with regularity or irregularity of desferal use.Maximum P-wave duration and P-wave dispersion were seen in older cases, which significantly get prolonged. This could show that the myocardial involvement and dysfunction was probably more in the older patients.

Phenyl ketonuria (PKU) is a congenital metabolic disease. Irreversible brain damage is the result of phenyl alanin accumulation, so its amount should be restricted in patients diet. In their diet, trace elements such as hem Iron, folic acid, vitamin B12 and, etc are also limited, and could represent anemia. In this study, the frequency of anemia in PKU patients in Yazd was investigated and compare with non-affected individuals.In this case-control study, all the PKU patients of Yazd who were under diet at least for 6 months were selected. The controls were selected from non PKU population and matched with cases according to age, gender and socioeconomic level. Hematologic factors were measured in both groups and analyzed using SPSS software using T-Test.This study consisted of 18 patients aged between 1 to 18 years old. Full blood count and blood indices did not show significant difference (p>0.05), except MCHC (p<0.05). The blood level of vitamin B12 and Folic acid were significantly higher in the cases than controls (p<0.05), but ferritin was not significantly different between them (P>0.05).Our results did not show significant difference in presentation of anemia in patients with PKU and normal controls. Screening for anemia among PKU patients and taking supplements is recommended.

Cancers are one of the most common chronic diseases in children that cause fear and anxiety in them and their families. Praying is one of the methods can be used for reducing anxiety. In this study, we examined praying effect on anxiety in mothers with children suffer from cancer.This randomized clinical trial was done on 60 mothers divided in two groups (n=30). In first group prayer therapy was done for three weeks by mothers. In control group prayer therapy was not done. Data was collected by state anxiety spilberger test and mean anxiety was compared between two groups by analytical statistical test.The results showed that difference between mean anxiety in two groups was significant (p=0.001), and mean anxiety reduced after praying from 56.2+_13.9 to 40.9+_12.4 in case group (p=0.001).The results of this study showed that praying can reduce anxiety in mothers with children suffer from cancer and could be useful for them.