فهرست مطالب

Pediatric Hematology and Oncology - Volume:3 Issue: 2, Spring 2013

Iranian Journal of Pediatric Hematology and Oncology
Volume:3 Issue: 2, Spring 2013

  • تاریخ انتشار: 1392/03/27
  • تعداد عناوین: 8
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  • M. Mehrabi, A. Javid, A. Hashemi, S. Rezaei, Zarchi Page 47

    Background Nanoparticulate drug delivery systems have attracted significant attention in the field of cancer nanotechnology. This study determines the effect of folate-based Fe2O3 nanoparticles. This study aimed to decorate nanoparticles with folate (FA), a molecular ligand for ‘active’ targeting of cancerous cells and the application of modified-nanoparticles in cancer treatment. Materials and Methods The nanoparticles were prepared by a solvent evaporation and emulsification cross-linking method and anticancer activity of agent was evaluated on CCRF CEM cells, derived from human blood cancer samples. Results The physicochemical properties of the nanoparticles were characterized by various techniques, and uniform nanoparticles with an average particle size of 110±15 nm were obtained. Cytotoxicity tests showed that the SPIO-FA had higher cell toxicity, and confocal microscopy analysis confirmed excellent cellular uptake efficiency. Conclusion These results indicate that FA based SPIO-NPs have potential uses as anticancer drug carriers and also have an enhanced anticancer effect.

    Keywords: Folate, Blood cancer, Nanoparticles
  • Ghasemi A, Gharavi Fard M, Sabzevari AR Page 54
    Background

    Multiple procedures (Lumbar puncture and bone marrow aspiration /biopsy) cause pain, stress, depression and etc for the patients and their families. Various methods have been recommended for pain reduction during invasive procedures. The aim of this study is to report the complications following general anesthesia.

    Materials and Methods

    In this prospective observational study, two hundred and two children with cancer were enrolled. All patients received propofol 2.5 mg /kg and fentanyl 1 µg/kg. After adequate anesthesia, procedures were performed by a pediatric oncologist. All anesthesia complications were classified into two groups: Intraoperative and Postoperative complications. Complications which were recorded include: abnormal age-specific bradycardia (≤20 × baseline), decrease in arterial oxygen saturation (≤90%), laryngospasm, vomiting, agitation, headache, hypothermia (<35 C°), hyperthermia (>37/8 C°), signs of allergy, traumatic LP (bloody), and unusual local bleeding.

    Results

    In this study, 118 males and 84 females underwent 623 general anesthetic procedures with a median of 3 procedures per patient. Intraoperative period complications occurred in 48 of total 623 procedures (7.7 %). The most common complications were traumatic LP, bradycardia and decrease in arterial oxygen saturation which occurred in 25, 6 and 6 cases, respectively. Postoperative period complications occurred in 74 (11.9%) cases. The most common complications were vomiting, agitation and headache, decrease O2 saturation and bradycardia.

    Conclusion

    General anesthesia by propofol and fentanyl may be a good choice for short-term painful procedures in children undergoing treatment for bone marrow aspiration/biopsy and intratechal injection.

    Keywords: Anesthesia, General, Spinal Puncture, Biopsy
  • I. Shahramian, E. Akhlaghi, A. Ramezani, A. Rezaee, N. Noori, E. Sharafi Page 59

    Background The aim of this study was to evaluate leptin serum levels in patients with major beta thalassemia which was also associated with their ferritin serum levels. Materials and Methods This case-control study was performed on 90 children -6 months to 16 years old, in Zabol, Amir- al- Momenin Hospital. Patients were divided in two groups and were matched in age and sex. All Children were examined and those eligible children who had not known heart disease, iron deficiency anemia, kidney disease, diabetes, fever and systemic diseases were enrolled after taking the informed consent of their parents. After collecting the samples, leptin and ferritin levels of the serum were measured in two groups by ELISA method. Then, the data was analyzed by the related statistical tests and SPSS 20 software. Results The mean of the serum levels of leptin and ferritin showed a significant difference in the case and control groups (P-value<0.05). An inverse statistical correlation was found for the serum levels of leptin and ferritin among the studied groups (P-value<0.05). Levels of leptin in the case group showed a significant gender difference (P-value<0.05), while based on BMI and age, no significant difference was observed for the serum levels of leptin in the case group. Conclusion Based on the results of this study, major thalassemia reduces serum levels of leptin regardless of age and body mass. The study also found an inverse statistical correlation between serum levels of leptin and ferritin among the studied people.

    Keywords: Beta, Thalassemia, Leptin, Ferritin, Child
  • L. Borjianyazdi, M. Froomandi, M. Noori Shadkam, A. Hashemi, R. Fallah Page 64
    Background 

    This study was conducted to evaluate the clinical effect of Granulocyte Colony Stimulating Factor (GCSF) on prognosis of neonatal sepsis.

    Materials and Methods

    Present study is a double- blinded randomized clinical trial, conducted on 46 preterm infants with neutropenia (Absolute Neutrophil Count (ANC) ≤ 5000 / μL) and clinical sepsis. Infants were randomly allocated into two groups. In the first group (treatment group), infants were treated with GCSF for up to 5 consecutive days with 10 μg/ kg in addition to standard treatment protocols, and in other group, infants received normal saline as the placebo. Each infant was monitored for 14 days. Primary outcome was mortality during 14 days after entering the study, and secondary outcome was the incidence of positive blood culture, weight gain on the fourteenth day, the duration of hospitalization and medication side effects.

    Results

    In the treated group, only one death was observed (P-value=1.00). However, no positive results for cultures were reported. Only one case in the treatment group and 3 patients in the control group showed feeding intolerance and needed respiratory support (P-value= 0.608). Length of hospitalization was 25 ± 6 days for the treatment group and 30 ± 7 days for the control group which was statistically significant (P-value=0.042).

    Conclusion

    The results of this study demonstrated that GCSF could reduce the hospital stay, but no significant effect was observed on mortality rate, respiratory or feeding status.

    Keywords: Granulocyte Colony, Stimulating Factor, Infant, Premature, Neutropenia, Sepsis
  • M. Pahlavanzadeh, S. Hekmatimoghaddam, M. Teremahi Ardestani, M. Ghafoorzadeh, Mm Aminorraaya Page 69
    Background

    About 7.5% of the world population carries one or two deficient copy of glucose-6-phosphate dehydrogenase (G6PD) genes. According to WHO, its prevalence in Iran is 10 to 14.9%. This study aimed on determination of frequency of G6PD deficiency in neonates with jaundice who were hospitalized during 6 months (September 2008 to February 2009) in the city of Yazd, Iran.

    Materials and Methods

    In this study, 105 icteric neonates in the hospitals of Yazd were evaluated. Data was collected from hospital records, and the G6PD activity was measured by photometric biochemical assay. Statistical analysis of data was performed by the SPSS-16 software, using Student's t-test and Pearson's chi-squared test.

    Results

    Between all of studied neonates, 19 (18.1%) had G6PD deficiency, and consisted of 15 boys (29.4% of boys) and 4 girls (7.4% of girls). In 100% of cases, the jaundice began in the first week after birth. The average total serum bilirubin at hospitalization was 17.22 mg/dL. In 31.5% of the G6PD-defficient neonates, exchange transfusion became necessary, which is significantly more than the rate in G6PD-sufficient (4.6%) neonates (P-value<0.05).

    Conclusion

    In general, the frequency of G6PD deficiency in this study seems quite high. Regarding its severity and frequent need for exchange transfusion, we recommend that all of the icteric neonates should be evaluated for G6PD activity. Also, it is better to test for G6PD deficiency in all of the neonates, to detect its presence and to prevent its complications such as favism and oxidant drug-induced hemolysis, since the test has a low cost.

    Keywords: Neonatal, Jaundice, Glucosephosphate Dehydrogenase Deficiency, Bilirubin, Favism
  • A. Dorgalaleh, M. Mahmoodi, B. Varmaghani, F. Kiani Node, O. Saeeidi Kia, Sh Alizadeh, Sh Tabibian, T. Bamedi, M. Momeni, S. Abbasian Page 73
    Background 

    Thyroid hormones have a crucial role in metabolism and proliferation of blood cells. Thyroid dysfunction induces different effects on blood cells such as anemia, erythrocytosis leukopenia, thrombocytopenia, and in rare cases causes’ pancytopenia. It also alter RBC indices include MCV, MCH, MCHC and RDW. Thus this study attempted to evaluate effect of hypo & hyperthyroidism on blood cell count and RBC indices.

    Materials and Methods

    This study performed on 102 patients with hypothyroid (14.1 years), 84 with hyperthyroid (15.6 years) and 118 healthy individuals (15.2 years) as control group. Initially patients TSH level of patients was determined by ELISA method, and then according to TSH ranges (0.3-5.5µIU/mL) patients were divided into two Hyperthyroidism (TSH<0.3µIU/mL) and hypothyroidism (TSH>5.5µIU/mL) groups. Then, complete blood count was measured by cell counter. Finally, obtained results were analyzed by SPSS software.

    Results

    Analyzes of obtained data revealed statistically significant difference between two groups of patients in RBC count, MCH, MCHC, RDW, HB and HCT(P-value<0.05), but the difference was not significant for WBC and PLT counts and MCV (P-value>0.05).

    Conclusion

    In case of patients with unknown hematological dysfunctions, must be evaluated for thyroid hormones.

    Keywords: Hypothyroidism, Hyperthyroidism, TSH
  • J. Ayatollahi_S. H Shahcheraghi_R. Akhondi_Ss Soluti Page 78
    Background

    Growth of drug resistance is related to number of microbial characteristics, selective pressure by antibiotic use and social and technical vicissitudes that enhance the transmission of antibiotic resistant organisms. The aim of this study was to investigate antimicrobial-resistance of Escherichia coli isolated from children in Shahid Sadoughi hospital of Yazd.

    Materials and Methods

    In this cross-sectional study, antimicrobial susceptibility to cefixime, cefotaxime, ceftazidime, ceftriaxone, ciprofloxacin, gentamicin, imipenem, cotrimoxazole and nalidixic acid was determined for 148 E. coli isolates obtained from patients less than 18 years of age (hospitalized and outpatient) in Shahid Sadoughi hospital of Yazd.

    Results 

    Ciprofloxacin was the most active antibacterial agent (78% susceptible), followed by gentamicin. High rates of resistance were observed for cefixime (57.9%) and cotrimoxazole. The results for ceftriaxone, cefotaxime, ceftazidime, ciprofloxacin, gentamicin, imipenem, cotrimoxazole and nalidixic acid were insignificant with P-value= 0.302, P-value= 0.550, P-value= 0.334, P-value= 0.084, P-value= 0.948, P-value= 0.686, P-value= 0.120 and P-value= 0.162, respectively. The results were significant for cefixime with P-value= 0.013.

    Conclusion

    The investigation of antimicrobial susceptibility is essential, and will help to identify E. coli resistance to antimicrobial agents. It also helps to limit E. coli spread.

    Keywords: Escherichia coli, Drug Resistance, Microbial, Child
  • Sh Taghipour Zahir_S. A Miratashi_M. Nazemian_S. Zand Page 83
    Background 

    Follicular lymphoma (FL) is the second most common adnexal lymphoma of the eye that almost all of them are reported in elderly patients. Primary FL of the eye has been reported in only two children. Pediatric FL appears to be biologically distinct from typical adult FL. In cases without other organ involvement excision alone with close monitoring is a treatment of choiceand the prognosis is excellent.

    Case presentation

    A 12 year -old male with a nodular lesion involving the inner can thus of the right eye was admitted to ophthalmology clinic. The lesion was painless and the nodule size gradually increased over a period of 6 months.Excisional biopsy demonstrated follicular lymphoma composed of neoplastic lymphoid cells which arranged in follicular pattern without germinal centers. Neoplastic cells were positive for Bcl2 and CD20.

    Conclusion

    Although follicular lymphoma of the conjunctiva is rare in childhood but it could be considered as one of the differential diagnosis in this age group.

    Keywords: Lymphoma, Follicular, Conjunctiva