فهرست مطالب

Iranian Journal of Pediatric Hematology and Oncology
Volume:7 Issue: 2, Spring 2017

  • تاریخ انتشار: 1396/01/09
  • تعداد عناوین: 8
|
  • Dr Mohammad Hossein Jarahzadeh, Dr Maryam Akhundi, Dr Shekoufah Behdad *, Dr Mohammad Hossein Dehghani Pages 68-75
    Background
    Ketamine increases blood pressure and heart rate. Propofol is an anesthetic drug with rapid recovery, but it causes respiratory depression, low heart rate and low blood pressure. Combination of ketamine and propofol provides sedation, analgesia, and rapid recovery with hemodynamic stability and minimal respiratory depression. There have been a few studies about the effect of different concentrations of ketofol on amnesia in the children with leukemia undergoing intrathecal injection of chemotherapy drugs, so this study investigated the effect of two concentrations of ketofol (1/5 with midazolam and 1/10) on amnesia in these patients.
    Materials And Methods
    This randomized, double blinded study was conducted on 64 ALL children aged between 5 to 12 years old and referred to Shahid Sadoughi hospital for intrathecal chemotherapy from July 2016 up to September 2016. The patients received titrated injection of a solution containing combination of one part of ketamine and ten parts of propofol (1:10) (group I) or one part of ketamine and five parts of propofol (1: 5) with midazolam(0.5mg) (group II) to sedate at the fifth level of Ramsay Sedation Scale. Amnesia was evaluated using visual recognition of posters and recall of specific events. Drug side effects such as nausea, vomiting, hallucination, allergies, dizziness, cough, and apnea were also evaluated in the patients.
    Results
    No significant difference between two groups was found regarding age and weight (p- value=0.625, p- value=0.830). Running Chi-square revealed no statistically different between groups in terms of posters recognition and recall of specific events. In terms of drug side effects, two groups were similar but for hallucination that was higher in group (p- value = 0.043).
    Conclusion
    The results showed that ketofol 1/10 is superior in comparison to ketofol 1/5 with midazolam (0.5 mg) according to less side effects and similarity in amnesia induction. Key
    Keywords: Amnesia, Chemotherapy, Intrathecal Injection, Ketofol, Leukemia, Sedation
  • Fatemeh Pourdeghatkar, Dr Minoo Motaghi *, Dr Bahram Darbandi, Dr Adel Baghersalimi Pages 76-81
    Background
    Mucositis is a complex inflammatory response of the digestive system mucous membrane and it is also one of the most common painful side effects following chemotherapy in children with carcinoma. Developing to mucositis affects the patient's life severely and can lead to long – term hospitalization.Therefore, this study was conducted to evaluate the effect of chamomile mouthwash on the prevention of oral mucositis in children with acute lymphoblastic leukemia.
    Materials And Methods
    This double-blinded clinical trial study was done on 31 children with acute lymphoblastic aged 6-15 who were admitted to hospital of 17 Shahrivar Rasht, Iran between 16 July and 8December 2015. Patients and their parents were instructed to resolve 15 drops of chamomile mouth wash in 10cc water, turn it one minute in the mouth, outpour it, and avoid eating for one hour. After three times tooth brushing a day, the mouth cavity of patients was evaluated one day before chemotherapy, the seventh day and fourteenth day of chemotherapy according to the criteria of world health organization. SPSS (version 11)was used in order to analyze the data and random statistical index and independent t test were run.
    Results
    The severity of oral mucositis on the seventh and fourteenth day after chemotherapy had no significant difference with the first day (P = 0.59). The incidence and severity of oral mucositis didnt increase 14 days after chemotherapy in comparison with the seventh day.
    Conclusion
    Chamomile mouthwash can be effective in preventing the incidence and severity of oral mucositis and it can be used as a suitable mouthwash in children undergoing chemotherapy.
    Keywords: Acute Lymphoblastic Leukemia, Chemotherapy, Mouthwashes, Oral Mucositis
  • Neonatal Thrombosis: Incidence and Risk Factors in a Tertiary Care Hospital in Iran
    Dr Parichehr Tootoonchi *, Dr Khadijeh Arjmandi, Dr Nastaran Khosravi Pages 82-89
    Background
    Neonatal thrombosis is one of the most important challenges among patients admitted in Neonatal Intensive Care Unit (NICU), which can lead to an asymptomatic condition, limb loss or even death. This study was performed to determine the incidence and risk factors of neonatal thrombosis in a tertiary care hospital in Tehran, Iran.
    Material and
    Methods
    In this historical cohort, all neonates admitted to Ali-Asghar children's hospital, Tehran, from Sep 2014 till Mar 2015 were enrolled. If thrombosis happened and proved with Color Doppler ultrasonography, the data about type and place of thrombosis, occurrence of complications, recurrence of thrombosis, and the swelling of the extremity distal to the thrombosis area were collected. The statistical significant level was set less than 0.05. SPSS (version 16) was used for data analysis.
    Results
    The neonatal thrombosis incidence was 2.87% (14 cases out of 489). Most of cases (13, 92.9%) had venous thrombosis and one case (7.1%) had arterial thrombosis. Femoral vein thrombosis following catheter insertion has occurred in 9 cases (64.2%) of thrombosis. In multivariate analysis with multiple regression, a statistical significant relation was found between thrombosis and neonatal age at admission (P
    Conclusion
    Most of our findings are in agreement with the results of other studies. Some interesting results included the significant relation between thrombosis and neonatal age at admission, history of exchange transfusion or exclusive breast feeding.
    Keywords: Incidence, Neonatal, Risk Factor, Thrombosis
  • Dr Ali Ghasemi, Dr Alireza Ataei Nakhaei, Dr Anahita Alizadeh Ghamsari, Dr Maryam Salehi, Dr Farnaz Kalani, Moghaddam* Pages 90-97
    Background
    Opium is a new source of lead and considered as a cause of lead poisoning. As anemia and lead poisoning affect growth and behavior negatively, their timely prevention, diagnosis, and treatment are essential. The aim of thi study is evaluation of the prevalence of anemia, iron deficiency anemia, and lead poisoning in children with opioid toxicity.
    Materials And Methods
    In this cross-sectional study, 150 children admitted to the pediatric poisoning unit of Imam Reza hospital, Mashhad, Iran from May 2015-2016 were divided into two groups of methadone/tramadol and raw opium toxicity. For each child hematocrit, hemoglobin, RDW (red blood cell distribution width ), MCV (mean corpuscular volume), CRP(C-reactive protein), and blood lead level (BLL) were tested. One hundred children without opioid toxicity from a simultaneous study were considered as control group and compared with our patients regarding BLL.
    Results
    The patients’ mean age was 33.08±33.35 months. The prevalence of anemia and lead poisoning was 40% and 83.3%, respectively; neither indicating a significant difference between the M/T and opium groups (p=0.241, 0.227). On the other hand, 125(83.3%) and 63(63%) cases and controls had lead poisoning (BLL>5µg/dl), respectively, showing a significant difference (p
    Conclusion
    A single episode of opioid toxicity does not result in anemia. However, a significant difference was observed between the cases and controls regarding lead poisoning. Although the BLL in the cases under two years of age was higher than the controls, the difference was not significant.
    Keywords: Iron deficiency anemia, Lead poisoning, Methadone, Opioids, Tramadol
  • Dr Hossein Ayatollahi, Dr Mohammad Hadi Sadeghian, Sepideh Shakeri *, Seyyede Fatemeh Shams, Maryam Sheikhi, Mohammad Alidadi, Dr Afsane Bahrami Pages 98-104
    increment. It is categorized based on genetic aberrations. Some of these genetic disorders can determine minimal residual diseases (MRD) and prognosis of AML patients. Wilms tumor (WT1) over expression is found in AML patients. The aim of this study was to determine the frequency of WT1 over expression in AML pediatric cases in North -East of Iran.
    Materials And Methods
    This retrospective Study was done in Mashhad, Iran during 2016 in 100 pediatric AML cases. WT1 expression was evaluated by quantitative reverses transcription PCR (qRT-PCR) and cloning method. Both WT1 and ABL genes were cloned to create a standard curve and then copy number of WT1 gene in patients was evaluated.
    Results
    One hundred children under 15 with mean age of 6.50± 4.22 were evaluated in this study. There were no significant differences between age and sex and WT1 expression (P>0.05). Mean expression of cited gene was 200.52±210.62 copies of WT1/ABL 104 in studied samples. WT1 gene over expression was observed in 82% of all patients.
    Conclusion
    WT1 assessment can be applied as a prognostic and diagnostic marker in AML patients under 15.
    Keywords: Acute myeloid leukemia pediatrics, quantitative reverses transcription PCR Wilms tumor
  • Dr Mehdi Azad, Dr Farshad Forooghi, Dr Hassan Ehteram, Mousa Vatanmakan, Hajar Nasiri, Dr Naser Mobarra * Pages 105-116
    Background
    Stem Cell differentiation is a process composed of vast variety of factors which are controlled by a network of certain mechanisms. This study aims to determine the possible role of DNA methylation, a potent regulator of VHL, ECAD and RUNX3 genes during Erythroid differentiation driven by miR-451.
    Materials And Methods
    To determine the methylation status of promoters and the expression levels of VHL, ECAD and RUNX3 genes, Methylation Specific PCR (MSP) and real-time PCR were used, respectively, on both Cord Blood CD34 Hematopoietic Stem Cells and differentiated cells. To measure the expression levels of mir-451, mirna qpcr technique was used.
    Results
    Our findings demonstrated a similar methylation pattern for the target genes before and after differentiation by miR-451. However, the expression levels were significantly increased after differentiation. Gene expression and surface marker analysis results further confirmed the potential of miR-451 for driving erythroid differentiation from hematopoietic stem cells.
    Discussion
    Our findings ruled out DNA methylation effect on the regulation of VHL, ECAD, and RUNX3 genes during miR-451 mediated erythroid differentiation. However, having CpG islands in their promoters, these three genes are candidates to be controlled by methylation which may not able to be detected by MSP method.
    Conclusion
    Taken together in this study we have shown a successful erythroid differentiation mediated by miR-451 which is at least in part, independent of DNA methylation. Further understanding of the underlying mechanisms driven by eryhtroid differentiation may lead to therapeutic measures to alter disorders of hematopoietic stem cell differentiation.
    Keywords: DNA methylation, Erythroid differentiation, Gene expression, MiR, 451, Stem cell
  • Dr Mohammad Reza Sobhan, Dr Shadi Mostafavi *, Dr Mahta Mazaheri, Hossein Neamatzadeh Pages 117-129
    Background
    Understanding the differences in genetics of malignancies is crucial for therapeutic decisions. This systematic review was conducted to evaluate the current evidence on genetics of bone tumors in the context of pediatric cancer.
    Material and
    Methods
    We performed a systematic review of the literature published on genetics of pediatrics bone tumors, using PubMed, Google scholar, Science Citation Index and Embase. The search profiles used were: pediatric/childhood malignant bone tumors, pediatric/ childhood bone cancer/neoplasm, osteosarcoma/bone sarcoma/Ewing's sarcoma and risk factors/etiology. Inclusion criteria were as follows: focused upon biology and genetics mechanism of primary bone tumors and published in the last 15 years in English.
    Results
    A total of 278 articles were searched for relevancy, determined by article title, abstract, and full copy. After screening the titles and abstracts, 239 articles were excluded because they were the same articles and case reports. Finally, 39 articles were found that fulfilled all inclusion criteria.
    Conclusion
    This systematic review shows that many genetic studies have been performed on the genetics basis of pediatrics bone tumors. The knowledge base formed by this review should facilitate more informative future research. It is important that orthopedics and other specialists be aware about genetics basis of pediatrics bone tumors.
    Keywords: Bone Tumor, Pediatric Tumors, Ewing sarcoma, Osteosarcoma, Rhabdomyosarcoma
  • Dr Mansour Moghimi *, Dr Hamid Reza Soltani, Dr Mojtaba Babaei Zarch Pages 130-132
    Fibroadenoma is the most common benign mass of breast in females 20-50 years of age. Juvenile fibroadenoma accounts for only 4% of total fibroadenomas. Moreover, the incidence of giant juvenile fibroadenoma is found to be only 0.5% of all fibroadenomas. A 15-year-old woman at the 12th week of gestation was referred to the Shahid Sadoughi Hospital, Yazd, Iran because of a mass in the right breast from one year ago. On Physical examination and imaging, a large mass was found in her right breast. Fine needle aspiration biopsy reported fibroadenoma. Mass enucleation and breast reconstruction were performed. Pathologic examination confirmed a giant fibroadenoma. No serious complications were reported during one-month follow up. The most highlighted point of this presentation was giant size of juvenile fibroadenoma in a pregnant woman. This case report shows that large breast tumors in the adolescent age group can be benign and breast-conserving surgery should be considered in such cases.
    Keywords: Breast, Fibroadenoma, Pregnancy, Surgery