فهرست مطالب

Iranian Journal of Pediatric Hematology and Oncology
Volume:8 Issue: 2, Spring 2018

  • تاریخ انتشار: 1397/01/29
  • تعداد عناوین: 8
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  • Duc Thuan Lao, Kim Phuong Truong, Thuy Ai Le Huyen Dr Pages 75-86
    Background
    Epstein-barr virus nuclear antigen 1 (EBNA1) plays a crucial role in Nasopharyngeal carcinoma (NPC), the most common cancer of head and neck cancer in Asian countries with high incidents. Sequence variations are of high frequency within the functionally important domains of EBNA-1, which have been classified into five subtypes: Phenotype (P)-ala, P-thr, V-val, V-leu and V-pro and are related to geographical location. This study aimed to evaluate the variations of EBNA-1 in NPC biopsy samples from Vietnamese patients.
    Materials And Methods
    In this descriptive analytical study, 20 NPC biopsy samples, which were positively confirmed to NPC, were collected from Cho Ray Hospital. Nested PCR – nucleotide sequencing was applied to analyze the carboxy-terminal region of EBNA-1. Phylogenetic analysis was performed using the Molecular Evolutionary Genetics Analysis, version 5.0, by Neighbor-Joining algorithm.
    Results
    The variants of EBNA-1 have been described based on the amino acid signature at codon 487, including V-val (75.0%), P-ala (10%), P-thr (5%), V-leu (5%). Additionally, the phylogenetic results confirmed that the V-val subtype, detected in this current study of the Vietnamese population, was in accordance with previous studies that V-val is almost an exclusive variation in Asian region, especially with Chinese populations and preferentially exists in biopsies of nasopharyngeal carcinoma.
    Conclusion
    In this initial study, the sub-strains of EBV within V-val subtype of EBNA-1 was preferential in biopsies of NPC patients. The finding provided the initial data for the potential contribution of EBNA-1 polymorphisms to etiology of NPC in Vietnamese population.
    Keywords: Esptein-barr virus, Nasopharyngeal carcinoma, Nuclear antigen, Variations
  • Hamidreza Shetabi, Mohammad Golparvar, Sahar Ghanbardezfulli, Mohammad Torfenejad Pages 87-96
    Background
    Lumbar puncture (LP) and bone marrow aspiration or biopsy in pediatric patients with hematological diseases is often repeated at regular intervals. These procedures are painful and unpleasant and bring a lot of stress for the children and their families. This study aimed to compare the effectiveness of two drug combinations of propofol-ketamine and propofol-remifentanil in children with acute lymphoblastic leukemia under bone marrow aspiration or biopsy and lumbar puncture (LP).
    Materials And Methods
    In this clinical trial, 81 children aged 6 months to 14 years old with acute lymphoblastic leukemia who were candidates for lumbar puncture, bone marrow aspiration or biopsy were randomly divided into two groups of receiving Propofol-Ketamine and receiving Propofol-Remifentanil. In each group, hemodynamic indices, sedation, side effects, the onset of effectiveness and duration of remaining in the recovery room were measured and recorded. Data were analyzed using Chi square test, Mann-Whitney, independent t-test, and Fisher’s exact test with a significant level of p
    Results
    The need for repeating drug’s dosage was significantly lower in the group received Propofol-Ketamine than the other group (p=0.009). The mean of systolic blood pressure and arterial oxygen saturation at the end of the procedure was significantly lower in the Propofol-Remifentanil receiving group (respectively p=0.040 and p=0.001). During the procedure, the frequency of hypotension was significantly higher in the Propofol-Remifentanil receiving group (p=0.048). The recovery duration was reported significantly longer for the Propofol-Ketamine receiving group (p=0.004). Sedation indices, other hemodynamic indices, and the onset of effectiveness caused no significant difference between two groups (p>0.05).
    Conclusion
    It seems that the combination of Propofol-Ketamine could be a more appropriate combination in children especially in patients with unstable hemodynamics due to lower need for repetition of the drug dose and more hemodynamic stability.
    Keywords: Acute Lymphoblastic Leukemia, Children, Ketamine, Propofol, Remifentanil, Sedation
  • Mehdi Mohammadi, Majid Naderi, Alireza Ansari Moghaddam, Neda Mahdavifar, Maryam Mohammadian Pages 97-104
    Background
    Leukemia is the most common childhood cancer. This cancer, considering its unknown cause(s), is considered as one of the most important health problems amongst children worldwide. The present study was aimed to determine the relationship between breastfeeding and leukemia in Sistan and Baluchestan province, southeast of Iran.
    Materials And Methods
    This case-control study was implemented on 120 children between 11 months and 17 years old with leukemia as the case group, and 240 children hospitalized due to other non-leukemia-related diseases in the study area (the mean age of children in both groups was about 8 years). The children were categorized according to age and gender. To determine the relationship between variables and the risk of leukemia morbidity, the odds ratio (OR) with 95% confidence intervals was estimated through conditional logistic regression using Chi-square and Fisher's exact test and utilizing SPSS-16.
    Results
    Out the 120 children with leukemia, about 60% were male and the age group of 5-9 years old was the most frequent age group (45%). The results of the study showed that breastfeeding was significantly associated with leukemia in children, P-value = 0.02(OR = 0.24, CI: 95%, 0.71-0.71).
    Conclusion
    Regarding the protective role of breastfeeding, the necessary measures for training to maintain and promote breastfeeding and its continuity up to 2 years are required to be taken.
    Keywords: Breastfeeding, Children, Leukemia
  • Bijan Keikhaei Dr, Parastoo Moradi-Choghakabodi Dr, Fakher Rahim Dr, Mohammad Pedram Dr, Homayoun Yousefi Dr, Khodamorad Zandian Dr, Khojasteh Hosseini Nejad Dr, Ashram Samavat Dr Pages 105-110
    the risk of sickle cell complications that is a common hemoglobin disorder in Southwest Iran. This study aimed at determining the incidence of Sickle Cell Disease (SCD) and other Hemoglobinopathies in newborn being at risk based on ethnic origin.
    Materials And Methods
    In this descriptive epidemiologic study, between September 2013 and September 2015, 8363 newborn blood samples were tested in four maternity units from Ahvaz, Khoramshahr, Sosangerd and Dezful. Complete cell count and cellulose acetate electrophoresis at pH 8.4 were performed on each blood sample. Parent's clinical status was also checked for more information. Presence of an abnormal band in the EDTA treated samples were further confirmed by citrate agar gel electrophoresis and automated high performance liquid chromatography (HPLC). Results were analyzed statistically by the One-Way ANOVA analysis.
    Results
    Among 8363 screened samples, 118 (1.41 %) samples were heterozygous for Hb S, and four (0.047%) for Hb C; none of newborns were Hb SS homozygotes. The incidence of silent and alpha thalassemia minor based on RBC indices was nearly 10%.
    Conclusion
    Present findings indicated the high quality and considerable impact of conducted screening program starting in 2007 at significantly decreasing the prevalence of SCD among newborns born between 2013 and 2015. The results also showed that the neonatal screening for SCD was not weighed to add as a new program in national health network.
    Keywords: Newborn screening, Sickle cell, Sickle cell trait
  • Abbas Ahmadi Vasmehjani, Sajad Yaghubi Dr, Seyed Mohammad Hashemi, Mohammad Farahmand, Omid Ali Adeli Dr, Amir Hossein Taravand, Maryam Beiranvand Pages 111-117
    Background
    Although regular frequent blood transfusion improves overall survival of multi-transfused patients like β-thalassemic ones, it carries a definite risk of infection with blood-borne viruses such as viral hepatitis. This study was done to determine seropositivity of hepatitis B virus (HBV), hepatitis C virus (HCV), and Human Immunedeficiency Virus (HIV) infections among β-thalassemia major patients, and estimate the infection-associated risk factors among them.
    Materials And Methods
    In this cross-sectional study, serums of 143 patients with β-thalassemia major were collected from 2015 to 2016. Enzyme-linked immunosorbent assay (ELISA) was performed for the detection of antibodies to hepatitis C virus anti-HCV, hepatitis B surface antigen HBs Ag, hepatitis B core antigen (anti-HBC), and human immunodeficiency virus (anti-HIV). The positive anti-HCV and anti-HIV results were confirmed by RIBA assay and Western blot. Demographic information and risk factors were collected and analyzed.
    Results
    The findings showed that the prevalence rate of anti-HCV was 4.2%; while no patients were detected with HIV and HBV infections. Among the six anti-HCV positive patients, 5 (3.5%) were positive for anti-HCV using RIBA test. The prevalence of HCV seropositivity was higher in patients with sexual exposure risk (p= 0.04). There was no significant difference between sex and other risk factors such as history of splenectomy and different city with anti-HCV seropositivity (p=0.6 and 0.51, respectively). Moreover, the number of blood transfusions received by HCV positive thalassemia patients was significantly higher than that of negative anti-HCV thalassemia patients (p=0.001).
    Conclusion
    The prevalence of HCV infection was much higher among β-thalassemic patients comparing with HBV and HIV infection patients. Older age, blood transfusion, and sexual risk were associated with HCV seropositivity. Routine screening of donated blood for HCV is highly recommended. More study is needed to assess continuous screening of blood products for patients with risks of exposure to HCV.
    Keywords: β –thalassemia, Hepatitis B, Hepatitis C, HIV infection
  • Zarrin Habibian Dr, Zahra Sadri, Hossein Nazmiyeh Pages 118-125
    Background
    Job stress is defined as the harmful physical and emotional responses happening when the requirements of the job do not match the capabilities, resources, or needs of the worker. Some jobs such as nursing are stressful. The aim of this study was to investigate the effects of group acceptance and commitment therapy (ACT) on job stress and burnout among pediatric oncology and special diseases nurses.
    Materials And Methods
    This interventional study was conducted on sixty nurses in special disease and oncology wards who then were assigned randomly in two group of experimental and control. During four sessions lasting for one and half, the experimental group received communication skills of ACT based on Bond and Hayes model and the control group received just communication skills. Three months after the main training in the follow-up stage, experimental and control group had two sessions lasting for 1.5 hours. During these sessions, previous contents were reviewed. Before and after the interventions and during follow up stage, the participants completed Osipow’s Occupational Stress Inventory and Maslach and Jackson Job Burnout Inventory. Data analysis was done using repeated measures analysis of variance.
    Results
    Group training based on the ACT not only decreased total job stress (p
    Conclusion
    Group ACT-based training can decrease job stress but had no considerable effect on job burnout.
    Keywords: Acceptance, commitment therapy, Job stress, Oncology, Pediatrics
  • Azam Hashemi Dr, Zahra Bahrololoomi Dr, Samaneh Salarian Dr Pages 126-138
    Background
    Early childhood caries (ECC) is one of the important caries occuring in children under the age of 6. ECC is defined as possible risk factor for iron deficiency-related anemia. In this review study, the current evidence about the effect of ECC on the prevalence of anemia was studied.
    Material and
    Methods
    A systematic review on ECC and anemia was done based on published article in PubMed and Google scholar databases. The search profiles included ECC/risk factor, SECC/ risk factors, ECC/anemia, ECC/ferritin, and ECC/iron deficiency. Inclusion criteria comprised of all studies that focused on ECC and anemia or related fields.
    Results
    A total of 3546 articles on early childhood caries were identified in PubMed and google scholar databases. After screening the titles and abstracts as well as limitation the subjects to ECC and risk factors, 175 articles underwent further investigation, of which 12 articles on ECC and anemia were finalized. Other research efforts in this regard had been made through theses and reported in non-PubMed English journals; thus, Conducting further search by Google, 3 more relevant articles were discovered.
    Conclusion
    According to this literature review on ECC and anemia, it is suggested to consider ECC as one of the risk factors for iron deficiency and anemia in children. More studies are needed to examine lifestyle and socioeconomic risk factors that can be associated with the malnourished status of these children. Preventive strategies against ECC should be developed to reduce the risk of iron deficiency and its related anemia.
    Keywords: Anemia, Caries, Iron Deficiency, Risk Factor
  • Emrah Can *, Sahin Hamilcikan Pages 139-141
    Pulmonary hemorrhage (PH) is rarely seen in neonates and generally occurs based on the pathological process as perinatal asphyxia. Additionally, hypothermia treatment can be associated with thrombocytopenia and hemorrhage in term infants. Generally, PH is severe and persistant hemorrhage can related to neonatal mortality. Sometimes, supportive therapies such as positive-end expiratory pressure (PEEP), antibiotherapy, and fresh frozen plasma may not affect PE in neonates. Tranexamic acid (TXA) is an antifibrinolytic agent that can reduce bleeding and decrease blood transfusions in pediatric surgery. In this study, a 5-year-old girl was reorted that who was presented with a 4 month history of pelvic and right lower limb pain and limping to the pediatric outpatient clinic in August 2016 at Shahid sadoughi Hospital,Yazd,Iran. In this case report, a severe PH was presented and treated with TXA. PH was reduced after administering first dose of TXA and full recovery was achieved on 3th day of therapy. No bacterial agent was observed in hemoculture result during first 72 hours and hemocoagulation was not affected with TXA administration.
    Keywords: Hemorrhage, Neonate, Tranexamic Acid