[Evaluation of IgG and IgM antibodies against Varicella zoster virus in children with acute lymphoblastic leukemia]

Background and Objective: Varicella zoster virus [VZV] can cause a moderate disease in children, but with high risk of serious disease or death in children with acute lymphoblastic leukemia [ALL] Vaccination from infection can be safe, immunogenic, and effective in children with leukemia. This study was done to evaluate the IgG and IgM antibodies against VZV in children with acute lymphoblastic leukemia

Methods: The descriptive-analytic study was performed on 66 children who were on chemotherapy in Dr Shigh hospital in Mashhad, Iran during 2012. Patients were receivied VZV vaccine. The title negative or positive serum sample for IgG-anti-VZV avidity was determined by using a test kit before and after injection of vaccines VZV for considering the efficacy of vaccines on pediatric patients

Results: Title serum sample IgG were positive in 32.6% patients, these children have history of chicken pox disease and to be safe against of VZV. 78.3% of the patients were negative for IgG antibody and sensitive against of VZV

Conclusion: Children with ALL receiving chemotherapy are sensitive to chicken pox disease according to negative IgG titer against VZV

Comparison of oral recombinant erythropoietin and subcutaneous recombinant erythropoietin in prevention of anemia of prematurity

Premature neonates are at risk for severe anemia and erythropoietin is the most important hormone in erythropoiesis. The aim of this study was to evaluate the influence of oral recombinant human erythropoietin [rhEPO] in proving erythropoiesis in neonates. This was a randomized clinical trial study. Thirty neonates were enrolled from September 2007 to September 2008. The first group received oral rhEPO and Fe and the second, subcutaneous rhEPO and Fe. The patients' Hb, HCT and the need to blood transfusion were recorded. We included all infants with gestational age <34 weeks, birth weight <1500 gr, without respiratory distress [O[2] Saturation> 85%, FiO[2] of 30%], full feeding tolerance so that oral Fe can be administrated. In first group [oral=PO], 65% of neonates were female and 35% were male, mean weight was 1140 g and mean GA was 32.6 weeks. In the second group [subcutaneous=SC], 42% were female and 58% were male. The mean weight was 1245 g and mean GA was 31.2 weeks and this was not statistically significant. In the first group, the mean Hb and HCT were 9.7 +/- 1.9 and 29.6 +/- 5.9 g/dl. In the second group, the figures were 12.5 +/- 1.7 and 38.8 +/- 5.1 which were statistically significant. There was no difference in the weight gain between two groups. In the first group, 3 neonates [20%] and in the second one, 1 neonate [15%] needed blood transfusion. rhEPO administration either PO or SC could prevent anemia of prematurity but SC rout was more effective

comparison of pain intensity and anxiety during bone marrow biopsy under general anesthesia or local anesthesia in children with acute leukemia

Background: In recent years, the need to decrease pain and anxiety in patients with acute leukemia during invasive diagnostic and therapeutic measures has been emphasized. This study was performed with the aim of evaluating pain and discomfort caused by bone marrow aspiration under general anesthesia compared with local anesthesia

Materials and Methods: This cohort study was performed on 239 patients with acute leukemia under 18 years of age admitted to Dr. Sheikh Hospital in Mashhad during two years

Children undergoing bone marrow aspiration with either general anesthesia with propofol or local anesthesia with lidocaine were compared in terms of pain intensity [Visual Analogue Scale], resistance to procedure, and the fear and anxiety during aspiration. Results were evaluated with SPSS software version 16 using t test and chi-squared test

Results: Among the 135 patients who were under general anesthesia, 20.1% showed a slight resistance to apply the anesthesia mask. The least amounts of pain, fear, and anxiety were reported. Among the 104 patients under local anesthesia, 80.2% had physical resistance, 44.4% had severe and very severe pain, and 86.1% showed intense fear and anxiety. In the general anesthesia group, physical resistance [p=0.01], pain [p=0.01], and fear and anxiety [p<0.005] were significantly lower than in the local anesthesia group

Conclusion: In bone marrow aspiration, general anesthesia is more acceptable to children and their parents than local anesthesia. This method can greatly reduce pain, resistance, and fear caused by the aggressive actions during bone marrow aspiration in children

Effectiveness of mindfulness-based cognitive therapy on reduction of depression and anxiety symptoms in mothers of children with cancer

Findings demonstrated that parents of children with cancer experience elevated levels of distress, depression, anxiety, posttraumatic stress symptoms, and subjective symptoms of stress. In this study, we determined effectiveness of Mindfulness-Based Cognitive Therapy [MBCT] on reduction of depression and anxiety symptoms in mothers of children with cancer. Four mothers whose children had cancer were diagnosed to have depression and anxiety symptoms, using Beck Anxiety Inventory, Beck Depression Inventory II, and Structured Clinical Interview for DSM-IV. They were selected through purposeful sampling to participate in this experimental single-case study. After the baseline was determined, subjects attended an eight-session program of Mindfulness-Based Cognitive Therapy. The comparison of baseline and post-test showed that depression and anxiety symptoms decreased through MBCT. Improvement quotient for depression and anxiety of each subject was good. Data showed that MBCT reduced depression and anxiety symptoms in mothers of children with cancer

Association between MDR1 C3435T gene polymorphism and acute lymphoblastic leukemia [ALL] in iranian population

P-glycoprotein [P-gp], an ATP-dependent efflux pump, is a membrane protein encoded by MDR1 gene. P-gp has an important role in protection of the cell against xenobiotics and toxic compounds. Recently, a silent C3435T polymorphism in exon 26 of MDR1 has been reported to be associated with a decreased expression of P-gp in TT genotypes carriers compared with CC genotypes carriers. To evaluate the distribution of allelic variants of C3435T MDR1 in a group of healthy population in Iran and find the association between MDR1 C3435T polymorphism and the incidence of ALL, 126 patients with ALL and 139 healthy controls were included in our study and their MDR1 polymorphisms were detected by PCRRFLP assay. 71.9% of the healthy people had 3435TC genotype, 15.8% had 3435TT genotype and 12.2% had 3435CC genotype. Also, the frequency of T allele was 51.8% and C allele 48.2%. The mutant homozygous TT and TC genotypes were found to be associated with the incidence of ALL [OR=1.96 for TT genotype and OR=0.53 for TC genotype]. MDR1 C3435T polymorphism may contribute to the incidence of ALL. TT genotypes carriers are more at risk of developing ALL than other genotypes carriers

Therapeutic assessment ofAntrokinon on minor oral aphthous lesions

Antrokinon is an herbal compound with anti-inflammatory properties. This substance is usually used for treatment of skin lesions and burns. The aim of this study was to assess the clinical therapeutic effects of Antrokinon on oral aphthous lesions. In a double blind clinical trial study, the therapeutic effect of Antrokinon was evaluated against placebo in 80 individuals attending the school of Dentistry, Mashhad University of Medical Sciences. To receive dental treatment. The Antrokinon and placebo were exactly similar in color and they were in drop form [5cc]. Five drops of drug or placebo were instructed to be used locally, 4 times a day, in regular intervals. The collected data was analyzed using Mann-Whitney U test at 95% confidence level [P < 0.05]. The statistical analysis showed that, the drug had positive effects on clinical improvement of aphthous lesions in the oral cavity when compared with placebo. A significant decrease in clinical wound healing time was observed after using the drug in comparison with placebo [P = 0.001]. Likewise, Mann-Whitney U test revealed that the, burn-healing time was significantly shortened in comparison with placebo group as well [P = 0.003]. Useing Antrokinon can significantly decrease both, the wound-healing time and burn-healing period in oral aphthous lesions

Hereditary ginfival fibromatosis: a 30 year follow up study in three genetations

Hereditary gingival fibromatosis [HGF] is a rare condition with undetermined etiology, thus is designated as idiopathic. Previous studies have revealed that the pattern of inheritance is autosomal dominant or [rarely] autosomal recessive. In our study a group of family members in three generations were followed for 30 years. This clinical and histological study was initiated by the extraction of remaining teeth and excision of the enlarged gingiva of the oldest member of the group. No recurrence happened after 30 years of follow-up. The other cases were operated twice during the primary and permanent dentition periods. After the second surgery, so far there has been no recurrence in any of the patients. In all cases the hyperplasia developed after the eruption of teeth and recurrence was observed after surgery in some of them who retained some teeth

[Evaluation of oral hygiene status in patients with Thalassemia in Dr. Sheikh hospital Mashhad in 2004]

Thalassemia disease is characterized by anemia with splenomegaly and bone change in the early ages of life. It is a blood disease with two subtypes; Alpha and Beta. The Disorder is in synthesis of RBC Globulins. According to genetic defects and globulin structure defect, this disease is classified into major,minor and intermediate. The aim of this study was evaluating the periodontal status and measuring the index of GI [Loe and Sillness] and OHI[DI-S and CI-S] compared with the control group. In this case-control study, 100 patients suffering from major thalassemia referring to Dr.Sheikh Pediatric Hospital as the case group and 100 patients referring to Mashhad dental school as the control group, were studied. The two groups matched in age, sex and tooth brushing frequency in a day. GI and OHI-S [CI-S and DI-S] were compared between the two groups. Statistical analysis was carried out by chi-square test. GI and DI were significantly different in the case group and GI and OHI-S were greater in 19-26 year old than other patients age groups. In patients undergone splenectomy, the periodontal diseases were more frequent than those without splenectomy. Discussion: These difference in GI and OHI between the case and control groups could be attributed to maxillo-facial disorders, mouth breathing, imperfect plaque control, as well as host immune factors due to splenectomy which predisposes these patients to periodontal diseases. Gingival diseases were more prevalent in patients with thalassemia due to more plaque formation

Quantitative assessment of cardiac function in children with beta-thalassemia major, using the doppler myocardial performance index

Introduction: Cardiac disease and early death due to my ocardial injuries because of Iron overload and hemosiderosis are still the major problems in the management of patients with beta-thalassemia major [BTM]. Valuable echocardiographic techniques have been limited in early detection of cardiac dysfunction in these patients. A new Doppler index combining systolic and diastolic time intervals [the Tei index] has been reported to be useful for assessment of global ventricular function in many cardiac diseases. The purpose of this study was to assess global ventricular function in children with BTM using Tei index and also to determine its correlation with hematologic parameters

Material and Methods: This analytic cross sectional study was performed on 59 patient with Beta-Thalassemia Major during Jan.2003 until Feb.2004 in hematologic clinics of Imam Reza and Dr. Sheikh Hospitals. Complete physical examination and Doppler Echocardiographic study was done for all the patients and patients' Tei indexes were compared with normal values in other studies statistically

Results: The mean Tei index of left ventricule [LV] and right ventricule [RV] was 0.35 +/- 0.11 [mean +/- SD] and 0.28 +/- 0.12 [mean +/- SD] respectively. There was a significant difference between both right and left ventricular Tei index in-patients with BTM and healthy children. There was also a significant correlation between mean blood transfused volume per year and Tei index in both right [PV70.05] and left ventricule [PV 70.05]. We also find a significant difference between two groups of thalassemic patients according to their mean pre-transfused Hgb per year [Hgb> 9 g/dl and Hgb>9 g/lit] for left ventricular Tei index

Conclusion: The Tei index is a simple, feasible and reproducible measure of global cardiac function in-patients with BTM with early Myocardial dysfunction

[ incidence of GI complications in patients with leukemia during chemotherapy]

Background: Acute leukemia is a common malignancy in childhood that is now curable with chemotherapy. The use of chemotherapeutic agents has numerous complications. We studied the incidence of gastrointestinal complications and its relation to specific phases of treatment

Material and Method: In a cross-sectional study we examined 75 patients with acute leukemia who were treated with chemotherapy [Oct 2003 - Aug 2004] in Sheikh Hospital in Mashad/Iran. These patients had at least one GI complication caused by chemotherapy. The data was collected using a questionnaire

Results: The most common complications were oral ulcers [56%] and odinophagia [25.3%]. The mean age of patients with diarrhea [p=0.01 8] and abdominal distention [p=0.008] was considerably, higher than of other patients and it was significantly lower in patients with odinophagia [p=0.001]; perioral ulcers [p=0.017], diarrhea [p=0.045], nausea and vomiting [p=0.031] and oral aphthes [p=0/043] were notably more common during the first phase of modified BFM Protocol for ALL treatment

Conclusion: The age of the patient and the phase of treatment have significant statistical relation with GI complications

Malignant histiocytosis: a case report and review of the literature

Malignant histiocytosis [MH] is a rare hematologic malignancy, especially in the first decade of life. The disease is clinically characterized by fever, hepatosplenomegaly, lymphadenopathy, pancytopenia and jaundice, and histologically by systemic proliferation of malignant histiocytes and hemophagocytosis. The prognosis is poor and often the diagnosis is not made before death. Because of the rarity of this disease, it is unusual for practitioners to diagnose it by bone marrow aspiration [BMA] alone