Parathyroid hormone in pediatric patients with b-thalassemia major and its relation to bone mineral density; a case control study

Background: Thalassemia syndromes are heterogeneous groups of inherited anemias. Its treatment depends on recurrent blood transfusion with a problem of iron overload, which leads to multiple endocrinopathies including hypoparathyroid. The aim of the study is to estimate the level of serum parathyroid hormone and its relation to bone mineral density in transfusion dependent beta-thalassemia major children

Subjects and methods: We measured serum calcium, phosphorus and parathyroid hormone in a sample of pediatric patients with thalassemia, compared them with age and sex matched healthy control. Measurement of bone mineral density by dual-energy X-ray absorptiometry was done in 2 sites: lumbar spine [L2-L4] in the anteroposterior position and left femur neck using Lunar Densitometry in osteoporosis Unit Ain Shams University Hospital for thalassemia patients

Results: Thalassemic patients had significantly higher alkaline phosphatase and lower bone mineral density

Conclusion: Osteopenia in b-thalassemia major patients is multifactorial and is mainly predisposed by defective function of the parathyroid gland and excessive iron deposition

Assessment of executive functions in chronic hepatitis c virus infected patients

Chronic infection with HCV is one of the most important causes of chronic liver disease, which can progress to cirrhosis and hepatocellular carcinoma [HCC]. It is well established that advanced forms of the disease .are accompanied by overt and global cognitive deficits [hepatic encephalopathy] but now there is a growing evidence that the alterations in cerebral function in patients with chronic HCV infection may appear long before the development of severe liver cirrhosis, it has been hypothesized that it is related to a direct effect of HCV on the brain; or the neurotoxic effect of HCV-related systemic inflammation. The purpose of the study was to assess the possible existence of executive dysfunction in chronic HCV infected patients without cirrhosis. case control study. 100 elderly patients aged 60 years and above, 50 patients are HCV positive [cases] and 50 patients are HCV negative [controls] both groups have no liver cirrhosis. All participants were subjected to the following: Diagnosis of HCV by detection of HCV ab using ELISA technique, non invasive assessment of liver cirrhosis using abdominal ultrasound, and evaluation of executive functions using 5 neuropsychological tests [block design, digit span backwards, animal verbal fluency, clock drawing, and EXIT 25]. The study showed that there is a significant difference between cases and controls regarding Exit 25 and Digit span backwards tests scores indicating affection of the phonological loop component of working memory among HCV positive patients. Executive functions are affected in patients with chronic HCV infection without liver cirrhosis