ABSTRACT
Background and Aim: In recent decades, the survival rates of the children with cancer have improved significantly and their five-year survival rates have reached 80 percent, but there are still many concerns about the survival of adolescents and young people
Methods and Materials: In this retrospective study, the data of 310 children and adults with leukemia in Kurdistan Province were extracted from their medical records. Univariate and multivariate survival analysis were performed through calculating hazard ratios using Cox relative risk model. Data analysis was carried out using Stata 12 software
Results: This study included 201 adults with mean age of 50.8 years and 109 children with mean age of 5.2 years. The frequency of AML was higher in the adults [30.8 percent], while the frequency of ALL cases was higher in the children [86.2 percent]. The respective one-year and five-year survival rates, were 94.4 percent and 49.5 percent in the adults, and 92.6 percent and 83 percent in the children. The hazard ratios [HR] were 5.18 [95 percent CI: 2.60-13] in the adults with ALL and 4.11 [95 percent CI: 1.55-10.4] in the adults with AML, and 2.78 [95 percent CI: 1.05-7.37] in the patients with CML. Based on the results of multivariate analysis, the rate of mortality in children with ALL was lower [HR=0.26, 95 percent CI: 0.08-0.77]
Conclusion: Timely diagnosis and provision of treatment services for the patients are recommended. Considering the high rate of survival in the patients with ALL especially in children, we recommend provision of appropriate treatment facilities and palliative care services, similar to those in other countries, for the patients with different types of leukemia with high rates of mortality
ABSTRACT
We studied the safety of a trivalent inactivated surface antigen [split virion, inactivated] influenza vaccine, Begrivac[registered sign] [Novartis Company], widely used in health care workers in Kurdistan. A longitudinal follow-up study was performed in Sanandaj city, west of Iran, recruiting 936 people. A questionnaire was completed for each participant, and all symptoms or abnormal physical findings were recorded. In part 1 of the study, the post-vaccination complaints were headache [5.3%], fever [7.9%], weakness [9.6%], chills [10.1%], sweating [10.5%], arthralgia [20.2%], and malaise [21.5%]. Swelling of the injection site was seen in 267 [30.3%] participants, and pruritus of the injection site was seen in 290 [32.9%] participants. Redness and induration were also reported in 42.5% of the participants. Local reactions were mainly mild and lasted for 1-2 days. No systemic reactions were reported in the second part of the study. None of the participants experienced any inconvenience. We concluded that local adverse reactions after the trivalent inactivated split influenza vaccine, Begrivac[registered sign], in health care workers were far more common than expected. Continuous surveillance is needed to assess the potential risks and benefits of newly produced influenza vaccines
ABSTRACT
Objective: The surveillance of acute flaccid paralysis [AFP] is a key strategy for monitoring the progress of poliomyelitis eradication and is a sensitive measure for detecting potential cases of poliomyelitis and poliovirus infection. This study was conducted to describe the characteristics of patients reported with AFP, and to evaluate the performance of the surveillance system in Kurdistan province, western Iran, using indicators recommended by the World Health Organization [WHO]
Methods: This observational study was conducted from January 2000 to December 2010 at the Kurdistan Center for Disease Control and the Department of Pediatrics. All children who fulfilled the WHO definition for AFP were included in our study. The stool samples of all the children were sent for poliovirus isolation. All the patients were evaluated for 60 days after the onset of symptoms to identify the signs of residual weakness
Findings: One-hundred thirty nine children aged <15 years were reported to the Center for Diseases Control with AFP. In 138 [99%] stool samples no poliovirus was isolated. None of the patients was diagnosed as having acute poliomyelitis or polio-compatible paralysis. Guillain-Barre syndrome was the most frequent final diagnosis [79 cases] followed by Transverse Myelitis [7 cases] and Encephalitis [6 cases]. By detecting 1.3 to 3.6 [mean 3.2] AFP cases per 100 000 population in Kurdistan during the study period, we achieved the WHO target for AFP surveillance. All performance indicators but one consistently met the WHO requirements and therefore demonstrated the effectiveness of the AFP surveillance program in Kurdistan
Conclusion: The effective surveillance system in Kurdistan and its evaluation may serve as a model for the surveillance of other infectious diseases
ABSTRACT
In developing countries, Helicobacter pylori infection is mainly acquired during childhood and may be a predisposing factor for peptic ulcer or gastric cancer later in life. Noninvasive diagnostic tools are particularly useful in children for screening tests and epidemiological studies. We aimed to determine the prevalence of H. pylori infection among Kurdish children in Sanandaj, West Iran. We used a Helicobacter Pylori Stool Antigen [HpSA] test to detect H. pylori infection. A questionnaire was used to collect data about age, sex, duration of breastfeeding, and family size. A total of 458 children aged 4 months to 15 years were enrolled in this study. The mean age of enrolled children was 5.6 +/- 5.4 years. Stool samples were positive for H. pylori in 294 [64.2%] children. The prevalence of H. pylori infection increased with age [P<0.001]. We found a significant increase in the infection rate as the family size grew [P=0.005]. There was no correlation between a positive H. pylori status and gender [P=0.6] or the duration of breastfeeding [P=0.8]. It seems that the prevalence of H. pylori infection is very high in children in Sanandaj. It begins at early infancy [before 4[th] month of age] and cumulatively increases with age