frequency of osteoporosis and osteopenia in the paitents with beta thalassemia major and correlation of biochemical markers with bone densitometry results in these patients in Sanandaj

Background and Aim: Beta thalassemia is one of the most common single gene disorders in the world which occurs due to a defect in the beta globin chain synthesis

In general, the majority of the patients with thalassemia, are suffering from decreased bone density

Osteoporosis is characterized by low bone mass and disorder of osteogenesis resulting in reduced bone strength Considering the serious consequences of osteoporosis, this study was performed to evaluate the prevalence of osteoporosis in the patients with beta thalassemia major

Materials and Methods: This study included 46 beta thalassemia patients above 5 years of age who had been admitted to the oncology ward of Besat Hospital in Sanandaj. Chemical biomarkers were measured and the results of densitometry of the lumbar spine and femoral head were investigated for the presence of osteoporosis, osteopenia and normal findings. Using SPSS 20 software, we used one-way analysis of variance to assess the association between chemical biomarkers

Results: The mean [SD] age was 19.8 [7.7] years, 24 patients [52.2%] were women and 32 [69.6%] were above 15 years of age. In this study, the most frequent findings of densitometry were osteoporosis [34.8%] and normal lumbar spine [34.8%]

Comparison between the chemical biomarkers and foldings of the densitometry of the femoral head revealed different levels of ferritin in these patients [P = 0.011]. This difference was observed in the patients who had osteoporosis and normal densitometry results [P = 0.009]

Conclusion: The results of this study showed no significant statistical relationship between chemical biomarkers and the densitometry results. Therefore, use of bisphosphonate is recommended for prevention of bone damage

Effect of neoprene dynamic orthosis on improvement of walking ability among children with spastic diplegic cerebral palsy

Improving the ability to walk is often a key target for the treatment of abnormal gait in children with spastic diplegic cerebral palsy [CP]. One of the goals of orthotic rehabilitation is to improve walking in this field. The aims of this study was to design and manufacture the dynamic neoprene orthoses and evaluate its impact on the gait parameters in children with cerebral palsy. This quasi-experimental study was done on 12 children with spastic CP at University of Social Welfare and Rehabilitation, in Tehran, Iran during 2010-11. Initially neoprene dynamic orthosis is designed specifithy for each subject, this neoprene dynamic orthosis was used for six weeks and 6-8 hrs daily. For evaluating the walking speed and the gait variation, 10 meter walking test and visual analogue scale have been used. Modified Ashworth's Scale and electro-goniometre were used to assess muscle spasticity and the flexion degrees of knee joint. Data were analyzed using SPSS-16, Kolmogorov-Smirnov and Paired t-tests. The alteration of knee flexion angle, walking speed and walking distance following dynamic orthosis were -18.31 +/- 4.61 [degree], 0.50 +/- 1.82 [meter] and 4.18 +/- 1.51, respectively. The improvement in knee joint angle and walking following dynamic orthosis was significant [P<0.05], but the walking speed was not significant. This study showed that neoprene dynamic orthosis can improve knee flexion angle and walking distance among children with spastic diplegic cerebral palsy

Prevalence of substance abuse in medical students of Kurdistan University

Substance abuse is one of the most prevalent problems in young adults. The aim of this study was to assess the prevalence rate of substance abuse among Kurdistan university students. This was a cross sectional and descriptive analytic study. The sampling method was census and sample size included all students of Kurdistan University [1186 student] in 2007. The data were collected and recorded in a questionnaire for each subject. Data were introduced into SPSS software and analyzed by mean of Chi Square test. The results of this study indicated the percentage of students who reported usage of substance one or more times in their lives as following: alcohol 17.1, cannabis 4.7%, opium 4.8%, heroin 0.7%, ecstasy 2.7, and other substances 5.2. Ongoing abuse of different substances was assessed as following: alcohol 1.1%, cannabis 0.1%, opium 0.1%, heroin 0.1%, ecstasy 0.1%, other substances 0.2. There was a correlation between substance abuse and male gender [p<0.001], age [p<0.001], living with friends [p<0.001], and being medical student [p<0.01]. There was no correlation between substance abuse and marriage and father education. All substances, except for opium, had been offered to the medical students for the first time by their friends. Curiosity was the most common motivation for cannabis and opium use and pleasure was the most common reason for alcohol, heroin and ecstasy use. The mean age of first use for different substances was 18.6, 18.3, 19.5, 20.3, and 20.2 years for alcohol, opium, heroin, ecstasy, and cannabis. Substance use among Kurdistan university students was similar to other universities of Iran. Although substance abuse by female students was much lower than male ones in Kurdistan University, it was higher in comparison to the results of studies in other universities

Prevalence of sub-clinical vitamin A deficiency in 2-5-year-old children in Tehran

To determine vitamin A status using conjunctival impression cytology [CIC] in children aged 2- 5 years, we assessed 1257 randomly selected children in urban and rural areas of Tehran. History of using supplemental vitamin A, respiratory or diarrhoeal infection in the previous 6 months, residential location, parents' education, family economic status, and child's age, sex and weight were recorded. Sub- clinical vitamin A deficiency [defined as abnormal CIC] was found in 23.6% of the sample, a rate classified as a moderate public health problem. There was a statistically significant relationship, between sex and age and abnormal CIC [P < 0.05]

[Early nasal CPAP treatment in premature neonates with respiratory distress syndrome]

Respiratory distress syndrome [RDS] is a major cause of mortality among premature neonates. The present study was conducted to find out whether early nasal CPAP therapy could eliminate the need for mechanical ventilation in premature neonates with RDS. For this clinical trial, premature neonates with RDS during the first 6 hours following the delivery were assigned in either case or control group. Case group received early treatment with nasal CPAP, however, standard treatments were applied for controls based on arterial blood gas analysis. Totally, 25 cases and 22 controls with the mean gestational age of 31.3 +/- 2.6 weeks and weight of 1621 +/- 540 gr. Totally, 68% of controls versus 40.9% of cases died [p=0.06]. However, 80% of controls and 36.4% of cases required mechanical ventilation [p=0.006] that lasted averagely 2.9 +/- 2.6 days for controls and 0.68 +/- 1.3 days for cases [p=0.0009]. Surfactant was injected in 48% of controls and 9.1% of cases [p=0.009]. Finally, pneumothorax occurrence, oxygen therapy, and duration of hospitalization in NICU did not significantly differ between groups. Early therapy with nasal CPAP could eliminate the need for mechanical ventilation, and surfactant in premature neonates with RDS. Thus, application of nasal CPAP in centers lack NICU and respirator is strongly suggested

Efficacy of combined xeloda/taxotere regimen in metastatic breast cancer

Taxotere and Xeloda have been previously shown to be effective in metastatic breast cancer when prescribed as a single drug; in addition, some studies have demonstrated their synergism in breast cancer. During the present study, we have used a combined Xeloda/Taxotere regimen in metastatic breast cancer patients who have never been on either drug. Twelve breast cancer patients who have been on anthracycline regimen and had at least one measurable metastatic site were included. They were put on the following regimen: Taxotere 75mg/m2 for the first day and Xeloda 1000mg/m2 twice a day for 14 days. This protocol was repeated 3 times with 3 weeks interval between each phase. Metastatic sites were reevaluated following the course of therapy. Of 12 patients, 4 have shown a complete response and 3 partial response. Myelosuppression was the most frequent drug side effect presenting in 5 patients. Combined regimen of Xeloda/Taxotere was found to be more effective than the single drug regimen. The side effects are acceptable

IVIG therapy in iso-immune hemolytic jaundice in full-term neonates

Previous studies have demonstrated the efficacy of intravenous immunoglobulin therapy [IVIG] in decreasing the severity of neonatal immune hemolytic jaundice, the need for exchange transfusion, duration of phototherapy and hospital stay. A randomized clinical trial was conducted in Taleghani Hospital in Tehran, between April 2003 and May 2004. Eighty full term infants with ABO or RH incompatibility and hyperbilirubinemia within the first 24 hours of life, were randomly assigned in two equal groups of experiment and control. A single dose of IV immunoglobulin 1g/kg was administered to 40 neonates over 4-6 hours during the first 24 hours of life along with phototherapy. 40 neonates in the control group received phototherapy alone. All patients were closely evaluated with respect to their general status, severity of jaundice, need for transfusion, and IVIG complications. T test and chi-square were used for data analysis. The IVIG-treated neonates had a smaller rise in their bilirubin levels, required significantly less phototherapy [91 hours vs. 141 hours, p=0.0001], a shorter duration of hospitalization, [p=0.0001], and fewer exchange transfusions, [p < 0.05], than those in the control group. We found no IVIG-related side effects. IVIG administration in newborns with ABO or RH hemolytic jaundice reduces the need for exchange transfusion, duration of phototherapy and hospital stay. However, further studies are required to determine the optimal dose and the frequency of infusions

Comparing immune response to hepatitis B vaccine between term and preterm infants at birth

Hepatitis B can be easily transmitted form mother to child and can be prevented via vaccination of the newborn. American Academy of Pediatrics recommends preterm infants weighing less than 2000 grams at birth and born to HBS-Ag negative mothers should have their first dose of hepatitis B vaccine moved up to 1 month of age. The aim of the present study was to assess and compare the immune response of preterm and term infants to hepatitis B vaccine. For this case-control study, 48 preterm [cases] and 49 term [controls] neonates were enrolled. The vaccine was administered at birth, 1.5 and 9 months of age. Antibodies against surface antigen [Anti-HBS] were measured at 15 months of age in all infants. Cases were 24 boys and 24 girls and controls were 26 boys and 23 girls. The mean birth weight was 1595.7 +/- 388.3 and 3238.8 +/- 511.9gr in the case and control group, respectively. Immune response to HB vaccine was protective and similar in both preterm and term groups [85.4% vs. 85.7%, respectively; NS]. There was no significant association between the type of response and the infant's birth weight or sex. However, there was a significant relation between antibody titer and mechanical ventilation and sepsis [p=0.01]. Hepatitis B vaccine is effective in most preterm infants when given at birth. Thus, there is no need to delay the timing of vaccination