Validity and reliability assessment of the Persian version of therapy-related symptom checklist

Therapy-related symptom checklist for children [TRSC-C] was developed as a symptom assessment tool in children receiving chemotherapy. The objective of the present study was to evaluate the validity and reliability of the Persian version of TRSC-C. This cross-sectional study was conducted in 2013-2014 in Tehran, Iran. TRSC-C was translated using backward-forward approach. The content validity, face validity, and comprehensiveness were investigated based on the opinion of experts. The item content validity index [I-CVI] and scale content validity index [S-CVI] were calculated by the mean approach and inter-rater agreement. The scale was revised based on the comments from a team of five experts, after which it was evaluated by an additional group of four experts. To assess the inter-rater reliability, two raters filled the scale with 29 and 30 patients in the outpatient clinic of Hazrat-e Ali Asghar Hospital. The Cronbach's alpha was calculated and factor analysis was performed. The scores of content validity were analyzed in Excel. Other statistical analyses were performed using the SPSS software version 20.0. Based on the initial assessment, the S-CVI with less conservative approach was 60% for clarity, 33% for relevancy, and 60% for simplicity. After revising the scale, the S-CVI reached 100%. The comprehensiveness and face validity of the scale were appropriate. The scale was inter-rater reliable and the Cronbach's alpha was 0.803. Eleven subscales were found in the TRSC-C. It is concluded that the Persian TRSC-C is a valid and reliable tool for measuring children symptoms. Availability of a valid and reliable checklist is a fundamental step in monitoring the symptoms of patients while receiving chemotherapy

Rhabdomyosarcoma with skin metastasis: report of a case

Rhabdomyosarcomas are the most common soft tissue sarcoma in adult and children that accompany with skeletal muscle differentiation. Skin metastasis of rhabdomyosarcomas is unusual and has only been sporadically reported in literature. In this paper we present a case of skin metastasis of rhabdomyosarcoma in an 8-year-old girl that has treated with chemotherapy

Results of treatment with 2-chlorodeoxyadenosine [2-CDA] in multiple reactivations or refractory langerhans cell histiocytosis

Langerhans cell histiocytosis [LCH] is the most common type of histiocytosis and characterized by abnormal proliferation and excess accumulation of inflammatory and langerhans cells at various tissue sites. Clinical manifestations are variable, ranging from spontaneously regressing single bone lesion to multisystem disease, life-threatening and refractory to treatment. Conventional chemotherapy has been shown to be effective in treatment of majority of patients with LCH. However, treatment of refractory disease or multiple reactivations is difficult. The aim of this study is to assess the efficacy of 2-CDA in relapsed or refractory LCH. Four patients with relapsed or refractory LCH that were treated with 2-chlorodeoxyadenosin [2-CDA] enrolled in this study. All patients had received at least one prior chemotherapy regimen. The dose and schedule of 2-CDA was 6 mg/m[2]/day for 5 days every 3-4 weeks. Median age at the time of treatment with 2-CDA was 9.7 years. Three patients had multisystem disease and one had multifocal bone lesions. All patients had multifocal bone lesions. None of them had risk organ involvement. Mean course of treatment with 2-CDA was 9.5. Radiologic evaluations revealed complete resolution of bone lesions in two [50%] patients. In one [25%] patient lesions regressed [partial response] and in another [25%] the disease remained stable. Drug related side effects were minimal. At the present time all patients are alive. Our study demonstrates that 2-CDA as a single agent is efficacious in treatment of multiple reactivations or refractory LCH and well-tolerated in children

Visceral Leishmaniasis without Fever in an 11-Month-Old Infant: a Rare Clinical Feature of Kala-azar

Visceral leishmaniasis or kala-azar is an endemic parasitic disease in some parts of the world which is characterized by fever, splenomegaly, and pancytopenia in most of the cases. Herein we report an 11 month-old male infant with diagnosis of kala-azar who presented with pallor, hepatosplenomegaly, failure to gain weight, and no history of fever. Surprisingly, fever started after beginning of meglumine antimoniate treatment in this patient. As far as we are aware of, this is a rare presentation of visceral leishmaniasis. Therefore, clinicians especially in endemic areas are highly recommended to include kala-azar among differential diagnosis of unexplained anemia without fever to prevent misdiagnosis of this potentially fatal, but treatable condition.

Incidence of hepatocellular carcinoma in patients with thalassemia who had hepatitis C

Hepatitis is the infections of a common cause disease among poly transfused patients. Hepatitis C is slowed progression and inducing HCC. This study assessed HCC incidences, the role of iron and possible antitumor activity of chelators in 170 thalassemia patients using deferoxamine [DFO] therapy. They are diagnosed with Hepatitis C due to positive PCR-RNA. They are Treated with IFN. The follow up program including tests every 3 Months and PCR-RNA, AFP and liver US every 6 months. Whenever there was suspicion of liver malignancy, Biopsy was performed. From the total of 170 patients, 59.4% were male, and 40.6% were female. Mean age of thalassemia diagnosis was 2.69 +/- 5.403 [1-41] years and mean Age of hepatitis diagnosis was 17.37 +/- 7.263 [3-51] years. 92.4% of Patient's MT, 0.6% SS, 2.9% TI. the viral genome was Ia3a. 73.5% of patients had first course of therapy. The frequency of AFP greater than 10 was 5.9%. And the incidence of HCC was 0.6% [1/170] with a 95% confidence interval. The main risk factor for HCC was HCV infection in TM patients, but it was iron activity in TI patients. Iron chelation with DFO appeared to play a Protective role

effectiveness of group hope therapy on hope and depression of mothers with children suffering from cancer in Tehran

Researches mainly focus on patients who suffer from cancer. Families and parents have been neglected in these researches although they experience levels of stress, depression and anxiety. This research aims at studying the effectiveness of Hope Therapy based on group therapy on hope and depression of mothers with children suffering from cancer in Aliasghar Children's Hospital, Tehran [2010]. In this applied and semi-experimental research, 20 mothers were selected based on Snyder Hope Scale and Beck Depression Inventory [pre-test]. They were randomly assigned into two groups of experimental and control. Intervention based on Hope Therapy protocol was executed on the experimental group for eight weeks [eight sessions, each lasted for 2 hours]. Afterwards, posttest was performed for both groups. After eight weeks, the experimental group completed questionnaires and the follow up phase. Results demonstrated that Hope Therapy increases hope [p<0.05], and decreases depression in mothers of children with cancer [p<0.001]. Covariance analysis indicated that Hope Therapy significantly decreases depression and increases hope of mothers whose children suffer from cancer. Follow up results showed no significant changes in hope of this group of mothers in the two months after post-test, but depression was decreased significantly during this period. It was concluded that effectiveness of Hope Therapy may be continued during the follow up phase.

[Auditory brainstem responses in children treated with cisplatin]

In view of improvement in therapeutic outcome of cancer treatment in children resulting in increased survival rates and the importance of hearing in speech and language development, this research project was intended to assess the effects of cisplatin group on hearing ability in children aged 6 months to 12 years. In this cross-sectional study, hearing of 10 children on cisplatin group medication for cancer who met the inclusion criteria was examined by recording auditory brainstem responses [ABR] using the three stimulants of click and 4 and 8 kHz tone bursts. All children were examined twice: before drug administration and within 72 hours after receiving the last dose. Then the results were compared with each other. There was a significant difference between hearing thresholds before and after drug administration [p<0.05]. Right and left ear threshold comparison revealed no significant difference. Ototoxic effects of cisplatin group were confirmed in this study. Insignificant difference observed in comparing right and left ear hearing thresholds could be due to small sample size. auditory brainstem responses test especially with frequency specificity proved to be a useful method in assessing cisplatin ototoxicity