Iranian Journal of Pediatric Hematology Oncology
Year:2014 | Volume:4 | Issue:2|Papers Count:8

Cancer diagnosis among children can cause high stress and anxiety in parents, and they may lose their life expectancy. The present study investigated the effectiveness of Logo therapy on anxiety and depression among mothers of children with cancer.Materials and Methods: This study was conducted by a semi-pilot method using pre-test and post-test with a control experimental group. Therapy sessions were held during 9 sessions of Logo therapy training for 90 minutes. The participants of this study were selected among 30 mothers of children with cancer and using sampling method in Yazd hospitals. The participants divided randomly into two groups: experimental and control. Participants in both experimental and control group completed questionnaires on Beck Anxiety Inventory and Beck Depression Inventory before and after training.Results: The results showed that the index of depression and anxiety in control and experimental groups are 32.3, 6.63, 7.4 and 6.75, respectively. So, the level among the experimental group has been decreased after intervention of Logotherapy training and a significant difference occurred in the pre-posttest stages. The results showed that Logo Therapy has a significant effect in reducing anxiety and depression among mothers of children with cancer (p<0.05).Conclusion: Regarding the efficiency of this approach to reduce anxiety and depression among mothers, this treatment is recommended to be practiced beside other cancer therapies, so they can practice the treatment process with a better mood and mentality.

We aimed to investigate the frequency of celiac disease in children with b-thalassemia major (B-TM) in Shiraz, southern Iran.Materials and Methods: In this study, the prevalence of celiac disease in children with B-TM was evaluated. Children with B-TM were screened for celiac disease by ant-tissue transglutaminase (anti-tTG) IgA antibody, IgA level and anti-tTG IgG. A total of 1500 school healthy children in Shiraz with age/sex matched were selected as control group.Results: A total of 215 B-TM patients with mean age of 12.7±4.4 years, were included into the study (52.1% was male). None of the patients were positive for anti-tTG IgA. Eight cases were IgA deficient in whom anti-tTG IgG was investigated but none of them were positive for anti-tTG IgG. The finding in control group has a seroprevalence of 2% and biopsy proven disease of 0.6%.Conclusion: Many patients with thalassemia major have multiple nonspecific symptoms that are not justifiable with underlying disease and might be due to atypical celiac disease. We didn't find any case of celiac disease among more than 200 children with β-thalassemia major in Shiraz, southern Iran. So it seems reasonable to screen only those who have features, even not classical, of celiac disease.

Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is one of the prevalent disorders in Guilan province, northern Iran, causing many patients to suffer from acute hemolysis. This disease has imposed tremendous costs both on patients and Health systems. The aim of this study was to compare the direct costs of favism treatment on patients and health system with G6PD enzyme screening test.Materials and Methods: In this descriptive prospective study, the medical and hospital costs of acute hemolysis due to G6PD deficiency were calculated and compared with the expenses of screening newly born infants for this disorder in Rasht. Data was collected by a questionnaire.Student’s t-Test and chi-squared test were recruited and data was analyzed using SPSS ver. 20.Results: In this study, 101 hospitalized patients with favism (72 male and 29 female) admitted from October 2011 to the end of September 2012 were included. The average cost of treatment for these patients was approximately 726000000 Rials (for each patient 7190000 Rials), which was about half of the cost of screening for all newborn infants in Rasht during this period.Conclusion: The cost of G6PD enzyme screening in Rasht is substantially lower than the cost of treating hospitalized patients with Favism.

With modern medical management, thalassemia major is now extending into adulthood and it is expected to have a negative impact on the quality of life (QOL) of the patients. The aim of this study was to evaluate quality of life in patients with thalassemia major.Materials and Methods: This is an analytic case control study. Two hundred and fifty patients and 51 participants as controls were assessed using WHOQOL-BREF (Farsi version) questionnaire. All questions were answered based on the self-evaluated status in the past 2 weeks before enrollment and were rated on a five-point Likert scale. Therefore, the raw item score ranged from 1 to 5 and scaled in a positive direction and 6 dimensions including overall QOL, overall health, physical, psychological, social, and environmental relationship were assessed.Results: Results showed that the QOL in all 6 dimensions was lower in patients compared to the controls (P<0.05).Also age, higher education level, lower ferritin level and using oral iron chelator were associated with better QOL scores. On the other hand, cardiac disease, hepatitis C and history of psychiatric disorders were associated with impaired QOL scores.Conclusion: These findings were important for future refinement of national thalassemia program. So, we recommended regular screening for psychiatric disorders and facilitated access to oral iron chelators. Regular monitoring and treatment of complications especially cardiac disease and hepatitis along with strict quality control of blood products were also mandatory. Also, higher education of the patients may improve quality of life.

Patients with beta thalassemia suffer from increased susceptibility to infections and putridity plays a major role in the patient's morbidity and mortality. The risk of transfusion-transmitted viral infection is well known in these patients. However, there is dearth of information about the seroprevalence of herpes simplex virus (HSV) infection in patients with beta thalassemia in literature. This study analyzes the prevalence of anti-HSV1, 2 IgG antibodies in patients with beta thalassemia in a major tertiary care hospital located in Yazd,Iran.Material and methods: In this case control study, we undertook a serological study of HSV1,2 IgG antibodies  among 45 patients  with beta thalassemia and  45  healthy individuals as  control group by ELISA method. A p.value<0.05 was considered statistically significant. Statistical analyses were performed using SPSS.20.Results: The prevalence of HSV 1,2 IgG antibodies were estimated 88.8% among patients  with beta thalassemia and 77.7% in control group. Regarding p.value=0.64, it showed no significant difference in these two groups.Conclusion: Although infectious diseases still represent a major challenge in patients with beta thalassemia, HSV past infection rate was not increased in these patients in our study. More studies are required to clarify this matter.

Patients with thalassemia major and intermedia are susceptible to osteopenia and osteoporosis. The mechanism of osteoporosis in these patients is multifactorial. Transfusion related iron overload in endocrine organs leads to impaired growth hormone secretion, diabetes mellitus, hypothyroidism, hypoparathyroidism, lack of sex steroids and vitamin D deficiency that contribute to impairment in achieving an adequate bone mass .The aim of this study was assessment of frequency of bone loss in patients with thalassemia major and intermedia in Urmia City of West Azerbaijan, IranMaterials and Methods: In this cross sectional descriptive study,10 patients (lower than 18 y/o)with transfusion dependent thalassemia attending to Motahari and Emam Khomeini hospitals in Urmia city of Iran were enrolled and scanned for Bone Mineral Density (BMD) starting at around 10 years old.Results: Tenatients (6 male and 4 female) with transfusion dependent thalassemia (β-thalassemia major and intermedia) aged 13 to 17 years in Urmia city of Iran were enrolled. Mean age of patients was 15.1±37year old. Among them, 8 patients (80%) had low BMD and2 of them (20%) had normal BMD in lumbar spine. Only 30% of patients had low BMD in the neck of femur.Conclusion: We should perform annual BMD in patients with thalassemia major and intermedia and hemoglobin H disease in age of higher than 8 year old and treat low BMD with administration of bisphosphonate, calcium and vitamin D supplements. Medical consultation with a rheumatologist and /or an endocrinologist should be performed in these patients. Changing lifestyle with mild daily exercise, adequate calcium containing foods, avoiding heavy activities, stop smoking, iron chelation therapy in adequate dosage, early diagnosis and treatment of endocrine insufficiency and regular blood transfusions can help to achieve an optimal bone density in these patients.

Blood is a liquid tissue in which dissolved with abundant chemical factors and millions of different cells The reduction of unwanted side effects, especially diseases that emerge through blood such as HIV and hepatitis, has a significant role for modern medicine of transfusion and transplantation. The issues and costs of human blood collection and storage, direct this procedure towards the use of alternatives blood. Two important research fields of this area were oxygen carriers based on hemoglobin and perfluoro chemicals. While they do not have the same quality as the blood cell products, the oxygen carrier solutions have potential clinical and non-clinical applications.The result showed that these products can reach to the body tissues easier than normal red blood cells, and can control the oxygen directly. The final aim of transfusion is to establish a transfusion system with no side effects, and the fact that oxygen carrier artificial blood has this property. The article attempts to step towards solving some problems of blood transfusion through describing the properties of artificial blood alternatives.

Autoimmune hemolytic anemia is a hematologic disorder that is rarely observed in infants and young children. Most of the cases are associated with viral or bacterial infections. In some cases, AIHA can be characterized by a chronic course and an unsatisfactory control of hemolysis, thus requiring prolonged immunosuppressive therapy.Case report: Especially in children younger than 2 years of age, the clinical course of the disease may show either resistance to steroids or dependence on high-dose steroids. We report here an infant fatal autoimmune Conclusion: This case suggests that investigation for the presence of CMV infection in infantile AIHA should be considered. Severe hemolysis is rare but could be a potentially life-threatening complication of CMV infection described mostly in immune compromised adults and children.