OTHERS_CITABLE
Lung Lesions Biopsy in Children by Computed Tomography (CT) Fluoroscopy Guided Versus Conventional CT Scan Guided
Abstract
Background
Computed tomography (CT)-guided biopsy of the lung is a well-established method of diagnosis. The aim of this study was to determine the success rate of fluoroscopic CT (FCT) and conventional CT (CCT) in needle navigation biopsies from the lung lesions.
Materials and Methods
A total of 78 patients were prospectively enrolled to receive CT-guided biopsy with (group I, n=23) or without (group II, n=55) fluoroscopic guidance. The mean age was 13.5, and the outcome measurements and complication rate of procedure were successful.
Results
The success rate was increased in the FCT group (87%) as compared with that of CCT group (80%, p=0.012). The complications (pneumothorax and bleeding) were not significantly different between the two groups (0 versus 8 cases, p=0.097).
Conclusion
The obtained results revealed that the FCT facilitates the CT-guided biopsy procedures, and it reduced the complications by allowing real-time visualization of the needle tip from skin entrance to the target point.
http://ijpho.ssu.ac.ir/article-1-76-en.pdf
2012-09-15
88
93
Tomography; Spiral Computed
Biopsy; Needle
lung; complications
R
Nafisi-Moghadam
1
AUTHOR
B
Shishesaz
2
AUTHOR
K
Ashrafi
3
AUTHOR
OTHERS_CITABLE
Effect of 1/25 (OH)2-Vitamine D on Bone Mineral Density in Childhood Acute Leukemia
Abstract
Background
Bone mineral density (BMD) may have occurred following treatment of Acute lymphoblastic Leukemia (ALL). 25-hydroxyvitamin D has been insufficiency described in these patients. In this Randomized Control Trial (RCT), we assessed the effectiveness of oral vitamin D administration after one year of treatment to protect bone density.
Materials and Methods
Twenty-four survivors of ALL patients (17 males and 7 females), who had completed their treatment with oral vitamin D supplement, at least 1 yr previously, and Twenty-five (20 males and 5 females) control group were examined with dual energy x-ray absorptiometry of the total body and L2–L4 vertebrae and neck of femur.
Result
Average of BMD (g/cm2) was significantly increased in oral vitamin D supplemented children (p=0.038) but average of Z-score decreased (p=0.006). Osteoporosis in this group was 4.2% and in control group, 40.9%.
Conclusion
Oral vitamin D supplementation to ALL children during 1 year did not show impact on Z-score and BMD (g/cm2). On the other hand, osteoporosis decreased in this group.
http://ijpho.ssu.ac.ir/article-1-77-en.pdf
2012-09-15
94
98
Leukemia
Vitamin D
Bone Density
Z
Namjou
1
AUTHOR
R
Ghilian
2
AUTHOR
A
Hashemi
3
AUTHOR
F
Vojdanifard
4
AUTHOR
F
Bakhshi
5
AUTHOR
Kh
Dehghani
6
AUTHOR
OTHERS_CITABLE
Study of the Association between Congenital Heart Defects and Neuroblastoma in Abdominal Sonography
Abstract
Background
A higher prevalence of congenital heart defects (CHD) in neuroblastoma patients in general population is reported in some publications, however, some authors did not find such an association. The evidence for this relation comes from the observation that, the neural crest cells accompany to the development of the heart and neuroblastoma as well.
Materials and Methods
We prospectively investigated this relation for the first time, in a cohort of 114 patients with CHD. Echocardiographic evaluations were made as two-dimensional morphological examination and the patients with CHD were evaluated with through physical examination, especially for the stigmata of neuroblastoma, telecardiogram and abdominal ultrasonography.
Results
In a period of 6 months, 114 children were diagnosed as CHD. Ventricular septal defect (VSD), atrial septal defect (ASD), pulmonary stenosis (PS) and tetrology of Fallot (TOF) were the most common diagnoses. We did not find any evidence for the association between CHD and neuroblastoma.
Conclusion
The possible association between the two entities was generally investigated by retrospective evaluation of echocardiographic studies in neuroblastoma patients. However, according to our preliminary results the presence of CHD is not a predilection for neuroblastoma. Detailed laboratory and radiological studies for neuroblastoma are not necessary in patients with CHD.
http://ijpho.ssu.ac.ir/article-1-78-en.pdf
2012-09-15
99
102
Heart Defects
Congenital; Neuroblastoma;Child
S
Küpeli
1
AUTHOR
B
Aldudak
2
AUTHOR
A
Baran
3
AUTHOR
OTHERS_CITABLE
Combined Therapy with Deferiprone and Desferrioxamine as Compared to Desferasirox on Ventricular Function in Thalassemia Major Patients
Abstract
Background
Myocardial iron overload is the leading cause of death in patients with beta-thalassemia major. Combined therapy with deferiprone(DFP) and desferrioxamine (DFO)were suggested to be more effective than deferasirox(DFX) for removing heart iron. Deferasirox has recently been made available, but its long-term efficacy on cardiac function has not yet been established. Our study aimed to compare the effectiveness of deferiprone and desferrioxamine with deferasiroxon ventricular function in thalassemia major patients.
Materials and Methods
In this clinical trial study,72 thalassemia major (TM) patients were randomised to receive either deferiprone combined with desferrioxamine and deferasirox ,and thencardiac functions were evaluated. Data were analysed for left ventricular ejection fractions(LVEF)at baselinebyechocardiograpy, following 12 months of treatment.
Results
72 TM patientswere enrolled in this study lasting 12 months, 36 TMwere placed on DFP/DFO (DFP,50–86 mg/kg body weight DFO, 24–52 mg/kg body weigh), 36 received DFX (range 18–40 mg/kg body weight). In 36 patients receiving combined therapy, left ventricular ejection fraction increased from 59.3+/-5.7% to 63.7+/-5.1% (p=0.001) over 12 months [baseline LVEF values 56-61%]. Deferasirox showed no change in LVEF (p = 0.93).We found improvement of left ventricular ejection fractionsin the deferiprone combined with desferrioxamine versus the deferasirox group (P = 0.008).
Conclusion
The patients treated with combined therapy with deferiprone and desferrioxamine showed better systolic ventricular function compared to the patients treated with deferasirox. The patients treated with combined therapy with deferiprone and desferrioxamine showed better systolic ventricular function compared to the patients treated with deferasirox.
http://ijpho.ssu.ac.ir/article-1-79-en.pdf
2012-09-15
103
108
beta- thalassemia
deferiprone
deferasirox
N
Shahvazian
1
AUTHOR
A
Hashemi
2
AUTHOR
MH
Farahzadi
3
AUTHOR
NH
Sartipzade
4
AUTHOR
OTHERS_CITABLE
Association between MTHFR 1298A>C Polymorphism with RSA and IVF Failure
Abstract
Background
Polymorphism A1298C of the methylenetetrahydrofolate-reductase (MTHFR) gene has been implicated in spontaneous abortion. In this study, we determined the allele and genotype frequencies of this polymorphism in recurrent spontaneous abortion (RSA) and implantation failure after in vitro fertilization (IVF).
Materials and Methods
We performed a case–control study on 60 women with RSA and 72 women with implantation failure after IVF (both of the groups have a problem in embryo implantation, so each other compare to the health group) and 60 fertile women to investigate the association between MTHFR A1298G, and pregnancy loss by polymerase chain reaction restriction fragment length polymorphism (PCR-RLFP) technique.
Results
Among the RSA patients 29 (72.5%) were heterozygote and 7 (17.5%) of them were homozygote for MTHFR mutation. In addition, 46 (63.9%) of IVF failure patients were heterozygote and the frequency of homozygote was 17 (23.6%). While in the control group 28 (56.0%) were heterozygote but none of them were homozygote. So the mutation rate of MTHFR in patients with abortion was statistically different from that in controls. Also significant difference was found in the frequencies of MTHFR between the patients and IVF failure group (p <0.001).
Conclusion
Our study revealed that the genotypes of MTHFR A1298C were significantly associated with increased risk of implantation failure of abortion and IVF failure.
http://ijpho.ssu.ac.ir/article-1-80-en.pdf
2012-09-15
109
115
Methylenetetrahydrofolate Reductase
Polymorphism; Genetic
Abortion; Spontaneous
Fertilization in Vitro
MH
Sheikhha
1
AUTHOR
SM
Kalantar
2
AUTHOR
N
Ghasemi
3
AUTHOR
S
Soleimanian
4
AUTHOR
OTHERS_CITABLE
Analgesic Effect of Regular Breathing Exercises with the Aim of Distraction during Venipuncture in School-aged Thalassemic Children
Abstract
Background
Pain is described as the fifth vital sign, and inadequate pain management is linked to numerous immediate and long-term negative outcomes. Venipuncture is one of the most painful medical procedures in children. Distraction is one of the main effective ways to relieve pain. Reducing patients’ pain sensation maybe feeling is important for all nurses for many reasons. Unnecessary pain can damage the nurse-patient relationship, whereas the knowledge of alternative techniques can improve patient care and satisfaction.
Materials and Methods
Forty patients (6–12 years) suffering from thalassemia and requiring venipuncture were randomized into distraction group (n=20, regular breathing exercise) and control group (n=20, without any intervention). The pediatric pain behavioral symptoms and Numeric Pain Rating Scale were used to assess pain caused by venipuncture.
Results
The mean of pain score based on the numerical scale was 5.60 ± 3.13 in the control group and 1.85±1.42 in breathing exercises and the mean score of behavioral pain symptoms was 3.80±2.80 in the control group and 0.96±0.75 in breathing exercise group. Results showed a significant difference between the mean of pain scores (based on numeric scale and pain behavior scale). (p≤0.001)
Conclusion
Distraction demonstrated to be effective in reducing pain. This intervention requires minimum effort and time and may be a cost-effective and convenient nursing intervention that could be used easily in clinical settings.
http://ijpho.ssu.ac.ir/article-1-81-en.pdf
2012-09-15
116
122
Pain
Thalassemia
Breathing Exercises
Child
S
Bagheriyan
1
AUTHOR
F
Borhani
2
AUTHOR
A
Abbaszadeh
3
AUTHOR
S
Miri
4
AUTHOR
M
Mohsenpour
5
AUTHOR
N
Zafarnia
6
AUTHOR
OTHERS_CITABLE
Assessment of Hypothyroidism in Children with Beta-Thalassemia Major in North Eastern Iran
Abstract
Background
Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major.
Materials and Methods
This research is a descriptive – cross sectional study, carried out in 2009 to assess thyroid function in 100 patients with beta thalassemia major at the ages between 2-18 years. The study was carried out retrospectively and 100 medical records from 400 samples of thalassemia major patients, under regular care of Sarvar Clinic, were assessed. Thyroid function and iron load status were evaluated by measuring the serum total triiodothyronine (T4), thyroid-stimulating hormone (TSH) and ferritin levels from the serum of patients, admitted to the Sarvar Clinic. TSH and T4 concentrations were estimated by enzyme-linked immunosorbent assay (ELISA). Primary hypothyroidism was defined by a TSH level >4µIU/ml. Results were analyzed by descriptive statistical methods, with the help of SPSS software.
Results
Subclinical hypothyroidism was seen in 7% patients. All of them had normal T4 levels with elevated TSH levels, consistent with a diagnosis of subclinical hypothyroidism. Mean age of hypothyroid patients was 10.2 ± 2.5 years. Frequency of hypothyroidism was associated with increased serum ferritin levels (p=0.037).
Conclusion
Subclinical hypothyroidism occurs in a significant proportion of thalassaemia major patients in the absence of obvious clinical signs of hypothyroidism. Regular follow-up for early detection and timely treatment of such complications could improve the quality of life of these patients.
http://ijpho.ssu.ac.ir/article-1-82-en.pdf
2012-09-15
123
127
Hypothyroidism
beta-thalassemia
Epidemiology
H
Hashemizadeh
1
AUTHOR
R
Noori
2
AUTHOR
OTHERS_CITABLE
Unilateral Ptosis as Initial Manifestation of Acute Myeloid Leukemia
Abstract
Background
In Acute Myeloid Leukemia (AML), malignant clones of immature myeloid cells (primarily blasts) proliferate, replace bone marrow, circulate in blood and invade other tissues. The unique presentation of unilateral ptosis and unilateral eyelid swelling in AML has been reported during the present study.
Case Report
A 7-year-old girl was encountered with progressively increasing unilateral right eyelid swelling and ipsilateral ptosis. There was no systemic manifestation of leukemia. Computed tomographic image reported right orbit anteromedial mass.
A high total leucocytic count in cell blood count with low platelet, the bone marrow aspirate and biopsy showing leukemic blast cells confirmed the diagnosis of AML. After diagnosis, an orbital MRI was done, which revealed a mass lesion antromedial of right orbit related to soft-tissue tumor. The patient was treated by chemotherapeutic drugs associated with intravenous steroids.
Conclusion
Unilateral ptosis and eyelid swelling is an initial manifestation of AML that has not been reported previously. A peripheral blood smear with bone marrow aspirate and biopsy helps in the early detection of AML. We should consider AML in any orbital mass with unknown origin.
http://ijpho.ssu.ac.ir/article-1-83-en.pdf
2012-09-15
128
132
Leukemia
Orbital Neoplasm
Blepharoptosis
M R
Besharati
1
AUTHOR
T
Rezaee
2
AUTHOR
A
Hashemi
3
AUTHOR
S
Taghipour Zahir
4
AUTHOR