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