1 2008-8892 Shahid Sadoughi University of Medical Sciences, Yazd 270 Heart Etiologic Agents of Candidemia in Pediatric Immunocompromised Patients Kafshdooz Jabari Sahar b Chadeganipour Mostafa c Ghahri Mohammad d Mohammadi Rasoul e b Medical Mycology, Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran c Professor, Medical Mycology, Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran d Assistant professor, Medical Mycology, Department of Biology, School of Applied Sciences, Imam Hossein University, Tehran, Iran e Assistant professor, Medical Mycology, Department of Medical Parasitology and Mycology, Infectious Diseases and Tropical Medicine Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 1 11 2016 6 4 209 215 01 06 2016 27 09 2016 Abstract Background: Candidemia is the main cause of fungal nosocomial bloodstream infections and is related to meaningful mortality specially, in pediatrics. Mortality rate range from 5% to 71%, and it can reach as high as 81%. Delays in beginning of treatment have also been linked to intensified mortality. The epidemiology of Candida infection is changing from region to region. Regional surveillance of the epidemiology of candidemia is necessary to identify patients at highest risk. The aim of this study is rapid and precise detection of Candida species isolated from blood stream by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Materials and Methods: This cross sectional study was conducted during October 2013 to January 2015. Sixteen Candida strains were isolated from 36 patients with positive blood culture in Milad hospital, Resalat Lab., Tehran, Iran. All isolates were identified by PCR-RFLP patterns after digestion with the restriction enzyme HpaII. Results: Candida albicans (72.2%) and Candida glabrata (22.2%) were the most prevalent species among isolates. Male to female ratio was 9/7, ranging in age from 4-16 years. Conclusion: Candida albicans remains the most frequently isolated species in the present study; however nonalbicans Candida species are increasing. Precise identification of Candida spp. can lead to a better management of candidemia. 
271 Heart Complementary and Alternative Medicine in Pediatric Oncology Patients in South of Iran Bordbar Mohammadreza f Kamfiroozi Roza g Fakhimi Narges h Jaafari Zahra i Zarei Tahereh j Haghpanah Sezaneh k f Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran g Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran h Imam Reza Oncology Clinic, Shiraz University of Medical Sciences, Shiraz, Iran i Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran j Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran k Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 1 11 2016 6 4 216 227 23 08 2015 05 01 2016 Abstract Background: Children suffering from cancer frequently use complementary and alternative medicine (CAM). Most of people do not disclose using CAM to their physicians as they fear to be blamed or prohibited using them. Some of these products may interfere with the conventional remedies. The aim of this study was to investigate the frequency and characteristics of CAM use in pediatric oncology patients in 2 referral centers in south of Iran. Materials and Methods: In this cross-sectional study, all pediatric cancer patients (from 5 months to 18 years old) registered at two referral center (n=135) were investigated from January to July 2015 in Shiraz, southern Iran. Interview with their parents and completing the specific check list were done. Data were analyzed by SPSS v. 21 using Chi-square and Student t- test. Results: From 150 families approached, 135 (90%) completed the questionnaires. Overall, 114 (84.4%) children ever used a kind of CAM product while 92.6% sought faith healing. Concurrently, 81.1% of the CAM admitted users applied them with their conventional treatments. The most common used CAM products were Zinc (43.7%) and multivitamins (31.9%). None of the evaluated variables significantly influenced CAM use in the patients. Most of the patients (77%) introduced their physicians as the source of knowledge about CAM which was the most trusted source as well. About half of the patients (50.9%) did not inform their physicians to use these products. Conclusion: Oncologists should be aware of highly prevalent use of CAM among their patients. They should discuss with the families about the possible interactions of these products may have with chemotherapy drugs. A filled diary at regular intervals may help the physicians to monitor CAM use in their oncology patients. 276 Heart Evaluation of Efficacy of Varicella Vaccine in Pediatric Patients with Acute lymphoblastic Leukemia Ghassemi Ali l Badiee Zahra m Farhangi Hamid n Banihashem Abdolah o Syedi Seed Javad p Ghodsi Razie Mokhtari Abolghassem Attaranzadeh Armin l Associate Professor of pediatric hematology & oncology, Mashhad University of medical Sciences, Mashhad , Iran m Associate Professor of pediatric hematology & oncology, Mashhad University of medical Sciences, Mashhad , Iran n Associate Professor of pediatric hematology & oncology, Mashhad University of medical Sciences, Mashhad , Iran o Professor of pediatric hematology & oncology, Mashhad University of medical Sciences.Mashhad, Iran p Associate Professor of Pediatrics, Mashhad University of medical Science.Mashhad, Iran Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Pediatrician, Mashhad University of medical Sciences. Mashhad, Iran Fellowship & cytogentics, Mashhad University of medical Sciences, Mashhad, Iran 1 11 2016 6 4 228 234 13 01 2016 26 04 2016 Abstract Background: Varicella is a highly contagious and dangerous disease especially in immunocompromised patients. Children with cancer are at increased risk of severe illness and may fatal cases occur. Vaccination from VZV ( varicella zoster vaccine) infection can be safe, immunogenic, and effective in children with leukemia who meet the criteria and are at the risk of serious disease or death. The aim of this study was   investigate the efficacy of vaccines VZV on pediatric patients with Acute Lymphoblastic Leukemia Materials and Methods: The study was performed on 46 ALL children aged between 1to15 years old who underwent chemotherapy. Considering the efficacy of vaccines on pediatric patients the title serum sample of IgG-anti-VZV avidity was determined using a test kit before and after the injection of vaccines VZV. Results: A total of 46 patients were included analysis. Their title serum sample IgG were negative before the injection of  vaccines VZV and after receiving VZV vaccine with respect to title serum sample IgG atatus,  31 (67.4%) patients were positive and 15 (32.6%) patients were negetive. No significant was observed association between either title of IgG-anti-VZV after receiving of VZV vaccine and gender (P = 1.0) title of IgG-anti-VZV and age groups (P =0.387). Conclusion:   Regarding the obtained results, it can be concluded that varicella vaccination can have an acceptable effectiveness on pediatric patients with ALL. Varicella vaccination can be recommended for protecting these patients against VZV in order to decrease the morbidity rate caused by this infection.  272 Heart Nursing Support System for Mothers of Hospitalized Leukemic Children: A Comparative Study Pourmovahed Zahra Roozbeh Behzad Social Determinates of Health Research Center, Shahid Sadoughi University of Medical Sciences , Yazd ,Iran Department of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 1 11 2016 6 4 235 243 28 03 2016 10 07 2016 Abstract Background: In addition to child, families can be influenced traumatically by the leukemia and hospitalization. Adopting the philosophy of a family-centered care approach can maximize the well being of pediatric patients and their family. The philosophy is based on the collaboration of the family, nurses and hospital staff to plan, provide and evaluate care to establish the best plan of care for leukemic child and improve family stability as well, nurses should support the family. The current study was conducted to compare the opinions of mothers with nurses regarding the availability of nursing support for mothers of hospitalized leukemic children in a pediatric oncology ward. Materials and Methods: This comparative descriptive study was conducted on all mothers with leukemic children who were hospitalized in a pediatric oncology ward (n=89) of Shahid Sadoughi Hospital, Yazd, Iran and all nurses (n=21) in this ward during 2015. Data were collected through the NPST( Nurse-parent Support Tool) and demographic questionnairs. The obtained data were analyzed with SPSS (version 22). Results: The most important dimensions in terms of mothers' opinions were "emotional" (3.34±0.56) and "quality of care" (3.26 ±0.55) and considering nurses' opinions were "emotional" (3.22± 0.47) and "informational-communicational" (3.22± 0.43). Mann-Whitney test showed no significant differences between mothers' and nurses' opinions regarding four subscales of nursing support (p < 0.21). Conclusion: The opinions of mothers and nurses in the pediatric oncology ward did not differ regarding the availability of nursing support. However with respect to the overall mean of nursing support from mother's perspective, it is necessary to provide further support for mothers by the nurses. The results of this study may be useful for improving nursing care in oncologic wards.  273 Heart Red Cell Enzymopathies in Patients with Hemolytic Anemia in Southern Iran: Case Series Tahmasebi Leila Haghpanah Sezaneh Rezaei Narges Karimi Mehran Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 1 11 2016 6 4 244 248 13 01 2016 10 04 2016 Abstract Background: Hereditary red cell enzyme disorders are a group of Non-immune/Spherocytic Hemolytic Anemia, although these disorders are rare and they have not public health problems, the detection of these defects could help to physician in treatment and differential diagnosis. This study evaluated 5 enzymopathies in patients with Hereditary Non –immune/Spherocytic Hemolytic Anemia (HNSHA) during one year. Materials and Methods: This cross-sectional study, evaluated 5 erythrocyte enzymes in 22 patients (mean age of 10 ± 9.3) with Hereditary Non-immune/ Spherocytic Hemolytic Anemia in Southern Iran from Jan 2014- Feb 2015. Evaluated erythrocyte enzymes consisted of pyruvate kinase (PK), G6PD, Catalase, Glutathion Proxidase( GP) and Glutathion Reductase( GR), all of these enzymes checked by quantitative assay except G6PD that evaluated by qualitative activity assay. The clinical and para clinical data were gathered from patient’s documents. Results: Results showed that 2 patients were PK deficient (9.1 %), 4 patients were G6PD deficient (18.2%), 1patient was GP deficient (4.5%), 1 patient was Catalase deficient (4.5%) and there is no patient with GR deficiency. Conclusion: This study showed that enzymopathies should be into consideration in patients with non-immune hemolytic anemia, if other common causes of hemolysis such as hemoglobinopathies and membranopathies have been excluded.  274 Heart Assessment of Liver and Kidney Functional Parameters along with Oxidative Stress and Inflammatory Biomarker in Patients with β- Thalassemia Major Shanaki Mehrnoosh Ehteram Hassan Nasiri Hajar Azad Mehdi Kouhkan Fatemeh Pakzad Reza Mobarra Naser Department of medical laboratory sciences, school of allied medical sciences, shahid Beheshti University of medical sciences, Tehran, Iran Department of pathology, School of medicine, Kashan University of Medical Sciences, Kashan, Iran Hematology-Oncology and Stem cell Transplantation Research Center, Tehran university of Medical Science, Tehran, Iran Department of Medical laboratory sciences, Faculty of Allied Medicine, Qazvin University of Medical Sciences, Qazvin, Iran Department of Molecular Biology and Genetic Engineering, Stem Cell Technology Research Center, Tehran, Iran Metabolic Disorders Research Center, Department of biochemistry, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran Department of Epidemiology, Faculty of Public Health, Ilam University of Medical Sciences, Ilam, Iran7. Metabolic Disorders Research Center, Department of biochemistry, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran 1 11 2016 6 4 249 260 14 03 2016 28 06 2016 Abstract Background: Thalassemias are the most common inherited blood disorders caused by some mutations which can reduce the synthesis of globin chains. Iron overload and its organ deposition are responsible for functional abnormalities and tissue injury in patients who affected by β-thalassemia major. The aim of this case-control study was evaluation of hematological parameters, oxidative stress and some serum liver and kidney risk factors which play crucial role for early prediction and prevention of patients to end-stage tissue failure and mortality. Materials and Methods: the present study consisted of Fifty young adult subjects with β-thalassemia major (β- TM) (aged<18 years) and same number age and sex- matched healthy subjects as control group. Hematological and biochemical laboratory parameters included Urea, Creatinine, Uric Acid, Aspartate Aminotransferase (AST), Alanine transaminase (ALT), Alkaline phosphatase (ALP) (pars azmoon kit), oxidative stress biomarker PAB, giving a redox index (chemically), and serum high-sensitivity C-reactive protein (hs-CRP) were evaluated. Results: Urea, Creatinine and Uric Acid were significantly decreased in patients group (P<0.001); in spite of, serum ferritin, liver biomarkers AST, ALT, ALP and risk factor biomarker PAB were statistically increased in patients versus control group(P<0.001), whereas hs-CRP(P>0.05) was not significantly difference in study groups. Exception hs-CRP and PAB (P>0.05), liver risk factors had a positive correlation with ferritin and serum Urea, Creatinine and Uric Acid tests had negative meaningful with hematological parameters (P<0.001). Likewise, PAB with AST showed a positive correlation (P<0.001) and irreversibly with urea and creatinine (P<0.001). We did not find a slight correlation between hs-CRP in the company to hematological and biochemical laboratory finding (P>0.05). Conclusion: Higher level of risk factors PAB values and key liver enzyme profiles are able to involve in the prognostic pathological consequences in patients with β-thalassemia major. Even so, they contribute toward the gradual development of tissue injuries. 275 Heart Prevalence of Hypothyroidism, Hypoparathyroidism and theFrequency of Regular Chelation Therapy in Patients with Thalassemia Major in Iran: A Systematic Review and Meta-analysis study Azami Milad Parizad Naser Sayehmiri Kourosh Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran Nursing and midwifery faculty, Urmia University of Medical Sciences, Urmia, Iran Department of Biostatistics, Psychosocial Injuries Research Center, Ilam University of Medical Sciences، Ilam, Iran 1 11 2016 6 4 261 276 18 05 2015 28 07 2015 Abstract The present study aimed to determine the prevalence of hypothyroidism, hypoparathyroidism and the frequency of regular chelation therapy in patients with thalassemia major in Iran. Searching process was performed by two independent  researchers using valid keywords in the national and international database, including: Magiran, Iranmedex, SID, Medlib, Scopus, PubMed, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library and google scholar search engine. All studies were searched until 2016 with no time limit. All articles met inclusion criteria were evaluated and the data were analyzed by using SATA Software Ver.11.1. Twenty-seven studies about hypothyroidism (sample size of 4851, the mean age of 16.36±5.5) and 19 studies related to hypoparathyroidism (sample size of 3219, the mean age of 17.44±6.5) were examined. The prevalence of hypothyroidism was calculated 5.7% (95% CI: 4.7-6.8) in patients with thalassemia major in Iran (P=0.000; I2 index=93.9%). The prevalence of overt and subclinical hypothyroidism was estimated 3.1% (95% CI: 1-4.7) and 6.7% (95% CI: 3.3-10), respectively. The prevalence of hypoparathyroidism was calculated 10% (95% CI: 7-12) in patients with thalassemia major in Iran. In reviewing 5 studies, the frequency of regular chelation therapy was estimated 54.6% (95% CI: 28-81.2) in these patients. The prevalence of hypothyroidism and hypoparathyroidism is high in patients with thalassemia major in Iran. Thus, new planning and supervising seem to be essential to minimize endocrine complications in these patients. There is no connection between serum ferritin level and developing hypoparathyroidism. A high percent of Iranian patients with thalassemia major perform the chelation therapy irregularly. It's been recommended to adopt the necessary measures such as educating and enhancing awareness of the patients about its complications. 277 Heart 18F-FDG PET/CT Images in a Child with Cutaneous B cell Lymphoblastic Lymphoma Presented with Bone Involvement Inci Uslu Biner Tatci Ebru Ozmen Ozlem Emir Suna Kacar Dilek Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey The ministry of Health Ankara Children’s Diseases Hematology Oncology Training and Reasearch Hospital, Pediatric Oncology Unit, Ankara, Turkey The ministry of Health Ankara Children’s Diseases Hematology Oncology Training and Reasearch Hospital, Pediatric Oncology Unit, Ankara, Turkey 1 11 2016 6 4 277 280 20 06 2016 11 08 2016 Abstract B-cell lymphoblastic lymphoma (B-LBL) is an uncommon subtype of pediatric non-Hodgkin Lymphoma (NHL) which rarely involves the skin primarily. The positron emission tomography with 2-deoxy-2-[fluorine- 18] fluoro-D: -glucose integrated with computed tomography (18F-FDG PET/CT) scan findings of a 8-year-old boy with cutaneous B-LBL were presented. PET/CT scan demonstrated mild FDG uptake in the lesion located on the scalp and also multiple bone metastases with increased FDG uptakes in several areas. The importance of 18F-FDG PET/CT scan in primary staging of the patients with primary cutaneous B-LBL. due to its impact on planning of therapy via the determination of unexpected malign infiltration sites was emphasized.