1 2008-8892 Shahid Sadoughi University of Medical Sciences, Yazd 99 Heart Socioeconomic Status and Other Characteristics in Childhood Leukemia Boroumand H Hashemizadeh H Noori R Darabian M 1 3 2013 3 1 5 1 09 03 2013 Abstract Background Leukemia is the most prevalent childhood cancer, and Acute Lymphoblastic Leukemia (ALL) constitutes 75% of all cases. Some epidemiological studies have shown a relationship between socioeconomic status (SES) and some childhood cancers. In the present study, an attempt was made to assess socioeconomical status in a case-control study. Materials and Methods In 2010, a case-control study was conducted on 100 cases of acute lymphoblastic leukemia aged 1 to14 years in Department of Pediatric Oncology of Dr.Sheikh Hospital in Mashhad – Iran and matched age and sex with 400 healthy controls. Data was collected by interview using a questionnaire. Ninety five percent confidence intervals were used to measure the relationship between childhood Acute Lymphoblastic Leukemia and parental education, income status, father's job (Socioeconomic status), number of children, birth score and paternal smoking. Results There was a significant difference in parental education level, income status, and number of children, birth score, father's job and paternal smoking between two groups. Regression analysis showed that the risk of childhood ALL associated with paternal smoking, and father's high risk job. Fifty percent cases and thirty five percent of control groups located in upper lower and lower middle class of socioeconomic status, respectively. There is a meaningful different between socioeconomic status in two groups. But the risk of childhood ALL did not associate with socioeconomic status. Conclusion The results suggest that paternal smoking and father’s high risk job are related to risk of childhood leukemia. It should be considered for planning support.
100 Heart Effect of two Different Concentrations of Propofol and Ketamine Combinations (Ketofol) in Pediatric Patients under Lumbar Puncture or Bone Marrow Aspiration Ayatollahi V Ghadami Yazdi A Hashemi A Behdad SH Ghadami Yazdi E 1 3 2013 3 1 11 6 09 03 2013 Abstract Background Ketamine is an anesthetic drug that is importantly analgesic without respiratory depression. Ketamine increases blood pressure and heart rate. Propofol is an anesthetic drug with good sedation, rapid recovery, but it causes respiratory depression, low heart rate and low blood pressure. Combination of Ketamine and Propofol provides sedation, analgesia and rapid recovery with hemodynamic stability and minimal respiratory depression. The aim of this study was to compare two different combinations of these two drugs to reach necessary sedation scale for the Lp or BMA in pediatric with ALL. Materials and Methods This randomized, double blinded study was designed to compare the quality of sedation and side effects of intravenous Ketofol on 60 patients of both gender. Patients received titrated injection of a solution containing combination of one part of Ketamine and two parts of Propofol (1:2) (group I) or one part of Ketamine and three parts of Propofol (1:3) (group II) to reach almost near 5 sedation level (using Ramsay Sedation Scale). Respiratory and hemodynamic profiles, amount of drug injected and side effects were recorded. Results These drug combinations were used on 60 children with a median age of 6.2 years. In this study, recovery time and hallucination was significantly high in group I, but in both groups hemodynamic were stable, amnesia was enough, and there was no respiratory depression. Conclusion Lower doses of Ketamine in these combinations have lower psycho mimetic side effects, and shorter recovery time. 101 Heart Evaluation of Cardiac Function in Patients with Thalassemia Intermedia Naderi M Nouri NM Rajaie S Dorgalaleh A Tabibian Sh 1 3 2013 3 1 18 12 09 03 2013 Abstract Background Thalassemia intermedia is a variety of beta thalassemia which shows clinical symptoms somewhere between asymptomatic carriers and thalassemia major. Cardiac dysfunctions due to chronic anemia and hemosiderosis are the major causes of death in these patients. The purpose of this study is to evaluate cardiac function in these patients by echocardiography. Materials and Methods This case-control study was conducted on 22 thalassemic patients (mean: 16.5±5.8 years) and 66 healthy individuals (mean:16.07± 2.9years) as a control group from January 2007 to July 2008. There was no sign of cardiac involvement by physical examination, chest x-ray and ECG in patients. Echocardiographic parameters were measured in groups, and finally data was analyzed by SPSS software. Results The mean of left ventricular myocardial performance index (MPI) (P-value=0.0001) and left ventricular mass index (LVMI) (P-value=0.0001) have statistically significant difference. Mean of interventricular septal dimension in diastole (IVSD), left ventricular posterior wall thickness in diastole (LVPWD), interventricular septal dimension in systole (IVSS) and left ventricular posterior wall dimension in systole (LVPWS) were also statistically significant with a P-value of, 0.002, 0.001, 0.01, 0.003, respectively. Aortic Pre-ejection period/Ejection time (PEP/ET) (P-value=0.009), ejection fraction (EF) (P-value=0.019), fractional shortening (SF) (P-value=0.041), left ventricular isovolumetric contraction time (ICT) (P-value=0.0001) and left ventricular isovolumetric relaxation time (IRT) (P-value=0.0001) were statistically significant. Mean of right ventricular MPI (P-value=0.0001) and IRT (P-value=0.0001) were also significantly different between two groups. Others echocardiographic parameters were not statistically significant (P-value>0.05). Conclusion Heart failures are earlier affected thalassemia intermedia patients compared with control group. 102 Heart Iron Deficiency and Iron Deficiency Anemia in Children with Febrile Seizure Akhavan Karbasi S Fallah R Tirandazi B Golestan M 1 3 2013 3 1 23 19 09 03 2013 Abstract Background Febrile seizure (FS) is the most common childhood seizures which occur in 2-5% of children. Studies about association between iron deficiency and febrile seizure have shown contradictory results. The purpose of this study was to compare the iron status of children with first febrile seizure and healthy control group. Materials and Methods In an analytic case-control study , iron status of 6 to 60 months old admitted children with first FS to Shahid Sadoughi Hospital from December 2011 to August 2012 was evaluated and compared with healthy age and sex matched control children whom were referred for routine health care to primary health care center of Azadshar Yazd, Iran. Results Forty five (44%) girls and 55 boys with a mean age of 23.7 ± 14.3 months were evaluated. In children with FS , hemoglobin level (11.46 ± 1.18 g/dl vs. 11.9 ± 0.89 g/dl, p= 0.042) , serum iron levels (48.91 ± 22.96 μg/dl vs. 75.13 ± 35.57 μg/dl , p= 0.001) and serum ferritin level (38.52 ± 11.38 ng/ml vs. 54.32 ± 13.46 ng/ml, p= 0.001) were lower than in healthy children group . Iron deficiency (48% vs. 28% , odds ratio 4.3, p=0.03) and iron deficiency anemia (22% vs. 10% , odds ratio = 3.16, p= 0.04) were more frequent in children with FS. Conclusion Based on the result of this study, iron deficiency could be an important risk factor for development of febrile convulsion. Evaluation of iron status is encouraged to be performed in children with febrile seizure. 103 Heart Thrombocytopenia and Associated Factors in Neonates Admitted to NICU during Years 2010_2011 Eslami Z Lookzadeh M.H Mohammad Pour N Noorishadkam M Hashemi A Ghilian R PirDehghan A 1 3 2013 3 1 28 24 09 03 2013 15 03 2013 Abstract Background Thrombocytopenia is the most common hematological abnormality which is encountered in the neonatal intensive care unit (NICU). The incidence in neonates varies greatly, depending upon the population studies. According to the frequency of thrombocytopenia and its complications and because of lack of such research in Iran, this study was performed on neonates admitted to Shahid Sadughi NICU during years 2011-2012. Materials and Methods In a retrospective study, 350 neonates who were admitted to NICU were enrolled in the study. They were categorized to three groups regarding platelet count: mild, moderate and severe thrombocytopenia. Incidence of thrombocytopenia was determined and contribution of variables such as sex, gestational age, intrauterine growth retardation, asphyxia, sepsis, necrotizing enterocolitis, blood group, placental insufficiency in Gestational Diabetes Mellitus (GDM) and hypertension (HTN) were analyzed. Results Neonatal thrombocytopenia was found in 100(28.5%) of 350 subjects, consisted of 75.3% early onset and 24.7% late onset, which most of them (96.5%) had mild and moderate thrombocytopenia, and just 3.5% had developed severe thrombocytopenia. Thrombocytopenia was associated with sepsis, intrauterine growth retardation sepsis, asphyxia, GDM, maternal hypertension and prematurity. There was no relation between occurrence of thrombocytopenia and gender. Conclusion The incidence of neonatal thrombocytopenia was 28.5 %. Significant maternal risk factors that lead to thrombocytopenia were HTN and preeclampsia, while risk factors of neonates were asphyxia, sepsis and Intera Uterus Growth Retardation. Key words Thrombocytopenia Intensive Care Units, Neonatal Incidence 104 Heart Premarital Screening of Beta Thalassemia Minor in north-east of Iran Hashemizadeh H Noori R 1 3 2013 3 1 34 29 09 03 2013 Abstract Background Beta thalassemia is a preventable disease. Iran has about 20,000Patients who are homozygote for β-thalassaemia and 3,750,000 carriers. The aim of this study was to determine the prevalence of beta thalassemia minor among men who underwent premarital screening in Quchana city in Khorasan Razavi region of Iran Materials and Methods This research is a descriptive cross-sectional study. From 2010 to 2011, all participants (1000) under marriage coming to health center of Quchan underwent routine mandatory tests. Participants were considered to have beta-thalassemia minor on the condition that hey had a mean corpuscular volume (MCV) <80fl and a mean corpuscular hemoglobin (MCH) 3.5%. Venous blood was taken into an EDTA tube and the complete blood count and red blood cell indices were measured with a Coulter automated cell counter. Electrophoresis was performed on cellulose acetate. Results Mean and SD of hemoglobin, MCV and MCH were 16±2.9, 91±4 and 28.4±2, respectively. Hemoglobin A2 Higher than 3.5 percent was reported as 3.5%.The prevalence of beta-thassemia minor with high hemoglobin A2 and microcytic hypochromic anemia was 3.5% (P-value). Conclusion In countries with high prevalence of hemoglobinopathies, a premarital screening program is helpful for identification and prevention of high-risk marriages. Detecting carrier couples with premarital screening program is an effective way of controlling thalassemia major. 105 Heart Crude Extract from Ziziphus Jujuba Fruits, a Weapon against Pediatric Infectious Disease Daneshmand F Zare-Zardini H Tolueinia B Hasani Z Ghanbari T 1 3 2013 3 1 40 35 09 03 2013 Abstract Background Pediatric infectious disease is one of the main problems in cancerous children that treat by chemotherapy drugs. Thus, study in this regard is necessary. The aim of this study was to evaluate antimicrobial properties of ethanolic extract of Ziziphus Jujuba fruits against different infectious pathogens. Materials and Methods This study is descriptive. In vitro antimicrobial activity of extract was assessed on gram negative and gram positive bacteria as well as fungi. The antimicrobial activity was tested by Radial Diffusion Assay (RDA) and Minimal Inhibitory Concentration (MIC) methods. Results The results showed a wide antimicrobial activity of the extract against the microbes studied. Escherichia coli was the most susceptible to the extracts among tested microorganisms for which the MIC was 0.65±0.22 mg/ml. Amongst the bacterial strains investigated, Staphylococcus aureus was the most resistant strain with MIC of 2.26±0.68 mg/ml. The ethanolic extract also showed antimicrobial activity on the fungi studied as no growth was observed in 2.35±0.38 and 2.86±0.7 mg/ml concentration for Candida albicans and Aspergillus fumigatus, respectively. The results of qualitive and quantitative test are well indicative of the extract effective activity against the microbes mentioned. Conclusion Confirming the potential antimicrobial activities of crude extract of Ziziphus Jujuba fruits, this study suggested that ethanolic extracts of this plant is appropriate candidate for treatment of microbial infections, especially pediatric infectious diseases. 106 Heart Homozygous delta-beta Thalassemia in a Child: a Rare Cause of Elevated Fetal Hemoglobin Gupta R Verma S Bhargava M Mittal SK 1 3 2013 3 1 46 41 09 03 2013 Abstract Background Delta beta (δβ) thalassemia is an unusual variant of thalassemia with elevated level of fetal hemoglobin (HbF). Homozygous patients of this disorder, unlike β-thalassemia, show mild anemia. Only few cases of δβ-thalassemia have been reported from India in the available indexed English literature. Case presentation A four-year old male child was evaluated for recent-onset jaundice. Hematological investigations showed mild anemia with microcytic hypochromic red cells. A comprehensive analysis of hemoglobin by high-performance liquid chromatography (HPLC) showed complete absence of HbA and HbA2 with HbF constituting 100% of the hemoglobin. Hemoglobin analysis of both parents showed elevated level of HbF with normal HbA2. A final diagnosis of δβ-thalassemia in the child with both parents being carriers was rendered. Conclusion Delta beta-thalassemia is an uncommon cause of markedly elevated fetal hemoglobin beyond fetal period. Clinical and haematological parameters should be evaluated to render an accurate diagnosis.