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Abstract Objective The incidence of childhood cancer has been increasing nearly one percent per year for the past two decades. Leukemia and lymphoma are the most common types of childhood cancers. This study assessed the relation between environmental factors (Hydrocarbon, agricultural toxin, insecticide) and leukemia/lymphoma in children, which was evaluated by the frequency of the parents’ hazardous occupations, and their smoking, drug addiction, and alcoholism habits. Methods This was a case-control study on 86 children with leukemia and non-Hodgkin's lymphoma and 188 healthy controls from March 2007 till March 2010. They were matched in age and sex. Information was gathered via a questionnaire and analyzed by SPSS 15. Result There were 32 (37.2%) girls and 54 (62.8%) boys in the case group and the majority were 3-5 years old. In case group fathers’ occupations were mostly farmers 50 (58.1%), followed by painter or exposed to hydrocarbons 14 (16.6%), but in the control group, farmers were 17 (19.7%), and painters or those exposed to hydrocarbons were 5 (5.8%). The frequency of fathers' various occupations was significantly different between cases and controls. In addition, smoking, drug addiction and alcoholism was significantly higher in cases fathers than controls fathers. Conclusion The frequency of leukemia and non-Hodgkin's lymphoma in children whose father were painters, exposed to hydrocarbons and farmers are higher than normal children. So people with these occupations should pay more attention and should be protected against these risk factors. The history of addiction and alcoholism was higher in their father.

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Abstract Background Tumor Lysis Syndrome (TLS) is an oncologic emergency that results from massive lysis of malignant cells. The incidence of TLS depends on the risk factors, such as baseline hyperuricemia, bulky tumor burden, elevated serum LDH, and elevated WBC. The objectives of the present study were to assess frequency of Tumor Lysis Syndrom in children with ALL in two methods of induction chemotherapy, aggressive and slow induction. Materials and Methods In this double blind randomized interventional study, the number of 60 ALL patients in the Shahid Sadoughi Hospital Yazd were studied. They randomly treated using two various methods 30 patients by invasive and 30 by slow induction chemotherapy. Results From 60 patients, 10 cases (16.6%) developed Tumor lysis syndrome. Seven of 10 treated by aggressive chemotherapy and remaining 3 by slow chemotherapy. No significant differences were found (PV= 0.166) between them. Conclusion Based on this study there was no significant difference between Tumor Lysis Syndrom in aggressive induction chemotherapy and slow induction, but WBC and LDH levels before treatment can predict Tumor Lysis Syndrom.

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Abstract Background Patients who are to receive chemotherapy require careful assessment of liver function prior to treatment to determine which drugs may not be appropriate, and which drug doses should be modified. Following therapy abnormalities of liver function tests may be due to the therapy rather than to progressive disease, and this distinction is of critical importance. Toxicity such as hepatotoxicity could be reduced by L-Carnitine (L.C) with out affecting its anti-cancer therapeutic efficacy. The objectives of the present study were to assess the role of L-Carnitine by evaluating the liver functions. Materials and Methods We performed randomized, double-blind, placebo-controlled study, the number of 64 ALL patients were enrolled in our study. Patients was randomly divided into two groups (each group 32 patients), and using double-blind administration, group A was treated with L-Carnitine and group B with placebo for 90 days. Results We observed differences in serum AST level 3,7,30 days after chemotherapy (p=0.006, p<0.001, p= 0.001), serum ALT level 7,30 days after chemotherapy (p=0.009, p<0.001), serum ALK-P level after 30,90 days after chemotherapy (p<0.001), Prothrombin time 3,7,30 days after chemotherapy (p=0.017, p=0.010, p=0.012).No significant differences were observed in Alb and GGT in either group of patients treated with L-Carnitin or placebo. Conclusion The benefits of L-Carnitine in comparison with placebo are demonstrated in reduction serum AST, ALT, ALK-P and PT but not in Alb and GGT. These issues deserved to evaluate the value of L-Carnitine in ALL patients.

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Abstract Arterial ischemic stroke defines as a new focal neurologic deficit that lasted 24 hours or longer. Stroke is relatively rare in children and incidence of cerebrovascular disease is 1 per 4000 in neonates and 1 per 7000 to 1 per 70000 in older children (1 month to 18 years). Protein S deficiency is one of the causes of the stroke in children. Major manifestations of protein S deficiency are deep venous thrombosis, superficial thrombophlebitis, and pulmonary emboli. The pathogenesis of vascular occlusion in patients with protein S deficiency is unknown. The prevalence of protein S deficiency is between 1% to 7% for first episode of deep venous thrombosis. We present a case of the 6-year-old boy with a history of tonic clonic sizure within a period of 3 years. He subsequently developed acute aphasia and right hemiparesis. Brain magnetic resonance imaging revealed lacunar infarction. Laboratory finding showed that low level of total protein S. The patient was treated with intravenous heparin and patient completely improved. There are no evidence based strategies for the treatment of children with prothrombotic abnormality (because of the lack of research on this subject). How ever this patient completely improved and discharged with oral anticoagulant.

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Abstract Background Leukemia is the most prevalent childhood cancer and Acute Lymphoblastic Leukemia (ALL) constitutes 75% of all cases. The most frequent presenting symptoms are fever, weight loss and pallor. Early detection of clinical symptoms positively affects timely diagnosis. The objectives of the present study were to assess frequency of presenting symptoms, laboratory data, immune phenotypes and prognostic factors in children with diagnosis of ALL. Materials and Methods We performed a prospective follow-up study of 100 patients aged 1-16 years diagnosed with ALL, admitted to Shahid Sadoughi hospital pediatrics ward from March 2006 to February 2010. Demographic and biochemical data were obtained from their medical record. Data were analyzed using SAS 9.1.3 software. Results The mean of patients’ ages was 9 years. Complete blood cell count was abnormal in all of the patients, and pancytopenia was detected in 27% of the patients. Of all the patients, 25% had abnormal white blood cell (WBC) count at presentation, 37% had leucopenia and 38% had leukocytosis. WBC count was above 50,000/mm³ in 22% of cases. Anemia was detected in 85% of the patients. There was no significant sex difference, but a significant age difference existed among patients (p < .05). According to flowcytometry results, 61% of patients had T-cell and 39% had B-cell immune phenotype. The frequency of undesirable prognostic factors was more in T-cell than the B-cell group, but this difference was only significant for male patients (p<0.05). The most common presenting symptoms were systemic symptoms, which comprised of lethargy and malaise in 81%, anorexia in 72%, pallor in 69% and fever in 59% of cases. Musculoskeletal system was the most common system involved. Conclusion In our study, T-cell immune phenotypes comprised the most frequent form of ALL in children. The presence of male sex and high WBC count could make its outcome worse. However, on time chemotherapy could alter the outcome of these patients.

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Background 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.

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