Showing 27 results for Mother
Azam Sadat Hashemi, Najme Shahvazian, Asghar Zarezade, Mehrdad Shakiba, Atef Atefi,
Volume 1, Issue 1 (11-2010)
Abstract
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.
M Kargar Najafi, F Borhani, Rabari Dortaj, S Sabzevari,
Volume 1, Issue 3 (9-2011)
Abstract
Abstract Background Thalassemia is one of the most common human genetic diseases in the world and it provides many problems for patients, families and health care system. This model helped the family with sick children to empower to face disease and its complications. To reach this aim, the knowledge and attitude of patients and their families about the disease should be increased. This study was aimed at determine the effectiveness of family-centered empowerment model on the mothers’ knowledge and attitudes about thalassemia disorder. Objective To assess the effect of family-centered empowerment model on the mothers knowledge and attitudes about thalassemia disorder in children with thalassemia. Materials and methods This semi-experimental study was performed on 86 children with thalassemia that were randomly divided into two groups. A questionnaire was filled with demographic information and knowledge and attitude of the mothers about the disease. These questionnaires were tested for content validity and reliability (internal correlation). Information was given to first group and second group did not receive any more information. After intervention final evaluation was performed one and half month later. Results Data analysis showed that before intervention, the average awareness and attitude of the mothers in test group were no significantly different with control group (p>0.05). However, after performing model in the test group, this averages were significantly higher in test group than control (p<0.05). Conclusions The results of this study indicated that implementation of the family-centered empowerment model are effective on knowledge and attitudes of mothers of children with thalassemia.
Msc Kh Dehghani , Msc A Zare Rahimabadi , Msc Z Pourmovahed , Msc H Dehghani , Bs A Zarezadeh, Bs Z Namjou ,
Volume 2, Issue 2 (6-2012)
Abstract
Abstract
Introduction
Cancers are one of the most common chronic diseases in children that cause fear and anxiety in them and their families. Praying is one of the methods can be used for reducing anxiety. In this study, we examined praying effect on anxiety in mothers with children suffer from cancer.
Materials and Methods
This randomized clinical trial was done on 60 mothers divided in two groups (n=30). In first group prayer therapy was done for three weeks by mothers. In control group prayer therapy was not done. Data was collected by state anxiety spilberger test and mean anxiety was compared between two groups by analytical statistical test.
Results
The results showed that difference between mean anxiety in two groups was significant (p=0.001), and mean anxiety reduced after praying from 56.2+_13.9 to 40.9+_12.4 in case group (p=0.001).
Conclusion
The results of this study showed that praying can reduce anxiety in mothers with children suffer from cancer and could be useful for them.
Aa Hiradfar , M Banihosseinian ,
Volume 4, Issue 4 (12-2014)
Abstract
Background
Recombinant human erythropoietin (rHuEPO) treatment can increase hemoglobin levels and decrease transfusion requirements. This study aims to investigate how blood transfusion influences Hemoglobin levels in patients receiving rHuEPO for 12 weeks.
Materials and Methods
This was a case-control study of 60 patients less than 15 years with anemia and a solid tumor in any location between February 2013 and March 2014. Median age of the patients were 6.27±0.58 years (range, 0.9-14 years). The patients were randomly assigned in two groups of rHuEPO receiving group and control group. 29 Patients in rHuEPO group received 150 IU/kg/dose rHuEPO subcutaneously, 3 times a week, for 12 weeks. The number of patients received transfusion during the treatment period was compared in the preceding 12 weeks. Also, adverse events (AE) were recorded at the 4th, 8th, and 12th weeks.
Results
Mean hemoglobin levels, before and after study, in rHuEPO group were 8.85±1.01 g/dl and 9.90±0.29 g/dl, respectively (p<0.001) and in
control group were, 9.00±0.09 g/dl and 7.81±0.23 g/dl, respectively (p=0.25). Among 60 patients initially eligible the present
study, 57 (29 in rHuEPO group and 28 in control group) completed study course.There was a significant decrease in transfusion requirements in the rHuEPO receiving group (p=0.004). 5 (17.2%) patients in the rHuEPO group needed a blood transfusion, whereas 15 (53.6%) patients needed a transfusion in the control group. rHuEPO occasioned hypertension in one patient at 4th week that caused to end the treatment. All other AE were transient, which did not reoccur after the transient discontinuation of the medication (p<0.05).
Conclusions
Results showed that the rHuEPO (150 IU/kg/day, 3 times a week) was effective in increasing hemoglobin levels as well as decreasing blood transfusion requirements in children with anemia following intensive chemotherapy.
L Khojastepour , S Zareifar , M Ebrahimi ,
Volume 4, Issue 4 (12-2014)
Abstract
Background
This cross sectional study was performed to evaluate dental ages and incidence of dental anomalies in children treated for acute lymphoblastic leukemia (ALL).
Methods and materials
A total of 25 ALL patient who passed at least 2 years of chemotherapy and 25 healthy sex and age matched children were evaluated. Dental age as well as dental anomalies in shape, size, number, and structure was recorded based on their panoramic radiographies which were taken for dental purposes.
Results
The number of dental anomalies significantly increased in ALL treated children. Seven ALL cases (28%) in compression to only one (4%) in control group had at least one dental anomaly. However, there was neither statistically significant differences between the mean of dental (p=0.32) and chronologic age (p=0.12) in both groups, nor between dental age of cases and control group (p=0.62).The age at the onset of treatment as well as treatment durations has not affected dental age and the incidence of dental anomalies significantly (p<0.05).
Conclusion
Chemotherapy in children results in emergence of dental anomaly. Dental age, maturity, and development process however seems to be independent from chemotherapy.
Ms H Boroumand, Mr M Moshki, Dr A Khajavi, Dr H Hashemizadeh,
Volume 5, Issue 3 (8-2015)
Abstract
Background Satisfaction evaluation is a good way to assess hospital conditions. In Health Care System, parentscan be also as children's main supporters, thus they may act as patient's viewpoints' representatives.This study aimed to evaluate mother’s satisfaction of hospital care in hematology – oncology ward in Dr Sheikh hospital. Materials and Methods A Cross-sectional descriptive analytic study was conducted using Pediatric Family Satisfaction (PFS) questionnaire and interviewing with 164 mothers duringMarchto February2013. The obtained data were analyzed using SPSS -16 software and descriptive statistics. Results The mean age of mothers and children was31.2±5.8, and 7.95 4/66 years.The children were 64 % male and 36 % femael. A large number of mothers (%56 (describedtheir satisfaction about medical care as moderate,(%70.7) reported their satisfaction about nursing care at very high level and(36.5 %) reported satisfaction about welfare services at high level(59%)and describe overall satisfaction at very high level . The totals mean of mothers’ satisfaction ratewas 121.8 ± 10.8. The mean of medical care, nursing care, welfare services was 2.9±34.1,4.6±50 and4.8± 32.9 respectively. Conclusion Overall satisfaction with medical, nursing and welfare staff was acceptable. For more satisfaction, it is widely recommended to improve veinipuncture by nurses, Physicians should inform parents about the tests results, and finally disturbance in ward with noise should be controled.
Dr A Eghbali, Dr B Taherkhanchi, Dr B Bagheri, Dr B Sadeghi Sedeh,
Volume 6, Issue 1 (3-2016)
Abstract
Background
Oral mucositis is an adverse effect of chemotherapy. Type of chemotherapy regimen is the most important factor causing
mucositis. Oral mucositis is usually associated with transient decrease in saliva production. The goal was to study effects of
gum consumption on oral mucositis in children undergoing chemotherapy.
Materials and Methods
This randomized controlled trial was done in Amir Kabir Hospital, Arak, Iran. 130 children 5 to 15 years of age were studied.
Control group was composed of 65 children who received mucotoxic drugs. Test group was made up of 65 patients received similar drugs in addition to sugar free gums. Patients consumed 6 pieces of gums per day for 15 days. A standardized follow up form and World Health Organization (WHO) grading system for oral mucositis were used for evaluation of patients during 15 days of treatment.
Results
Severe oral mucositis occurred in 30 (46%) of 65 patients in the test group and in 26 of 65 (40%) patients in the control group.
Difference was not statistically significant (P > 0.05). Rate of mild to moderate mucoitis (grade 1 and 2) was significantly lower in patients who used gums (15 % vs. 35%, P < 0.05).
Conclusion
Our study showed that stimulation of saliva flow by chewing gum could decrease mild to moderate inflammatory injuries of the
oral mucosa during chemotherapy. However, it was not effective to subside severe mucositis.
Dr Vahid Pakpour , Mansour Ghafourifard , Ms Zahra Sadri ,
Volume 6, Issue 2 (6-2016)
Abstract
Abstract
Background: Childhood cancer as a life-threatening illness has negative consequences for both the patients and their family. The aim of this study was to examine the impact of child cancer on their mother’s quality of life and to assess the association of quality of life with resilience among mothers of children with cancer.
Materials and Methods: In this cross-sectional study, a total of 145 mothers of children with cancer participated. Data were collected by two questionnaires: (a) PedsQL™ Family Impact Module, (b) Connor-Davidson Resilience Scale. Datawere analyzed using SPSS version 13. Pearson correlation test was run for the analysis.
Results: The result showed that total scale score, HRQOL Summary score, and the Family Functioning Summary Score were 41.68±20.62, 43.10±22.40, and 45.06±24.30, respectively. The mean score of resilience among mothers of children with cancer was 86.80±19.08. There was a positive association between resilience and all dimensions of life quality (p<0.05).
Conclusion: Measuring HRQOL and resilience in a preventive strategy would help to address vulnerable mothers and to present psychosocial support for them. Designing and implementing family-oriented and parent-focused intervention strategies in health care systems are recommended for improving the quality of life of families with cancer children.
Ms Zahra Pourmovahed, Dr Behzad Roozbeh,
Volume 6, Issue 4 (11-2016)
Abstract
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.
Ms Fatemeh Pourdeghatkar, Dr Minoo Motaghi, Dr Bahram Darbandi, Dr Adel Baghersalimi,
Volume 7, Issue 2 (3-2017)
Abstract
Background: Mucositis is a complex inflammatory response of the digestive system mucous membrane and it is also one of the most common painful side effects following chemotherapy in children with carcinoma. Developing to mucositis affects the patient's life severely and can lead to long – term hospitalization.Therefore, this study was conducted to evaluate the effect of chamomile mouthwash on the prevention of oral mucositis in children with acute lymphoblastic leukemia.
Materials and Methods: This double-blinded clinical trial study was done on 31 children with acute lymphoblastic aged 6-15 who were admitted to hospital of 17 Shahrivar Rasht, Iran between 16 July and 8December 2015. Patients and their parents were instructed to resolve 15 drops of chamomile mouth wash in 10cc water, turn it one minute in the mouth, outpour it, and avoid eating for one hour. After three times tooth brushing a day, the mouth cavity of patients was evaluated one day before chemotherapy, the seventh day and fourteenth day of chemotherapy according to the criteria of world health organization. SPSS (version 11)was used in order to analyze the data and random statistical index and independent t test were run.
Results: The severity of oral mucositis on the seventh and fourteenth day after chemotherapy had no significant difference with the first day (P = 0.59). The incidence and severity of oral mucositis didn't increase 14 days after chemotherapy in comparison with the seventh day.
Conclusion: Chamomile mouthwash can be effective in preventing the incidence and severity of oral mucositis and it can be used as a suitable mouthwash in children undergoing chemotherapy.
Dr Mohammad Hossein Jarahzadeh , Dr Maryam Akhundi , Dr Shekoufah Behdad, Dr Mohammad Hossein Dehghani,
Volume 7, Issue 2 (3-2017)
Abstract
Background: Ketamine increases blood pressure and heart rate. Propofol is an anesthetic drug with 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. There have been a few studies about the effect of different concentrations of ketofol on amnesia in the children with leukemia undergoing intrathecal injection of chemotherapy drugs, so this study investigated the effect of two concentrations of ketofol (1/5 with midazolam and 1/10) on amnesia in these patients.
Materials and Methods: This randomized, double blinded study was conducted on 64 ALL children aged between 5 to 12 years old and referred to Shahid Sadoughi hospital for intrathecal chemotherapy from July 2016 up to September 2016. The patients received titrated injection of a solution containing combination of one part of ketamine and ten parts of propofol (1:10) (group I) or one part of ketamine and five parts of propofol (1: 5) with midazolam(0.5mg) (group II) to sedate at the fifth level of Ramsay Sedation Scale. Amnesia was evaluated using visual recognition of posters and recall of specific events. Drug side effects such as nausea, vomiting, hallucination, allergies, dizziness, cough, and apnea were also evaluated in the patients. Results: No significant difference between two groups was found regarding age and weight (p- value=0.625, p- value=0.830). Running Chi-square revealed no statistically different between groups in terms of posters recognition and recall of specific events. In terms of drug side effects, two groups were similar but for hallucination that was higher in group (p- value = 0.043).
Conclusion: The results showed that ketofol 1/10 is superior in comparison to ketofol 1/5 with midazolam (0.5 mg) according to less side effects and similarity in amnesia induction.
Mrs Seyedeh Zahra Shafipour, Mrs Nadia Mosayebi, Miss Fariba Asgari, Dr Zahra Atrkarroushan, Dr Ardalan Pasdaran,
Volume 7, Issue 4 (9-2017)
Abstract
Background: Phlebitisis is the inflammation of the veins that negatively affect the patient’s health status. This study was conducted to determine the effect of external use of sesame oil in prevention of chemotherapy-induced phlebitis in children with ALL.
Materials and Methods: This double-blind clinical trial was conducted on 60 patients aged 2 to 14 years old who were admitted for chemotherapeutic management to the 17th Shahrivar Hospital, Rasht, Iran, between January 2016 and January 2017.The patients were randomly divided into two groups: intervention and control. Ten drops of sesame oil in the sesame oil group and10 drops of oral liquid paraffin in the control group were given daily for 30 days. Data collection tools were run in both groups: a demographic questionnaire and the Visual Infusion Phlebitis Scale for the measurement of phlebitis. Data were analyzed using SPSS (version 23).
Results: The survival time for vein received chemotherapy in the sesame oil group was 44%.The results of the present study showed that there is statistically significant difference between the mean grade of phlebitis in both groups (p = 0.0001).The relative risk of phlebitis incidence was two times more than the sesame oil group.
Conclusion: External use of sesame oil can be effective in the prevention of chemotherapy-induced phlebitis.
Mr Mohammad Javad Forouzani-Moghaddam , Mrs Parastoo Nabian , Mrs Arefeh Gholami , Mrs Neda Dehghanbaghi, Mrs Mahdieh Azizipanah , Mrs Kimia Jokar , Mrs Fatemeh Eslami , Mrs Zahra Kargarian , Mrs Motahhareh Tamehri , Mrs Nazanin Zare , Mrs Safiehsadat Heydari, Mrs Marzieh Esmaeili-Karbasi Najafabadi , Mrs Maryam Boyerhasani , Dr Hadi Zare-Zardini , Dr Farzad Ferdowsian,
Volume 8, Issue 4 (10-2018)
Abstract
Neuroblastoma is considered as the most common solid tumor in children and it is a special types of nervious cells cancer. Neuroblastoma has high potency for metastasis to other organs such as neck, chest, abdomen, or spine. In this narrative review, we assessed prevalence, diagnosis, related factors, and treatment of neuroblastoma based on published articles from 2007 to 2017. All published articles in mentioned interval were evaluated and all required data were collected. The collected data were categorized based on determined outlines. According to our findings, neuroblastoma allocated about 10 percent of pediatric cancer to itself. Mortality rate of this cancer is 15% to20% (annualy 15 per million children aged< 9 years). The incidence of this tumor is higher at the first year of life than other years. The highest incidence is observed in children with age range of 0-5 years. This tumor has low prevalence between people aged > 18 years. Important symptoms of neuroblastoma are: fatigue, loss of appetite, fever, bone pain, blemishes of the skin, a lump in the abdomen, neck, or chest, or a painless bluish lump under the skin, weakness, and slackness. The genes involved in this disease include ALK, BARD1, ERBB2, KIF1B, LMO1, MYCN, PHOX2B, 17q gain, loss of 9p, and 3p, loss of 1p 11q. Surgery, chemotherapy (cyclophosphamide, cisplatin, vincristine, doxorubicin, uteroside, and topotecan), radiotherapy, bone marrow transplantation, and transplantation of peripheral blood stem cells are different type of treatment methods for neuroblastoma. The findings of this review also showed that the use of drug delivery system such as lipidic nanostructures, magnetic nanostructures, and other related devices can improve the treatment of neuroblastoma and reduce the side effects induced by different treatments.
Dr Ahmad Tamaddoni, Dr Morteza Alijanpour, Dr Hassan Mahmoudi , Dr Beniamin Miladi, Dr Ali Bijani , Dr Ehsan Assadollahi, Mrs Faeze Aghajanpour,
Volume 9, Issue 2 (3-2019)
Abstract
Background: Hyperglycemia is one of the most complications of corticosteroid and asparaginase during induction phase of chemotherapy in children suffering from acute lymphoblastic leukemia (ALL).
This study was carried out to evaluate the incidence of hyperglycemia and associated risk factors during chemotherapy induction phase at Amirkola Children's Hospital.
Materials and Methods: In this cross-sectional (retrospective) study, 150 children (mean age: 79.16±42.68 months) with ALL were evaluated (2000- 2011). Hyperglycemia was described as random blood glucose level more than 200mg/dl in patients less than 2 years old. In patients older than 2 years, fasting blood glucose level more than 110-125 mg/dl was considered as impaired glucose level and fasting blood glucose level more than 126 mg/dl was defined as diabetes mellitus. The data were analyzed using SPSS (version 18) and running chi square test, pearson Ccorrelation, and logistic regression. P-values less than0.05 was considered statistically significant.
Results: Out of 150 children with ALL, 21 (14%) of them had hyperglycemia, but none of them had diabetic ketoacidosis. Hyperglycemia was significantly associated with gender (P=0.014) and age. (P=0.000) which was more likely in patients older than 10 years. The incidence of hyperglycemia was also related to BMI (P=0.000). Relapse rate for ALL was 14.7%, which was not significantly associated with hyperglycemia.
Conclusion: Hyperglycemia was common and transient during induction phase of chemotherapy and it was correlated with age, sex, and weight.
Mrs Fatemeh Khademi, Dr Maryam Rassouli, Dr Leila Khanali Mojen, Dr Mehdi Heidarzadeh, Dr Azam Shirinabadi Farahani5, Dr Nasrin Borumandnia,
Volume 9, Issue 3 (6-2019)
Abstract
Background: Attention to the family care provider needs and their caring power is essential. Since mothers are considered as the child’s main care provider, this study aimed to determine the caring power and its predictors among mothers of children with cancer.
Materials and Methods: In this descriptive-correlational study, 196 mothers who had a child with cancer were selected through purposive sampling. The data were collected using two questionnaires, namely demographics questionnaire and the care power of the care providers of cancer patient questionnaire. The data were analyzed using SPSS 19 and running descriptive statistics and regression analysis.
Results: The highest average score belonged to dimensions of “effective role play” (44.62 ± 5.28) and “trust” (14 ± 1.67), and the lowest ones respectively belonged to dimensions of “fatigue and resignation” (22.38 ± 6.33), “awareness” (8.46 ± 2.70), and “uncertainty” (12.38 ± 3.50). In addition, variables of educational level (p <0.001), adequacy of family income (p <0.001), and duration of illness (p0.29) were found as predictors of caring power.
Conclusion: The results of this study showed that the caring power of mothers with a child with cancer is favorable. High trust and effective role-play reduced fatigue and resignation of mothers, and low awareness about the provision of care caused uncertainty affecting negatively the care power. In addition, the adequacy of family income, the high level of mother's education, and the reduction in the duration of the disease had a direct impact on care power.
Dr Morteza Mousavi_hasanzadeh, Dr Arefeh Adelnia, Dr Golrokh Farokhmehr, Dr Sarvenaz Mehrabi, Dr Siam Zahedi , Dr Aigin Eghbali, Dr Aziz Eghbali,
Volume 10, Issue 1 (1-2020)
Abstract
Background: Nausea and vomiting are the common side-effects of chemotherapy in children with malignancy. In this study, the effectiveness of vitamin B6 in reducing the chemo-induced nausea and vomiting (CINV) in children was tested.
Material and methods: A triple-blind clinical trials was performed on 100 children with malignancy referring to the pediatric clinic of Amir Kabir Hospital, Arak, Iran. Besides the infusion of granisetron (3mg/3ml) half an hour before each chemotherapy cycle, an intravenous dose of vitamin B6 (100 mg for children from 2 to 5 years old, 200 mg for children from 5 to 10 years old, and 300 mg for children older than 10) was given 6 hours before the first chemotherapy cycle and placebo was injected (2-5 years old: 100 mg, 5-10 years old: 200 mg, age≥ 10 years old: 300mg) 6 hours before the second cycle. Then the severity of nausea and the frequency of vomiting episodes in each cycle were recorded to be compared.
Results: The mean age of children was 7.98 ± 3.133 years old. The most common and rare malignancy were acute lymphocytic leukemia (ALL) (46%) and ependymoma (0.5%), respectively. Vincristin was the most commonly used chemotherapy agent (28%). A positive correlation between the severity of nausea(R=0.313, P-value=0.0016) and frequency of vomiting with age was found (R=0.319, P-value=0.0012). However, no noticeable association was observed between N/V and gender (P-value.0.05). There was a considerable correlation between the frequency of vomiting and different tumor types in this study (P-value=0.0006).In comparison with placebo, Vitamin B6 significantly reduced the severity of nausea (P = 0.0001) as well as the frequency of vomiting (P-value = 0.0005). It was also more effective in ALL compared to rhabdomyosarcoma (P-value=0.001).
Conclusion: This study suggested that vitamin B6 can be considered as an appropriate alternative to treat CINV in children with malignancy.
Dr Alireza Moafi , Dr Hanieh Basirkazeruni, Dr Nahid Reisi , Dr Moein Dehbashi , Dr Leila Ghanbarinia , Dr Alireza Merrikhi ,
Volume 10, Issue 4 (10-2020)
Abstract
Background: Acute kidney injury (AKI) is defined as a failure in renal function leading to insufficiency of fluid and electrolyte homeostasis. Thus, sensitive biomarkers of renal tubular injury are needed to detect AKI earlier. In this study, urinary beta 2-microglobulin (β2-MG) and urinary N-acetyl-β-D-glucosaminidase (NAG) were evaluated for AKI prognosis/diagnosis in pediatric patients suffering different cancers prescribed with Ifosfamide, Ifosfamide plus Carboplatin, and Ifosfamide plus Cisplatin.
Materials and Methods: In this prospective study done in Isfahan, Iran, urinary β2-MG, urinary NAG, blood urea nitrogen (BUN), and serum and urinary creatinine (Cr) were measured in 40 pediatric cancer patients less than 16 years old in three age groups during 61 courses of chemotherapy on day 0, three and six after the treatment.
Results: Using ANOVA and t-test, the mean levels of urinary β2-MG (p= 0.001), urinary β2-MG/Cr (p= 0.003) and urinary NAG/Cr (p= 0.001), before and on day six of the treatment were statistically significant (p< 0.05). Also, the mean levels of BUN (p= 0.01), urinary β2-MG (p= 0.001), β2-MG/Cr (p= 0.001) and NAG/Cr (p= 0.004) based on the gender groups, the mean levels of urinary NAG (p=0.001), NAG/Cr (p= 0.001) and β2-MG/Cr (p= 0.008) based on three age groups, and the mean levels of serum Cr (p= 0.047), urinary β2-MG (p= 0.005), β2-MG/Cr (p= 0.032) and NAG/Cr (p= 0.032) based on the Ifosfamide dosage were statistically significant during the time of the treatment.
Conclusion: Urinary β2-MG, urinary β2-MG/Cr, and urinary NAG/Cr are more significant biomarkers than serum Cr in earlier diagnosis and treatment of AKI in cancer patients. However, urinary NAG should be further studied to prove its reliability for AKI prognosis/diagnosis. It is suggested that urinary NAG can be used along with other renal biomarkers such as urinary β2-MG, kidney injury molecule-1(KIM-1), or interleukin-18 (IL-18) for AKI prognosis/diagnosis.
Dr Reza Kazemi, Dr Shirin Saberianpour, Dr Hanieh Salehi, Dr Mohammad Hatampour, Dr Elnaz Sheikhpour ,
Volume 11, Issue 2 (3-2021)
Abstract
Acute Kidney Injury (AKI) occurs if the kidneys suddenly lose their ability to remove waste products. When the kidneys lose their ability to filter, dangerous levels of waste products can accumulate, which can upset the chemical composition of the blood and urine. Chemotherapy is one of the methods used to treat or temporarily reduce cancer by using certain medications. The main task of this treatment is to kill cancer cells without seriously damaging the surrounding tissues. However, this type of treatment also has destructive effects on healthy cells and tissues in the body. Researchers studying cancer patients undergoing chemotherapy found that people undergoing this type of treatment may develop serious kidney problems and be forced to use treatments such as dialysis and kidney transplants. Research showed that people with more severe cancers and advanced tumors are more likely to have acute kidney injury than those with early-stage cancer. AKI biomarkers can be selected from the patient's serum, urine, or body imaging components. Various studies showed that urine is a source of the best markers in AKI. Biomarkers in plasma and urine, such as N-acetyl-β-glucosaminidase, Cystatin-C, β2-microglobulin , Cysteine-Rich Protein, Osteopontin, Fetuin-A, Kidney Injury Molecule-1, Liver-type fatty acid-binding protein, Netrin-1, Neutrophil gelatinase-associated lipocalin, and interleukin-18 are effective tools for early detection of AKI. In this review study, an attempt was made to collect biomarkers related to AKI disease.
Mr Kazem Ghaffari, Dr Simin Sarlak, Dr Abdorahim Absalan, Dr Roghayeh Rahimi Afzal, Dr Aygin Eghbali, Dr Aziz Eghbali,
Volume 12, Issue 1 (1-2022)
Abstract
Backgrounds: Epigenetic regulation such as DNA methylation plays a major role in chromatin organization Background: Chemotherapy suppresses immunoglobulin production as a result of cell toxicity. Decreased immunoglobulin levels can result in the onset of opportunistic infections. The aim of the current study is to compare the immunoglobulin G (IgG) levels of the selected vaccine-preventable disease (VPD) before and six months after chemotherapy in a group of Iranian children with malignancies.
Materials and Methods: In this interventional study, serum levels of Rubella, Diphtheria toxin, Hepatitis B virus (HBV), Tetanus Toxoid, Mumps, and Measles IgG were measured in 30 children with malignancy and previously vaccinated for these diseases. Six months after chemotherapy, serum IgG levels were reassessed and compared with their corresponding pre-chemotherapy levels.
Results: In this study, 17 (56.7%) male and 13 (43.3%) female were included. The mean age was 7.69±3.09 years. After chemotherapy, Rubella IgG levels dropped from 73.88±85.11 to 56.59±72.84 IU/mL (P<0.05; r= 0.956; 33.4% become serum negative (SN)). Diphtheria toxin IgG was diminished from 0.683±0.454 to 0.174±0.248 IU/mL (P<0.05; r=0.601; 26.7% SN). Anti-HBV IgG showed a reduction from 46.26±101.56 to 25.56±80.49 IU/mL (p<0.05; r= 0.524; 60% SN) and Anti-Tetanus Toxoid IgG fell down from 1.031±0.582 to 0.321±0.408 IU/mL (p<0.05; r= 0.365; 33.4% SN). Anti-Measles and Anti-Mumps IgGs showed no significant change (p>0.05).
Conclusion: Pediatric chemotherapy was associated with dropped serum IgG levels of most VPDs. A good correlation was also observed between serum levels of IgG before and six months after chemotherapy. Revaccination of children with malignancies may be necessary upon declined serum IgG titers.
Dr Abbas Heydari, Dr Zahra Sadat Manzari, Dr Elahe Ghayebie,
Volume 13, Issue 1 (1-2023)
Abstract
Background: In 40-80% of children undergoing chemotherapy, oral mucositis is an acute complication which imposes significant financial and physical burdens on patients. In this article, a systematic review of published studies is conducted to investigate the role of nursing intervention in reducing oral mucositis.
Materials and methods: This systematic review investigated, critically appraised, and rated the evidence on nursing intervention to manage oral mucositis (OM) in children undergoing chemotherapy. The review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist in 2018. A search was conducted through the literature using international databases (e.g., PubMed, Scopus, the Cochrane Database of Systematic Reviews and the Web of Science). Only English-language trials published from January 2007 to December 2019 were selected to consider. There were eleven studies relevant enough to review.
Results: A total of 127 articles were extracted in an electronic search. The excluded studies were combined research works on adults and children, descriptive studies, observational studies, and those about adults’ endurance of chemotherapy, mucositis produced by other cancer treatments, and cohorts. Finally, eleven studies were deemed eligible for inclusion in this review. Based on them, honey, olive oil, ice chips and chewing gum have been used to prevent, reduce and treat chemotherapy-induced mucositis.
Conclusion: This review made a comprehensive examination of the available treatment options for nursing. Nurses can use one of the treatments depending on the child's conditions.