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Papers by ADEL BAGHERSALIMI

Iranian journal of pediatric hematology and oncology, Mar 30, 2022

Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patie... more Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patients with Thalassemia Major (TM). Materials and Methods: This analytic cross-sectional study was conducted in17 Shahrivar children's hospital, Rasht, Iran, from November 2017 to November 2018. The inclusion criteria were indicated as the presence of TM in patients aged 12-19 years old with records of their regular visits. The exclusion criteria were noted as the presence of any chronic bone diseases such as osteomalacia or osteogenesis imperfecta, delayed puberty, hypothyroidism, parathyroid dysfunction, renal failure, liver failure, and growth hormone deficiency. Ferritin level was assessed, and bone densitometry was performed for all patients with TM. Results: In this study, 53 females (54.6%) and 44 males (43.4%) were enrolled. Results showed that 36 (37.1%), 49 (50.5%), and 12 (12.4%) patients had a normal bone density, osteopenia, and osteoporosis, respectively. Comparing these three groups showed that despite higher mean serum level of ferritin in TM patients with osteoporosis than patients with osteopenia and normal bone density, no significant statistical difference was noted in these three groups (P >0.05). Besides, the mean ferritin level in patients with abnormal bone densitometry (osteopenia and osteoporosis) was higher than in patients with normal ones. A significant difference was noted between abnormal and normal densitometries (p=0.03). The Area under the Curve for ferritin was 0.708, and the cutoff point was indicated for ferritin was 2006 ng/ml. Conclusion: Regarding the results, there was a high frequency of osteoporosis and osteopenia in teenagers with TM. As bone density abnormality formation is time-consuming, and prevention is the primary strategy for management, it is highly recommended to assess bone mineral density regularly starting from early childhood.

Iranian journal of pediatric hematology and oncology, Jun 25, 2019

Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its stora... more Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme deficiency of the human red blood cells. Most of G6PD deficient individuals are asymptomatic, but acute hemolytic anemia may be presented with nausea, vomiting, abdominal pain, headache, jaundice, pallor, discoloration of the urine, chills, and fever. Seizure is reported as a rare symptom, as well. The present study aimed to investigate seizure following acute hemolysis caused by Glucose-6-phosphate dehydrogenase deficiency. Material and Methods: This analytic cross-sectional study was conducted on all consecutive patients aged 1-12 years with G6PD deficiency hospitalized for hemolysis in 17 Shahrivar children hospital, Rasht, Iran, in 2016. Demographic characteristics and other variables such as place of inhabitants, type of drinking water, history of seizure in the patients and family, cause of hemolysis, hemoglobin level and hemoglobinuria on admission, and infection history prior to hemolysis were recorded. Data were analyzed by Mann-Whitney U test and Fischer Exact Test. P-value < 0.05 indicated statistical significance and data were assessed by SPSS (version 20). Results: The youngest patient was one year old and the oldest was 11 years old. Most of them were males (68.9%). Out of 244 patients, 8 ones (3.3%) experienced seizure. There was a significant correlation between seizure occurrence and family history of seizure (p=0.03) as well as fava bean consumption (p=0.019) as the causes of hemolysis; but not with infection as the cause of hemolysis, hemoglobin or hemoglobinuria level on admission, types of drinking water, place of living, and gender. Methemoglobinemia was considered as the main cause of the seizure. Conclusion: Although the rate of seizure was not so high (3.3%), it seems that seizure can be a critical and potentially life-threatening complication in these patients. Environmental factors may also play a role in the pathogenesis of the seizure in these patients.

International journal of science and research, May 5, 2016

We conducted a case control study to compare the quality of life (QOL) in 50 children with thalas... more We conducted a case control study to compare the quality of life (QOL) in 50 children with thalassemia and 50 demographically matched healthy controls at a referral hospital in Northern India. Quality of life among children with thalassemia was significantly worse in emotional (P= 0.025) and school (P=0.011) functioning in self report and also in psychosocial (P=0.001), emotional (P=0.00), physical (P=0.03), social (P=0.00) functioning in parent proxy report. Factors [except age (P=0.000)] such as gender (P=0.951, socioeconomic status (P=0.593) and parent living status (P=0.478) did not significantly influence QOL scores.

58th Annual ESPE, Aug 22, 2019

Iranian journal of pediatric hematology and oncology, Mar 10, 2017

Background: Mucositis is a complex inflammatory response of the digestive system mucous membrane ... more 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.

Research Journal of Biological Sciences, 2009

ABSTRACT Major β-thalassemia is the most inherited hemoglobinopathy that caused severe and progr... more ABSTRACT Major β-thalassemia is the most inherited hemoglobinopathy that caused severe and progressive anemia. Iron overload due to repeated blood transfusion cause organ damage such as heart, liver, endocrine gland and skeletal system. Desferal, as an iron chelator is used to eliminate iron from the blood that despite its side effects is few, ophthalmic toxicity due to it is exactly known. Eighty six major β-thalassemia, 10-35 years old selected 51 females and 35 males. They used desferioxamine regularly &amp;gt;5 years 3-6 times/week subcutaneousely. Patients information filled in a questionnaire and then ophthalmologic examination was done. Likewise, personal and familial history of ophthalmic diseases has recorded and finally Visual Evoked Potential (VEP) by procedure of pattern reversal has been done for all patients. In 9 patients (10.5%) some symptoms as to desferal toxicity have been found that included: Abnormal VEP in 3 patients, macular pigmentation in 3 patients, color vision disorder in 2 patients (green and red colors) and cataract in one patient. These patients didn’t have any ophthalmic complaints. The age of starting to use desferal in this 9 patients was lower than others (3.3±3.8 years, p = 0.03), but there was no difference in age, desferal dose, weight, average of ferritin, splenectomy, heart disease and diabetes mellitus between these patients and others. Ophthalmic complications of desferioxamine in &amp;gt;10 years in age patients are lower than other areas in the world, but VEP can not be used as a screen test in this area contrary to other places. Also, desferal is an effective and low risk with very low risk/benefit ratio that is recommended to use regularly and to be under regulation and modification on base of serum ferritin.

Journal of Pediatric Hematology Oncology, Jun 16, 2021

Background: The survival of thalassemia patients has increased, but there are still challenges re... more Background: The survival of thalassemia patients has increased, but there are still challenges regarding the complications of cardiac or endocrine dysfunction and the psychological problems of these patients. Many patients with chronic disease, including thalassemia major (TM), have shown a reduction in communication skills and self-efficacy. Objective: The aim of this study was to investigate the self-efficacy among TM patients and determine the related factors among them. Materials and Methods: This research was a cross-sectional study and consisted of 40 TM patients 7 to 19 years of age. The control group was 80 nonthalassemia patients. Data were gathered using a 2-part questionnaire. The collected data was entered into the SPSS (version 21) and were analyzed using descriptive and analytical statistics (Mann-Whitney U, and multiple linear regression model). Results: According to the Mann-Whitney test, there was no significant difference between self-efficacy score among the affected and nonthalassemia groups (P=0.62). According to the regression model, only, the frequency of monthly blood transfusion was significantly correlated with self-efficacy score, so that by 1 U increase in frequency of monthly blood transfusion, we will have 11 U decrease in self-efficacy score (β=−11, P=0.011). Conclusions: The results of this study showed that the rate of self-efficacy in children with thalassemia was moderate (52.5%) to good (45%). The allocation of a specific ward, easy access to health care staff, and social support for patients may seem to justify the moderate to good self-efficacy in these patients.

Iranian Journal of Parasitology

Background: Visceral leishmaniasis (Kala-azar) is an inherently dangerous and progressive disease... more Background: Visceral leishmaniasis (Kala-azar) is an inherently dangerous and progressive disease that can be seen in many parts of the world, including Iran. Therefore, we decided to conduct this study on children with Kala-azar in Rasht-Iran. Methods: In this descriptive study, the hospital records of all children with Kala-azar disease admitted to 17 Shahrivar Hospital, Rasht- Iran from 2009 to 2021 were reviewed. Required information were collected from patients' records and descriptive statistical analysis was done using SPSS version 24 statistical software. Results: A total of 22 children with visceral leishmaniasis were admitted to 17 Shahrivar Hospital during the study period. The average age of the children was 2.93 ± 3.32 years. Most of them (59.1%) were boys and lived in the foothills (59.1%). The most common season for children to get the disease was spring (45.5%), and the average duration of the disease until hospitalization was 16.5 ± 13.54 days. In this study, th...

Iranian Journal of Blood and Cancer

Iranian Journal of Pediatric Hematology & Oncology

Background: Atherosclerosis is an important cardiovascular disorder in beta-thalassemia major pat... more Background: Atherosclerosis is an important cardiovascular disorder in beta-thalassemia major patients. The present study aimed to predict factors of atherosclerosis in children with beta-thalassemia major. Materials and Methods: This cross-sectional study was conducted on 36 patients with beta-thalassemia major and 36 healthy children as the control group. The carotid intima-media thickness (CAIMT) and osteoprotegerin (OPG) were compared between groups. Results: The mean age of the patients in the case and control groups were 13.5 ± 3.7 and 13 ± 3.1 years old, respectively. Significant differences in CAIMT in the right (P = 0.001) and left (P = 0.001) arteries were recorded between the two groups. The mean serum OPG in the beta-thalassemia group was significantly higher than the control group (3.9 ng/ml and 1.4 ng/ml, respectively, P=0.001). Conclusion: CAIMT is a non-invasive method for diagnosing atherosclerosis. According to the significant difference between groups, serum OPG c...

Iranian Journal of Pediatric Hematology & Oncology

Background: Deferasirox is an oral iron chelator widely used to treat iron overload in patients ... more Background: Deferasirox is an oral iron chelator widely used to treat iron overload in patients with transfusion-dependent β-thalassemia. This study investigated the prevalence of visual and auditory complications caused by deferasirox. Materials and Methods: This cross-sectional study included 156 patients aged less than 18 years with transfusion-dependent β-thalassemia and deferasirox iron chelator consumption admitted to the 17 Shahrivar Hospital and the Besat Clinic in Rasht, Iran. All the patients were examined for visual and auditory complications caused by deferasirox in 2019. A checklist of the patients' demographical and clinical data was recorded. Data analysis was done with SPSS and reported by descriptive statistics. Then, Fisher's exact test was performed to examine the association between visual and auditory disorders and the use of deferasirox in terms of disease-related variables including age, sex, age of onset of using chelator, drug use duration, drug dos...

Iranian Journal of Pediatric Hematology & Oncology

Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patie... more Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patients with Thalassemia Major (TM). Materials and Methods: This analytic cross-sectional study was conducted in17 Shahrivar children's hospital, Rasht, Iran, from November 2017 to November 2018. The inclusion criteria were indicated as the presence of TM in patients aged 12-19 years old with records of their regular visits. The exclusion criteria were noted as the presence of any chronic bone diseases such as osteomalacia or osteogenesis imperfecta, delayed puberty, hypothyroidism, parathyroid dysfunction, renal failure, liver failure, and growth hormone deficiency. Ferritin level was assessed, and bone densitometry was performed for all patients with TM. Results: In this study, 53 females (54.6%) and 44 males (43.4%) were enrolled. Results showed that 36 (37.1%), 49 (50.5%), and 12 (12.4%) patients had a normal bone density, osteopenia, and osteoporosis, respectively. Comparing these ...

Background This study aim to determine the association between height and cancer in the children ... more Background This study aim to determine the association between height and cancer in the children aged 14 years at the time of diagnosis in Rasht, Iran. Materials and Methods In this cross-sectional study, height of patients with a malignancy (≤14) at the time of diagnosis measured in the standard charts of United States National Center for the Health Statistics (NCHS). Data were reported by descriptive statistics and analyzed by Regression tests in SPSS version 19. Results Overall, 78 male (38.6%) and 124 female (61.4%) patients with various kinds of malignancies were evaluated for their heights. Leukemia was the most common type of cancer. The median height of the patients was more than 20 th percentile and under 50 th

Acute lymphoblastic leukemia (ALL) is a malignant transformation and proliferation of lymphoid pr... more Acute lymphoblastic leukemia (ALL) is a malignant transformation and proliferation of lymphoid progenitor cells in bone marrow and blood, which is mainly found in children. Thiopurine methyltransferase (TPMT) is a thiopurine drug metabolizer enzyme that is prescribed for the treatment of ALL. Several single nucleotide polymorphisms in the TPMT gene have been reported to be associated with the decreased and deficient activity of the enzyme, which disrupts thiopurine drug metabolization and results in severe hematopoietic toxicity, which could be fatal in the patients. Since genetic screening before the thiopurine drug treatment of patients could be helpful for dosage optimization and efficient chemotherapy, this study was conducted to evaluate the association of G>A 146 TPMT gene polymorphism (rs1800460) with ALL susceptibility in an Iranian childhood population from the province of Guilan. This case-control study was performed on 400 individuals including 200 patients and 200 hea...

Background: Osteoporosis is one of the main causes of morbidity in patients with thalassemia majo... more Background: Osteoporosis is one of the main causes of morbidity in patients with thalassemia major. Osteoprotegerin (OPG) is secreted by osteoblasts and osteogenic stromal stem cells and protects the skeleton from excessive bone reabsorption. In this study, the authors aimed to assess the relationship between OPG with osteoporosis and osteopenia in patients with thalassemia major. Materials and Methods: In this analytic cross-sectional study, 37 patients aged 8-18 years, with thalassemia major were enrolled. Biochemical markers including hemoglobin, ferritin, calcium, phosphorus levels, and MRI T2* heart and liver were assessed. A bone mineral densitometry (BMD) was performed as well. Statistical analysis was performed by the independent T-test and Chi-Square test using the SPSS 20. The Multiple linear regression analysis was used to investigate the association between the BMD Z-score and OPG by the effect modification. Results: The mean age of patients was 14.86±3.72 years. Normal ...

Iranian Journal of Pediatric Hematology and Oncology, 2015

Background In the early months of life, Breastfeeding increases chance of survival, reduces recov... more Background In the early months of life, Breastfeeding increases chance of survival, reduces recovery time after disease and mortality due to infections such as diarrhea and acute respiratory infections. However, infants who are exclusively breast-fed for more than 6 months in developing countries may be at increased risk of anemia. Therefore, the aim of study was to assess the relation between duration of breastfeeding and anemia. Materials and Methods In this analytical cross-sectional study, 400 neonates registered in primary health care system since birth time. Complete blood count and serum ferritin were obtained. Data were analyzed by chi- square test and regression analysis. P-value less than 0.05 was considered significant and 95% confidence interval was noted. Results Results of this study showed that 199 infants were anemic (Hemoglobin (Hb) concentration <11 mg/dl). Ten percent of anemic patients reported Ferritin< 12ng/dl and %25 of anemic children had iron deficienc...

Journal of Pediatric Hematology/Oncology, 2021

Background: The survival of thalassemia patients has increased, but there are still challenges re... more Background: The survival of thalassemia patients has increased, but there are still challenges regarding the complications of cardiac or endocrine dysfunction and the psychological problems of these patients. Many patients with chronic disease, including thalassemia major (TM), have shown a reduction in communication skills and self-efficacy. Objective: The aim of this study was to investigate the self-efficacy among TM patients and determine the related factors among them. Materials and Methods: This research was a cross-sectional study and consisted of 40 TM patients 7 to 19 years of age. The control group was 80 nonthalassemia patients. Data were gathered using a 2-part questionnaire. The collected data was entered into the SPSS (version 21) and were analyzed using descriptive and analytical statistics (Mann-Whitney U, and multiple linear regression model). Results: According to the Mann-Whitney test, there was no significant difference between self-efficacy score among the affec...

Journal of Pediatric Hematology/Oncology, 2018

Background: Thalassemic patients have ineffective erythropoiesis. In recent treatment protocols, ... more Background: Thalassemic patients have ineffective erythropoiesis. In recent treatment protocols, there are little data on folic acid supplementation for patients with thalassemia because it is supposed that regular blood transfusions prevent bone marrow hyperfunctioning. Objective: Investigators aimed to assess serum folic acid and homocysteine (Hcy) in thalassemia major patients before and after folic acid supplement cessation. Patients and Methods: This study was a before-after controlled clinical trial conducted in 17th Shahrivar Hospital, Rasht, North of Iran, during May to October 2016. The patients enrolled in this study had thalassemia major on regular blood transfusion and older than 2 years of age. They had at least a 6-month history of folic acid supplement consumption before enrollment in the study (1 mg/daily). Complete blood count, serum folic acid, and serum Hcy were measured before discontinuation of folic acid supplement. Then, patients did not receive folic acid for...

Iranian Journal of Pediatric Hematology & Oncology, 2019

Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its stora... more Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme deficiency of the human red blood cells . Most of G6PD deficient individuals are asymptomatic, but acute hemolytic anemia may be presented with nausea, vomiting, abdominal pain, headache, jaundice, pallor, discoloration of the urine, chills, and fever. Seizure is reported as a rare symptom, as well. The present study aimed to investigate seizure following acute hemolysis caused by Glucose-6-phosphate dehydrogenase deficiency. Material and Methods: This analytic cross-sectional study was conducted on all consecutive patients aged 1-12 years with G6PD deficiency hospitalized for hemolysis in 17 Shahrivar children hospital, Rasht, Iran, in 2016. Demographic characteristics and other variables such as place of inhabitants, type of drinking water, history of seizure in the patient...

Iranian journal of pediatric hematology and oncology, Mar 30, 2022

Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patie... more Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patients with Thalassemia Major (TM). Materials and Methods: This analytic cross-sectional study was conducted in17 Shahrivar children's hospital, Rasht, Iran, from November 2017 to November 2018. The inclusion criteria were indicated as the presence of TM in patients aged 12-19 years old with records of their regular visits. The exclusion criteria were noted as the presence of any chronic bone diseases such as osteomalacia or osteogenesis imperfecta, delayed puberty, hypothyroidism, parathyroid dysfunction, renal failure, liver failure, and growth hormone deficiency. Ferritin level was assessed, and bone densitometry was performed for all patients with TM. Results: In this study, 53 females (54.6%) and 44 males (43.4%) were enrolled. Results showed that 36 (37.1%), 49 (50.5%), and 12 (12.4%) patients had a normal bone density, osteopenia, and osteoporosis, respectively. Comparing these three groups showed that despite higher mean serum level of ferritin in TM patients with osteoporosis than patients with osteopenia and normal bone density, no significant statistical difference was noted in these three groups (P &gt;0.05). Besides, the mean ferritin level in patients with abnormal bone densitometry (osteopenia and osteoporosis) was higher than in patients with normal ones. A significant difference was noted between abnormal and normal densitometries (p=0.03). The Area under the Curve for ferritin was 0.708, and the cutoff point was indicated for ferritin was 2006 ng/ml. Conclusion: Regarding the results, there was a high frequency of osteoporosis and osteopenia in teenagers with TM. As bone density abnormality formation is time-consuming, and prevention is the primary strategy for management, it is highly recommended to assess bone mineral density regularly starting from early childhood.

Iranian journal of pediatric hematology and oncology, Jun 25, 2019

Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its stora... more Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme deficiency of the human red blood cells. Most of G6PD deficient individuals are asymptomatic, but acute hemolytic anemia may be presented with nausea, vomiting, abdominal pain, headache, jaundice, pallor, discoloration of the urine, chills, and fever. Seizure is reported as a rare symptom, as well. The present study aimed to investigate seizure following acute hemolysis caused by Glucose-6-phosphate dehydrogenase deficiency. Material and Methods: This analytic cross-sectional study was conducted on all consecutive patients aged 1-12 years with G6PD deficiency hospitalized for hemolysis in 17 Shahrivar children hospital, Rasht, Iran, in 2016. Demographic characteristics and other variables such as place of inhabitants, type of drinking water, history of seizure in the patients and family, cause of hemolysis, hemoglobin level and hemoglobinuria on admission, and infection history prior to hemolysis were recorded. Data were analyzed by Mann-Whitney U test and Fischer Exact Test. P-value < 0.05 indicated statistical significance and data were assessed by SPSS (version 20). Results: The youngest patient was one year old and the oldest was 11 years old. Most of them were males (68.9%). Out of 244 patients, 8 ones (3.3%) experienced seizure. There was a significant correlation between seizure occurrence and family history of seizure (p=0.03) as well as fava bean consumption (p=0.019) as the causes of hemolysis; but not with infection as the cause of hemolysis, hemoglobin or hemoglobinuria level on admission, types of drinking water, place of living, and gender. Methemoglobinemia was considered as the main cause of the seizure. Conclusion: Although the rate of seizure was not so high (3.3%), it seems that seizure can be a critical and potentially life-threatening complication in these patients. Environmental factors may also play a role in the pathogenesis of the seizure in these patients.

International journal of science and research, May 5, 2016

We conducted a case control study to compare the quality of life (QOL) in 50 children with thalas... more We conducted a case control study to compare the quality of life (QOL) in 50 children with thalassemia and 50 demographically matched healthy controls at a referral hospital in Northern India. Quality of life among children with thalassemia was significantly worse in emotional (P= 0.025) and school (P=0.011) functioning in self report and also in psychosocial (P=0.001), emotional (P=0.00), physical (P=0.03), social (P=0.00) functioning in parent proxy report. Factors [except age (P=0.000)] such as gender (P=0.951, socioeconomic status (P=0.593) and parent living status (P=0.478) did not significantly influence QOL scores.

58th Annual ESPE, Aug 22, 2019

Iranian journal of pediatric hematology and oncology, Mar 10, 2017

Background: Mucositis is a complex inflammatory response of the digestive system mucous membrane ... more 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.

Research Journal of Biological Sciences, 2009

ABSTRACT Major β-thalassemia is the most inherited hemoglobinopathy that caused severe and progr... more ABSTRACT Major β-thalassemia is the most inherited hemoglobinopathy that caused severe and progressive anemia. Iron overload due to repeated blood transfusion cause organ damage such as heart, liver, endocrine gland and skeletal system. Desferal, as an iron chelator is used to eliminate iron from the blood that despite its side effects is few, ophthalmic toxicity due to it is exactly known. Eighty six major β-thalassemia, 10-35 years old selected 51 females and 35 males. They used desferioxamine regularly &amp;gt;5 years 3-6 times/week subcutaneousely. Patients information filled in a questionnaire and then ophthalmologic examination was done. Likewise, personal and familial history of ophthalmic diseases has recorded and finally Visual Evoked Potential (VEP) by procedure of pattern reversal has been done for all patients. In 9 patients (10.5%) some symptoms as to desferal toxicity have been found that included: Abnormal VEP in 3 patients, macular pigmentation in 3 patients, color vision disorder in 2 patients (green and red colors) and cataract in one patient. These patients didn’t have any ophthalmic complaints. The age of starting to use desferal in this 9 patients was lower than others (3.3±3.8 years, p = 0.03), but there was no difference in age, desferal dose, weight, average of ferritin, splenectomy, heart disease and diabetes mellitus between these patients and others. Ophthalmic complications of desferioxamine in &amp;gt;10 years in age patients are lower than other areas in the world, but VEP can not be used as a screen test in this area contrary to other places. Also, desferal is an effective and low risk with very low risk/benefit ratio that is recommended to use regularly and to be under regulation and modification on base of serum ferritin.

Journal of Pediatric Hematology Oncology, Jun 16, 2021

Background: The survival of thalassemia patients has increased, but there are still challenges re... more Background: The survival of thalassemia patients has increased, but there are still challenges regarding the complications of cardiac or endocrine dysfunction and the psychological problems of these patients. Many patients with chronic disease, including thalassemia major (TM), have shown a reduction in communication skills and self-efficacy. Objective: The aim of this study was to investigate the self-efficacy among TM patients and determine the related factors among them. Materials and Methods: This research was a cross-sectional study and consisted of 40 TM patients 7 to 19 years of age. The control group was 80 nonthalassemia patients. Data were gathered using a 2-part questionnaire. The collected data was entered into the SPSS (version 21) and were analyzed using descriptive and analytical statistics (Mann-Whitney U, and multiple linear regression model). Results: According to the Mann-Whitney test, there was no significant difference between self-efficacy score among the affected and nonthalassemia groups (P=0.62). According to the regression model, only, the frequency of monthly blood transfusion was significantly correlated with self-efficacy score, so that by 1 U increase in frequency of monthly blood transfusion, we will have 11 U decrease in self-efficacy score (β=−11, P=0.011). Conclusions: The results of this study showed that the rate of self-efficacy in children with thalassemia was moderate (52.5%) to good (45%). The allocation of a specific ward, easy access to health care staff, and social support for patients may seem to justify the moderate to good self-efficacy in these patients.

Iranian Journal of Parasitology

Background: Visceral leishmaniasis (Kala-azar) is an inherently dangerous and progressive disease... more Background: Visceral leishmaniasis (Kala-azar) is an inherently dangerous and progressive disease that can be seen in many parts of the world, including Iran. Therefore, we decided to conduct this study on children with Kala-azar in Rasht-Iran. Methods: In this descriptive study, the hospital records of all children with Kala-azar disease admitted to 17 Shahrivar Hospital, Rasht- Iran from 2009 to 2021 were reviewed. Required information were collected from patients' records and descriptive statistical analysis was done using SPSS version 24 statistical software. Results: A total of 22 children with visceral leishmaniasis were admitted to 17 Shahrivar Hospital during the study period. The average age of the children was 2.93 ± 3.32 years. Most of them (59.1%) were boys and lived in the foothills (59.1%). The most common season for children to get the disease was spring (45.5%), and the average duration of the disease until hospitalization was 16.5 ± 13.54 days. In this study, th...

Iranian Journal of Blood and Cancer

Iranian Journal of Pediatric Hematology & Oncology

Background: Atherosclerosis is an important cardiovascular disorder in beta-thalassemia major pat... more Background: Atherosclerosis is an important cardiovascular disorder in beta-thalassemia major patients. The present study aimed to predict factors of atherosclerosis in children with beta-thalassemia major. Materials and Methods: This cross-sectional study was conducted on 36 patients with beta-thalassemia major and 36 healthy children as the control group. The carotid intima-media thickness (CAIMT) and osteoprotegerin (OPG) were compared between groups. Results: The mean age of the patients in the case and control groups were 13.5 ± 3.7 and 13 ± 3.1 years old, respectively. Significant differences in CAIMT in the right (P = 0.001) and left (P = 0.001) arteries were recorded between the two groups. The mean serum OPG in the beta-thalassemia group was significantly higher than the control group (3.9 ng/ml and 1.4 ng/ml, respectively, P=0.001). Conclusion: CAIMT is a non-invasive method for diagnosing atherosclerosis. According to the significant difference between groups, serum OPG c...

Iranian Journal of Pediatric Hematology & Oncology

Background: Deferasirox is an oral iron chelator widely used to treat iron overload in patients ... more Background: Deferasirox is an oral iron chelator widely used to treat iron overload in patients with transfusion-dependent β-thalassemia. This study investigated the prevalence of visual and auditory complications caused by deferasirox. Materials and Methods: This cross-sectional study included 156 patients aged less than 18 years with transfusion-dependent β-thalassemia and deferasirox iron chelator consumption admitted to the 17 Shahrivar Hospital and the Besat Clinic in Rasht, Iran. All the patients were examined for visual and auditory complications caused by deferasirox in 2019. A checklist of the patients' demographical and clinical data was recorded. Data analysis was done with SPSS and reported by descriptive statistics. Then, Fisher's exact test was performed to examine the association between visual and auditory disorders and the use of deferasirox in terms of disease-related variables including age, sex, age of onset of using chelator, drug use duration, drug dos...

Iranian Journal of Pediatric Hematology & Oncology

Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patie... more Background: This study aimed to assess cutoff of ferritin for evaluation of osteoporosis in patients with Thalassemia Major (TM). Materials and Methods: This analytic cross-sectional study was conducted in17 Shahrivar children's hospital, Rasht, Iran, from November 2017 to November 2018. The inclusion criteria were indicated as the presence of TM in patients aged 12-19 years old with records of their regular visits. The exclusion criteria were noted as the presence of any chronic bone diseases such as osteomalacia or osteogenesis imperfecta, delayed puberty, hypothyroidism, parathyroid dysfunction, renal failure, liver failure, and growth hormone deficiency. Ferritin level was assessed, and bone densitometry was performed for all patients with TM. Results: In this study, 53 females (54.6%) and 44 males (43.4%) were enrolled. Results showed that 36 (37.1%), 49 (50.5%), and 12 (12.4%) patients had a normal bone density, osteopenia, and osteoporosis, respectively. Comparing these ...

Background This study aim to determine the association between height and cancer in the children ... more Background This study aim to determine the association between height and cancer in the children aged 14 years at the time of diagnosis in Rasht, Iran. Materials and Methods In this cross-sectional study, height of patients with a malignancy (≤14) at the time of diagnosis measured in the standard charts of United States National Center for the Health Statistics (NCHS). Data were reported by descriptive statistics and analyzed by Regression tests in SPSS version 19. Results Overall, 78 male (38.6%) and 124 female (61.4%) patients with various kinds of malignancies were evaluated for their heights. Leukemia was the most common type of cancer. The median height of the patients was more than 20 th percentile and under 50 th

Acute lymphoblastic leukemia (ALL) is a malignant transformation and proliferation of lymphoid pr... more Acute lymphoblastic leukemia (ALL) is a malignant transformation and proliferation of lymphoid progenitor cells in bone marrow and blood, which is mainly found in children. Thiopurine methyltransferase (TPMT) is a thiopurine drug metabolizer enzyme that is prescribed for the treatment of ALL. Several single nucleotide polymorphisms in the TPMT gene have been reported to be associated with the decreased and deficient activity of the enzyme, which disrupts thiopurine drug metabolization and results in severe hematopoietic toxicity, which could be fatal in the patients. Since genetic screening before the thiopurine drug treatment of patients could be helpful for dosage optimization and efficient chemotherapy, this study was conducted to evaluate the association of G>A 146 TPMT gene polymorphism (rs1800460) with ALL susceptibility in an Iranian childhood population from the province of Guilan. This case-control study was performed on 400 individuals including 200 patients and 200 hea...

Background: Osteoporosis is one of the main causes of morbidity in patients with thalassemia majo... more Background: Osteoporosis is one of the main causes of morbidity in patients with thalassemia major. Osteoprotegerin (OPG) is secreted by osteoblasts and osteogenic stromal stem cells and protects the skeleton from excessive bone reabsorption. In this study, the authors aimed to assess the relationship between OPG with osteoporosis and osteopenia in patients with thalassemia major. Materials and Methods: In this analytic cross-sectional study, 37 patients aged 8-18 years, with thalassemia major were enrolled. Biochemical markers including hemoglobin, ferritin, calcium, phosphorus levels, and MRI T2* heart and liver were assessed. A bone mineral densitometry (BMD) was performed as well. Statistical analysis was performed by the independent T-test and Chi-Square test using the SPSS 20. The Multiple linear regression analysis was used to investigate the association between the BMD Z-score and OPG by the effect modification. Results: The mean age of patients was 14.86±3.72 years. Normal ...

Iranian Journal of Pediatric Hematology and Oncology, 2015

Background In the early months of life, Breastfeeding increases chance of survival, reduces recov... more Background In the early months of life, Breastfeeding increases chance of survival, reduces recovery time after disease and mortality due to infections such as diarrhea and acute respiratory infections. However, infants who are exclusively breast-fed for more than 6 months in developing countries may be at increased risk of anemia. Therefore, the aim of study was to assess the relation between duration of breastfeeding and anemia. Materials and Methods In this analytical cross-sectional study, 400 neonates registered in primary health care system since birth time. Complete blood count and serum ferritin were obtained. Data were analyzed by chi- square test and regression analysis. P-value less than 0.05 was considered significant and 95% confidence interval was noted. Results Results of this study showed that 199 infants were anemic (Hemoglobin (Hb) concentration <11 mg/dl). Ten percent of anemic patients reported Ferritin< 12ng/dl and %25 of anemic children had iron deficienc...

Journal of Pediatric Hematology/Oncology, 2021

Background: The survival of thalassemia patients has increased, but there are still challenges re... more Background: The survival of thalassemia patients has increased, but there are still challenges regarding the complications of cardiac or endocrine dysfunction and the psychological problems of these patients. Many patients with chronic disease, including thalassemia major (TM), have shown a reduction in communication skills and self-efficacy. Objective: The aim of this study was to investigate the self-efficacy among TM patients and determine the related factors among them. Materials and Methods: This research was a cross-sectional study and consisted of 40 TM patients 7 to 19 years of age. The control group was 80 nonthalassemia patients. Data were gathered using a 2-part questionnaire. The collected data was entered into the SPSS (version 21) and were analyzed using descriptive and analytical statistics (Mann-Whitney U, and multiple linear regression model). Results: According to the Mann-Whitney test, there was no significant difference between self-efficacy score among the affec...

Journal of Pediatric Hematology/Oncology, 2018

Background: Thalassemic patients have ineffective erythropoiesis. In recent treatment protocols, ... more Background: Thalassemic patients have ineffective erythropoiesis. In recent treatment protocols, there are little data on folic acid supplementation for patients with thalassemia because it is supposed that regular blood transfusions prevent bone marrow hyperfunctioning. Objective: Investigators aimed to assess serum folic acid and homocysteine (Hcy) in thalassemia major patients before and after folic acid supplement cessation. Patients and Methods: This study was a before-after controlled clinical trial conducted in 17th Shahrivar Hospital, Rasht, North of Iran, during May to October 2016. The patients enrolled in this study had thalassemia major on regular blood transfusion and older than 2 years of age. They had at least a 6-month history of folic acid supplement consumption before enrollment in the study (1 mg/daily). Complete blood count, serum folic acid, and serum Hcy were measured before discontinuation of folic acid supplement. Then, patients did not receive folic acid for...

Iranian Journal of Pediatric Hematology & Oncology, 2019

Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its stora... more Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme deficiency of the human red blood cells . Most of G6PD deficient individuals are asymptomatic, but acute hemolytic anemia may be presented with nausea, vomiting, abdominal pain, headache, jaundice, pallor, discoloration of the urine, chills, and fever. Seizure is reported as a rare symptom, as well. The present study aimed to investigate seizure following acute hemolysis caused by Glucose-6-phosphate dehydrogenase deficiency. Material and Methods: This analytic cross-sectional study was conducted on all consecutive patients aged 1-12 years with G6PD deficiency hospitalized for hemolysis in 17 Shahrivar children hospital, Rasht, Iran, in 2016. Demographic characteristics and other variables such as place of inhabitants, type of drinking water, history of seizure in the patient...