Ferrous Sulfate Versus Ferrous Fumarate Plus Zinc Sulfate and Vitamin C for Treatment of Iron Deficiency Anemia in Children

During childhood, different oral iron preparations are widely used in iron deficiency anemia (IDA) and prophylaxis. The purpose of this study was to compare the efficacy of different oral iron preparations in children with IDA. Eighty-nine children (age range, 1 to 17 years) with IDA were randomized to receive therapy orally in two divided doses of either 5 mg Fe2+/kg/day ferrous sulfate (FS group, n = 45) or ferrous fumarate plus zinc and vitamin C (FZ group, n = 44). Hematological profile and iron status were evaluated at the beginning and on days 15 and 45 of treatment. Mean Hb, mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), red cell distribution weight (RDW), and iron and ferritin levels were significantly higher in both groups on days 15 and 45 of treatment. Mean changes in Hb were 2.5 ± 1.2 g/dL and 2.1 ± 0.7 g/dL on day 15 (P = 0.295), and 3.9 ± 1.8 g/dL and 3.5 ± 1.2 g/dL on day 45 (P = 0.331) in the FS and FZ groups, respectively. Our study suggests that ferrous sulfate and ferrous fumarate plus zinc and vitamin C were well tolerated and were highly effective in correcting IDA in children. Ferrous fumarate plus zinc and vitamin C did not influence hematologic recovery compared with ferrous sulfate in this group

The Impact of Patient and Parents’ Education by Nurses on Serum Ferritin Levels in Children with Beta-Thalassemia Major

Background: Through education and information, nurses can help patients learn more about their health status and can contribute to improvement in patient drug adherence, clinical and laboratory outcomes. The aim of this study was to assess the impact of patient and their family education by nurses on serum ferritin levels. Methods: The study included 85 children with transfusion-dependent beta-thalassemia aged between 2.4 to 17 (mean 7.6 ± 3.3) years, 44 (52%) of whom were male. All patients received deferasirox doses ranged from 12 to 40 mg/kg/day. Patients and their families were requested for education intervention provided by nurses. Seventeen patients (group 1) (11 male, 6 female) refused to receive education or not compliant with the study protocol. Sixty-eight (33 male, 35 female) patients (group 2) and their parents educated by nurses, including drug instructions, telephone interviews and home visits for 12 months. Results: Mean deferasirox dose at the 24th and 36th months of the study were 31.6 ± 7 and 32 ± 8 mg/kg/day in group 1, and were 32.7 ± 8 and 33.6 ± mg/kg/day in group 2, respectively. Mean serum ferritin levels at the 24th and 36th months of the study were reduced from 4424 ± 2305 ng/mL to 3425 ± 1661 ng/mL (the mean difference was 662 ng/mL) (P =0.044) in group 1, and were reduced from 3177 ± 1645 to 2748 ± 1343 ng/mL (the mean difference was 274 ng/mL) (P = 0.033) in group 2, respectively Conclusion: Our study’s results suggested that patient and parents’ education by nurses have no significant impact in reducing ferritin levels in children with beta-thalassemia major. Deferasirox dose was the only significant predictor that contributed to reduction in ferritin levels

Effect of Environmental Tobacco Smoke on Plasma Iron, Zinc and Copper Concentrations in Infants

The deleterious effects of cigarette smoking on trace elements concentrations are well known. Recent studies show that exposure of nonsmokers to environmental tobacco smoke (ETS) results in many biochemical processes and diseases. The aim of this study was to investigate the plasma concentrations of iron (Fe), zinc (Zn) and cooper (Cu) in 29 infants (14 boys and 15 girls, age range: 2-6 months, mean age: 3.6 months) who had been exposed to ETS (range 8-30 cigarettes/day mean 12.4 ± 4.7) for at least two months at home, while the control group included 30 infants (13 male, 17 female, age range: 2-6 months, mean age: 3.3 months) who had never been exposed to ETS. All infants had been breast fed. The plasma iron concentrations were determined by commercial kit, cotinine levels were determined by luminometric method. Cu and Zn concentrations were analyzed by atomic absorption spectrometry. The plasma Fe and Zn concentrations in the study group were significantly lower than in the controls (P < 0.05). However, plasma Cu levels were not different between the two groups (P > 0.05). In conclusion, the plasma Fe and Zn concentration decline in the ETS exposed infants

Prevalence and Treatment of Pediculus Humanus Capitis with 1% Permethrin and 0.4% d-Phenothrin in Turkey

Pediculosis humanus capitis (head lice) is an important public health problem among school children. In our study, 20,612 schoolchildren (10,367 boys, 10,245 girls) were examined for Pediculus humanus capitis in 36 elementary schools between December 1996 and February 1998 in Ankara, Turkey. The prevalence of pediculosis capitis infestation was found to be 3.4% (701 / 20, 612). Of these, 382 students were treated with application of 1% permethrin cream rinse, and 184 students with 0.4% d-phenothrin shampoo. On day 14 of the controlled trial, the success rates were 93.7 % in the 1% permethrin cream rinse group and 75.5 % in the 0.4% d-phenothrin shampoo group. The 1% permethrin cream rinse was also significantly more active in pediculicidal efficacy when compared to the 0.4% d-phenothrin shampoo (p<0.001). As a result, these findings demonstrate that pediculosis capitis still remains a widespread health problem

Aumento do estresse oxidativo em pré-escolares expostos ao tabagismo passivo

OBJETIVOS: Estudar o efeito do fumo passivo sobre o estado plasmático oxidativo e antioxidativo em pré-escolares fumantes passivos e compará-los com controles. MÉTODOS: Trinta e quatro pré-escolares fumantes passivos (cinco a 50 cigarros/dia) (grupo de estudo) e 32 controles que nunca estiveram expostos à fumaça de cigarro foram escolhidos aleatoriamente entre crianças de 4 a 6 anos. Foram determinados os níveis de cotinina urinária e de indicadores do estado oxidativo e antioxidativo, isto é, estado oxidante total (EOT), capacidade antioxidante total (CAT) e índice de estresse oxidativo (IEO). RESULTADOS: A média do consumo ambiental de cigarros foi de 22±13 cigarros por dia nas crianças fumantes passivas. Os níveis médios de cotinina urinária foram 77,6±41,4 ng/mL e 11,9±2,3 ng/mL nos grupos de estudo e controle, respectivamente (p < 0,001). Os níveis médios da CAT plasmática foram 0,95±0,13 mmol equivalente de Trolox/L e 1,01±0,09 mmol equivalente de Trolox/L, respectivamente (p = 0,039). Os níveis médios de EOT plasmático foram 28,6±7,9 µmol H2O2 equivalente/L e 18,5±6,3 µmol H2O2 equivalente/L, respectivamente (p < 0,001). Os níveis médios de IEO foram 3,08±0,98 unidade arbitrária e 1,84±0,64 unidade arbitrária, respectivamente (p < 0,001). Uma pequena quantidade de fumaça de cigarro (cinco a 10 cigarros/dia) causa estresse oxidativo considerável. Não houve correlações significativas entre o número de cigarros consumidos e os níveis de estado oxidante e de IEO. CONCLUSÕES: O tabagismo passivo é um potente oxidante em pré-escolares. Seus efeitos deletérios não se limitam apenas tabagismo passivo pesado, mas também ocorrem com a exposição a pequenas quantidades de fumaça

The surgical treatment of far lateral lumbar disc herniation: 33 cases

 Surgical approaches to far lateral disc herniation are challenging because of the anatomical limitations in the region. We describe an extraforaminal approach for far lateral lumbar disc herniation (FLLDH) in a group of patients and discuss the results in patients with far lateral disc protrusion.Between 2006 and 2011, 33 patients (18 females, 15 males; mean age, 51.2 years) underwent surgery for FLLDH. The majority of patients had herniation at disc levels L3-4 (12 patients) or L4-5 (15 patients). All patients were operated on via either median-paramuscular (61%) or paramedian-intermuscular (39%) approaches. The mean VAS score improved from 7.3 preoperatively to 2.8 in the short-term. The long-term functional outcome of surgery according to the MacNab Criteria, the recovery was excellent, good, fair, and poor in 18, 11, 4, and 0 patients, respectively.The far-lateral approach for FLLDH is a safe, effective procedure that avoids the risk of secondary spinal instability