Respiratory viral infection’s frequency and clinical outcome in symptomatic children with cancer: A single center experience from a middle-income country

In developing countries, acute respiratory tract infections are a significant cause of morbidity and mortality in children, particularly in pediatric cancer patients. A majority of these illnesses are precipitated by viral infections. In our country, studies were conducted on the single respiratory viral infection in a pediatric hematology-oncology unit; however, the analysis of respiratory viral infections in children with cancer is lacking. The present study aimed to provide analysis of multiple respiratory viral infections and clinical outcome in children with cancer who receive chemotherapy and show signs and symptoms of respiratory tract infections. During January, 2014 and January, 2015 children with cancer under treatment who presented with respiratory tract infections were assessed for viruses by using multiplex real-time reverse transcription polymerase chain reaction (rRT-PCR). Specimens were collected by nasal swabbing at in-patient and out-patient clinics. Overall, 72 samples of respiratory tract infection episodes, collected from children with cancer were evaluated with the simultaneous detection of 20 respiratory viruses. A respiratory viral pathogen was obtained in 56.9% samples. Rhinovirus (24.3%) and co-infection with two viruses (19.5%) were the most frequently isolated pathogens. There were four (9.6%) samples of severe pneumonia. Patients with febrile neutropenic episodes and pneumonia were hospitalized and treated with broad-spectrum antibiotics. Other non-neutropenic and mild respiratory tract infections were treated with supportive care as outpatient procedures. There were no deaths. Because there are no effective antiviral agents for certain respiratory viruses, infection control and early diagnosis are crucial in preventing the spread of infection. Clinical findings and serological results of viral respiratory tract infections help us to accurately determine the treatment approach and avoid the unnecessary use of antibiotics

Comparison of Heparin and Saline for Prevention of Central Venous Catheter Occlusion in Pediatric Oncology: A Systematic Review and Meta-Analysis

Objective: The management of central venous catheter (CVC) occlusion remains an area without clear evidence-based guidelines. Studies have been conducted that compare the use of heparin and normal saline for reducing thrombosis, but the evidence is not strong enough to suggest a significant advantage of one over the other. Therefore, the study aimed to assess the effectiveness of heparin and normal saline flushing in preventing CVC occlusion in pediatric patients with cancer. Data Sources: A comprehensive search was conducted in PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Embase, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov platform using specific keywords. The search was conducted until March 2022. Five randomized controlled trials are included in this study. Conclusion: Five studies with a total of 316 pediatric cancer patients met the inclusion criteria. The studies were found to be heterogeneous due to variations in the types of cancer, heparin concentration, flushing frequency of CVCs, and methods used to measure occlusion. Despite these differences, there was no significant difference in the effect of flushing with heparin and normal saline in preventing CVC occlusion. The analysis revealed that normal saline is as effective as heparin in preventing CVC occlusion among pediatric cancer patients. Implications for Nursing Practice: This systematic review and meta-analysis demonstrated that there is no significant difference between the use of heparin and normal saline flushing in preventing CVC occlusion among pediatric cancer patients. Considering the potential risks of heparin, the use of normal saline flushing may be recommended to prevent CVC obstruction

EVALUATING THE METHYLATION STATUS OF RB1 GENE PATIENTS WITH RETINOBLASTOMA

OBJECTIVES: The most frequently diagnosed malignant ocular tumor of infancy and childhood is Retinoblastoma. Due to the mutation on the q14 on chromosome 13 causes the retinoblastoma. There are two types of basic gene mutations: genetic and sporadic. This cancer is initiated by RB1 mutation, responsible for the cell cycle regulation and genome stability in the cells of the retina in children under 5 years old. The retinoblastoma comprises about 40% inherited mutations, 10% of germline mutations of RB1 inherited from an affected parent, and 30% from de-novo germline mutations. MATERIAL&METHODS: Methylation of the RB1 gene on promoter region is unknown. The results obtained by MLPA analysis and sequence analysis were investigated for RB1 gene methylation in patients without RB1 mutation. The methylation determination is done with OneStep qMethyl-PCR Kit using a Real-Time PCR system. Methylation changes were investigated in peripheral blood samples of 60 patients with retinoblastoma, 18% of the patients (11/60) had bilateral and 82% of patients (49/60) had unilateral disease and 52 healthy controls. RESULTS: The mean methylation levels of 60 retinoblastoma patients and 52 healthy controls were 35% and 34%, respectively. Mann Whitney U test was compared between the patient and healthy controls and no statistically significant difference was detected between the two groups (p = 0.882). CONCLUSIONS: The promoter methylation levels in RB1 gene patients having familial history was believed to be large deletion and duplication and small indel absence mutations in the RB1 gene are not effective especially in the etiology of heritable retinoblastoma. Keywords: Retinoblastoma, RB1 gene mutation, Promoter Methylatio