The Impact of Education via Short Message Service (SMS) versus that of by e-mail: A Quasi-Experimental Study Among Parents of Children with Leukemia in Shiraz, Iran

Educating parents of children with leukemia increases the quality of provided care to pediatric patients. This study has been designed to determine the impact of education via email and Short Message Service (SMS) on caring knowledge of chemotherapy complications in parents of children with acute lymphoblastic leukemia (ALL). The valid and reliable questionnaire consisted of personal information and knowledge of the effects of chemotherapy in children with leukemia. Seventy four SMS were sent to the parents in form of 5 categories of education about how to care complications of chemotherapy during 10 weeks of the study. The findings of this study indicated that, the awareness of parents increased significantly within a week and a month after the education (

The clinical presentation of Post-Transplant Lymphoproliferative Disorder (PTLD) following pediatric liver transplantation

Post-transplant lymphoproliferative disorder is a life-threatening complication of solid organ transplantation. In pediatric recipients, PTLD has been reported in 6.4-19.5 of lung, heart and heart-lung transplants, 4-15 of liver transplants and 1.2-10.1 of kidney transplants. Although most lymphomas typically occur in lymph nodes, extranodal involvement is also common. The aim of our study was to determine the site and symptoms of PTLD in children who underwent liver transplantation during 2009-2012 in Liver Transplantation Center of Nemazee Hospital. Material and methods: This study is a cohort study on existing data of children who received liver transplant between Juanury 2009 and December 2012 at Liver Transplant Center of Nemazee Hospital in Shiraz. During the study period, the PTLD occurrence was assessed in follow up visits, if the diagnosis of PTLD was confirmed the affected patient was entered the study and additional information was obtained. The diagnosis of PTLD was considered in patients with fever of undetermined origin, lymphadenopathy, allograft dysfunction, and pulmonary infiltrates. The data was analyzed using SPSS software ver.18. Statistical descriptive methods, Chi square test, and independent t-test, were used for analyzing the data. P value smaller than 0.05 were considered significant. Results: Totally, 203 children undergoing liver transplant surgery were evaluated. The age range of patients was 8 months to 18 years with mean of 8.8±5.6 years old. In our study 17 (8.4) patients developed PTLD. The mean interval between transplantation and PTLD diagnosis was 8.4 ±5.61 months ranging from 4 to 24 months. A total of five patients (2.5) died during the follow-up period and all of them were PTLD affected children (29.4 of PTLD patients). Lymph nodes were the most predominant site involved (64.7), while liver and GI involved in 35.2. Conclusion: The results of this study emphasize the relatively high incidence of PTLD after liver transplantation in children. Because of its impact on patient's outcome and reducing recipient's survival, it is important to minimize this problem by early diagnosis and providing effective treatment

Rare Coexistence of Myasthenia Gravis and Lambert-Eaton Myasthenic Syndrome with Adenocarcinoma of the Bladder: A Case Report

Abstract Introduction: The coexistence of myasthenia gravis and Lambert-Eaton myasthenic syndrome (LEMS) is very rare.Case report: Herein we report an 82 year old man a known case of adenocarcinoma of bladder who came with ptosis in left eye, diplopia, and dysphagia, weakness of both lower extremities and autonomic dysfunction. According to history, physical examination and para clinical work ups coexisting of myasthenia gravis and LEMS was diagnosed.Discussion: our patient is the first patient with Overlap myasthenic syndrome on the base of adenocarcinoma of bladder. The purpose of this case report is to emphasize on this fact that a patient with LEMS should be evaluate carefully for detecting underlying malignancies. Although in the most cases the origin is lung, extra pulmonary origin such as urinary system should be evaluate carefully too

Acute Progressive Visual Loss in a Case of Acute Myeloid Leukemia: Challenges in the Utility of Molecular Tests in Early Diagnose of Cytomegalovirus Retinitis

Cytomegalovirus (CMV) retinitis is one of the rare but debilitating presentations of the CMV infection in children with leukemia. Herein, we report a 12-year-old boy with acute myeloid leukemia complicated by rapid progressive visual loss during relapse of leukemia. The definite diagnosis of CMV retinitis was made after vitreous aspiration. Despite prompt treatment and ophthalmologic intervention, he died because of AML relapse. Viral infections, especially cytomegalovirus infection, may present with vague clinical pictures during any time of chemotherapy, which may not be easily distinguishable from bacterial or fungal retinitis and also chemotherapy-induced retinopathies. Clinician should consider CMV retinitis in seropositive patients especially those without detectable viremia

Termination of pregnancy due to Thalassemia major, Hemophilia, and Down's Syndrome: the views of Iranian physicians

<p>Abstract</p> <p>Background</p> <p>Genetic disorders due to <b>kindred </b>marriages are common medical conditions in Iran; however, the legal aspects of abortion remain controversial. This study was undertaken to determine physicians' opinions regarding the termination of pregnancy for three genetic diseases: thalassemia major, hemophilia, and Down's syndrome.</p> <p>Methods</p> <p>A questionnaire was administered to selected physicians by stratified random sampling to determine the following: age, gender, knowledge about prenatal diagnosis of diseases in high risk pregnancies, agreement with abortion, recommended gestational age for abortion, and, if opposed to abortion, the reason.</p> <p>Results</p> <p>Of 323 physicians, who participated in the study, 91.3(295), 40.6(131), and 78.6%(254) were in agreement and 8.7(28), 59.4(192), and 21.4%(69) were opposed to abortion for thalassemia major, hemophilia, and Down's syndrome, respectively. Among 289 physicians opposed to abortion in respect of each of all three conditions, the following reasons were cited: religion, 18; emotional, 10; quality of care, 23; hope to find a new treatment option in the future, 103; miscellaneous reasons, 6; and a combination of these reasons, 129. Among 680 physicians in agreement with abortion in relation to all of the diseases, 4.6%(31) were agreed with abortion in less than 12 weeks gestation, 79.2%(538) in less than 16 weeks gestation, 5.6%(38) in less than 20 weeks gestation, 2.2%(15) in less than 24 weeks gestation, and 8.4%(58) were agreed with beyond the 24 weeks of gestational age.</p> <p>Conclusion</p> <p>The majority of physicians were in agreement with abortion for thalassemia major and Down's syndrome because of the overall prognosis, but opposed to abortion for hemophilia.</p

Bilateral Intraocular Rhabdomyosarcoma: A Case Report

Here we report the case of a 1.5-year-old Iraqi boy who was referred for chemotherapy after left eye enucleation. The patient had a history of left eye leukocoria since 2 months of age. According to history, physical examination and paraclinical work up, he was first diagnosed as a case of retinoblastoma by an ophthalmologist. However, the pathology report favored embryonal rhabdomyosarcoma. In conclusion, a patient with leukocoria should be evaluated carefully for other underlying malignancies

Pleuropulmonary blastoma is a rare malignancy in young adult and childhood

Pleuropulmonary blastoma (PPB) is a rare childhood cancer occurs in the chest; specifically in the lungs or pleura with various histopathological appearances. Treatment for type I consist of surgery and possibly chemotherapy; for types II and III PPB surgery, chemotherapy and possibly radiation therapy. In this case report we present 2 patients with PPB which were unrecognized for several weeks and managed as pneumonia with pleural effusion. These cases are interesting because of the diagnostic difficulties and radiographic appearances

Pericardial Effusion and Atrial Thrombosis: A Rare Complication of Childhood Leukemia

Background: Acute lymphoblastic leukemia (ALL) is the most common malignancy diagnosed in children. Extramedullary leukemia including hepatosplenomegaly, lymphadenopathy, and mediastinal mass are the clinical presentations of T-cell ALL. Pericardial effusion and atrial mass are rare presentations of pediatric leukemia. Case Presentation: We report a 15-year-old girl with T-cell ALL, who presented initially with pericardial effusion and cardiac tamponade and subsequently developed right atrial mass. The mediastinal and right atrial masses were excised by surgical procedure as a treatment strategy for prevention of arrhythmia and sudden death. Conclusion: T-cell ALL can present with pericardial and mediastinal involvement as an initial manifestation. Pericardiocenthesis and systemic anticancer chemotherapy without local chemotherapy should be considered in these cases