Comparison of the Effects of Deferasirox (Nanojade®) and Deferoxamine (Desferal®) on Serum Ferritin Level Changes in Major Beta-Thalassemia Patients: A Randomized Clinical Trial

Background: Different drugs with different mechanisms have been used to remove iron overload in thalassemia patients. This study aimed to compare the effects of Nanojade and Deferoxamine in reducing serum ferritin levels. Methods: This randomized clinical trial was conducted on 41 major thalassemia patients. The selected patients were allocated to two groups by the permuted block randomization method. The first group was treated with Deferasirox (Nanojade) and the second group was treated with Deferoxamine (Desferal). All patients received the drugs at 14 mg/kg. Blood samples were collected at baseline, after 3 and 6 months after intervention. Chi-square test, Mann-Whitney U-test, and Friedman test were used for analytical statistics at the significance level of 0.05. Results: 51.9% of patients in the Nanojade group and 40% in the Desferal group were females. Before the intervention, no difference was observed in terms of basic and demographic information. Before the intervention, as well as 3 months, and 6 months after the intervention, none of the blood parameters in the studied groups were significantly different (p> 0.05). The overall mean ferritin levels had a significant decrease, in both groups, 6 months after the intervention (PDeferasirox = 0.001 vs PDeferoxamine = 0.043); However, in the comparison between the two groups, no significant difference was observed between the levels of ferritin and creatinine at any of the time points (p> 0.05). Conclusions: Deferasirox oral tablet (Nanojade®) is as effective as an injectable form (deferoxamine (Desferal®)) in reducing serum ferritin in patients with beta-thalassemia major without causing nephrotoxic effects. Therefore, it can be a suitable alternative to its injectable form

Echocardiographic Comparison of Myocardial Performance between Obese and Normal Weight Children and Adolescents

Background: Obesity prevalence has increased alarmingly in recent decades as a result of lifestyle changes. Obesity can have adverse effects during childhood and adolescence, which often persist into adulthood. Some studies have shown that echocardiographic findings are associated with obesity, accompanied by an increase in the left ventricle's size, diameter, and weight. This study compared Tissue Doppler and Pulse Doppler echocardiographic changes between obese and normal weight children and adolescents.Method: In 2021, this research was conducted on 66 children and adolescents aged 9 to 18 in Birjand. It included 33 individuals, comprising 25 boys and 8 girls, with a Body Mass Index (BMI) greater than 95, classified as the obese group, and 33 individuals, comprising 21 boys and 12 girls with a BMI between 10 and 85, ranked as the control group. The two groups' parameters were measured using Tissue Doppler Index (echocardiography), and the data was analyzed using SPSS version 16 at a significance level of less than 0.05.Result: The obese and normal weight groups had average ages of 12.84±1.92 and 12.87±2.87, respectively. In the obese group, the average BMI was 28.52±4.3, while in the control group, it was 16.55±2.21. The average EF (Ejection Fraction) in the obese group was 247.13±32.44, and in the control group, it was 249.6±24.68.In the obese group, the mean values of the parameters S´, A', and A were 12.91±2.63, 12.61±2.75 and 74.83±16.75, while in the control group, they were 11.47±2.66, 10.28±2.72, and 63.21±15.41. The obese group had substantially higher values compared to the control group (P<0.05). The mean values of IVRT, IVCT, MPI, E', and E were more significant in the obese group than in the control group, whereas ET and E/A were more significant in the control group. These differences, however, were not statistically significant.Conclusion: The significant increase in diastolic dysfunction parameters, including A' and E'/A', in the obese group may indicate a severe type of LV Compliance Decrease

Evaluation of the Prevalence of Congenital Cytomegalovirus Infection and its Clinical Outcomes in Neonates Born in Vali-e-Asr Hospital of Birjand, Iran

Background Cytomegalovirus (CMV) has been known as the most common cause for congenital infections worldwide which can lead to death in fetus and neonates as well as neuropsychiatric deficits. The aim of this study was to determine the prevalence of congenital CMV infection in newly born neonates and to evaluate the medical outcomes. Materials and Methods In this cross-sectional study, 868 neonates were selected using unconditional random sampling in 2017. Neonatal saliva was given on the first or second day of birth using a Dacron swab and tested by PCR for the presence of CMV DNA. All infants with positive CMV infection went through further tests and examinations to evaluate the clinical outcomes. Results: 787 (90.67%) and 81 (9.33%) births were term and preterm respectively. The PCR test was positive results only in 14 term neonates (1.61%). Thus, the prevalence of CMV infection in term neonates (n=14, 1.61%) was higher than that of preterm infants (n=0), although there was no statistically significant difference (P>0.05). The most common abnormalities were neutropenia (50%, n=4) followed by anemia (37.5%, n=3). Conclusion The prevalence of CMV infection in this study (1.61%) was within the global range and there was no association between CMV infection and birth weight, infant gender, and as well ae neonatal type. The frequency of symptomatic neonates at birth in this study was higher than the average global range, but almost the same as in developing countries

Epidemiology of Pediatric Acute Poisoning in Iran: A Systematic Review and Meta-Analysis

Background: The epidemiology of pediatric poisoning differs from one country to another. Due to the scarcity of reviews on this issue in Iran, we performed a systematic review and meta-analysis of studies providing data on Iranian pediatric poisoning epidemiology. Methods: PubMed, Web of Sciences, Science direct, Embase, Scopus and the Persian databases Magiran, Scientific Information Database (SID), and Iranmedex were searched. Twenty-seven studies published between 2002 and 2019 were included, based on the inclusion and exclusion criteria. Results: 54.7% of the participants in the reviewed studies were male, and 88.1% of them were unintentional. Most of the children were in the age range of 3-5 years. Non-pharmaceutical agents were the most common causes of poisonings (n=7175, 59.2%) and among them, illicit drugs (19.3%) followed by hydrocarbons (16.4%) constituted the most common non-pharmaceutical poisonings. Illicit drugs, especially opioids, showed an upward trend from 2002 to 2019. Among pharmaceuticals, central nervous system (CNS) drugs (50.4%), especially benzodiazepines (BZDs) (25.8%) and analgesics (14.5%), were the most frequent agents implicated. CNS complaints (51.8%), followed by gastrointestinal complaints (27.6%), were the most common symptoms. Ingestion was the most common route of poisoning (22.1%). Most of the poisoning cases occurred in summer (28.2%). 21.7% of the cases were hospitalized and the mortality rate was 0.8%. A remarkable downward trend in both hospitalization and death rates occurred over time. Conclusion: Overall, non-pharmaceutical toxicity was found to be the most common cause of poisoning. However, considering the agents separately, pharmaceuticals, illicit drugs, and hydrocarbons were the most common causes of poisoning, respectively. In contrast to the decreasing trend in hydrocarbons, pesticides, and pharmaceutical poisonings, we found an increase in opioid poisoning during our study period

Cardiac involvement in patients with thalassemia major and control group: a case-control study

Background: The most common cause of death in thalassemic patients is cardiac involvement especially cardiomyopathy. If the early stages of heart disease in people with thalassemia are diagnosed, mortality of patients reduced significantly. In this case-control study we compare the clinical symptoms, signs and para-clinic finding in thalassemia patients with control group. Methods: In this case-control study, thalassemia patients who had visited in special clinic of Vali-e-Asr hospital of Birjand University Medical Sciences during January of 2013 to May of 2014 compared with normal subjects. They matched by age and sex. After explaining the aims of the project, the written consent was received from both groups. Clinical examinations including history taking and auscultation of heart and lungs were performed by Pediatrician. Moreover, using the standard methods, the measurement of height, weight and blood pressure were performed. In following, electrocardiography (ECG) was taken in both groups. Also, both groups underwent transthoracic echocardiography by one cardiologist. Results: 42 thalassemia patients and 42 healthy subjects was compared in this study. Dyspnea was the only different symptom in the two groups. (23.8% in case and 4.8% in control P=0.01) In physical examination respiratory rate (RR) is only higher in patients with thalassemia that controls, but heart rate (HR), abnormal heart and lung sounds were not different significantly between two groups. In ECG, PR interval and QTc interval in patients with thalassemia was longer than healthy subject. In echocardiography, ejection fraction was lower but left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and size of the right ventricle and pulmonary artery pressure (PAP) was significantly higher than those in the control group. Conclusion: According the result of this study, dyspnea was higher in patients with thalassemia from normal subjects and PR interval and QT interval was longer in thalassemic patients. As well as the size of the left ventricle, size of right ventricle, pulmonary artery pressure were higher than normal population. Also, LV ejection fraction was lower in thalassemia than normal population

Prevalence of high blood pressure in primary school children in Birjand-Iran

Background and Aim: High blood pressure is a health problem in children. High blood pressure is a health problem in children, increasing of blood pressure during childhood predisposes children to hypertension in later life stages. In addition, high blood pressure during childhood is a risk factor to atherosclerosis in future the present study was conducted to determine prevalence of high blood pressure in primary schoolers in Birjand-Iran. Materials and Methods: This cross-sectional study was done on 1521 primary schoolers, aged 6-11 yrs, in Birjand selected through randomized multiple cluster sampling. A demography questionnaire was filled out for each child and each one's blood pressure was measured using the standard method. Systolic or dyastolic blood pressure between 90 and 95 percentile with respect to age and gender was taken as prehypertension and B.P≥95 was accounted as hypertension. The obtained data was analysed by means of SPSS software (V: 15) using T test, X2, and ANOVA at the significant level P<0/05 . Results: overall prevalence of prehypertension and hypertension was 11.6%, 7.4%, respectively regarding systolic blood pressure and 9.5%, and 0.9% for diastolic blood pressure, respectively. The most prevalence of prevalence was 13.5%. in obese children .With increasing age, mean systolic and diastolic pressure showed a significant increase. Conclusion: Prevalence of high blood pressure in Birjand children is high. Routine control of blood pressure and taking preventive measures to control obesity through lifestyle changes should be considered

Prevalence of Dyslipidemia among Elementary School Children in Birjand, East of Iran, 2012

Background: Various studies have indicated that dyslipidemia starts in childhood. There is a relationship between the concentration of blood lipids and atherosclerosis. In this study, we assessed the prevalence of dyslipidemia in elementary school children. Methods: This cross-sectional study was performed on 1,626 (882 girls and 744 boys) elementary school children aged between 6 and 11 years in Birjand in 2012. Samples were selected through multistage random sampling. The lipid profiles (i.e., cholesterol, triglyceride, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C]) of the subjects were measured after 12 hours’ fasting. The definition of dyslipidemia was based on the criteria of The American Children Academia in 2011.   Results: Dyslipidemia (at least one abnormal level of a serum lipid) was detected in 31% of the children (31.3% of the girls vs. 30.6% of the boys). Total cholesterol was ≥ 200 mg/dL in 13.4% of the children, LDL-C was ≥ 130 mg/dL in 8.5%, HDL-C was < 40 mg/dL in 11.3%, and triglyceride was ≥ 130 mg/dL in 15.3%. The prevalence of hypertriglyceridemia was significantly higher in the females than in the males (16.3% in the girls vs. 13.8% in the boys; p value = 0.01) - while hypercholesterolemia (12.2% in the girls vs. 14.9% in the boys; p value = 0.16), high LDL-C (8.5% in the girls vs. 8.5% in the boys; p value = 0.05), and low HDL-C (12.7% in the girls vs. 9.5% in the boys; p value = 0.1) were not significantly different between the two sexes. Conclusion: The prevalence of dyslipidemia was high in the school children in Birjand and, thus, requires preventive measures.