This study aimed to evaluate serum levels of pro-inflammatory cytokines and TGF-β in sickle cell disease (SCD) patients, and to compare the results during vaso-occlusive crisis (VOC) or steady state (StSt) conditions. 54 SCD patients (37HbSS and 17Sβ(+)Thal) were enrolled in the study and evaluated in two groups as follows; group A consisted of 39 VOC patients and group B comprised 15 StSt patients. Nineteen healthy volunteers were included as controls. Circulating levels of IL-1, IL-6, IL-8, IL-17,TNF-α and TGF-β were measured using ELISA. Patients in VOC showed higher mean levels of all cytokines than those found in steady-state patients, but this was only marginally significant for IL-8 levels (P = 0.08). Increased levels of TGF-β and IL-17 were found in StSt patients versus normal controls (P = 0.004 and P<0.0001 respectively). A positive correlation was observed between IL-8 and IL-17 in both groups of patients (P = 0.002 and P = 0.005 respectively). Decreased levels of TNF-α, IL-1β and IL-17 were found in hydroxyurea-treated patients. Additionally, significantly higher levels of IL-6 and IL-8 were observed in hydroxyurea-treated and untreated patients than in controls respectively (P = 0.04 and P = 0.01). Our findings indicate that pro-inflammatory cytokines, especially IL-8 and IL-17, could be used as related markers for assessing disease severity, and consequently therapeutic intervention.

Introduction: This study aimed to evaluate the frequency rate of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) causing bloodstream infections (BSIs) in cancer patients referred to one of the major referral hospitals in Ahvaz city, southwest Iran. Materials and Methods: In this study, 1700 blood cultures were collected from 610 cancer patients suspected to have BSI from October 2016 to August 2017 referred to the Shafa cancer hospital, Ahvaz, southwest of Iran. The blood culture bottles were incubated aerobically at 35– 37ºC for 24 hours and then sub-cultured on routine microbiology culture media. The bacterial colonies were identified using standard tests. The antibiotic susceptibility testing was achieved by the disc-diffusion method. The phenotypic detection of ESBLs was carried out by the combination disc-diffusion test (CDDT). Finally, the polymerase chain reaction (PCR) was performed to investigate the presence of bla_TEM, bla_CTX, bla_SHV, and bla_PER genes. Results: The prevalence of BSI in cancer patients was 16.4% (100/610). Gram-negative rods with rate of 74% (74/100) were the most prevalent bacteria. The frequency of Enterobacteriaceae family was 21% including Escherichia coli (n: 8), Klebsiella pneumoniae (n: 6), Enterobacter spp. (n: 5), Citrobacter freundii (n: 1), and Serratia marcescens (n: 1). All isolates were multidrug-resistant (resistance to three or more antibiotics). The results of CDDT showed that 42.8% (9/21) of Enterobacteriaceae isolates had a positive ESBL test of which 100% (9/9) indicated positive band for at least one of the ESBL genes by PCR method. The bla_CTX-M and bla_TEM genes were detected in 38% (8/21) and 23.8% (5/21) of isolates, respectively, while the bla_SHV and bla_PER were not detected in any isolates. Conclusion: Based on the results, surveillance, and antibiotic stewardship programs should be implemented for cancer patients to prevent the spread of more ESBL-PE that have limited therapeutically choices.

Background: Iron deficiency is a major health problem worldwide and especially in developing countries. Iron-deficiency anemia has adverse effects on the development of children. Objective: The purpose of this study was to determine the prevalence of iron-deficiency anemia in children under 5 years of age in southwest Iran. The study also sought to investigate the association between socioeconomic, demographic, cultural, and nutritional factors and iron-deficiency anemia in the selected area. Methods: A randomized, cross-sectional study was performed of children 6 to 59 months of age living in urban and rural areas of Ahwaz District in Khuzestan Province. At eight randomly selected health centers, the children's height (or length) and weight were measured, and information on length and weight at birth was obtained from growth charts. Blood samples were taken from 337 randomly selected children. Results: The results showed that 43.9% of the children had anemia and 29.1% iron-deficiency anemia. The highest prevalence of iron-deficiency anemia was in the 12- to 24-month age group. In the urban areas, infants 6 to 11 months of age had the highest prevalence of iron-deficiency anemia. Conclusions: The high prevalence of iron-deficiency anemia among children in southwest Iran indicates a major nutrition and health problem.

BACKGROUND & AIM: it is well known that hydroxyurea impacts on clinical and hematologic indices in sickle cell disease (SCD), we aimed to evaluate the effect of hydroxyurea on clinical and hematological improvement of sickle cell anemia. METHODS & MATERIALS: In this cohort study 48 patients with sickle cell disease were enrolled and pain crisis, severity of pain, acute chest syndrome, the number of hospitalization, the rate of transfusion, spleen size, total Hb, HbF levels, MCV, MCH were compared before and after treatment with HU 10 mg/kg/day/for one year. RESULTS: In patients with Sickle cell disease Hu significantly decreased the rate of transfusion, hospitalization, spleen size and significantly increased Hb, RBC indices and HbF. Furthermore, we did not find any remarkable adverse effect related to HU during the one year follow up in patients. CONCLUSION: We demonstrated that in the course of one year hydroxyurea 10 mg/kg/day can significantly increase HbF, total hemoglobin and RBC indices without any notable side effect in patients with SCD.