Background: Storage of platelet concentrates (PCs) at room temperature (20-24°C) limits its storage time to 5 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common inherited enzyme deficiency of the human red blood cells . Most of G6PD deficient individuals are asymptomatic, but acute hemolytic anemia may be presented with nausea, vomiting, abdominal pain, headache, jaundice, pallor, discoloration of the urine, chills, and fever. Seizure is reported as a rare symptom, as well. The present study aimed to investigate seizure following acute hemolysis caused by Glucose-6-phosphate dehydrogenase deficiency. Material and Methods: This analytic cross-sectional study was conducted on all consecutive patients aged 1-12 years with G6PD deficiency hospitalized for hemolysis in 17 Shahrivar children hospital, Rasht, Iran, in 2016. Demographic characteristics and other variables such as place of inhabitants, type of drinking water, history of seizure in the patients and family, cause of hemolysis, hemoglobin level and hemoglobinuria on admission, and infection history prior to hemolysis were recorded. Data were analyzed by Mann-Whitney U test and Fischer Exact Test. P-value < 0.05 indicated statistical significance and data were assessed by SPSS (version 20). Results: The youngest patient was one year old and the oldest was 11 years old. Most of them were males (68.9%). Out of 244 patients, 8 ones (3.3%) experienced seizure. There was a significant correlation between seizure occurrence and family history of seizure (p=0.03) as well as fava bean consumption (p=0.019) as the causes of hemolysis; but not with infection as the cause of hemolysis, hemoglobin or hemoglobinuria level on admission, types of drinking water, place of living, and gender. Methemoglobinemia was considered as the main cause of the seizure. Conclusion: Although the rate of seizure was not so high (3.3%), it seems that seizure can be a critical and potentially life-threatening complication in these patients. Environmental factors may also play a role in the pathogenesis of the seizure in these patients.

Introduction: Gastroenteritis (GE) is one of the most common pediatric diseases. Hyponatremia commonly occurs by administering hypotonic fluids to GE and hospitalized children. Yet, there is no consensus on the ideal method of treatment. Objectives: we aimed to assess suitable intravenous (IV) fluid for preventing dysnatremia in children with GE. Patients and Methods: This is a double blind randomized clinical trial, which was conducted on infants of 6 months up to 14 years children with GE. Children were randomly assigned in 2 different groups. Group A; received 20 cc/kg 0.9% isotonic saline as a bolus, and 0.45% hypotonic saline as sum of maintenance fluid and volume deficit. Group B was treated with the same bolus and 0.9% isotonic saline with 20 mEq/L KCl as sum of maintenance fluid and volume deficit. Blood and urine samples were taken at admission, 4 and 24 hours. Data were analyzed by independent t test, Mann-Whitney U test, Friedmann test, chi-square and 2-tailed repeated measurements by SPSS version 19. Results: Baseline hyponatremia and isonatremia were detected in 24 (31.5%) and 51 (67.1%) patients, respectively. Mean level of sodium at T0, T4 and T 24 mentioned no significant difference between groups. No hypernatremia was noted by administering isotonic saline. Results showed that 4 and 24 hours after administration isotonic saline, the mean plasma sodium differed significantly in baseline hyponatremic patients. However, no significant difference was noted after 4 and 24 hours in group A. Conclusion: According to the considerable effect of isotonic saline on hyponatremic patients, it seems that administering isotonic fluids regardless of the types of dysnatremia can be recommended to lessen clinicians’ conflicting decision-making in selecting an appropriate fluid.

Background: Osteoporosis is one of the main causes of morbidity in patients with thalassemia major. Osteoprotegerin (OPG) is secreted by osteoblasts and osteogenic stromal stem cells and protects the skeleton from excessive bone reabsorption. In this study, the authors aimed to assess the relationship between OPG with osteoporosis and osteopenia in patients with thalassemia major. Materials and Methods: In this analytic cross-sectional study, 37 patients aged 8-18 years, with thalassemia major were enrolled. Biochemical markers including hemoglobin, ferritin, calcium, phosphorus levels, and MRI T2* heart and liver were assessed. A bone mineral densitometry (BMD) was performed as well. Statistical analysis was performed by the independent T-test and Chi-Square test using the SPSS 20. The Multiple linear regression analysis was used to investigate the association between the BMD Z-score and OPG by the effect modification. Results: The mean age of patients was 14.86±3.72 years. Normal bone density, osteopenia, and osteoporosis were noted in 2 (5.4%), 21 (56.8%), and 14 (37.08%) patients, respectively. The number of girls (P=0.042), mean age (P=0.045), and MRI T2* heart (P=0.033) in patients with osteopenia was significantly higher than patients with osteoporosis. The BMD Z-score was not significantly associated with OPG regarding the total number of participants, whereas in patients with osteoporosis, this association was significant (P=0.001). In all effect modified models, BMD remained statistically non-significant except for body mass index modification (P=0.046). Conclusion: Based on the results, it seems that further complicated studies are needed to be performed on this issue.