Iron-overload-associated cardiomyopathy has been one of the primary causes of mortality in thalas... more Iron-overload-associated cardiomyopathy has been one of the primary causes of mortality in thalassemia patients with iron burden. There is growing evidence citing the beneficial effects of ebselen as an antioxidant selectively blocking the divalent metal transporter 1 (DMT-1) to deter iron ingress into cardiomyocytes, raising internets in viewing this component in this population in order to treat and even prevent cardiomyopathy occurring from iron surplus. In this article, we reviewed the potential advantageous effects of ebselen in thalassemia patients who suffer from iron excess, susceptible to cardiomyopathy induced by iron overload. A systematic search in several databases, including PubMed, Scopus, and Web of Science, was conducted to explore the role of ebselen in controlling iron-overload-related cardiomyopathy in thalassemia patients by the keywords of Ebselen AND iron. The inclusion criteria were English-written preclinical and clinical studies investigating the efficacy a...
Background and Aim: Ferritin is frequently used to screen some dire consequences of iron overload... more Background and Aim: Ferritin is frequently used to screen some dire consequences of iron overload in β-thalassemia patients. The study aimed to define the best cutoff point of ferritin to screen for cardiac and liver hemosiderosis in these cases.Methods: This was a registry-based study on β-thalassemia patients living throughout Mazandaran province, Iran (n=1959). In this diagnostic research, the index test was ferritin levels measured by a chemiluminescent immunoassay. As a reference test, T2*-weighted magnetic resonance imaging (T2*-weighted MRI) was applied to determine cardiac and liver hemosiderosis.Results: A cutoff point of 2027 ng/mL for ferritin showed a sensitivity of 50%, specificity 77.4%, PPV 42.1%, and NPV 82.5% for cardiac hemosiderosis (area under curve [AUC] 0.66, 95% CI 0.60–0.71, adjusted odds ratio [OR] 2.05, 95% CI 1.05–4.01). At an optimum cutoff point of 1090 ng/mL, sensitivity 66.7%, specificity 68%, PPV 82.9%, and NPV 46.8% for liver hemosiderosis were estim...
Background: Beta thalassemia major is the most prevalent genetic disease in Mazandaran province. ... more Background: Beta thalassemia major is the most prevalent genetic disease in Mazandaran province. The national prevention program is successful, however our patients grow older and their managements get more complicated. Paper based clinical notes are being used and there are some electronic data banks mainly for financial matters. This registry (ETR Mazandaran) is designed to be a reliable data bank for epidemiologic and clinical data for beta thalassemia major patients living in the province. This registry will be a source for health system decision makers.
Background: Methicillin Resistance Staphylococcus aureus (MRSA) could be considered as a major co... more Background: Methicillin Resistance Staphylococcus aureus (MRSA) could be considered as a major concern in medicine can cause nosocomial infection and bacteremia, especially in patients using catheter and household medical devices. Methods: Using molecular diagnostic methods are important for identification of MRSA from the Methicillin Sensitive Staphylococcus aureus (MSSA). Here we described a fluorescent assay using biotin-labelling Loop-mediated isothermal amplification (LAMP) method assisted with streptavidin-coated Quantum Dots (QDs) for detection of MRSA. For comparison, another fluorescent assay using LAMP assisted with Green Viewer (GV; a fluorescent dye) was applied for detection of MRSA. The mecA gene was selected as the target for amplification by LAMP and for biotin-labeling of the LAMP amplicons, biotin-11-dUTP was mixed with the dNTPs (deoxy Nucleotide Phosphates) in LAMP reaction. For determining the clinical performance of the developed assay, 30 blood samples with MR...
Background: Major thalassemia prevention project in Iran began in 1997. Mazandaran Province in no... more Background: Major thalassemia prevention project in Iran began in 1997. Mazandaran Province in northern Iran took effective steps in preventing the birth of patients with thalassemia major in the country. We report on the demographic status of patients with thalassemia major registered in the electronic system of Mazandaran Province in Iran.Methods: The web-based application of the Mazandaran Thalassemia Registry (THRegistry) was designed based on the Net Framework platform in VB.Net and the 2014Sql Server database. The information source included clinical records in 14 thalassemic wards of the Mazandaran province hospitals. Epidemiological data of patients and date of transfusion, blood group, educational status, employment, marital status and having children were recorded.Results: The study population was 1,725 patients including 889 (51.5%) women and 836 (48.5%) men with a mean age of 30±9.6 years. A total of 188 patients born have been identified after the launch of the country&...
Background: Thrombophilia is an abnormality of blood clotting due to both genetic and non genetic... more Background: Thrombophilia is an abnormality of blood clotting due to both genetic and non genetic factors. Among genetic causes, Factor V Leiden (R506Q), G20210A in prothrombin, and C667T in methylenetetrahydrofolate reductase (MTFHR) mutations are more important. The purpose of this study was to define the frequency of these three risk factors among normal individuals and betathalassemia from Mazandaran, a province in north of Iran. Methods and findings: In this study, 105 normal individuals (as control) and 158 patients with beta-thalassemia were investigated in Sari, Mazandaran province. After DNA extraction, genotyping for three genes was determined using PCRRFLP methods. Frequency of the FV Leiden was 4.8% in normal control and 4.43% in beta-thalassemia cases, respectively. C667T allele frequency (allele T) in the MTHFR gene was 45.19% and 36.70% in normal and patients, respectively. Frequency of G20210A variant in normal control was 0.96 percent, but it was not seen in patient...
Background and Objective: Diabetes mellitus is one of complications that thalassemia major patien... more Background and Objective: Diabetes mellitus is one of complications that thalassemia major patients face with. Hence, blood glucose monitoring is of vital importance to these patients. Because of high level of fetal hemoglobin in these patients, the measurement of hemoglobin A1c is not reliable and should be displaced by fructosamine test. Material and Methods: The current descriptive study was carried out on 33 beta-thalassemia major patients afflicted with diabetes mellitus (21 female and 12 male cases). Blood glucose level, fructosamine, hemoglobin A1c, serum ferritin and fetal hemoglobin were measured. Results: Blood glucose levels are 204±103 mg/dL and 221±101 mg/dL (p=0.63); fetal hemoglobin levels are 9%±7% and 13%±9% (p=0.22); serum ferritin levels are 1744±1534 ng/mL and 3253±1773 ng/mL (p=0.96) in female and male patients, respectively. The level of fructosamine (42±124 mmol/L) and glycosylated hemoglobin (8.9%±1.8%) are correlated significantly (r=0.69, p<0.01). Both H...
Journal of Mazandaran University of Medical Sciences, 2017
Background and purpose: The electronic registry of patients with beta thalassemia major was devel... more Background and purpose: The electronic registry of patients with beta thalassemia major was developed in Thalassemia Research Center affiliated with Mazandaran University of Medical Sciences in order to provide an accurate database for researchers and health planners. This study reports the condition of patients registered in Mazandaran province till summer 2016. Materials and methods: In this descriptive study, the following information was recorded in the registry system: epidemiologic data, clinical examination data, complications, routine laboratory test results, medications, new cases, and death. Descriptive statistics were used to summarize the data. Results: Until the summer 2016, 1053 patients including 500 (47.5%) males and 553 (52.5%) females were registered in 14 hospitals. These were half of the number of patients receiving care by the aforementioned University. Among the patients, 920 (87.4%) were transfusion dependent. Single patients included 54.2% (n= 571). The level...
This study examined whether administration of amlodipine could improve myocardial iron loading st... more This study examined whether administration of amlodipine could improve myocardial iron loading status in patients with transfusion dependent β‐thalassemia (TDT), through a placebo‐controlled, crossover study.
Numerous problematic disorders such as vitamin D (Vit-D) deficiency subsequent to large iron load... more Numerous problematic disorders such as vitamin D (Vit-D) deficiency subsequent to large iron loading can be developed in patients with β-thalassemia. The study aimed to estimate Vit-D insufficiency and its risk factors in patients with β-thalassemia. In this multicenter and observational study, all β-thalassemia patients, who referred to 14 hospital-based thalassemia divisions or clinics in Mazandaran province, Iran were included in the study. The data belong to December 2015 until December 2019. The study population was made of transfusion dependent thalassemia (TDT) and non-transfusion-dependent thalassemia (NTDT) patients. Serum levels of 25-OHD3 have been measured by high performance liquid chromatography (HPLC) method as ng/mL. Demographic and clinical information along with some biological tests, as well as the results of T2*-weighted magnetic resonance imaging were analyzed. Of 1959 registered patients, 487 (24.9%) patients had Vit-D-related data. The prevalence of Vit-D insu...
Background: In β-thalassemia major (β-TM) patients, iron overload is one of the main causes of in... more Background: In β-thalassemia major (β-TM) patients, iron overload is one of the main causes of inflammation. This study investigated whether use of silymarin could improve inflammatory status in patients with β-TM and iron overload, through a placebo-controlled, crossover study. Methods: Silymarin (140 mg, 3 times a day) or placebo were prescribed to all patients (n = 82) for 12 weeks, and after a 2-week washout period, patients were crossed over to the other group. The efficacy of silymarin was assessed by measuring serum C-reactive protein (CRP) (mg/dL), interleukin (IL)-6 (pg/mL), and IL-10 (pg/mL). Results: Sixty-nine patients completed the study. Data analysis showed that compared to the placebo, silymarin could decrease CRP, IL-6, and raise IL-10 significantly (the p values for all variables were <0.001). Cohen’s d for CRP adjusted according to the baseline CRP value was –1.72, the 95% confidence interval (CI) –2.12 to –1.33. The adjusted Cohen’s d equal to –1.12, 95% CI –1....
Background: Electronic registry system of beta-thalassemia patients was run by Thalassemia Resear... more Background: Electronic registry system of beta-thalassemia patients was run by Thalassemia Research Center (TRC) in 2017. The aim of the current study was presentation of therapeutic status in these patients at Mazandaran Province, Iran. Methods: Therapeutic status variables including: Name of cities and hospitals, age and sex of patients, dependent and non-transfusion-dependent, starting age of the blood transfusion and iron-chelating agents, blood group and Rh, washed blood transfusion, abnormal antibody, transfusion reactions, mean hemoglobin during the last 3 months, type of iron chelators, iron chelators dosage, serum ferritin, and the use of hydroxyurea. Results: Overall, 1831 patients were registered [891 male (48.7%)]. Mean age of patients was 30±9.7 yr. Average of hemoglobin levels for female and male were 9.1±5.1 and 9.4±6.3 gr/dl, respectively. Seventy-six percent of transfusion-dependent patients (1385) have received iso-group PRBC (packed red blood cells), after crossma...
Abstract Diabetes mellitus (DM) is one of the potential complications in patients with transfusio... more Abstract Diabetes mellitus (DM) is one of the potential complications in patients with transfusion-dependent β-thalassemia major (β-TM). In this case-controlled study, we examined the pancreatic iron levels in outpatients with β-TM. In this study, cases of patients with β-TM and DM were gender- and age-matched with control subjects, who were non-diabetic and had normal blood glucose on standard oral glucose tolerance (OGTT) tests. One of four diagnoses [normal, pre-diabetes, impaired glucose tolerance (IGT), DM] was made according to the American Diabetes Association (ADA) criteria. The T2*-weighted magnetic resonance imaging (T2*-weighted MRI) of the heart, liver, and pancreas was performed using a 1.5 Tesla scanner. The study enrolled 26 diabetic cases, 17 non-diabetic cases, and eight cases of IGT or pre-diabetes cases. The severity of pancreatic and cardiac iron siderosis was significantly different between the groups. We found a statistically significant difference at 5.6 ms in the T2*-weighted MRI values for the pancreas between patients with normal vs. abnormal glucose metabolism [p < 0.009; odds ratio (OR): 11.2; 95% confidence interval (95% CI): 1.32-94.4)]. The receiver operating characteristic (ROC) curve for the 5.6 ms cutoff led to an area under the curve (AUC) of 0.69 (95% CI: 55.0-84.0; p < 0.02), with sensitivity and specificity of 94.0 and 42.0%, respectively. There was a moderate positive correlation between pancreatic and cardiac T2*-weighted MRI (r = 0.4; p < 0.001), and a weak correlation between the pancreas and the liver (r = 0.38; p < 0.005). To conclude, we have introduced a cutoff of 5.6 ms on T2*-weighted MRI of the pancreas for prediction of abnormal glucose metabolism in β-TM patients.
This study aimed to determine the potential iron-chelating effects of silymarin in patients with ... more This study aimed to determine the potential iron-chelating effects of silymarin in patients with β-thalassemia major receiving standard iron-chelation therapy. We evaluated whether addition of silymarin to standard iron-chelation therapy could improve iron burden markers and liver and cardiac function in these patients, via a placebo-controlled, crossover clinical study. Silymarin (140 mg) or placebo were administered thrice daily to all patients (n = 82) for 12 weeks, and after a 2-week washout period, patients were crossed over to the other groups. Silymarin efficacy was assessed by measuring serum iron level, ferritin level, total iron-binding capacity and liver and cardiac function on magnetic resonance imaging. Silymarin treatment resulted in a negative change in the serum iron and ferritin levels and a positive change in the total iron-binding capacity levels (treatment effect, p < .001, p = .06, and p = .05, respectively). Silymarin treatment led to positive changes in car...
Iron-overload-associated cardiomyopathy has been one of the primary causes of mortality in thalas... more Iron-overload-associated cardiomyopathy has been one of the primary causes of mortality in thalassemia patients with iron burden. There is growing evidence citing the beneficial effects of ebselen as an antioxidant selectively blocking the divalent metal transporter 1 (DMT-1) to deter iron ingress into cardiomyocytes, raising internets in viewing this component in this population in order to treat and even prevent cardiomyopathy occurring from iron surplus. In this article, we reviewed the potential advantageous effects of ebselen in thalassemia patients who suffer from iron excess, susceptible to cardiomyopathy induced by iron overload. A systematic search in several databases, including PubMed, Scopus, and Web of Science, was conducted to explore the role of ebselen in controlling iron-overload-related cardiomyopathy in thalassemia patients by the keywords of Ebselen AND iron. The inclusion criteria were English-written preclinical and clinical studies investigating the efficacy a...
Background and Aim: Ferritin is frequently used to screen some dire consequences of iron overload... more Background and Aim: Ferritin is frequently used to screen some dire consequences of iron overload in β-thalassemia patients. The study aimed to define the best cutoff point of ferritin to screen for cardiac and liver hemosiderosis in these cases.Methods: This was a registry-based study on β-thalassemia patients living throughout Mazandaran province, Iran (n=1959). In this diagnostic research, the index test was ferritin levels measured by a chemiluminescent immunoassay. As a reference test, T2*-weighted magnetic resonance imaging (T2*-weighted MRI) was applied to determine cardiac and liver hemosiderosis.Results: A cutoff point of 2027 ng/mL for ferritin showed a sensitivity of 50%, specificity 77.4%, PPV 42.1%, and NPV 82.5% for cardiac hemosiderosis (area under curve [AUC] 0.66, 95% CI 0.60–0.71, adjusted odds ratio [OR] 2.05, 95% CI 1.05–4.01). At an optimum cutoff point of 1090 ng/mL, sensitivity 66.7%, specificity 68%, PPV 82.9%, and NPV 46.8% for liver hemosiderosis were estim...
Background: Beta thalassemia major is the most prevalent genetic disease in Mazandaran province. ... more Background: Beta thalassemia major is the most prevalent genetic disease in Mazandaran province. The national prevention program is successful, however our patients grow older and their managements get more complicated. Paper based clinical notes are being used and there are some electronic data banks mainly for financial matters. This registry (ETR Mazandaran) is designed to be a reliable data bank for epidemiologic and clinical data for beta thalassemia major patients living in the province. This registry will be a source for health system decision makers.
Background: Methicillin Resistance Staphylococcus aureus (MRSA) could be considered as a major co... more Background: Methicillin Resistance Staphylococcus aureus (MRSA) could be considered as a major concern in medicine can cause nosocomial infection and bacteremia, especially in patients using catheter and household medical devices. Methods: Using molecular diagnostic methods are important for identification of MRSA from the Methicillin Sensitive Staphylococcus aureus (MSSA). Here we described a fluorescent assay using biotin-labelling Loop-mediated isothermal amplification (LAMP) method assisted with streptavidin-coated Quantum Dots (QDs) for detection of MRSA. For comparison, another fluorescent assay using LAMP assisted with Green Viewer (GV; a fluorescent dye) was applied for detection of MRSA. The mecA gene was selected as the target for amplification by LAMP and for biotin-labeling of the LAMP amplicons, biotin-11-dUTP was mixed with the dNTPs (deoxy Nucleotide Phosphates) in LAMP reaction. For determining the clinical performance of the developed assay, 30 blood samples with MR...
Background: Major thalassemia prevention project in Iran began in 1997. Mazandaran Province in no... more Background: Major thalassemia prevention project in Iran began in 1997. Mazandaran Province in northern Iran took effective steps in preventing the birth of patients with thalassemia major in the country. We report on the demographic status of patients with thalassemia major registered in the electronic system of Mazandaran Province in Iran.Methods: The web-based application of the Mazandaran Thalassemia Registry (THRegistry) was designed based on the Net Framework platform in VB.Net and the 2014Sql Server database. The information source included clinical records in 14 thalassemic wards of the Mazandaran province hospitals. Epidemiological data of patients and date of transfusion, blood group, educational status, employment, marital status and having children were recorded.Results: The study population was 1,725 patients including 889 (51.5%) women and 836 (48.5%) men with a mean age of 30±9.6 years. A total of 188 patients born have been identified after the launch of the country&...
Background: Thrombophilia is an abnormality of blood clotting due to both genetic and non genetic... more Background: Thrombophilia is an abnormality of blood clotting due to both genetic and non genetic factors. Among genetic causes, Factor V Leiden (R506Q), G20210A in prothrombin, and C667T in methylenetetrahydrofolate reductase (MTFHR) mutations are more important. The purpose of this study was to define the frequency of these three risk factors among normal individuals and betathalassemia from Mazandaran, a province in north of Iran. Methods and findings: In this study, 105 normal individuals (as control) and 158 patients with beta-thalassemia were investigated in Sari, Mazandaran province. After DNA extraction, genotyping for three genes was determined using PCRRFLP methods. Frequency of the FV Leiden was 4.8% in normal control and 4.43% in beta-thalassemia cases, respectively. C667T allele frequency (allele T) in the MTHFR gene was 45.19% and 36.70% in normal and patients, respectively. Frequency of G20210A variant in normal control was 0.96 percent, but it was not seen in patient...
Background and Objective: Diabetes mellitus is one of complications that thalassemia major patien... more Background and Objective: Diabetes mellitus is one of complications that thalassemia major patients face with. Hence, blood glucose monitoring is of vital importance to these patients. Because of high level of fetal hemoglobin in these patients, the measurement of hemoglobin A1c is not reliable and should be displaced by fructosamine test. Material and Methods: The current descriptive study was carried out on 33 beta-thalassemia major patients afflicted with diabetes mellitus (21 female and 12 male cases). Blood glucose level, fructosamine, hemoglobin A1c, serum ferritin and fetal hemoglobin were measured. Results: Blood glucose levels are 204±103 mg/dL and 221±101 mg/dL (p=0.63); fetal hemoglobin levels are 9%±7% and 13%±9% (p=0.22); serum ferritin levels are 1744±1534 ng/mL and 3253±1773 ng/mL (p=0.96) in female and male patients, respectively. The level of fructosamine (42±124 mmol/L) and glycosylated hemoglobin (8.9%±1.8%) are correlated significantly (r=0.69, p<0.01). Both H...
Journal of Mazandaran University of Medical Sciences, 2017
Background and purpose: The electronic registry of patients with beta thalassemia major was devel... more Background and purpose: The electronic registry of patients with beta thalassemia major was developed in Thalassemia Research Center affiliated with Mazandaran University of Medical Sciences in order to provide an accurate database for researchers and health planners. This study reports the condition of patients registered in Mazandaran province till summer 2016. Materials and methods: In this descriptive study, the following information was recorded in the registry system: epidemiologic data, clinical examination data, complications, routine laboratory test results, medications, new cases, and death. Descriptive statistics were used to summarize the data. Results: Until the summer 2016, 1053 patients including 500 (47.5%) males and 553 (52.5%) females were registered in 14 hospitals. These were half of the number of patients receiving care by the aforementioned University. Among the patients, 920 (87.4%) were transfusion dependent. Single patients included 54.2% (n= 571). The level...
This study examined whether administration of amlodipine could improve myocardial iron loading st... more This study examined whether administration of amlodipine could improve myocardial iron loading status in patients with transfusion dependent β‐thalassemia (TDT), through a placebo‐controlled, crossover study.
Numerous problematic disorders such as vitamin D (Vit-D) deficiency subsequent to large iron load... more Numerous problematic disorders such as vitamin D (Vit-D) deficiency subsequent to large iron loading can be developed in patients with β-thalassemia. The study aimed to estimate Vit-D insufficiency and its risk factors in patients with β-thalassemia. In this multicenter and observational study, all β-thalassemia patients, who referred to 14 hospital-based thalassemia divisions or clinics in Mazandaran province, Iran were included in the study. The data belong to December 2015 until December 2019. The study population was made of transfusion dependent thalassemia (TDT) and non-transfusion-dependent thalassemia (NTDT) patients. Serum levels of 25-OHD3 have been measured by high performance liquid chromatography (HPLC) method as ng/mL. Demographic and clinical information along with some biological tests, as well as the results of T2*-weighted magnetic resonance imaging were analyzed. Of 1959 registered patients, 487 (24.9%) patients had Vit-D-related data. The prevalence of Vit-D insu...
Background: In β-thalassemia major (β-TM) patients, iron overload is one of the main causes of in... more Background: In β-thalassemia major (β-TM) patients, iron overload is one of the main causes of inflammation. This study investigated whether use of silymarin could improve inflammatory status in patients with β-TM and iron overload, through a placebo-controlled, crossover study. Methods: Silymarin (140 mg, 3 times a day) or placebo were prescribed to all patients (n = 82) for 12 weeks, and after a 2-week washout period, patients were crossed over to the other group. The efficacy of silymarin was assessed by measuring serum C-reactive protein (CRP) (mg/dL), interleukin (IL)-6 (pg/mL), and IL-10 (pg/mL). Results: Sixty-nine patients completed the study. Data analysis showed that compared to the placebo, silymarin could decrease CRP, IL-6, and raise IL-10 significantly (the p values for all variables were <0.001). Cohen’s d for CRP adjusted according to the baseline CRP value was –1.72, the 95% confidence interval (CI) –2.12 to –1.33. The adjusted Cohen’s d equal to –1.12, 95% CI –1....
Background: Electronic registry system of beta-thalassemia patients was run by Thalassemia Resear... more Background: Electronic registry system of beta-thalassemia patients was run by Thalassemia Research Center (TRC) in 2017. The aim of the current study was presentation of therapeutic status in these patients at Mazandaran Province, Iran. Methods: Therapeutic status variables including: Name of cities and hospitals, age and sex of patients, dependent and non-transfusion-dependent, starting age of the blood transfusion and iron-chelating agents, blood group and Rh, washed blood transfusion, abnormal antibody, transfusion reactions, mean hemoglobin during the last 3 months, type of iron chelators, iron chelators dosage, serum ferritin, and the use of hydroxyurea. Results: Overall, 1831 patients were registered [891 male (48.7%)]. Mean age of patients was 30±9.7 yr. Average of hemoglobin levels for female and male were 9.1±5.1 and 9.4±6.3 gr/dl, respectively. Seventy-six percent of transfusion-dependent patients (1385) have received iso-group PRBC (packed red blood cells), after crossma...
Abstract Diabetes mellitus (DM) is one of the potential complications in patients with transfusio... more Abstract Diabetes mellitus (DM) is one of the potential complications in patients with transfusion-dependent β-thalassemia major (β-TM). In this case-controlled study, we examined the pancreatic iron levels in outpatients with β-TM. In this study, cases of patients with β-TM and DM were gender- and age-matched with control subjects, who were non-diabetic and had normal blood glucose on standard oral glucose tolerance (OGTT) tests. One of four diagnoses [normal, pre-diabetes, impaired glucose tolerance (IGT), DM] was made according to the American Diabetes Association (ADA) criteria. The T2*-weighted magnetic resonance imaging (T2*-weighted MRI) of the heart, liver, and pancreas was performed using a 1.5 Tesla scanner. The study enrolled 26 diabetic cases, 17 non-diabetic cases, and eight cases of IGT or pre-diabetes cases. The severity of pancreatic and cardiac iron siderosis was significantly different between the groups. We found a statistically significant difference at 5.6 ms in the T2*-weighted MRI values for the pancreas between patients with normal vs. abnormal glucose metabolism [p < 0.009; odds ratio (OR): 11.2; 95% confidence interval (95% CI): 1.32-94.4)]. The receiver operating characteristic (ROC) curve for the 5.6 ms cutoff led to an area under the curve (AUC) of 0.69 (95% CI: 55.0-84.0; p < 0.02), with sensitivity and specificity of 94.0 and 42.0%, respectively. There was a moderate positive correlation between pancreatic and cardiac T2*-weighted MRI (r = 0.4; p < 0.001), and a weak correlation between the pancreas and the liver (r = 0.38; p < 0.005). To conclude, we have introduced a cutoff of 5.6 ms on T2*-weighted MRI of the pancreas for prediction of abnormal glucose metabolism in β-TM patients.
This study aimed to determine the potential iron-chelating effects of silymarin in patients with ... more This study aimed to determine the potential iron-chelating effects of silymarin in patients with β-thalassemia major receiving standard iron-chelation therapy. We evaluated whether addition of silymarin to standard iron-chelation therapy could improve iron burden markers and liver and cardiac function in these patients, via a placebo-controlled, crossover clinical study. Silymarin (140 mg) or placebo were administered thrice daily to all patients (n = 82) for 12 weeks, and after a 2-week washout period, patients were crossed over to the other groups. Silymarin efficacy was assessed by measuring serum iron level, ferritin level, total iron-binding capacity and liver and cardiac function on magnetic resonance imaging. Silymarin treatment resulted in a negative change in the serum iron and ferritin levels and a positive change in the total iron-binding capacity levels (treatment effect, p < .001, p = .06, and p = .05, respectively). Silymarin treatment led to positive changes in car...
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