Beliefs of Jordanian Children with Thalassemia toward Using Iron Chelation Therapy

Adherence to thalassemia treatment including chelation drugs is influenced by numerous factors. This study aims to explore beliefs about iron chelation therapy and adherence to this medication in Jordanian children with thalassemia major. In this descriptive cross-sectional study, seventy three patients were selected conveniently to complete the study instruments. Participants reported high adherence to their chelation therapy (88.1%). The majority (87.6%) expressed necessity for chelation therapy. However, 42.18% of the participants expressed their concerns about the therapy in which 57.9% of them showed concerns about dependency on medicine and 46.4% of them revealed concerns about the long-term effect of medicine. Overall, about 12.9% of the participants recorded correct and complete answers about thalassemia and its treatment. Knowledge about thalassemia and concerns about chelation were not significantly associated with adherence to the chelation therapy (r = 0.32, p = 0.19;r = 0.29, p = 0.25, respectively). However, there was a significant positive relationship between beliefs about the necessity of the therapy and adherence to it (r = 0.38, p = 0.03). In conclusion, Jordanian children showed proper adherence to their chelation therapy. Health care professionals should discuss patients’ concerns about chelation therapy which might increase patients’ adherence to their therapy.

Influence of CaNa_2 EDTA on topical 5-aminolaevulinic acid photodynamic therapy

Background We asssessed whether the CaNa_2 EDTA could improve the accumulation of protoporphyrin Ⅸ (PpⅨ) and photosensitisation in HEp-2 cells as well as the depth of treatment of skin cancers on the topical 5-Aminolaevulinic acid (5-ALA) PDT.Methods HEp-2 cells were incubated with 5-ALA (0-1mmol/L) and CaNa_2EDTA (0-1mmol/L) for 4 hours,intracellular protoporphyrin Ⅸ content was quantified by extraction,and cell viability was assessed by use of the methyl-tetrazolium (MTT) assay four hours after exposure to light. In comparison with the pictures before and after treatment,depth of treatment could be determined using a Acuson Sequioa 512 phase-array system in paired experiments.Results PpⅨ accumulation increased with increasing extracellular concentrations of ALA (0-1mmol/L). Adding 1mmol/L of CaNa_2EDTA increased 30% PpⅨ accumulation over the same period of incubation in the concentration of 1mmol/L ALA. Significant difference was observed between the 5-ALA alone group and 5-ALA combined CaNa_2 EDTA group in the PpⅨ accumulation ( P <0.01). Cell viability after exposure to light decreased with adding CaNa_2 EDTA,a statistical difference in a same fluence above 1.2 J/cm 2 between two groups was demonstrated ( P <0.05,P <0.01 respectively). Depth of treatment of skin cancers were increased in CaNa_2 EDTA-treated group.conclusion CaNa_2 EDTA could improve the PpⅨ accumulation and photosensitisation in HEp-2 cells. Clinically,CaNa_2 EDTA could increase the depth of treatment in the cutaneous cancers.