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Prevalence of Hypogonadism in β-Thalassemia Major Patients from Gaza Strip

مدى انتشار قصور الغدد التناسلية في مرضى التلاسيميا العظمى ( (β في قطاع غزة

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 Publication date 2021
  fields Pharmacy
and research's language is العربية
 Created by Shamra Editor




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This study was conducted to determine the prevalence of hypogonadism among β-Thalassemia Major (β-TM) adolescent patients, and the role of iron chelation therapy (ICT) in its prevention. Data was collected from 60 β-TM patients and 35 controls aged 13─ 30 years through a questionnaire and a review of medical history to collect sociodemographic characteristics, transfusion regimen, chelating history and pubertal status. Complete blood count, serum ferritin, and pituitary-gonadal function tests were analyzed 1–2 weeks after blood transfusion. Logistic regression, independent t-test, and chi-square test were used to analyze our results and the significance was tested at p≤ 0.05. The overall prevalence of hypogonadism among β-TM patients was 75%, the mean of serum ferritin was 6704.83± 2849 ng/ml and all patients had serum ferritin above 2000 ng/ml indicating a severe iron overload. Low hemoglobin level (p=0.006), high ferritin level (p=0.018), high blood transfusion per year (24-blood transfusions) (p=0.007), and poor compliance to iron chelation therapy programs (p=0.001), were detected had significant partial effect in hypogonadism. In conclusion, hypogonadism is highly prevalent among Gaza strip β-TM patients. Its presence being associated with lower hemoglobin values, iron overload, high blood transfusion and low compliance of iron chelation therapy


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Research summary
تهدف هذه الدراسة إلى تحديد مدى انتشار قصور الغدد التناسلية بين مرضى التلاسيميا العظمى (β-TM) في قطاع غزة، ودور العلاج بإزالة الحديد في الوقاية منه. تم جمع البيانات من 60 مريضًا و35 شخصًا سليمًا تتراوح أعمارهم بين 13 و30 عامًا من خلال استبيان ومراجعة السجلات الطبية. أظهرت النتائج أن معدل انتشار قصور الغدد التناسلية بين مرضى التلاسيميا العظمى بلغ 75%، وكان متوسط تركيز الفريتين في الدم 6704.83±2849 نانوغرام/مل، مما يشير إلى زيادة شديدة في الحديد. كما أظهرت الدراسة أن انخفاض مستوى الهيموغلوبين، وارتفاع مستوى الفريتين، وارتفاع معدل نقل الدم، وضعف الالتزام ببرامج إزالة الحديد هي عوامل مرتبطة بشكل كبير بحدوث قصور الغدد التناسلية. توصي الدراسة بضرورة تحسين بروتوكولات إدارة المرضى، بما في ذلك برامج نقل الدم والعلاج بإزالة الحديد، لتحسين النتائج الصحية لهؤلاء المرضى.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة جدًا في تسليط الضوء على مشكلة صحية خطيرة تواجه مرضى التلاسيميا العظمى في قطاع غزة. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها في الدراسات المستقبلية. أولاً، كان حجم العينة محدودًا نسبيًا، مما قد يؤثر على تعميم النتائج. ثانياً، لم تتناول الدراسة تأثير العوامل النفسية والاجتماعية بشكل كافٍ، والتي قد تكون لها دور كبير في الالتزام بالعلاج. ثالثاً، كان من الأفضل تضمين مجموعة أوسع من الاختبارات الهرمونية لتقديم صورة أكثر شمولية عن الحالة الصحية للمرضى. وأخيراً، لم تتناول الدراسة بشكل كافٍ تأثير العلاجات البديلة المتاحة في الأسواق العالمية والتي قد تكون أكثر فعالية وأقل تأثيرًا جانبيًا.
Questions related to the research
  1. ما هو معدل انتشار قصور الغدد التناسلية بين مرضى التلاسيميا العظمى في قطاع غزة؟

    معدل انتشار قصور الغدد التناسلية بين مرضى التلاسيميا العظمى في قطاع غزة بلغ 75%.

  2. ما هي العوامل الرئيسية المرتبطة بحدوث قصور الغدد التناسلية في هذه الدراسة؟

    العوامل الرئيسية المرتبطة بحدوث قصور الغدد التناسلية هي انخفاض مستوى الهيموغلوبين، وارتفاع مستوى الفريتين، وارتفاع معدل نقل الدم، وضعف الالتزام ببرامج إزالة الحديد.

  3. ما هو متوسط تركيز الفريتين في الدم لدى مرضى التلاسيميا العظمى في الدراسة؟

    متوسط تركيز الفريتين في الدم لدى مرضى التلاسيميا العظمى كان 6704.83±2849 نانوغرام/مل.

  4. ما هي التوصيات التي قدمتها الدراسة لتحسين إدارة مرضى التلاسيميا العظمى؟

    أوصت الدراسة بضرورة تحسين بروتوكولات إدارة المرضى، بما في ذلك برامج نقل الدم والعلاج بإزالة الحديد، لتحسين النتائج الصحية لهؤلاء المرضى.


References used
Abuloha, S., Alabbadi, I., Albsoul-Younes, A., Younes, N., & Zayed, A. (2016). The role of clinical pharmacist in initiation and/or dose adjustment of insulin therapy in diabetic patients in outpatient clinic in Jordan. Jordan Journal of Pharmaceutical Sciences, 9(1), 33-50
Shivashankara, A., and Jailkhani,R. Hemoglobinopathies in Dharwad, North Karnataka: A Hospital-Based Study. Journal of Clinical and Diagnostic Research. 2008; 1: 593-599.
Tareq, L. M., Nuseir, K. Q., Biltaji, E., & Alefan, Q. (2015). Students’ perceptions of pharmacy as a specialization and their future career, a cross sectional study of final year pharmacy students in Jordan. Jordan Journal of Pharmaceutical Sciences, 8(3).
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