Thalassemic Children Research Articles

Serum Calcium, Phosphate and Parathormone Levels in Thalassemic Children with High Ferritin Level

Background: In thalassemic children with high ferritin level due to iron accumulation in parathyroid gland may developed hypoparathyroidism leading to impaired homeostasis of calcium & phosphate. Parathyroid dysfunctions may not be evident clinically in early state. So the parathyroid status should be evaluated at regular interval. Objective: To find out the association of serum calcium, phosphate and parathormone levels in thalassemic children with high serum ferritin level. Materials and methods: The study was a cross-sectional study carried out in Department of Paeditarics, Dhaka Medical College Hospital, Dhaka, Bangladesh during January, 2019 to December, 2019. Total 70 thalassemia patients both male &female were included in this study between the age ranged from 5 to 12 years with serum ferritin level >1000 ng/ml irrespective of chelation therapy. All study subjects were fully evaluated clinically, thoroughly investigated and properly treated as per protocol. Results: Total 70 patients were included in our study. Male were 39 (55.7%) and female were 31(44.3%). S. Calcium level was decrease in 22(31.4%) patient, S PO4 level increased in 44 (62.9%) patients & parathyroid level was low in 16 (22.9%) patients. Conclusion: Based on result it could be concluded that thalassemic children age ranged from 5 years to 12 years, presenting with high ferritin level are likely to have low calcium, high phosphate & low parathormone level.

Prevalence of dental caries, oral health status, malocclusion status, and dental treatment needs in thalassemic children: A cross-sectional study

ABSTRACT Background: Thalassemia is a hemoglobinopathy-associated genetic disease resulting due to defective synthesis of globin chains, causing defects in the skeletal and oral structures. Aim: This cross-sectional study was designed to analyze the prevalence of dental caries, oral health status, malocclusion status, and dental treatment needs in thalassemic children. Materials and Methods: Institutional Ethical committee clearance was obtained before starting the study. The study sample comprised 100 thalassemic and 100 normal children in which oral disease markers like dmft/DMFT index, plaque index, gingival index, and Angle’s classification for malocclusion were used. The statistical tool used was ‘one-way ANOVA’ with the probability set at 0.05. Results and Observations: Statistically significant differences in prevalence of dental caries, periodontal disease, malocclusion, and treatment needs were noted in thalassemic individuals when compared to normal subjects. Conclusion: The present study has given an insight into the various oral and dentomaxillofacial manifestations of thalassemia, thus considering the importance of routine oral examination for the prevention of dental caries and periodontal diseases.

Prevalence of Hypothyroidism in Children with Transfusion Dependent Thalassemia Patient Attending in A Tertiary Care Hospital of Bangladesh

Background: Blood transfusions and iron chelation are standard treatments for β-thalassemia major and Hb E-Beta-Thalassemia. However, repeated transfusions raise body iron levels, leading to secondary hemosiderosis and complications in the heart, endocrine system, and liver. Thyroid dysfunction results from gland infiltration, chronic hypoxia, free radical damage, and iron overload. This study aimed to find out the prevalence of hypothyroidism in transfusion-dependent thalassemic children attending Bangladesh Shishu Hospital & Institute. Methods: A descriptive cross-sectional study was conducted at the Thalassemia Centre, Department of Hematology and Oncology, Bangladesh Shishu Hospital & Institute, from December 2019 to November 2020. The study included 140 children with thalassemia, aged 5 to 16 years, who were receiving blood transfusions. Data were collected using a structured questionnaire with participant consent. Statistical analysis was performed using SPSS version 23.0. Results: In this study, hypothyroidism was observed in 26.2% of patients, with 23.5% having subclinical and 2.9% overt hypothyroidism. In most of the patients (n=85), aged 11-16 years, 58.3% had normal thyroid function, 36.5% had subclinical, and 4.7% had overt hypothyroidism, which was statistically significant (p<0.05). Of the 91 patients with hemoglobin levels below 11.5 g/dL, 85.7% had normal thyroid function, 13.2% had subclinical hypothyroidism, and 1.1% had overt hypothyroidism, also significant (p<0.05). In the group with ferritin levels of 1200-2000 ng/mL, 78.1% had normal thyroid function, 18.8% had subclinical hypothyroidism, and 3.1% had overt hypothyroidism, which was not statistically significant (p>0.05). Conclusion: Subclinical hypothyroidism is commonly seen in thalassemia patients aged 5 to 16 years who undergo regular blood transfusions. Regular physical exams and thyroid function assessments are crucial to detect overt hypothyroidism early. Timely hormone replacement can

Serum Homocysteine Levels and Their Relationship With Serum Vitamin B12, Folate, and Ferritin Levels in Transfusion-Dependent Thalassemic Children.

The purpose of this study was to assess serum homocysteine levels and their relationship with serum vitamin B12, folate, and ferritin levels in transfusion-dependent thalassemic children. This study was proposed due to a paucity of literature regarding the status of homocysteine levels in thalassemic children and their relationship with the levels of vitamins and iron overload (serum ferritin values). A descriptive observational study was conducted on transfusion-dependent thalassemic children aged 1-18 years, who were registered at the Thalassemia Day Care Centre (TDCC), Umaid Hospital, Dr. SN Medical College, Jodhpur, over a period of six months. A total of 100 children were enrolled in the study, with a mean age of 8.89±4.50 years. The mean pre-transfusion hemoglobin level in the last six months was 8.23±1.02 gm/dL. The mean serum levels of homocysteine, vitamin B12, folic acid, and ferritin were 10.93±3.72 µmol/L, 164.03±80.54 pg/mL, 7.69±5.77 ng/mL, and 2175.78±1341.39 ng/mL, respectively. A statistically significant negative correlation was detected between serum vitamin B12 concentration and serum homocysteine concentration (r=-0.285, p=0.004). Statistically non-significant positive correlations were detected between serum folic acid and serum homocysteine levels (r=0.033, p=0.748) and between serum ferritin and serum homocysteine levels (r=0.179, p=0.075). A statistically significant negative correlation between serum homocysteine and vitamin B12 levels was noted, whereas statistically non-significant positive correlations were observed between serum homocysteine andserum folic acid levels and between serum homocysteine andserum ferritin levels.

Genetic Study for Identifying Beta Thalassemia Trait in Relatives of Children with Beta Thalassemia Major.

The most common inherited illness, thalassemia, is thought to have a detrimental effect on public health, particularly in endemic areas. Children with beta thalassemia disease have several mutations. Prevention and premarital examination are still the most effective measures to lessen the burden of beta thalassemia. This study primarily aimed to determine the beta thalassemia carriers in relatives of beta thalassemia major children, the role of gene study in the confirmation of beta thalassemia trait diagnosis, and to detect the genetic defect in the relatives of beta thalassemia major children. The cross-sectional study was conducted on 109 healthy children, aged between six months and 18 years, who were the relatives (second and fourth degree) of beta thalassemia major cases. Gene screening, using the amplification refractory mutation system (ARMS) polymerase chain reaction (PCR), covered the most common 22 alleles in the Mediterranean region, and was successful in detecting 61.5% of beta-globin chain mutations of studied participants, in addition to high prevalence (34.8%) of beta thalassemia carriers among the relatives of beta thalassemia children. The beta thalassemia carrier rate was found to be highly prevalent among relatives of beta thalassemia major children. Despite the accuracy of gene screening in the detection of beta thalassemia carriers, the use of the most common 22 alleles can only detect 61.5% of carriers; hence, the value of tested gene study is still limited in the detection of carrier rates.

Evaluation of cardiac iron deposition in thalassemia children

Evaluation of cardiac iron deposition in thalassemia children

Cholelithiasis Diagnosis and Management in Thalassemia

Background: Cholelithiasis, while infrequently found in children, carries a significant risk for those with underlying conditions like thalassemia compared to the general population. This study aimed to described the manifestations of cholelithiasis in thalassemic children. Case: A 12-year-old girl with beta-thalassemia major presented with recurrent right upper quadrant abdominal pain and vomiting. Imaging revealed cholelithiasis and choledocholithiasis. Due to complications related to her thalassemia, she underwent endoscopic retrograde cholangiopancreatography (ERCP) for gallstone removal followed by laparoscopic cholecystectomy. Post-operative management addressed post-ERCP pancreatitis and bleeding concerns. The patient recovered well and is scheduled for follow-up. Discussion: Increased bilirubin production, iron overload, and altered bile properties in beta-thalassemia contribute to cholelithiasis risk. The patient presented with typical symptoms and underwent successful laparoscopic cholecystectomy after initial management with ERCP, which led to post-ERCP pancreatitis. Conclusion: This case underscores the elevated risk of cholelithiasis in thalassemic children and the importance of early diagnosis and intervention for optimal outcomes.

Faktor-Faktor yang Memengaruhi Stress pada Anak Thalasemia Bergantung Transfusi

This study aims to determine the factors influencing stress in children with transfusion-dependent thalassemia. The method used in writing this article is a systematic review. This article was written using a database owned by the University of Indonesia through lib. UI is a website that facilitates students' search for literature. Eight databases were used to write the systematic review in this article, namely Proquest, ScienceDirect, Pubmed, Scopus, EMBASSE, EBSCO, Taylor & Francis Online, and SpringerLink, and used the "Reporting Items for Systematic Reviews and Meta-Analysis Flow Diagram" (PRISMA) guidelines. The research results show that factors that influence stress in transfusion-dependent thalassemia children include age, frequency of transfusions, onset of chelation therapy, duration of illness, body image, self-confidence, complications of the disease, hemoglobin (Hb), and ferritin levels. In conclusion, factors that can cause stress in children with thalassemia can be complications of the disease, age, gender, and duration. Keywords: Pediatric, Stress, Thalassemia

“The Parental Perspective of Thalassemia in Bangladesh: Challenges for Prevention and Management of Thalassemia”

Introduction: Thalassemia is a genetic blood disorder characterized by abnormal hemoglobin production, poses significant challenges for families worldwide. In Bangladesh, where the prevalence of thalassemia is notable, parents face unique hurdles in both preventing and managing this condition. Aim of the study: The aim of this study is to explore the parental perspective of thalassemia in Bangladesh, focusing on the challenges faced in the prevention and management of the disease. Methods: This was a cross section retrospective study conducted in the Department of Paediatrics of M Abdur Rahim Medical College, Dinajpur, Bangladesh during the period from June 2023 to December 2023. Result: Among the total of 320 caregivers, 46.9% were father, while 53.1% were mother respectively. Minority 14.1% of marriages were consanguineous, while the majority (85.9%) was not. The majority (82.8%) of respondents had one thalassemic child, while 17.2% had two or more thalassemic children. Before the diagnosis of thalassemia in their child, 90.9% of respondents had not heard about thalassemia. All respondents (100%) reported not undergoing thalassemia screening before marriage. The median age at diagnosis of thalassemia among the participants was 1.32 years. Beta thalassemia was diagnosed in 30.6% of the participants, while 68.8% had E-beta thalassemia. The majority 65.9% of respondents correctly identified thalassemia as a genetic disease, while 22.5% provided an incorrect response. Conclusion: Thalassemia presents significant challenges for affected individuals and their families in Bangladesh, ranging from limited access to diagnostic services and blood transfusions to social stigma and financial burdens.

Psychosocial Aspects of Children with Thalassemia in Mosul City

Background: Thalassemia is a widespread heritable disease in Mediterranean region, the assessment of psychological and social status of thalassemic children is an important issue.
 Objectives: The main aim is to assess psychosocial status of children with thalassemia and to find out the association between some demographic characteristics and psychosocial aspects.
 Methodology: A cross-sectional study of (101) randomly selected thalassemic children. The study was conducted at Al-Hadbaa Specialist Hospital for blood diseases and bone marrow transplantation, Mosul City, Iraq for the period from 1st November 2023 to 5th January 2024.In order to collect the required data, a questionnaire was developed based on the standards of the pediatric quality of life Scale (PedsQoL).
 Results: shows that the largest proportion of samples belong to the age group (9-12) years and the highest percentage of the study sample is female (50.5%).Regarding education, the table presents that the highest percentage of patients are student (67.3%). The table also shows that (65.3%) of patients have family history of thalassemia. For the number of blood transfusion, the highest percentage was (every 3 weeks) to be (59.4%). The mean+SD emotional domain score was 1.8733±0.602, social domain score was 1.2436±3.55.
 Conclusion: The present study indicates that psychosocial aspects were range between moderate for emotional functioning and good for social functioning. And there is significant association between some demographic variables and psychosocial functioning of thalassemic children.
 Recommendations: The current study recommended to provide psychological and social support units for thalassemic children to help them to adapt with the disease by reducing negative thoughts about themselves and building a positive self-image.

Effectiveness of the application of an educational program based on the Theory of Planned Behavior (TPB) in adopting preventive behaviors among mothers who have thalassemia children in Iran: a randomized controlled trial

BackgroundThalassemia is one of the most common chronic diseases, which cause many problems for the patients, families, and health system. The aim of this study was to evaluate the effectiveness of the application of an educational program based on the Theory of Planned Behavior in adopting preventive behaviors from thalassemia.MethodsThis randomized controlled trial study was associated with the participation of 160 mothers of children suffering from thalassemia major, who were divided into two groups including intervention and control. Demographic information, knowledge, and data related to the constructs of the Theory of Planned Behavior were collected. Data were analyzed using SPSS16 software and descriptive and analytical tests.ResultsThe mean scores of perceived behavioral control, behavioral intention, and behavior in the intervention group in the pre-intervention phase were 9.83 ± 1.45, 9.1 ± 21.32, and 2.1 ± 18.42, respectively. The stage after the intervention was increased to 12.00 ± 0.00, 11.51 ± 0.59, and 5 ± 0.37.95, respectively, and the difference of the means in the two stages was significant (P value < 0.0001). But no significant change was observed in the control group (P value > 0.05).ConclusionThe results of the study showed the effect of the training intervention based on the Theory of Planned Behavior on the promotion of preventive behaviors in mothers of children suffering from thalassemia major.

Nursing Implementation Of Distraction Techniques: Play Therapy (Doll) With Anxiety Problems In Thalasemia Children

Thalassemia is a disease that is passed from parents to their children in the womb which results in sufferers having to undergo regular blood transfusions to increase hemoglobin levels in the blood. Routine transfusions can cause psychological impacts such as anxiety in children. Playing is an effective way to reduce anxiety in children and can be a diversion or relaxation. The aim of the case study is that researchers are able to carry out nursing implementation of distraction techniques: play therapy (dolls) with anxiety problems in thalassemia children. Method: This research design uses descriptive methods in the form of a case study. Two respondents took cases, namely thalassemia patients with anxiety in the Talang Betutu Community Health Center area and the Sei Selincah Community Health Center area. Results: The implementation of nursing provided in the form of doll play therapy was effective in reducing anxiety in children. Anxiety scores decreased after doll play therapy. Conclusion: Nursing implementation of distraction techniques: play therapy (dolls) is effective in reducing anxiety in thalassemia children

Challenges of Iron Chelation in Thalassemic Children

Thalassemia treatment still relies on supportive care, mainly including blood transfusion and iron chelation therapy. Iron chelation is considered the main factor responsible for the marked improvement in survival rates of thalassemic patients. Hemosiderosis may be prevented if appropriate chelation therapy is offered from early childhood, with timely dose adjustments according to changing body weight and close monitoring of organ iron load. With three iron chelators currently available, the choice of appropriate chelation, either as monotherapy or combined therapy, should be individualized depending on the iron overload of target organs, patient’s age, presence of adverse events and compliance issues, given known limitations related to each agent’s administration.

Audiologic and vestibular assessment in children and adolescents with transfusion dependent beta thalassemia major: The era of deferasirox film coated tablet

BackgroundHearing impairment has frequently been described in β-thalassemia patients with a significant impact on the patients’ quality of life. Most studies provided evidence of deferoxamine (DFO) dose-related ototoxicity, however, the data is scarce regarding deferasirox (DFX) as a sole iron chelator. AimWe aimed to assess the prevalence and risk factors of sensorineural hearing loss (SNHL) and vestibular dysfunction in regularly transfused β-thalassemia patients who had been treated with DFX film coated tablets. MethodsWe conducted a case control study on 57 transfusion dependent β-thalassemia patients with a mean age of 15.3 years who received DFX FCT as monotherapy for at least one consecutive year, and 57 healthy age and sex-matching controls. Comprehensive audiological evaluations using pure tone audiometry (PTA) and transient evoked otoacoustic emission (TEOAE) as well as vestibular evaluation using Video-nystagmography (VNG) were done. ResultsSNHL was identified in 12 patients (21.1 %) using PTA and a statistically significant difference was detected between controls and patients at 6 KHz and 12 KHz frequencies. A higher incidence of SNHL was detected using TEOAE, 22 patients (43.1 %) failed to pass TEOAE, with a statistically significant decrease in the signal at frequencies 1, 4 KHz bilaterally and at frequencies 1.5, 2 KHz in the right ear compared to controls. Canal paresis was detected in 21 (36.8 %) of thalassemic children using bithermal caloric test with significantly more unilateral weakness than control children (P = 0.008). We found no significant correlation between audio-vestibular dysfunction and age, sex, serum ferritin, frequency of blood transfusion and dose of DFX FCT in thalassemic children. ConclusionWe conclude that the incidence of SNHL and vestibular dysfunction was high among transfusion dependent β-thalassemia patients. Therefore, we recommend performing pre-treatment baseline audio-vestibular assessment and yearly audio-vestibular monitoring to early detect high risk patients and initiate timely management to prevent permanent damage.

CORRELATIONS BETWEEN FERRITIN LEVELS AND CREATININE IN PEDIATRIC THALASSEMIA PATIENTS PRODIA CILEGON

Thalassemia is a blood disorder that is passed down genetically from parents to their children. The body cannot form normal red blood cells resulting in them being damaged easily and having a short life of less than 120 days and anemia, requiring continuous blood transfusions to maintain hemoglobin levels in the body. A history of repeated blood transfusions can cause excess iron in the body which is characterized by an increase in serum ferritin levels which can cause damage to kidney function by looking at creatinine levels. The purpose of this study was to determine whether there is a relationship between ferritin and creatinine levels in children with thalassemia. This study used a quantitative method with a cross sectional approach. The sampling technique used in this study was the total sampling technique. The sample used was 12 samples. Data processing in this study used the Shapiro-Wilk Normality test and the Pearson Correlation test in bivariate analysis. The results of the analysis of this study indicate that there is no significant relationship between the ferritin and creatinine levels in children with thalassemia where the value of Sig. 0.212 &gt; 0.05 (p&gt; 0.05), and shows a significant negative correlation of -0.389. This study in thalassemia children had high ferrtin levels but creatinine levels were still within normal limits.

Estimation of Microalbuminuria in Children with Beta Thalassaemia Major: A Cross-sectional Study

Introduction: Improvement in the standard of care of Thalassaemia by regular blood transfusion increases life expectancy. Multiple transfusions with concurrent iron overload and chronic anaemia, leading to tissue-level hypoxemia, cause significant renal dysfunction. Microalbuminuria is a sensitive marker of glomerular damage, and studies in thalassemic children have demonstrated variable prevalence rates of microalbuminuria. Aim: To study the prevalence of microalbuminuria and its association with clinical and laboratory parameters in children with Beta Thalassaemia Major (BTM). Materials and Methods: A cross-sectional study was conducted from January 2018 to June 2019 at Indira Gandhi Institute of Child Health, Bangaluru, Karnataka,India. A total of 155 children with Beta Thalassaemia Major (BTM) aged 2-18 years, attending the Thalassaemia Day Care Centre, were included in the study. Their demographic details such as age, gender, clinical parameters like frequency of transfusions, type of chelation therapy, height, weight, Body Mass Index (BMI), organomegaly, and laboratory parameters like serum creatinine, ferritin, pretransfusion Hb%, and Urinary Microalbumin Creatinine Ratio (UMCR) were studied as per a predesigned proforma. The association between microalbuminuria with clinical and laboratory parameters was evaluated using the independent sample T-test or Mann-Whitney U test and Chi-square/Fischer’s-exact test. Results: A total of 155 children with BTM were studied. In the present study, out of a total of 155 patients, microalbuminuria was found in 66 (42.6%). A significant increase in the prevalence of microalbuminuria was observed as the age advanced, as the frequency of blood transfusions increased, with low pretranfusion haemoglobin (g%), and with elevated serum ferritin. Conclusion: In the present study, the prevalence of microalbuminuria was found to be 42.6%. Screening for microalbuminuria is recommended in all children with beta thalassaemia major for the early detection of renal dysfunction, prevention of disease progression, and improvement in the quality of their lives.

Investigation of the Relationship between Thalassemia and Depression to Predict a Base for Rehabilitation Measures

This study examines the relationship between thalassemia, an inherited blood disorder, and depression, a psychologically debilitating illness. Thalassemia, which is characterized by insufficient hemoglobin production, significantly affects the quality of life and well-being of patients. As more effective treatment and even a cure for thalassemia have become possible, attention is being drawn to the assessment of depression, which is common among those affected. In addition to investigating the relationship between depression and thalassemia, this research also aims to provide a basis for patient rehabilitation. The study is conducted with a sample of 60 subjects consisting of thalassemia and non-thalassemia children aged 4 to 14 years from different areas of the province. The Beck Depression Inventory scale’s second revision has been used for this purpose. The results confirmed the hypothesis that there is a positive correlation between thalassemia and depression. Statistical analysis was performed using SPSS t-test and revealed a significant level of comorbidity with a calculated coefficient alpha of 0.768, mean of 41.40, standard deviation (SD) of 2.009, Cohen’s d of 0.188, and significance of 0.50. These results are consistent with the previous research conducted by the Iranshahr Institute (2014-2015) indicating a marked occurrence of depression in thalassemia patients. This research is needed overall to understand the relationship between mental health problems and thalassemia. However, the scope of the study is limited to a local hospital with challenges such as language barriers and cultural stigma. Despite these limitations, this study highlights the need for further research on depression in thalassemia patients and suggests avenues for future research and therapeutic rehabilitation interventions. In addition, this topic can be further researched, as diseases such as thalassemia pose great challenges in dealing with those affected. It can also help parents support the suffering child in coping with the psychological burden of the physical illness.

Using bone mineral apparent density for BMD adjustment in chronic diseases: Thalassemia an example.

Low BMD is a common problem in major thalassaemia patient, but the use of DXA in chronic disease children with smaller bones, has some problems. Utilizing bone mineral apparent density (BMAD) helps in preventing this obstacle. Testing the usefulness of this method in resolving the effects of bone size on BMD by comparing the BMD and BMAD of our thalassemics with results of our healthy ones, is our goal. Sample size was 110 cases with mean age of 9.6 ± 4.3 y/o and contained 73 males. Gauge of BMDs done by dual x-ray absorptiometry. Then BMAD was calculated. We did comparison of BMDs and BMADs results of thalassemic children with results of healthy Iranian pediatrics. Mean of femoral BMD and BMAD, spinal BMD and BMAD was 0.579±0.134 g/cm2, 0.162±0.096 g/cm3, 0.563±0.118 g/cm2 and 0.107±0.015, respectively. When results of 9-18 patients compared with BMDs and BMADs of normal children, BMD of femur and BMD and BMAD of spine of patients found significantly lower (P-values, 0.003, <0.001, <0.001, respectively). BMAD of femur of patients was not significantly different from normals. When bone mineral density of femur modifies by bone mineral apparent density formula, the remarkable difference between BMD of patients and normals; vanishes. Utilizing bone mineral apparent density helps in interpretation of femoral dual X-ray absorptiometry at least in thalassemic patients. As the results of vertebrae, after modification by calculating BMAD, remains significantly different, we cannot bring forward BMAD for mentioned aim in the spine of thalassemics.

Family Management and Its Relation to Health-related Quality of Life among Thalassemic Children

Family Management and Its Relation to Health-related Quality of Life among Thalassemic Children

Cognitive impairment in beta thalassemia major and intermedia pediatric patients: a cross-sectional study

BackgroundThalassemia is a commonly occurring genetic hemoglobinopathy worldwide. Periodic and routine blood transfusions, iron chelation therapy and splenectomy procedures are all required for the treatment of thalassemia. Numerous organs and bodily systems could be impacted by thalassemia, particularly the nervous system, which could impede cognitive performance. The study aimed to assess cognitive abilities of pediatric patients diagnosed with beta thalassemia major and intermedia.Patients and methodsA total of 168 participants [54 β-thalassemic major children, 51 with β-thalassemia intermedia and 63 age-matched healthy controls from both genders (85 girls and 83 boys)] with age ranging from 8 to 16 years were participated in a cross-sectional study. Cognitive function was evaluated for all children by using the Wechsler Intelligence Scale For Children 4th edition.ResultsCompared with control group, a significant decline was found in all Wechsler Intelligence Scale subtests as well as in verbal comprehension index, perceptual reasoning index, working memory index, processing speed index and full scale index scores of thalassemia major and intermedia patients (p < 0.001). When compared to children with thalassemia intermedia, the beta thalassemic major children showed a significant decrease in all Wechsler Scale subtests as well as in all its five index scores (p < 0.001).ConclusionsThe study concluded that thalassemia negatively affects and impairs cognition and intellectual capacities.