Objective: The objective of this research was to formulate and evaluate iron oxide nanoparticles for treatment of iron deficiency anemia (IDA). Methods:Iron oxide nanoparticles were prepared by co-precipitation method and stabilized by coating with folic acid or chitosan. The prepared nanoparticles were characterized in vitro for morphology, particle size, zeta potential, crystallinity and ultraviolet-visible (UV-Vis) absorption. In vivo studies were performed to evaluate the efficacy of the prepared nanoparticles in treating iron-deficient anemic rats compared to the commercial iron product. Results:In vitro results revealed that particle sizes were 65.95±5 nm, 220.2±12 nm and 295.3±19 nm for uncoated iron oxide nanoparticles, folic acid-coated iron oxide nanoparticles and chitosan coated iron oxide nanoparticles, respectively. UV-Vis absorption spectrum and x-ray diffraction (XRD) patterns confirmed that the prepared nanoparticles were iron oxide nanoparticles. In vivo results indicated that folic acid-coated iron oxide nanoparticles showed effective restorative action, returning haemoglobin (Hb) concentration to normal levels, where not only complete recovery of Hb within short time from the anemic state to the high normal level, but also improved Hb concentrations compared to the commercial iron product. Conclusion:The results obtained in this research work clearly indicated a promising potential of folic acid-coated iron oxide nanoparticles for the effective treatment of IDA.

Context Pituitary blastoma is a rare, dysontogenetic hypophyseal tumor of infancy first described in 2008, strongly suggestive of DICER1 syndrome. Objective To describe genetic alterations, clinical courses, outcomes, and complications in all known pituitary blastoma cases. Design and Setting: Multi-institutional case series from tertiary pediatric oncology centers. Patients Children with pituitary blastoma. Interventions Genetic testing, surgery, oncologic therapy, endocrine support. Outcome Measures Survival, long-term morbidities, germline and tumor DICER1 genotypes. Results Seventeen pituitary blastoma cases were studied (10 female and 7 male); median age at diagnosis was 11 months (range 2–24). Cushing syndrome was the most frequent presentation (n=10). Cushingoid stigmata were absent in seven children (two with raised ACTH; five with normal/unmeasured ACTH). Ophthalmoplegia and increased intracranial pressure were also observed. Surgical procedures included gross/near-total resection (n=7), subtotal resection (n=9), and biopsy (n=1). Six children received adjuvant therapy. At a median follow-up of 6.7 years, nine patients were alive; eight patients died of early medical/surgical complications (n=3), sepsis (n=1), catheter-related complication (n=1), aneurysmal bleeding (n=1), second brain tumor (n=1), and progression (n=1). Surgery was the only intervention for five of nine survivors. Extent of resection, but neither Ki67 labelling index nor adjuvant therapy, was significantly associated with survival. Chronic complications included neuroendocrine (n=8), visual (n=4), and neurodevelopmental (n=3) deficits. Sixteen pituitary blastomas were attributed to DICER1 abnormalities. Conclusions Pituitary blastoma is a locally destructive tumor associated with high mortality. Surgical resection alone provides long-term disease control for some patients. Quality survival is possible with long-term neuroendocrine management.

Clinical Case Our case represents a previously fit 17-year-old male. Retrospectively admitting to some fatigue, he was actively playing sports with no background/family history. Blood tests performed at a GP practice, at the time of investigation for a swollen knee/sports injury, reported a serum creatinine > 1000mmol/L and subsequent urine analysis reported >3 g of protein in 24 hours. Dialysis was initiated due hyperkalaemia, rising creatinine and uraemia and a renal biopsy reported greater than 90% fibrosis. A PTH level was reported greater than 300ng/L, indicating that renal impairment had been progressing for some time. Initial vasculitic and autoimmune serology have all been reported as negative, and our patient is currently being worked up for a renal transplant. Discussion This case represents ESKD due to idiopathic IN. IN is steroid responsive and when diagnosed and treated promptly, renal impairment can be limited. Unfortunately, in our case, there was no indication to perform urine or serum analysis, which may have prompted earlier intervention. This highlights the possible benefits for routine screening in the community. As well as medical issues associated with renal impairment and transplantation there are also huge psychosocial implications for an adolescent including compliance with medications and self-image post transplantation, (Abdel-Kader, et al., 2009) .

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