different treatment modalities in the management of the painful crisis in pediatric sickle- cell anemia

Conditions: Vaso-occlusive Crisis; Sickle Cell Disease; Sickle Cell Anemia in Children

Summary: the aim of the present study is comparing the effectiveness of different treatment regimens for investigating the therapeutic potential for each one in management of vaso-occlusive pain in pediatric sickle cell disease. in addition, investigators apply the cost-effectiveness analysis (cea) as a form of economic analysis that compares the relative costs and outcomes (effects) for different treatment regimens on vaso-occlusive painful crisis.

"sickle cell disease is an inherited blood disorder characterized by defective hemoglobin (a protein in red blood cells that carries oxygen to the tissues of the body). sickle cell disease involves the red blood cells, or hemoglobin, and their ability to carry oxygen. normal hemoglobin cells are smooth, round, and flexible, like the letter "o," so they can move through the vessels in our bodies easily. sickle cell hemoglobin cells are stiff and sticky and form into the shape of a sickle, or the letter "c," when they lose their oxygen. these sickle cells tend to cluster together and cannot easily move through the blood vessels. the cluster causes a blockage in small arteries or capillaries and stops the movement of healthy, normal oxygen-carrying blood. this blockage is what causes the painful and damaging complications of sickle cell disease". "acute vaso-occlusive crisis (voc) is a hallmark of sickle cell disease (scd). multiple complex pathophysiological processes can result in pain during a voc. despite significant improvements in the understanding and management of scd, little progress has been made in the management of pain in scd, although new treatments are being explored". the painful episodes: "the day-to-day management of sickle cell disease often equates with the management of acute and chronic pain. patients manage many painful events at home so that hospital visits underestimate the frequency of pain acute painful episodes are the most commonly encountered vaso-occlusive events in patients of all ages. presumed to be caused by sickle vaso-occlusion, pain often starts in young children as the hand-foot syndrome or dactylitis, a painful swelling of hands and feet due to inflammation of the metacarpal and metatarsal periosteum. painful episodes, which last from hours to many days, usually occur with little warning and a clear precipitating event is not often found.

Eligibility criteria:
inclusion criteria: any case with the full manifestation of sickle cell disease accompanied by acute painful crisis aged from 5-15 years old. exclusion criteria: 1. the presence of any other chronic illness. 2. patient age\>18 years old or \< 3 years old. 3. patients with hepatic diseases including cholestasis hepatic encephalopathy and jaundice. 4. patients with renal impairment 5. diabetic patients

Keywords: omega3 vaso-occlusive painful crisis pediatric sickle cell anemia comparative effective analysis in voc anti-inflammatory effect of vit-d anti-hemolytic effect of vit-d anti-hyperlipidemia of vit-d effect of omega-3 on blood rheology effect of omega-3 on blood viscosity antiaggregation effect of omega-3 anti-inflammatory effect of statins anti-inflammatory effect of zinc supplements effect of zinc supplements on blood viscosity effect of zinc supplements on blood rheology antiaggregation effect of zinc supplements pediatric sickle cell disease