title: The Effects of Nutrition, Exercise, and a Praying Program on Reducing Iron Overload in Patients With Beta-Thalassemia Major: A Randomized Clinical Trial.
abstract: BACKGROUND
  Excessive iron accumulation in the visceral organs creates problems for patients with beta-thalassemia major. Despite chelation therapy, mortality rate from the complications of this disease is still quite high.
  
  
  OBJECTIVE
  This study aimed to investigate the effectiveness of nutrition, exercise, and a praying program at reducing iron overload in patients with beta-thalassemia major.
  
  
  METHODS
  This randomized clinical trial assessed the effect of the designed care program on iron overload. The study was conducted in 38 patients with beta-thalassemia major who ranged in age from 15 - 35 years and had been referred to the largest center for thalassemic patients in Shiraz. The patients were randomly assigned to an intervention (n = 18) and a control (n = 20) group. Blood samples were collected from the participants before and two months after the intervention. Then, the data were statistically analyzed using chi-square, Fisher's exact test, Mann-Whitney U-test, Wilcoxon, independent samples t-test, and paired samples t-test.
  
  
  RESULTS
  The results showed that the mean level of serum ferritin significantly decreased in the intervention group two months after beginning the intervention. Also, the mean level of serum iron decreased in the intervention group, but the difference was not statistically significant.
  
  
  CONCLUSIONS
  The planned educational program could be used to reduce iron overload and ultimately improve the patients' health status.
authors.affiliation: Community Based Nursing and Midwifery Research Center, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Molazem
authors.affiliation: Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Roghaye
authors.initials: R
authors.lastname: Noormohammadi
authors.affiliation: Department of Nursing, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Dokouhaki
authors.affiliation: Department of Internal Medicine, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zakerinia
authors.affiliation: Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Bagheri
keywords: Beta-Thalassemia Major; Exercise; Ferritin; Iron; Nutrition; Praying