No abstract

The low prevalence of parasites among the appendectomy specimens did not support the notion that parasites were a major cause of appendicitis in pediatric patients.

Background:Few previous studies proved that complications related to sickle cell disease (SCD) were common with regional anesthesia compared with general anesthesia while others reported no differences. This study was carried out to evaluate the role of prophylactic vitamin D on anesthetic outcome among male children with SCD undergoing circumcision.Materials and Methods:A comparative study was carried out on 58 children undergoing circumcision with the regional block under light general anesthesia. The study sample was classified into two groups: one group received daily 400 IU vitamin D for 6 months before surgery while the other group without vitamin D. All patients were followed regarding the post-operative analgesia and the incidence of post-operative SCD related complications (acute chest syndrome, painful crisis and cerebrovascular accident). Data were analyzed with Statistical Package for Social Sciences version 13, produced by IBM SPSS, Inc. in Chicago, Illinois, USA.Results:There was a highly significant difference between the two groups (P < 0.001) regarding first analgesic request and total analgesic consumption per day: there was delayed analgesic request and less total analgesic consumption per day in vitamin D group. Comparison of post-operative sedation scores showed highly significant difference (P < 0.001) between the two groups, Sedation scores was increased significantly in vitamin D group. This study also reported that the administration of vitamin D was associated with less noticeable post-operative SCD complications.Conclusion:The use of prophylactic vitamin D in SCD will result in delayed post-operative analgesic request and less total analgesic requirement. Administration of vitamin D was also associated with less post-operative complications.

BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital (JGH) in the southwest corner of Saudi Arabia. METHODS:A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies. RESULTS:The mean age of the patients was 25.3±16.8 years. Most (45.1%) of the patients were at age of 18-30 years. Males (64.3%) were affected by trauma more common than females. More than half (60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury (60%), followed by blunt trauma (30.9%) and then penetrating trauma (9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority (48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffi c accidents accounting for the majority.

Sonoelastography may be superior to other US modalities in elucidating different cervical lymph node biopsy helping to distinguish benign from malignant lesions. This may replace the lymph node biopsies in the future. Moreover, its use in the follow-up of patients with cervical malignancies may reduce the number of future biopsies. Further studies with more patients may be needed for a better assessment of results.

Objective To investigate whether the division of the cryptorchidism was significantly higher in the 90-180-day-old mature rats than in 30-day-old preproximal genitofemoral nerve (GFN) in neonatal rats induces testicular undescent or ascent in adulthood.pubertal rats (P<0.01). The mean (sd) weight of the undescended testes, at 2.36 (0.21) mg/g body weight, Materials and methods Neonatal Wistar King A rats underwent a unilateral proximal GFN transection on was significantly less than that of the contralateral scrotal testes, at 3.83 (0.23) mg/g; P<0.01) and of either the right or left side. At the age of 30 days, testicular descent was examined in all rats and the the control testes at the age of 90-180 days. In the sham-operated rats, all testes were located at the position of the testis recorded. The animals were allowed to develop further and the position of the bottom of the scrotum at 30 days of age and no rats showed any testicular ascent thereafter. testis re-examined at the age of 90-180 days, when the testes were removed and weighed. Sham-operatedConclusions The proximal division of the GFN in neonatal rats not only causes inguinoscrotal testicular malrats were used as controls.Results At the age of 30 days, four of the 46 (9%) descent but may also induce testicular ascent in adulthood. Testicular ascent may thus be caused by some operated rats showed a unilateral undescended testis on the operated side. At the age of 90-180 days, 43 intrauterine disorders of the GFN in patients with ascending testis. rats were re-examined (three rats died before re-examination); 34 (79%) of these rats showed undeKeywords Ascending testis, genitofemoral nerve, rat scended testes on the operated side. The occurrence of induced cryptorchidism, although Clarnette et al. [11] Introduction and Han and Choi [12] reported that accurate division of the GFN did not cause undescended testes. In the Several authors have described ascending testes as a new variant of cryptorchidism in which the testis once present study, we investigated whether division of the proximal GFN in neonatal rats induced testicular ascent descends into the scrotum in early infancy and then later spontaneously ascends out of the scrotum [1][2][3][4][5][6][7][8].in adulthood. However, the mechanism involved in spontaneous testicular ascent is still not completely understood. Some Materials and methods authors have postulated that the absorption of the processus vaginalis would retract the testis [2], whileWistar King A newborn rats, used within 72 h after birth, were obtained from a colony maintained at Kyushu other authors suggested that a failure of the natural elongation of the spermatic cord may cause spontaneous University and anaesthetized with ether. Forty-six rats underwent a laparotomy through a small transverse ascending testes [1].On the other hand, the genitofemoral nerve (GFN) has lower abdominal incision just below the umbilicus. The GFN was transected proximally by dividing the nerve on been proposed to play an important role in inguinoscrotal ...

BackgroundAppendicitis is the most common surgical emergency in children; yet, diagnosis of equivocal presentations continues to challenge clinicians.AimThe objective of this study was to investigate the hypothesis that the use of a modified clinical practice and harmonic ultrasonographic grading scores (MCPGS) may improve the accuracy in diagnosing acute appendicitis in the pediatric population.Patients & MethodsMain outcome measuresSensitivity, specificity, and accuracy of the modified scoring system. Five hundred and thirty patients presented with suspected diagnosis of acute appendicitis during the period from December 2000 to December 2009 were enrolled in this study. Children's data that have already been published of those who presented with suspected diagnosis of acute appendicitis- to whom a special clinical practice grading scores (CPGS) incorporating clinical judgment and results of gray scale ultrasonography (US) was applied- were reviewed and compared to the data of 265 pediatric patients with equivocal diagnosis of acute appendicitis (AA), to whom a modified clinical practice grading scores (MCPGS) was applied. Statistical analyses were carried out using Z test for comparing 2 sample proportions and student's t-test to compare the quantitative data in both groups. Sensitivity and specificity for the 2 scoring systems were calculated using Epi-Info software.ResultsThe Number of appendectomies declined from 200 (75.5%) in our previous CPGS to 187 (70.6%) in the MCPGS (P > 0.05).Specificity was significantly higher when applying MCPGS (90.7%) in this study compared to 70.47% in our previous work when CPGS was applied (P < 0.01). Furthermore, the positive predictive value (PPV) was significantly higher (95.72%) than in our previous study (82.88%), (P < 0.01). Overall agreement (accuracy) of MCPGS was 96.98%. Kappa = 0.929 (P < 0.001). Negative predictive power was 100%. And the Overall agreement (accuracy) was 96.98%.ConclusionsMCPGS tends to help in reduce the numbers of avoidable and unnecessary appendectomies in suspected cases of pediatric acute appendicitis that may help in saving hospital resources.

The aim of this study was to evaluate the postoperative clinical outcome, colorectal function, and fecal continence score after Soave's transanal endorectal pull-through surgery (TERPT) for Hirschsprung's disease (HD) comparing them in preschool and school children with the results of younger children. This comparative retrospective study was done on 40 HD children treated over a period of 8 years from January 2001 to December 2008. Patients were classified into two equal groups according to their age: group I (n = 20) included children with age <6 months up to 42 months, and group II (n = 20) included children from 3.5 years up to 13 years. Demographic, clinical data, preoperative investigations, operative records, postoperative outcome and follow-up including defecation problems, fecal continence score rate (FCSR), anal manometry and electromyography were all reviewed. Obtained data were statistically analyzed using SPSS. Forty patients were included in this study, 28 males and 12 females with the male to female ratio of 2.3:1. The median age of the studied patients in group I was 8.9 months, while in group II, the median age was 65.95 months. The postoperative follow-up period ranged from 18 to 24 months in group I with a mean of 21 months, while it ranged from 2 to 26 months in group II. In group I, most of children showed no abnormal defecation problems, 16 patients had excellent FCSR, 4 were having good FCSR and no poor continence score rate, while 3 patients suffered from constipation. Meanwhile, in group II, 15 patients showed excellent FCSR in 10 patients and 5 with good FCSR. While the rest of patients suffered from different abnormal defecation behavior that was constipation in 5 patients. The remaining 5 patients suffered from continence problems varying from fair in 3 patients (20%), with the remaining 2 patients having a poor continence score rate. It can be concluded that TERPT can be performed with some difficulties in older children; yet, the follow-up results are statistically low when compared with those patients who had undergone the operation at younger age.