The results of present study show that, in pediatric patients with severe head injuries, initial mixed metabolic acidosis plus respiratory acidosis and GCS are significant predictors of mortality, but other factors after adjustment for potential confounding factors had no prognostic effect.

The main aim of management of pediatric traumatic brain injury (TBI)  is to hold normal ranges for optimizing the most proper outcomes. However, for providing physiologic requirements of an injured brain it is very important to enhance the quality of recovery and minimize secondary injury. Within this study it is tried to regulate the most proper guidelines for management of pediatric TBI. A comprehensive research was conducted on some biomedical and pharmacological bibliographic database of life sciences such as PubMed, EMBASE, MEDLINE, LILACS database, global independent network of Cochrane, Science Direct and global health library of Global Index Medicus (GIM). By referencing these databases, a universal literature review was carried out through combining various recent studies in terms of pediatric traumatic brain injury, epidemiology, management and related clinical guidelines in accordance with various related articles published from 2000 to 2019 which could cover this area of recommendations.Based on the main objective of this study for providing a comprehensive review around available clinical practice guidelines for more precise management of TBI. These guidelines can be administered especially for pediatric population which possibly could improve the quality of clinical practice guidelines for TBI. The guidelines of TBI could be applied worldwide in various traditional demographic and geographic boundaries which could affect pediatric populations in various ranges of ages. Accordingly, advances in civil foundation and reforms of explicit health policy could decrease the pediatric TBI socioeconomic burdens.

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Introduction:Abdominal pain, in particular appendicitis, is a common cause of emergency department visits in children. Therefore, early diagnosis is very important. There are different scoring systems for the diagnosis of appendicitis. This study is the first study to evaluate the performance and accuracy of pediatric appendicitis score (PAS) in Iranian children with abdominal pain in emergency departments.Methods:This is a cross-sectional study of children under 18 years with suspected appendicitis who were referred to the emergency medicine department of hospitals affiliated to SBMU during 2015. Acute appendicitis was determined according to pathological findings, and final PAS scores were calculated for all children. With statistical analysis, comparison between two groups was calculated and the diagnostic accuracy of PAS score was estimated.Results:88 children with mean age of 10.5 ± 3 were studied. According to clinical examination 58 of the children were suspected to have acute appendicitis and 30 others were healthy. In current study, the diagnostic accuracy and precision of PAS at cutoff of 5.5 in patients younger than 18 years admitted to the emergency department with suspected acute appendicitis was 91% and 92%, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 93.88%, 86.21% and 92%, 89.29%, respectively.Conclusions:The results of current study showed that PAS has high diagnostic predictive value for the diagnosis of acute appendicitis in children under 18 years and due to the advantages listed for this score, its use is recommended for children in emergencies.