Pediatric trauma score: Is it reliable in predicting mortality?

The Pediatric Trauma Score (PTS) is rapidly gaining acceptance for use in prehospital triage. This study examines its reliability in predicting mortality. The charts of the 533 trauma patients hospitalized between 1984–1989 were reviewed and the PTS was calculated for each. There were 3 deaths in 370 patients with PTS >8, while 24 of 163 children with PTS ?8 died. Size categorization was found to be overemphasized because of the low mortality (7.7%) in children smaller than 10 kg, although their mean PTS (6.4 ± 2.1) was significantly lower than the mean PTS (9.0 ± 2.2) of children over 10 kg. Forty-nine of 71 surgically treated patients having intra-abdominal organ injuries had a PTS >8. The existing parameters of PTS did not have equal relationships to mortality, and may even all be inadequate in the correct triage of children with blunt abdominal trauma. © 1993, Springer-Verlag. All rights reserved

Management of vaginal stenosis during pregnancy: case report

Edinsel vajinal darlık ender görülen bir klinik durumdur. Bu çalışmada gebe bir kadında, geçirilmiş sezaryen operasyonunda vajinal sütürasyon yapılmasına bağlı gelişmiş vajinal darlık olgusunun yönetiminin sunulmasını amaçladık. Yirmi beş yaşında, gravida 2, parite 1, 33 hafta gebeliği olan hasta hafif preeklampsi ve intrauterin gelişme geriliği nedeniyle kliniğimize sevk edildi. Vajinal muayenede vajinanın üst 1/3'lik kısmının yalnızca 1 mm bir açıklık olacak şekilde kapalı olduğu ve serviksin izlenemediği tespit edildi. Hastanın tıbbi kayıtlarında bir önceki sezaryen operasyonu sırasında gelişen vajinal yırtığın primer sütürasyonla tamir edildiği görüldü. Otuz dört gebelik haftasında fetal distres gelişen hasta sezaryene alındı. Fetusun doğurtulmasının ardından antegrad manuel eksplorasyonla serviks ve vajen üst kısmı izlendi. Aynı anda 6 numara dilatator retrograd olarak vagenden geçirildi ve vajinal darlık genişletildi. Doğumdan sonra vajinal akıntıda bir sorun izlenmedi. Postoperatif üçüncü ayda hastaya ofis histereskopi yapıldı ve vajinal darlık bölgesi düzeltildi. Sezaryen operasyonu sırasında gelişen vajinal yırtıkların primer sütürasyonu vajinal darlık gelişmesine neden olabilir. Eğer vajinal darlığın tanısı gebelik sırasında konursa darlığın geniş- letilmesi sezaryen sırasında yapılmalı ve künt yöntemler tercih edilmelidir. Daha agresif tedavi metodların seçimi hastanın semptomları ve beklentileri göz önüne alınarak yapılmalıdır.Acquired vaginal stricture is a rare clinical entity. In this study, we aimed to present the management of acquired vaginal stenosis in a pregnant woman which had developed due to vaginal suturing performed during previous cesarean section. A 25-year-old, 33 weeks pregnant woman gravida 2, para 1, referred to our clinic because of intrauterine growth retardation and mild preeclampsia. On vaginal examination, it was detected that the upper thırd of the vagina was closed with only a 1 mm hole at the vaginal dome. The cervix could not be seen. Her previous medical records revealed that vaginal tear developed during the previous cesarean section had been closed with primary suturing. When fetal distress developed in the 34th week, a cesarean section was carried out. At the same session, following delivery, antegrade manual exploration of the cervical canal was performed and upper portion of the vaginal canal was observed. At the same time, a 6 F stylet dilator was advanced retrogradely through the vaginal route, and the vaginal stricture was dilated. No interference with vaginal post-delivery flow was noted. In the third postoperative month an office hysteroscopy was performed and the vaginal stenosis was corrected. Primary suturing of vaginal laceration at the time of cesarean section may cause vaginal stenosis. If the diagnosis of the vaginal stenosis is made during pregnancy, dilatation of vaginal stenosis should be done at the time of cesarean section and blunt techniques should be chosen. The symptoms and the expectations of the patients should be considered before selecting more aggressive treatment options

Evaluating the Efficacy of Chemical Disinfectants on Contaminated Dental Materials Contaminated by An Airborne Disease Tuberculosis Similar to COVID-19.

Background: Tuberculosis (TB) is a communicable disease as well as an airborne disease. Mycobacterium tuberculosis (MTB) could survive on dental materials shipped to dental laboratories. Aims: The aim of this study was to determine the number of bacilli held on the prosthetic material and the effect of chemical disinfection agents on various prosthetic materials that were shipped to dental laboratory of TB patient. Materials and Methods: The study consisted of three study groups, and a control group. 10 mm x 2 mm disc-shaped (n = 18 for each group, n = 72 in total) nickel-chromium alloy (Ni-Cr), polymethylmethacrylate (PMMA), and dental ceramic (DC) samples were prepared. After exposure to MTB 24 hours in a 37°C incubator, six samples for each group (PMMA), Ni-Cr alloy and a control group DC samples) were exposed to three disinfectants; 10 minutes into 2% glutaraldehyde, 10 minutes into 5% sodium hypochlorite, and 1 minute into alcohol-based disinfectant after vortexed in distilled water. Colony forming units (CFU/ml) were calculated per milliliters. Two-way ANOVA statistical analysis method was used, and a P value less than 0.05 was considered as significant. Results: The bacteria count for six Ni-Cr alloy disc-shaped specimens were recorded as 40, 10, 8, 6, 5, and 4 CFU/ml, respectively. Intensity of the colonies were found to be lower in other groups. 5 CFU/ml were detected on a single PMMA sample in the control group, and 40 CFU/ml were detected on one of the dental ceramic sample. No MTB uptake was observed on any sample in the 2% glutaraldehyde and 5% NaOCl disinfectant study groups. In alcohol-based disinfectant group, 1 CFU/ml was observed on Ni-Cr alloy sample. The effect of prosthetic materials used in this experimental study were not statistically significant on the CFU (p = 0.293). However, the disinfectants use was statistically significant on the number of colonies (p = 0.004). Conclusion: NaOCl and glutaraldehyde appeared to be more effective than alcohol-based disinfectant in removing MTB from Ni-Cr alloy, PMMA and dental ceramic surfaces. © 2021 Wolters Kluwer Medknow Publications. All rights reserved