A Rare Case of Mediastinal Ganglioneuroma in a 12-Year-Old Boy

Ganglioneuromas (GNs) represent the most benign form of tumor, comprising gangliocytes and mature stroma, and are typically asymptomatic. GNs are fully differentiated neuronal tumors lacking immature elements and can potentially arise at any location along the peripheral autonomic ganglia. The primary treatment involves complete surgical excision. Chemotherapy and radiotherapy are not recommended following tumor resection. This report describes a 12-year-old boy who presented to Abouzar Hospital in Ahvaz with cough, coldness, and shortness of breath. An abdominal and pelvic computed tomography scan revealed a heterogeneous hypodense mass measuring 135×105 mm in the left upper quadrant. Pathological examination confirmed the diagnosis of ganglioneuroma. The patient underwent surgical intervention through a midline incision extended into the 6-7th intercostal space. He was subsequently discharged in good general health. This case underscores the significance of imaging in diagnosing ganglioneuroma, mainly when located in the posterior mediastinum

Effect of nebulized 3% hypertonic saline in the treatment of acute viral bronchiolitis in children.

Background: Bronchiolitis is the most common viral respiratory infections in children under 2 years. No effective Short-term or long-term treatment for bronchiolitis has been approved yet. Treatment is still supportive with oxygen, fluid and mechanical ventilation as necessary. Several studies have shown that 3% hypertonic saline improve immediate and longterm cleaning of small airways in these patients. This study aimed to compare the effects of 3% hypertonic saline with 0.9% saline in 2-24 month children with bronchiolitis. Materials and Methods: In a non-randomized clinical trial, 60 children aged 2 to 24 months with diagnosis of acute viral bronchiolitis were enrolled. Thirty children recieved 3% hypertonic saline with nebulizer as the treatment group and 30 children treated with nebulized normal saline 0.9% as the control group. In entrance, oxygen saturation (by pulse oximetry), respiratory rate, pulse rate and severity of disease were measured using a combination score (sum of Clinical Score (YALE Observation Scale) and RDAI (Respiratory Distress Assessment Index)) . The primary outcomes change in clinical score and hospitalization rate, and secondary outcomes were duration of hospitalization, need to oxygen therapy and recovery time from wheezing and cough. Results: Two groups were not different in terms of baseline variables, except age (8.9±4.9 months in the hypertonic saline group and 6.4 ± 4.6 months in normal saline group P=0.046). After the intervention, the difference in clinical severity between the hypertonic saline group (10.9±5.6) and normal saline (10.4±5.7) was not significant (adjusted for age P=0.77). The hospitalization rate was not significantly different in the two groups (60% vs 63.3%). Length of hospital stay, the need for oxygen therapy, number of days requiring intravenous fluid therapy and recovery time from cough and wheezing were not significantly different between two groups. Conclusion: It seems, 3% hypertonic saline does not have significant effect in reducing the severity of symptoms, rate of hospitalization and duration of hospitalization in 2-24 months children with viral bronchiolitis compared with normal saline 0.9%

Pediatric Patients Undergoing Surgery with Peroperative SARS-Cov-2 Infection: An Iranian Case Brief Report: Peroperative SARS-Cov-2 Infection in Pediatric Patients Undergoing Surgery

Introduction: The present study aimed to assess COVID-19 disease complications and its related 30-day mortality in pediatric patients with perioperative SARS-CoV-2 infection who had surgery. Materials and Methods: A multi-center, prospective, brief report of pediatric patients who had surgery at 6 hospitals in 4 cities of Khuzestan Province, South-western Iran, one of the provinces with the highest prevalence and death rates due to COVID-19 disease. COVID-19 status and its effect on the course and outcome of the patients was investigated. Results: 246 pediatric patients who had surgery between Jan 20 and Jun 01, 2020 with a 30-day follow-up period enrolled in the study. Four (1.62%) of the 246 patients who underwent surgery had perioperative COVID-19 infection. The most common symptoms included dyspnea, fever, and cough. Surgical procedures included total gastrectomy and esophagojejunostomy, bilateral pleural effusions tap, catheter placement for dialysis, and CV-line placement. Three patients had comorbidities including congestive heart failure (CHF), end-stage renal disease (ESRD), and diabetes. Conclusion: Based on our results, it can be said that the prevalence of this disease in children is lower than the average of the society; and the outcome in younger patients seems to be better. Though it seems that COVID-19 disease is a low risk and somehow benign condition in children undergoing surgery, but due to the unpredictable nature of the disease, public health recommendations at both general and special levels have been made by the World Health Organization (WHO) to prevent the disease. Further studies with larger samples are necessary to confirm our findings and to clarify which age groups are at increased risk for developing severe COVID-19 infection and its related morbidities and death