Evaluation of Omphalocele Treatment Using New Surgical Technique

Introduction: The aim of this study was to evaluate a new technique for treatment of omphalocele using mesh fixation to skin with preserved omphalocele sac. Materials and Methods:  Chart of patients who treated with mesh fixation were reviewed. Demographic features, mortality and morbidity following treatment were recorded. Results: in the current study 68 patients (f=32, m=36) were included. Of 68 csaes, 44(64.7%) had giant omphalocele. Among all cases, 20(29.4%) had isolated omphalocele. Mortality was 26.5%(18 of 68).  Of survived cases, 21(42%) had detached mesh. Adhesion band was seen in 4(8.2%) of cases. Sepsis was seen in 11.8% of the cases. Conclusion: According to the result of the study, suggested technique is promising and had several benefits. Duration of hospital staying, duration of intubation was less than previous technique

Effect of probiotics in diarrhea and GE Reflux in pediatrics.

Probiotics are defined as nonpathogenic bacterial depravities (Lactobacillus GG Enterococcus faecium,Lactobacilus acidophilus & Bifidobacterium bifidum) that provides better ,and normal intestinal floral and  function ,which balances Intestinal micro-organism and supports the immune system. One of the most common form of diarrhea is Antibiotic induced diarrhea, in which probiotics are used as preservative therapy. A significant number of patients with diarrhea are children (infant –toddler), who have underdeveloped immune system and diarrhea may cause life-threatening event. GE reflux is a common disease in infants. probiotics are now taking a part in the treatment of these children but it is not approved by FDA, although some surveys have shown its benefits. Introduction: The aim of this study is to see the role of probiotics in prevention and treatment of diarrhea and control of GE reflux, versus its high cost. Methods and Results: Four groups were studied in this analysis. The first group had diarrhea without probiotic treatment, the second group were patients with GE Reflux without probiotic treatment. The third group had diarrhea treated with probiotics, and the fourth group had GE reflux and were treated with probiotics. We used patients precise age, weight. variables were sex(female/male)age, (months), weight duration of disease with and without probiotics. In this study mean age was 24 months ,the minimum was 6 months and maximum was 78 months.58%of them were male and 42% were female. The mean treatment duration in group1 was 10 days. In third group was 7days which was reduced by 3 days. The mean treatment duration in group 2 was nearby 26 days. In third group was  near 25 days. Conclusions: Probiotics have significantly reduced the duration of diarrhea but there has not been a prominent improvement in duration of disease in GE Reflux

EVALUATION OF RISK FACTORS AFFECTING ANASTOMOTIC LEAKAGE AFTER REPAIR OF ESOPHAGEAL ATRESIA Avaliação dos fatores de risco que afetam deiscência de anastomose após reparação de atresia esofágica

ABSTRACT -Background: Anastomotic leak are reported among neonates who underwent esophageal atresia. Aim: To find risk factors of anastomotic leakage in patients underwent esophageal repair. Methods: All cases with esophageal atresia were included. In this case control study, patients were classified in two groups according to presence or absence of anastomotic leaks. Duration of study was 10 years. Results: Sixty-one cases were included. Mean±SD age at time of surgery in patients with leakage and without leakage was 9.50±7.25 and 8.83±6.93 respectively (p=.670). Blood transfusion and two layer anastomosis had significant correlation with anastomotic leakage. Conclusion: Blood transfusion and double layer anastomosis are associated with higher rate of anastomotic leakage. RESUMO

Comparison Outcomes of Divided End Loop Versus Separate Double Barrel Colostomy in Neonates with Imperforate Anus: Divided End Loop Versus Separate Double Barrel Colostomy in Imperforate Anus

Introduction: the aim of current is to compare clinical outcomes between the divided end loop and separate double barrel colostomy in neonates with imperforate anus. Materials and Methods: This is a retrospective study to review 184 patients who presented with imperforate anus and were managed with a divided end loop or separate double barrel colostomy between 2017 and 2020. Complications were compared in the two groups. Results: There was more skin excoriation in separate double barrel colostomy compared to divided end loop colostomy (p=0.001).  The mean of scar size in patients of divided end loop colostomy group was lower than that of separate double barrel colostomy significantly (p<0.0001). Conclusion: Our results suggest that divided end loop colostomy may be more acceptable than separate double barrel colostomy for neonates with imperforate anus

Skin Bridge versus Rod Colostomy in Children – Comparison between Complications

Due to economic problems, sigmoid loop colostomy using glass rod may cause problems for our patients for finding glass rod and several visits. The aim of the study was to compare rod versus skin bridge colostomy. Material and methods. In this study, 42 cases who are candidate for colostomy were included. Cases were randomly placed in skin bridge and rod colostomy group. Independent sample t-test and Chi-square were used for comparison. SPSS version 16.0 (SPSS Inc, Chicago, IL, USA) was used for analysis. Results. Of 42 cases, 20 were male and 22 were female. Hirschsprung’s disease was the indication of colostomy in 33 cases. In nine cases, imperforate anus was the indication of colostomy. Mean time of surgery was 79.4 and 82.5 minute for the rod and skin bridge group respectively (P>0.05). Retraction was seen in 2 case of rod group, and no case of skin bridge group. Prolapse was seen in 2 (9.5%) case of rod group and 1(4.7%) case in skin bridge. There were no reports of necrosis, stenosis, and hernia in both groups. Conclusion. In the skin bridge group the rates of complications were lower but the groups are too small for statistical analysis. Colostomy with a skin bridge method may decrease number of revision and expenses and may be appropriate option. Sigmoid loop colostomy using skin bridge flap may be appropriate choice in developing country. Another study with more samples is recommended to better comparison of Skin Bridge versus rod colostomy

RESULTS OF POSTERIOR MYECTOMY FOR THE TREATMENT OF CHILDREN WITH CHRONIC CONSTIPATION

Background and Objectives - The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Methods - Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA). Results - Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months). Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months). Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant ( P <0.001). Of all cases, 52% continued treatment of constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Conclusion - Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment

A Survey on Factors Promoting Early and Delayed Complications in Neonate and Infants Using Cvc Line: A survey on factors complications in neonate and infants using CVC line

Abstract Introduction: Central venous catheter placement (CVC) is an accepted venous access method in the treatment of critically ill neonates &amp; infants, evaluation of factors that induce complications are nescessary. Therefore, the aim of this study was to investigate the effective factors in causing early and late complications of central venous catheter placement in infants less than one year hospitalized in Imam Khomeini and Golestan hospitals. Methods: This study was performed on 400 infants less than one year old. Patients informations,early and delayed complications were recorded. Data were compared based on Chi-square and Fisher tests. Results: The most common complication of central venous catheter placement in the neonates and infants were as followed, infection (5.5%), venous thrombosis (5%), thrombophlebitis (4.3%), bleeding (3.8 %), hematoma (2.5%), arterial injury (0.3%) and pneumothorax (0.3%). Hemothorax and malposition were not observed. Frequency of bleeding in patients in whom catheterization was attempted 3 times was significantly higher (75%) than&nbsp; patients that had been tried twice (26.3%). Also, the frequency of hematoma and arterial injury were higher in cases who had tried twice. Finally, one case of pneumothorax was observed in cases who had been tried three times (25%). Also, the incidence of infection and thrombophlebitis in patients who had a catheter for more than 14 days was significantly higher than patients who had a catheter less than 14 days. However, it was found that the frequency of complications was not related to age, sex, height and weight, underlying disease of the infant, catheter location and catheter needle. Conclusion: The incidence of central venous catheter complications in infants is low and has a significant relationship with the attempting times of placement and duration of catheter placement. This is a suitable venous access method for the treatment of infants and had no association with the underlying disease and neonatal demographic indicators. Keywords: Central venous catheter, Early and late complications, Infant Abstractter, Early and late complications, Infan