Recurrence and complications of pediatric inguinal hernia repair over 5 years

Introduction and aim Inguinal hernia is one of the most common pediatric diseases in children and it presents most commonly during the first year of life. The aim of this study was to determine epidemiologic indexes and complications of inguinal hernia repair in pediatric patients who underwent inguinal hernia surgery.Patients and methods This retrospective study was carried out in the Imam Khomeini and the Abuzar hospitals. All inpatients who underwent surgery for inguinal hernia from 2003 to 2004 were included in this study. Their hospital records were reviewed till 2007 for age, sex, wound infection, recurrence, and other complications. The v2-test was used for analysis using SPSS, version 13.0.Results In this study, 269 children were included. Of all the patients, 237 (88.1%) were boys and 32 (11.9%) were girls (P < 0.001). The median age at the first reference to the surgeon was 2.93 years. Right-side and left-side inguinal hernia was observed in 136 (50.55%) and 92 (34.20%) cases, respectively. Bilateral inguinal hernia was observed in 41 (15.25%) cases. The frequency of recurrence was 2.2%, and was observed only in boys. Postoperative complications were observed in 5.2% of the cases. The most common of them was anesthetic complication.Conclusion Most of the cases involved male patients. All of the recurrences were in male patients. Postoperative complications were observed in 5.2% of the cases. Keywords: complication, inguinal hernia, pediatric, recurrenc

The ϵ\epsilon-ζ\zeta Transition in Solid Oxygen

The structure of solid oxygen has been studied at pressures from 50 to 140~GPa using static structure search methods and molecular dynamics simulations with density functional theory and a hybrid exchange functional. Several crystalline structures with space group symmetries {\it Pnma}, {\it P}\,2$_{1}${\it /m}, {\it Pm} and {\it P}\,6$_3$/{\it mmc} have been identified as candidates for the $\zeta$ phase of oxygen at 0~K. Within the hybrid exchange functional framework and at 300~K temperature, {\it Pm} is shown to be energetically most favorable above 111~GPa. A comparison with experimental X-ray diffraction, spectroscopic and superconductivity measurements is provided for all competing structures.Comment: 6 pages, 5 figure

Evaluation of epidemiologic indices of neonate’s diseases in the Pediatric Surgery Ward of the Ahvaz Jundishapur University hospitals during the period 1993–1996 and 2002–2005

Introduction and aim The neonatal period is a critical time for infants, and 2/3 of first-year mortality occurs during this period. In developing countries, surgical diseases are the most important cause of neonatal mortality. Mortality was reduced in the past decade due to the availability of well-trained pediatric surgeons and the development of sophisticated instruments. The aim of this study was to show neonatal mortality and other indices in the period when there were no pediatric surgeons compared with the period when pediatric surgeons were available. Patients and methods This retrospective study was conducted in the Imam Khomeini and Abuzar Hospital during the period 1993–1996 and 2002–2005. All neonates admitted in the surgical wards of the Imam Khomeini and Abuzar Hospital were included in this study. Only cases of those patients who died before data accumulation was completed or discharged against medical advice were excluded from our study. In the first period, no pediatric surgeon was available and all surgeries were performed by general surgeons. In the second period, pediatric surgeons were available. Data were statistically analyzed and χ2-test was used to compare noncategorical data. A P value of less than 0.05 was considered to be significant. This study was approved by the ethics committee of the hospital, and no intervention was used. Results In our study, 88 cases (males = 60.2%, female =39.8%) in the first period and 452 cases (males =61.7%, females= 38.3%) in the second period were included. The mean age at admission time in the first and second period was 6 days for both groups. The mean weights in the first and second period were 2886 ±766 g and 2915± 658 g, respectively. The mean lengths of hospital stay in the first and second period were 5 days and 10.5 days, respectively. In the first period, 68 cases (37.3%) were admitted in the first 7 days of life and 54 cases (61.4%) had a birth weight of 2500–3500 g. Of the 88 cases, 40 cases died (45.5%). In the second period, 353 cases (78.1%) were admitted in the first 7 days of life and 278 cases (61.5%) had a birth weight of 2500–3500 g. Of the 452 cases, 101 cases died (22.3%). Conclusion In our study, the most common surgical diseases in both the periods were imperforate anus, esophageal atresia with or without tracheoesophageal fistula (TEF), Hirschsprung’s disease, and jejunoileal atresia; these were similar to results found in other studies.Keywords: Hirschsprung’s disease, imperforate anus, inguinal hernia, pediatric, surger

Etiology of acute scrotal pain in children and adolescent patients admitted in Ahvaz Educational Hospitals

Purpose Acute scrotum is an emergency condition requiring rapid intervention. The aim of this study was to evaluate the clinical and epidemiological specifications of acute scrotum.Patients and methods This retrospective study was carried out on patients less than 21 years admitted with a diagnosis of acute scrotum in the surgical and medical wards from 2009 to 2010. One hundred and thirty-nine patients were included in this study. Epi-info version 6.4 (CDC) was used for data analysis.Results The final diagnoses were as follows: spermatic cord torsion (n =57, 41.00%), incarcerated inguinal hernia (n =30, 21.60%), epididymo-orchitis (n= 28, 20.14%), missed torsion (n =15, 10.79%), testicular trauma (n=5, 3.60%), and torsion of the appendix of the testis (n= 4, 2.87%). The most common age groups in relation to the diagnoses were as follows: testicular torsion and missed torsion (10–15 years, 34.7%), torsion of appendix testis (10–15 years, 100%), epididymo-orchitis (15–21 years, 85.71%), and incarcerated inguinal hernia with two peaks of age ( <5 years, 46.7%). Fifty-eight patients (41.72%) visited the hospital less than 6 h after the onset of pain. Twenty-eight patients underwent orchiectomy or orchiopexy and 38 patients underwent detorsion and bilateral orchiopexy. A herniotomy was performed in 15 patients and herniorraphy in 10 patients. An appendectomy was performed in four patients. Other procedures were carried out in seven patients. Out of 72 patients diagnosed with torsion (57 patients) or missed torsion (15 patients), 38 patients (52.7%) underwent a testicular salvage surgery (detorsion and orchiopexy). Out of all patients (139 patients), 92 patients underwent surgery and the rest (47 patients) were treated conservatively. These 47 patients had epididymo-orchitis (n= 28), testicular trauma (n =4), incarcerated inguinal hernia (n= 5), and missed torsion and testicular torsion (n= 10). Out of 27 patients with abnormal urinary findings, 19 patients had epididymo-orchitis.Conclusion The most common important differential diagnosis for acute scrotum is spermatic cord torsion. Most of the abnormal urinary findings were observed in patients with epididymo-orchitis. Most of the patients underwent surgery less than 6 h of disease onset. In patients with spermatic cord torsion, the affected testis has to be evaluated and treated during the first 6 h of presentation.Keywords: epididymitis, epididymo-orchitis, herniotomy, hydrocele, inguinal hernia, orchiopexy, scrotum, testicular torsion, traum

Congenital anomalies in low- and middle-income countries: the unborn child of global surgery.

Surgically correctable congenital anomalies cause a substantial burden of global morbidity and mortality. These anomalies disproportionately affect children in low- and middle-income countries (LMICs) due to sociocultural, economic, and structural factors that limit the accessibility and quality of pediatric surgery. While data from LMICs are sparse, available evidence suggests that the true human and financial cost of congenital anomalies is grossly underestimated and that pediatric surgery is a cost-effective intervention with the potential to avert significant premature mortality and lifelong disability