Dilemma of Retained Intraorbital Fragment of Pencil

Juvenile injuries by intraorbital foreign body in extremities are common and usually trivial (1) but they may lead to debilitating sequels in the head and neck. Because of their availability in comparison to other sources of trauma, accidental injuries may occur while children play with their friends. Injuries by pencils are special types of intraorbital foreign body, the final outcome of which is dependent to concurrent injuries of the ocular and also neurologic structure and comorbiditie. Orbital injury requires comprehensive evaluation, especially in child victims when there is not sufficient information regarding trauma mechanism and the intraorbital foreign body should be ruled out before any closure of wounds, as shown in the sample case presented here. In school age children with a history of falling, intraorbital fragments of pencils should be kept in mind. Preoperative information about the true number and exact location of retained fragments is paramount for an appropriate management. When there is high suspicion for retained foreign body, further detailed studies with CT and if needed MR scans and in selected cases plain X- ray are very helpful

Periorbital Ecthyma Gangrenosum Due to Pseudomonas Aeruginosa Septicemia in an Infant with Sepsis: A Case Report

Purpose: This article aimed to report an infant case of congenital neutropenia (CN) with periorbital ecthyma gangrenosum (EG) due to pseudomonas aeruginosa septicemia.Case report: A previously healthy six-month-old male infant with fever, diarrhea, poor feeding, pancytopenia, periorbital swelling, and eyelid ulcers in the left eye was admitted in pediatric intensive care unit (PICU). He had positive blood and eyelid wound cultures for pseudomonas aeruginosa. He was treated with broad spectrum intravenous antipseudomonal antibiotics and debridement of periorbital lesions and discharged after 18 days with a stable condition. Adequate hematologic workup for pancytopenia revealed the diagnosis of CN.Conclusion: There is a possibility that EG be developed in patients with immunodeficiency as preseptal cellulitis with isolated typical lesions, and this should be considered in the treatment

Hemi-Central Retinal Vein Occlusion in a Premature Infant: A Case Report

Background: This study reports the case of an infant patient with organized vitreous hemorrhage (VH) due to hemi-central retinal vein occlusion (Hemi-CRVO) secondary to thrombocytosis.Case report: A twenty-seven-day-old female infant with the gestational age of 30 weeks and 2040 grams weight at the time of birth and the history of a twenty-five-day admission in a neonatal intensive care unit (NICU) due to idiopathic hydrops was referred to the retinopathy of prematurity (ROP) clinic of the Khatam-al-Anbia Eye Hospital, for usual ROP screening. We found an organized VH in her left eye; so, we vitrectomized her eye. With the diagnosis of hemi-CRVO due to thrombocytosis, she is under observation.Conclusion: In this report, thrombocytosis showed to be a cause of hemi-CRVO; and the patient’s laboratory test review is important in such case

Biomaterials in Valvular Heart Diseases

Valvular heart disease (VHD) occurs as the result of valvular malfunction, which can greatly reduce patient\u27s quality of life and if left untreated may lead to death. Different treatment regiments are available for management of this defect, which can be helpful in reducing the symptoms. The global commitment to reduce VHD-related mortality rates has enhanced the need for new therapeutic approaches. During the past decade, development of innovative pharmacological and surgical approaches have dramatically improved the quality of life for VHD patients, yet the search for low cost, more effective, and less invasive approaches is ongoing. The gold standard approach for VHD management is to replace or repair the injured valvular tissue with natural or synthetic biomaterials. Application of these biomaterials for cardiac valve regeneration and repair holds a great promise for treatment of this type of heart disease. The focus of the present review is the current use of different types of biomaterials in treatment of valvular heart diseases

Differentiation of Biliary Atresia from the Intrahepatic Etiology of Infantile Cholestasis with Alagille Criteria

Background: Biliary atresia (BA) is an important etiology of liver disease in pediatric patients which manifests as extrahepatic cholestasis. Alagille criterion is a combination of noninvasive findings for the diagnosis of BA. In this regard, the current retrospective study aimed to evaluate the diagnostic accuracy of Alagille criteria for BA. Methods: This cross-sectional study was conducted in Ghaem Hospital, affiliated to Mashhad University of Medical Sciences during 2009-2014. All infants less than 2 years old with cholestasis referred to the pediatric gastrointestinal ward were included in this study. Alagille criteria were evaluated for each patient, and BA was confirmed with intraoperative cholangiography. Finally, sensitivity, specificity, and positive and negative predictive values of Alagille criteria were determined according to the final diagnosis. Results: In general, 92 patients were included in this study. The male-to-female ratio and the mean age of patients were 54/38 and 42±5 days (ranging between 1 and 5 months), respectively. There was a significant difference between the two groups in terms of gender, onset time of jaundice, and the presence of the acholic stool (P=0.02, 0.04, and 0.005, respectively). Eventually, the acholic stool had the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: Based on the findings, the presence of the acholic stool was the most valuable criterion for the diagnosis of BA among all Alagille criteria