Clinical Study The Comparison of Pain Caused by Suprapubic Aspiration and Transurethral Catheterization Methods for Sterile Urine Collection in Neonates: A Randomized Controlled Study

This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants' faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised ( = 0.1). The mean (SD) of the PIPP pain scores did not differ between groups (9.95 ± 3.7 in SPA and 9.64 ± 3.2 in TUC, = 0.6). The duration of TUC was longer. Both methods can be used to collect urine from neonates, but the difficulty of performing TUC on females and uncircumcised males should be considered

The Comparison of Pain Caused by Suprapubic Aspiration and Transurethral Catheterization Methods for Sterile Urine Collection in Neonates: A Randomized Controlled Study

This study was performed to compare the levels of pain experienced by young infants undergoing either suprapubic aspiration (SPA) or transurethral catheterization (TUC) for the collection of sterile urine samples. This prospective randomized clinical trial was conducted in hospitalized neonates in a university-affiliated hospital. Patients who required urine cultures were randomly assigned into one of two groups, the SPA or TUC group. The infants’ faces were videotaped, and the changes in the facial expression and physiological parameters during the procedure were scored using the Premature Infant Pain Profile (PIPP) in a blind manner. The primary outcome was the severity of the pain experienced during each procedure, and the secondary outcomes were the success rate, the duration, and the complications of each procedure. Ninety-four percent of male infants in the TUC group and 77.3% in the SPA group were uncircumcised (P=0.1). The mean (SD) of the PIPP pain scores did not differ between groups (9.95 ± 3.7 in SPA and 9.64 ± 3.2 in TUC, P=0.6). The duration of TUC was longer. Both methods can be used to collect urine from neonates, but the difficulty of performing TUC on females and uncircumcised males should be considered

Trans-nasal puncture for bilateral congenital choanal atresia

Aims: There are many surgical techniques to repair bilateral congenital choanal atresia, among them trans-nasal approach with simple puncture, dilation and stenting technique is most frequently used. We describe a series of trans-nasal puncture and stenting technique, by using pediatric urethral sounds and nalaton N 14. Materials and Methods: We used this technique in 10 patients with equal sex distribution, between 1997 and 2004 in our hospital. Mean age at operation was 3.5 days. Mean duration of stenting was 33.6 days (2-8 weeks) and patients were followed for an average duration of 28.8 months after surgery. Results: Three patients (30%) developed re-stenosis after stent removal, which was easily managed by simple dilatation and re-stenting for more two weeks. There was a minimal operative bleeding with no infection or central nervous system trauma. Conclusion: This safe, simple operation by using pediatric urethral sounds is a non-expensive way to treat this anomaly with a low complication rate

Trans-nasal puncture for bilateral congenital choanal atresia

<b>Aims: </b> There are many surgical techniques to repair bilateral congenital choanal atresia, among them trans-nasal approach with simple puncture, dilation and stenting technique is most frequently used. We describe a series of trans-nasal puncture and stenting technique, by using pediatric urethral sounds and nalaton N 14. <b> Materials and Methods: </b> We used this technique in 10 patients with equal sex distribution, between 1997 and 2004 in our hospital. Mean age at operation was 3.5 days. Mean duration of stenting was 33.6 days (2-8 weeks) and patients were followed for an average duration of 28.8 months after surgery. <b> Results:</b> Three patients (30&#x0025;) developed re-stenosis after stent removal, which was easily managed by simple dilatation and re-stenting for more two weeks. There was a minimal operative bleeding with no infection or central nervous system trauma. <b> Conclusion:</b> This safe, simple operation by using pediatric urethral sounds is a non-expensive way to treat this anomaly with a low complication rate

Pyloric Atresia Associated with Epidermolysis Bullosa: A Report of 4 Survivals in 5 Cases

Objective: Pyloric atresia (PA) is a rare congenital anomaly that constitutes approximately 1% of all intestinal atresias, and its incidence is approximately 1 in 100,000 live births. PA may occur as an isolated condition or associated with other abnormalities, the most common being Junctional epidermolysis bullosa (EB). Evidence suggests that PA-EB is a distinct entity. In this report, we present 5 cases of pyloric atresia associated with Junctional epidermolysis bullosa, 4 of whom survived after surgery. Cases Presentation: Prospective evaluation of 5 patients with pyloric atresia associated with Epidermolysis bullosa undergoing therapeutic surgery. Biopsy of the fresh bulla was compatible with Junctional EB in all 5 patients. All patients underwent laparatomy after stabilization. Four neonates underwent gastroduodenostomy, and one patient had excision of membrane and pyloroplasty. Out of 5 neonates, 4 survive and one died from fulminant septicemia 12 days after operation. Conclusion: Although association of PA with EB has been reported to be fatal, recently there have been encouraging reports of survival among these patients. These 5 patients underwent surgery and survived, and are doing well on follow up