The Role of Cremaster Muscle as a Cause of Ascending Testis after Inguinal Hernia/Hydrocele Repair

Background Ascending testis (AT) is one of the rare but serious complication that may occurs following inguinal hernia/hydrocele repair. We aimed to review our more than 7 years’ experience and discuss the possible mechanism through which the AT possibly occurs following inguinal hernia/hydrocele repair. Materials and Methods A retrospective analysis of 7,212 boys who had undergone inguinal hernia/hydrocele repair between March 2009 and April 2016 was conducted. Exclusion criteria were: undescended testis, misdiagnosed AT, and retractile testis. Two types of surgical procedures were performed based on the medical records: (1) transection of the hernia sac and processus vaginalisalone and (2) isolation of the vas deferens and testicular vessels and a global transection of the remaining structures. Subsequently, post-operative incidence of AT was compared across variables extracted from the medical records. Results Sixteen (0.22%) patients were diagnosed with AT post operatively. AT incidence after inguinal hernia/hydrocele repair was reported in approximately 0.19% of the entire patient sample (in the 8491 hernia/hydrocele repairs). Comparison of AT incidence with the age at initial operation showed significant increase at the age of one year or less (P =0.017). In addition, AT incidence was significantly higher in the patients for whom only the sac/processus vaginalis was transected rather than the patients who underwent hernia/hydrocele repair with isolation of the vas deferens and testicular vessels (0.06% vs. 0.27%, respectively, P =0.023). Other subgroup analyses remained non-significant. Conclusion We conclude that transection of the cremaster muscle might decrease the incidence of ascending testis following inguinal hernia/ hydrocele repair

Diagnostic Value of Hematologic and Inflammatory Profile in Adjunction to Blood Culture in Patients Suspected to Septicemia

Background Septicemia is a serious condition in pediatric population which highly depends on immediate diagnosis and treatment in terms of mortality and morbidity rate. Developing adjunctive laboratory tests to help clinicians make appropriate decision is of great priority. In this study we aimed to evaluate the predictive value of each biomarker to find the most valuable one based of which a reasonable empiric therapy would be initiated prior to definite diagnosis by blood culture. Materials and Methods Hospital records of Patients who referred to the Hazrat-Masumeh hospital of Qom province were reviewed between March 2013 and March 2017. Diagnostic tests including blood culture and hematologic indices (WBC, ANC, ABC and Platelets) as well as inflammatory biomarkers (ESR, CRP) were measured for all participants. Patients over 6 year-old and those received antibiotic within a week prior to admission were excluded from the study. Results Total number of 378 patients was enrolled in this retrospective study, of which 200 (52.91%) were boys. Positive blood culture was achieved in 171 (45.23%) patients. Significant increase observed in ANC, ABC, Platelets, ESR and CRP levels among patients with positive blood culture compared with negative blood culture (P-value of 0.0012