Novel Presentation of Complete Coronal Urethral Duplication: a Case Report

Urethralduplication is a rare condition occurs as a congenital malformation either independently or in the setting of other congenital malformations such as caudal duplication syndrome. Its prevalence becomes even rarer if it manifests as two side-by-side tracts in coronal plan.Nonetheless, we introduce a unique presentation of complete coronal urethral duplication accompanied by astounding manifestations of gastrointestinal malformations different from what is expected for a normal hind gut or caudal duplication syndrome. A 6-year-old boy with complete coronal duplication of urethra along with duplication of appendix, sigmoid and rectum as well as developmental delay, attracted our attention to report

Metabolic and Anatomic Abnormalities Associated with Pediatric Nephrolithiasis: a Cross-Sectional Study

Background Pediatric nephrolithiasis is a condition the prevalence of which varies geographically with multiple etiologies. The aim of this study was to determine possible concomitant anatomic and metabolic disturbances in children with nephrolithiasis and to answer the questions regarding the role of each metabolic and anatomic abnormality. Materials and Methods Between 2007 and 2015, 1,080 patients referred to our pediatric hospital of Hazrat Masumeh in Qom city, with the diagnosis of nephrolithiasis. Complete history from each eligible patient has taken using a prespecified data extraction form. Then, each child was referred for metabolic and anatomical evaluation using laboratory and imaging tests. Results According to the extracted data, 92% of our patients had at least one concomitant metabolic disorder and 12.5% had an anatomic abnormality. Recorded metabolic disorders in our series were hypocitraturia (56.9%), hyperuricosuria (21.4%), hypercalciuria (19.3%), hyperoxaluria (14.7%), phosphaturia (11.4%), and cystinuria (1.4%). According to data analysis, 12.5% of patients had an anatomical abnormality of which the ureteropelvic junction obstruction and vesicoureteral reflux were the most common. Conclusion The current study showed that the most common abnormalities in association with nephrolithiasis were metabolic disturbances, which highlight the importance of further metabolic study, even in patients with anatomical abnormalities

Relationship between urinary reflux and nephrolithiasis in children- a cross-sectional study

Aim: Urinary reflux is a probable reason of nephrolithiasis among children. This study aimed to assess the relationship between urinary reflux and other reason of stone formation in children.Methods: This cross-sectional study was carried out with 199 children diagnosed with nephrolithiasis using ultrasonography. They were hospitalized in a referral children hospital in an urban area of in Iran. This study was conducted between 2014 and 2016. The presence of urinary reflux was assessed and graded by using the voiding cystourthrography modality.Results: Overall, 83.9% of the children had normal conditions regarding urinary reflux, while 1.5% had reflux grade I, 5.5% reflux grade II, 8.1% reflux grade III, and 1% reflux grade IV with the total urinary reflux rate of 16.1%. The most prevalent observed clinical manifestation was irritability (45.2%) followed by fever (45.2%), and dysuria (19.6%). Also, no relationship was reported between the size of stones in both kidneys and the presence of reflux and its reflux. Furthermore, the size of stones in left and right kidneys was not related to hematuria, pyuria, and urinary tract infection.Conclusion: Vesicoureteral reflux and kidney stones in children may have interdependent identities. Therefore, the presence of reflux may not be a decisive reason for the diagnosis of nephrolithiasis

Distal Radioulnar Joint Instability

Distal radioulnar joint (DRUJ) instability is a common clinical condition but a frequently missed diagnosis. Both surgical and nonsurgical treatments are possible for chronic cases of DRUJ instability. Nonsurgical treatment can be considered as the primary therapy in less active patients, while surgery should be considered to recover bone and ligament injuries if nonsurgical treatment fails to restore forearm stability and function. The appropriate choice of treatment depends on the individual patient and specific derangement of the DRU