Alireza Pedram; Fatemeh Asadian; Naghmeh Roshan
Volume 7, Issue 3 , July 2019, , Pages 278-283
Abstract
Objective: To evaluate the diagnostic accuracy of ultrasonography in pediatric acute appendicitis.Methods: In this cross-sectional study, 230 children aged 5-15 years with the diagnosis of acute appendicitis were studied. This study included the evaluation of demographic indices, ultrasound findings ...
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Objective: To evaluate the diagnostic accuracy of ultrasonography in pediatric acute appendicitis.Methods: In this cross-sectional study, 230 children aged 5-15 years with the diagnosis of acute appendicitis were studied. This study included the evaluation of demographic indices, ultrasound findings at diagnosis, and then comparing the results with the description of the patient's procedure and the pathology report of these patients. Patients who did not undergo ultrasound before surgery or their ultrasound did not include the evaluation of appendicitis or their pathologic report was not available were excluded.Results: Overall, we have included a total number of 230 children with clinical diagnosis of acute appendicitis among whom there were 121 (52.6%) girls and 109 (47.4%) boys with mean age of 11.44 ± 2.90 years. Preoperative ultrasound report showed that 51.3% were normal and 48.7% had acute appendicitis. 34.8% had normal appendix and 65.2% had a pathological diagnosis of acute appendicitis. The sensitivity and specificity of ultrasound in these children were 58% and 68%, respectively. Positive and negative predictive values were 77% and 46%, respectively. The area under curve (AUC) was 0.853 (CI 95% 0.788-0.917) indicating a test with moderate accuracy. Conclusion: According to the obtained results, abdominal ultrasonography is of acceptable diagnostic accuracy in pediatric patients with acute appendicitis. The use of auxiliary techniques in ultrasound would increase the sensitivity and specificity in the diagnosis of acute appendicitis in children.
Zenon Pogorelic; Tonći Vodopić; Miro Jukić; Dubravko Furlan
Volume 7, Issue 2 , April 2019, , Pages 169-175
Abstract
Objective: To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods: From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 ...
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Objective: To analyze outcomes of treatment and complications in children treated with elastic stable intramedullary nailing (ESIN) due to femoral fracture.Methods: From May 2002 until May 2018 case records of 103 patients (76 male and 27 female), with median age of 9 (range, 3-17) and follow-up of 92 months, who underwent ESIN because of displaced femoral fracture were retrospectively reviewed. The patient’s information including age, sex, side involved, trauma mechanism, type of fracture, associated injuries, neurovascular status, complications, operation time, duration of hospital stay, time to implant removal were analyzed. The surgical procedure implied a reposition of bone fragments and osteosynthesis with titanium elastic nails introduced through an incision over the lateral and medial border of the distal femoral metaphysis.Results: All patients achieved complete radiographic healing at a mean of 8.5 (range, 5-15) weeks. Nine (8.49%) postoperative complications were recorded: three entry site skin irritation, two cases of valgus angulation and one case of nail protrusion, re-fracture, Varus angulation and delayed union. All complications, except case of re-fracture and one valgus angulation, were treated conservatively, with no long term consequences for the patients. Two patients were re-operated. After removal of nails all patients recovered complete function of the extremity, without long term consequences.Conclusion: The ESIN for treatment of femoral fractures shows very good functional and cosmetic results. It allows an early functional and cast-free follow-up with a quick pain reduction. Because of the excellent objective and subjective results, the operative stabilization of femoral fractures with ESIN should be recommended to all pediatrics patients.
Robab Mehdizadeh Esfanjani; Homayoun Sadeghi-Bazargani; Mina Goletsani; Reza Mohammadi
Volume 5, Issue 4 , October 2017, , Pages 280-284
Abstract
Objective: To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.Methods: Injury data were derived from a national-based injury supervision system during 2000–2002. This registry involved all of home-related injuries ...
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Objective: To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.Methods: Injury data were derived from a national-based injury supervision system during 2000–2002. This registry involved all of home-related injuries for children less than 7 years of age that treated in health or emergency centers. The study population included 25% of Iranian people. The descriptive statistical methods were used for representing the distribution of the variables like age, sex, injury mechanisms, types of injuries, etc. Data were presented as mean ± SD and proportions as appropriate.Results: Of the total 307,064 domestic injuries registered during 2000–2002, 77,500 cases (25.2%) were children. 70% of these children (54581 cases) were in age group of 1-5 years.The large fraction (58.8%) of injuries among children under 7 years of age went back to burn injuries. Cuts and lacerations were at the second level with 17.4%. 51% of injuries had contact with hot liquids. Of all children under 7 years of age injuries, 282 died, 86 were disabled, while the rest improved or being under treatment when recording data.Conclusion: Injuries, particularly burns (especially those who had contact with hot liquids that led into scald), are major public health problem that children under 7 years of age encounter. Therefore, it seems necessary to provide adequate plans to promote children under 7 years of age safety issues.
Marjan Jeddi; Mohammad Hossein Dabbaghmanesh; Alireza Kharmandar; Gholamhossein Ranjbar Omrani; Marzieh Bakhshayeshkaram
Volume 5, Issue 1 , January 2017, , Pages 29-35
Abstract
Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content ...
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Objective: To determine the prevalence of fractures and associated risk factors in healthy Iranian children and adolescents.Methods: In this cross sectional population based study, 478 healthy Iranian children and adolescents aged 9–18 years old participated. Baseline data and bone mineral content and density have been determined. One questionnaire was completed for all individuals including previous history of fracture, its location, and level of trauma. Albumin, calcium, phosphorus, alkaline phosphatase, and vitamin D levels were measured.Results: We found a prevalence of 12.9% for fracture. (34.5% for girls and 65.5% for boys); about 71% suffered long bone fracture with distal forearm as the most common site. Totally 58% of the boys and 54% of the girls had fracture with low-energy trauma. The fracture group had lower bone mineral apparent density in the lumbar spine (0.19±0.04 vs. 0.20±0.03, p=0.04), lower serum albumin (4.6±0.5 vs 4.8±0.4, p=0.02), and higher serum alkaline phosphatase level (446±174 vs. 361±188, p=0.02) compared with non-fracture subjects. By logistic regression analysis, we found a significant association for sex, and bone mineral content of the lumbar spine with fracture (p=0.003, p=0.039).Conclusion: Compared to other studies, our subjects had lower rate of fracture. We found an association between low bone density and fracture in children and adolescents. This finding has important implications for public health. Further research may contribute to recognition of preventive measures.
