مهران پیوسته

Congenital abnormalities are of the main causes of death and disability in children, infants and neonates in most countries in the world where a remarkable part of these disorders can be prevented with timely measures. The aim of this study was to provide the epidemiological characteristics of congenital anomalies in Iran.

This cross sectional investigation was conducted on neonates of the birth year of 2016 in six major geographical regions in Iran including Tehran (capital), East Azerbaijan (northwest), Isfahan (center), Khuzestan (southwest), Sistan and Baluchistan (southeast) and Fars (south) Iran. Congenital defects were classified according to the coding system of the International Classification of Diseases (ICD_10). The sources of ascertainment of congenital defects were records of the cases diagnosed with birth defects, and hospital discharge forms. Fully trained and supervised data officers including midwives, nurses and medical coders were assigned to collect and management of the data for this investigation.

The prevalence of congenital anomalies in Tehran was estimated at 163.2, East Azerbaijan 356.4, Isfahan 326.0, Khuzestan 94.3, Sistan and Baluchistan 264.1, and Fars 376.0 per 10,000 births. The prevalence of major defect groups of genital organs, limb anomalies and heart defects were ranked the first, second and third, respectively, in the country. Hydrocele, undescended testicle and club-foot were the most common anomalies diagnosed in the organs in the study regions.

Congenital anomalies are considerably prevalent in Iran, and it is estimated more than 100.000 cases of birth defects occur annually in the country. It seems, therefore, necessary to develop and implement new methods of screening procedures before, during and after birth to avoid occurring congenital anomalies in the country.

 Indirect inguinal hernias in children are due to the opening of the vaginal process and the entry of viscera into it. We conducted this study to compare the rate of complications and recurrence after open and laparoscopic hernia surgery.

 This case-control study included the patients who underwent surgery by laparoscopic and open methods from 2018 to 2020. The study data were extracted from a checklist based on sex, age, infection rate, side effect, hydrocele rate, scar length, testicular swelling rate, and recurrence rate.

 A total of 261 patients were examined. The results showed a statistically significant difference between the time of surgery in both surgical methods (Z=-9.903, P<0.001). Also, there is a significant statistical relationship between recurrence and surgical procedure (P=0.021). None of the patients in the study had an infection, hydrocele, or testicular swelling after surgery.

Both methods are safe and can be selected according to the patient's condition. It is recommended that further clinical studies be performed to evaluate and compare these two surgical procedures.

Esophageal atresia is one of the most common congenital anomalies in neonates, and it can increase the incidence of complications and mortality, so it is essential to find a way to cure this disease more successfully. Therefore, the aim of this study was to evaluate the efficacy of maintaining the azygos vein in esophageal fistula in esophageal atresia patients.

This study was performed on 40 neonates (20 patients in the preserved group and 20 patients in the ligation group). After recording the patient's demographic data, the complications of both surgical procedures, duration of surgery and hospital stay were recorded. Chi-square and t-tests were used to compare the data.

In the present study, it was found that the maintenance of azygos vein in neonates with esophageal atresia can increase the duration of surgery (P <0.05), but it also reduces the hospitalization and ICU stay and, on the other hand, the incidence of various complications such as pneumonia and anastomosis leak decreased. (P <0.05)

Therefore, in neonates who are candidates for surgical treatment of esophageal atresia and who are admitted to the surgical department, this surgical method can be used instead of the classical

The purpose of this study is to evaluate the degree of satisfaction and familiarity of undergraduate speech therapy students with clinical education in the presence of treatment team in people with cleft lip and palate. The population of this interventional Quasi Exerimental study was 29 speech therapy students. In the first group there were 17 students who spent their internship outside the cleft lip and palate clinic and without getting familiar with team work and in the second group there were 12 students who spent their internship in cleft lip and palate clinic and got familiar with team work. At the end of the course, the degree of student’s satisfaction and familiarity was examined by the researcher-made questioner. The result showed that the mean score of satisfaction and familiarity from team therapy was more in the second group and had significant difference with the first group. (p-value≤0.000). According to resent result, in order to increase student's familiarity from treatment team, increase quality and strengthen the communication and cognitive skills, it is recommended to use team attendance approach in student's clinical education.

The management of children with major abdominal injuries has changed significantly over the past 2 decades. Few surgeons have extensive experience with massive abdominal solid organ injury requiring immediate surgery. Prompt identification of potentially life-threatening intraabdominal injuries with rapid resuscitation and therapeutic intervention is now possible in the overwhelming majority of children. CT has become the standard of care in the evaluation of the pediatric trauma patient. Modern generation CT scanners are highly sensitive in the evaluation of possible solid organ and retroperitoneal injuries. There must be a high index of suspicion for a hollow viscus injury in the child with free intraperitoneal fluid and no identifiable solid organ injury on CT. Clinician-performed sonography for the early evaluation of the injured child has been shown to be useful in many situations but does have limitations. A negative FAST exam does not exclude a significant solid organ or hollow viscus injury. The ready availability of high-resolution CT scanners and the nonoperative management of many pediatric injury patterns have increased، thus minimizing the utility of DPL. The use of laparoscopy for the injured child may have its place in the evaluation armamentarium of the hemodynamically stable patient. The spleen and liver are the organs most commonly injured in blunt abdominal trauma، each accounting for one third of the injuries. Each nonoperative treatment of isolated splenic and hepatic injuries in stable children is now standard practice. The clinical experience accumulated over the past 20 to 30 years، which has settled these concerns، is reviewed.

Splenic cyst is not a common disease. Robbins reported 32 primary splenic cysts from 42327 autopsies examined during 25 years. Splenic cysts are divided into two groups: parasitic and non-parasitic cysts. Splenic cysts are clinically divided to primary and secondary cyst. Ten % of and are primary or true splenic cysts. Because these cysts have non-specific symptoms like vague abdominal pain, abdominal distension and dyspnea, they may become huge by the time of diagnosis. Proliferation of epithelial cell and increased secretion of this cyst layer may be the cause of the growth. The traditional treatment is splenectomy.Subjects and In this case report, a 17-year male old patient with signs of weakness, abdominal distension, and mild dyspnea, which had begun 8 months ago, is presented. On Sonography we found a huge 217x 166 x 301 mm cyst in his spleen. Laparatomy revealed splenic cyst 30x 20x20cm with the same the same pathology. After splenectomy patient was completely cured and left the hospital with a good general condition.