ABSTRACT
<p><b>PURPOSE</b>Pediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergent surgery. The objective of this study was to determine the predictive values of injury severity score (ISS), new injury severity score (NISS) and revised trauma score (RTS) on children's mortality, hospitalization and need for surgery.</p><p><b>METHODS</b>In this study, records of trauma patients under 15 years old transported from a trauma scene to emergency department of Poursina hospital from 2010 to 2011 were included. Statistical analysis was applied to determine the ISS, NISS and RTS ability in predicting the outcomes of interest.</p><p><b>RESULTS</b>There were 588 records in hospital registry system. The mean age of the patients was (7.3 ± 3.8) years, and 62.1% (n = 365) of patients were male. RTS was the more ability score to predict mortality with an area under curve (AUC) of 0.99 (95% CI, 0.99-1). In the hospital length of stay (LOS), ISS was best predictor for both the hospital LOS with AUC of 0.72 (95% CI, 0.67-0.76) and need for surgical surgery with AUC of 0.94 (95% CI, 0.90-0.98).</p><p><b>CONCLUSION</b>RTS as a physiological scoring system has a higher predicting AUC value in predicting mortality. The anatomic scoring systems of ISS and NISS have good performance in predicting of hospital LOS and need for surgery outcomes.</p>
ABSTRACT
Background and Aim: Spinal cord injury [SCI] is one of the worst kinds of traumatic injuries with remarkable social and economic effects on communities
Methods and Materials/Patients: In this prospective randomized clinical trial, 122 patients with traumatic spinal cord injury were admitted to Poursina hospital within 48 hours of injury to compare granulocyte colony stimulating factor [G-CSF] and high-dose methylprednisolone as neuroprotective therapy
Results: In this research, 122 patients were studied out of whom 62 patients were included in the granulociote colony-stimulating factor [G-CSF] group with a mean age of 40.4, and 60 patients in the methylprednisolone group with an average age of 40.10 years. 55 out of 122 patients [45%] were completely paralyzed [Grade AIS:A] and 67 [55%] were with incomplete spinal injury [Grade AIS:B,C,D]. The average American spinal injury association [ASIA] sensory scores in the two groups were similarly compared in the same four time intervals, and p values were 0.7, 0.3, 0.2, and 0.1. They were not statistically significant
Conclusion: According to the results, the G-CSF was shown to be beneficial in average ASIA motor and sensory scores in the two groups of male patients at six months of onset of G-CSF treatment [p value=0.04], and average ASIA motor scores improvement in the falls subgroup patients also differed significantly within six months of onset of G-CSF treatment [p value=0.03]. A multicentre prospective randomized clinical trial to compare the placebo effect with G-CSF protocol's treatment, and also assessment of the cost benefits of the common medical treatment versus G-CSF are needed
ABSTRACT
Background and Aim: the purpose of this study was to evaluate and compare the pain of patients with spondylolisthesis who had undergone either of the surgery techniques: posterolateral fusion [PLF] or posterior lumbar interbody fusion [PLIF]
Methods and Materials/Patients: in a prospective observational study, 102 surgical candidates with low grade degenerative and isthmic spondylolisthesis were enrolled from 2012 to 2014. The observed patients were into two groups: PLF and PLIF. Assessing of pain has been done by a questionnaire using Visual Analogue Scale [VAS] scores. The questionnaire was completed by all patients before surgery, the day after surgery, after six months and after one year
Results: there were no statistically significant differences in terms of age and sex distribution, type of spondylolisthesis and pre-operation pain between groups [p>0.05]. Comparison of the mean VAS scores of two groups over the whole study period showed a significant statistical difference [p-value<0.05], although comparison of VAS at three points in time showed a mixed result. VAS scores showed no significant differences between two groups before surgery, the day after surgery and one year after surgery [p>0.05], but the difference of mean VAS scores between groups 6 months after surgery was statistically significant [p<0.05]. Analyzing the course of VAS scores over the study period showed a descending pattern for either of the groups [p<0.0001]
Conclusion: both surgical fusion techniques [PLF and PLIF] showed to be effective in treating low grade degenerative and isthmic spondylolisthesis, but PLIF was related to better outcome with respect to pain control
ABSTRACT
Background and Aim: we described the presentation, management and subsequent treatment outcomes of children and adolescents diagnosed with a pituitary adenoma in a joint neuroendocrine setting followed up by a single service as well as assessing long-term outcomes in terms of endocrine status and neurology symptoms
Methods and Materials/Patients: a total of 21 participants with histologically verified pituitary adenoma between January 2011 and June 2014 were studied. Patients' data from clinical, radiological and pathological records were analyzed using SPSS [Version 16]
Results: all these children and adolescents with pituitary adenomas were managed with microscopic transsphenoidal surgery. The most common symptom was Cushing [47.6%, n=10]. The functional type [76.2%, n=16] was more than the non-functional. The post-operative control MRI of most of them was clear [90.5%, n=19]. The lab control of most of them was normal [76.2%, n=16]. Apoplexy was seen in 5 patients [33.8%]. Gross-total resection [GTR; 100% tumor removal as judged by early post-operative imaging] was achieved in 19 cases. Only one of these patients showed evidence of radiologic recurrence
Conclusion: in our study, all patients underwent microscopic transsphenoidal surgery due to limitation of endoscopic approach in pediatric and avoided wide anatomical deficit. Doing a comparative study between these two approaches will bring about promising results