value of chest x -ray in foreign body aspiration of children

Foreign body aspiration [FBA] is a common cause of respiratory distress in children. Delay in diagnosis and treatment can cause serious complication especially chronic pneumonia. The aim of this study was evaluation of plain chest X- Ray [CXR] as the first and available imaging modality in FBA of children. A retrospective analysis was conducted on the records of pediatric patients less than 18 years of age with the discharge diagnosis of FBA from 1999 to 2003 at the Imam Reza Hospital [a large tertiary center in Khorasan province]. From 140 patients with FBA 87 [62%] were male. The mean age was 48 month. The most common clinical findings were: history of chocking [77%], decreased breath sounds [42%], wheezing [38%], cough [20%], respiratory distress [15.5%] and fever. CXR was normal in 47% of patients with a sensitivity about 64%. Air trapping [Emphysema] was most common radiological findings [24.5%]. Other radiological finding were, consolidations [10.5%], atelectasis [6.5%] and opaque foreign bodies [6.5%]. In all cases except four cases, aspirated foreign bodies were food materials and watermelone seeds were the commonest one [40%]. Bronchoscopic removal of foreign body was done successfully in 133 patients [95%]. Although FBA in children diagnosed by history, physical examination and radiographic findings, but this findings may be misleading. Negative CXR should not preclude diagnosis of FBA in children with a strong history of FBA, and early bronchoscopic examination will be safe and life saving

Turner syndrome: Cardiovascular abnormalities and correlation with clinical phenotype and karyotype

Turner Syndrome [TS] is the most common sex chromosomal abnormality. Patients [Pts] with TS are known to have higher incidence of congenital heart disease [CHD] than the general population. No studies have reported echocardiographic data according to the phenotype and chromosomal pattern in our country. The aim of our study was to assess an institutional experience. During 1995 to 2002, 37 unselected Pts with TS underwent cardiologic evaluation at the Imam-Reza Hospital. Karyotype distribution was: 45,X [65%], X-structural abnormalities [30%] and X-mosaism [5%].The mean age at the time of diagnosis was 12.81 +/- 4.48 years. The prevalence of CHD was 21%. Coarctation of Aorta [CoA] was the most prevalent CHD. [Absolute and relative risk was 16% and 75% respectively] The Pts with 45, X karyotype had the greatest prevalence of CHD, and the PTS with X-mosaism showed no signs of CHD. The PTS with severe dysmorphic signs had 45, X karyotype and showed a significant higer relative risk of cardiac malformations. There is an absolute higher prevalence of CHD in Pts with TS. An accurate, periodic cardiologic evaluation is necessary in all Pts with TS.