Clinical presentation of novel influenza A [H[1]N[1]] in hospitalized children

Human pandemic influenza [H[1]N[1]] virus as the cause of febrile respiratory infection ranging from self-limited to severe illness has spread globally during 2009. Signs and symptoms of upper and lower respiratory tract involvement, fever, sore throat, rhinitis, myalgia, malaise, headache, chills and fatigue are common. In this article we report the clinical presentation of Influenza A [H[1]N[1]] in our hospitalized children. Between September and October 2009, all children requiring hospitalization for suspected [H[1]N[1]] infection were transferred to Pediatric Infectious Diseases ward. For all patients the throat swab was taken for PCR testing to confirm or exclude the diagnosis of [H[1]N[1]] Influenza A. Case patients consisted of [H[1]N[1]]-positive patients. Age, sex, symptoms, signs, laboratory data, CXR changes, details of therapy, duration of admission and patient outcome were documented. Twenty patients were [H[1]N[1]] positive. Mean age of the patients was 65.50 +/- 9.8 months. Fever and coughs were with 55% the most commonly reported symptoms. Other presentations included vomiting [55%], abdominal pain [25%], cyanosis and dyspnea [5%], body ache [40%], rhinorrhea [80%], sore throat [35%], head stiffness [5%] and loss of conciousness [5%]. The median temperature of the patients was 38.5°C. Chest X-Ray changes were noted in 13 out of 20 patients [65%]. Mean leukocyte and platelet was 6475 and 169000 respectively. Seventeen [85%] patients were treated with Oseltamivir, 3 patients received adjuvant antibiotics. The mean duration of admission was 3 days. Three patients required intensive care support and all of them expired due to superinfection. Our data confirm that the presentation of influenza in children is variable and 2009 [H[1]N[1]] influenza may cause leucopenia and thrombocytopenia

Vasal irrigation with sterile water and saline solution for acceleration of postvasectomy azoospermia

Vasectomy is the safest and most reliable method of all the contraception methods, but azoospermia is not achieved immediately by this method. We decided to determine whether irrigation of the vas deferens with sterile water or hypertonic saline solution irrigation during vasectomy would reduce the time needed to obtain azoospermia. A total of 126 fertile men presented for vasectomy were divided in 3 groups. No-scalpel vasectomy was done for all of the participants and irrigation of the vas deferens was carried out during the procedure in 2 groups with either sterile water or hypertonic saline solution [9 g/L sodium chloride solution]. Forty-two participants underwent vasectomy without irrigation. Semen analysis was performed at 4, 8, 12, and 16 weeks after vasectomy. Azoospermia was achieved in all of the men with sterile water after 12 weeks, while at the end of the study [16 weeks] it was achieved in 37 [88.1%] of those with saline solution and in 11 [26.2%] of those without irrigation. There were significant differences in the rates of azoospermia between the participant with sterile water and saline solution at 8 weeks [38.1% versus zero; P < .001], 12 weeks [100% versus 30.9%; P < .001], and 16 weeks [100% versus 88.1%; P = .02]. No pregnancy developed during the follow-up and no complication was reported. Vasal irrigation with sterile water and hypertonic saline solution during vasectomy were effective in removing sperm from the distal vas and increasing the rate at which men achieved azoospermia. Sterile water was a promising option with no complications

New method in laparoscopic surgery of xanthogranulomatous pyelonephritis

Laparoscopic surgery for Xanthogranulomatous pyelonephritis [XGP] is a difficult one so it seems that our experience may be helpful in other similar surgeries. The patient was a 75 years old woman who had right flank pain, several stones were observed in her kidney via IVU [Intra Venous Urogram]. The patient underwent transperitoneal laparoscopic nephrectomy and on pathology, XGP was reported. Total nephrectomy is the treatment of choice for XGP, but it is usually contraindicated for laparoscopic or retroperitoneoscopic techniques. We propose that in laparoscopic surgery of XGP, the ureter should be preserved until the end of procedure in order to use it as a handle. Also the adhesion of the superoposterior of kidney should not be free before ligaturing the pedicle. We suggest that in laparoscopic surgery of XPG, in case of difficulties in dissection of artery and vein, we could initially clamp and cut the vein, then ligator and cut the artery