Posterior fossa tumor in children

Primary brain tumors are the most common solid neoplasms of childhood, representing 20% of all pediatric tumors. The best current estimates place the incidence between 2.76 and 4.28/100,000 children per year. Compared with brain tumors in adults, a much higher percentage of pediatric brain tumors arise in the posterior fossa. Infratentorial tumors comprise as many as two thirds of all pediatric brain tumors in some large series. Tumor types that most often occur in the posterior fossa include medulloblastoma, ependymoma, cerebellar astrocytoma and brainstem glioma. All pediatric cases of posterior fossa tumor that were considered for surgery from 1981 to 2011 were selected and the demographic data including age, gender and tumor characteristics along with the location and pathological diagnosis were recorded. The surgical outcomes were assessed according to pathological diagnosis. Our series consisted of 84 patients [52 males, 32 females]. Cerebellar symptoms were the most common cause of presentation [80.9%] followed by headache [73.8%] and vomiting [38.1%]. The most common histology was medulloblastoma [42.8%] followed by cerebellar astrocytoma [28.6%], ependymoma [14.3%], brainstem glioma [7.2%] and miscellaneous pathologies [e.g., dermoid, and tuberculoma] [7.2%]. The diagnosis of brain tumors in the general pediatric population remains challenging. Most symptomatic children require several visits to a physician before the correct diagnosis is made. These patients are often misdiagnosed for gastrointestinal disorders. Greater understanding of the clinical presentation of these tumors and judicious use of modern neuroimaging techniques should lead to more efficacious therapies

[ case-control study about routs of transmission of cholera during summer outbreak in Zahedan]

Background: within the past few years out breaks of cholera has occurred in different points of Sistan and Baluchestan province of Iran, especially in the Zahedan district. The objective of this study was definition of the most important routs of transmission of cholera in the rural areas of Zahedan district involved in the cholera outbreak of summer 2003. The outbreak lasted for about 1.5 months

Methods and Materials: a case-control study was performed on 20 patients and 89 subjects as controls. A questionnaire was completed for eve1y subject about individual hygiene, hygiene regulations of' the family, the source of' the drinkable water, use of' chlorination of' water, use of soap jar hand washing, eating and drinking outside in feasts [such as weddings], getting ice .from street vendors, and travel history. Stool culture for detection of cholera was performed for all cases and also for consent controls

Results: in multivariate analysis age [OR = 0. 8, P = 0. 004], eating food in parties [OR = 34.5, P = 0.020], absence of soap in hand-washing place [OR = 4. 7, P = 0. 000] and household size [OR = 1.3, P = 0.002] were significantly associated with cholera in univariate analysis, getting ice from street vendors [P = 0.032] also had relationship with catching cholera

Conclusions: different routes of transmission of cholera are mentioned in reference books; however every outbreak has its own special circumstances. The most important points with regard to this outbreak were the importance of individual hygiene [especially using soap in hand washing], control of production and distribution of ice by street vendors, and the importance of' eating and drinking in ceremonies even feats and weddings. Warning of people about these points may play key role in controlling a cholera outbreak