Sero-prevalence of hepatitis- a virus among children aged 1- 18 years in Easter Anatolia, Turkey

To determine the seroprevalence of hepatitis A virus among children aged 1-18 years in Elazig before national hepatitis A virus immunization program in Turkey. Prospective study. Elazig Education and Research Hospital and Elazig Harput State Hospital in Eastern Anatolia, Turkey. 1258 patients admitted to pediatric polyclinic with suspicion of hepatitis A virus infection between January 2011 and December 2012 were included in the study. ELISA blood test. Serological markers of hepatitis A, anti-HAV IgM and anti-HAV IgG, were tested using the ELISA method. Two hundred and forty-eight patients who were Anti-HAV IgM positive were excluded from study. The mean age of the remaining 1010 pediatric patients was 10.7 +/- 5.1 years [range: 1-18 years]. Out of these, 558 [55.2%] were male and 452 [44.8%] female. Overall, 575 [56.9%] cases were seronegative against hepatitis A virus. Anti-HAV IgG was detected in435 patients [43.1%]. Out of these, 236 [54.3%] were male and 199 [45.7%] female. The mean age of seropositive cases was 11.7 +/- 5.2 years. Hepatitis A is an important public health problem in our region. This study has revealed an advanced age of exposure to hepatitis A virus infection. We argue that the application of routine hepatitis A vaccine to children in our region will reduce the potential severe complications of the infection

The comparison of single incision laparoscopic cholecystectomy and three port laparoscopic cholecystectomy: prospective randomized study / 대한외과학회지

PURPOSE: Laparoscopic techniques have allowed surgeons to perform complicated intra-abdominal surgery with minimal trauma. Single incision laparoscopic surgery (SILS) was developed with the aim of reducing the invasiveness of conventional laparoscopy. In this study we aimed to compare results of SILS cholecystectomy and three port conventional laparoscopic (TPCL) cholecystectomy prospectively. METHODS: In this prospective study, 100 patients who underwent laparoscopic cholecystectomy for gallbladder disease were randomly allocated to SILS cholecystectomy (group 1) or TPCL cholecystectomy (group 2). Demographics, pathologic diagnosis, operating time, blood loss, length of hospital stay, complications, pain score, conversion rate, and satisfaction of cosmetic outcome were recorded. RESULTS: Forty-four SILS cholesystectomies (88%) and 42 TPCL cholecystectomies (84%) were completed successfully. Conversion to open surgery was required for 4 cases in group 1 and 6 cases in group 2. Operating time was significantly longer in group 1 compared with group 2 (73 minutes vs. 48 minutes; P < 0.05). Higher pain scores were observed in group 1 versus group 2 in postoperative day 1 (P < 0.05). There was higher cosmetic satisfaction in group 1 (P < 0.05). CONCLUSION: SILS cholecystectomy performed by experienced surgeons is at least as successful, feasible, effective and safe as a TPCL cholecystectomy. Surgeons performing SILS should have a firm foundation of advanced minimal access surgical skills and a cautious, gradated approach to attempt the various procedures. Prospective randomized studies comparing single access versus conventional multiport laparoscopic cholecystectomy, with large volumes and long-term follow-up, are needed to confirm our initial experience. (ClinicalTrials.gov Identifier: NCT01772745.)