Meckel's diverticulum: prevalence in 1000 laparatomies

To detect the prevalence of Meckel's Diverticulum in children and adults aged 1 day to 90 years old. This is a cross sectional descriptive study of 1000 cases aged 1 day to 90 years old in the surgery wards of two educational hospitals, Mashhad, Iran from 1998 to 2004. The prevalence of Meckel's diverticulum, age, sex, and chief complain of patient and the site and size of the diverticulum were evaluated. Meckel's diverticulum was seen in 5.4% of patients. 62% of patients were younger than 2 years and 80% were male. Gastrointestinal and obstructive symptoms were the most common presenting feature of the condition [38%]. Meckel's diverticulum was observed at 40-59 cm distance from the ileosecal valve with 1-1.49cm length and 0.5-0.99 cm width. Meckel's diverticulum was more common in children younger than 2 years and was presented by GI obstructive signs in most patients.

Osseous metastase of occult paraganglioma: a diagnostic medical error

Diagnostic errors have a natural complexity. Medical diagnoses make up a large proportion of all medical errors and cause much suffering and harm. Compared to other types of error, diagnostic errors receive little attention-a major factor in continuity of unacceptable rates of diagnostic error. A 55-year-old woman presented to the emergency department [ED] complaining of bone pain which has been started a month ago and increased gradually in the upper right thigh. Following the emergency evaluation she was sent home with pain medication. On the second visit, a femur neck fracture was seen in the x-ray. She underwent hemiarthroplasty and was discharged. Over several weeks she was reevaluated by many Physicians, because of her worsening pain .In the third visit after the surgery, her x-ray showed bone destruction and following bone biopsy, malignant paraganglioma was diagnosed. In all cases in which patient comes to us with skeletal pain, getting a comprehensive history and a full physical examination are prior to lab tests and x-rays. Bone metastasis which can develop severe pain and pathological fractures, is common in patients with malignant paraganglioma. Effective steps for diagnostic error prevention are: Considering the diagnostic error in the normal range of quality assurance surveillance and review, identifying the elements leading to diagnostic errors and getting feedback on the diagnoses Physicians make, in order to improve their skills. It is an every health system priority to identify, analyze, and prevent diagnostic errors in order to improve patient safety.

Simple febrile seizure: the role of serum sodium levels in prediction of seizure recurrence during the first 24 hours

Simple febrile seizures are the most common form of childhood seizures, often recurring within the first twenty-four hours. This study was conducted to determine the probable role of low serum sodium levels in predicting seizure recurrence in febrile children. For the study, 226 patients with seizures, aged between 6 months to 5 years, were divided into 3 groups of simple febrile seizure, simple febrile seizure with recurrence, and the control group of afebrile patients with seizures. For all groups, serum sodium levels were evaluated. The mean age of our cases, predominantly male, was 22 months. No significant difference was observed in the serum sodium levels between the simple febrile seizure and the simple febrile seizure with recurrence groups [P value 0.465]; however a significant relative hyponatremia was observed in the simple febrile seizure group as compared to the afebrile seizure control group [P value: 0.016]. Based on the findings, although serum sodium levels cannot assist in prediction of recurrence of simple febrile seizures in children, relative hyponatremia may predispose the febrile child to occurrence of simple febrile seizure

Etiology and symptoms of pediatric admission in the emergency and pediatric wards in Qa'em Hospital in Mashad, Iran in 1382-83 [2003-4]

Background and Purpose: Etiology of pediatric admission is changing. In this study the most common causes of children's admission and duration of hospitalization were reviewed. In regard to complications of disorders, the_results of this study will promote managing and facilities in pediatric ward

Methods and materials: Pediatric patients admitted to Qa'em Hospital in Mashad, Iran in one year were studied. After filling out the questionnaires using the patient's records, relevant data were analyzed in SPSS and Excel using chi-sequence and t-test.

Results: Among 800 admitted fever in 57.8%, convulsion in 41%, cough in 20.9% and dyspnea in 7.3% of cases were chief complains. The most common diagnosis included febrile convulsion [41.4%], pneumonia [13.4%], bronchiolitis [8.6%] and asthma [5%]

Conclusion: The prevalence of pneumonia, acute bronchiolitis and febrile convulsion were more common than world's statistics. But asthma is lower than other regions. Therefore, attention to infections disease and respiratory system disease in particular is necessary