ABSTRACT
A common belief is that alkali ingestion causes severe esophageal damage and limited gastric injury due to the buffering action of acid. Gastric injury has been observed in patients who ingested alkali. Gastric outlet obstruction [GOO] secondary to caustic ingestion occurs due to fibrosis after resolution of the acute injury and inflammation, most commonly 6 to 12 weeks after initial ingestion. The traditional treatment for GOO related to ingestion of corrosive agents is surgery. Experience with endoscopic balloon dilation of corrosive-induced GOO is limited in children. This is the first report of endoscopic pyloroplasty in a child with GOO due to caustic alkalis ingestion that was treated with balloon dilation [using TTS balloon ranging from 6-15 mm] in Iran. Four dilation sessions were required for symptomatic relief of dysphagia. After one year of follow up, weight gain was normal
Subject(s)
Infant , Humans , Endoscopy, Gastrointestinal , Alkalies , Eating , ChildABSTRACT
Backgound: Neonatal respiratory distress is a main cause of preterm neonatal mortality. Surfactant is one of its standard treatments. The current study was conducted to compare clinical effects of different kinds of surfactant in the treatment of respiratory distress of preterm neonates admitted to NICU of Sabzevar.
Materials and Methods: This cross-sectional study was conducted on the preterm neonates admitted to NICU of Shahid Mobini Hospital of Sabzevar University of Medical Sciences, in 2009-2010. Sample size was 115 neonates at 95% confidence interval. Inclusion criteria were neonates with respiratory distress and 26-37 weeks gestional age who had been treated with surfactant. Exclusion criteria were neonates with 5-min Apgar score less than 7, neonates with major congenital anomalies, or neonates whose mothers received steroids before giving birth. The data were gathered by questionnaire to assess clinical effects of different kinds of surfactant in the treatment of preterm neonatal respiratory distress. The questionnaire was confirmed by content validity and inter-rater reliability [r=0.9]. The data were analysed in SPSS software version 20 using descriptive statistics and non-parametric tests including ANOVA and multiple comparisons, kruskalwalis and chi-square.
Results: 41 neonates were allocated in a group with birth weight less than 1500 g and 74 neonates in a group equal or grater than 1500 g. According to the statistical tests, intubation duration in neonates less than 1500 g who received Newfactan was significantly more than the two other drugs [P=0.01]. Duration of CPAP in Curosurf group was more than Survanta and Newfactan groups with a significant difference. Time of starting feeding was lesser in neonates who had recieved Survanta than Newfactan. In neonates less than 1500 g, none of the variables had a significant difference after surfactant therapy.
Conclusion: This study showed that Survanta has a better efficacy than Newfactan and Curosurf. But in regard to the importance of applying this drug, and the controversy of results obtained from studies, it is recommended to perform further studies about this issue.