Timely versus delayed operation in infants with correctable congential anomalies: a surgery in Isfahan, 2000-2001

Unless performing a timely and appropriate correction, congenital anomalies can conduce to irrecoverable complications. There are different reasons for delay in referring such patients to physician for surgery. By understanding these considerations, we can make an effective approach to reduce the severity of this problem in our community and this is the aim of our study. In a cross sectional study, all 359 eligible cases [neonates and infants suffered from a correctable anomaly which were referred to our centers] and 110 physicians were included for a period of 15 months [2000-2001]. Two main hospitals in our city were set as the data collection centers [Al-Zahra]. Parents' views were extracted by interview. Physicians' knowledge about study subject was assessed by self administered MCQs. In this study 65 percent of all cases who were operated on had been taken to hospital with delay [male to female ratio was 4:1]. Among the cases who received delayed surgical treatment, inguinal hernia was the most prevalent one [39 percent]. Surgery in 32 percent of cases who had delay in their operation caused some degrees of complications. Physicians' misadvise [42 percent], economic problems [25 percent], and hospital terror [17 percent] were accounted as the most prevalent reasons for delayed referrals. Physicians' knowledge about the correctable congenital anomalies in infants was estimated very poor [3 score from 10]. Delay to refer for operation in correctable congenital anomalies is an important dilemma in our community. Public education and also health professional education about this matter can play an admissible role improving the situation. Also, it is needed to make decisions for improving assurance supports in such cases

[Injection of Beliomycin as a primary treatment of cystic hygroma]

Cystic hyfroma is a disorder in lymphatic vessel formation that involves the adjacent organs and can affect them due to its fast growing nature. The main treatment for cystic hygroma is surgical intervention that an have many complications after surgery. Treatment other than surgical interventions is the use of sclerosing agents. The goal of this study is to analyze the effect of Beliomycin in treating cystic hygroma. This quasi experimental study was carried out clinically at st-al Zahra and Kashaine hospitals of Isfahan from 1372 to 1383. A checklist including age, sex, cyst location, cystic hygroma volume before and after Beliomycin injection and/or surgery, was completed for each patient. Data was analyzed by T and paired T-Tests. p< 0.05 was considered meaningful. The study was carried out on 72 patients. 24 patients were treated with Beliomycin and 48 patient by surgery. Patients age was below 1 months up to 18 years old. Cystic hygroma was mainly located at neck region [46.8%]. The average size of cystic hygroma was 103.9 +/- 29.66cm[3] before Beliomycin injection and 34.91 +/- 16.19cm[3] after that [p=0.004]. and 43.511 +/- 7.81cm[3] before surgery and 1.39 +/- 1.39cm[3] after that [p=0.006]. The rate of recurrence of lymphingoma in the surgery treated group was 25.1% and in the group treated with Beliomycin was 29.2% with no significant diffference. Regarding the considerable decrease in cyst volume after Beliomycin injection and it's low complication compared to surgery, this method can be used as a primary treatment or supplementary to surgery

Improvement of renal function after relief of chronic partial upper urinary tract obstruction

Kidney's functional and anatomical changes reversibility of after treatment of partial ureteropelvic junction obstruction [UPJO] is not defined well. Therefore, in this clinical trial study, we've evaluated these changes. In a clinical trial study with non randomized-simple sampling, 32 patients with chronic partial obstruction of urinary tract due to unilateral UPJO were studied. In each patient, IVU, DMSA, DTPA, and bilateral kidney sonography were down pre and post operatively. Paired t-test, Wilcoxon, and McNemar tests analyzed data. P-value less than 0.05 was considered significant. Mean age of the patients was 5.44 +/- 0.47 years old and 40.6% of the patients were male. Split function mean in DMSA had significant difference, comparing pre and post operatively [P<0.05]. There also was a significant difference in mean of retention time and T1/2 of DTPA [P<0.05], comparing pre and post operatively [P<0.05]. Mean of kidney pelvis diameter had significant difference, comparing pre and post operatively [P<0.05]. Our study showed that operation of chronic partial obstruction of kidney, could improve kidney function. We also showed that sonographic evaluation of kidneys could help to evaluate kidney function in these patients