Parasitic infestation in pediatric and adolescent appendicitis: a local experience

The relationship between parasites and pediatric appendicitis is a highly debatable issue. This study aims to investigate the role of parasitic infestation in the etiology of acute pediatric appendicitis. A retrospective study including 1600 pediatric and adolescent patients who had undergone surgical therapy for a diagnosis of acute appendicitis over a period of ten years from Jan 2001 to Dec 2010. Demographic data were retrieved including the patient's age, sex, clinical data, clinical presentations, laboratory investigations, operative data and pathological findings to identify the presence and type of parasites. Patients were divided into two groups according to the presence or absence of parasites in the appendix lumen. In group I [n: 88], parasitic infestation was observed, whereas in group II [n: 1502], no parasitic infestation was present. Parasites were present in 5.5% [88 patients], and of those 88 parasitic infestations, 45 [51.1%] were Enterobaisis, 8 [9.1%] were Schistosomiasis, 23 [26.1%] were Ascariasis, 7 [8%] Trichuriasis, and 5 [5.7%] were Teania Saginata. The percentage of patients with suppurative, gangrenous or perforated appendicitis was similar in both groups with no statistical significance, irrespective of the presence or absence of parasitic infestation. The low prevalence of parasites among the appendectomy specimens did not support the notion that parasites were a major cause of appendicitis in pediatric patients

Prenatal Diagnosis of congenital diaphragmatic hernia improves the postoperative outcome: a local experience

To date, uniform standards for congenital diaphragmatic [CDH] management have not existed. This study was to compare infants with congenital diaphragmatic hernia [CHD] who had undergone a prenatal diagnosis to those who had not undergone such diagnosis. Sixteen infants with CDH who were admitted to the neonatal intensive care unit [NICU] of Suez canal university hospital from December 2000 to August 2004 were prospectively studied. They were classified into two groups; group I including 7 infants who were prenatally diagnosed as CDH by serial ultrasound scans. In group II: 9 infants were diagnosed as having CDH after birth with no prenatal diagnosis. Special care for respiration and resuscitation was performed for all patients in the two group according to a special resuscitation protocol. After stabilization and resuscitation, surgical intervention was done under special anesthetic care. The outcome of the morbidity and mortality in both groups were studied and statistically evaluated. The mean gestational age was 37. +/- 1.05 weeds in group I in contrast to 35.18 +/- 2.7 weeks in group II. [P=0.04] and the mean birth weight was 2.5 +/- 0.8 kg in group I in contrast to 2.1 +/- 1.3 in group II. All infants required mechanical ventilation. In group I, the mean gestational age at prenatal diagnosis was 26.5 weeks. The lung area head circumference ratio [LHR] ranged from 0.36 to 0.23. associated abnormalities in group I included ventricular septal defect, atrial septal defect, polyhydramnios, premature rupture of membrane and preterm labor. In group I, the overall survival rate was 4 patients out of 7 [57.1%] in group II, 2 infants out of 9 survived with a survival rate of 22.2% with a statistically significant difference. Prenatally diagnosed infants with CDH have a better survival rate and a less morbidity compared with those who have not undergone this diagnosis