Prediction of vesicoureteral reflux in children with first urinary tract infection by dimercaptosuccinic acid and ultrasonography

Urinary tract infection [UTI] is one of the most common causes of febrile pediatric diseases. Also, vesicoureteral reflux [VUR] is a significant risk factor for UTI. Voiding cystourethrography [VCUG] is the method of choice for evaluation of VUR. This study was done to predict VUR by DMSA scan [technetium 99 m-labeled dimercaptosuccinic acid] and ultrasonography [US]. In a prospective study, all children with first time acute pyelonephritis were selected and evaluated by DMSA scan and US. Then VCUG was done with negative urine culture. All children with final diagnosis of obstructive congenital anomaly were excluded. The sensitivity, specifity, positive predictive values, negative predictive values, Confidence Interval of DMSA scan and US were calculated for prediction or exclusion of VUR. Among 100 children with UTI diagnosis, VUR was detected in 39 children and 63 [31.5%] kidneys. DMSA scan was abnormal in 103 [51.5%] units, 45 units had VUR [PPV=44%], 79 units with normal DMSA scan had no VUR [NPV=81%]. Of kidney units that were abnormal by DMSA or US, 51 units had VUR. PPV and NPV were 44% and 56%, respectively. DMSA scan alone or with US cannot predict VUR [especially low grade VUR]. But according to NPV, it seems that absence of VUR can be predicted. So, more studies are needed to determine the usefulness of DMSA scan and US instead of VCUG for detection of VUR

effect of performing preoperative preparation program on school age children's anxiety

The purpose of this study was to examine effects of performing preoperative preparation program on children's anxiety. This study was performed in Amirkola Pediatrics Hospital, Mazandaran. A randomized controlled trail was performed on 122 children [7-12 years of age] admitted for elective surgery during 15 months. The researcher randomly assigned eligible participants in to the experimental and control groups, after pre-test baseline measurement had been taken. Analyzing was performed through independent t-test and x[2] test. P<0.005 was considered statistically significant. The experimental group received therapeutic play and the control group received routine preoperative information preparation. The mean and standard deviation of the state anxiety scores of children in experimental and control groups before intervention were 35.52 +/- 6.99 and 34.98 +/- 6.78, after intervention 31.44 +/- 5.87 and 38.31 +/- 7.44 respectively. The state anxiety score was lower significantly in the experimental group prior to preoperative surgery than in the control group [P=0.000]. Performing preoperative program with using therapeutic play intervention is effective for preparing children before surgery and decreases their anxiety