Paediatric blunt torso trauma: injury mechanisms, patterns and outcomes among children requiring hospitalisation at the sultan Qaboos university hospital, Oman

Objectives: Trauma is the greatest cause of morbidity and mortality in paediatric/adolescent populations worldwide. This study aimed to describe trauma mechanisms, patterns and outcomes among children with blunt torso trauma admitted to the Sultan Qaboos University Hospital [SQUH] in Muscat, Oman

Methods: This retrospective single-centre study involved all children

Results: A total of 70 children were admitted with blunt torso trauma during the study period, including 39 [55.7%] male patients. The mean age was 5.19 +/- 2.66 years. Of the cohort, 35 children [50.0%] received their injuries after having been hit by cars as pedestrians, while 19 [27.1%] were injured by falls, 12 [17.1%] during car accidents as passengers and four [5.7%] by falling heavy objects. According to computed tomography scans, thoracic injuries were most common [65.7%], followed by abdominal injuries [42.9%]. The most commonly involved solid organs were the liver [15.7%] and spleen [11.4%]. The majority of the patients were managed conservatively [92.9%] with a good outcome [74.3%]. The mortality rate was 7.1%. Most deaths were due to multisystem involvement

Conclusion: Among children with blunt torso trauma admitted to SQUH, the main mechanism of injury was motor vehicle accidents. As a result, parental education and enforcement of infant car seat/child seat belt laws are recommended. Conservative management was the most successful approach

Laparoscopic splenectomy alone for sickle cell disease account of 50 paediatric cases

Objectives: In Oman, the most frequent indication for a splenectomy in children is sickle cell disease [SCD], which is one of the most common haematological disorders in the Gulf region. This study aimed to describe paediatric laparoscopic splenectomies alone for SCD at a tertiary hospital in Oman

Methods: This study was conducted between February 2010 and October 2015 at the Sultan Qaboos University Hospital, Muscat, Oman. The medical records of all children aged

Results: A total of 71 children underwent laparoscopic splenectomies during the study period; of these, 50 children [28 male and 22 female] underwent laparoscopic splenectomies alone for SCD. The children's weight ranged between 11-43 kg. The most common indication for a splenectomy was a recurrent splenic sequestration crisis [92%]. Surgically removed spleens weighed between 155-1,200 g and measured between 9-22 cm. Operative times ranged between 66-204 minutes and intraoperative blood loss ranged between 10-800 mL. One patient required conversion to an open splenectomy. Postoperative complications were noted in only four patients. The median hospital stay duration was three days

Conclusion: Among this cohort, the mean operating time was comparable to that reported in the international literature. In addition, rates of conversion and postoperative complications were very low. These findings indicate that a laparoscopic splenectomy alone in paediatric patients with SCD is a feasible option

Factors responsible for the prolonged stay of surgical neonates in intensive care units

The length of hospital stay [HS] for patients is a major concern due to its social, economic and administrative implications; this is particularly important for neonates admitted to intensive care units [ICUs]. This study aimed to determine the factors responsible for prolonged HS in surgical neonates. This retrospective study was conducted at Sultan Qaboos University Hospital, in Muscat, Oman. The medical records of 95 neonates admitted to the neonatal ICU who underwent general surgical procedures between July 2009 and June 2013 were reviewed. Mann-Whitney U and Pearson's Chi-squared tests were used for non-parametric numerical and categorical variables, respectively. A multiple regression analysis was performed to find a relationship between the variables and to detect the most important factor responsible for prolonged HS. A P value of <0.05 was considered statistically significant. Gestational age, birth weight, number of days on a ventilator and postoperative morbidity were associated with prolonged HS. Furthermore, the age of neonates at first full enteral feed was associated with increased HS using both independent and multiple regression analyses. Prolonged HS can occur as a result of many factors. In this study, a number of factors were identified, including low gestational age, low birth weight, increased number of days on a ventilator and postoperative morbidity. Additionally, neonate age at first full enteral feeds also correlated with increased HS. Further research on this topic is suggested to explore this correlation in more detail and to inform future practices

Cost comparison between laparoscopic and open appendectomies in children

Laparoscopic appendectomy [LA] for children has become very popular and is routinely performed in most health care centres around the world. The cost of surgical procedures is always a concern for patients and health care providers. This study compares, the total cost of open appendectomy [OA] with LA in children who required an appendectomy for acute appendicitis. Suitable and safe cost-effective techniques were also explored to reduce the cost of these procedures. The medical records of all the children [ranging between 0 and 12 years] at Sultan Qaboos University Hospital in Oman, who required OA or LA from June 2009 to July 2011, were reviewed. LA were performed in 75 patients while OA were done in 34. Patients from the OA and LA groups were age- and gender-matched. The average operative time was 76 minutes for LA and 49 minutes for OA [P <0.001] while the average hospital stay was 3.14 days for LA and 2.15 days for OA [P = 0.08]. The average cost of the two procedures was Omani riyals [OMR] 534 for LA and OMR 343 for OA [P = 0.00]. The complication rate following procedures was lower in the case of LA, however this was not statistically significant [LA = 8% versus OA = 11.7%, P = 0.32]. LA are costlier procedures than OA, however they are as safe as OA, and do not increase morbidity or the duration of hospital stay