In Silico Identification of MicroRNAs with B/CYDV Gene Silencing Potential

ABSTRACT Computational investigation of a set of publicly available plant microRNAs revealed 19 barley- and other plants-encoded miRNAs and their near-complement reverse sequences (miRNA*) that have potential to bind all B/CYDV open reading frames (ORFs) except ORF0 and ORF6. These miRNAs/miRNAs*, their binding positions and targets are discussed in the context of biological protection of cereals against B/CYDV, based on antiviral silencing.

[Attention deficit hyperactivity disorder at schools in Sfax-Tunisia]

Background: Frequency, social impact, the negative effects of ADHD on personal development, make it a public health problem. Tunisian existing data confirm its frequency and severity in clinical population. The absence of data in student population has led us to develop this work. The objectives of our study were to study epidemiological profile of ADHD in school population

Methods: The analysis involved a cross-sectional descriptive study conducted from April 2008 to October 2008 using a representative randomized multistage sample of schoolchildren between 6 and 12 years old. Measurement was performed in two stages first the parents and teachers of each children filled Conners questionnaire separately then students with the score in subscales inattention, hyperactivity with impulsivity higher than 70 were selected for psychiatric interview. Psychiatric interview was intended to confirm or refute the diagnosis of ADHD. The diagnoses were made according to DSM IV-TR. To study the possible associated factors with the disorder they were compared in children with ADHD and children without the disorder taken as controls

Results: A total of 51 students out of 513 had ADHD. Prevalence was found to be 9,94%. For the study of factors associated with ADHD were found in males, neonatal hospitalization, psychiatric and family history of ADHD and the existence of a family dysfunctionment

Conclusion: Our prevalence is similar to the majority of those reported by studies conducted through the same methodology as ours. The etiology of ADHD is not unequivocal. The disorder appears to be multifactorial

Testicular tumours in prepubertal children: about eight cases

Background: To analyze the spectrum of testicular tumors in prepubertal children and the therapeutic resultants in an unselected population. Materials and Methods: Our hospital database was analyzed for testicular tumors from January 1995 to December 2010 concerning clinical presentation; treatment and therapeutic results. Results: Eight patients were operated on because of testicular tumors. In six cases (75) the tumor was benign: benign teratoma (four cases); epidermoid cyst (one case) and immature teratoma (one case). Two patients (25) had a malignant tumour: yolk-sac tumour (two cases). All this children underwent surgery. Radical inguinal orchidectomy was performed in six cases and conservative surgery was performed in two cases. One patient has received adjuvant chemotherapy. Follow-up was uneventfully three years after primary surgery. Conclusion: In prepubertal children; most testicular tumours are benign. If tumour markers were negative testis-preserving surgery can be proposed; complete excision of the tumour should be ascertained. In the case of testicular teratoma; the possibility of contralateral tumour should be considered in the follow-up

[Liver injuries in children: the role of selective non-operative management]

Trauma remains the leading cause of mortality in the pediatric population. Liver injuries occur commonly in blunt abdominal trauma. To assess the selective non-operative management of liver injuries in children. A retrospective review of 51patients with a discharge diagnosis of traumatic liver injuries at Tunis Children's Hospital, over a 14-year period from 1996 to 2009. We identified 51 patients with liver trauma. The median age was 7 years. Boys accounted for 58% [n= 30], and the most common cause was traffic accident. Head injuries were the most common associated injuries. Forty-nine patients [96%] required non-operative management without complications. The mean in-hospital stay was 10 days in this group. The ultrasound demonstrated complete resolution and healing after 3-6 months. Two patients underwent surgery for hemodynamic instablity. The mortality rate was 0.2%. Safe, non-operative management involves careful serial examination, a CT scanning facility and close monitoring of the patient in a fully equipped high-dependency unit with trained staff to run it. Even though most patients can be treated non-operatively the challenge is to identify the severely injured child early and institute aggressive resuscitation and expedite laparotomy

Volvulus of the small intestine associated to left paraduodenal hernia: a case report

To report a rare case of a left paraduodenal hernia presenting as volvulus of the small intestine associated to an intestinal malrotation. A 2 months-old girl presented with history of bilious vomiting, sonography showed signs of volvulus and emergency laparotomy was performed and confirmed left paraduodenal hernia containing a part of the ileon, coecum with right colon and volvulus of the small intestine out of the hernia sac. Paraduodenal hernia is an uncommon cause of small bowel volvulus. It can be suspected by clinical and radiological findings, surgery is always required to prevent small bowel necrosis and to repair the defect

[Alimentary tract duplication in children]

Duplications of the alimentary tract are a rare congenital anomalie in children, characterized by an important anatomoclinical polymorphism. Diagnosis suspected on clinics and evoked by radiology, requires histological confirmation. Thirty four children with duplications were managed in our department, from 1991 to 2009. Their hospital chart was retrospectively studied. Clinical signs consisted on pain and abdominal mass. The radiological investigations depended on the location of the digestive duplication. There was four oesophageal duplication, five on the stomach, the pylorus was involved in two cases, the duodenum in three cases, the jejuno-illeum is seventeen cases, the colon in two cases and the rectum in one case. All cases benefited from surgical treatment, and resection procedure was chosen according to duplication type and site. Histological study showed six cases of ectopic gastric mucosa. Diagnosis and surgical precocious treatment of digestive duplications are the only warn complications of this benign pathology

[Long terms result of surgical treatment of intestinal malrotation]

The total volvulus of small intestine [TVSI] on intestinal malrotation [IM] is a rare pathology. The incidence is 16 for one thousand neonatal occlusions. The purpose of this work was to evaluate the long-term results of the Ladd procedure in the treatment of the TVSI on IM. It's a retrospective study concerning 36 cases of TVSI on IM treated in the unity of pediatric surgery "B" in Tunis children's hospital over a period of 18 years. This study was about 26 boys and 10 girls, old from one day to 9 years at the time of the diagnosis. Twenty nine children were of less than 1 year old [80,5 per cent], among which 24 cases [66,6 per cent] before 1 month. The bilious vomits were the most frequent mode of revelation [91 per cent]. The diagnosis was realized by the ultrasound in 63 per cent of the cases [19/30] and by the oesogastroduodenal enema in 92 per cent of the cases [13/14]. All the patients were treated according to the Ladd procedure with immediate simple consequences operating in 80 per cent of the cases. Among 33 operated and alive patients, the distant evolution was favorable in 90 per cent of the cases with an average recession of 8 years. No patient presented a second recurrence of the volvulus. A single patient presented an occlusion on brides and two patients have a chronic constipation. The treatment of intestinal malrotation is based on the Ladd procedure which is a safe and effective surgical technique

Indications for Nephrectomy in children: what has changed?

The last decade has witnessed significant refinements in preoperative diagnostic evaluation and an improvement in surgical techniques and postoperative management for paediatric patients. There has been an improvement in our understanding of the natural history of some congenital renal anomalies which has caused some changes in management approach. To review the indications for nephrectomy in children between 1996 and 2008, at the departement of paediatric surgery, children's hospital in Tunis. There were 80 nephrectomies. A retrospective review of the patients' notes was performed. The 13-year period was divided into two halves [1996-2000 and 2001-2008] which were then compared. The total number of nephrectomies per year significantly increased over the period of the study [4,6 and 8 nephrectomies per year for 1996-2000 and 2001-2008, respectively; P< 0.05], as did the number of nephrectomies for Multicystic dysplastic kidney [MCDK] [zero and 5 for 1996-2000 and 2001-2008, respectively] and wilms'tumour [8,3% and 29,16% for 1996 - 2000 and 2001 - 2008, respectively].Wilms' tumour, vesico-ureteric reflux [VUR] and pelvi-ureteric junction [PUJ] obstruction accounted for more than half of the nephrectomies [80% and 58% for 1996-2000 and 2001-2008, respectively]. The proportion of nephrectomies performed for VUR did not change [15% and 12% for 1996-2000 and 2001-2008, respectively] but fewer nephrectomies were performed for pelvi-ureteric junction [PUJ] obstruction in the second half of the study period [44% and 4,16% for 1996-2000 and 2001-2008, respectively ;P<0.05]. The total number of nephrectomies, including partial nephrectomies, has increased significantly. The decrease in nephrectomies for PUJ obstruction could be accounted for by a more aggressive approach in the management and follow up of prenatally diagnosed hydronephrosis. Of note is that there was no significant change in the proportion of nephrectomies performed for VUR. On the contrary, the proportion of nephrectomies increased for neoplastic lesions and MCDK

Is there an age for a testicular torsion?

Classically, testicular torsion occurs in neonates or during puberty. Between these two ages, is really an exception? In order to answer the question, we reviewed the charts of the patients referred to the department of pediatric surgery of children's hospital between 2000 and 2008. We studied the preoperative examinations, the operative data and the long term evolution. Cases of torsion occurring during neonatal or pubertal periods were excluded. During nine years, 85 patients with 'acute scrotum symptoms" underwent surgery. The ages of patients ranged from one month to 11 years [average age: 70 month in 49 patients, among which 12 had true testicular torsion. Consultation at the emergency room occurred after one to 72 hours [average of 17]. The localization of the pain was on the left in eight cases and on ectopic testicle in two. The testicular volume was increased in 11 cases. Cremasteric reflex was absent in four cases. The doppler flow was normal in four cases and absent in two. During surgery, the testis appearance was considered as normal in six testicles, as necrotized in three [and an orchidectomy was performed] and as ischemic in three. In seven cases, a peroperative controlateral testicle fixation was performed and later one in two. The postoperative course was simple, without infection and with a normal testicular volume in eight cases, increased in one ischemic testis. Testicular atrophy was noted in an ischemic testis, after several months. Whatever the age, testicular torsion remains a surgical emergency even with a normal doppler flow

[ epidemiological data of children burns in Tunis. about 134 cases]

Burns injuries represented the most children common domestic accident which can be responsible of a dramatic consequences. To analyse the epidemiological data and preventive aspects of this victims, a retrospective study is reported between 1 January and 31 December 2006 concerning 134 children who were examined during this period in the emergency of the surgery department [B] of the children Hospital of Tunis. In 43 cases, a hospitalisation was necessary. The mean age of the patients was 36 months. The accident occurs in the house in 99 per cent of cases, especially in the kitchen in 93 per cent. The most common agents were scalding liquid in 89.5 per cent followed by flames in 8 percent. The mean total burns surface areas was 4 per cent for the non-hospitalised children and 14 per cent for those whose been hospitalised, 16 per cent of this children developed an infection of the burns injuries during their hospitalisation. In 3 cases an amputation was necessary due to a third degrees burn with carbonisation of the members. One patient died 48hrs after his admission by a respiratory distress. The children burn injuries can be considerably reduced by preventive measures and active public health programs to promote immediate cooling of burns with cool water which is at least as important as subsequent medical and surgical treatment in determining the outcome of burns in children

[Infantile hypertrophic pyloric stenosis. A 142 cases report]

Hypertrophic pyloric stenosis [HPS] is a common condition affecting infants before the first three months of life. Analysis of our results and comparison with literature to determine particularities of HPS in our country. We conducted a retrospective review of 142 patients presenting HPS, between 1990 and 2003. In this study male sex was predominant, with a sex-ratio of 3,8/1. The classical symptom of projectile vomiting was always present, a pyloric tumor was palpated in 19,7% of the cases, metabolic disturbance was noted in 44,3% of patients. The diagnosis was confirmed by ultrasonography and sometimes contrast upper gastrointestinal study. All the infants were treated surgically unless three patients dying before operation, because of a late diagnosis. Postoperative courses were uneventful in 87.4% of cases. Three patients were dead after operation, because of medical complication. The cause of HPS is unknown. The diagnosis is suggested by clinic features and confirmed by imaging. Early diagnosis prevents from metabolic complications due to vomiting. Surgical treatment allows early feeding and is associated with a low complication rate and a good long-term outcome

[ adnexal torsion in children]

Adnexal torsion is the most frequent gynaecological emergency in children. It requires an early diagnosis and an urgent surgical treatment. To study the clinical, paraclinical and therapeutic aspect of adnexal torsion in paediatric population this is a retrospective review of nine girls with the diagnosis of ovarian torsion observed over a 7 years period [January 1999 to December 2005]. The average age is 9 years [extreme 6 to 13 years]. This pathology was located in 5 cases on the right side and in 3 cases on the left side; a case of bilateral torsion of poly-cystic ovary was encountered in a girl with Down's syndrome. Clinical presentation is made in all the cases by abdominal pains and vomiting. The disorders of the transit and the urinary signs are associated in 3 and 2 cases respectively, the clinical examination objectified a pelvic defense in all the cases and an abdominal mass in 2 cases. Pelvic ultra-sonography was made in 6 observations and give the diagnosis of torsion of the ovary in 4 cases, whereas it was doubtful in the 2 remaining cases when an ovarian mass was observed. In the 3 remaining cases, this examination was not performed since one the diagnosis of acute appendicitis was retained and the patient operated in emergency. All the children of our series were operated; in 1/3 of the cases we found a necrosis of the ovary. 4 cases out of 9 present a torsion on pathologic ovary [cyst, dysplasia], whereas in the 5 remaining cases. We noted a torsion on healthy ovary 4 young girls have undergoes a annexectomy, of which one was bilateral. The evolution was favorable in all the cases. Adnexal torsion is a surgical emergency that need an early diagnosis and management to preserve ovarian function in girls and Doppler sonography every must be done every time there is a pelvic pain without fever in girls