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Publisher: Wolters Kluwer - Lippincott Williams and Wilkins   (Total: 291 journals)

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AACN Advanced Critical Care     Full-text available via subscription   (Followers: 11, SJR: 0.31, h-index: 32)
Academic Medicine     Full-text available via subscription   (Followers: 46, SJR: 1.936, h-index: 91)
ACSMs Health & Fitness J.     Full-text available via subscription   (Followers: 7, SJR: 0.135, h-index: 7)
Addictive Disorders & Their Treatment     Hybrid Journal   (Followers: 3, SJR: 0.27, h-index: 11)
Advanced Emergency Nursing J.     Full-text available via subscription   (Followers: 25, SJR: 0.279, h-index: 6)
Advances in Anatomic Pathology     Hybrid Journal   (Followers: 6, SJR: 1.435, h-index: 51)
Advances in Neonatal Care     Full-text available via subscription   (Followers: 21, SJR: 0.565, h-index: 23)
Advances in Nursing Science     Full-text available via subscription   (Followers: 19, SJR: 0.528, h-index: 38)
Advances in Skin & Wound Care     Full-text available via subscription   (Followers: 9)
Adverse Drug Reaction Bulletin     Full-text available via subscription   (Followers: 3, SJR: 0.12, h-index: 6)
AIDS     Hybrid Journal   (Followers: 10, SJR: 3.701, h-index: 173)
Alzheimer Disease & Associated Disorders     Hybrid Journal   (Followers: 9)
Alzheimer's Care Today     Full-text available via subscription   (Followers: 1, SJR: 0.176, h-index: 6)
American J. of Clinical Oncology     Hybrid Journal   (Followers: 17, SJR: 0.951, h-index: 56)
American J. of Dermatopathology     Hybrid Journal   (Followers: 8, SJR: 0.689, h-index: 50)
American J. of Forensic Medicine & Pathology     Hybrid Journal   (Followers: 13)
American J. of Nursing     Full-text available via subscription   (Followers: 31, SJR: 0.321, h-index: 33)
American J. of Physical Medicine & Rehabilitation     Hybrid Journal   (Followers: 31)
American J. of Surgical Pathology     Hybrid Journal   (Followers: 15, SJR: 2.828, h-index: 146)
American J. of Therapeutics     Hybrid Journal   (Followers: 5, SJR: 0.491, h-index: 43)
Anesthesia & Analgesia     Full-text available via subscription   (Followers: 71, SJR: 1.737, h-index: 142)
Anesthesiology     Full-text available via subscription   (Followers: 52, SJR: 2.517, h-index: 158)
Annals of Pediatric Surgery     Full-text available via subscription   (Followers: 4, SJR: 0.163, h-index: 2)
Annals of Plastic Surgery     Hybrid Journal   (Followers: 10, SJR: 0.961, h-index: 60)
Annals of Surgery     Hybrid Journal   (Followers: 29, SJR: 4.261, h-index: 216)
Anti-Cancer Drugs     Full-text available via subscription   (Followers: 8, SJR: 0.82, h-index: 73)
Applied Immunohistochemistry & Molecular Morphology     Hybrid Journal   (Followers: 3)
ASA Refresher Courses in Anesthesiology     Full-text available via subscription   (Followers: 14)
ASAIO J.     Hybrid Journal   (SJR: 0.648, h-index: 44)
Asia-Pacific J. of Ophthalmology     Full-text available via subscription   (Followers: 2)
Behavioural Pharmacology     Full-text available via subscription   (Followers: 1, SJR: 1.125, h-index: 60)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 10)
Blood Coagulation & Fibrinolysis     Hybrid Journal   (Followers: 20)
Blood Pressure Monitoring     Hybrid Journal   (Followers: 1, SJR: 0.912, h-index: 46)
Burns & Trauma     Open Access  
Canadian J. of Rural Medicine     Full-text available via subscription   (SJR: 0.238, h-index: 12)
Cancer J.     Full-text available via subscription   (Followers: 2, SJR: 2.079, h-index: 52)
Cancer Nursing     Hybrid Journal   (Followers: 23, SJR: 1.047, h-index: 54)
Cardiology in Review     Hybrid Journal   (Followers: 2, SJR: 1.2, h-index: 37)
Cardiovascular Endocrinology     Hybrid Journal  
CIN Computers Informatics Nursing     Full-text available via subscription   (Followers: 11)
Clinical Dysmorphology     Hybrid Journal   (SJR: 0.287, h-index: 16)
Clinical J. of Pain     Hybrid Journal   (Followers: 7, SJR: 1.142, h-index: 89)
Clinical J. of Sport Medicine     Hybrid Journal   (Followers: 22, SJR: 0.901, h-index: 67)
Clinical Neuropharmacology     Hybrid Journal   (Followers: 1, SJR: 0.787, h-index: 59)
Clinical Nuclear Medicine     Hybrid Journal   (Followers: 3, SJR: 0.428, h-index: 42)
Clinical Nurse Specialist     Full-text available via subscription   (Followers: 15, SJR: 0.312, h-index: 22)
Clinical Nutrition Insight     Full-text available via subscription   (Followers: 9)
Clinical Obstetrics & Gynecology     Full-text available via subscription   (Followers: 17)
Clinical Pulmonary Medicine     Full-text available via subscription   (Followers: 2, SJR: 0.133, h-index: 12)
Cognitive and Behavioral Neurology     Hybrid Journal   (Followers: 1, SJR: 0.607, h-index: 47)
Contemporary Diagnostic Radiology     Full-text available via subscription   (Followers: 2)
Contemporary Neurosurgery     Full-text available via subscription   (Followers: 2)
Contemporary Spine Surgery     Full-text available via subscription   (Followers: 3)
CONTINUUM : Lifelong Learning in Neurology     Full-text available via subscription   (Followers: 1, SJR: 0.257, h-index: 7)
Cornea     Hybrid Journal   (Followers: 1, SJR: 1.514, h-index: 86)
Coronary Artery Disease     Hybrid Journal   (SJR: 0.604, h-index: 49)
Critical Care Medicine     Full-text available via subscription   (Followers: 302, SJR: 3.361, h-index: 196)
Critical Care Nursing Quarterly     Full-text available via subscription   (Followers: 10, SJR: 0.362, h-index: 22)
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 1, SJR: 0.706, h-index: 15)
Current Opinion in Allergy and Clinical Immunology     Hybrid Journal   (Followers: 7, SJR: 1.209, h-index: 57)
Current Opinion in Anaesthesiology     Hybrid Journal   (Followers: 23, SJR: 1.044, h-index: 39)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 3, SJR: 1.266, h-index: 57)
Current Opinion in Clinical Nutrition & Metabolic Care     Hybrid Journal   (Followers: 11)
Current Opinion in Critical Care     Hybrid Journal   (Followers: 18, SJR: 1.298, h-index: 59)
Current Opinion in Endocrinology & Diabetes     Full-text available via subscription   (Followers: 20)
Current Opinion in Endocrinology, Diabetes and Obesity     Hybrid Journal   (Followers: 10, SJR: 1.526, h-index: 37)
Current Opinion in Gastroenterology     Hybrid Journal   (Followers: 9, SJR: 1.894, h-index: 53)
Current Opinion in Hematology     Hybrid Journal   (Followers: 12, SJR: 1.829, h-index: 74)
Current Opinion in HIV and AIDS     Hybrid Journal   (Followers: 8, SJR: 2.221, h-index: 30)
Current Opinion in Infectious Diseases     Hybrid Journal   (Followers: 9, SJR: 2.173, h-index: 69)
Current Opinion in Lipidology     Hybrid Journal   (Followers: 2, SJR: 2.585, h-index: 95)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 8)
Current Opinion in Neurology     Hybrid Journal   (Followers: 9, SJR: 2.423, h-index: 84)
Current Opinion in Obstetrics & Gynecology     Hybrid Journal   (Followers: 10)
Current Opinion in Oncology     Hybrid Journal   (Followers: 9, SJR: 1.784, h-index: 70)
Current Opinion in Ophthalmology     Hybrid Journal   (Followers: 10, SJR: 1.557, h-index: 58)
Current Opinion in Organ Transplantation     Hybrid Journal   (Followers: 3, SJR: 1.007, h-index: 26)
Current Opinion in Otolaryngology & Head & Neck Surgery     Hybrid Journal   (Followers: 10, SJR: 0.862, h-index: 41)
Current Opinion in Pediatrics     Hybrid Journal   (Followers: 2, SJR: 1.109, h-index: 56)
Current Opinion in Psychiatry     Hybrid Journal   (Followers: 28, SJR: 1.451, h-index: 53)
Current Opinion in Pulmonary Medicine     Hybrid Journal   (Followers: 5, SJR: 1.281, h-index: 52)
Current Opinion in Rheumatology     Hybrid Journal   (Followers: 1, SJR: 1.919, h-index: 79)
Current Opinion in Supportive and Palliative Care     Hybrid Journal   (Followers: 12, SJR: 0.714, h-index: 20)
Current Opinion in Urology     Hybrid Journal   (Followers: 5, SJR: 0.957, h-index: 42)
Current Orthopaedic Practice     Hybrid Journal   (Followers: 7, SJR: 0.201, h-index: 15)
Current Sports Medicine Reports     Full-text available via subscription   (Followers: 13, SJR: 0.543, h-index: 25)
Dermatitis     Full-text available via subscription   (SJR: 0.384, h-index: 38)
Diagnostic Molecular Pathology     Full-text available via subscription   (Followers: 6, SJR: 1.055, h-index: 42)
Dimensions of Critical Care Nursing     Full-text available via subscription   (Followers: 5, SJR: 0.286, h-index: 18)
Diseases of the Colon & Rectum     Full-text available via subscription   (Followers: 5, SJR: 1.948, h-index: 120)
Ear & Hearing     Hybrid Journal   (Followers: 7)
Egyptian J. of Histology     Partially Free   (Followers: 1, SJR: 0.107, h-index: 1)
Egyptian J. of Oral and Maxillofacial Surgery     Partially Free  
Egyptian J. of Pathology     Partially Free   (Followers: 1)
Egyptian Liver J.     Partially Free   (Followers: 2, SJR: 0.101, h-index: 1)
Emergency Medicine News     Full-text available via subscription   (Followers: 7)
Epidemiology     Hybrid Journal   (Followers: 36, SJR: 2.697, h-index: 118)
European J. of Anaesthesiology     Hybrid Journal   (Followers: 13, SJR: 1.138, h-index: 50)
European J. of Cancer Prevention     Full-text available via subscription   (Followers: 2, SJR: 1.046, h-index: 59)

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Journal Cover   Annals of Pediatric Surgery
  [SJR: 0.163]   [H-I: 2]   [6 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 1687-4137 - ISSN (Online) 2090-5394
   Published by Wolters Kluwer - Lippincott Williams and Wilkins Homepage  [291 journals]
  • Exploratory laparotomy in the management of confirmed necrotizing
           enterocolitis
    • Authors: Lakhoo; Kokila; Morgan, Robert D.; Thakkar, Hemanshoo; Gupta, Amit; Grant, Hugh W.; Wagener, Silke; Willetts, Ian E.
      Abstract: image Introduction: Necrotizing enterocolitis (NEC) is a serious gastrointestinal emergency in newborn infants. Surgical management includes primary peritoneal drainage and/or exploratory laparotomy with bowel resection. This study describes obstetric complications, postnatal comorbidities, surgical care and intermediate postoperative outcomes in all infants with surgically and/or histologically proven NEC, who underwent exploratory laparotomy at our tertiary referral centre. Materials and methods: We conducted a retrospective review between January 2005 and December 2010. Results are reported as median (range). Fisher’s exact test (two tailed) was used for statistical analysis. A P-value of 0.05 or less was considered statistically significant. Results: A total of 71 infants had suspected (Bell’s stage≥1) NEC. Of them, 32 infants underwent laparotomy for stage 2–3 NEC. We excluded 11 infants with surgically and/or histologically proven spontaneous intestinal perforation. In the remaining 21 infants with confirmed NEC, median gestational age was 27 weeks (23–39 weeks) and median birth weight was 720 g (440–3510 g). NEC was suspected after a median 14 days of life (1–49 days of life). Fifteen patients (71%) were initially managed medically for a median total of 8 days (1–25 days). Laparotomy was performed after a median of 7 days (
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Right thoracotomy approach for patients with congenital tracheoesophageal
           fistula associated with right-sided aortic arch: a multicentric study
    • Authors: Shreef; Khalid; El Sadeck, Nabil; Saleem, Mervat; Khalifa, Mohamed; Kassem, Rasha
      Abstract: image Background: A right-sided aortic arch (RAA) occurs in 5% of patients with esophageal atresia (EA). Its presence has significant surgical implications. Repair of the atresia has been considered difficult with the usual approach through the right chest. We hereby report our experience with cases of EA and RAA treated over the past 13 years in three pediatric surgical departments to determine the optimal surgical approach. Patients and methods: This is a retrospective study, which included all patients having EA with tracheoesophageal fistulas (TEFs) treated between January 2000 and September 2013 at four pediatric surgery departments (Zagazig University Hospital, Egypt; Assir Central Hospital, Kingdom of Saudi Arabia; MCH Najran, Kingdom of Saudi Arabia; Soba University Hospital, Sudan). The study compared a group of 22 patients who had EA with TEFs with RAA and no associated congenital disorder with another group of 22 patients who had the same condition but with normally situated left-sided aortic arch. Results: A total of 44 patients having EA with fistula were included into this study. They were divided into two groups on the basis of the side of aortic arch; 22 patients had left-sided aortic arch (group L), and the other 22 patients had RAA (group R). All patients were treated through right thoracotomy. It was possible to achieve successful, although difficult management, in all patients with RAA through right thoracotomy. There was significant difference between the two groups of patients with regard to the operative time (104±9.8 vs. 149±15.4 min). Twenty patients (45%) developed postoperative complications, with a morbidity rate of 41 and 50%, respectively, with no significant difference between the two groups. No mortality was recorded. Conclusion: Repair of congenital TEF associated with RAA can be performed through right thoracotomy safely but with some difficulty and longer time.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Reduction glossectomy for macroglossia in children
    • Authors: Elhalaby; Essam E.; Hassan, Hussam S.; Almetaher, Hisham A.
      Abstract: image Background/aim: Although several surgical techniques have been described for reduction glossectomy in children, many general pediatric surgeons are still skeptical about the treatment of patients with macroglossia because of potential surgical complications. The aim of this study was to describe our initial surgical experience with reduction glossectomy in a series of eight patients with macroglossia. Materials and methods: A retrospective file review was carried out for all patients who underwent reduction glossectomy during the period from October 2009 to December 2014. Charts were designed to collect the following data from the patients’ files: age; etiology of macroglossia; and full clinical examination including the functional respiration, deglutition, phonation deficit, and dental occlusion alterations. Results: The records of eight patients were retrieved. Five patients, in whom macroglossia affected the tongue width and length, underwent peripheral glossectomy, whereas two patients, in whom macroglossia affected the tongue in all directions, underwent key-hole glossectomy. In one patient in whom only half the tongue was affected, a central longitudinal strip was excised. Motor and sensory functions, especially taste sensation, were not affected by resection. Speech articulation errors were corrected in cases that stared speech. One complication occurred in one patient who had undergone a key-hole glossectomy: wound infection, followed by partial wound disruption. Conclusion: Partial glossectomy for macroglossia in children is both feasible and safe. It results in minimal complications. Many clinical problems caused by the pathology improve after surgery repair. The recommended surgical technique should be based on the extent of involvement of the tongue.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • An artifice in the insertion of the Hickman catheter in small children
    • Authors: Ohya; Yuki; Asonuma, Katsuhiro; Kadohisa, Masashi; Honda, Masaki; Murokawa, Takahiro; Hayashida, Shintaro; Lee, Kwang-Jong; Inomata, Yukihiro
      Abstract: Although the Hickman catheter is commonly used in pediatric patients, it is difficult to place this catheter safely in small children, especially infants. A multiple-step method, starting with a thinner catheter, makes the placement easier and safer.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Multifocal necrotizing fasciitis following Hirshsprung’s disease
           surgery away from the surgical wound site
    • Authors: Haseeb; Ahmed A.; Okasha, Shadi; Elbarawi, Atef
      Abstract: image Necrotizing fasciitis (NF) is a life-threatening infection with rapidly progressive necrosis. Escherichia coli is rarely reported as causative agent of type 2 NF. NF typically arises in a single area usually secondary to penetrating injury. NF was only reported as a postoperative complication of Hirshsprung’s disease in one report, where the causative agent was Pseudomonas aeruginosa. We here present a case of synchronous multifocal NF in a 7-month Hirshsprung’s disease patient after abdominal Soave procedure. The patient presented with constipation and had a colosotomy undergone at the splenic flexure through a left transverse supraumbilical incision during neonatal period. At the age of 7 months and after preoperative preparation, abdominal Soave procedure was performed through a Pfannestiel incision. Few days following operation he had fever, tachycardia, and pain. Local examination showed red edematous areas at both flanks away from the wounds. Shortly afterwards skin became dark, tense, and started to slough. At this stage the clinical diagnosis of NF was raised and surgical debridement was done. Blood and tissue cultures were positive for E. coli. Five days later the patient had another debridement due to necrotic wound edges. Vacuum assisted closure therapy with Aquacel Ag dressings was fitted and changed every 48 h. Eighteen days later split thickness skin-graft was carried out. The patient was discharged home; 10 days later he is doing fine on follow-up.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Type IIA2 urethral duplication: report of an unusual case
    • Authors: Gupta; Amit; Pant, Nitin; Debnath, Pinaki R.; Yadav, Pratap S.; Agarwala, Surendra K.; Saxena, Rahul; Chadha, Rajiv
      Abstract: image This report describes a rare case of type IIA2 sagittal urethral duplication. The presentation, investigation, and management of this rare anomaly are briefly discussed. A 3½-year-old boy presented with urinary obstruction and recurrent urinary tract infection due to a stenosed dorsal urethra and segmental stenosis of the dominant ventral urethra. The child also had left-sided vesicoureteric reflux. Staged surgical management consisted of an initial vesicostomy followed by serial dilatation of the ventral urethral stricture, left ureteric reimplantation, and a 2-cm long distal urethrourethrostomy between the dorsal urethra, opening at the tip of the penis, and the ventral urethra, which had a hypospadic opening at the base of the glans. The functional and cosmetic outcomes were satisfactory. The management needs to be individualized as best suited for the patient.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Secondary involvement of Meckel’s diverticulum by group A
           β-hemolytic streptococcus in a child with upper airways infection
           treated by laparoscopic-assisted resection
    • Authors: Bertozzi; Mirko; Verrotti, Alberto; Latini, Maria Elena; Rinaldi, Victoria Elisa; Di Cara, Giuseppe; Appignani, Antonino
      Abstract: image We report a case of a 5-year-old boy with acute abdomen following an upper airways infection who developed Meckel’s diverticulum perforation secondary to group A β-hemolytic streptococcus and its successful treatment by a laparoscopic-assisted intervention. To the best of our knowledge, such an event has never been reported previously.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Diagnostic challenge of intestinal obstruction secondary to
           Henoch–Schonlein purpura
    • Authors: Ahmed; Ali M.; Al-Shahrani, Mohammad S.; Aljubab, Abdulwahab S.
      Abstract: image Henoch–Schonlein purpura is the most common form of vasculitis in pediatric age group. Gastrointestinal manifestations have been long recognized as part of the disease, but usually preceded by other manifestations. We present a case of a boy whose initial manifestation of the disease was bowel obstruction and ischemia requiring surgical intervention twice with diagnostic dilemma prior to diagnosis of Henoch–Schonlein purpura. Although common surgical diseases prove to be the culprit in most cases, a surgeon should always keep an open mind for possibility beyond surgical diseases. Multidisciplinary approach to situations where ambiguities in diagnosis exist proves to be a valuable tool aiding surgical decision.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Spontaneous bile duct perforation in an infant, managed with simple
           drainage: a case report
    • Authors: Alwabari; Abdullah; Abbas, Gammal
      Abstract: image Spontaneous bile duct perforation is a very rare but important cause of surgical jaundice in pediatric patients and one of the most common causes of surgical jaundice during infancy after biliary atresia. Preoperative diagnosis may not be possible in most of the cases. The exact cause of the perforation remains unclear. The diagnosis is usually made at the time of laparotomy. We report a case of spontaneous bile duct perforation in an infant and showed the successful minimal surgical intervention with T-tube insertion as the sole management.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Supportive pericardial suspension for surgical airway management of
           tracheobronchomalacia in unilateral pulmonary agenesis
    • Authors: Hasegawa; Tomomi; Oshima, Yoshihiro; Okata, Yuichi; Maruo, Ayako
      Abstract: image Unilateral pulmonary agenesis, a rare developmental defect of the lung, is often accompanied by tracheobronchial stenosis or malacia due to displacement, distortion, and compression of the surrounding great vessels. We present two cases of unilateral pulmonary agenesis complicated by tracheobronchial problems that were successfully managed surgically with supportive pericardial suspension.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Giant juvenile xanthogranuloma of the tongue presenting from birth in a
           1-month-old infant: a case report
    • Authors: Kurian; Jujju J.; Kabeer, Ahmed; Singh, Deepak Samson; Mathai, John
      Abstract: image Juvenile xanthogranuloma is a rare benign proliferative lesion of the non-Langerhans cell histiocytic group. Extracutaneous involvement is extremely rare. We present a case of a giant juvenile xanthogranuloma involving the tongue from birth.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Thoracoschisis: case report and review of the literature
    • Authors: Eck; Dustin L.; Maryak, Brooke N.; Poulos, Nicholas D.; Tepas, Joseph J. III; Felema, Gohalem G.; Robie, Daniel K.
      Abstract: image Introduction: Thoracoschisis is a rare congenital malformation characterized by herniation of intra-abdominal contents through a thoracic wall defect. There have been six previously reported cases. We describe our novel approach incorporating closure of the chest wall defect with temporary abdominal wall expansion utilizing a silastic pouch. Case report: A male child born at 29 weeks’ gestation was transferred to our institution for the management of a right anterior chest wall defect with herniation of intra-abdominal contents through this defect. The patient was taken to the operating room for reduction of the herniated viscera from the right chest wall defect into the abdomen utilizing a spring-loaded silastic pouch to cover the abdominal viscera. Discussion: The cause of thoracoschisis is unclear. Multiple mechanisms have been proposed for the development of thoracoschisis, including amnionic rupture, vascular injury, and embryologic maldevelopment. In previously reported cases, a majority of patients had associated limb abnormalities. It has been proposed that this association between extremity agenesis/deformity and chest wall defects is related to the limb–body wall complex. In addition, most of the cases reported also had an accompanying diaphragmatic defect, allowing the abdominal viscera to enter the chest and then herniate through the thoracic defect. Conclusion: Overall, thoracoschisis is a very rare congenital abnormality characterized by a chest wall defect with herniation of intra-abdominal organs through this defect. Previously, only six cases have been reported, most of which had an associated limb anomaly or diaphragmatic hernia.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Community survey of childhood injuries in North-Central Nigeria
    • Authors: Abdur-Rahman; LO; Taiwo, JO; Ofoegbu, CKP; Adekanye, AO; Ajide, OO; Ijagbemi, CY; Solagberu, BA
      Abstract: image Background and purpose: Childhood injury is of great significance globally and epidemiological data on the subject in most developing countries are inadequate. Informed demographics can help direct resources toward research and programs most likely to reduce the burden. Methods: A survey to determine the prevalence, mechanism of injury, and intervention measures was conducted using pretested questionnaires distributed to consented parents/guardians of children 15 years and younger who presented at six selected hospitals (representing public and private and low or high income clientele hospitals) for healthcare needs for any reason. Results were analyzed using Epi Info (6.04) and SPSS software (version 15). Results: There were 1088 respondents comprising parents (96.5%) and guardians (3.5%). Most were 21–40 years old (86.2%) and 51.9% of them had more than three children living with them. Over 50% had witnessed injuries of their wards within the previous 12 months and about a quarter admitted that a child was injured more than once. The risk of injury was twice in the male child mainly in the 1–4 years age group. Most injuries (65.2%) occurred at home, with 98% being unintentional from falls (62.6%) and 71.9% of the times the parents witnessed the injury as it occurred. The intentional injuries (2%) followed assaults during fights among peers. Treatment was provided at home in 58.5% of children by the parents, whereas only 27.5% took their wards to the hospital; 12.6% received treatment at patent medicine stores and 1.3% from the herbal/traditional bone setters’ home. Two deaths resulted from the injuries from fall, whereas six children had residual deformity as a result of home injury. Three-quarter (74.8%) of the respondents believed childhood injuries were preventable. Conclusion: Childhood injuries are not uncommon in the community. The significant proportions of respondents using inappropriate means of treatment and who believed that injuries are not preventable represent targets for health education and counseling in the community.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Outcome of neonatal surgeries in Nnewi, Nigeria
    • Authors: Ekwunife; Okechukwu H.; Okpata, Adaobi; Ugwu, Jideofor O.; Osuigwe, Andrew N.
      Abstract: image Background: A surgical neonate is a challenge, especially in developing countries such as Nigeria, where neonatal surgical practice is still evolving. Mortality is still high compared with developed nations. Data from developing countries on this emerging aspect of paediatric surgery, however, are scarce. We reviewed all neonatal surgical cases that were managed at the Nnamdi Azikiwe University Teaching Hospital Nnewi, a tertiary institution located in the South Eastern region of Nigeria, with a view of determining the outcome. Patients and methods: This was a retrospective review of Hospital records of infants aged 0–28 days who were treated at the Special Baby Care Unit of the hospital from January 2009 to June 2012. Results: Out of 1863 babies admitted to the Special Care Baby Unit of the hospital, 147 (8%) were surgical cases. There were 91 males and 56 females (M : F=1.6 : 1). The mean weight of the babies was 2.5 kg (range=0.1–4.3 kg). Thirty-two babies (16.9%) were premature. The most frequent indication for admission is gastrointestinal conditions, accounting for 78.2% of all neonatal surgeries. The most common procedure carried out was intestinal anastomosis and repair (36%). One hundred and thirteen neonates (76.9%) presented beyond 48 h of onset of symptoms. Of the delayed cases, 65% sought medical attention early at the primary and secondary health centres, but referral was delayed from periods ranging from 2 to 21 days (mean=5 days). Only 15 of the neonates had a valid prenatal ultrasound diagnosis. In only three of the cases were the mothers referred for planned delivery and specialist care. Infective conditions (sepsis, surgical site infection, respiratory tract infections) accounted for 45.4% of morbidity. Mortality was higher in the late presenters, premature babies, babies with weight less than 2.5 kg and in thoracic surgeries. Overall, 41 neonates died, yielding a mortality of 27.9%. Conclusion: The high morbidity and mortality from neonatal surgeries still persists. Factors that negatively affect the outcome include late presentation, prematurity, low birth weight and thoracic surgeries. Enhanced prenatal diagnosis, early patient referral, further personnel training and improvement in facilities will improve outcome.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
  • Pancreatic pseudocyst in children: a single-institute experience
    • Authors: Khalifa; Mohamed; Gobran, Tarek; Shreef, Khaled S.; Waly, Amira
      Abstract: image Background and objectives: Pancreatic pseudocysts are rare in children, with most series describing not more than 24 patients. At Zagazig University Hospital we have managed a range of cases of this disorder and feel this experience should add to the existing experience with children. This study aimed to analyze the causes, clinical presentation, and management of symptomatic pancreatic pseudocysts treated at our institution. Patients and methods: This study included 19 children. Their ages ranged from 1 month to 17 years. All cases were diagnosed as pancreatic pseudocysts and were admitted and treated in the Pediatric Surgery Unit, Zagazig University Hospital, during the period from 1996 to 2011. The collected data included age, sex, etiology, clinical presentation, radiological information, operative data, postoperative complications, and the final outcome. Results: Twelve patients (63.2%) had a history of abdominal trauma, whereas the remaining seven patients (36.8%) had no abdominal trauma. The pseudocysts were acute in 11 patients, chronic in seven patients, and only one patient had congenital pseudocyst. Nine patients improved with expectant treatment; however, 10 patients required surgery. The surgical intervention included cystogastrostomy for four patients, cystojejunostomy for two patients, complete excision with distal pancreatectomy in two children, and partial excision with external drainage in the remaining two patients. One patient developed postoperative wound infection, and two cases had external pancreatic fistula. Conclusion: Although spontaneous resolution of pancreatic pseudocysts occurred, more commonly, in acute, small-sized, and post-traumatic cysts, the surgical treatment of pancreatic pseudocyst is a valid, safe, effective, and satisfactory treatment, especially in complicated cases.
      PubDate: Wed, 01 Apr 2015 00:00:00 GMT-
       
 
 
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