Background:
Injection sclerotherapy is one of the commonly used modalities for treatment of parti... more Background: Injection sclerotherapy is one of the commonly used modalities for treatment of partial rectal prolapse in children. Various materials are available for such injection, but each has its advantage and complications. Comparing different materials used in the treatment of such pathology form the basis of this study trying to define the best material with the least complications.
Materials and methods Data records of 130 children with partial rectal prolapse referred to the Department of Pediatric Surgery at Al Galaa Teaching Hospital, Cairo over a 3 year period were analyzed. Their age ranged from 6 months to 12 years (mean 6.14 years ±3.4). Forty five patients (35%) responded to conservative treatment and 85 patients (65%) required injection sclerotherapy and were divided into 3 groups: group 1 (35 cases patients) injected with 98% ethyl alcohol, group 2 (22 patients) injected with phenol in almond oil 5% and group 3 (28 Patients) injected with Deflux (Q-Med, Uppsla, Sweden). Follow-up period ranged from 2 months to 3 years, clinical data and all complications were recorded.
Results: Parasitic infestations mainly enterobiasis and amoebiasis and bad toilet training are common association with rectal prolapse in developing countries. Submucosal injection of 3 sclerosing materials alcohol, phenol in almond oil and deflux showed no mortality in this series, but in group I (Injection with alcohol 35 pts), 7 had recurrence on short term follow-up that required re-injection, but long term follow-up in this group showed a recurrence rate of 11% (4pts), two patients had mucosal sloughing, and one girl developed a rectovaginal fistula. The second group (injection with phenol in almond oil 22 pts) showed abscess formation and mucosal sloughing in 4 patients (18%) and 2 developed perianal fistula. The third group showed immediate post-operative prolapse in 2 cases but ameliorated spontaneously. No patients had mucosal ulceration or abscess formation and long-term follow up showed no recurrence.
Conclusion: Deflux has the least complication rate with no recurrence on long term follow up. Phenol in almond oil 5% injection should not be used for treating such condition due to its high complication rate. Alcohol is commercially cheap and available, and should be considered an alternative for deflux.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2015
To develop reference cutoff values for mean fetal lung volume (FLV) and pulmonary artery resistan... more To develop reference cutoff values for mean fetal lung volume (FLV) and pulmonary artery resistance index (PA-RI) for prediction of neonatal respiratory distress syndrome (RDS) in low-risk term pregnancies. As part of a cross-sectional study, women aged 20-35 years were enrolled and admitted to a tertiary hospital in Cairo, Egypt, for elective repeat cesarean at 37-40 weeks of pregnancy between January 1, 2012, and July 31, 2013. FLV was calculated by virtual organ computer-aided analysis, and PA-RI was measured by Doppler ultrasonography before delivery. A total of 80 women were enrolled. Neonatal RDS developed in 11 (13.8%) of the 80 newborns. Compared with neonates with RDS, healthy neonates had significantly higher FLVs (P<0.001) and lower PA-RIs (P<0.001). Neonatal RDS is less likely with FLV of at least 32 cm(3) or PA-RI less than or equal to 0.74. Combining these two measures improved the accuracy of prediction. The use of either FLV or PA-RI predicted neonatal RDS. The...
Children treated for cancer face the risk of complications later in life, including pulmonary dys... more Children treated for cancer face the risk of complications later in life, including pulmonary dysfunction. The objective of this study was to evaluate frequency and severity of pulmonary complications in survivors of childhood leukemia and lymphoma treated with chemotherapy alone or combined with radiotherapy. Seventy cancer survivors of hematological malignancies were evaluated for pulmonary complications through history taking, chest examination, high-resolution computed tomography (HRCT) chest, and pulmonary function testing (PFTs). Although most survivors were not clinically compromised, the spectrum of impaired PFTs included obstructive pattern (14.3%), restrictive pattern (5.7%), and mixed pattern (20%). Significant pulmonary dysfunction was seen in children older than 10 years of age (P = .003), and in patients treated with combined chemotherapy and radiotherapy (72.7%) compared with those treated with chemotherapy alone (25%) (P = .001). Cumulative dose of bleomycin was sign...
Background:
Injection sclerotherapy is one of the commonly used modalities for treatment of parti... more Background: Injection sclerotherapy is one of the commonly used modalities for treatment of partial rectal prolapse in children. Various materials are available for such injection, but each has its advantage and complications. Comparing different materials used in the treatment of such pathology form the basis of this study trying to define the best material with the least complications.
Materials and methods Data records of 130 children with partial rectal prolapse referred to the Department of Pediatric Surgery at Al Galaa Teaching Hospital, Cairo over a 3 year period were analyzed. Their age ranged from 6 months to 12 years (mean 6.14 years ±3.4). Forty five patients (35%) responded to conservative treatment and 85 patients (65%) required injection sclerotherapy and were divided into 3 groups: group 1 (35 cases patients) injected with 98% ethyl alcohol, group 2 (22 patients) injected with phenol in almond oil 5% and group 3 (28 Patients) injected with Deflux (Q-Med, Uppsla, Sweden). Follow-up period ranged from 2 months to 3 years, clinical data and all complications were recorded.
Results: Parasitic infestations mainly enterobiasis and amoebiasis and bad toilet training are common association with rectal prolapse in developing countries. Submucosal injection of 3 sclerosing materials alcohol, phenol in almond oil and deflux showed no mortality in this series, but in group I (Injection with alcohol 35 pts), 7 had recurrence on short term follow-up that required re-injection, but long term follow-up in this group showed a recurrence rate of 11% (4pts), two patients had mucosal sloughing, and one girl developed a rectovaginal fistula. The second group (injection with phenol in almond oil 22 pts) showed abscess formation and mucosal sloughing in 4 patients (18%) and 2 developed perianal fistula. The third group showed immediate post-operative prolapse in 2 cases but ameliorated spontaneously. No patients had mucosal ulceration or abscess formation and long-term follow up showed no recurrence.
Conclusion: Deflux has the least complication rate with no recurrence on long term follow up. Phenol in almond oil 5% injection should not be used for treating such condition due to its high complication rate. Alcohol is commercially cheap and available, and should be considered an alternative for deflux.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2015
To develop reference cutoff values for mean fetal lung volume (FLV) and pulmonary artery resistan... more To develop reference cutoff values for mean fetal lung volume (FLV) and pulmonary artery resistance index (PA-RI) for prediction of neonatal respiratory distress syndrome (RDS) in low-risk term pregnancies. As part of a cross-sectional study, women aged 20-35 years were enrolled and admitted to a tertiary hospital in Cairo, Egypt, for elective repeat cesarean at 37-40 weeks of pregnancy between January 1, 2012, and July 31, 2013. FLV was calculated by virtual organ computer-aided analysis, and PA-RI was measured by Doppler ultrasonography before delivery. A total of 80 women were enrolled. Neonatal RDS developed in 11 (13.8%) of the 80 newborns. Compared with neonates with RDS, healthy neonates had significantly higher FLVs (P<0.001) and lower PA-RIs (P<0.001). Neonatal RDS is less likely with FLV of at least 32 cm(3) or PA-RI less than or equal to 0.74. Combining these two measures improved the accuracy of prediction. The use of either FLV or PA-RI predicted neonatal RDS. The...
Children treated for cancer face the risk of complications later in life, including pulmonary dys... more Children treated for cancer face the risk of complications later in life, including pulmonary dysfunction. The objective of this study was to evaluate frequency and severity of pulmonary complications in survivors of childhood leukemia and lymphoma treated with chemotherapy alone or combined with radiotherapy. Seventy cancer survivors of hematological malignancies were evaluated for pulmonary complications through history taking, chest examination, high-resolution computed tomography (HRCT) chest, and pulmonary function testing (PFTs). Although most survivors were not clinically compromised, the spectrum of impaired PFTs included obstructive pattern (14.3%), restrictive pattern (5.7%), and mixed pattern (20%). Significant pulmonary dysfunction was seen in children older than 10 years of age (P = .003), and in patients treated with combined chemotherapy and radiotherapy (72.7%) compared with those treated with chemotherapy alone (25%) (P = .001). Cumulative dose of bleomycin was sign...
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Injection sclerotherapy is one of the commonly used modalities for treatment of partial rectal prolapse in children. Various materials are available for such injection, but each has its advantage and complications. Comparing different materials used in the treatment of such pathology form the basis of this study trying to define the best material with the least complications.
Materials and methods
Data records of 130 children with partial rectal prolapse referred to the Department of Pediatric Surgery at Al Galaa Teaching Hospital, Cairo over a 3 year period were analyzed. Their age ranged from 6 months to 12 years (mean 6.14 years ±3.4). Forty five patients (35%) responded to conservative treatment and 85 patients (65%) required injection sclerotherapy and were divided into 3 groups: group 1 (35 cases patients) injected with 98% ethyl alcohol, group 2 (22 patients) injected with phenol in almond oil 5% and group 3 (28 Patients) injected with Deflux (Q-Med, Uppsla, Sweden).
Follow-up period ranged from 2 months to 3 years, clinical data and all complications were recorded.
Results:
Parasitic infestations mainly enterobiasis and amoebiasis and bad toilet training are common association with rectal prolapse in developing countries. Submucosal injection of 3 sclerosing materials alcohol, phenol in almond oil and deflux showed no mortality in this series, but in group I (Injection with alcohol 35 pts), 7 had recurrence on short term follow-up that required re-injection, but long term follow-up in this group showed a recurrence rate of 11% (4pts), two patients had mucosal sloughing, and one girl developed a rectovaginal fistula. The second group (injection with phenol in almond oil 22 pts) showed abscess formation and mucosal sloughing in 4 patients (18%) and 2 developed perianal fistula. The third group showed immediate post-operative prolapse in 2 cases but ameliorated spontaneously. No patients had mucosal ulceration or abscess formation and long-term follow up showed no recurrence.
Conclusion:
Deflux has the least complication rate with no recurrence on long term follow up. Phenol in almond oil 5% injection should not be used for treating such condition due to its high complication rate. Alcohol is commercially cheap and available, and should be considered an alternative for deflux.
Injection sclerotherapy is one of the commonly used modalities for treatment of partial rectal prolapse in children. Various materials are available for such injection, but each has its advantage and complications. Comparing different materials used in the treatment of such pathology form the basis of this study trying to define the best material with the least complications.
Materials and methods
Data records of 130 children with partial rectal prolapse referred to the Department of Pediatric Surgery at Al Galaa Teaching Hospital, Cairo over a 3 year period were analyzed. Their age ranged from 6 months to 12 years (mean 6.14 years ±3.4). Forty five patients (35%) responded to conservative treatment and 85 patients (65%) required injection sclerotherapy and were divided into 3 groups: group 1 (35 cases patients) injected with 98% ethyl alcohol, group 2 (22 patients) injected with phenol in almond oil 5% and group 3 (28 Patients) injected with Deflux (Q-Med, Uppsla, Sweden).
Follow-up period ranged from 2 months to 3 years, clinical data and all complications were recorded.
Results:
Parasitic infestations mainly enterobiasis and amoebiasis and bad toilet training are common association with rectal prolapse in developing countries. Submucosal injection of 3 sclerosing materials alcohol, phenol in almond oil and deflux showed no mortality in this series, but in group I (Injection with alcohol 35 pts), 7 had recurrence on short term follow-up that required re-injection, but long term follow-up in this group showed a recurrence rate of 11% (4pts), two patients had mucosal sloughing, and one girl developed a rectovaginal fistula. The second group (injection with phenol in almond oil 22 pts) showed abscess formation and mucosal sloughing in 4 patients (18%) and 2 developed perianal fistula. The third group showed immediate post-operative prolapse in 2 cases but ameliorated spontaneously. No patients had mucosal ulceration or abscess formation and long-term follow up showed no recurrence.
Conclusion:
Deflux has the least complication rate with no recurrence on long term follow up. Phenol in almond oil 5% injection should not be used for treating such condition due to its high complication rate. Alcohol is commercially cheap and available, and should be considered an alternative for deflux.