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Background & Objective: Transureteral lithotripsy is an effective procedure in lower ureteral stone. This study was done to evaluate lithotripsy method in pediatric ureteral stones in Mashhad’s Imam-Reza Hospital. Materials & Methods: In our institute 38 patients went under ureteroscopy and lithotripsy for ureteral stones. Mean age in our patients was 6.8 years (Range 2-13 years). 16 patients were male and 22 patients were female. The mean stone size was 7 mm (Range 6-16 mm). Ultrasonography and KUB or IVP was performed in all cases. After general anesthesia and cystoscopy guide wire introduced in ureter, ureteroscopy were performed for lithotripsy used ultrasound pneumatic or electrohydrolic. Results: Stone were located in the distal ureter in 32 patients, in the midureter in 4 and in the proximal ureter in 2 cases. Ureteroscopy was successfully in 35 cases. Lithotripsy was used: Ultrasound, electrohydrolic or pneumatic. We were unable to introduce the ureteroscope into the ureter in 3 patients. In 3 patients stone migrated to the kidney after ureteroscopy. Then, they candidated for ESWL. Stone free was done in 32 cases (85%). A complication was 25% and treated with medical treatment. Conclusion: Our investigation demonstrates the high success rate ureteroscopy in pediatric group especially with a small caliber ureteroscope. Ureteroscopy should be considered the first choice for treatments of calculi in the distal ureter in children.

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Background&Objective: Pediatric renal tumors represent approximately 7% of all childhood cancers and are completely different from those occurring in adults. The aim of this study was to make an analysis of clinical and pathological characteristics of these tumors. Materials&Methods: In this descriptive study all of the pediatric patients diagnosed as having renal neoplasm in departments of pathology of Dr Sheikh children hospital and Imam Reza hospital from 1991-2006 were evaluated. Results: 52 patients including 27 boys and 25 girls with mean age of 40.63 months were studied. Tumors involved each kidney in 24 (45.3%) and were bilateral in 5 (9.4%) patients. Abdominal mass was the commonest clinical symptom and sign. Congenital anomalies were presented in 6 (14.6%) patients. Histopathological examination showed Wilms tumor in 46 (86.8%), cystic partially differentiated nephroblastoma in 2 (3.8%), mesoblastic nephroma in 2 (3.8%) rhabdoid tumor of the kidney in 1 (1.9%), metanephric adenofiroma and low-grade tubulopapillary carcinoma in 1 (1.9%) and clear cell sarcoma of the kidney in 1 (1.9%) patient. 11 (20.8%) cases were in stage I, 16 (30.2%) stage II, 13 (24.5%) stage III, 8 (15.1%) stage IV and 5 (9.4%) stage V. Conclusion: Although Wilms tumor is the commonest renal neoplasm in childhood there are also recently described entities such as metanephirc tumors and juvenile renal carcinoma that must be considered in histopathological evaluation of a pediatric renal neoplasm. Role of molecular and cytogenetic methods is increasing for classification and treatment of childhood renal neoplasms.

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Background and Objective: Zinc is one of the micronutrient with many roles in health, especially among the growing children. It has been thought that Zinc deficiency cause diarrhea, and Zinc supplementation can prevent it in children. Materials and Methods: This study was carried out to determine the effect of Zinc sulphat on 4-24 month old children dirrahea. This clinical trial study was done double blind, the sample were study 4-24 month old afflicted with acute diarrhea in pediatric ward of Besat Hospital in Sanandaj, Iran during 2006. The sample size was 40 and mached by Blocks Randomization. The children in case group (intervention) received Zinc sulfate (9mg/kg/day) during ten days. In the Control groups they there given distilled water instead. The data was analyzed, using t-test and manwitney test. Results: During ten days of monitoring there was not significant differences between two groups. Duration of diarrhea in case and control groups was 5.72±3.15 and 5.32±2.58 days respectivley this diffence was not significant. Conclusion: This study showed that Zinc sulfate has no benefit on acute diarrhea in childhood

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Background and Objective: Post-operative nausea vomiting (PONV) and laryngospasm are the most common of complication following surgery. This study was conducted to compare the incidence of laryngospasm and PONV after pediatric infra umbilical surgery using two anesthetic methods: control ventilation and spontaneous respiration. Materials and Methods: This double-blind clinical trial study was conducted on 192 children with 2-7 year-old undergoing infra-umbilical surgery of ASA-I class with the estimated operation period of an hour in Tehran pediatric hospital, Tehran-Iran during 2009-10. The patients were randomly divided into two groups: controlled ventilation and spontaneous respiration. After anesthetization, Atracurium was injected to the control ventilation (CV) group and anesthesia continued with mechanical ventilation. For the patients of the second group (spontaneous respiration/SR), after the gradual increase of the dose of halothane and certainty of the optimal depth of anesthesia, patients were intubated to allow spontaneous respiration. After intubation, all patients were anesthetized with Halothane 1-2% and the N2O/O2. The rate of nausea, vomiting, laryngospasm, excessive post-operative discharge was recorded. Data were analyzed using SPSS-13, student’s t-test, chi-square and Fisher’s exact tests. Results: Post-operative nausea was non significantly higher in CV group (8%) than SR (6.52%). The rate of vomiting was higher in CV (16%) as compared to SR group (2.17%). (P<0.001, RR=8.57, CI: 1.91-38.41). The rate of laryngospasm at the end of the surgery was higher in CV group (15.21%) as compared to SR group (26%) (P<0.02, RR= 0.94, CI: 0.05-1.77). The rate of excessive discharge at the end of the surgery was significantly higher in CV group (52%) in comparison with SR group (11.95%) (P<0.001, RR=0.94, CI: 0.05-1.77). Conclusion: This study showed that in infra-umbilical surgeries in a period of less than an hour the incidence of post-operative vomiting and laryngospasm is higher in control ventilation group than spontaneous respiration group, which might be due to the injection of neostigmine to counter-act the effects of muscle relaxants.

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Background and Objective: Trauma is the third cause of death and the main cause of disability in Iran. Children are more susceptible to trauma due to physiological conditions and the growth process. This study was done to evaluate the epidemiolog of pediatric trauma in Hamedan, Iran during 2016-2017.

Methods: This descriptive-analytical study was done on 482 traumatic children (330 boys, 152 girls) at the age of 0 to 14 years whom referred to Besat Hospital in Hamedan, Iran during April 2016 to March 2017. Age, gender, season, type of troma and the outcome of trouma were recorded for each subject.

Results: The highest rate of trauma was observed between the ages of 7-14 years old (40.5%). The rate of trauma was significantly higher in boys than the girls (P<0.05). The most rate of trauma occured in summer (36.9%). The most common, place, cause, type, region of traumas were home (44%), falling down (53%), fracture (35%), and region (41%) respectively. Regarding the subsequence of discharge of subjects, 10 deaths and 42 disabilities after trauma were observed.

Conclusion: Regarding the most common type and place of accidents, providing safety at home and knowledge of parents are nesscery for preventing of pediatric teruma in Iran.

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Background and Objective: Poisoning is one of the most common reasons for emergency department visits worldwide. Awareness of poisoning patterns helps identify risk factors and enables early diagnosis. In Iran, narcotics are among the main causes of poisoning in children. The current study aimed to determine the prevalence of narcotics-induced poisoning in children under 18 years old referring to the Al-e-Jalil Educational and Therapeutic Center in Aq Qala, Golestan Province.
Methods: This retrospective descriptive study was conducted on 36 children aged 1 month to 18 years (22 boys and 14 girls; mean age: 51.62±36.25 months) referring to the Al-e-Jalil Educational and Therapeutic Center in Aq Qala due to narcotics-induced poisoning from 2020 to 2022. Samples were included in the study using census. Patients’ medical records were reviewed and recorded in a checklist.
Results: The highest poisoning rate stemmed from the consumption of opium (69.4%), followed by methadone (25%). Decreased level of consciousness upon hospital admission was determined to be 66.7%. The interval between poisoning and hospital admission was 5.60±3.86 hours. The mean length of hospital stay was 1.25±0.80 days, and no patients died. Most children were male (61.1%), Turkmen (69.4%), and rural residents (86.1%). The highest cases of poisoning occurred in the summer (36.1%). The most common route of contact was oral (97.2%).
Conclusion: The poisoning rate with opium is higher compared to other narcotics. However, there is strong evidence of increased opium use among young people and some evidence of increased methadone use.