javad ghoroubi

Congenital hyperinsulinism (CH) is a well-known cause of the persistent neonatal hypoglycemic state that may lead to irreversible neurological damage. While medical therapy can improve the condition in some cases, refractory cases require further investigation to identify focal or diffuse pancreatic lesions. Surgery is the main treatment for refractory cases and can improve the neurological and glycemic status of patients. The study aimed to evaluate the short-term outcomes of surgical intervention in cases of CH who underwent surgical treatment.
A multicenter cross-sectional survey was conducted to review cases of CH that underwent surgery between 2018 and 2020. Focal cases were treated with simple enucleation or distal pancreatectomy, while diffuse cases underwent near-total pancreatectomy. The glycemic and neurological states of the patients were evaluated and the results were analyzed.
Among the 56 neonates who underwent pancreatic surgery, 48 (85%) had diffuse disease, and the remaining cases suffered from focal lesions. All focal cases achieved normoglycemia, while 24 (50%) of the diffuse cases achieved normal glycemic levels (P≤0.003). Additionally, the incidence of irreversible neurological deficits was higher in the diffuse group (P=0.029).
The focal form of CH seems to be totally curative by surgical operations. However, the proper management of diffuse form is still demanding. Although in our study, we had an acceptable success rate in the short-term, lifelong euglycemia may not be obtainable in these patients.

Biological resources, along with patient-related clinical data, are basically required for personalized medicine and translational research. In this regard, pediatric cancer biobanks have considerable significance due to their special challenges, which include the need for long-term sample collection (due to high diversity and rare tumors), the difficulty of working with children, as well as the limited volume of samples available in children.

After obtaining all necessary approvals (from the ethics committee, scientific board, and financial support), standard operating procedures (SOPs) were defined for all aspects of the biobank procedures, including equipping the lab, sample collection, processing, storage, as well as clinical data recording.

Until July 2022, approximately 8,000 samples from 720 patients have been collected in the biobank. In summary, the samples in the biobank are classified into three categories: leukemia (40.7%), solid tumors (39.44%), and central nervous system tumors (15.56%). The unique activities of the biobank include the collection of various biological samples from patients and their parents, inter-university cooperation, the use of a vacuum system to preserve tissue, the launching of an online database for recording patients' medical data, and the setting up of a bilingual website for announcements at the national and international levels.

 Iranian Childhood Cancer Biobank (ICCBB) is the first pediatric biobank center in Iran that collects various samples and associated clinical data from patients with a wide range of childhood cancers. The ICCBB aims to advance clinical research in the field of pediatric cancer by providing both the required quantity and quality of biological samples.

Caustic esophageal injuries often lead to severe strictures untreatable with endoscopic methods which necessitate surgical interventions. The aim of this study was to evaluate the outcomes and efficacy of these different techniques including trans-hiatal gastric pull up, gastric pull up via thoracotomy, reverse gastric tube, and colonic interposition and compare their complications.

This reto- and prospective study was conducted from 2014 onward at Mofid Children Hospital in Tehran. Data of patients who had undergone esophageal replacement surgery from 2007 to 2017 was retro- and prospectively retrieved from the hospital archives and the newly referred patients during the study. Required data were extracted from medical records. Data analysis was performed with SPSS 21 software package.

27 patients (mean age: 4.01 years, 59.3% males) were included in this survey. Average time from ingestion to surgery was 8.44 months. All patients had dysphagia. 5.8 sessions of endoscopic dilatation were performed for each patient, on average. 70.4% of patients underwent thoracotomy and gastric pull-up. ICU stay duration was 6.88 and time to extubation was 2.25 days. The most common complication was post-discharge stricture. Surgical methods were all the same regarding different parameters except post-discharge stricture and iatrogenic esophageal perforation.

Overally, surgical methods did not differ in terms of outcomes and complications.

Long-term central venous access is used in children for various reasons specially for delivering chemotherapy. Since vessels in children have smaller diameters, they are more prone to injury and complications such as thrombosis. Different methods are used for implantation of port-a-cath in children. We aimed to compare the complications of insertion of central venous access ports between two methods of open and ultrasound (US) guided. 

All children who were referred to pediatric surgery department of a children hospital from April 2018 to March 2020 for implantation of port-a-cath were included. Right jugular vein was the target vein and patients were randomly divided between two methods of insertion of open lateral neck exploration and ultrasound real-time guided percutaneous insertion and the reservoir was fixed in subpectoral fascia pouch. All open cases in which jugular vein was ligated proximally were excluded. Patients were followed up for early and late complications two days and one week later by the surgical team, then monthly by a trained nurse and were referred to the surgeon if any complication or malfunction had occurred for at least 6 months.

We included 76 patients (21 girls and 55 boys) less than 18 years of age: 24 patients with ultrasound guided method (1-13 years, median 3 years) and 52 patients with open exploration method (4 months-17 years, median 6 years). We observed no statistically significant difference between two groups with respect to sex, underlying disease, and complications. Most patients had hematological malignancies including ALL (52.9%), AML (19.1%) and the rest had solid organ malignancies. Early complications were observed in 2 (3.8%) in the open and 1 (4.2%) in the US- guided group (P=1). Late complications were observed in 9 (17.3%) patients in the open group and 1 (4.2%) in the US guided group. Infection was observed in 9.6% and malfunction in 5.8% of the open group leading to earlier removal of the catheter. There was not any complication indicative of infection in the US-guided group.

US-guided method can be suggested for routine use as a safe method of insertion of port venous access in children.

A patient suffering from cleft palate has speech problems even after undergoing surgical procedures to correct it. These problems can be improved by some modality of speech therapy. In this study we aimed to evaluate the outcome of our surgical approach and also the impact of speech therapy on quality of speech in patients who suffered from cleft palate and had undergone surgical correction in Mofid hospital since2011 to 2015.

We evaluated the quality of speech in the patients suffering cleft palate, older than 3 years who had undergone surgical correction since 2011 to 2015 in our center. Parameters were evaluated in this study included hypernasality, audible nasal emission and disarticulation due to velopharyngeal insufficiency. This process was performed by our center’s speech professionals and informed consent was obtained from the patient's parents.

We studied 202 children, 101 males and 101 females. The first surgical procedure was done in the average age of 16 months. Among the postoperative complications, 90.1% of the patients had hypernasality and 66% of the patients had velopharyngeal insufficiency. All these patients were referred to speech therapy and it was shown that there is a significant improvement in the quality of their speech. There was no significant relationship between gender and prevalence of postoperative complications orhypernasality as one of the speech quality elements (P value: 0.34) and there was no significant difference between the age of first surgical reconstructive surgery and speech quality outcomes, but the early reconstruction had strong relation with reduction in postoperative complications and overall final result (P value: 0.043).According to Kruskal-Wallis statistical analysis, there were no significant superiority on speech quality outcome among the three mentioned different surgical methods (P value: 0.203).Also there was a significant improvement in correcting hypernasality as one of the main complications after speech therapy courses (P value:0.0087).

In this study, supportive measures such as speech therapy have been shown to improve post-operative complications of cleft palate, such as hypernasality, nasal emission and disarticulation due to velopharyngeal insufficiency. Duration of speech therapy was also significantly effective on speech improvement.

Wilms’ tumor (nephroblastoma) is the major renal cancer in children.

The aim of this study was to assess the individuality of Wilms’ tumor and the consequences of management attained in our referral subspecialty center.

In this study, we composed the data of children with Wilms’ tumor in 2 decades; 55 cases between 1992 and 2002 and 49 patients between 2006 and 2016 were diagnosed with Wilms’ tumor. Demographic characters, a form of presentation, tumor stage, related underlying disease, histopathology consequences, type of management, and the survival rates were assessed.

In the first decade, 24 patients were females and 31 were males (M/F = 1.2); in the other groups, 30 were females and 19 were males (M/F = 0.61). The mean age was 45.2 months at the time of diagnosis for the first group and the mean age was 36 months for the other group. In the first decade, the surgical stage after the operation was as follows: stage I (32.7%), stage II (16.36%), stage III (38.1%), stage IV (9%), and stage V (1.8%) who did not operate. In second decade, 49 patients were as follows: stage I (14.3%), stage II (40.8%), stage III (24.5%), stage IV (10.2%), and stage V (10.2%). In 54.5% of the first group, histology was favorable, and in 43.6% of the first group, histology was unfavorable; in the second group, 95.4% were the favorable type. The patients were managed based on protocols of the National Wilms’ Tumor Study. In the first decade, relapse-free was 71% and 4-year survival rates were estimated at 86%, and in the second decade, pulmonary metastasis was observed at 28.6%, liver metastasis in 2.3%, recurrence in 5%, and 4-year survival rates were estimated at 90%.

This study demonstrated development in the management of children with Wilms’ tumor in recent 20 years, with comparable relapse-free and survival rates to the National Wilms’ Tumor study. But with more adjustment in treatment protocols, the superior outcome will be attainable.

Laparoscopic appendectomy has recently been trended to be performed by using a less trocar technique. In children, appendectomy is performed more by open approach; so this study was designed to compare benefits of non-invasive laparoscopic appendectomy with usual open technique.

After obtaining institutional review board approval, from 2015 to 2018, 73 children with acute, nonperforated appendicitis were treated by single-incision laparoscopic or open approach. The patients were randomized to two treatment groups: 36 patients underwent open operation, and 37 by laparoscopic approach via single-incision in umbilicus. 3 cases of laparoscopic approach were converted to open surgery and removed from the study. In patient selection, cases of complicated appendicitis confirmed by imaging modalities were excluded. The outcomes were investigated in both groups by length of operation, duration of hospital stay, presence of postoperative fever, wound infection, ileus after operation, and pelvic abscess after surgery.

73 appendectomies were carried out totally by single surgeon, 37 were single-incision laparoscopy and 36 underwent open procedure. Total anesthesia time and duration of operation showed significantly longer in the laparoscopic group. On the other handuration of hospital stay showed similar duration in both groups. No mortality occurred in the study. Overall complications demonstrated no significant difference between two groups. Also there was no difference in infectious complications between the laparoscopic group and the open group.

Our study suggests that Assisted Transumbilical laparoscopic appendectomy is a reasonable alternative to open surgery for appendicitis in acute none ruptured condition. All analyzed complications were similar between the groups, suggesting that Assisted Transumbilical laparoscopic appendectomy is a suitable ingrained method in pediatric cases with appendicitis. d, time to tolerate liquid diet was significantly shorter in the laparoscopic group. The

A large number of patients who underwent pull-through surgery due to Hirschsprung's disease (HD) were not followed up properly and they suffered from many complications such as fecal soiling, constipation, and etc. Although some of these complications may relief over time, it is rational to consider an evaluative protocol to identify anatomical or pathological complications in these patients.

The aim of the present study is to evaluate and introduce these catastrophic complications.

In this historical cohort study, 193 patients with HD who had undergone pull- through surgery between 2006 to 2013 were considered. All files and questionnaires were used to collect patients' information and patients were physically examined individually. The mean duration of the follow-up was 96.4±17.2 months ranging from 60 to 144 months The follow-up performed for all patients via the outpatient clinics or by telephone. All statistical information was analyzed by SPSS software version 17.

At first presentation, intestinal obstruction was more frequent than constipation. The most common involved segment was in rectosigmoid. The most common early postoperative complication was stricture in anal canal and the most common late complications were constipation and focal soiling.

Although surgical advancements, a large number of patients underwent surgical procedures due to HD experience long term complications. Surgical treatment of HD generally present with high-quality outcome and the majority of children survive in satisfactory situation for long time but occasionally pediatric surgeons meet head-on catastrophic complication in these patients that require extended team work to be resolved

The corrosive esophageal injury would result in mucosal damage related to type, exposure time, and volume of ingested substance ranging from mild burn to severe necrosis. It is usually seen in childhood. Stricture and dysphagia are common. Swallowing problems are due to prolonged stricture and would require surgery. However postoperative problems should also be considered. The purpose of this study was to determine the results of esophagus substitution in the management of corrosive esophageal injury in three methods; colon interposition, gastric pull up, and reverse gastric tube. In this observational descriptive-comparative study, 50 consecutive patients attending to Mofid children hospital since 2006 to 2016 were enrolled and the results of esophagus substitution in the management of corrosive esophageal injury in three methods; colon interposition, gastric pull up, and reverse gastric tube among them were determined and compared according to other variables. The results in this study demonstrated that 68% required surgery that 82.3% had repeat surgery. Out of them 22 were performed with Gastric Pull up method that was successful in majority of subjects. Esophageal stricture (74%), vomiting (46%), and dysphagia (40%) were most common preoperative problems and dysphagia (46%), stricture (36%), and vomiting (26%) were most common postoperative problems. There were 4 mortality cases. Totally, according to the obtained results, it may be concluded that esophagus substitution in the management of corrosive esophageal injury is effective that Gastric Pull up method is best option.

Broncho-esophageal fistula (BEF) is a rare congenital anomaly affecting the respiratory and upper gastrointestinal tract. The rarity makes its timely diagnosis very challenging. This study presents a rare case of missed congenital BEF in a six-year-old girl with repaired esophageal atresia in the neonatal period suffering from recurrent respiratory symptoms, choking, and respiratory distress following eating, resulting in vomiting or regurgitation for three years before admission. While the contrast esophagography and endoscopy had failed to diagnose her problem, the methylene blue test via an esophageal catheter observed by fiberoptic bronchoscopy could detect the presence of BEF reliably in the present case. Presenting this case can raise physicians’ knowledge of the diagnostic role of methylene blue test via fiberoptic bronchoscopy.

Hidden penis may have different categories: Concealed, trapped, and buried types. The aim of this study is to evaluate the results and outcomes of repaired cases.
Material & Totally 40patients (5months -12years old)were surgically repaired due to different types of hidden penis from April 2010toDecember 2015 in our hospital. Multiple surgical procedures were performed for each type. Data were collected and evaluated for number of patient’s type of anomalies, surgical techniques, outcome and follow-up.
All forty cases underwent surgical repair, of which all concealed and buried patients had penile degloving and penile fixation, that all reported improved in function, and good in outcome.
Patients with hidden penis are in psychological risks. The aim of hidden penis is to restore an aesthetic and functional penis.

There are various techniques for treatment of proximal hypospadias disease.Surgical correction is often associated with complications. Proximal hypospadias can be repaired by Duckett or Bracka two-stage repair procedure. This study was to evaluate the outcomes, complications and long term follow-up of these two techniques in our referral hospital.
From January 2006 to January 2015 totally 1550 cases of hypospadias were diagnosed in our hospital, of which 164 patients with high type hypospadias underwent Duckett (78 cases) and modified Bracka (86 cases) surgical repair procedures. Sufficient data were analyzed for age at operation, type of pathology, chordee type, number of operations, complications, outcomes and follow-up.
One hundred sixty four cases with a mean age of 2.70 ± 2.6 (range 0.5 - 13) years underwent proximal hypospadias repair. Follow up ran in average to 5 (range 1 - 10) years.Chordee was seen in 19 (11.58%) cases which 15 (78.9%) cases released and 4 (21.1%) corrected by dorsal Nesbit plication. Fifteen of 164 (9.1%) cases had meatal stenosis: 5 in Bracka and 10 in Duckett group, all of which were repaired by dilatation. Six patients in Duckett group and only one in Bracka series had urethrocutaneous fistula. One case in Bracka group and five cases in Duckett series underwent re-operation.
Our study shows that proximal hypospadias repair with modified Bracka procedure has significantly a lower complication rate, also a better and more cosmetic outcome than Duckett technique.

As recently some reported is investigated about relation between cold weather and testicular torsion (TT), so we decided to evaluate this hypothesis risk factor for testicular torsion in our children’s hospital.
The aim of this study is to evaluate the relation between cold weather and testicular torsion in children.
From January 2011 toDecember 2015 totally Hundred seventy patients due to acute scrotum admitted in Mofid Children’s Hospital. According to our hospital guidelines,those patients who had proven TT were candidate for this study.The records of all operated patients were evaluated and analyzed by age, season of year, and operation type.
Totally Hundred seventy patients were included in this study within five years, with the mean age of 28.6 32.9 (range1 to 144).Winter season showed most frequently (42%) referred cases of testicular torsion.
The incidence rate of testicular torsion will be increased with cold weather.

Longitudinal follow-up of bowel function in children with anorectal malformations (ARMs)) as they grow, to determine the anorectal function problems and help to resolve them somedeal.
Material and This study included 262 patients with ARM that operated in our center between 2006 until 2013.Patients that definitive reconstruction was performed in another center and underwent reoperation in this center excluded. Also children that expired or did not come for visit removed. Bowel function was prospectively evaluated by using a structured questionnaire that asked from their parents. Additional bowel treatment with enemas and stool softeners and use of diapers were recorded.
Interviews were completed with 242 children, age ranging from 3 to 10 years. 37.7% of patients had constipation.32.5% Grade 1 Manageable by changes in diet,54.3% Grade 2 Requires laxative and 13.2% Grade 3 Resistant to laxatives and diet. 18.6% of patients had fecal soiling , 31.5% Grade 1: Occasionally (once or twice per week),24% Grade 2: Every day, no social problem and 44.5% Grade 3:Constant, social problem.
In the present study there were many bowel function problems in ARM children, that needs additional attention to achieve them more near to level of healthy children. Pediatric surgeons who do the definitive surgery on anorectal malformations Should don’t lose contact with the patients as they become adults .These patients have many great troubles in adolescence.

Teratomas arise from three germ cell layers, the ectoderm, endoderm and mesoderm1, 2, and have several degrees of differentiation. We report our experience with teratomas at a tertiary pediatric surgery center.
Patients and The hospital records of all patients with the pathological diagnosis of teratoma treated during 10 years between 2004 and 2014 were reviewed and the following information was obtained: Sex, site of tumor, treatment and outcome.
Sixty seven patients consisting of 49 girls (73%) and 18 boys (27%) were treated with teratomas at various sites of the body. These included: sacrococcygeal (SC) 32 patients (27 females& 5 males), ovarian 12 cases, cervical 4 patients (1 females & 3 males), retroperitoneal 9 (5 females & 4 males), Nasopharyngeal 2 patients both of which were females, mediastinal 2 cases (1 female & 1 male) and 5 testicular teratoma patients. All patients underwent surgery, and the most common procedure was total resection in 63(94%) of patients. Twenty eight (42%) received chemotherapy. In follow-up 52(77%) patients were in complete remission, 8(12%) had died, and 4 cases did not attend follow-up visits.
Teratomas are a group of tumors with similar histological picture but different behaviors. Sacrococcygeal teratomas are the commonest and the majorities are benign but the risk of malignant transformation increases with age. Management of teratomas is a combination of surgery and chemotherapy which may lead patients to a better prognosis.

Penile agenesis (PA) and diphallus (DP) are extremely rare genital anomaly in children. Numerous associated anomalies have been described with these malformations. These patients need several investigations and finally surgical intervention.
Material & In a retrospective study, 14 patients who were treated for phallus malformation in Mofid Children’s Hospital from January 2004 to December 2013 were studied. Detailed history was taken and para clinical examinations were performed in each patient and diagnosis was confirmed by laboratory tests, abdominal ultrasonography, voiding cystourethrography (VCUG), and karyotype study. Data regarding age, sex, clinical findings, associated anomalies and treatment were collected.
From 14 patients, eight cases had PA (aged 2 to 4320days), and six had DP (aged 2 to 5040 days).Karyotype in all PA’s patients was 46XY. Five of DP cases had completed, and one had bifid phallus type.
All patients were treated surgically after complete investigations, and followed within period of study.
All patients with phallus anomalies need extensive evaluations and surgical intervention. No surgical intervention should take place without counseling the parents.

Urethral duplication (UD) is a rare congenital anomaly with multiple anatomical variants.
In this article we present a four year-old child with complete UD. The patient was admitted for hypospadias repair, in evaluation we found type IIA1 UD according to Effmann classification. Patient underwent hypospadias repair saving complete UD.
After one year follow-up he has normal and continent urination.

Burkitt’s lymphoma is a high grade B-cell neoplasm, which is a kind of small non-cleaved cell lymphoma. It is presumably the fastest growing human malignancy, and the patients are prone to develop tumor-lysis syndrome. Here we present findings on our patients with Burkitt lymphoma.
This descriptive retrospective study included 46 children with abdominal Burkitt's lymphoma who were treated during 15 years from June 1998 to Dec 2013 at Mofid Children’s Hospital.
Offourty six patients 32 (70%) were boys and 14 (30%) were girls with ages ranging from 2 to 14 years. Surgical exploration was carried out in all cases, the lesions were located in the small intestine (N=17), large intestine (N=15), ileocecal region (N=12), and stomach (N=2). We performed a complete mass resection in 16 cases, debulking in 10 and lymph node/mass biopsy in 20 cases. Pathologic examination revealed Burkitt’s lymphoma for all patients. The majority were stageIIE and stage IIIE (24 and 19 respectively). Post-operative complications were seen in five cases with the most common being persistent ileus. All patients received a sort of systemic chemotherapy. The mean follow up duration was 6 years. Death occurred in 7(15%) of our patients, due to tumor lysis syndrome and acute renal failure.
The extent ofdisease at presentation is the most important prognostic factor in abdominal Burkitt’s lymphoma. Children with BL are at a high risk of tumor lysis syndrome before or during chemotherapy. Surgery still plays an important role in this pathology, and chemotherapy offers an excellent chance for long term disease free survival.

In order to assess our skill in the tubularized incised plate (TIP) urethroplasty technique in children with hypospadias.
Material and Of 307 children (mean age 38 month) who received a TIP urethroplasty, all had primary hypospadias. Patients who were referred with complication were eliminated from our study. The hypospadias defects were subcoronal in 25 (8%), distal penile in 236 (76%), midpenile in 25 (8%), proximal in 14(4%) and unknown in 7(2%) cases. Chordee was present in 53 (17.2%) patients. Presence of complications requiring reoperation and overall general appearance was recorded.
The mean follow-up was 36 (19-72) months. Overall success rate was 70 % (215). Re-operation was required in 92 patients (30%): for urethrocutaneous fistula in 79 (26%), complete disruption of the repair in 2(0.6%) cases and meatal stenosis requiring meatoplasty in 12 (3%). Complete glans dehiscence occurred in 3 patients, which was repaired using the MAGPI technique. Partial breakdown of the glans occurred in 10 cases which did not require further surgery. One case had a huge urethral diverticulum.
This technique is relatively common compared to other accessible operations, but attention to details is necessary in order to achieve good results. It appears that complications, such as fistulas and meatal stenosis are more common in this method than other techniques, which require more research in the future.

Considerable controversy exists regarding the optimal surgical technique for the treatment of Hirschsprung disease. Currently, both Swenson and Soave procedures are used for its treatment.. The purpose of this study was to compare outcomes and complications of Swenson and Soave pullthrough using a matched case control analysis..Patients and A cross-sectional study was done on patients with Hirschsprung disease (HD) admitted in Mofid Children’s hospital from 2006 to 2012. Children with HD who underwent Soave procedure and sufficient data to analyze were matched 1:1 to a Swenson study sample. Patients were matched with respect to gestational age (37 - 42 weeks), age of patient at pullthrough procedure, operation stages, level of aganglionosis (rectosigmoid, sigmoid, descending and transverse colon) and the presence of comorbidities (major cardiac, trisomy 21, and other syndromes). SPSS version 18.0 was used for statistical analysis. Descriptive statistics and the Chi-square test and Student t-test were used. P < 0.05 was considered as significant.. Sixty patients (30 patients undergone Soave, 30 patients undergone Swenson) had adequate data for matching and analysis. Mean follow-up time was 3 years for both groups. Mean (SD) age of patients at the time of pullthrough procedure was 43.1 (35.6) months in Swenson group (range; 1 - 168) and 41.9 (49.6) months in Soave group (range; 1 - 132) (P value = 0.920). No significant differences were seen in mean (SD) operating time (Soave: 156.7 (59.0) minutes, Swenson: 134.3 (51.4) minutes) (P value=0.145). There were no significant differences between 2 groups with regard to operative time, hospital stay, early and late complications such as postoperative obstructive symptoms, enterocolitis, fecal incontinence, perianal abscess and fistula, anastomotic leakage, peritonitis, and pelvic abscess formation. Rate of complication was 47% for Soave group and 40% for Swenson group (P value = 0.795, risk ratio = 1.147).. There were no significant differences in the early and late complications between Soave and Swenson pullthrough procedures..

Capillaria hepatica (Calodium hepaticum) is a parasite that cause very rare but life threatening infection in human beings.. The current paper reports a case of Capillaria hepatica infection in a four-year-old boy which presented with fever, hepatomegaly, peripheral eosinophilia, and noticeable weight loss. The diagnosis was made on the histological finding of degenerated nematode in the liver. He improved clinically by corticosteroid and albendazole therapy.. Capillaria hepatica should be considered in differential diagnoses in any child with fever, hepatomegaly, eosinophilia and hyperglobulinemia..

Bacillus Calmette-Guérin (BCG) vaccine, a live attenuated Mycobacterium bovis strain, is administrated to all newborn infants in endemic regions according to the current World Health Organization (WHO) recommendation.. We report a 10-month-boy who was a known case of severe combined immunodeficiency (SCID) admitted with multi-focal fusiform painful swelling in his hands. He had undergone bone marrow transplantation 7 weeks before admission. Multidisciplinary management was done to treat this rare post-transplant occurrence of Bacillus Calmette-Guérin complication.. BCG vaccination administrated routinely in Iran, given that of no screening program for primary immune deficiency currently achieved in our country, exact attention to reschedule of immunization programs in suspicious newborn (with primary immune deficiency) always is necessary and is one of the most effective strategy to prevent BCG complication..

Bacillus Calmette-Guérin (BCG) vaccine, a live attenuated Mycobacterium bovis strain, is administrated to all newborn infants in endemic regions according to the current World Health Organization (WHO) recommendation.. We report a 10-month-boy who was a known case of severe combined immunodeficiency (SCID) admitted with multi-focal fusiform painful swelling in his hands. He had undergone bone marrow transplantation 7 weeks before admission. Multidisciplinary management was done to treat this rare post-transplant occurrence of Bacillus Calmette-Guérin complication.. BCG vaccination administrated routinely in Iran, given that of no screening program for primary immune deficiency currently achieved in our country, exact attention to reschedule of immunization programs in suspicious newborn (with primary immune deficiency) always is necessary and is one of the most effective strategy to prevent BCG complication..

Here, we report on a ten-year-old girl with chronic draining nonhealing ulcer in her neck and unilateral cervical chronic lymphadenopathy. Her ulcer had poor clinical response to broad spectrum antibiotics and anti-tuberculosis treatment. She had undergone several wound biopsies with no conclusive results. She was otherwise healthy with no known underlying disease. Final wound excisional biopsy with specific immunohistochemistry (IHC) staining confirmed her diagnosis. Histopathology report and IHC were compatible, indicating an anaplastic large cell lymphoma..

Disability is a relatively common problem in children. The pattern of admission in these children and their common infections may differ from other children because of their special disabilities.. We aimed to determine common infectious diseases resulting in admission of these children to our hospital..Patients and Between September 2006 and September 2007, 60 disabled children aged between 4 months and 15 years were admitted to infectious ward of Mofid children hospital Tehran, Iran. A questionnaire was filled at the time of admission, containing particular details of their recent complaint. They were completely examined and the final diagnosis was established at the time of discharge.. In this study 25 (42%) boys and 35 (58%) girls aged from 4 to168 months were included. The patients were divided practically into three groups: 21 patients (35%) with physical or developmental disabilities, 8 (13%) patients with mental or behavioral disabilities, and 31 (52%) patients with both developmental and mental disabilities. The common diseases among these children were lower respiratory tract infections (LRTI) in 24 patients (40%), urinary tract infections (UTI) in 8 patients (13.3%), and nonspecific infections in 9 patients (15%). Dental caries and periodontal problems were significantly higher in children having both mental and developmental disabilities this correlation was similar between different types of disability and skeletal deformity (P = 0.006). Children having both mental and developmental disabilities were admitted more than children with either of those disabilities (P = 0.08).. Lower respiratory tract infections were the most common reasons for admission of these children in our study, but we found no significant correlation between the type of disability and one special infectious disease. We need more prospective studies to complete our findings..