Modern aspects of diagnosis and treatment of chronic pancreatitis in children: experience of the center Center for the treatment of developmental anomalies and diseases of the hepatopancreatobiliary system in children

Chronic pancreatitis is one of the most pressing problems of pediatric gastroenterology and surgery of hepatopancreatobiliary organs. Diagnosis and treatment of this category of patients requires a comprehensive examination using modern highly sensitive research methods and the collegial participation of a surgeon, gastroenterologist and endocrinologist. Due to the fact that the algorithm for managing these patients is not regulated, patients often receive enzyme replacement therapy for a long time, with indications for surgical treatment. In addition, the non-specificity of complaints and clinical manifestations of chronic pancreatitis, the asymptomatic course and the initial detection of exo- and endocrine insufficiency lead to a later choice of the optimal treatment method and increase the risk of complications. The key to effective care for children with chronic pancreatitis is the staging and continuity in research and treatment. At the Center for the Treatment of Developmental Anomalies and Diseases of the Hepatopancreatobiliary System in Children on the basis of the Filatov Hospital, highly effective interventions are carried out for chronic pancreatitis in children, the purpose of which is to ensure an adequate outflow of pancreatic juice using longitudinal pancreaticojejunostomy, which, in addition to draining the pancreas, allows to achieve clinical remission and stop the progression pathological process, including diabetes mellitus. The article reflects the experience of diagnosis and treatment of chronic pancreatitis in children.

Treatment of children with incomplete duodenal membrane

BACKGRAUND: An incomplete or perforated duodenal membrane is a rare developmental pathology of the gastrointestinal tract. AIM: This study aimed to analyze the diagnostic and treatment results of children with an incomplete duodenal membrane in the Republican Childrens Clinical Hospital in Ufa. MATERIALS AND METHODS: This study retrospectively analyzed case histories of 34 children who underwent surgery for incomplete duodenal membrane from 2005 to 2020. Features of the life history of the children, clinical picture of the disease, presence of concomitant developmental anomalies, laboratory and instrumental examination data, surgical correction methods, and postoperative period were analyzed. All children underwent ultrasound examination of the abdominal organs and contrast-enhanced radiography of the upper gastrointestinal tract with barium sulfate. Esophagogastroduodenoscopy was performed in 17 cases. RESULTS: Antenatally, the diagnosis was made in 21 cases. Patients age at the time of hospitalization was 9.7 2.7 days. Children were presented with symptoms such as persistent regurgitation or vomiting of curdled milk, which was sometimes mixed with bile (22 cases). Bloating in the epigastric region, retraction of the lower abdomen, and low weight gain after birth were found in nine children, and in five children, no weight changes were observed. Moreover, 13 (38.2%) children had concomitant developmental anomalies; 4 (11.7%) children had Down syndrome. Surgical treatment of 10 children was performed laparoscopically. Of the 24 children, three received laparotomic access, including conversion. The procedures included duodenotomy, partial excision of the membrane, and suturing of the duodenum. Enteral feeding was started 4.9 0.6 days after surgery. The average duration of hospitalization was 27 1.4 days. CONCLUSION: Vomiting or frequent regurgitation in infants and low-weight gain should alert pediatricians and pediatric surgeons. Malformation of the duodenal membrane in combination with other malformations necessitates a comprehensive examination. Laparoscopic excision of the duodenal membrane is the preferred treatment.

Developmental Anomalies of Teeth – A cross-sectional study

Background: This study was conducted to find out prevalence of tooth developmental anomalies and tooth agenesis syndrome in patients of Fariyal Dental College Lahore visiting the out-door department during the year 2017. Objective: The objective of this study was to conduct a retrospective examination of prevalence of developmental tooth anomalies and tooth agenesis syndrome .The relationship of age and gender was also focused. Methods: All patients of Fariyal Dental College Lahore visiting the out-patient department during the year 2017 were observed and analyzed. The documents scrutinized for this purpose were hospital history charts including patient’s biodata, family history and oral examination details. Results: Out of 160 total cases, 10 cases were of tooth developmental anomalies and 7 cases were of tooth agenesis syndrome were observed. Conclusion: There are 6% cases of developmental anomalies and 4% cases of tooth agenesis were found. Both findings are quite significant in the given number of patients. Keywords: Fariyal Dental College, Tooth Developmental Anomalies, Tooth agenesis.

Prevalence and distribution of selected developmental dental anomalies in Taif, Saudi population

Background: Developmental dental anomalies are seen as abnormalities in tooth size, shape, position, and structure due to multiple reasons during various stages of tooth development. These anomalies can create disturbances in dental arch lengths and occlusions. Hence, it is very important to treat, recognise and perform proper treatment. The purpose of this study was to find out the prevalence and distribution of selected developmental anomalies in shape, size and position of teeth in the Saudi population of Taif Region.Design and Methods: The study was based on the clinical examination of 2481 adults who are Saudi nationals came for dental treatment from September 2019 to February 2020, at Taif University Dental Hospital, Saudi Arabia. These patients were examined clinically for developmental dental anomalies affecting shape, size and position.Results: We found that a total of 512 individuals (20.63%) had developmental anomalies and out of which 386 persons (15.56%) had at least one developmental dental anomaly. The frequency and distribution of anomalies of shape and size, number and position were 46.8%, 26.9% and 42.9% respectively. In the present study, 15.56% individuals exhibited at least one anomaly, 8.54% subjects had more than one anomalies and 79.36%.did not any developmental anomaly. On comparison, statistical significant results were seen between different groups of anomalies.Conclusions: The present study had varying results for the prevalence rate of selected dental anomalies. This variation in results might be due racial differences or discrepancy in sample size or/and diagnostic or inclusion criteria. Treatment of developmental anomalies necessitates a multidisciplinary approach and mostly may comprise of orthodontic correction or prosthetic replacement.

Pulpectomy in a Primary Tooth with Gemination: A Case Report

Developmental anomalies may affect the number and morphodifferentiation of teeth. Development of two teeth from one tooth bud gives rise to gemination. Geminated teeth with caries may lead to pulpal pathologies for which extraction may be a preferred treatment. We report a case of geminated maxillary carious primary incisor treated with pulpectomy in a five year-old child.

A UNIQUE DISORDER OF THE STERNUM : HONEYCOMB STERNA

This article describes an uncommon example of a human sternal developmental anomaly in an anatomical specimen from the Department of Anatomy at Shahid Nirmal Mahto Medical College Dhanbad. The non-fusion of lateral ossication centres in the sternebrae caused the uncommonly recognized developmental anomaly, which results in a honeycomb-like appearance of the mesosternum. Sternal deciencies are normally under diagnosed in the clinical literature due to the fact that many instances are asymptomatic. As a result, there is a gap in our modern understanding of the development and anatomical variations of the sternum. Although in the past, large-scale CT investigations have been conducted to explore the incidence of sternal developmental anomalies. A very rare work has been reported on sternal malformations. Most of the sternal abnormalities are clinically insignicant; a lack of awareness of these variants can lead to interpretation of radiological and pathological evidence. Hence, anatomical variants are asymptomatic which is vital in nature.

Toxic Effect of Khat in Rat Embryos and Fetuses

Khat (Catha edulis Forsk) is a plant consumed by many people in Eastern Africa, including Ethiopia, and Southern Arabia to be stimulated. There are several human and animal studies on khat that provide information about its toxic effects. However, the potential toxic effects of khat on embryos and fetuses have not been elucidated. The aim of the present study was to investigate the embryotoxic and fetotoxic effects of khat exposure during the earliest period of gestation in rats. Pregnant Wistar albino rats were treated with khat extract at 250, 500, and 750 mg/kg doses from day 6 through day 12 of gestation. The treatment was delivered by gavage. Embryos and fetuses were recovered on gestational day 12 or day 20, respectively, and were quantitatively and qualitatively assessed for developmental anomalies. Placentae from the treatment and control groups were investigated for histopathological effects. Results of the present study showed that khat exposure during pregnancy had dose-dependent toxic effects in rat embryos and fetuses. Prenatal growth retardation such as reduced fetal weight and crown-rump length was observed in near-term fetuses, especially, in animals treated with the highest dose of khat ( p < 0.05 ). Growth retardation and developmental anomalies were also observed in day 12 embryos of khat-treated rats. Maternal weight gain of the khat-treated group was also significantly lower than the control group. Cytolysis, decidual hypoplasia, and atrophy were observed in the placenta of the khat-treated rats. Findings of the present study revealed, for the first time, that exposure of pregnant rat to crude extract of khat causes embryotoxic and fetotoxic effects.