Physical Examination Of Children Research Articles

The Use of Medical Chaperones During Physical Examinations: The Perceptions of Adolescents and Their Caregivers.

A medical chaperone serves as a witness for a patient and health care practitioner during a medical examination. We sought to better understand the preferences of parents and children toward the use of chaperones during pediatric physical examinations. This cross-sectional study surveyed patients aged 8 to 18 years and their parents presenting primarily to the emergency department as well as primary care ambulatory clinic and inpatient units. Participants were asked which individuals (patient alone, parent, or medical chaperone) should be present for each aspect of the child's physical examination. The survey was completed by 121 patients (mean age 14 years, 58.5% girls) and 122 parents (mean age 42 years, 82.8% women) in a variety of clinical settings (17 in inpatient, 17 in outpatient clinic, and 87 emergency department admissions). Significant differences existed between male and female patients regarding preferred presence for every body part being examined ( P ≤ 0.002). Female patients preferred to have a same-sex parent in the room, particularly for examination of the breasts, genitalia, or rectum and when the examination was performed by a male provider. Male patients preferred to be alone or with either parent for any body part being examined, regardless of provider sex. Adolescents have significant differences in who they prefer to be in the room for the physical examination based on patient and provider sex in settings where they are unfamiliar with the health care examiner. Few patients and parents preferred a medical chaperone; most preferred a parent to be in the room. Patient and parent considerations should be prioritized when creating policies for the use of medical chaperones.

Koronavirüs-19 Pandemisi Öncesi ve Sırasında Çocuklarda Akut Apandisit Yönetiminin Karşılaştırmalı Analizi

Objective: Acute appendicitis (AA) is one of the most common surgical emergency in pediatric population. Herein, we aimed to compare the incidence and severity of AA before and during the Coronavirus Disease-19 (COVID-19) outbreak. Materials and Methods: This multicenter study was conducted in three medicine faculty hospitals between the periods of 15 March-30 June 2019 (Group A), and the pandemic period of 15 March-30 June 2020 (Group B). We evaluated the clinicopathological characteristics of the patients in each group in terms of age, gender, serum leukocyte, C-reactive protein, radiological imaging use of postoperative peritoneal drain and presence of serious complications. Results: A total of 141 patients were identified and divided into two groups as Group A (n=64) and Group B (n=77). We found higher complication rates in Group B. Fewer patients applied in Group B, but a higher rate of AA was diagnosed. During the COVID-19 period, more patients were admitted with the later stages of the AA and with significant complications. Radiological imaging of patients with appendicitis in Group B showed more severe findings compared to Group A. Conclusion: Higher rate of perforated and complicated appendicitis in the pandemic period was due to misdiagnosis/delayed diagnosis in primary care centers as a result of fear from contagious coronavirus. Although the period of the COVID -19 pandemic brings out difficulties in treatment of patients, comprehensive assessment and physical examination in children with suspected surgical conditions should always be emphasized.

INFLAMMATORY MARKERS IN THE DIAGNOSIS OF COMPLICATED APPENDICITIS IN CHILDHOOD

Acute abdominal pain is challenging because of the nonspecific nature of symptoms and difficulties in physical examination in children. In most of them, it is a manifestation of an urgent surgical or medical condition, where the biggest challenge is a timely diagnosis to start appropriate treatment without any diagnostic delays. There are many conditions that present with abdominal pain in all age groups, ranging from a common viral illness to a life-threatening surgical condition. History, physical examination, laboratory tests, and imaging are initially used to differentiate surgical illnesses categorized as urgent. Their characteristics, age, and physical examination of the patient direct appropriate tests in the context of these differences.

Haematocolpos and Secondary Hematometra Due to Imperforate Hymen: Diagnosis and Treatment

BackgroundImperforate hymen is an uncommon congenital anomaly of the female genital tract and is rarely diagnosed in newborns. An imperforate hymen is a cause of primary amenorrhea. Case DescriptionA 12-year-old girl was admitted to the pediatric outpatient clinic with cyclic abdominal pain for eight days. She had lower abdominal pain with dysuria and constipation for the previous six weeks. There is a bulging mass on the perineal that appears when straining. Fever, nausea, vomitus, abdominal enlargement, and leucorrhea were denied; breast enlargement since 12 years old with no history of menarche. The patient vital signs were normal. On physical examination obtained, lower abdominal pain and tender suprapubic mass were palpable. The pubertal status was normally secondary sexual characteristics. An interlabial mass was found protruding from the introitus vagina and the hymen intact on inspection of the external genitalia. Laboratory and urinalyses revealed normal. Hematometra and hematocolpos were found on abdominal ultrasonography, which led to the diagnosis of imperforate hymen. Therefore, a hymenectomy was performed and evacuated 520 ml of dark red blood. The patient’s condition was good, and she had regular menstruation. ConclusionsImperforate hymen is an easy diagnosis, but sometimes clinicians are oblivious to including this in the differential diagnosis of lower abdominal pain in pubescent girls with primary amenorrhea. Also, a lack of awareness about the importance of external genitalia examination as part of routine physical examination in children and adolescents makes this diagnosis easily missed or delayed.

Диагностика и лечение пахово-мошоночных грыж у детей

Введение. Паховая грыжа — наиболее частое заболевание в практике детского хирурга и составляет 70–85 % от всех грыж у детей. Целью нашей работы является улучшение результатов диагностики и лечения пахово-мошоночных грыж у детей. Материалы и методы. Проанализировано 186 детей с пахово-мошоночными грыжами в период с 2010 по 2015 г. Односторонняя паховая грыжа — 68,4 % случаев, двусторонняя — 31,6 % случаев. У 76 детей паховая грыжа сочеталась с пупочной грыжей, с водянкой оболочек яичек — у 20 детей. Результаты и обсуждение. Анализируя полученные результаты, мы обнаружили, что у 84,9 % детей диагностика грыж основывалась на жалобах родителей и физикальном осмотре детей. Оперативное лечение 78 (42 %) детям произведено открытым доступом. 108 (58 %) пациентам произведена лапароскопическая коррекция. Из них у 28 детей грыжа с другой стороны была диагностирована во время оперативного вмешательства. В течение года после операции у 18 детей выявлена метахромная грыжа (контралатеральной области). У 12 детей с пахово-мошоночными грыжами огромных размеров выявлена водянка оболочек яичек. Выводы. 1. Оптимальным сроком операции является время установления диагноза с целью предупреждения осложнений и повреждений органов мошонки. 2. Лапароскопический доступ позволяет без труда произвести операцию с двух сторон, что, в свою очередь, предупреждает возникновение контралатеральных грыж в катамнезе.

CHILDREN'S AGE WHEN GETTING COMPLEMENTARY FOOD AND SHORT STATURE EVENTS IN CHILDREN 12-24 MONTHS

Introduction: Short stature remains a nutritional problem in Indonesia. World Health Organization (WHO) data showed that Indonesia is the third-highest ranked for short stature prevalence among countries in Southeast Asia. National Basic Health Research (Riskesdas) in 2013 stated that the prevalence of short stature children was 37.2%. Short stature is caused by various factors, and one of the causes is early complementary feeding. Purpose: To analyze the association between child age when receiving complementary feeding and short stature in children 12-24 months. Method: This research was an observational analytic study with a cross-sectional design. Sampling technique using non-probability sampling, i.e., consecutive sampling. Data collected through interviews, questionnaires, and physical examinations of children's body length and weight. Research location was in the working area of the Sidorejo Community Health Center. Statistical analysis using Chi-square test. There were 182 subjects included in this study. Results: Among those who received complementary feeding before six months old, 53 children (76.8%) had short stature, and 16 children (23.2%) were normal. Meanwhile, after six months old, those who received complementary feeding were 40 children (35.4%) who had short stature, and 73 babies (64.4%) received complementary foods after six months with normal growth. Chi-square test showed a significant association between child age when receiving complementary feeding and short stature among children aged 12-24 months in the working area of the Sidorejo Community Health Center (p<0,001; PR = 2.17, 95% CI=1.642.87). Conclusion: There is a significant relationship between child age when receivingcomplementary feeding and short stature in the working area of the Sidorejo Community Health Center.

Pneumonia remains a leading public health problem among under-five children in peri-urban areas of north-eastern Ethiopia.

Pneumonia is a leading cause of morbidity and mortality among children under five years of age in developing countries, including Ethiopia. However, data on this serious illness among highly susceptible and vulnerable children living in local peri-urban areas are limited. Establishing the prevalence of pneumonia and identifying the associated factors are important for proper planning and intervention. A community-based cross-sectional study was conducted among 560 systematically selected children under the age of five years in peri-urban areas of Dessie City from January through March 2019. Data were collected using a pretested structured questionnaire, physical examination of children and direct observation of housing conditions. Pneumonia was examined using World Health Organization (WHO) guidelines as the presence of the symptoms of fast breathing or indrawn chest with or without fast breathing during the two weeks prior to the study. A principal component analysis was used to construct a household wealth index. Data were analyzed using a binary logistic regression model at 95%CI (confidence interval). The analysis involved estimating the crude odds ratio (COR) using bivariate analysis, and adjusted odds ratio (AOR) using multivariable analysis. From the multivariable analysis, variables at p-value of less than 0.05 were declared statistically significant. The prevalence of pneumonia among children under five was 17.1% (95%CI: 13.9%-19.9%). Of the participating children, 113 (21.0%) had a cough, 92 (17.1%) had fast breathing, 76 (14.1%) had fever, and 40 (7.4%) of the children had chest indrawn. Domestic fuel was the most common source of cooking fuel 383 (71.1%). Majority 445 (82.6%) of children were fully vaccinated and 94 (17.4%) were not fully vaccinated. Most (481, 89.2%) of the children were got exclusive breastfeeding. Slightly more than half (284, 52.7%) of the under-five children had acute malnutrition and 27.1% of the children had a childhood history of ARI. The multivariable analysis showed using domestic fuel as the energy source for cooking (adjusted odds ratio [AOR] = 3.95, 95%CI: 1.47-10.62), cooking in the living room (AOR = 6.23; 95%CI: 1.80-21.68), overcrowding (AOR = 3.37, 95%CI: 1.56-7.27), child history of acute respiratory infection (ARI) (AOR = 6.12 95%CI: 2.77-13.53), family history of ARI (AOR = 4.69, 95%CI: 1.67-13.12) and acute malnutrition (AOR = 2.43, 95%CI: 1.18-5.04) were significantly associated with childhood pneumonia. In this study, pneumonia remains a leading public health problem among under five children in the study area and higher than national averages. Domestic fuel as the energy source for cooking, cooking in the living room, overcrowding, child history of ARI, family history of ARI and acute malnutrition were predictors of pneumonia. Community-based interventions focusing on improving housing conditions, reduced use of domestic biofuels, adequate and balanced food intake, including exclusive breastfeeding of infants, and early treatment of ARIs.

The Utility of Focused Assessment With Sonography for Trauma Enhanced Physical Examination in Children With Blunt Torso Trauma.

Computed tomography (CT), the reference standard for diagnosis of intraabdominal injury (IAI), carries risk including ionizing radiation. CT-sparing clinical decision rules for children have relied heavily on physical examination, but they did not include focused assessment with sonography for trauma (FAST), which has emerged into widespread use during the past decade. We sought to determine the independent associations of physical examination, laboratory studies, and FAST with identification of IAI in children and to compare the test characteristics of these diagnostic variables. We hypothesized that FAST may add incremental utility to a physical examination alone to more accurately identify children who could forgo CT scan. We reviewed a large trauma database of all children with blunt torso trauma presenting to a freestanding pediatric emergency department during a 20-month period. We used logistic regression to evaluate the association of FAST, physical examination, and selected laboratory data with IAI in children, and we compared the test characteristics of these variables. Among 354 children, 50 (14%) had IAI. Positive FAST (odds ratio [OR]= 14.8, 95% confidence interval [CI]= 7.5 to 30.8) and positive physical examination (OR= 15.2, 95% CI= 7.7 to 31.7) were identified as independent predictors for IAI. Physical examination and FAST each had sensitivities of 74% (95% CI= 60% to 85%). Combining FAST and physical examination as FAST-enhanced physical examination (exFAST) improved sensitivity and negative predictive value (NPV) over either test alone (sensitivity= 88%, 95% CI= 76% to 96%) and NPV of 97.3% (95% CI= 94.5% to 98.7%). In children, FAST and physical examinations each predicted the identification of IAI. However, the combination of the two (exFAST) had greater sensitivity and NPV than either physical examination or FAST alone. This supports the use of exFAST in refining clinical predication rules in children with blunt torso trauma.

A child with Gradenigo syndrome presenting with meningism: a case report

BackgroundThe symptoms of meningitis which include fever, headache, photophobia and irritability along with abducens nerve palsy pose a diagnostic dilemma requiring urgent attention. Here we report how such a dilemma was methodically and sequentially resolved using anatomical knowledge supported by neuroimaging and the eventual diagnosis of Gradenigo syndrome was made.Case presentationA 6-year-old previously healthy boy from Sri Lanka presented with high grade fever, headache, photophobia and left eye pain for 10 days and diplopia for 2 days duration. Neurological examination was unremarkable except for left sided abducens nerve palsy. He had high inflammatory markers and white blood cell count. A tentative differential diagnosis of acute bacterial meningitis complicated by cerebral oedema, acute hydrocephalus or cerebral abscess was made. However, non-contrast CT brain, cerebrospinal fluid analysis and electroencephalogram were normal leading to a diagnostic dilemma. MRI brain with contrast performed 3 days later due to limited resources revealed left mastoiditis extending to petrous temporal bone confirming Gradenigo syndrome.ConclusionThis case report highlights the importance of a thorough physical examination in children presenting with unrelated neurological symptoms and signs. Unilateral abducens nerve palsy raises the suspicion of increased intracranial pressure and neuroimaging is vital in diagnostic uncertainties. Gradenigo syndrome emphasises the importance of incorporating anatomical knowledge into clinical practice.

Intestinal Surgery Contributes to Acute Cerebellar Ataxia Through Gut Brain Axis.

Introduction: Acute cerebellar ataxia (ACA) is the most common form of pediatric ataxia. Changes in gut flora can modulate the nervous system, influencing brain function via the gut-brain axis (GBA). This study aimed to illustrate the relationship between intestinal microbiota and ACA.Method: A total of 30 and 12 children were randomly sampled from history of intestinal surgery (HOIS) and no intestinal surgery groups (NHOIS), respectively. In addition, 10 healthy children who sought physical examination in Children's Hospital of Nanjing Medical University were recruited as a control group. The stool samples were 16S rRNA detected.Results: We observed that many ACA children had intestinal surgery history prior to the onset of ACA. The 16S rRNA sequencing indicated that HOIS and control groups were well-distinguished by principal component analysis. The discrepancy between HOIS and NHOIS groups were also displayed by principal component analysis score plot. However, no differences were found between NHOIS and control groups. The results of student's t-test were consistent with principal component analysis. A total of nine different genera were identified between HOIS and control groups. Five genera and a phylum showed significant differences between HOIS and NHOIS groups.Conclusion: Altered genera and phyla associated with ACA were identified. Our findings provide new insight into treating and preventing ACA.

Could digital photography be an alternative to postoperative physical examination for pediatric tonsillectomy patients?

ObjectiveTo evaluate and compare the efficacy of postoperative control with digital photographs and physical examination for children who underwent tonsillectomy? MethodsIn this prospective study, 86 children (46 boys (53.5%) and 40 girls (46.5%) were enrolled for postoperative clinical visit and for obtaining photographs of the tonsillar bed with a digital camera at clinic control. ResultsNo difference in tonsillar fossa healing was observed between the two methods 2 weeks after surgery. ConclusionsDigital photographs proved to be a safe method for postoperative control of pediatric patients who underwent tonsillectomy. Adding control with outpatient follow-up will be useful for minimizing postoperative complications.

Age-dependent Reliability of Semmes-Weinstein and 2-Point Discrimination Tests in Children.

Objective sensory testing is a critical component of the physical examination in children as they may be unable to communicate whether or not numbness is present. The purpose of this study was to determine at what age objective sensory tests could reliably be performed. Normal, uninjured participants aged 2 to 17 years were enrolled in the study. Monofilament and static/moving 2-point discrimination tests were performed bilaterally assessing the median, ulnar, and radial nerves. Performance scores were recorded using the monofilament size and 2-point discrimination distance. Statistical analysis was performed utilizing univariable linear regression, 1-way ANOVA, and Welch t test. A total of 396 hands were tested utilizing the Semmes-Weinstein monofilament and static/moving 2-point discrimination tests. For the monofilament test, 27% of 3-year-olds, 83% of 4-year-olds, and all participants 5 years of age and older were capable of performing the monofilament test. The average monofilament scores were 2.874, 2.868, and 3.043 for the ulnar, median, and radial nerves, respectively, with no correlation with advancing age present. The ulnar and median nerve distributions were more sensitive than the radial nerve distribution (P<0.001).For 2-point discrimination tests, 33% of 4-year-olds, 61% of 5-year-olds, 88% of 6-year-olds, 95% of 7- and 8-year-olds, and all participants 9 years and older were capable of performing the static/moving 2-point discrimination tests. The average static 2-point discrimination scores were 3.348, 2.806, and 9.637 mm for the ulnar, median, and radial nerves, respectively. The average moving 2-point discrimination scores were 2.977, 2.483, and 8.506 mm for the ulnar, median, and radial nerves, respectively. There was no correlation between advancing age and performance scores. Children are the most sensitive in the median, then ulnar, and then radial nerve distribution (P<0.001). Better discrimination is present between 2 moving points than static points (P<0.001). Objective threshold testing utilizing a monofilament can reliably be performed in the vast majority of children aged 4 years and above, whereas density testing utilizing 2-point discrimination can reliably be performed in the vast majority of children aged 6 years and above. Level II.

The Application of the First Year Inventory for ASD Screening in China

PurposeThe First Year Inventory (FYI) is a parent-report instrument, and is developed to assess behaviors of 12-month-old infants that could suggest risk for an eventual diagnosis of autism. This study was designed to examine the application of the FYI in the Chinese community. Design and methodsFYIs were completed at a community health center by 541 families during the child's physical examination at 12 months of age from 2013 to 2015. The weighted risk scores used in this study were based on US norms, and compared the FYI differences between China and the U.S. ResultsThe total risk scores ranged from 5 to 42 points; the 95th percentile cutoff was 27.00(9.8 points higher than the 95th percentile cutoff in the US), the 98th percentile cutoff was 29.66(7.04 points higher than the 98th percentile cutoff in the US), and the 99th percentile cutoff was 31.83. Higher risk scores were found for boys than girls. Mothers with a junior college education reported significantly higher FYI risk scores than other three groups including high school, college graduates and post-graduates. ConclusionsThere were no significant effects of birth parity, investigator, or investigation year on risk scores. Large-scale longitudinal research is encouraged in the future to develop an early detection model of autism in China.

Seroepidemiology of varicella in Hangzhou, China in the vaccine era

ABSTRACTObjective To delineate seroepidemiology of VZV in children aged 1–14 years in Hangzhou, to evaluate immunological response of VarV via 2 dose regimen immunization of VarV, for improving immunization strategy of VarV. Methods From 2014–2016, a multi-stage stratified random sampling method was employed to select participants included via physical examination for children in the Community Health Centre in Hangzhou. Results were compared among 11 various age groups: 1-,2-,3-,4-,5-,6-,7-,8-,9-,10-,11–14 years. Demographic data and vaccination history of all subjects derived from Zhejiang Information System for Immunization Program. Then, the second dose of the VarV was conducted on children aged 4–6 years who had immunization history of one dose of VarV. ELISA was used to detect VZV IgG in serum samples. Results 895 subjects with available information were included. The rate of VZV IgG seropositivity was 65.59% and the geometric mean concentration (GMC) for VZV IgG was 5.14 ± 1.89 mIU/ml. The GMC in urban subjects were higher than rural ones. Both the rate of VZV IgG seropositivity and the GMC in children aged 4–6 years groups were statistically lower than participants younger than 4 years and aged 7–14 years (1-,2-,3-,7-,8-,9-,10-,11–14 years). 627 subjects had immunization history of VarV. Both the rate of VZV IgG seropositivity and the GMC in subjects had immunization history of VarV was higher than who had no immunization history.90 subjects were included after the 2nd dose immunization of VarV. Both the rate of VZV IgG seropositivity and the GMC were significantly increased after the immunization of the 2nd dose of VarV. Conclusions The GMC for VZV IgG in children aged 4–6 years were lower than participants groups (1-,2-,3-,7-,8-,9-,10-,11–14 years).2 doses regimen immunization of VarV are effective for increasing both the rate of VZV IgG seropositivity and the GMC in these subjects.

Reliability of Examination Findings in Suspected Community-Acquired Pneumonia.

The authors of national guidelines emphasize the use of history and examination findings to diagnose community-acquired pneumonia (CAP) in outpatient children. Little is known about the interrater reliability of the physical examination in children with suspected CAP. This was a prospective cohort study of children with suspected CAP presenting to a pediatric emergency department from July 2013 to May 2016. Children aged 3 months to 18 years with lower respiratory signs or symptoms who received a chest radiograph were included. We excluded children hospitalized ≤14 days before the study visit and those with a chronic medical condition or aspiration. Two clinicians performed independent examinations and completed identical forms reporting examination findings. Interrater reliability for each finding was reported by using Fleiss' kappa (κ) for categorical variables and intraclass correlation coefficient (ICC) for continuous variables. No examination finding had substantial agreement (κ/ICC > 0.8). Two findings (retractions, wheezing) had moderate to substantial agreement (κ/ICC = 0.6-0.8). Nine findings (abdominal pain, pleuritic pain, nasal flaring, skin color, overall impression, cool extremities, tachypnea, respiratory rate, and crackles/rales) had fair to moderate agreement (κ/ICC = 0.4-0.6). Eight findings (capillary refill time, cough, rhonchi, head bobbing, behavior, grunting, general appearance, and decreased breath sounds) had poor to fair reliability (κ/ICC = 0-0.4). Only 3 examination findings had acceptable agreement, with the lower 95% confidence limit >0.4: wheezing, retractions, and respiratory rate. In this study, we found fair to moderate reliability of many findings used to diagnose CAP. Only 3 findings had acceptable levels of reliability. These findings must be considered in the clinical management and research of pediatric CAP.

O34: Case- control study to identify deviations in gait and physical examination in children and adolescents with Dravet syndrome

Quantum confinement effects in one, two, or three dimensions in solids lead to increased electronic bandgaps. Accordingly, the optical behavior of low-dimensional systems, also affected by the nature of the excitons, is completely different from that of the bulk material. This is especially true in the case of quantum dots because of confinement in all three dimensions. This chapter presents the key optical properties of systems of reduced dimensionality. Additionally, the changes induced in the optical behavior of quantum wells and superlattices by the application of electric fields will be discussed, leading to Stark ladders and Bloch oscillations.

Analysis of a Case of Child Abuse with Ethical Approach

Analysis of a Case of Child Abuse with Ethical Approach

Managing acute abdominal pain in pediatric patients: current perspectives.

Acute abdominal pain in pediatric patients has been a challenge for providers because of the nonspecific nature of symptoms and difficulty in the assessment and physical examination in children. Although most children with acute abdominal pain have self-limited benign conditions, pain may be a manifestation of an urgent surgical or medical condition where the biggest challenge is making a timely diagnosis so that appropriate treatment can be initiated without any diagnostic delays that increase morbidity. This is weighed against the need to decrease radiation exposure and avoid unnecessary operations. Across all age groups, there are numerous conditions that present with abdominal pain ranging from a very simple viral illness to a life-threatening surgical condition. It is proposed that the history, physical examination, laboratory tests, and imaging studies should initially be directed at differentiating surgical versus nonsurgical conditions both categorized as urgent versus nonurgent. The features of the history including patient’s age, physical examination focused toward serious conditions, and appropriate tests are highlighted in the context of making these differentiations. Initial testing and management is also discussed with an emphasis on making use of surgeon and radiologist consultation and the need for adequate follow-up and reevaluation of the patient.

General health status and intelligence scores of children of mothers with acromegaly do not differ from those of healthy mothers.

To determine the physical status and intelligence scores of children of acromegalic mothers and to compare them with those of children from mothers without acromegaly. Six women with acromegaly who became pregnant under follow-up between 2010 and 2014 and their 16 children (group A) were assessed and compared with 16 children of healthy women (group B) and 15 children of women with prolactinoma (group C). The physical examinations of children were performed by the department of pediatric endocrinology and intelligence quotient (IQ) testing was undertaken by adult and pediatric psychiatry departments, using appropriate scales for their ages. Six of the 16 children (girls/boys: 7/9) were born after the diagnosis of acromegaly. Five of the 6 pregnancies occured when the patients were taking somatostatin analogs, none continued taking the drugs during pregnancy. The mean IQ of groups A, B, and C were 106.4±12.5, 105.3±12.5, and 103.2±16.1 respectively (p>0.05). The mean ages, birth percentiles, recent weight and height standard deviation scores were similar between groups (p>0.05). Two siblings from group A and 1 child from group B were large for gestational age at birth. At recent follow-up, two children from group A were found tall for their age and one from group C was short for his age and was placed under the care of pediatric endocrinology clinic. Pregnancies in acromegaly seems to be uneventful and the general health status and IQ scores of children from women with and without acromegaly were found similar.

External Genital Abnormalities and Inguinal Hernia among Males of Children Nurseries, North West of Iran

Background Abnormalities of external genitalia in male children nurseries and inguinal hernia are the most common congenital disorders in children. We aimed to determine prevalence rate of inguinal hernia and other genital among children nurseries, in Shahrood-Iran. Materials and Methods In this descriptive cross-sectional study, we examined 920 children nurseries boys. Physical examination of children was performed in presence of a parent in a warm room in supine and upright position with and without Valsalva maneuver. A written consent was obtained from parents before examination. Past medical history and history of surgery on inguinal and genital area was taken. Examination was performed 2 interns who were trained about genital system examination. Results A total of 920 children nurseries boys aged 3 to 6 years were examined which were detected in 88 children and prevalence rate of these abnormalities were 9.6%. The prevalence of abnormalities in the children under study were as follows: Inguinal hernia (5.1%), cryptorchidism (2.1%), Hydrocele (1.5%), hypospadias (0.4%), Varicocele (0.1%), micropenis (0.4%). Conclusion Regarding to relatively high prevalence rate of these abnormalities and low level of people knowledge, seem screening systems for diagnosis and appropriate treatment of these abnormalities to be necessary.