35 results on '"Khaleghnejad-Tabari, Ahmad"'
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2. Pediatric Surgery Workforce Around the World: A Need to Revise Residency Programs?
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Khaleghnejad Tabari, Ahmad, Mohajerzadeh, Leily, Ebrahimian, Manoochehr, Rouzrokh, Mohsen, Jahangiri, Fariba, Rouzrokh, Saghar, Eghbali Zarch, Reyhaneh, and Ahmadi Amoli, Arian
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- 2024
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3. Study of the prevalence and associated factors of major congenital anomalies at birth in Shahreza County during 2016-2018
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Salesi, Mina, additional, Khaleghnejad Tabari, Ahmad, additional, and Maracy, Mohammad Reza, additional
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- 2023
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4. The effect of the caudal insertion angle of pedicle screws on postoperative thoracic kyphosis in adolescent idiopathic scoliosis: a pilot study.
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Karami, Mohsen, Eghbali, Ahmad, Tabari, Ahmad Khaleghnejad, Shahrbabak, Mahdi Moradi, Keyhaninejad, Nima, Khaleghnejad Tabari, Ahmad, and Moradi Shahrbabak, Mahdi
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- 2023
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5. Evaluating the Effect of Bowel Management Training Program on Quality of Life in Children with Fecal Incontinence
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Hojjati, Shiva, primary, Khanali Mojen, Leila, additional, Hosseini, Amirhossein, additional, Khaleghnejad Tabari, Ahmad, additional, Afaghi, Siamak, additional, Mohajerzadeh, Leily, additional, Rahimi, Fatemeh Sadat, additional, Shirinabadi Farahani, Azam, additional, and Ashrafizadeh, Hadis, additional
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- 2022
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6. Comparing Mathieu and Tubularized Incised-Plate Urethroplasties for Repairing Distal Penile Hypospadias: A Single-Center Experience with Long-term Outcome
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Mohajerzadeh, Leily, primary, Dooghaie Moghadam, Arash, additional, Khaleghnejad Tabari, Ahmad, additional, Rouzrokh, Mohsen, additional, and Moghimi, Nadiya, additional
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- 2021
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7. Gil-Vernet antireflux surgery in children’s primary vesicoureteral reflux
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Mirshemirani, Alireza, Khaleghnejad Tabari, Ahmad, Roshanzamir, Fatollah, and Shayeghi, Shahnaz
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- 2010
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8. Sporadic Insulinoma as a Rare Cause of Recurrent Hypoglycemia in Children
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Saneifard, Hedyeh, Khaleghnejad Tabari, Ahmad, Kazemi Aghdam, Maryam, Musavi Khorshidi, Mohadese, and Sheikhy, Ali
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endocrine system ,endocrine system diseases ,Article Subject - Abstract
Insulinoma is a rare pancreatic tumor in children and adolescents. As a result of insulin hypersecretion, signs and symptoms are more commonly consequences of the pathophysiologic responses to hypoglycemia. According to rarity of this tumor in children and nonspecificity of clinical presentations, diagnosis of insulinoma in this group of patients is usually delayed. Early diagnosis is very important for preventing neurologic damage. In this case report, we present the case of a 10-year-old boy with signs and symptoms of hypoglycemia and final diagnosis of insulinoma.
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- 2017
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9. Duckett versus Modified Bracka Technique for Proximal Hypospadias Repair A 10-Year Experience
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Sadeghi, Afsaneh, primary, Mirshemirani, Alireza, additional, Khaleghnejad Tabari, Ahmad, additional, Sadeghian, Naser, additional, Rozroukh, Mohsen, additional, Ghoroubi, Javad, additional, Mohajerzadeh, Leila, additional, and Sarafi, Mehdi, additional
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- 2017
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10. Impact of parental presence during induction of anesthesia on anxiety level among pediatric patients and their parents: a randomized clinical trial
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Sadeghi,Afsaneh, Khaleghnejad Tabari,Ahmad, Mahdavi,Alireza, Salarian,Sara, Razavi,Seyed Sajjad, Sadeghi,Afsaneh, Khaleghnejad Tabari,Ahmad, Mahdavi,Alireza, Salarian,Sara, and Razavi,Seyed Sajjad
- Abstract
Afsaneh Sadeghi, Ahmad Khaleghnejad Tabari, Alireza Mahdavi, Sara Salarian, Seyed Sajjad Razavi Department of Anesthesiology, Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Introduction: Anesthesia induction is a stressful event for children and their parents, and may have potentially harmful consequences on the patient’s physiological and mental situation. Stressful anesthesia induction has psychological adverse effects that recur with repeated anesthesia, can lead to increased pediatric discomfort during the recovery period, and may even induce reactionary postoperative behavior. A randomized controlled trial was performed to assess the impact of parental presence during induction of anesthesia (PPIA) on preoperative anxiety of pediatric patients and their parents at three different times, cooperation of child with anesthesiologist at induction of anesthesia, and parental satisfaction.Patients and methods: A total of 96 pediatric patients undergoing elective minor surgery (ASA 1–2) were randomly divided into two groups. Both groups received oral midazolam (0.5 mg/kg) at least 20 minutes before surgery, but in the PPIA group, the parents were also present in the operating room until loss of consciousness of child at anesthesia induction. Anxiety in the patients (as measured by the modified Yale Preoperative Anxiety Scale [mYPAS]) and parents (as measured by the State and Trait Anxiety Inventory [STAI]), the Induction Compliance Checklist (ICC), and parental satisfaction (as measured by visual analog scale) were assessed. Results: There was no significant difference in the mean anxiety scores (mYPAS) of participants in the control and PPIA groups at ward T0 and upon arrival to operating room T1 (P>0.05). However, between the PPIA and control groups, mean mYPAS score was different at the time of induction of anesthesia T2 (35.5±16.6 vs 59.8±22.4; P&
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- 2017
11. Outcomes of Congenital Diaphragmatic Hernia: An 8-Year Experience
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Fallahi, Minoo, primary, Mohajerzadeh, Leily, additional, Borhani, Samira, additional, Kazemian, Mohammad, additional, Roozroukh, Mohsen, additional, Khaleghnejad-Tabari, Ahmad, additional, Azma, Roxana, additional, and Mahdavi, Alireza, additional
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- 2017
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12. Impact of parental presence during induction of anesthesia on anxiety level among pediatric patients and their parents: a randomized clinical trial
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Sadeghi, Afsaneh, primary, Khaleghnejad Tabari, Ahmad, additional, Mahdavi, Alireza, additional, Salarian, Sara, additional, and Razavi, Seyed Sajjad, additional
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- 2017
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13. Congenital Rhabdomyosarcoma of Shoulder
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Khaleghnejad-Tabari, Ahmad, Mirshemirani, Alireza, Rouzrokh, Mohsen, Nariman, Shahin, Hassas-Yeganeh, Shaghayegh, Gharib, Atoosa, and Khaleghnejad-Tabari, Nasibeh
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Congenital ,Shoulder ,Rhabdomyosarcoma ,Case Report ,Newborn - Abstract
A 16-day-old female was referred with congenital swelling on her right shoulder. On examination, there was a hard, round, ecchymotic, nontender, slightly movable, warm and shiny 10x15 cm mass on the right axillary pits which was extended to the right side of neck and chest wall. The mass separated the shoulder from the chest wall causing paralysis of right hand. Chest X-ray, ultrasound and MRI with contrast demonstrated a soft tissue mass suspected to be a hemangioma. The mass rapidly increased in size despite aggressive steroid therapy with rupture and bleeding. On the 45th post natal day the baby was taken to operating room to control the bleeding and if possible total excision of the mass. The mass was separated easily from the surrounding tissue and was excised along with right upper extremity. At the end of surgery the baby had cardiac arrest, and apparently died of Disseminated Intravascular Coagulation (DIC). The final pathology report was Rhabdomyosarcoma (RMS).
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- 2012
14. Evaluation of Onlay Island Flap Technique in Shallow Urethral Plate Hypospadiasis
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Mohajerzadeh, Leily, primary, Mirshemirani, Alireza, additional, Rouzrokh, Mohsen, additional, Sadeghian, Naser, additional, Khaleghnejad-Tabari, Ahmad, additional, Mahdavi, Alireza, additional, and Poorhasan, Sareh, additional
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- 2016
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15. Comparison Between Swenson and Soave Pull-Through in Hirschprung Disease
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Mohajerzadeh, Leily, primary, Khaleghnejad Tabari, Ahmad, additional, Rouzrokh, Mohsen, additional, Mirshemirani, Ali Reza, additional, Sadeghian, Naser, additional, Ghoroubi, Javad, additional, Roshanzamir, Fathollah, additional, Mahdavi, Ali Reza, additional, and Gilaki, Zahra, additional
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- 2015
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16. Complete colonic duplication in children
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Khaleghnejad Tabari, Ahmad, Mirshemirani, Alireza, and Khaleghnejad Tabari, Nasibeh
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Case Report ,digestive system diseases - Abstract
Background: Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics.
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- 2012
17. Outcomes of Second Look Exploration in Testicular Torsion of Children
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Rouzrokh, Mohsen, primary, Mirshemirani, Alireza, additional, and Khaleghnejad-Tabari, Ahmad, additional
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- 2015
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18. Laparoscopic Appendectomy in Complicated Appendicitis of Children
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Mohajerzadeh, Leily, primary, Rouzrokh, Mohsen, additional, Khaleghnejad Tabari, Ahmad, additional, Mirshemirani, Alireza, additional, Atqiaee, khashayar, additional, and Dara, Naghi, additional
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- 2014
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19. Pediatric Germ Cell Tumors; A 10-year Experience.
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Khaleghnejad-Tabari, Ahmad, Mirshemirani, Alireza, Rouzrokh, Mohsen, Mohajerzadeh, Leily, Khaleghnejad-Tabari, Nasibeh, and Hasas-Yeganeh, Shaghayegh
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OVARIAN tumors , *TERATOMA , *TESTIS tumors , *EVALUATION of medical care , *PEDIATRICS , *SERIAL publications , *SURVIVAL , *TUMOR classification , *DATA analysis , *RETROSPECTIVE studies , *DATA analysis software , *KAPLAN-Meier estimator , *DIAGNOSIS , *GERMINOMA , *THERAPEUTICS - Abstract
Objective: The aim of this study was to evaluate the outcome of germ cell tumors in patients admitted to our center during a ten year period. Methods: In a retrospective descriptive study, patients with the pathological diagnosis of germ cell tumor (GCT) were included. All records were evaluated and patients followed by personal visit in clinic or phone call. Data regarding age, sex, tumor site, bio-chemical assay, pathology, treatment and outcomes were gathered. For qualitative variables we computed frequency and percentage and for quantitative variables, mean and standard deviation. Survival analysis was performed using Kaplan-Meier. All statistical analyses were performed by SPSS version16.0. Findings: Forty four patients consisted of 32 girls (72.7%) and 12 boys (27.3%). Their median age was 23 months. The most common pathological tumor types were 18 (40.9%) mature teratomas and 14 (31.8%) yolk sac tumors. Extra gonadal tumors were more prevalent (32 cases) and consisted of 21 (47.7%) sacrcoccygeal, 7 (15.9%) retroperitoneal, 2 (4.4%) mediastinal and 2 (4.4%) cervical tumors. In gonadal tumors 9 patients had ovarian and 3 patients testicular involvement. Staging at the time of diagnosis revealed stage one in 23 (52.3%) cases. All patients were treated surgically and the most common procedure was total resection in 41 (93.2%) patients. Fifteen (34.1%) patients received chemotherapy. In follow-up 31 (77.5%) patients were in complete remission, 9 (22.5%) had died, and 4 cases did not appear to follow-up visits. The median survival was 16 months (IQR 4-49 months). The highest mortality rate was found in patients with yolk sac tumors (8 of 13 cases). Conclusion: The patients with extra-gonadal GCT and a high AFP level have the worst prognosis and lower survival rate. Combination of surgery and chemotherapy can lead to a better prognosis. [ABSTRACT FROM AUTHOR]
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- 2014
20. Protective Temporary Vesicostomy for Upper Urinary Tract Problems in Children: A Five-Year Experience.
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Rouzrokh, Mohsen, Mirshemirani, Alireza, Khaleghnejad-Tabari, Ahmad, Sadeghian, Naser, Mohajerzadeh, Leily, and Mohkam, Maesomeh
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BLADDER diseases ,CYSTOSTOMY ,QUESTIONNAIRES ,RESEARCH funding ,SCALE analysis (Psychology) ,URINARY tract infections ,URINATION disorders ,VESICO-ureteral reflux ,RETROSPECTIVE studies ,DISEASE complications - Abstract
Objective: Temporary vesicostomy is a urinary diversion procedure for patients with upper urinary tract (UUT) dilatation, secondary to bladder outlet obstruction or dysfunction. The aim of this study was to evaluate our experience in children undergoing such diversion, analyzing its efficacy to prevent urinary tract infection (UTI), improve or resolve hydronephrosis, stabilize or improve kidney function and restore the health of UUT. Methods: In this retrospective study, patients who had vesicostomy by Blocksom technique due to bladder outlet obstruction or dysfunction were evaluated in Mofid Children's Hospital (in Tehran) from March 2007 to March 2012. The reason for applying this procedure was failure in clinical treatment. Data regarding gender, age, diagnosis, time of any surgical intervention, associated anomalies, primary/secondary complications and mortality were collected using a questionnaire, and evaluated by giving a grade that ranged from 0 (worst) to 10 (best) based on Lickert's scale. Findings: From a total number of 53 patients, (88.7% male and 11.3% female) with a mean age of 225 days, 66% had posterior urethral valve and 16 (30%) neurogenic bladder. UTI was present in all cases, hydronephrosis in 52 (98.1%), and vesico-ureteral reflux only in 45 (84.9%) patients. Valve ablation was performed in 17 cases, and clean intermittent catheterization in14 patients which were unsuccessful. We performed vesicostomy in all patients. Mortality rate was 7.5%. Vesicostomy was closed in 35 patients. Cure rate was 85% in UTI, 82.7% in hydronephrosis, 80% in VUR, and 86.5% in kidney function. Conclusion: Vesicostomy is a simple procedure that protects upper urinary tract, decreases hydronephrosis, and improves kidney function. The procedure is well tolerated and reversible, with less complication and should be considered in children in whom conservative and medical treatment has failed. [ABSTRACT FROM AUTHOR]
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- 2013
21. Clinical Evaluation of Disc Battery Ingestion in Children.
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Mirshemirani, AliReza, Khaleghnejad-tabari, Ahmad, Kouranloo, Jaefar, Sadeghian, Naser, Rouzrokh, Mohsen, Roshanzamir, Fatolah, Razavi, Sajad, Sayary, AliAkbar, and Imanzadeh, Farid
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DIAGNOSTIC imaging , *ELECTRIC power supplies to apparatus , *ENDOSCOPY , *FOREIGN bodies , *INGESTION , *RETROSPECTIVE studies - Abstract
BACKGROUND The purpose of this study was to evaluate the characteristics, management, and outcomes of disc battery ingestion in children. METHODS We reviewed the medical records of children admitted to Mofid Children's Hospital due to disc battery ingestion from January 2006 to January 2010. Clear history, clinical symptoms and results of imaging studies revealed diagnosis of disc battery ingestion in suspected patients. The clinical data reviewed included age, gender, clinical manifestation, radiologic findings, location of disc battery, duration of ingestion, endoscopic results and surgical treatment. RESULTS We found 22 cases (11 males and 11 females) of disc battery ingestion with a mean age of 4.3 years (range: 9 months to 12 years). Common symptoms were vomiting, cough, dysphagia, and dyspnea. The mean duration of ingestion was 2.7 days (4 hours to 1.5 months). A total of 19 patients had histories of disc battery ingestion, but three cases referred with the above symptoms, and the batteries were accidentally found by x-ray. Only three cases had batteries impacted in the esophagus. Twelve batteries were removed endoscopically, 6 batteries spontaneously passed through the gastrointestinal (GI) tract within 5 to 7 days, and 4 patients underwent surgery due to complications: 3 due to tracheo-esophageal fistula (TEF) and 1 due to intestinal perforation. There was no mortality in our study. CONCLUSION Most cases of disc battery ingestion run uneventful courses, but some may be complicated. If the battery lodges in the esophagus, emergency endoscopic management is necessary. However, once in the stomach, it will usually pass through the GI tract. [ABSTRACT FROM AUTHOR]
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- 2012
22. Can We Rely on Frozen Sections of a Rectal Biopsy for One-stage Trans-anal Pull-through Operation in Hirschsprung's Disease?
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Rouzrokh, Mohsen, Jadali, Farzaneh, Gharib, Atoosa, Khaleghnejad-Tabari, Ahmad, Tavassoli, Azita, and Mohajerzadeh, Leily
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BIOPSY ,COMPUTER software ,FROZEN tissue sections ,HIRSCHSPRUNG'S disease ,RESEARCH methodology ,RECTUM ,DATA analysis - Abstract
Objective: Successful results after one-stage trans-anal pull-through (OSTAPT) operation for Hirschsprung's disease (HD) depend on accurate identification of the aganglionic segment in intraoperative frozen section (FS). Misinterpretation of the findings of the rectal biopsy is an anxiety- evoking pitfall for the surgeon. This study aims to describe our experiences in comparing results of FS and permanent Section (PS) rectal biopsies in children with HD who were candidates for OSTAPT in a single-step operation. Methods: Subjects under the age of 14 years, admitted from March 2000 to July 2008 in a university-affiliated children's hospital for open rectal biopsy to diagnose HD were included in the study. Ml biopsies were taken 2-3 cm above the dentate line. 210 specimens of full-thickness rectal biopsy were obtained for both frozen section and permanent biopsy from all patients^ examined by two well experienced pédiatrie pathologists for ascertaining the presence of ganglion cells, and the results were compared. Analysis was performed by SPSS Software version 11.5. Findings: Two-hundred one infants and children underwent FS rectal biopsy to exclude HD. Positive results were seen in 63.8% of the specimens examined as PS and in 58.3% of FS samples. 93.9% of positive results in FS studies were confirmed by PS studies. 6.1% of FS reports were false positive and 21,7% were false negative (P<0.001). The sensitivity of FS was 85.8% and specificity 90.2%. Positive predictive value (PPV) was 93.9% and negative predictive value (NPV) was 78.3% in FS studies (P<0.001). The accuracy of FS was 80.4%. Conclusion: Although FS of the rectal biopsy is useful in defining the aganglionic segment during operation, according to this study, it cannot be used as the sole base fer perfetntingprfftiary pull» through operation before the results ofthe permanent sectionare önfcand, [ABSTRACT FROM AUTHOR]
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- 2011
23. Early Exploration in the Management of Acute Scrotum in Children.
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Khaleghnejad-Tabari, Ahmad, Mirshermirani, Alireza, Rouzrokh, Mohsen, Mahmudi, Morteza, Baghaiepour, Mohamad-Reza, Ghaffari, Parand, and Hatamian, Bijan
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GENITOURINARY diseases , *ANALYSIS of variance , *EPIDIDYMIS , *INFLAMMATION , *ORCHITIS , *RESEARCH funding , *SCROTUM , *SPERMATIC cord torsion , *SURGICAL complications , *THERAPEUTICS - Abstract
Objective: Acute scrotal conditions are a common clinical setting that present with pain and swelling of the hemiscrotum. The aim of our study has been to evaluate the findings in boys operated on acute scrotum. Methods: A descriptive study was conducted on 100 patients with acute scrotum admitted to Mofid Children's Hospital from March 1993 to March 2007. Data included history, age, primary symptoms, definite diagnosis, side involvement, paraclinical tests, imaging modalities, medical or surgical management and type of the surgery. Findings: Diagnosis was made mainly by clinical signs and symptoms and surgical exploration. Torsion of testis (n=31) was the most common cause of acute scrotum followed by incarcerated inguinal hernia (n=30), torsion of testicular appendage (n=27), epididymo-orchitis (n=7), idiopathic scrotal edema (n=4) and hematocele (n=1). Most (34%) of the patients were in the first year of life and the mean age was 5.4 years. The commonest signs were pain and swelling (62%) followed by pain, swelling and redness (21%) and pain alone (16%). 83 patients consisting of 31 with torsion of testis, 14 with torsion of testicular appendage, 30 with incarcerated hernia and 7 with epididymo-orchitis underwent surgical exploration after careful physical examination. 10 of 31 patients with torsion of testis had orchiectomy and orchiopexy of contra-lateral testis and the rest had detorsion and bilateral orchiopexy. 80% of patients were referred to the hospital after 12 hours of clinical onset of symptoms. Conclusion: Early exploration of scrotum based on careful physical examination excludes the risk of misdiagnosis by diagnostic procedures and unnecessary delay by diagnostic techniques. Exploration of scrotum is a relatively safe and simple procedure with good cosmetic results, it also allows an accurate diagnosis to be made. [ABSTRACT FROM AUTHOR]
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- 2010
24. Treatment of Bilateral Macrostomia (Lateral Lip Cleft): Case Report.
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Khaleghnejad-Tabari, Ahmad, Salem, Katayoun, and Ghajar, Masoud Fallahinejad
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FACIAL abnormalities , *CLEFT lip , *THERAPEUTICS ,FACIAL bone abnormalities - Abstract
Background: Macrostomia as a rare facial deformity is classified among facial clefts. It originates from failure in union of maxillary and mandibular prominences of first brachial arch during 7th embryonic week. Case Presentation: We report a case of bilateral macrostomia (bilateral lip cleft) in a female newborn as a sole entity without other skeletal and facial deformities. The cleft was repaired by a simple linear triangular flap using extra oral landmarks to locate lip commissures. Patient was followed through a six-month period. Acceptable results were gained in mouth appearance as well functional aspects. Conclusion: Commissural repair through a linear flap can result in minimal visible scar with satisfying results in both esthetics and functional aspects. [ABSTRACT FROM AUTHOR]
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- 2012
25. The effect of the caudal insertion angle of pedicle screws on postoperative thoracic kyphosis in adolescent idiopathic scoliosis: a pilot study.
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Karami M, Eghbali A, Khaleghnejad Tabari A, Moradi Shahrbabak M, and Keyhaninejad N
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- Humans, Adolescent, Pilot Projects, Thoracic Vertebrae diagnostic imaging, Thoracic Vertebrae surgery, Retrospective Studies, Scoliosis diagnostic imaging, Scoliosis surgery, Lordosis diagnostic imaging, Lordosis surgery, Pedicle Screws, Spinal Fusion, Kyphosis diagnostic imaging, Kyphosis etiology, Kyphosis surgery
- Abstract
The study was a prospective analysis of collected data to compare the effect of the insertion angle (parallel or oblique relative to the upper-end plates) of thoracic pedicle screws on postoperative thoracic kyphosis in patients with idiopathic thoracic scoliosis. This study was conducted on idiopathic adolescent scoliosis (AIS) patients. Two groups of patients were defined according to the insertion angle of thoracic pedicle screws in relation to the upper-end plate of the corresponding vertebra, the insertion angles being either oblique or parallel. Seven consecutive AIS patients were compared in each group. Pre- and postoperative standing X-rays were obtained. Cobb's angles, sagittal parameters such as thoracic kyphosis (TK) (T1-T12) and lumbar lordosis (LL) (L1-S1) were all measured. The average of the main curve or compensatory curve corrections showed no significant differences between the two groups. From a sagittal profile perspective, the mean TK in the oblique screw group was 39.3 ± 11.5 preoperatively, which was reduced to 30.9 ± 6.41 after surgery. The mean TK in the parallel group was 36.4 ± 14 preoperatively and 42.1 ± 13.9 postoperatively. There was a significant reduction in TK in the oblique screws group compared with the second group ( P = 0.038). The insertion angle of pedicle screws had no significant effect on Cobb's angle and lumbar lordosis changes. However, oblique insertion of thoracic screws decreased thoracic kyphosis postoperatively, which could be considered a negative point. As such, the insertion of thoracic screws in a caudal direction should not be routinely used because of its lordogenic effect., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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26. Types and frequency of ovarian masses in children over a 10-year period.
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Sadeghian N, Sadeghian I, Mirshemirani A, Khaleghnejad Tabari A, Ghoroubi J, Abdollah Gorji F, and Roushanzamir F
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Background: Ovarian masses represent a range of pathology from benign cyst to highly aggressive malignant tumors. It has been estimated that gynecologic malignancy account for approximately 2% of all types of cancer in children, 60-70% of these lesions arise in the ovary., Methods: All ovarian masses which were resected or biopsied in Mofid Children's Hospital from 2002 to 2012 were reviewed retrospectively. Patient's age, presenting symptoms, surgical procedures, pathological diagnosis, postoperative treatment, and outcome were obtained from medical records., Results: Fifty-seven girls (aged 40.2±57months with the range of 1 day to 15 years) underwent different types of ovarian operations (24 salpingo-oophorectomies, 10 oophorectomies, 21 ovarian cystectomies, and 2 ovarian biopsies). 50 children had unilateral ovarian mass (49.1% right and 38.6 left, respectively). The most common presenting symptoms were acute abdominal pain in 46%.Twenty one (37%) of our patients had ovarian torsion. Four (7%) patients had benign tumors, and 8 (14%) had malignant tumors. There were no age differences between those with benign type (8.2±2.6years) and malignant tumors (6.1±5.3years) (P=0.683)., Conclusion: Ovarian tumors are rare in children. Most are benign, in children presenting with acute abdominal pain, ovarian mass particularly neoplastic tumors should be suspected. An important proportion of these patients may require postoperative chemotherapy.
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- 2015
27. Ileocecal patch -low rectal anastomosis in total colectomy: New idea for the prevention of fecal incontinence.
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Mehrabi V, Mohajerzadeh L, Mirshemirani A, Khaleghnejad Tabari A, Falahi A, Abtahi S, and Kafaei M
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Background: Total colectomy is used in children with total colonic aganglionosis, Ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The purpose of this study was to maintain ileocecal valve and rectal-sparing surgery for the prevention of fecal incontinence in these children., Methods: From1990 to 2011, 14 children with diagnosis of UC, FAP and Hirschsprung's disease were operated. Total colectomy was done with the preservation of patch of cecum with ileocecal valve and half of the rectum with ileocecorectal anastomosis. Distal ileum designed as S shape pouch and ileocecal valve were preserved. In Hirschsprung's disease, posterior rectal myotomy was established. The data were collected and analyzed., Results: The mean age of the patients was 54 months (ranged from 2 months to 18 years). Ten patients were male. Among 14 patients, Hirschsprung's disease, ulcerative colitis and FAP were seen in 10, 3, and one case, respectively. They were followed up annually. Clinical and endoscopic examinations were performed to evaluate the function of ileocecorectal anastomosis. They followed from 2 to 24 years. At first year, the patients experienced four to six bowel movements during the day and one at night. This frequency decreased over time. The main postoperative complications included recurrent enterocolitis (n=2), perianal fistula (n=2). Only 2 patients were suffering from some degree of fecal soiling., Conclusion: The results show that the Ileocecal patch- low rectal anastomosis in total colectomy leads to low complications and prevent fecal frequency and incontinence. It also increases absorptive function of ileum in children.
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- 2014
28. State's pull-through for total colonic aganglionosis and GI dismotility.
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Khaleghnejad Tabari A, Foroutan H, Banani A, Mohajerzadeh L, Ruozrokh M, and Mirshemirani A
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- Anastomosis, Surgical methods, Child, Child, Preschool, Female, Humans, Ileostomy methods, Infant, Postoperative Complications, Retrospective Studies, Treatment Outcome, Colectomy methods, Digestive System Surgical Procedures methods, Hirschsprung Disease surgery, Rectum surgery
- Abstract
Background: Total colonic aganglionosis (TCA) is present in 4% - 5% of the patients with Hirschsprung's disease and has a high surgical mortality rate between 13% - 23%. Diagnosis and treatment of TCA is still a major challenge for pediatric surgeons. Many techniques with several advantages and disadvantages were established for its treatment. We have performed State's pull-through as total colectomy and ileo-proctostomy with long posterior rectal myotomy in TCA and severe dysmotility disorders., Methods: In this retrospective study, 13 patients with TCA were evaluated from 1992 through 2012 in two pediatric surgery centers, which consisted of 10 TCA, one intestinal neuronal dysplasia (IND), and two chronic intestinal pseudo- obstruction syndrome (CIP). All patients underwent total colectomy, resection of part of the involved small intestine, and rectal anastomosis in one layer with 4/0 vicryl with long posterior rectal myotomy. All patients had preoperative barium enema and rectal biopsy for diagnosis. Leveling ileostomy was performed in 12 patients and mid-jejunostomy in one patient. In two of 13 children, proximal diverting loop ileostomy was established after definitive operation. In three patients, trans-rectal myotomy was needed two weeks after the initial operation., Results: All patients were females with the age ranging from six months to six years. State's pull-through was carried out for all (the mean age of definitive procedure was 5.1 months). Rectal biopsy of 10 patients reported no ganglion cells of which one had extended aganglionosis to mid- jejunum, one had IND, and two had ganglionicbowel bowel with clinical presentation of CIP. The follow- up period was from six months to 10 years (the mean follow- up period was 10 months). There were no significant complications in 12 patients except episodes of diarrhea and severe dehydration which needed hospitalization. One patient with mid- jejunum aganglionosis had severe failure to thrive and needed repeated hospitalization for parenteral nutrition. All patients had acceptable bowel function following operation (two to six times a day). Now, five of the 13 patients are above the age of toilet training, having voluntary bowel movement with little or no medication (Leopromid)., Conclusion: State's pull-through is recommended in all cases of TCA and severe dysmotility problems of the colon. This technique is less difficult to perform, and avoids the complications and disadvantages of removal of the rectum and has satisfactory results.
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- 2013
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29. Complete colonic duplication in children.
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Khaleghnejad Tabari A, Mirshemirani A, and Khaleghnejad Tabari N
- Abstract
Background: Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics., Case Presentation: We present two patients with complete colonic duplication with different types and presentations. Case 1: A 2- year old boy presented to the clinic with abdominal protrusion, difficulty to defecate, chronic constipation and mucosal prolaps covered bulging (rectocele) since he was 6 months old. The patient had palpable pelvic mass with doughy consistency. Rectal exam confirmed perirectal mass with soft consistency. The patient underwent a surgical operation that had total tubular colorectal duplication with one blind end and was treated with simple fenestration of distal end, and was discharged without complication. After two years follow up, he had normal defecation and good weight gain. Case 2: A 2 -day old infant was referred with imperforate anus and complete duplication of recto-sigmoid colon, diphallus, double bladder, and hypospadiasis. After clinical and paraclinical investigations, he underwent operations in several stages in different periods, and was discharged without complications. After four years follow up, he led a normal life., Conclusion: The patients with complete duplication have to be examined carefully because of the high incidence of other systemic anomalies. Treatment includes simple resection of distal common wall, fenestration, and repair other associated anomalies.
- Published
- 2012
30. Survey on childhood solid malignant tumors in cases admitted to mofid pediatric hospital from 1996-2010: a single-center study.
- Author
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Jadali F, Aghayan Golkashani H, Habibi G, Rouzrokh M, Abdollah Gorji F, Dini F, Khodami M, Nilipour Y, Khaleghnejad Tabari A, and Sadeghian N
- Abstract
Background: As children comprise a considerable proportion of our population, the importance of local epidemiologic research and geographic and racial differences can't be disputed on childhood malignancies., Methods: In this descriptive retrospective study, we extensively reviewed the medical records of patients younger than 15 years of age, diagnosed with solid malignant tumors, from 1996 to 2010, using the last version of International Classification of Childhood Cancers., Results: In our study the order of incidence of solid malignancies was relatively similar to the other national studies, with lymphomas and Central Nervous System (CNS) tumors as the most common, followed by Sympathetic Nervous System (SNS) tumors, soft tissue sarcomas and renal tumors. The peak age of diagnosis was between 1 and 4 years old. In our study, the overall male to female ratio was 1.38, with a trend towards male dominance in the older age groups. We also observed a disturbing trend of childhood solid malignancies. The total number of cases almost doubled from 2009(54(6.9%)) to 2010(96(12.2%)) .This trend was particularly detected in CNS and SNS tumors. Further analysis showed that malignant CNS tumors had played a more pronounced role in this change., Conclusion: Changes in trends of some tumor categories have illustrated a desperate need to further research in regional and national levels. Also the gathered data can be used to make more accurate programs for a better control of cancer and to help policymakers to allocate more evidence-based resource for hospitals.
- Published
- 2012
31. Tracheoesophageal fistula following disc battery ingestion and foreign body impaction.
- Author
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Khaleghnejad Tabari A, Mirshemirani A, Rouzrokh M, Seyyedi J, Khaleghnejad Tabari N, Razavi S, and Talebian M
- Abstract
Background: Ingestion of foreign bodies may result in the formation of a tracheoesophageal fistula (TEF), which causes severe morbidity in children. We describe four cases of TEF, who underwent emergent surgery for repair., Case Presentation: In this report, we present about four patients aged between 9 months to 2.5 years, who referred due to disc battery ingestion. There were two boys and two girls. The common symptoms were cough, cyanosis, and dysphagia, choking and vomiting. The diagnosis was performed through an x-ray, barium swallow and CT Scan. All batteries were impacted in the esophagus, two in upper, one in the middle, and one in lower esophagus position. All disc batteries were removed endoscopically, but had tracheoesophageal fistula (TEF). All the patients underwent TEF repaired surgically. There was no morbidity in four patients, but one patient developed moderate esophageal stenosis, which was repaired by staged dilatation. There was no mortality in our cases., Conclusion: Long-term impaction of foreign bodies may result in tracheoesophageal fistula. This complication may be seen earlier with alkaline disc batteries. Removal of these foreign bodies should be followed carefully for the diagnosis and treatment of these fistulas.
- Published
- 2011
32. Assessment of the Analgesic Effects of Extrapleural Infusion of Ropivacaine in Neonates with Esophageal Atresia (EA) Repair.
- Author
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Rouzrokh M, Mirkheshti A, Mirshemirani A, Sadeghi A, Tavassoli A, and Khaleghnejad Tabari A
- Abstract
Insufficient control of post-thoracotomy pain can produce breathing dysfunction and long term staying in neonatal intensive care unit (NICU). It can increase the incidence of pulmonary complications such as atelectasis, pneumonia and respiratory failure. The aim of this study was to determine the analgesic effect of continuous extrapleural nerve block, using ropivacaine, in neonates younger than 7 days old with esophageal atersia (EA) and the incidence of atelectasis and duration of hospitalization in NICU. For this purpose, from February 2007 till January 2009 in Mofid children's hospital, 68 neonates under 7 days old whom were candidate for thoracotomy due to esophageal atresia were, randomly divided into two groups in a controlled clinical trial. The cases received extrapleural infusion of ropivacaine 0.5% (0.1 mL/kg/h for 48 h) and controls received acetaminophen 20 mg/kg three times a day via the rectal route. Hemodynamically unstable patients and those who suffered from hospital infections were excluded from the study. After the surgery, all patients had spontaneous breathing without endotracheal tube and stable hemodynamic in NICU. Pain level was determined for each neonate, based on the neonatal infant pain scale (NIPS) grading. The incidence of atelectasis in the first 48 h after operation and throughout the NICU staying were also determined. Results showed that there were no significant difference in the mean age, sex proportions and mean weight between the two groups. The mean pain score in the group received ropivacaine (1.9 ± 0.7) was significantly less than the control group (5.2 ± 0.6) (p < 0.001). Five percent of cases (n = 1) and 100% of the control group (n=20) had pain scores equal or greater than 3 (p < 0.001). The incidence of atelectasis among cases was less than the control group (35% vs. 65% respectively; p = 0.58). Duration of hospitalization in the case group (12 ± 5.6 days) had no significant difference from the control group (13.6 ± 4.8 days) (p = 0.3) In conclusion, the results showed that continuous extrapleural infusion of ropivacaine reduces the pain noticeably and atelectasis relatively, after thoracotomy in neonates younger than 7 days suffering from EA, compared to the acetaminophen group.
- Published
- 2010
33. Totally implantable subpectoral vs. subcutaneous port systems in children with malignant diseases.
- Author
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Rouzrokh M, Shamsian BS, KhaleghNejad Tabari A, Mahmoodi M, Kouranlo J, Manafzadeh G, Arzanian MT, Fallah F, Anoush M, and Abdollah Gorji F
- Subjects
- Adolescent, Catheterization, Central Venous adverse effects, Child, Child, Preschool, Female, Humans, Infant, Male, Necrosis, Skin pathology, Catheterization, Central Venous methods, Neoplasms drug therapy
- Abstract
Background: For many years, subcutaneous therapeutic port system was known as a major route to access central veins. However, significant complications have been reported through recent years. One of the most important complications of subcutaneous port implantation is skin necrosis. In order to decrease this complication, we would like to introduce subpectoral fascia port implantation through this study., Methods: Five hundred and twenty four patients with a variety of neoplastic diseases underwent port implantation, from March 2003 to March 2008 (60 months). All suitable size catheters were put in the superior vena cava through the internal jugular vein under general anesthesia. The ports were placed in the subcutaneous pocket (SCP group) in 342 patients and in the subpectoral fascia pocket (SPFP group) in 182 patients. Data were analyzed using Chi-square test and survival analysis for time (Kaplan-Meier)., Results: A total of 538 devices were placed for 524 patients in two groups (14 patients received a second device after removal of the first one, due to failure of the first implantation). Mean follow-up period was 508 days (8 - 2025 days).Common complications observed in the SPFP group were as follows: wound infection (7 cases, 3.8%), catheter obstruction (7 cases, 3.8%), catheter displacement (6 cases, 3.2%), port related infection (5 cases, 2.7%), and pocket hematoma (2 cases, 1.1%).Common complications observed in the SCP group were as follows: catheter displacement (12 cases, 3.5%), skin necrosis (11 cases, 3.21%), port exposure (9 cases, 2.6%), port related infection (8 cases, 2.3%), catheter obstruction (8 cases, 2.3%), and port rotation (3 cases, 0.9%)., Conclusion: The results showed that port implantation in the subpectoral fascia pocket had a lower rate of skin complications than the subcutaneous pocket implantation. According to this study, this procedure was not complicated by skin necrosis over the port, port exposure or port rotation.
- Published
- 2009
34. Wilms' tumor: a 10 year retrospective study.
- Author
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Seyed-Ahadi MM, Khaleghnejad-Tabari A, Mirshemirani A, Sadeghian N, and Amonollahi O
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- Biopsy, Child, Child, Preschool, Combined Modality Therapy, Disease-Free Survival, Female, Follow-Up Studies, Humans, Infant, Iran epidemiology, Male, Neoplasm Staging, Prognosis, Retrospective Studies, Severity of Illness Index, Survival Rate trends, Time Factors, Tomography, X-Ray Computed, Kidney Neoplasms diagnosis, Kidney Neoplasms mortality, Kidney Neoplasms therapy, Wilms Tumor diagnosis, Wilms Tumor mortality, Wilms Tumor therapy
- Abstract
Background: Wilms' tumor (nephroblastoma) is the most common renal malignancy of childhood. The aim of the study was to evaluate the characteristics of Wilms' tumor and the results of combined modality treatment obtained in our center in Tehran., Methods: Fifty-five patients diagnosed as having Wilms' tumor were studied in the period between February 1992 and March 2002. Demographic features, mode of presentation, associated anomalies, the stage of tumor, histopathologic results, and the survival rates were evaluated., Results: Of these 55 patients, 31 were males and 24 were females (M/F = 1.2). The mean age at the time of diagnosis was 45.2 months. The distribution of 54 operated patients according to the surgical stage was: stage I 32.7%, stage II 16.36%, stage III 38.1%, stage IV 9%, and stage V 1.8% (one patient (1.8%) has not been operated). Favorable histology was diagnosed in 54.5% and unfavorable histology in 43.6% of the patients. The patients were treated according to National Wilms' Tumor Study protocols. The relapse-free and overall 4 years survival rates were 71% and 86%, respectively., Conclusion: As a developing country, with similar relapse free and overall survival rates to National Wilms' Tumor Study, our institution showed an improvement in the treatment of patients with Wilms' tumor in recent 10 years, but with more adaptation to the National Wilms' Tumor Study treatment protocols better optimum results seem to be achievable.
- Published
- 2007
- Full Text
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35. Generalized myelolipoma.
- Author
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Arzanian MT, Khaleghnejad-Tabari A, Shamsian BS, Jadali F, Gharib A, and Esfahani H
- Subjects
- Child, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Abdominal Neoplasms diagnosis, Adrenal Gland Neoplasms diagnosis, Myelolipoma diagnosis, Orbital Neoplasms diagnosis, Thoracic Neoplasms diagnosis
- Abstract
Myelolipoma is a benign tumor originating from hematopoietic and adipose tissue. This tumor usually develops in the adrenal gland, but rare presentations of extraadrenal myelolipoma are also reported, which usually arise from the presacral region. Herein, we present a 6-year-old girl with myelolipoma with generalized involvement of her abdomen, pelvis, chest, and retroorbital region.
- Published
- 2006
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