ABDOMINAL mass is one of the commonest clinical findings in children. The purpose of this study was to evaluate ABDOMINAL masses in different age groups in a referral children surgical center. We retrospectively reviewed records of 325 patients (57% boys, mean age 37.7 monts) admitted to Amir Kabir hospital in a period of 12 years for ABDOMINAL mass surgery. The 4 most common ABDOMINAL masses was Wilm's tumor(22.4%), ABDOMINAL lymphoma(13.5%), neuroblastoma (12.5%) and hydronephrosis (12.3% ).These masses composed 60% of ABDOMINAL masses and the remaining were: hydatid cyst of liver, ovarian masses, liver masses, choledochal cyst. mesentary and omental cyst, etc.This results were found to be similar with little differents to results of other centers.

The following article aims to provide contemporary information on therapeutic nuclear medicine. Neuroblastoma is the most common MALIGNANCIES among PEDIATRIC MALIGNANCIES. PEDIATRIC extra cranial solid cancer characterized by meta-iodobenzylguanidine (MIBG) avidity in=>90% of patients. There exists approximately a 30-year experience with I-131-MIBG treatment. Neuroendocrine tumors (NETs) are very rare neoplasms in the paediatric population accounting for<1% of all PEDIATRIC MALIGNANCIES. These neoplasms are characterized by the presence of neuroamine uptake mechanisms and/or peptide receptors at the cell membrane. These features constitute the basis of the clinical use of peptide receptor In radionuclide therapy (PRRNT) using radiolabeled somatostatin analogues. Patients with chemoresistant CNS acute lymphoblastic leukemia (ALL) require carniospinal radiotherapy which is assossiated with major toxicities including growth and learning disorders in young children. Radioimmunotherapy with I131-labeled anti-CD10 and anti-CD19 mAbs administered intrathechally is associated with clearing of the cerebrospinal fluid lymphoblasts. Osteosarcoma is the most common primary bone tumor in children usually treated with chemotherapy and surgery. In palliative situations bone seeking radionuclide therapies (strontium-89 [Sr-89], rhenium-186 hydroxyethylene diphosphonate [Rh-186 HEDP] and Samarium-153-ethylene diamine tetramethylene phosphonic acid [Sm-153-EDTMP]) may be offered to patients with painful metastatic osteosarcoma or in case of recurrent bone sites inaccessible to local therapies (surgery, external irradiation). Thyroid cancer is a rare childhood malignancy but is the most frequent tumor of endocrine glands in children and adolescents. Management includes radioiodine therapy, but there are some distinct differences in comparison to adult thyroid cancer management.

The management of children with major ABDOMINAL injuries has changed significantly over the past 2 decades. Few surgeons have extensive experience with massive ABDOMINAL solid organ injury requiring immediate surgery. Prompt identification of potentially life-threatening intraABDOMINAL injuries with rapid resuscitation and therapeutic intervention is now possible in the overwhelming majority of children. CT has become the standard of care in the evaluation of the PEDIATRIC trauma patient. Modern generation CT scanners are highly sensitive in the evaluation of possible solid organ and retroperitoneal injuries. There must be a high index of suspicion for a hollow viscus injury in the child with free intraperitoneal fluid and no identifiable solid organ injury on CT. Clinician-performed sonography for the early evaluation of the injured child has been shown to be useful in many situations but does have limitations. A negative FAST exam does not exclude a significant solid organ or hollow viscus injury. The ready availability of high-resolution CT scanners and the nonoperative management of many PEDIATRIC injury patterns have increased, thus minimizing the utility of DPL. The use of laparoscopy for the injured child may have its place in the evaluation armamentarium of the hemodynamically stable patient. The spleen and liver are the organs most commonly injured in blunt ABDOMINAL trauma, each accounting for one third of the injuries. Each nonoperative treatment of isolated splenic and hepatic injuries in stable children is now standard practice. The clinical experience accumulated over the past 20 to 30 years, which has settled these concerns, is reviewed.

Objective: Cryptosporidium parvum is a common protozoan pathogen with worldwide distribution. It localizes on the intestinal cells and prolonged diarrhea in immunocompromised patients. The aim of this study was to estimate the prevalence and the clinical features of enteric cryptosporidiosis in PEDIATRIC patients with lymphohematopoietic MALIGNANCIES. Material & Methods: In this cross-sectional study stool samples were collected from 100 children (67 boys, 33girls) with lymphohematopoietic MALIGNANCIES who underwent chemotherapy between the ages of 6 months and 17 years (mean age 7.5 years). All of the specimens were examined for the oocysts of C. parvum by modified Ziehl Neelsen (MZN) staining technique and coproantigens of C. parvum by ELISA. Findings: Cryptosporidium infection was detected in 22 patients. 16 (72.7%) of the infected patients were male and 6 (27.3) female. 7 (31.8%) patients were <5 years, 8 (36.4%) 5-10 years and 7(31.8) >10 years old. Parasites were detected in 19/85 (86.4%) patients with ALL, 2 of 5 (9.1%) with AML, and 1 of 10 (4.5%) with NHL. Clinical symptoms were found in 11 (50%) of the patients. We found longer duration of chemotherapy in patients who were positive for cryptosporidium infection (Mean=2067 days) in comparison to negative group (Mean=258.5 days) (ANOVA, f=2.82, P=0.04).Conclusion: The incidence of cryptosporidium infection was 22% among PEDIATRIC patients with lymphohematopoietic MALIGNANCIES. We recommend evaluation of these patients with at least two different diagnostic methods in order to prevent possible life threatening outcomes.

Introduction: Although cancers occur rarely in children, they considered as the second cause of death in children under 14 years old.Cancers in children differ markedly from those in adults according their nature, distribution, and prognosis. Acute Lymphoblastic leukemia and lymphoma account about 40%, central nervous system tumors consist of 30% and embryonal MALIGNANCIES and sarcoma account for about another 10% of all PEDIATRIC cancers.Objective: Epidemiologic evaluation of PEDIATRIC causes of cancer who referred to 17 Sharivar hospital in Rasht during 2001-2007.Materials and Methods:  This descriptive cross- sectional study was carried out in 17 Sharivar hospital in Rasht from 2001-2007. All cases of PEDIATRIC cancers were included in this study. All information about the age, sex, type of cancers and residence of patients were collected from their medical records; 152 forms were completed and the data were analyzed by SPSS.Results: Among 152 patients with different types of malignancy there were 89 male (58.6%) and 63 female (41.4%). Ratio of male to female was 1.36 in acute lymphoblastic leukemia, 0.71 in AML, 4 in non-hokin ulmphoma (NHL) , 0.33 in sarcoma. 1.6 in Wilms Tumor, 2 in Hodgkin disease, 5 in neuroblastoma 0.25 in soft tissue sarcoma and 0.5 in medulloblastoma.  The peak incidence of cancer was in the ages between 3 to 4 years. (11.2%) and lowest was in the ages of 14 to 15 years. (0.7%). ALL was the most common cancer 47.6%  and Langerhanse histiocytosis was the least common  one (0.7%). The prevalence of other MALIGNANCIES  were NHL 9.9%, Wilms Tumor 8.6%, AML 7.9% CNS Tumors5.9%. HD 5.9%. The majority of patients were inhabitance of Rasht (47.4%). Hashtpar 7.2%, Rudsar 5.9% Langrood 5.3% and Fouman 4.6% consisted the next four cities with high rates of PEDIATRIC cancers. Amlash and Siahkal had the lowest prevalence of patients (0.7%).Conclusion: In this study PEDIATRIC MALIGNANCIES were more prevalent in males and the other epidemiological characteristics were quite different from the other studies, It need further evaluation.

Objective: To evaluate the diagnostic accuracy of ultrasonography in PEDIATRIC acute appendicitis. Methods: In this cross-sectional study, 230 children aged 5-15 years with the diagnosis of acute appendicitis were studied. This study included the evaluation of demographic indices, ultrasound findings at diagnosis, and then comparing the results with the description of the patient’ s procedure and the pathology report of these patients. Patients who did not undergo ultrasound before surgery or their ultrasound did not include the evaluation of appendicitis or their pathologic report was not available were excluded. Results: Overall, we have included a total number of 230 children with clinical diagnosis of acute appendicitis among whom there were 121 (52. 6%) girls and 109 (47. 4%) boys with mean age of 11. 44± 2. 90 years. Preoperative ultrasound report showed that 51. 3% were normal and 48. 7% had acute appendicitis. 34. 8% had normal appendix and 65. 2% had a pathological diagnosis of acute appendicitis. The sensitivity and specificity of ultrasound in these children were 58% and 68%, respectively. Positive and negative predictive values were 77% and 46%, respectively. The area under curve (AUC) was 0. 853 (CI 95% 0. 788-0. 917) indicating a test with moderate accuracy. Conclusion: According to the obtained results, ABDOMINAL ultrasonography is of acceptable diagnostic accuracy in PEDIATRIC patients with acute appendicitis. The use of auxiliary techniques in ultrasound would increase the sensitivity and specificity in the diagnosis of acute appendicitis in children.

Introduction:  Radiotherapy is one of the therapeutic options for MALIGNANCIES associated with the ABDOMINAL cavity. However, the delivered dose must be limited to the kidneys' custom shielding blocks. This study aimed to propose a method in which kidney shielding blocks can be replaced with multi-leaf collimators (MLCs). Materials & Methods: In the initial phase, both kidneys were protected, and the open field area was irradiated. However, the region between each kidney and the lateral ABDOMINAL wall was inevitably shielded. Therefore, in subsequent phases, the dose to the shielded region was necessarily compensated. This process was analyzed by treatment planning and Kodak EDR2 film dosimetry. The dosimetric film results, read with MATLAB, were compared with TPS data, showing a mean difference of less than 5%, indicating acceptable agreement between the two methods. Results: The MLC-based shielding method demonstrated a noticeable reduction in treatment time compared to the time required for custom block fabrication and patient setup. The use of MLCs resulted in only a 3.86% increase in MU, which was not clinically significant. The mean dose to both kidneys in the MLC and cerrobend block methods remained within the renal tolerance limits. Furthermore, the consistency of average V10, V15, and V20 data for the left and right kidneys supported the agreement between the cerrobend block and MLC methods. Conclusion: MLC application to the island organ as a shield is suggested, especially in AP/PA WAR. But sufficient accuracy in field matching is needed.

Background and Purpose: Today, with the development of critical patient care and the increase in intravascular invasive methods, the survival rate of patients diagnosed with hematological and solid organ MALIGNANCIES is increasing, and unfortunately, the incidence of Candida parapsilosis candidemia is also increasing due to multiple risk factors. In this study, we aimed to determine the clinical-demographic characteristics of C. parapsilosis candidemia and the antifungal susceptibility profile of C. parapsilosis in PEDIATRIC patients with hematological and solid organ MALIGNANCIES.Materials and Methods: The present study included PEDIATRIC patients with hematologic and solid organ MALIGNANCIES presenting with signs and symptoms consistent with candidemia, in whom C. parapsilosis was isolated from blood and catheter cultures between January 2010 and September 2024.Results: Thirty (65.2%) of the patients had hematologic and 16 (34.8%) had solid organ MALIGNANCIES. In all patients, 23 (50%) had non-catheter-related candidemia and 23 (50%) had catheter-related candidemia. At least one of the risk factors examined was detected in these patients. Catheter-related candidemia was found to be more common in patients diagnosed with hematologic malignancy. The difference was found to be statistically significant (p= 0.030). Drug resistance rates of C. parapsilosis were 6.5% for amphotericin B, 6.5% for fluconazole, 2.2% for voriconazole and 2.2% for micafungin. No patient with caspofungin resistance was detected. The mean treatment duration of the patients was 21 days (min 3-max 103) and it was observed that amphotericin B and caspofungin were used most frequently in the treatment regimen. The mortality rate of patients with candidemia was 6.5%.Conclusion: Our study showed that patients with hematologic MALIGNANCIES exhibited a higher susceptibility to catheter-related C. parapsilosis candidemia compared to patients with solid organ tumors. Caspofungin resistance was not detected in our study, and we believe that each center should know its own antifungal drug sensitivity, determine the treatment regimen accordingly, and that catheters should be removed rapidly in patients with catheter-related C. parapsilosis candidemia in malignant patients.

Malignances are most frequent causes of mortality in children aged 1-16 years. In an epidemiologic study, all cases of PEDIATRIC cancer (aged 1-16 years) registered by the Medical Universities in Iran are studied regarding the age, sex and type of malignancy. This study refers to the cancer diagnosed and histopathologically confirmed in 1996.Of the data received from 9 Provinces, a frequency of cancer in 420 children (58.3% male, 41.7% female) with a median age of 7.1 years was established. Hematologic MALIGNANCIES with 20% of all cases were the most frequently encountered censer types. The next cases consisted of brain (15%), lymph nodes (15%), bone (8%), Kidney (7%), ophthalmic (6%), and (5%) MALIGNANCIES.