RESUMO
Introduction: Small bowel obstruction (SBO) is known as a common cause of acute abdominal complaints in the emergency department (ED). The modality of choice for the diagnosis of SBO has not yet been established. This systematic review and meta-analysis aimed to investigate the accuracy of ultrasonography for the diagnosis of SBO. Methods: Systematic search was performed on five electronic databases including Medline, Scopus, Web of Sciences, Embase, and Cochrane Library, and the retrieval period was from the inception of each database to November 2023. The quality of the included studies were investigated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The pooled values of diagnostic characteristics for ultrasonography were estimated using meta-Disc and Stata statistical software. Results: Twenty-one studies with a total of 1977 patients were included in the meta-analysis. The pooled estimate for sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary ROC curve of ultrasonography for diagnosing SBO were 0.93 (95% CI: 0.91-0.95), 0.8 (95% CI: 0.77-0.83), 5.69 (95% CI: 3.64-8.89), 0.1 (95% CI: 0.07-0.16), 83.51 (95% CI: 18.12-182.91) and 0.96, respectively. Conclusion: The findings of this meta-analysis showed that the utilization of ultrasonography holds promise as a diagnostic imaging for SBO with high accuracy. However, additional worldwide studies are essential to get more evidence on the value of ultrasonography for the diagnosis of SBO.
RESUMO
The infant's refusal to breastfeed can be a stressful and concerning matter for a mother. This study aimed to investigate the frequency and factors leading to nursing strikes in Rafsanjan city. This descriptive study was performed on infants who had been referred to the pediatrician's office with a complaint of a nursing strike. The research sample included 70 infants, and all the required data, including the causes of the nursing strike and the demographic information of the mother and the infant, were collected using a checklist. The Statistical Package for the Social Sciences (SPSS) software version 20 was used to analyze the data. The percentage was used to express qualitative indices, and the mean and standard deviation were used to express quantitative indices. The results showed that the most common factors contributing to the infants' breast refusal were playfulness and distraction (50%) and recent vaccinations in the last 12 days (48.6%). Besides, the most common maternal factors affecting breast refusal were level of education (67.1%), recent acute stress (41.4%), and inadequate milk production (35.7%). The results of the present study showed that playfulness and distraction of the baby, recent vaccination, use of a pacifier, level of education and recent stress of the mother, breastfeeding program, and insufficient milk production are the most common reasons for nursing strikes.