Protective effects of passiflora incarnata on ovarian ischemia/reperfusion damage in rats with ovarian torsion.

BACKGROUND: This study aimed to investigate whether Passiflora Incarnata (PI) has a protective effect against ischemia-reperfu-sion (IR)-induced oxidative and inflammatory ovarian damage. METHODS: The effects of PI on ovarian ischemia-reperfusion injury were investigated in female Wistar albino rats. The animals were randomly divided into three groups: Group 1 (sham), Group 2 (IR), and Group 3 (IR+PI). RESULTS: The mean levels of Malondialdehyde (MDA), Myeloperoxidase (MPO), and Total Oxidant Status (TOS) were higher in the IR group (p=0.025, p<0.001, and p=0.016, respectively). The Total Antioxidant Status (TAS) levels were lower in the IR group (p=0.005). Immunostaining revealed significant differences across the groups for Tumor necrosis factor-alpha (TNF-α): 13.84%, 49.51%, and 22.51% for Groups 1, 2, and 3, respectively (p<0.01). Bax: 10.53%, 46.74%, and 26.46% for Groups 1, 2, and 3, respectively (p<0.01). Annexin V: 12.24%, 44.86%, and 23.28% for Groups 1, 2, and 3, respectively (p<0.01). The mean scores for hemorrhage, inflammation, follicular degeneration, and congestion showed significant variations among the groups, all registering p<0.001. CONCLUSION: Passiflora Incarnata exhibited antioxidant, anti-inflammatory, and anti-apoptotic properties, promoting cell survival, histologically protecting ovarian tissue, and ameliorating IR injury by reducing oxidative stress.

Effectiveness of extracorporeal shock wave lithotripsy in urolithiasis patients under 2 years of age.

OBJECTIVE: In this study, we present our extracorporeal shock wave lithotripsy (ESWL) outcomes in urolithiasis patients under the age of two. MATERIALS AND METHODS: The procedure was performed with patients < 2 years of age sedated, under anesthesia using ketamine and Dormicum (midazolam), in the supine position. Fragmentation was evaluated by fluoroscopy after the procedure. RESULTS: A total of 74 procedures were performed on 65 kidneys. One patient with bilateral stones had two sessions of ESWL on the right side; three sessions of ESWL were performed in one patient with a unilateral stone, and two sessions were performed in seven patients with unilateral stones. All other patients underwent one session of ESWL. As post-procedural complications, hematuria was observed in 14 patients (12 mild and 2 significant), and vomiting occurred in 1 patient. Ureterorenoscopy was performed in 5 patients, and percutaneous nephrolithotomy in 6 patients due to a failed procedure. CONCLUSION: As a result, ESWL treatment is effective and has advantages such as a short hospitalization time, good reproducibility, cost-effectiveness, and a low rate of complications. Therefore, we recommend ESWL as the first-line treatment for renal and proximal ureteral stones in infants < 2 years of age.

OBIETIVO: En este estudio, presentamos nuestros resultados de ESWL en pacientes con urolitiasis menores de dos años. MATERIALES Y MÉTODOS: El procedimiento se realizó con pacientes menores de dos años sedados, bajo anestesia con ketamina y Dormicum (midazolam), en posición supina. La fragmentación se evaluó mediante fluoroscopia después del procedimiento. RESULTADOS: Se realizaron total de 74 procedimientos en 65 riñones. Un paciente con cálculos bilaterales tuvo dos sesiones de ESWL en el lado derecho; se realizaron tres sesiones de LEOC en un paciente con litiasis unilateral y dos sesiones en siete pacientes con litiasis unilateral. Todos los demás pacientes se sometieron a una sesión de ESWL. Como complicaciones post-procedimiento se observó hematuria en 14 pacientes (12 leves y 2 significativas) y vómitos en 1 paciente. Se realizó URS en 5 pacientes y NLP en 6 pacientes debido a un procedimiento fallido. CONCLUSIONES: Como resultado, el tratamiento de la ESWL es efectivo y tiene ventajas como un tiempo de hospitalización corto, buena reproducibilidad, costo-efectividad y baja tasa de complicaciones. Por tanto, recomendamos la ESWL como tratamiento de primera línea para cálculos renales y ureterales proximales en bebés < 2 años de edad.

[A rare cause of intestinal obstruction: sock ingestion]. / Una causa rara de obstrucción intestinal: ingestión de calcetines.

Although most foreign bodies leave the gastrointestinal tract spontaneously without causing serious injuries such as bleeding and obstruction, they can sometimes occlude the intestine and may present with symptoms of ileus. A 14-year-old boy with cerebral palsy was admitted to our center due to persistent bilious vomiting. A foreign body (sock) was seen in the jejunal loops at laparotomy. Enterotomy and enterostomy were performed.

Aunque la mayoría de los cuerpos extraños abandonan el tracto gastrointestinal de forma espontánea sin causar lesiones graves como sangrado y obstrucción, a veces pueden ocluir el intestino y pueden presentarse con síntomas de íleo. Un niño de 14 años con parálisis cerebral ingresó en nuestro centro por vómitos biliosos persistentes. Se observó un cuerpo extraño (calcetín) en las asas yeyunales en la laparotomía. Se realizó enterotomía y enterostomía.

The beneficial effects of the transanastomotic feeding tube in the management of congenital duodenal obstruction: a meta-analysis.

OBJECTIVE: We aimed to assess the evidence on the efficacy and safety of transanastomotic feeding tubes (TAFTs) in neonates with congenital duodenal obstruction (CDO), we conducted a systematic review. MATERIAL AND METHODS: Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing TAFT + and TAFT - for CDO were included. We applied a random effect model. RESULTS: 505 CDO patients who met the inclusion criteria were selected. The TAFT + group had a shorter time to reach full feeds (weighted mean difference [WMD]: -6.63, 95% confidence interval [CI]: -8.83 - -4.43; p < 0.001) and had significantly less central venous catheter (CVC) insertion (I2 = 85%) (RR: 0.43, 95% CI: 0.19-1.00; p < 0.05). Fewer patients in the TAFT + group received parenteral nutrition (PN) (I2 = 78%) (RR: 0.43, 95% CI: 0.20-0.95; p < 0.05). There was no statistically significant difference in terms of the development of sepsis (I2 = 37%) (risk ratio [RR]: 1.35, 95% CI: 0.52-3.46; p > 0.05). No statistically significant difference was observed in terms of length of stay (I2 = 82%) (WMD: 2.22, 95% CI: -7.59-12.03; p > 0.05) and mortality (I2 = 0%) (RR: 0.55, 95% CI: 0.07-4.34; p > 0.05). CONCLUSIONS: The use of the transanastomotic tube resulted in early initiation of full feeding, less CVC insertion, and less need for PN.

OBJETIVO: Nuestro objetivo fue evaluar la evidencia sobre la eficacia y seguridad de TAFT en recién nacidos con CDO, realizamos una revisión sistemática. MATERIAL Y MÉTODOS: Utilizando las bases de datos EMBASE, PubMed y Cochrane, realizamos una búsqueda bibliográfica exhaustiva hasta 2022. Se incluyeron estudios que compararan TAFT + y TAFT - para CDO. Aplicamos un modelo de efectos aleatorios. RESULTADOS: Se seleccionaron 505 pacientes con ODC que cumplían con los criterios de inclusión. El grupo TAFT + tuvo un tiempo más corto para alcanzar la alimentación completa (DMP -6.63, IC del 95 %: −8.83 a −4.43; p < 0.001) y tuvo una inserción de CVC significativamente menor. Menos pacientes en grupo TAFT + recibieron NP (I2 = 78%) (RR: 0.43, IC del 95%: 0.20 a 0.95; p < 0.05). No hubo diferencia estadísticamente significativa en cuanto al desarrollo de sepsis. No se observaron diferencias estadísticamente significativas en cuanto a la duración de la estancia (I2 = 82 %) (DMP 2.22, IC del 95 %: −7.59 a 12.03; p < 0.05) y mortalidad (I2=0 %) (RR: 0.55, IC del 95 % 0.07 a 4.34; p > 0.05). CONCLUSIONES: El uso de la sonda transanastomótica resultó en el inicio temprano de la alimentación completa, menor inserción de CVC y menor necesidad de NP.

A novel diagnostic scoring system for pediatric appendicitis based on age and sex-adjusted hematological parameters.

BACKGROUND: Acute appendicitis diagnosis can sometimes be a real challenge in pediatric patients. OBJECTIVE: To establish the importance of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other hematological parameters adjusted for age and sex in the prediction of acute appendicitis, as well as to describe a new scoring system. MATERIAL AND METHODS: Medical records of 946 children hospitalized for acute appendicitis were retrospectively analyzed. A scoring system based on NLR, PLR, lymphocyte/monocyte ratio (LMR), and C-reactive protein (CRP) adjusted for age and sex was developed. RESULTS: Patients were divided into group I, with negative examination, and group II, with acute appendicitis; mean ages were 12.20 ± 2.31 and 11.56 ± 3.11, respectively. Leukocyte count, neutrophil percentage, NLR, PLR, LMR and PCR were higher in group II. The scores ranged from 0 to 8 points; 4.5 was determined to be the best cut-off point for acute appendicitis with the highest area under the curve (0.96), sensitivity (94%), specificity (86%), positive predictive value (97.5%), negative predictive value (65%), accuracy (92.6%) and misclassification rate (7.4%). CONCLUSION: The proposed scoring system, calculated based on patient age and gender, can be used for unnecessary surgeries to be avoided.

ANTECEDENTES: El diagnóstico de apendicitis aguda representa un reto en pacientes pediátricos. OBJETIVO: Establecer la importancia del índice neutrófilos-linfocitos (INL), índice plaquetas-linfocitos (IPL) y otros parámetros hematológicos ajustados por edad y sexo en la predicción de apendicitis aguda, así como describir un nuevo sistema de calificación. MATERIAL Y MÉTODOS: Se analizaron retrospectivamente expedientes clínicos de 946 niños hospitalizados por apendicitis aguda. Se desarrolló un sistema de calificación basado en INL, IPL, ILM y proteína C reactiva (PCR) ajustados por edad y sexo. RESULTADOS: Los pacientes se dividieron en grupo I de exploración negativa y grupo II de apendicitis aguda; las medias de edad correspondientes fueron 12.20 ± 2.31 y 11.56 ± 3.11. El recuento leucocitario, porcentaje de neutrófilos, INL, IPL, ILM y PCR fueron superiores en el grupo II. La calificación osciló entre 0 y 8 puntos; se determinó que 4.5 fue el mejor punto de corte para apendicitis aguda con mayor área bajo la curva (0.96), sensibilidad (94 %), especificidad (86 %), valor predictivo positivo (97.5 %), valor predictivo negativo (65 %), precisión (92.6 %) y tasa de clasificación errónea (7.4 %). CONCLUSIÓN: El sistema de calificación que se propone, calculado por edad y sexo de los pacientes, se puede utilizar para evitar cirugías innecesarias.

Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis.

OBJECTIVE: Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia. MATERIALS AND METHODS: Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included. RESULTS: Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n = 689) and open portoenterostomy (OPE) (n = 818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I2 = 84%), (WMD - 4.70, 95% CI - 9.14 to - 0.26; P = 0.04). Significantly decreased blood loss (I2 = 94%), (WMD - 17.85, 95% CI - 23.67 to - 12.02; P < 0.00001) and time to feed were found in the laparoscopic group (I2 = 97%), (WMD - 2.88, 95% CI - 4.71 to - 1.04; P = 0.002). Significantly decreased operative time was found in the open group (I2 = 85%), (WMD 32.52, 95% CI 15.65-49.39; P = 0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not significantly different across the groups. CONCLUSIONS: Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No differences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.

Comparison of Single-incision Laparoscopic Percutaneous and Cystoscope Forceps Assisted Morgagni Hernia Repair Techniques.

OBJECTIVE: Our goal was to compare single-incision laparoscopic percutaneous and cystoscope forceps-assisted Morgagni hernia repair techniques. MATERIALS AND METHODS: A total of 40 patients were allocated to two groups, each with 20 patients. Group 1: Single incision (port) laparoscopic surgical percutaneous Morgagni hernia repair (with a 5 mm Storz laparoscopic scope entered through the umbilicus). Group 2: Single incision (port) laparoscopic surgical percutaneous Morgagni hernia repair (with an 11 Fr [3.6 mm] cystoscope entered through the umbilicus + using forceps + sac plication, and sac cauterization). In Group 1; the sac was not removed. In group 2; we advanced the forceps through the cystoscope, caught the sac, pushed the needle through the sac, plicated the sac, and then cauterized the sac with Bugbee electrode. RESULTS: Of the 40 patients, 70 % (n = 28) were male. The symptoms at admission included repeated chest infections (40 %), dyspnea (30 %), vomiting (22 %), and abdominal pain (22 %). No difference was found between groups in terms of age, gender symptomatology, or associated anomalies. The operation time was shorter in group 2 compared to group 1 (p < 0.05; 25 min vs 40 min). Although there was one recurrence in Group 1, no recurrence was reported in Group 2. The recurrence incidence did not differ between groups (p > 0.05). CONCLUSIONS: Cystoscope-assisted repair of Morgagni hernia was found to be superior in terms of safety and shorter operation time. LEVEL OF EVIDENCE: Type III. TYPE OF THE STUDY: Retrospective study.

Translation and Validation of the Turkish Version of the Quality of Postoperative Recovery Score QoR-15: A Multi-Centred Cohort Study.

OBJECTIVE: The Quality of Recovery-15 questionnaire is a self-rated questionnaire used to assess the quality of the postoperative recovery and health status of patients in the early period following surgery. The aim of this study was to assess the reliability, validity, and responsiveness of the Turkish version of the Quality of Recovery-15. METHODS: After approval by the Maltepe University local ethics committee, this observational study was conducted among patients who received surgical interventions at Mersin University Hospital between July 2019 and January 2020. Reliability, feasibility, and validity were assessed to validate the Turkish version of the Quality of Recovery-15. RESULTS: The completion rate of the form was determined to be 92% and a total of 200 patients were enrolled in the study. The Cronbach's alpha of the global Turkish version of the Quality of Recovery-15 was 0.927. Test-retest reliability was 0.84 [CI 95%: 0.75-0.90] and Cohen's effect size was 0.319. The total standardized response mean was determined as 0.53. CONCLUSIONS: This is the first study in which the Quality of Recovery-15 scale was translated into Turkish with our knowledge. The Turkish version of the Quality of Recovery-15 showed satisfactory reliability and validity in evaluating the quality of recovery after surgery in the Turkish population.

The effect of low-dose Cordyceps on ischemia-reperfusion injury of the kidney in rats.

OBJECTIVE: None of studies have been conducted in terms of demonstrating the same effect with the low dose in cordycepin. In our study, we analyzed the histopathological and biochemical changes of low-dose Cordycepin(c) on a rat model in the kidney. MATERIALS AND METHODS: Twenty-four male Wistar Albino rats were randomly allocated to three groups (n = 8): the sham-control group (Group 1), the renal I/R-untreated (Group 2) group, and the I/R-C-treated (Group 3) group. Cordyceps was administered intraperitoneally at 5 mg/kg twice. Renal histological changes were compared and the relevant parameters of oxidative stress and inflammation were detected. RESULTS: In blood and tissue biochemistry, it was observed that IL-1 Beta, IL 6, TNF alpha, MDA, TOS, and OSI increased in Group 2 and decreased in Group 3. It was determined that TAS values were increased in Group 3, and decreased in Group 2. In the histopathological evaluation, while Group 1 was evaluated as normal, significant kidney damage was detected in Group 2. It was determined that there was a significant decrease in kidney damage in Group 3. CONCLUSION: These results suggest that low dose Cordycepin was as effective as normal dose on renal ischemic reperfusion and reduction of damage.

OBJETIVO: Ninguno de los estudios se ha realizado en términos de demostrar el mismo efecto con la dosis baja de cordicepina. En nuestro estudio, analizamos los cambios histopatológicos y bioquímicos de Cordycepin(c) en dosis bajas en un modelo de rata con isquemia-reperfusión (I/R) inducida en el riñón. MATERIALES Y MÉTODOS: Veinticuatro ratas macho Wistar Albino se asignaron al azar a tres grupos (n = 8): el grupo de control simulado (Grupo 1), el grupo sin tratamiento I/R renal (Grupo 2) y el grupo tratado con I/R-C (Grupo 3). Cordyceps se administró por vía intraperitoneal a 5 mg/kg dos veces. Se compararon los cambios histológicos renales y se detectaron los parámetros relevantes de estrés oxidativo e inflamación. RESULTADOS: En bioquímica sanguínea y tisular se observó que IL-1 Beta, IL 6, TNF alfa, MDA, TOS y OSI aumentaron en el Grupo 2 y disminuyeron en el Grupo 3. Se determinó que los valores de TAS aumentaron en el Grupo 3, y disminuyó en el Grupo 2. En la evaluación histopatológica, mientras que el Grupo 1 fue evaluado como normal, se detectó daño renal significativo en el Grupo 2. Se determinó que hubo una disminución significativa del daño renal en el grupo 3. CONCLUSIÓN: Estos resultados sugieren que la cordicepina en dosis bajas fue tan efectiva como la dosis normal en la reperfusión isquémica renal y la reducción del daño.

Intraoperative pectoral block versus thoracic paravertebral block for postoperative analgesia after breast cancer surgery: A randomized controlled trial.

BACKGROUND AND METHODS: With the increasing rate of breast cancer surgery, the pain management of these patients gains importance. The aim of this study is to compare the ultrasound (US) guided thoracic paravertebral block (TPV) versus intraoperative pectoral nerve block (PECS) with a low volume local anaesthetic for postoperative analgesia after breast cancer surgery. A total of 41 patients underwent mastectomy and sentinel lymph node biopsy or modified radical mastectomy were included in this randomized controlled, single-blinded trial. The patients were divided into two groups as PECS and TPV blocks. In the PECS group, 10 ml of 0.5% bupivacaine was administered to the fascial plane by the surgeon. In the TPV group, 25 ml of 0.25% bupivacaine at T3 level was administered by the anaesthetist under US-guidance. Visual analogue scale (VAS) scores and additional analgesic requirements were recorded at postoperative 0, 6, 12, 24 and 48 h. RESULTS: In the TPV group, mean VAS score (VAS0) was significantly lower (p ˂ 0.001). In other time periods, there was no significant difference between the groups. CONCLUSIONS: It was observed that intraoperative PECS block was as effective as TPV in providing postoperative analgesia and additional analgesic requirements were similar. This result suggests PECS block may be a good alternative to TPV.

Comparison of the suprainguinal fascia iliaca compartment block with continuous epidural analgesia in patients undergoing hip surgeries: a retrospective study.

BACKGROUND AND OBJECTIVE: Pain control is one of the major concerns after major hip surgeries. Suprainguinal fascia iliaca compartment block (S-FICB) is an alternative analgesic technique that can be considered as an effective and less invasive method than epidural analgesia (EA). In this retrospective study, we compared postoperative analgesic efficacy of single shot ultrasound guided S-FICB and EA after major hip surgery. METHODS: We retrospectively examined 150 patients who underwent major hip surgeries and who received S-FICB or EA. Seventy-two patients submitted to EA and 78 patients who received S-FICB were included and their medical records retrospectively reviewed. Morphine consumptions, VAS scores, and side effects were recorded. Patients under antiplatelet or anticoagulant theraphy were also registered. Morphine consumption and VAS scores were the primary endpoints, succes rate and complications were the secondary endpoints of our study. P-values less than 0.05 were considered statistically significant. RESULTS: Morphine consumption was lower at the emergence in the EA group but there was no statistically significant difference between the two groups according to total opioid consumption (0 [0-0] vs 0 [0-0]; p = 0.52). There was no difference between VAS scores in the first 18 hours. Hypotension was significantly higher in the EA group (9 vs 21; p = 0.04). CONCLUSION: In conclusion, S-FICB can provide comparable analgesia with EA in the early postoperative period after hip surgery but VAS scores were found lower in the EA group than S-FICB group after 18th hour. Hypotension has occured more frequently in patients receiving EA.

Association between acute kidney injury and mortality after successful cardiopulmonary resuscitation: a retrospective observational study.

BACKGROUND AND OBJECTIVES: Acute Kidney Injury (AKI) affect mortality and morbidity in critically ill patients. There have been few studies examining the prevalence of AKI and mortality after successful cardiopulmonary resuscitation. In the present study, we investigated the association between AKI and mortality in post-cardiac arrest patients admitted to the Intensive Care Unit (ICU). METHODS: Our retrospective analysis included 109 patients, admitted to the ICU following successful cardiopulmonary resuscitation between 2014 and 2016. We compared two scoring systems to estimate mortality. RESULTS AND DISCUSSION: AKI were diagnosed in 46.7% (n = 51) of the patients based on the RIFLE criteria and 66.1% (n = 72) using the KDIGO. Mortality rate was significantly higher among patients with AKI diagnosed according to the RIFLE criteria (p = 0.012) and those with AKI diagnosed using KDIGO criteria (p = 0.003). Receiver Operating Characteristic (ROC) analysis showed that both scoring systems were able to successfully detect mortality (Area under the ROC curve = 0.693 for RIFLE and 0.731 for KDIGO). CONCLUSION: AKI increases mortality and morbidity rates after cardiac arrest. Although more renal injury and mortality were detected with KDIGO, the sensitivity and specificity of both scoring systems were similar in predicting mortality in patients with Return of Spontaneous Circulation (ROSC).

Quantitative Neuromuscular Monitoring With Train-of-Four Ratio During Elective Surgery: A Prospective, Observational Study.

OBJECTIVES: Postoperative residual neuromuscular block (PRNB) is a serious problem that can cause death after surgery. It was aimed to evaluate the adequacy of neuromuscular block (NMB) during endotracheal intubation and the adequacy of neuromuscular recovery during clinically extubation decision and follow-up with the train-of-four ratio (TOFR) using quantitative monitoring. METHODS: This study has a prospective-observational single-blind study design. A total of 205 adult patients who underwent elective surgery, who had American Society of Anesthesiologists physical statuses I to III, and who were intubated with neuromuscular blocking agent under general anesthesia were included in the study. Train-of-four ratio measurements were provided single-blindly by another anesthesiologist outside the team. The TOFRs were measured at the time of intubation (TOFRind), before reversal agent administration (TOFRpre-rev) and after (TOFRpost-rev), at the time of extubation (TOFRext), and on admission to the postoperative care unit (TOFRPACU). If clinical signs of PRNB appeared, the recovery protocol was applied and then TOFRrec was measured. Postoperative respiratory complications were also evaluated for the first 24 hours after surgery. RESULTS: Endotracheal intubation was performed in 41.5% of the patients (n = 85) without adequate NMB. In 48.8% (n = 100) of the patients, adequate recovery (TOFRext ˂0.9) was not available at the time of extubation. Adequate TOFRPACU rate was found to be significantly higher in those who did not receive additional neuromuscular blocking agent doses (P < 0.001). In the recovery protocol, low-dose sugammadex administered to patients with clinical signs of PRNB significantly increased the TOFRrec rate compared with neostigmine (P ˂ 0.001). The first 24 hours, postoperative respiratory complication rate was 5.4% (n = 11), and the most common hypoxemia was observed. CONCLUSIONS: Approximately half of the patients are intubated without sufficient NMB and extubated without sufficient neuromuscular recovery. This suggests that routine use of quantitative neuromuscular monitoring is necessary for patient safety.

Crystallized phenol for treatment of pilonidal sinus disease in children: a comparative clinical study.

BACKGROUND: The aim of this study was to present our experience in the use of crystallized phenol (CP) to treat pediatric patients with 'simple' and complex' Pilonidal sinus disease (PSD). MATERIALS AND METHODS: Patients who underwent CP treatment in between January 2015 and January 2020 were evaluated retrospectively, using prospectively collected data. The patients were divided into simple and complicated groups. The groups were assigned depending on the number of sinuses and clinical presentation. The groups were compared in terms of age, sex, number of sessions, cost analysis, body mass index (BMI), recurrence, time resolution, cosmetic results, results /improvement, and complications. RESULTS: This study included 54 patients: 28 (52%) girls and 26 (48%) boys. The mean number of sinuses was 2.4. Symptoms included discharge in 50 (92%) patients, and pain in 42 (78%) patients. Fifty (93%) patients experienced mild pain during the procedure, whereas four (7%) patients had moderate pain. The mean number of CP sessions was 2.9; mean numbers of CP sessions were 2.2 and 4.2 in the Simple and Complicated groups. In total, 5 of 54 patients (9%) had recurrence.At the end of treatment, therapeutic success was achieved in 49 of 54 (91%) patients: 31 of 33 (94%) patients in the Simple group and 18 of 21 patients (86%) in the complicated group. The mean treatment cost for the whole cohort was $17.40. One patient (2%) presented with moderate skin burns. Cosmesis was deemed acceptable by patients, although there was evidence of minor skin burns following the procedure. CONCLUSIONS: The findings showed that the CP procedure was advantageous for treatment of PSD, because it was minimally invasive, cost-effective, provided good cosmesis, and had a high success rate and low complication rate. Furthermore, it did not require prior examination, and could be performed under local anesthesia. Therefore, the CP procedure may be useful as a first-line treatment option in children with PSD.