Percutaneous endoscopic gastrostomy in children: a single center study at Tertiary hospital Iran.

INTRODUCTION: The aim of this study was to evaluate complications after percutaneous endoscopic gastrostomy among children who underwent percutaneous endoscopic gastrostomy in Nemazee hospital. MATERIALS AND METHODS: All children who underwent percutaneous endoscopic gastrostomy were included in the current study. Place of the study was department of pediatric gastroenterology of Nemazee children hospital of Shiraz university of medical sciences. Duration of the study was 5 year starting from 2008. All drugs such as aspirin, NSAIDS, and heparin were discontinued 1-7 days before procedures. All patients were kept NPO 6-8 hours before procedure according to the age. Single dose antibiotic was prescribed for all cases before procedure. During procedure, all patients were sedated using propofol and or midazolam. Some patients required intubation. RESULTS: Of 39 cases who underwent PEG, 4 (10.2%) patients showed complication. The most common indication for PEG insertion were neurologic problem (84.6%) and metabolic disease (10.2%). Of our patients, 84.6% of the cases had the weight below third percentile. CONCLUSION: The most common indication for percutaneous endoscopic gastrostomy was cerebral palsy. The complication rate in our study was 10.2%. Celulitis was the most common complication.

Percutaneous endoscopic gastrostomy in children: a single center study at Tertiary hospital Iran / Gastrostomía percutánea en niños: reporte de un hospital terciario de Iran

Introduction: The aim of this study was to evaluate complications after percutaneous endoscopic gastrostomy among children who underwent percutaneous endoscopic gastrostomy in Nemazee hospital. Materials and methods: All children who underwent percutaneous endoscopic gastrostomy were included in the current study. Place of the study was department of pediatric gastroenterology of Nemazee children hospital of Shiraz university of medical sciences. Duration of the study was 5 year starting from 2008. All drugs such as aspirin, NSAIDS, and heparin were discontinued 1-7 days before procedures. All patients were kept NPO 6-8 hours before procedure according to the age. Single dose antibiotic was prescribed for all cases before procedure. During procedure, all patients were sedated using propofol and or midazolam. Some patients required intubation. Results: Of 39 cases who underwent PEG, 4 (10.2%) patients showed complication. The most common indication for PEG insertion were neurologic problem (84.6%) and metabolic disease (10.2%). Of our patients, 84.6% of the cases had the weight below third percentile. Conclusion: The most common indication for percutaneous endoscopic gastrostomy was cerebral palsy. The complication rate in our study was 10.2%. Celulitis was the most common complication

Introducción: El objetivo de este estudio fue evaluar las complicaciones luego de una gastrostomía endoscópica percutánea (PEG) en niños realizada en el hospital Nemazee. Material y métodos: Se incluyeron al estudio todos los niños que se realizaron PEG en el hospital. El lugar del estudio fue el departamento de gastroenterología pediátrica del Hospital para niños Nemazee de la Universidad Shiraz de ciencias médicas. La duración del estudio fue cinco años, iniciando en el año 2008. Todas las drogas como aspirina, AINES y heparina fueron suspendidas entre 1 a 7 días previos al procedimiento. Todos los pacientes estuvieron entre 6 a 8 horas del examen en ayunas dependiendo de la edad. Se prescribió una dosis de antibioterapia profiláctica en todos los casos previo al procedimiento. Durante el procedimiento, todos los pacientes fueron sedados usando propofol y/o midazolam. Algunos pacientes necesitaron intubación. Resultados: De 39 casos que se sometieron a PEG, 4 (10,2%) tuvieron alguna complicación. La indicación más frecuente de PEG fueron los problemas neurológicos (84,6%) y luego las enfermedades metabólicas (10,2%). De nuestros pacientes, 84,6% de los casos estuvieron por debajo del tercer percentile. Conclusión: La indicación más común de gastrostomía endoscópica percutánea fue la parálisis cerebral. La tasa de complicación en nuestro estudio fue 10,2%. La celulitis fue la complicación más común

The effect of gluten-free diet among celiac patients aged 3-12 years old on BMI during 2006 to 2014 at Nemazee Teaching hospital / El efecto de la dieta libre de gluten en pacientes celiacos de 3 a 12 años en su índice de masa corporal desde el 2006 al 2014 en el hospital universitario de Nemazee

Introduction: Celiac disease (CD) is increasingly diagnosed and weight changes are common after adoption of a gluten- free diet (GFD) and there is concern that patients might gain further weight on a GFD. Objectives: This study examined to evaluate the impact of a GFD on the body mass index (BMI), whether favorable or unfavorable. Materials and methods: In this retrospective study, we reviewed electronic records of 44 patients with serologic study and intestinal biopsy confirmed CD who was visited in Nemazee hospital, Shiraz. All patients were put on GFD for 2 years and followed closely by pediatric gastroenterologist. BMIs were categories to four group underweight, normal weight, overweight and obese. Initial BMI and follow-up BMI was comparing together and also compared with general population. Result: At diagnosis, 27.27% of subjects were underweight, 63.64% normal and 9.09% were obese. On a GFD, 66.66% of underweight patients gained weight and became normal weight and 25% of normal weight and 75% of obese patients had increase weight; and the rest of the patients, BMI remained stable. The follow-up BMIs were statistically higher than initial BMIs (mean 17.17 vs. 15.62, p <0.0001). Conclusion: Individuals with celiac disease have lower BMI than the regional population at diagnosis. On the GFD, BMI is increased significantly in all categories

Introducción: La enfermedad celiaca está siendo cada vez más diagnosticada y los cambios en el peso corporal son comunes después de ponerlos en una dieta libre de Gluten (DLG) y hay preocupación de que sigan ganando peso con esta dieta. Objetivos: Este estudio evalúa el impacto de la DLG en el índice de masa corporal (IMC) ya sea este favorable o desfavorable. Materiales y métodos: En este estudio retrospectivo se revisaron las historias de 44 pacientes con estudio serológico y biopsia intestinal confirmatorios de enfermedad celiaca que llegaron al hospital en Nemazee en Shiraz. A todos los pacientes se les puso en una DLG por 2 años y fueron seguidos por un gastroenterólogo pediatra. El IMC fue dividido en cuatro categorías, peso bajo, normal, sobrepeso y obesos. El IMC inicial y su seguimiento fueron comparados también con la población general. Resultados: Al momento del diagnóstico, el 27,27% estaban con bajo peso, el 63,64% con peso normal y el 9,09% eran obesos. En una DLG, el 66,66% de los pacientes con bajo peso llegaron a su peso normal y el 25% de los de peso normal y el 75% de los obesos también ganaron peso. Esta variación de IMC fue estadísticamente significativa (media 17,17 vs. 15,62, p <0,0001). El resto de los pacientes permaneció con su IMC estable. Conclusión: Las personas con enfermedad celiaca tienen el IMC más bajo que la población de la región al momento del diagnóstico. Puestas en la DLG, el IMC aumenta significativamente en todas las categorías

The effect of gluten-free diet among celiac patients aged 3-12 years old on BMI during 2006 to 2014 at Nemazee Teaching hospital.

INTRODUCTION: Celiac disease (CD) is increasingly diagnosed and weight changes are common after adoption of a glutenfree diet (GFD) and there is concern that patients might gain further weight on a GFD. OBJECTIVES: This study examined to evaluate the impact of a GFD on the body mass index (BMI), whether favorable or unfavorable. MATERIALS AND METHODS: In this retrospective study, we reviewed electronic records of 44 patients with serologic study and intestinal biopsy confirmed CD who was visited in Nemazee hospital, Shiraz. All patients were put on GFD for 2 years and followed closely by pediatric gastroenterologist. BMIs were categories to four group underweight, normal weight, overweight and obese. Initial BMI and follow-up BMI was comparing together and also compared with general population. RESULT: At diagnosis, 27.27% of subjects were underweight, 63.64% normal and 9.09% were obese. On a GFD, 66.66% of underweight patients gained weight and became normal weight and 25% of normal weight and 75% of obese patients had increase weight; and the rest of the patients, BMI remained stable. The follow-up BMIs were statistically higher than initial BMIs (mean 17.17 vs. 15.62, p <0.0001). CONCLUSION: Individuals with celiac disease have lower BMI than the regional population at diagnosis. On the GFD, BMI is increased significantly in all categories.