Risk Factors for Post-ERCP Pancreatitis in Pediatric and Young Adult Patients.

OBJECTIVES: Post-ERCP pancreatitis (PEP) is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Limited existing data suggest that prophylactic pancreatic duct (PD) stenting in pediatric patients may increase the risk of PEP. The aim of this study is to identify factors associated with PEP in pediatric patients. METHODS: Patients at a single institution who underwent ERCP between 2012 and 2020 were retrospectively reviewed. Patient and procedure-related factors were collected. Data were analyzed using Chi-square or Fisher exact tests as appropriate and Mann-Whitney-Wilcoxon tests. RESULTS: Seven hundred thirty-six ERCPs were performed for 402 unique patients. Ninety-four cases were complicated by PEP (12.8%), of which 91 were mild and 3 were moderately severe. Pancreatic indication, native major papilla, PD cannulation and injection, and higher American Society for Gastrointestinal Endoscopy (ASGE) complexity were associated with PEP. A higher proportion of patients who received rectal indomethacin (65% vs 47%, P = 0.002), or who had placement of a prophylactic (31% vs 20%, P = 0.01) or therapeutic PD stent (37% vs 27%, P = 0.04) developed PEP; however, in a subgroup analysis of high-risk patients, this association was not persistent. A smaller proportion of PEP patients had PRSS1 mutation compared to non-PEP patients (22% vs 40%, P = 0.04). CONCLUSIONS: This study evaluates factors associated with developing PEP in a large pediatric cohort. A high rate of PEP was observed, likely secondary to higher rates of pancreatic indication and higher ASGE complexity scores compared to previously reported literature. Randomized prospective trials are needed to better define the utility of various interventions.

Fractional Nadeem trigonometric non-Newtonian (NTNN) fluid model based on Caputo-Fabrizio fractional derivative with heated boundaries.

The fractional operator of Caputo-Fabrizio has significant advantages in various physical flow problems due to the implementations in manufacturing and engineering fields such as viscoelastic damping in polymer, image processing, wave propagation, and dielectric polymerization. The current study has the main objective of implementation of Caputo-Fabrizio fractional derivative on the flow phenomenon and heat transfer mechanism of trigonometric non-Newtonian fluid. The time-dependent flow mechanism is assumed to be developed through a vertical infinite plate. The thermal radiation's effects are incorporated into the analysis of heat transfer. With the help of mathematical formulations, the physical flow system is expressed. The governing equations of the flow system acquire the dimensionless form through the involvement of the dimensionless variables. The application of Caputo-Fabrizio derivative is implemented to achieve the fractional model of the dimensionless system. An exact solution of the fractional-based dimensionless system of the equations is acquired through the technique of the Laplace transform. Physical interpretation of temperature and velocity distributions relative to the pertinent parameters is visualized via graphs. The current study concludes that the velocity distributions exhibit an accelerating nature corresponding to the increasing order of the fractional operator. Moreover, the graphical results are more significant corresponding to the greater time period.

EUS-guided gallbladder drainage in a patient with Billroth II reconstruction.

Video 1EUS-guided gallbladder drainage in a patient with Billroth II gastrojejunostomy.

Prevalence of Temporomandibular Disorder among Schoolchildren in Jordan.

PURPOSE: The purpose of this study was to evaluate the prevalence of temporomandibular disorders (TMDs) in schoolchildren. MATERIALS AND METHODS: In this study a questionnaire taken as part of RDC/TMD of the samples on TMD symptoms. The samples were school students, who were of the age range 15-17 years old (n = 396), 200 are males and 196 are females. All from eight randomly selected schools. They were asked to answer the questionnaire in their classrooms. RESULTS: The prevalence of periauricular pain was 29.0%. More males were affected by TMD than females and most of the affected students were of ages 16 and 17 years old. Severe depression occurs in 69.6% of the affected students with periauricular pain. Periauricular pain resulted in low disability low-intensity pain (grade I) in 64.9%. CONCLUSION: Based on the results obtained it can be concluded that: (1) Data obtained from the questionnaire identified a nearly lower percentage of TMD in schoolchildren than most of the studies published in the literature; (2) Comparing with females, males with TMD had a higher disability, depression, and non-specific symptoms with and without pain. CLINICAL SIGNIFICANCE: Temporomandibular disorder in adolescents is relatively high, in addition, the accompanying pain and depression that is high to worsen the condition. HOW TO CITE THIS ARTICLE: Jomhawi JM, Elsamarneh AM, Hassan AM. Prevalence of Temporomandibular Disorder among Schoolchildren in Jordan. Int J Clin Pediatr Dent 2021;14(2):304-310.

A screening tool for attention deficit hyperactivity disorder in children in Saudi Arabia.

BACKGROUND AND OBJECTIVES: A clinically validated attention deficit hyperactivity disorder (ADHD) scale in Arabic for evaluating children in Saudi Arabia who might be suspected of having ADHD is lacking. Thus, we studied the validity of an Arabic version of the ADHD Rating Scale in discriminating children with an ADHD diagnosis from normal children or from those with non-ADHD psychiatric diagnoses, including mental retardation. METHODS: The guardians of 119 children provided demographic data and completed the standardized Arabic version of the ADHD Rating Scale on their children, who were either normal, had a diagnosis of ADHD, or had a non-ADHD psychiatric diagnosis. The mean rating scores of the groups were compared, and the cutoff points were calculated for both sexes. RESULTS: The scores discriminated children with ADHD diagnosis (mean and [SD], 28 [6.288]) from normal children (10.93 [8.009]), and those with a non-ADHD psychiatric diagnosis (16.63 [8.865]). ADHD cutoff points were obtained for male (23.5) and female (22.5) children. Psychosocial characteristics associated with children having ADHD were not associated with the diagnosis of ADHD. CONCLUSION: The ADHD Rating Scale (Arabic version), in terms of either the grand total score or the total score of each of its two subscales, demonstrated concurrent and discriminant validity by discriminating children with ADHD from other clinical and non-clinical children groups. The study obtained cutoff points for both sexes based only on the grand total score of the scale because of the relatively small sample size. Replication of the study, utilizing a larger sample and eliciting ratings from both parents and teachers, is recommended.