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Comparison of oral and intra venous midazolam for sedation in children undergoing upper gastrointestinal endoscopy
Mohammadreza Esmaeilidooki, Sanaz Mehrabani, Ozra Molai, Manuchehr Askari, Mahsa Ghajarzadeh, Ali Bijani,
Volume 1, Issue 2 (9-2015)
Abstract

Background: Selecting the best medication for upper GI endoscopy in children is a challenging issue. The goal of this study was to compare the effects of oral and intravenous midazolam for upper gastrointestinal endoscopy (UGIE) on children.

Methods: In this randomized clinical trial study conducted in Amirkola Children's Hospital, 110 children were randomly assigned to oral or intravenous groups. An expert nurse recorded O2 saturation, heart rate before, during and 5 minutes after endoscopy for all patients. Sedation, separation from parents and child cooperation were recorded.

Results: Heart rate before and during endoscopy was not significantly different between two groups while heart rate was significantly lower in IV group after endoscopy. Cooperation during bite block was significantly better in oral group. Cooperation during endoscopy was not significantly different between two groups. Separation from parents in both male and female ones was significantly better in oral group. Complications were reported in 7 cases in oral group and 6 in IV group.

Conclusion: Oral midazolam in comparison with IV midazolam is better and may be a method of choice for pediatric UGIE purposes.


Ingestion of Corrosive Chemicals in Children: 8-Year Experience at Amirkola Children's Hospital
Mohammad Gholami, Sanaz Mehrabani, Mohammadreza Esmaeili Dooki, Hoda Shirafkan,
Volume 9, Issue 1 (3-2023)
Abstract
Background and Objective: Ingestion of corrosive substances in children is associated with complications and costs to the health care system. The aim of this study was to determine the incidence and complications of ingesting corrosive substances in children.
Methods: This cross-sectional study was conducted on children aged 6 months to 14 years who underwent upper endoscopy at Amirkola Children's Hospital during 2014-2021 for complaints of corrosive ingestion. Information studied included demographic information, type of corrosive substances, clinical symptoms, endoscopic findings, complications, and laboratory results.
Findings: In the 79 children (mean age of 31.33±20.38 months), 65.8% were boys, the most common type of ingested substance was alkaline (86.1%) and the most common ingested substance was bleach (69.6%). Totally, 70.1% of children had symptoms. The most common clinical symptoms were vomiting (68.4%) and oral lesions (39.2%). The esophagus (59.5%) was more affected than the stomach, and the most common esophageal endoscopic finding was grade 1 esophagitis (45.6%). No significant relationship was found between clinical symptoms, the incidence of esophageal-gastric involvement, or the severity of esophageal involvement. Leukocytosis (p=0.009), the increase in C-reactive protein (CRP) (p=0.001), erythrocyte sedimentation rate (ESR) (p=0.007), and blood sugar (BS) (p=0.019) were significantly related to the severity of esophageal involvement.
Conclusion: The results of the study showed that the rate of dangerous side effects caused by ingestion of corrosive substances was not high in children, but often caused by the use of alkaline drain openers, so attention and appropriate diagnostic measures are recommended, as well as preventive measures.

Foreign Body Ingestion in Children Admitted to Amirkola Children's Hospital, Iran: An 8-Year Experience
Ali Mahmoudi, Sanaz Mehrabani, Mohammadreza Esmaeili Dooki, Hoda Shirafkan,
Volume 10, Issue 1 (3-2024)
Abstract
Background and Objective: Foreign body ingestion is one of the most common problems and reasons for emergency endoscopy in children. The aim of this study was to determine the type and location of entrapped objects and endoscopic observations in children with foreign body ingestion.
Methods: This cross-sectional study was conducted on all children with complaints of foreign body ingestion who underwent upper endoscopy at Amirkola Children's Hospital, north of Iran during 2014-2021. Demographic information, type of foreign body, clinical symptoms, and examinations during hospitalization, endoscopic findings, and short- and long-term outcomes were recorded. A value of P<0.05 was considered significant.
Findings: The mean age of 84 children in the study was 47.98±31.51 months and 56% of them were boys. The most commonly ingested foreign bodies were food (26.2%) and coins (25.0%). The most common location of the foreign body was the upper part of the esophagus (41.7%) and 29.7% of children were without clinical symptoms, and among those with clinical symptoms, vomiting (38.1%) was the most common symptom. The most common endoscopic findings were esophageal ulcer (11.9%). No significant relationship was found between gender and type of ingested foreign bodies (p=0.528).
Conclusion: The results of the study showed that the most common foreign bodies were food and coins and that the most common site of injury was in the esophagus, and the incidence of dangerous complications in children was low, with no deaths. Therefore, monitoring of children and providing appropriate treatment based on existing guidelines are helpful.

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