PURPOSE: This study was designed to evaluate the effects of caudal block or/and local infiltration on postoperative pain control in pediatric patients, and whether the faces pain rating scale (FPS), visual analogue scale (VAS) or sleep disturbance scale (SDS) values were estimator dependent (parents, doctors and nurses). MATERIALS AND METHODS: Thirty four children (average age 2.8+/-2.4 years), undergoing inguinal and scrotal surgery, were randomly allocated to one of three groups; combined caudal block with local infiltration (group I), caudal block only (group II) and neither of the above two (group III). Parents, doctors and nurses assessed the FPS, VAS and SDS before and after surgery, and the side effects were assessed after surgery. RESULTS: The mean SDS, FPS and VAS values in Group III were significantly higher than those in groups I and II at 1 and 3 hours postoperatively. All patients slept with a discontented look 1 hour postoperatively, but gradually improved and normalized 12 hours postoperatively. The mean FPS and VAS values were highest 1 hour postoperatively, and decreased with time in all groups. The mean pain value, as assessed by parents, tended to be higher than those assessed by healthcare professionals - doctors and nurses, but the correlation between the parents and healthcare professionals for the SDS, FPS and VAS assessments was statistically significant (intraclass correlation coefficients; 0.64, p<0.05). There were no side effects in any patient. CONCLISIONS: This study suggests that caudal block with local infiltration may be more useful for postoperative pain control, and all three pain scales are useful for assessing the postoperative pain associated with pediatric urological surgery of the penoscrotal and inguinal regions.
Anesthesia ; Child ; Delivery of Health Care ; Humans ; Pain Measurement ; Pain, Postoperative* ; Parents ; Surgical Procedures, Minor ; Weights and Measures

Cases of intracranial complication following infections of head and neck have been reported rarely, but the case of intracranial complication following tubo-ovarian abscess has not been reported yet. In this case, the 35-year-old women patient with lower abdominal pain and mild headache that was diagnosed as pelvic inflammatory disease was admitted to our hospital and was cared. In the course of admission, headache was aggravated and lateral deviation of eyeballs occurred. She was diagnosed as intracranial abscess following tubo-ovarian abscess in the result of neurological surgery department consultation. So we report it with brief review of literatures.
Abdominal Pain ; Abscess ; Adult ; Brain Abscess ; Female ; Head ; Headache ; Humans ; Neck ; Ovary ; Pelvic Inflammatory Disease

Cases of intracranial complication following infections of head and neck have been reported rarely, but the case of intracranial complication following tubo-ovarian abscess has not been reported yet. In this case, the 35-year-old women patient with lower abdominal pain and mild headache that was diagnosed as pelvic inflammatory disease was admitted to our hospital and was cared. In the course of admission, headache was aggravated and lateral deviation of eyeballs occurred. She was diagnosed as intracranial abscess following tubo-ovarian abscess in the result of neurological surgery department consultation. So we report it with brief review of literatures.
Abdominal Pain ; Abscess ; Adult ; Brain Abscess ; Female ; Head ; Headache ; Humans ; Neck ; Ovary ; Pelvic Inflammatory Disease

BACKGROUND/AIMS: Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux disease. Endoscopic assessment of LPR is needed for convenient diagnosis and documentation of treatment efficacy. The aim of this study was to investigate the interrater reliability of LPR among endoscopists based on endoscopic laryngeal images. MATERIALS AND METHODS: Nineteen endoscopists participated in this study. Before the test, they completed an intensive education program by an otorhinolaryngologist on the reflux finding score (RFS), which is a validated laryngoscopic assessment of LPR. A total of 100 endoscopic laryngeal images were used for 3 tests of RFS. Cohen's and Fleiss' kappa coefficients were used to determine the degree of interrater agreement in the diagnosis of LPR. RESULTS: In the first test, the mean of Cohen's kappa coefficients for LPR diagnosis between the otorhinolaryngologist and each of the 19 endoscopists was 0.3. In the second test, after additional education, the mean kappa value was 0.32. Fleiss' kappa coefficients for diagnosis of LPR among the 19 endoscopists in the first and second tests were 0.30 and 0.26, respectively. CONCLUSIONS: A short-term education program for endoscopists did not result in an improvement of accuracy in the diagnosis of LPR. Further studies using advanced educational programs for endoscopists are required.
Diagnosis* ; Education ; Endoscopy* ; Gastroesophageal Reflux ; Laryngopharyngeal Reflux* ; Treatment Outcome