Sultan Mohsin Ghanim Alsaadi

ry. The book provides the reader the information on which a surgeon relies on in diagnosis and treatment. Chapters start with the physiology of infants before progressing into separate topics about the surgery of different sections including the head and neck, chest, abdomen, reproductive organs, cancers, and the nervous system. Information is presented in a simple manner, which makes the text easy to understand for both students and medical residents.

ry. The book provides the reader the information on which a surgeon relies on in diagnosis and treatment. Chapters start with the physiology of infants before progressing into separate topics about the surgery of different sections including the head and neck, chest, abdomen, reproductive organs, cancers, and the nervous system. Information is presented in a simple manner, which makes the text easy to understand for both students and medical residents.

ry. The book provides the reader the information on which a surgeon relies on in diagnosis and treatment. Chapters start with the physiology of infants before progressing into separate topics about the surgery of different sections including the head and neck, chest, abdomen, reproductive organs, cancers, and the nervous system. Information is presented in a simple manner, which makes the text easy to understand for both students and medical residents.

ry. The book provides the reader the information on which a surgeon relies on in diagnosis and treatment. Chapters start with the physiology of infants before progressing into separate topics about the surgery of different sections including the head and neck, chest, abdomen, reproductive organs, cancers, and the nervous system. Information is presented in a simple manner, which makes the text easy to understand for both students and medical residents.

Abstract Purpose Progressive familial intrahepatic cholestasis (PFIC) is a hereditary disease characterized by cholestasis, which may cause jaundice, severe pruritus, and cirrhosis in the later stages. By the invention of biliary diversion methods, these patients were prevented from undergoing liver transplant. Using biliary diversion techniques, the entero-hepatic cycle was inter- rupted. This lowers the bile acid pool and resolves the pruritus. Herein, we report 44 cases of PFIC who underwent partial internal biliary diversion (PIBD) and long-term follow-up of these children. This comprises the largest case series of PIBD. Methods All patients were diagnosed by liver biopsy as PFIC before the operation. All underwent cholecysto colic bypass by jejunal interposition due to severe pruritus unresponsive to medication. Laboratory blood tests, sonography, and physical exam were done before and after the operation once every 3 months. Besides, a questionnaire was designed to ask the patients about the symptoms after the operation, and a pruritus score was measured using the 5D-itch scale. Results 44 children (25 boys, 19 girls), between 1.75 and 27.5 years (at the time of this study) were followed for a median period of 54 months. Age at operation ranged from 2 months to 18 years, with a median of 29 months. Of these children, 14 were lost to follow up. Results showed a significant decrease in pruritus and sleep disturbance after the surgery (p < 0.001). Also, jaundice decreased from 82.1 before to 7.1% following the surgery. 50% of the patients became medication-free at follow-up. Conclusion PIBD is a safe procedure which helps non-cirrhotic children preserve their liver function. Therefore, PIBD pre- vents them from undergoing liver transplant. Effective results were achieved in terms of severe pruritus and jaundice, and children were able to regain their sleep patterns. It also avoided external stoma, which is more convenient from the patient’s point of view. Keywords Progressive familial intrahepatic cholestasis · Biliary diversion · Partial internal biliary diversion

COVID 19 vertical transmission is a great concern in different aspects of mother, child, healthcare staff and community safety and protection. There is lack of definitive evidence confirming or declining mother to child COVID 19 transmission. This article is an update on this challenging issue.