OBJECTIVES: To determine the frequency of lumber puncture-proven acute bacterial meningitis among children with fever and seizures of first onset.METHODOLOGY From March 2020 to March 2021, a hospital-based descriptive cross-sectional study was conducted at the paediatrics department of Hayatabad Medical Complex Peshawar. The sample size for a total of 342 people was estimated using WHO software. The study included all children who had first-onset febrile seizures through OPD and the emergency department. All children underwent lumber punctures using a stringent aseptic procedure, and the hospital laboratory received the samples to look for bacterial meningitis. On a pre-made Proforma, details including name, age, and gender were entered. The gathered data were input into the computer for additional SPSS analysis (version 23).RESULTS Most individuals were male and were lies in the 21-40 months of age group. Mean weight and length/height were evaluated, respectively. The majority had a history of 6-10 days of disease duration. Bacterial meningitis was found significantly (p<0.05) associated with age, gender and neurological deficit, while non-significantly (p>0.05) associated with the duration of diseases.CONCLUSION All children between the ages of 6 months and 60 months who presented with episodes of fever and seizures were found to have a statistically significant (p<0.05) association found among bacterial meningitis and age groups.
Omental torsion is a rare cause of acute abdominal pain. Diagnosis of omental torsion is usually difficult because clinical signs and symptoms are similar to other common causes of abdominal pain. The most common preoperative diagnosis is acute appendicitis and the proper preoperative diagnosis is important for the appropriate treatment option. Diagnosis of omental torsion is difficult and mainly based on ultrasound and computed tomography (CT) scan analysis. Case Presentation: A 26 years old male patient presented to emergency department with acute abdomen mimicking acute appendicitis. The chest and abdominal X-rays were normal. Due to intense clinical signs and worsening of the symptoms the patient underwent an operation with the probable diagnosis of acute appendicitis. In this case patient explored via gridiron incision, the omentum was found to be gangrenous that had encased the appendix so midline incision given. Post-operative recovery was uneventful. Conclusion: Omental torsion is highly uncommon cause of right lower abdominal pain and difficult to diagnose preoperatively. It presents with non-specific symptoms, mimicking other abdominal conditions presenting a similar clinical settings. CT scan is very helpful in diagnosis. Surgical treatment is the procedure of choice with laparoscopy being the preferable approach.
Introduction: Laparoscopic cholecystectomy has become the gold standard treatment for symptomatic gall stone disease all over the world. In laparoscopic cholecystectomy gall bladder is traditionally removed through umbilical port. In this approach surgeon has to change his position and telescope has to be changed in xiphoid port. Another approach to remove the gallbladder is through 10mm xiphoid port without changing position of telescope and surgeon. Both approaches are compared for their pros and cons regarding post-operative pain at site of removal. Study Design: Randomized control study. Setting: Department of surgery of Allama Iqbal medical college/ Jinnah hospital Lahore. Period: August 2017 to February 2018. Material & Methods: To compare mean post-operative pain in gall bladder retrieval through umbilical versus xiphoid port in four ports laparoscopic cholecystectomy for acute cholecystitis. Patient were divided in two equal groups with first group had their gall bladder retrieved through umbilical port while the other underwent retrieval through xiphoid port. Standard analgesia was used in both groups and post-operative outcome was noted. Results: A total 70 patient with equal distribution in two groups were enrolled to compare post-operative pain at port site comparing umbilical versus xiphoid process. Mean post-operative pain visual analogue scale (VAS) was as lower (p<0.0001) at 1, 6, 12 & 24 hrs. In umbilical port group as compared to xiphoid port group. Conclusion: Mean post-operative pain in gall bladder retrieval umbilical port give advantage in post-operative period regarding significantly reduced pain when compared with xiphoid port in four ports laparoscopic cholecystectomy for acute cholecystitis in selective cases.
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