A transverse vaginal septum is a horizontal wall of tissue that has formed during embryologic development and essentially creates a blockage of the vagina. It can occur at different levels of the vagina. We report a neonate who was diagnosed antenatally with an enlarged lower abdominal mass suggestive of an enlarged urinary bladder with hydronephrosis and hydroureter. Shortly after birth, she developed urinary retention and neonatal sepsis. Following multiple postnatal investigations, she was found to have a vaginal septum with hydrometrocolpos.
The routine investigation of doing lumbar puncture in patient with febrile convulsion is increasing practiced in many hospital. Objectives: The aim of this study was to assess the necessity of routine lumbar puncture (LP) to diagnose meningitis in children who present with fever and convulsions. Methods: This is an observational, cross-sectional, hospital-based study, carried out in Mohammed AL-Amin Hamid pediatrics hospital-Omdurman Sudan, during the period from the first of January through 31 July 2018. It involved all (146) children aged 5 months to 6years , who presented with fever and convulsions, undergone lumbar puncture, and parents signed written informed consents. Children with known neurological diseases were excluded from this study. Data collected included, age, gender, convulsions type and duration, post-ictal state, routine vaccination status, general condition, recent antibiotics use, past history of fever and convulsions, temperature degree, signs of meningeal irritation, and conscious level. Data were analyzed by Statistical Package for Social Sciences (SPSS) version 23. Results: The result revealed that total number of 146 children, male were 62% (n=91), female were 38% (n=55). 5-11 months 35.6% (n=52) 1-3years 43.8% (n=64), and 4-6 years 20.6% (n=30). About 80% of the patients were younger than 4 years of age. Convulsion was generalized in 97.9%, lasted less than 15 minutes in 99.3%, spontaneously aborted in 94.5%, post-ictal state was brief in 88.4%, first attack in 98.6%, and there was no family history in 97.3%,p=0.000. There was no neck stiffness and photophobia in 92.5% and 98.6% respectively, p=0.000. Patients general condition were well in 76.7% and toxic in 23.3%. Cerebrospinal fluids (CSF) color was clear in 97% and turbid in 3% of patients. CSF white cells was less than 5 in 93.8%, and CSF sugar and protein were normal in 97.3% and 96.6 % respectively, p=0.000. CSF culture was negative for all patients, and almost all (97%, n=141) of the patients were diagnosed as febrile convulsions and sent home, compared to 3% (n=5) who were diagnosed clinically as meningitis. Conclusion: This study revealed that, CSF culture was negative for all patients, and almost all were diagnosed as febrile convulsions. However, 5 patients were diagnosed clinically as meningitis. Hence, this findings, challenge the routine lumbar puncture in children who present with fever and convulsion.
Craniopagus conjoined twins represent a rare phenomenon of congenital malformation/ dysmorphism. The clinical pathology of this complex entity is reviewed and placed in perspective. Confusion surrounds the severity of craniopagus conjoined twins especially in relation to the difficulty of separation and subsequent outcome. Successful separation of craniopagus twins remains a rarity, however modern neurosurgical techniques have created opportunities for successful separation and brought hope for a normal survival of these children who in the past were often left as historical footnotes or put on display as oddities of nature. We report on a craniopagus conjoined twins from Sudan who had been successfully separated.
Background: Duplication cysts are rare congenital anomalies that can occur anywhere in the gastrointestinal tract from the mouth up to the anus. Acquired gastric outlet obstruction (GOO) during infancy beyond the neonatal period is a very rare condition and should be considered when other causes of GOO such as infantile hypertrophic pyloric stenosis, antral diaphragm, and pyloric atresia are excluded.Case Presentation: We report a one-year old female infant who presented with an acute onset of copious persistent vomiting that was initially diagnosed with a duplication cyst of the duodenum, but was found to have GOO after surgical exploration.Conclusion: Clinicians should be mindful of the common causes of GOO and have a high index of suspicion for acquired causes.
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