Background: Trauma meets the pandemic criteria, with a daily worldwide mortality as high as 16000. Abdominal trauma remains a leading cause of mortality in all age groups. Blunt abdominal trauma (BAT) mainly results from motor vehicle accident, fall from height and assaults. The commonest organ injured is the spleen, followed by the liver and small bowel. Lately, the management of BAT has changed from operative to non-operative management. This study was done to analyse the incidence, patterns, current management practiced, and challenges encountered in BAT treated operatively.Methods: This Prospective study was conducted in tertiary care centre in Bangalore during August 2015 to December 2017. 475 patients with blunt abdominal injuries who reported to emergency department were selected for the study based on following inclusion and exclusion criteria.Results: A total of 475 cases of BAT were assessed with a mean age of males and females was 32.6 and 28.3year respectively. Most patients (65%) were between 21 to 30 years of life. Most common mode of injury was motor vehicle accident (57.68%), 60% patients presented to hospital within the initial 4 hours. Abdominal CT had highest accuracy. Most common solid organ injury being spleen (26.5%). 80.84% patients were selected for SNOM and 15.62% had Failed SNOM. 28.48% patients had complications with most common complication wound infection followed by aspiration pneumonia and 7 patients had mortality.Conclusions: Initial resuscitation with thorough clinical examination with correct usage of imaging modalities with timely and proper decision making is the key of management of patients with BAT and there is a need to identify newer imaging modality/procedure which helps to determine better management scheme in all blunt trauma patients.
We are describing a case of plasmodium vivax malaria in a child with complications including pancytopenia secondary to marrow involvement, jaundice and neurological features. The child improved with antimalarial treatment.DOI: 10.3126/jnps.v30i3.3922J Nep Paedtr Soc 2010;30(3):168-170
Neuropsychiatry is an area of medicine that deals with behavioural issues caused by brain dysfunction. It is found at the intersection of neurology and psychiatry. Individuals with congenital and genetic diseases are more likely to experience neuropsychiatric symptoms (particularly mental retardation), which can lead to considerable disability and a lower quality of life. Developmental delay, intellectual disability, autism spectrum disorders (ASDs), and cognitive dysfunction are the most common symptoms of neuropsychiatric illnesses. Many intellectual developmental abnormalities are caused by complex genetic components (such as attention deficit hyperactivity disorder), pregnancy or birth complications, or environmental variables, among other things. Patients with congenital and genetic diseases with neuropsychiatric indications benefit from a multidisciplinary approach to management. Interdepartmental liaisoning may be advantageous in the absence of a multidisciplinary team.
Iliopsoas abscesses are rare in neonates. Clinical presentation of neonates with iliopsoas abscess often mimic other common neonatal illness. Typical clinical features as described in adults may not be observed in neonates. Such abscesses cause a diagnostic dilemma for the clinician, often resulting in a delay in clinical diagnosis and institution of specific treatment. We report a case of a 10-day old term male neonate from community who presented with high grade fever, abdominal distension, left lower limb swelling with limitation of movement and diagnosed to have left sided iliopsoas abscess on ultrasonography. The neonate undergone and extraperitoneal surgical drainage of the abscess along with a course systemic antimicrobial agent. The case is of clinical importance because it describes the presence of a localized abscess in an uncommon location and Methicillin resistant staphylococcus being the causative organism, which represents a rare and potentially life-threatening infection in neonates.
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