unusual complication of unsafe abortion

Unsafe abortion is a significant medical and social problem worldwide. In developing countries, most of the unsafe abortions are performed by untrained personnel leading to high mortality and morbidity. Case Report: A 30 year-old female, gravida 7, para 6 underwent uterine evacuation for heavy bleeding per vaginum following intake of abortifacient to abort a 14 weeks gestation. The procedure was performed at a rural setup and her bowel was pulled out of the introitus through the perforated wound, an unusual complication of unsafe abortion. Illiteracy, unawareness about health services, and easy accessibility to untrained abortion providers lead to very high mortality and morbidity in India. There is unmet need to bring awareness among the people about the safe and effective methods of contraception and abortion services to avoid such complications

Pediatric cancer pain management at a regional cancer center: implementation of who analgesic ladder

collect data on the prevalence of various types of cancer pain in a sample of children with cancer, and to implement the WHO Analgesic Ladder in the management of pain in pediatric cancer. Eighty four pediatric patients suffering of cancer pain were studied during the period 2001-2006. Patients were requested to rate their global intensity of pain on 0-100 mm visual analogue scale [VAS 0 = no pain 100 = maximum pain]. Pain management was performed in accordance with the WHO Analgesic Ladder for cancer pain. Patients were followed up weekly for three weeks. Of the 84 pediatric children with cancer, pain was nociceptive in 26 [31%], neuropathic in 12 [14.3%] and mixed in 46 [54.8%]. Almost 7 [8.3%] of patients were on WHO step 3 at baseline. Thereafter the WHO step 3 increased; first week visit 36 [43%] patients; second week visit 58[69%], and third week 69 [82.1%]. At baseline, 40 [47.6%] patients took NSAID only, 2 [2.4%] patients took adjuvant, while 38 [45.2%] patients took combination of NSAID and adjuvant treatment. There was statistically significant [p = 0.000] reduction in VAS as time progressed. Cancer pain in pediatric age group can be well managed in accordance with the WHO Analgesic Ladder. Aggressive symptoms and control of treatment of related side effect are also needed to ensure successful implementation and the WHO Analgesic Ladder

Ipsilateral re-expansion pulmonary edema in a neurosurgical patient - a case report

We report a case of a 42-year-old female with right parietal glioma, scheduled for elective craniotomy and tumor excision. The patient developed pneumothorax in the postoperative period. An incidence of unilateral pulmonary edema occurring as a result of rapid re-expansion of collapsed lungs is described. This type of pulmonary edema may delay postoperative recovery and have a catastrophic course especially in neurosurgical patients