ABSTRACT
Foreign bodies in the vagina in paediatric population are not commonly suspected. The presentation of such cases is similar to that of pathological diseases of cervix and the vagina like vaginitis and cervicitis which are more common. Infections of young female genital tract are common because of higher pH, relatively low oestrogen level and unfavourable bacterial flora.(1)Foreign bodies in the vagina are usually introduced accidently and history is negative. Patients commonly present with blood stained discharge, foul smelling pus, pain in the abdomen, dysuria or constipation. Symptoms secondary to vaginal foreign body account to 4 % of paediatric population visiting gynaecological OPD as reported by Dahiya et al.(2) In girls <6 years of age, who underwent examination under general anaesthesia, aetiology of vaginal discharge in 45 % of the cases was found to be foreign body. He has suggested that it is becoming important in most settings to organize special gynaecology clinics for pre-pubertal girls in order to develop special knowledge and skills needed in paediatric gynaecology. Here we report a case of pre-pubertal girl with vaginal foreign body not responding to medical line of management (antibiotics), rendering further evaluation for vaginal discharge. Unusual scenario in this report is a simple case which remained undiagnosed for one year. Another issue was absence of mother from the scene and constant denial by father to bring her which raises the suspicion of sexual abuse.
ABSTRACT
Background: The aim of the study was to evaluate whether light-emitting diode (LED) phototherapy is as efficacious as compact fluorescent tube (CFT) phototherapy for the treatment of non-hemolytic jaundice in healthy term and late preterm neonates.Methods: Study design was open label randomized controlled trial conducted at tertiary care NICU. Healthy term and late preterm neonates with non-haemolytic jaundice included in the present study. Intervention was double-surface LED or CFT phototherapy. Primary outcome variable was duration of phototherapy.Results: A total of 60 neonates were randomized to receive LED (n=30) or CFT (n=30) phototherapy. The baseline demographic and biochemical variables were similar in the two groups. The median duration of phototherapy (Mean'SD) in the two groups was comparable (26.7'7.0) h vs (24.8'6.05) h, P=0.0.241). The rate of fall of serum total bilirubin (STB) during phototherapy in initial 6 hours was significantly more LED group (n=30), 3.43'0.65 versus (n=30) 2.22'0.55 with P-value of <0.001.Conclusions: LED and CFT phototherapy units were equally efficacious in the management of non-haemolytic hyperbilirubinemia in healthy term and late-preterm neonates.' Side effects were rare, comparable in the two groups and included only rash.