Rota virus diarrhea in hospitalized children

To determine the frequency and clinical features of Rota virus diarrhea in children presenting in a tertiary care hospital. A cross-sectional, observational study. National Institute of Child Health, Karachi, from January to June 2007. A total of three hundred children of either gender aged 1 month to 5 years, who presented with diarrhea of < 7 days as a primary illness were enrolled. Children with bloody diarrhea or nosocomial gastroenteritis acquired during hospitalization for other disease were not included. Detection of Rota virus in stool was done by enzyme linked immunoassay. Out of 300 children, 188 [63%] tested positive and 112 [37%] tested negative for Rota virus. Positive Rota virus cases in 7 - 12 months of age was [n = 34, 18.08%]. Overall, 151 [80.3%] children with Rota virus were less than 3 years old. 182 [60.7%] had fever, 118 [39.3%] had vomiting and 156 [82.9%] children had both fever and vomiting. This study shows that Rota virus is a common organism causing diarrhea in children less than 3 years of age. There is a need to incorporate Rota virus vaccine in the national EPI program to decrease the disease burden as highlighted in this study

Left paraduodenal hernia: a rare cause of large bowel obstruction and gangrene

Internal hernias are a rare cause of intestinal obstruction. Paraduodenal hernias are the most common type of internal hernias. Although small bowel obstruction is associated with internal hernias, large bowel obstruction is unique. The authors here report a case of left para duodenal hernia with simultaneous small and large bowel obstruction and gangrene. The patient underwent emergency laparotomy and generous resection of gangrenous small and large bowel was carried out and stoma was created. Postoperatively, the patient had a smooth recovery and was discharged after a few days. Reversal of stoma was carried out after 2 months

Pilonidal sinus: following the Aristotelian middle!

Pilonidal sinus of the sacrococcygeal region is a fairly common malady. Many surgical and non-surgical methods have thus far been described with variable success rates. No standard operation is in practice, owing to discouraging rates of recurrence. A simple excision and primary repair is described with fairly good results. Thirty two patients with this condition were operated upon by the author between January 2003 and December 2007. A simple excision and primary repair were undertaken in all. Their retrospective data were tabulated from the respective files and analysed. Mean follow-up period was 11.7 months [range, 6-24 months]. Only two patients had partial dehiscence of the suture line that responded to conservative management. There was no full-fledged recurrence in the duration of follow-up. Simple excision and primary closure is a straightforward procedure with good results. A meticulous technique, including follow-up advice [hygiene, depilation etc.] can have a beneficial effect on post-operative outcomes