ABSTRACT
The Bacille-Calmette-Guerin [BCG], a living attenuated vaccine with characteristic residual virulence, has been used to prevent tuberculosis since 1921. The world health organization [WHO] has recommended BCG Vaccination as a part of the global expanded program for immunization [EPI] in developing countries. Lymphadenitis with or without suppuration is the most common complication of this vaccination. Retrospective Study. This study was conducted in Nishtar Hospital, Multan Pakistan and King Faisal Hospital Taif, KSA between May 2009 to June 2012. All patients referred to pediatric surgical service in a period of three years were retrospectively studied for optimum management. Our all 28 patients underwent surgical management and were advised antituberculous treatment but only 6 [21.4%] were compliant with medical treatment. All patients recovered after surgery with or without antituberculous treatment. Optimum treatment for post BCG lymphadenitis who are unresponsive to medical treatment is surgery. Post operative antituberculous treatment seems to be unnecessary
ABSTRACT
Morbidity in children treated with right iliac fossa pain results either from late diagnosis or negative appendectomy. Diagnosis in equivocal cases is difficult. A prospective analysis of the Alvarado score for early diagnosis of appendicitis and to avoid unnecessary admissions for all patients with right iliac fossa pain was conducted. 255 patients with right iliac fossa pain from age 3 to 12 were enrolled in this prospective study in a period of 2 years. Patients were categorized into three groups according to the Alvarado score. Group 1 patients [63] with the Alvarado score 1 to 4 were discharged but reviewed in OPD, group 2 [139] with the Alvarado score 5 to 6 were kept under observation and group 3 [53] with Alvarado score 7 to 9 were operated. Of the discharged patients 9 were admitted due to worsening of symptoms. 3/9 were operated. 2/3 were diagnosed as appendicitis. Patients under observation, 12/139 [8.6%] underwent appendectomy, 10/12 were found to have appendicitis. All of group 3 patients were operated. 49/53 [92.4%] were found to have acute appendicitis. As a whole only 68/255 [26.6%] patients were operated, 61/68 were diagnosed as appendicitis on histopathology. Negative appendectomy rate fell on 10.2%. Sensitivity of score >/= 7 to diagnose appendicitis was 92.4%. The Alvarado score is simple, easy and reliable to decide whether to discharge, observe or operate the patients who visit emergency department with right iliac fossa pain
Subject(s)
Humans , Male , Female , Appendicitis/complications , Abdominal Pain/etiology , Abdominal Pain/therapy , Prospective Studies , Child , Disease ManagementABSTRACT
A Prospective analytic study of 24 case of Hirschsprung's disease [H.D] was conduct over a period of two years first January 2000 to December 2001 in the Department of Paediatric Surgery, Mayo Hospital, Lahore, to evaluate the outcome of the patients after modified Duhamel pull through procedure. The results showed that Modified Duhamel procedure with the help of Mechanical stapling device had minimum complications with no mortality and were consistent with other studies showing that Modified Duhamel procedure is quite safe for Hirschsprung's Disease