Characteristics of recurrent pericardial effusions

<p><b>INTRODUCTION</b>There are various aetiologies for recurrent pericardial effusions. Malignancy is the commonest cause in the West, but in Asia and sub-Saharan Africa, tuberculosis is common and contributes towards a high prevalence of tuberculous recurrent pericardial effusions.</p><p><b>METHODS</b>In our hospital-based descriptive study of 32 patients, we looked into various characteristics of recurrent pericardial effusions using the hospital data.</p><p><b>RESULTS</b>We found tuberculosis to be the commonest cause of recurrent effusions, occurring in 50 percent (n = 16) of our patients, followed by malignancy (n = 9). The clinical features at presentation in patients who eventually developed recurrent pericardial effusions were more severe, compared to uncomplicated pericardial effusions.</p><p><b>CONCLUSION</b>Knowledge of the presenting features of patients with recurrent pericardial effusions is crucial, so that they can be placed under increased surveillance and considered for early institution of pericardial fluid drainage procedures.</p>

Fixation of bilateral pelvic osteotomies with external fixator in exstrophy bladder complex

To present the early results of pelvic osteotomies performed for repair of exstrophy bladder. Five cases of exstrophy bladder were treated with closure following bilateral iliac osteotomies. Three patients underwent closure of pubic symphysis diastasis by use of external fixator, one by screws and cerclage wires, and one by use of K-wires and suture. The patients were followed up by the pediatric urologist and orthopedic surgeon. All patients achieved a closure of diastasis and a tension free repair after the index surgery. The average follow-up was 3.6 years with range of 4 months to 6 years. All osteotomies healed within two months and had closure of the diastasis, except one which had a partial failure with loss of 50% correction. No patient had any wound dehiscence or breakdown of the bladder repair. Preoperative mean diastasis of symphysis pubis was 6 cm [range; 4.5 cm to 7 cm] and post operative mean diastasis was 3.5 cm with the range of 2.5 cm to 4 cm at 12 months follow up. All patients achieved urinary continence post operatively and were passing urine per-urethra with satisfactory urinary control as followed-up with the pediatric urologists. Bilateral iliac osteotomies and use of external fixator in our series was found to be helpful in achieving a tension free closure and preventing dehiscence of the repair

Postfixation pseudoaneurysm of the superficial Femoral artery in Femoral shaft Fracture

This case report describes a young female child presenting with a painful, expansile swelling at the medial aspect of her right thigh which had followed an open reduction internal fixation of a closed fracture of midshaft of right femur. An angiogram confirmed pseudoaneurysm of the superficial femoral artery probably caused by overpenetration of the drill bit or any sharp instrument while applying dynamic compression plate. It was treated surgically by resection of the aneurysm, reconstruction with inter-positional sephanous vein graft and removal of the hardware