RESUMEN
Peritonitis as a result of spontaneous rupture of the uterus due to pyometra is a very rare entity. Since 1980, only a few cases of spontaneous rupture of the uterus due to pyometra have been reported in the literature. It is a diagnostic dilemma for a surgeon and a possibility of this entity though very rare should be borne in mind in an elderly female patient with diffuse peritonitis as outcome improves greatly on timely diagnosis and proper management. We present a case of peritonitis due to spontaneous rupture of the uterus due to pyometra which was diagnosed at laparotomy and managed successfully.
RESUMEN
Objective: To compare analgesic effect of direct breast feeding, 25% dextrose solution and placebo as we give 1st intramuscular whole cell DPT injection to 6week - 3month old infants. Design: Randomized, placebo controlled trial. Setting: Immunization clinic of Department of Pediatrics, LLRM Medical College. Participants: Infants coming for their 1st DPT vaccination were randomized in to three groups of 40 each. Outcome measures: The primary outcome variable was the duration of cry after vaccination. Secondary outcome variables were Modified Facial Coding Score (MFCS) and latency of onset of cry. Results: 120 babies were equally enrolled in breast feed group, 25% dextrose fed group and distilled water fed group. Median (interquartile range) of duration of cry was significantly lower in breast fed (33.5 (17-54) seconds) and 25% dextrose fed babies (47.5 (31-67.5) seconds) as compared to babies given distilled water (80.5 (33.5-119.5) seconds) (P<0.001). MFCS at 1 min and 3 min was significantly lower in direct breast fed and dextrose fed babies. Conclusions: Direct breastfeeding and 25% dextrose act as analgesic in young infants undergoing DPT vaccination in young infants less than 3 month of age.