Bacterial meningitis in children

To study the demographic features, yield of gram staining, cerebrospinal fluid culture and etiological pattern of bacterial meningitis in children of 2 months to 12 years. Material and A hospital based prospective and descriptive study was carried out at the Department of Pediatrics, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar. All those children in the age group between 2 months to 12 years having clinical suspicion of meningitis and cerebrospinal findings suggestive of meningitis i.e. >10'106 WBC/L and/or CSF sugar <40mg% or [<50% of the circulating blood sugar] and/or CSF protein >80mg% were included in the study. Children having history of intake of antibiotic in the last 5 days which can cross the blood brain barrier and children with tuberculous meningitis were excluded. A total of 120 patients [1.7% of the total admissions] were included in the study. Male patients were 69 [57.5%] and female were 51 [42.5%]. Out of 120, 47[39.2%] were in the age group of 2 months- 1 year, 39 [32.5%] were in the age group of >1-5 years and 34 [26.3%] were in the age group of >5-12 years. Majority of our children were below 5years i.e. 71.7%. Gram staining was positive in 68[56.7%] cases and negative in 52[43.3%]. The CSF cultures were positive in 59[49.2%] cases and negative in 61[50.8%]. The three most common pathogens isolated were Streptococcus Pneumoniae 27[22.5%] cases, Neisseriae Meningitides 20[16.7%] cases and Hemophilus influenzae B 11[9.2%] cases. Bacterial meningitis is the major cause of morbidity in children below the age of 5 years. The yield of gram staining and culture though comparable with the national studies but lower than reported internationally. S Pneumoniae, N Meningitides and H Influenzae are the three most common causes of Bacterial Meningitis in our children as reported nationally and internationally

etiology pattern of pancytopenia in children upto 15 years

Pancytopenia is a common finding [I%] in clinical practice. It is not a disease in itself but there are various causes of this clinical triad of anaemia, neutropenia and thrombocytopenia. The early diagnosis of the causation of Pancytopenia is important because most of these causes are treatable. This one year descriptive study was done to know the etiological pattern of Pancytopenia in children. The children who were selected for this study were upto the age of 15 years with clinical suspicion of Pancytopenia and special blood smear showing Pancytopenia. A total of 60 patients [0.85% of the total admission in Paediatric ward] were included in this study. Males were 48 [80%] and females were 12 [20%]. Age distribution was 0-5 year 30 cases [M=22, F = 8], > 5-10 years 20 cases [M=17, F=3], > 10 -15 years 10 cases [M-9, F- 1]. Out of these 60 cases of Pancytopenia the cause was identified in 55 [91.57%] cases with the help of bone marrow examination and other supportive tests. In the remaining 5 [8.43%] the cause of Pancytopenia could not be identified. The common cause of Pancytopenia was aplastic anaemia followed by iron deficiency and megaloblastic anaemia. Mylodysplasia, ALL, Leishmaniasis, Malaria and Fanconi's anaemia were found in the descending order

Abdominal contouring with liposuction

This article introduces and highlights the different techniques of abdominal liposuction. The new concept of minimal invasive surgery has revolutionized the body contouring surgery. Liposuction, also known as lipoplasty or liposculpture, is the surgical removal of adipose tissue through small metal cannula. Abdominal contouring with liposuction has advanced with the passage of time for removal of exercise-resistant fat over the abdomen to make a person slimmer and good-looking. Skilful surgery and meticulous techniques can prevent its complications and make it more safe and effective procedure

Anesthesia in children with upper respiratory tract infection

Children can develop plugging of tracheal tube from tenacious mucoid secretions and this impairs the adequate gas exchange. An airway obstruction could end in a catastrophe. To avert any possible adverse out come from anaesthesia in children with history of resolving upper respiratory tract infection [URTI] vigilance, adequate oxygenation, close observation of respiration and perioperative monitoring of arterial oxygen saturation by pulse oximetry are mandatory. Careful consideration to postpone the surgery is also needed at times