Impact of age and delayed presentation on outcome of intussusception in children

To evaluate the impact of age, weight. delayed presentation on outcome. Retrospective study Period: 7 Years period [January 1997 - December 1999 and January 2001 - December 2004]. Setting: Department of Pediatric Surgery, Mayo Hospital and The Children's Hospital, Lahore. During 7 years period total 130 cases of intussusception were admitted. Most of patients presented under 1 year of age. Majority of patients presented after 72 hours of duration. All were operated and ileocolic was the most common type followed by ileoileal intussusception. Below 1 year 58.25% patients required resection anastomosis and after 5 years 27.7% patients required resection. Before 72 hours 25% patients required resection and after 72 hours 74% patients required resection. We conclude that duration and age have definite impact on outcome of intussusception

Modified Duhamel procedure for Hirschsprung's disease: an analysis of 24 cases

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

Oesophageal atresia and tracheosophageal fistula

Forty-six neonates with esophageal atresia and tracheoesophageal fistula were admitted in Mayo Hospital Lahore over a three and half years period from Jane 1995 to December 1998. Of these 76.08 percent were male. Delayed referral of 24 hours or more was noted in 78.20 percent. Among the neonates admitted 88 percent had moderate to severe chest infection and 70 percent weighed three or more than three kilograms. Associated congenital anomalies were noted in 41.3 percent, of which high imperforate anus accounted for more than 50 percent. Ligation of fistula and primary oesophageal end to end anastormosis was performed in 28 patients and in 4 neonates oesophagostomy and gastrostomy were performed. Survival rate of category A was 80 percent and overall survival was 40.63 percent

Acute appendicitis: Metronidazole as monotherapy and early intake of oral fluids

In acute appendicitis role of monotherapy still needs appreciation where there is no perforation or abscess formation. In these patients when a straightforward appendectomy has been performed early intake of oral fluids reduce patients stay in hospitals. A total number of 40 patients divided into two groups. A and B. Group A received one preoperative and two postoperative metronidazole doses and Group B received tripple therapy preoperative and for 72 hours postoperatively. Group A patients were started with oral fluids 6 hours after operation but in Group B oral fluids were started after 24 hours after listening bowel sounds. Results were same in both groups with reduction of hospital stay in Group A patients. No wound infection or complication seen in either group. Monotherapy with metronidazole is as effective as tripple therapy and early intake of oral funds can reduce hospital stay