Floating death in pericardium

A 12-year-old boy referred from another facility after sustaining stray bullet injury to chest on left side with no exit wound. He remained stable through out although chest intubation was done in referring hospital. In our Emergency Room he remained well therefore shifted to surgical unit. Investigations revealed bullet in pericardial cavity. It was decided to remove the bullet on elective basis. Surgery was deferred at the request of parents. Six months later child was operated. Initially thoracoscopy was performed but it was converted to open thoracotomy as bullet could not be identified. It was then retrieved easily from paricardial cavity. Post operative recovery was uneventful

Splenic hydatid cyst: a rare site of involvement

A case of splenic hydatid cyst is reported in which the only complaint was left sided abdominal pain. Hydatid disease was diagnosed on ultrasound abdomen and CT scan. IHA was also significantly raised. Patient was kept on albendazole pre-operatively. On splenic exploration due to the presence of good splenic tissue cystectomy and capitonnage was done

Congenital pyloric atresia: Isolated and associated with aplasia cutis congenita

Two cases of congenital pyloric atresia [CPA] are, hereby, reported. One was suspected on antenatal ultrasound and turned out to be an isolated anomaly. Other patient had a rare association of aplasia cutis congenita with congenital pyloric atresia. The lesions of aplasia cutis congenita were multiple while congenital pyloric atresia was of type II. The patient with an isolated lesion survived following surgery while the other baby died of sepsis in postoperative period

Antibiotic sensitivity pattern in burn wound cultures

To find out the pattern of microbial flora and their sensitivity to antibiotics in burn wounds cultures. Design: Descriptive study. Place and Duration During year 2003, at Burns unit, National Institute of Child Health, Karachi. Subject And Twenty five consecutive patients were included in the study and pattern of most common pathogens was studied with special reference to their antibiotic sensitivity. The bacterial cultures were taken at different intervals during the hospital stay, first on the second day of admission and then subsequently, following every 7-10 days. Antibiotic sensitivity pattern was correlated to the antibiotic the patients were receiving. Our results revealed that the most frequent isolate was pseudomonas [80%] followed by staphylococcus aureus [40%], klebsiella [28%], proteus [16%] and streptococcus [8%]. Time related changes showed that the bacterial isolates were predominantly gram negative rods [70%]. in the first culture taken on the 2nd day of admission and remained high throughout the hospital stay and was up to 90% in the final culture. There is a specific pattern of burn wound microbial colonization, with time related changes in dominant flora. Antibiotic sensitivity profile is helpful to make guidelines for dealing with the burn wound at the outset and for which antibiotic to start with. Following this protocol the morbidity and the resistant flora could be avoided