Haemophilia B: clinical manifestations and complications

Haemophilia B is X-linked recessive inherited disorder of factor IX deficiency. It is classified as severe, moderate and mild depending upon plasma levels of factor IX. The development of inhibitors is seen during treatment of haemophilia B against F-IX. This study was aimed to determine the frequency of different complications in haemophilia B patients. Total 45 patients of Haemophilia B already enrolled in the Haemophilia society of Pakistan Lahore chapter were included in this study. Clinical history and physical examinations were recorded on a pre designed proforma. Laboratory testing for establishment of diagnosis of haemophilia B and inhibitors of FIX was done. Out of 45 patients, 10 [22.2%] had severe disease while 28 [62.2%] had moderate and 07 [15.6%] had mild disease. Twenty nine [64.4%] of patients with severe and moderate disease were diagnosed below 5 years of age while none with mild disease was diagnosed under 5 years of age. Arthropathy was the most frequently developing complication in patients 10 [100%] of severe Hemophilia B. Post circumcision bleeding was found to be the most common first episode of bleeding in patients of haemophilia B 29 [64.4%]. Inhibitor against F-IX developed in only one patient of severe disease 1 [10%]. Arthropathy is the commonest complication and circumcision is the first bleeding site in most of the haemophiliacs

Circumcision-related complications in the male : experience amongst the Igbo's of Southeast Nigeria

Objectives To evaluate male circumcision and the complications associated with it amongst the Igbo people of Southeast Nigeria. Patients and Methods This study was a prospective review of male circumcision and its complications amongst the Igbo's of Southeast Nigeria carried out over a period of six months. It was conducted in three centers (public; private and a mission hospital) in Anambra State (a core Igbo state) of Nigeria. Circumcision was done after birth at any convenient time; and the babies were followed up at the post natal clinic (six weeks after birth) for possible complications. A questionnaire is usually filled at the time of circumcision and completed at the post natal visit. Results A total of 141 circumcisions were performed during the study period. Most of the circumcisions (73.8) were done between 7 and 9 days after birth. The plastic bell method was used more extensively than the traditional method (68.1and 31.2; respectively). The method preferred by the mothers was not statistically different from the method used. The overall complication rate in this study was 24.1. A higher complication rate was recorded with the use of the traditional method compared to the plastic bell method (43.2vs. 15.6; P0.01); and when circumcision was performed by midwives instead of physicians (30.6vs. 14.5; P0.01). Conclusion Two factors were responsible for a high complication rate: the use of the traditional method of circumcision and the competence of the performer. It is therefore suggested that circumcision be done by the use of the plastic bell and only by qualified and trained personnel

Usefuless of Caudal Block in children

We are becoming aware of the need for adequate analgesia in children. Aim: is to find the effectiveness of caudal analgesia in children undergoing circumcision. Forty boys undergoing circumcision were studied in Services Hospital, Lahore. Caudal Block [CB] was given after general anaesthesia but before the start of surgery. Half the boys [LAG], received CB with 0.5 ml/kg of 0.2% bupivacaine solution, the other half received equivalent volume of normal saline [NSG].Behaviour of the boys, pain relief and side effects were assessed postoperatively. Complete pain relief was obtained in 100% of LAG while in [NSG] only 10% boys had adequate pain relief. Boys in LAG were pain free for 12 to 18 hours postoperatively. NSG required pethidine to achieve pain relief. Complications were only few and minor, but the pain relief was very good with CB. CB for circumcision in children is quite simple, safe and provides effective analgesia for 12 to 18 hours postoperatively

Estenosis del meato: una complicación en la circuncisión del recién nacido / Meatal stenosis: a complication of the neonatal circuncision

La estenosis del meato es una complicación común de la circuncisión en el recién nacido; sin embargo, su frecuencia exacta es difícil de establecer. El propósito del presente trabajo es analizar los casos de estenosis adquirida del meato, tratados en el Servicio de Cirugía Pediátrica del Hospital Militar "Dr. Carlos Arvelo", en el período comprendido desde enero de 1976 hasta diciembre de 1986, y estudiar su relación con la operación de circuncisión previa