The kidney is the most common genitourinary organ injured from external trauma, occurring in 1% to 5% of all injuries. Non operative management of renal injuries with renal salvage as the primary aim has gained much support in the past decades; though paediatric data is limited. Here we present a case of unilateral complete transection managed conservatively and the renal salvage was possible with retaining normal function.

Introduction: Central line associated blood stream infection (CLABSI) is a primary blood stream infection in a patient that had a central line within the 48-hour period before the development of bacteraemia and is not related to an infection at another site. It is often associated with serious infectious complications resulting in significant morbidity, increased duration of hospitalization and additional medical costs. Objective: We aimed to study the course of infection, microbiology of CLABSI, & to identify the degrees of severity of sepsis associated with CLABSI. Materials & Methods: Patients admitted in Intensive care units who fulfilled the inclusion criteria were enrolled. Various demographic, microbial and patients characteristics were noted along with outcome using a prestructured proforma. Results: We studied 58 patients in ICU in which males were common, Sepsis seen in 43% of patients, 37% had Staph. Aureus, and the mortality was 24.1%. Conclusion: CLABSI infection is best prevented rather than cured. It has mortality as high as 24.13%. It can manifest with varying degrees of severity of sepsis. Organ Dysfunction, multi organ involvement, TLC abnormalities, Oliguria, altered mental status, Hypotension are all markers of poor prognosis. More scientific data on the subject is required to formulate guidelines and protocols for prevention and treatment of CLABSI.

No abstract

Background: The aim of this study is to present their initial 5-year experience in the treatment of fistula-in-ano by means of VAAFT (Video-Assisted Anal Fistula Treatment).Methods: 76 patients were competent for the VAAFT procedure. Patients were subjected to routine diagnostic tests. 20 patients had classical fistula surgery. In the remaining 56 patient full procedure i.e. diagnostic fistuloscopy, closing the internal ostium, and coagulation of the fistula canal was done. The mean observation period was 23 months.Results: Majority of the cases, inter-sphincter fistula and multiple branching was observed during the diagnostic fistuloscopy. Nine patients had additional fluid compartments. In 56 patients subjected to the full VAAFT procedure the internal ostium was closed using a linear stapler. A recurrence of fistula was observed in one, while non-healing was seen in two patients. Major complications like stool and gas control deterioration (based on the FISI scoring) were not observed in VAAFT operated patients.Conclusions: The VAAFT method preserves sphincter competency, no major intraoperative and postoperative complications were observed. The recovery rate is observed to be comparable with other techniques without the risk of incontinence. It is one of the best method enabling intraoperative visualisation and identification of the internal ostium and fistula canal. Initial optimistic results require further investigations on a larger group of patients.

No abstract