Vaginal melanoma is a rare cancer usually diagnosed as a locally advanced disease. Aggressive surgical management of the primary tumor and local-regional recurrences, combined with the use of adjuvant radiation and chemotherapy, improves disease-free interval and, perhaps, survival times. Techniques of regional chemotherapy allow the delivery of high doses of chemotherapy to the tumor bed, while minimizing systemic toxicities. These treatments can be used to decrease tumor size, render bulky tumors resectable, and decrease the need for radical procedures. Additionally, they may help eradicate clinically inapparent local-regional disease and have a favorable effect on survival times.

A total of 60 cases of thoracic trauma in children, treated over a period of 4.5 years (January 1983 to June 1987), were analysed. Blunt-impact trauma was the major cause in 58.33% cases, stressing that bullock-cart accidents and bull-horn and buffalo-hoof injuries are still a continuing cause of chest injury in developing countries. Haemo- and/or pneumothorax were the main injuries (78.33%), but cardiac and oesophageal involvement were seen, in two cases each. Isolated first rib fracture was another surprising finding. Except for three, all the cases presented within 24 h of injury. Cyanosis and profound shock were found in five patients each. The majority of the patients (60%) were treated with intercostal tube drainage and major surgical operations were needed in 30%. In the remaining 10%, observation was sufficient. There were two deaths (3.33%), with a success rate of 96.67%.

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