Abstract:Chronic pyelonephritis presenting as retroperitoneal hemorrhage is an unknown complication and to the best of our knowledge there is only one reported case of acute retroperitoneal hemorrhage complicating a Xanthogranulomatous pyelonephritis. We present an atypical case of Xanthogranulomatous pyelonephritis presenting with acute retroperitoneal haemorrhage ending up with nephrectomy.

Background: Perinatal hypoxic ischaemic encephalopathy affects 1-2 per 1000 live births. Therapeutic hypothermia is now a standard treatment shown to reduce the severity of neurological damage in mild to moderate cases. Cooling should be commenced within six hours of birth and the target core temperature is 33-34°C. Currently, the recommended practise is for transfer within Neonatal Networks to a centre with experience of providing therapeutic hypothermia for further management. This requires the provision of passive cooling during transport. Method: We conducted a retrospective case note review to look at the temperature regulation during transfer of the babies in Yorkshire and Humber region. The temperature data is expressed as an interquartile range (IQ1-IQ3) and was analysed using Microsoft Excel. Result: In total the Yorkshire and Humber Infant & Paediatric Transport Service transferred nineteen babies to regional cooling centres during April 2010 and November 2010. All the babies were term (>37week gestation). All the babies were passively cooled and in one baby ice packs were used when referred. The median temperature at referral was 35.4°C (34.7-35.7°C), on arrival of the transport team 34.4°C (33.1-36.0°C), on departure 33.4°C (33.0-34.4°C), at receiving unit 33.1°C (32.7-33.6°C). In 2 babies the temperature was unrecordable.The target temperature was achieved in only 47% of cases. Conclusion: Maintenance of temperature within the target range is challenging during transport. Following the audit there has been increased awareness about monitoring core temperature while cooling babies. As a service we aim to use active cooling method to achieve target temperature.

Scaphoid fractures are common, but present unique challenges because of the particular geometry of the fractures and the tenuous vascular pattern of the scaphoid. Delays in diagnosis and inadequate treatment for acute scaphoid fractures can lead to nonunions and subsequent degenerative wrist arthritis. Scaphoid nonunions can present with or without avascular necrosis of the proximal pole, and may show a humpback deformity on the radiograph. If left untreated, scaphoid nonunions can progress to carpal collapse and degenerative arthritis. Surgical treatment is directed at correcting the deformity with open reduction and internal fixation with bone grafting. Recently, vascularized bone grafts have gained popularity in the treatment of scaphoid nonunions, particularly in cases with avascular necrosis. This study gives us a radiological and functional outcome of 10 cases operated by pronator quadratus based muscle pedicle bone graft for scaphoid non unions at waist level.

Background: Osteoporotic vertebral compression fractures have gradually evolved into serious health care problem globally. Vertebroplasty is an outpatient procedure for OVCF. Materials and methods: Our Prospective Study Consists of Twenty Patients of Which Fifteen Wre Female and Fiove Were Male. Percutaneous Vertebroplasty Was Done In Single Level For 14 Patients Double Level For 4 Patients And Three Level For 2patients. Results: Results After 2 Year Follow up Was Excellent In 14 Patients Good In 3 Patients Fair In 1 Patient. 2 patients had cement leakage. Conclusion:Percutaneous vertebroplasty is a technically feasible treatment in patients with osteoporotic compression fractures which doesn't respond to the best possible conservative treatment. Percutaneous vertebroplasty works as internal splint for the microfractures of vertebral body by methyl methacrylate cement which helps to relief severe pain.

Breast abscess is less common in developed countries due to improved puerperal hygiene, nutrition, early administration of antibiotics and standard of living, breast abscess remains a morbid condition among lactating women in developing countries. Breast abscess is a most common cause of morbidity in puerperal women. Breast abscess ranges from mastitis to deep abscess. The Incidence of lactation breast abscess is high in India. The aim of this study is to compare the results of ultrasound guided aspiration and incision and drainage in the management of breast abscess. This is a comparative study between ultrasound guided aspiration and incision and drainage consist of 50 patients who underwent both the treatment alternatively. Even though recurrence rate is slightly high in USG guided aspiration when compared to incision and drainage, USG guided aspiration is effective method of treatment in breast abscess with good patient satisfaction. Even though recurrence rate is slightly high in USG guided aspiration when compared to incision and drainage, USG guided aspiration is effective method of treatment in breast abscess with good patient satisfaction.