A 66-year-old patient was admitted to a peripheral hospital with necrotising fasciitis and septic shock, with a background history of severe co-morbid diseases. The septic shock was managed at an intensive care unit with IV vasopressors and IV antibiotics via right internal jugular central venous catheter (CVC). Insertion of CVC was complicated by migration of guide wire in to the inferior vena cava (IVC). This case illustrates the migration of a guide wire as a complication of CVC insertion, and the subsequent retrieval of this guide wire.

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PTBD is used for temporary decompression of an obstructed biliary system prior to surgical resection as it is believed to reduce major post operative complications. This is preferred over endoscopic biliary stenting(EBS)by most as EBS induces an inflammatory response making resection difficult. For palliation of malignant biliary obstruction and as treatment for common bile duct stones endoscopy is preferred. PTBD is used if endoscopy fails. In this subset internalization for malignancies and surgery for calculi are done once the patient's general condition improve.

Objectives: To determine the prevalence of childhood overweight, obesity and metabolic abnormalities among children aged 12-15 years within the schools in Kandy Municipality area, Sri Lanka.