Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

Background: Pain in abdomen is common reason for which a child is brought to a surgeon and acute appendicitis is one of the common differential diagnoses in these children. In spite of availability of modern radiological and pathological investigations, even today the diagnosis of acute appendicitis depends mainly on clinical grounds and simple blood count. Pediatrics appendicitis scoring (PAS) which is based on clinical symptoms and sign along with WBC count is a good guide in diagnosis of acute appendicitis. The patient with scoring more than 7, were found to have acute appendicitis and required surgical intervention while those with score <5 could be treated conservatively without any squeal. The Paediatric appendicitis scoring could be helpful to diagnose acute appendicitis early thus reducing morbidity and mortality of the condition by early surgical intervention on one hand and reducing unnecessary exploration on the other. Methods: Patients of acute abdomen admitted in paediatric surgical ward of Kamla Nehru Hospital, Gandhi Medical College, Bhopal, MP, India during the period 14 October 2002 to 03 October 2003 were studied. All the case (25) of acute abdomen suspected to be acute appendicitis were included in this series. A uniform prospective data form was completed which included Demographic data, duration of symptoms, Physical signs, Laboratory, Histopathological examination. Patients were classified into two groups, group I with appendicitis and group 2 nonappendicitis according to final score obtained by each variable. Patients with scoring >7 were included in group I while those with >5 scoring were in group 2. Treatment was given accordingly. (Operative or Non-operative) outcome of the study was noted. Results: In the study, children of age group from 4 to 12 years were included; peak incidence was between 8-10 years, with male: female ratio of 3:1. The size of incidence in both the sex is maximum between 9 to 12 years of age. Tenderness in the rt. Lower quadrant of abdomen on cough/percussion/hopping and tenderness over right iliac fossa has the highest incidence. Leucocytes also has the sensitivity of >75% while anorexia is least sensitive. The patients were grouped in two categories as per the paediatric appendicitis scoring, those patients with PAS >7 were grouped under group I, 10 out of 15 patients underwent appendectomy. Conclusions: Pediatric appendicitis score is a simple relatively accurate diagnostic tool for accessing an acute abdomen and diagnosing acute appendicitis in children. According to this study, PAS is of value in the preclinical evaluation of patients with suspected acute appendicitis and may be instrumental as a quality control tool and in clinical guidelines.

No abstract

A 15 days newborn presented to paediatric OPD for evaluation of abdominal distension, not accepting feed properly and scrotal swelling. On examination gangrene was found on the scrotum, blood culture showed growth of streptococcal organism. Patient was treated with 3rd generation cephalosporin and local debridement of gangrenous scrotal tissue. Wound got healed by secondary intention and patient was discharged alive and healthy. The outcome of treatment of Fournier’s gangrene in neonate is good. Key words: Fournier’s gangrene; Septicemia; Scrotal swelling; Phimosis; Wound debridement. DOI: 10.3126/jnps.v30i3.3921J Nep Paedtr Soc 2010;30(3):166-167

Background: 50-75% of all the patients who are on dialysis suffer from significant xerosis. But the exact cause is difficult to trace. Acquired ichthyosis is seen in some patients. Atrophy of sebaceous glands is seen in patients with uraemia. Such patients also show overall decrease in sweet volume. Objective was to study the clinical profile of patients with cutaneous disorders.Methods: A hospital based prospective study was carried out from September 2012 to February 2013 at a tertiary care centre of Late Baliram Kashyap memorial government medical college, Jagdalpur, Chhattisgarh, India. A total of 50 patients with cutaneous disorders were studied with respect to their clinical profile. Patients not willing to participate in the present study as per the protocol were excluded from the study. But patients giving their willingness to participate in the present study as per the protocol of the study were included in the study.Results: The males constituted 58% of the total cases and the females constituted 42% of the total cases. Maximum patients were seen in the fourth and fifth decade of their life i.e. 24% followed by the age group of 31-40 years i.e. 22%. The most common cutaneous manifestation was pruritus in 24% of cases followed by xerosis in 16% of cases. Next most common cutaneous manifestation was Tinea versicolor inn 14% of cases followed by oral candidiasis in 8% of cases and scabies were seen in 6% of cases. Both among males and females, pruritus was the most common skin lesion seen.Conclusions: The most common cutaneous lesion found in the present study was pruritus in 24% of cases followed by xerosis (16%), Tinea versicolor (14%), oral candidiasis (8%) and scabies in 6% of cases. Cases of nail changes, herpes zoster, Tinea cruris, hyper pigmentation, folliculitis, Exfoliative dermatitis, and Kyrle’s disease, Vitiligo, Melisma and Keloid were also seems.