Background To study the role of conservative management and various reasons for conversion to surgical intervention in traumatic extradural hematoma (EDH).

Even under ideal circumstances, isolation rates of Mycobacterium Tuberculosis (M.Tb) from gastric lavage range from 28% to 40% in children with suspected pulmonary tuberculosis, although rates can rise to 75% in infants [1]. One year prospective study was undertaken in SMGS Hospital, Jammu to compare Induced Sputum (IS) with Gastric lavage (GL) for yield of M.Tb in children with suspected pulmonary tuberculosis.Children aged 6 months to 18 years admitted for chronic cough (more than 28 days) who could not expectorate and had one of the following: household contact (within past 2 years); failure to gain or loss of weight (in 3 months); Positive mantoux test (>10 mm); Chest radiography with pleural effusion, lymphadenopathy or nonresolving consolidation, were included in the study.Sixty-five children were initially included. Sixty children in whom successful sputum induction (SI) was possible took part in the study. They underwent GL and SI on three consecutive days according to a standard protocol [2].Children underwent morning GL after an overnight fast of at least 4 h. Gastric aspirate was immediately placed in a tube containing sodium carbonate. SI was undertaken after 2-3 h fast about 6 h after GL. Sputum was obtained by suctioning through nasopharynx after chest percussion.Samples were subjected to decontamination (Petroff's method) and centrifugation. Treated specimens were inoculated simultaneously on Lowenstein Jenson (LJ) medium and in Middlebrook 7 H9 media (MB7H9). Mycobacterial presence was confirmed by Acid Fast Bacilli (AFB) on direct smears or culture media. Classification as M.Tb was made by typicality of colony morphology and a positive niacin test.The median age of children was 4 years. Samples from IS to GL were positive in 8 (13%) and 5 (8%) children, respectively. The difference between yields for M.Tb from AFB smears to cultures on IS and GL was statistically insignificant (p=0.99) using the χ 2 test. Zar HJ, et al. noted that SI was more sensitive than GL, detecting almost twice the number of children with pulmonary tuberculosis [3].

in which patients attending / admitted in the Department of E.N.T., with cancer of head and neck, were assessed for lymph node metastasis (at different levels). 16 patients, all cases of squamous cell carcinoma head and neck, underwent appropriate neck dissections. The patients were examined clinically as well as with ultrasonography for detection of various enlarged lymph nodes at different levels. Computed tomography and magnetic resonance imaging were done, wherever indicated. Patients were subjected to fine needle aspiration cytology in cases of palpable lymph nodes. The removed lymph nodes were examined histopathologically. Results: The findings of clinical, radiological and histopathological studies were compared. We concluded that clinical palpation should be supplemented by ultrasonography in every case of head and neck cancer. However, since computed tomography picks up lymph nodes missed by ultrasonography in a significant number, is important in imaging primary tumour and picks up necrosis and extracapsular spread at the most, it should be included in each case of head and neck cancer. Conclusion: Magnetic resonance imaging being equivalent to computed tomography in picking up the nodes, but lagging behind the criteria such as picking up of nodal necrosis and extra capsular spread of lymph nodes, and is too costly, so may be included as an imaging modality wherever computed tomography is contraindicated.

Background: The concomitant laparoscopic Common Bile Duct exploration with clearance(LCBDE) of CBD stones during cholecystectomy has demonstrated many advantages when compared with other surgical techniques. We study the outcomes of primary CBD closure over endobiliary stent in patients who underwent laparoscopic CBD exploration for CBD stones. Patients and method: we studied retrospectively a series of 38 patients with majority of them being females (26), who underwent LCBDE for CBD stones from May 2009 till June 2017 in our Hospital. Results: No mortality was reported in our study. The CBD clearance rate with laparoscopy was around 89 % in this study with short hospital stay and fewer complications. Patients with residual CBD stones were later removed Endoscopically in the postoperative period without any difficulty or increasing the morbidity. Conclusion: Indeed, laparoscopic CBD exploration is a feasible, effective and safe method. With anterograde stenting during this procedure the morbidity associated with T-Tube is avoided with the same benefit of Biliary Decompression. It should be given preference against T-tube.

Aims: Settings: To study role of Laparoscopy in treating Pediatric Inguinal Hernia and Hydrocele. Department of Surgery, Government Medical College Srinagar. A prospective observational study involving 43 children who underwent la Materials and Methods: paroscopic repair of inguinal hernia / hydrocele over a period of 2 years in our tertiary care institute. T Results: here were 57 children enrolled but only 43 patients were included for the study. Age ranged from 7 month to 12 years. There were 38 boys and 5 girls in the study group. There were 32 unilateral and 11 bilateral cases. Among unilateral 26 were on the right side and 6 on the left side. 54 hernia / hydrocele / open DIR were treated laparoscopically. IPSI for unilateral, SEAL for bilateral cases among boys and LIHIL technique was performed in girls. There were no signicant differences among various techniques performed with respect to hospital stay, post operative analgesia requirement but difference was signicant for higher complication rates in SEAL. Also the difference was found to be signicant when compared unilateral versus bilateral cases for operative time and post operative return to activity. Absorbable suture material was used in all cases and there were no recurrences seen during a mean follow up period of 16.5 months. Laparoscopic treatment of pediatric inguinal hernia/hydrocele/Open DIR i Conclusions: s a safe and effective approach. We found a very low rate of complications which were all minor in nature and were managed conservatively. There were no recurrences thus making laparoscopic herniotomy a potentially gold standard approach in the near future but the ideal/gold standard laparoscopic technique for pediatric inguinal hernia appears yet to be achieved.