Objectives: In non-operative methods, hip spica casting is a gold standard for children under six years of age because of excellent bone union and remodeling qualities. The study was conducted to determine the frequency of limb shortening in femur shaft fractures in children treated by hip spica casting. Study Design: Descriptive cross sectional study. Setting: Orthopedics Department of Combined Military Hospital, Rawalakot, Pakistan. Period: One year from July, 2016 to June, 2017. Material and Methods: After approval of the study from institution’s ethical committee, all patients fulfilling the inclusion criteria were admitted through emergency or outpatient department for hip spica casting. It was descriptive cross sectional study and sampling was done by non-probability convenience sampling in 107 femur fracture patients treated by hip spica casting. Diagnosis of the fracture was based upon history of trauma with break in the continuity of shaft as seen by X-ray. Informed consent was obtained from parents/guardian to be included in the study. Results: The mean age was 5(± 2.04) years. Sixty eight percent patients were male and 32% were female. Sixty three percent patients had proximal femoral shaft fracture, 32% had middle femoral shaft fracture and 4% patients had distal femoral shaft fracture. The shortening of limb length was found in14% of patients. Conclusion: In closed femoral shaft fractures, hip spica casting is a safe treatment in children. It has a low risk of complications. We recommend its use except for open fractures, multiple fractures, or fractures in older children.

Background and Objectives: Urolithiasis is prevalent globally. Over time, innovation in endoscopic instruments and miniaturization has untangled the interventional strategy for carrying out remedial surgical procedures for renal stones. However, studies have been scarce as for sequelae of Percutaneous Nephrolithotomy (PCNL) in varying body mass index group patients in the developing world. We aimed to report success rates and complications in different BMI groups. Methods: This was a retrospective study wherein data of 359 patients was reviewed in charts. These patients went through PCNL at our department from July 2011 till September 2019. Three groups of patients were made in agreement with WHO BMI classification. Information concerning study variables was noted in designated and then processed in SPSS version 16 for the statistical computations. Results: On the whole, the mean age of patients was 44.6± 14.4 years. While the mean calculus size was 3.1± 1.4 cm. Moreover, the majority of stones in all the three groups belonged to Guy’s stone score 1 and 2 (see Table-I). The overall mean procedure time and inpatient stay were almost comparable in the obese group. The highest stone-free rate was observed in the normal weight group (77.69 %), however, stone-free status in overweight and obese groups was not comparatively too lower (p=0.74). Complication rates were being close among the three groups. Conclusion: PCNL can be ventured with safety and in an effectual manner for attaining stone treatment goals alike in obese and non-obese group patients. doi: https://doi.org/10.12669/pjms.38.8.3663 How to cite this:Iqbal N, Hasan A, Razzaq S, Rashid FS. Effect of Body Mass Index on complications and success rates of percutaneous nephrolithotomy-A tertiary care hospital experience. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.3663 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: With optimal perioperative and postoperative care, the survival and outcomes of new-born with anorectal malformations (ARM) have improved significantly in developed countries, but sepsis, low birth weight, late presentation, and intense new-born care is still lacking in developing countries influencing the outcome. This analysis was conducted to assess aspects for poor outcomes (mortality) in new-born with anorectal malformations. Study Design: A prospective analytical study. Place and duration: In the Department of Paediatric Surgery at Divisional Headquarters Teaching Hospital Mirpur for six months duration from January 2021 to June 2021. Methods: 48 total consecutive neonates with anorectal malformations (ARMs) admitted to the Paediatric Surgery department were included. The studied variables comprised age at admission, birth weight, sex, type of malformation, sepsis at admission, type of surgery performed, postoperative issues, and their association with the results. Statistical analysis was executed with SPSS 21.0. Results: 48 neonates with ARM were enrolled in the study. 60.4% (29) of the research population are male neonates and 39.6% (19) are female neonates. 2.3 ± 0.7 days was the mean age at admission (minimum age was 1 day and the maximum 4 days) and 2.8 ± 0.9 kg was the mean body weight at birth (minimum weight was 1.7 kg, and the maximum weight was 4.5 kg). The communal reason of mortality in patients postoperative was sepsis (50%). There was a statistically significant correlation amid sepsis and low birth weight (p = <0.01) on admission (p = 0.002) with mortality. Comparing the result with age at the time of presentation (p = 0.19) and complications postoperatively (p = 0.18), no statistically significant correlation was found. Conclusions: Lack of trained midwives / LHV, Lack of resources, late admission, intensive care sepsis, and ultimately mortality are contributing factors in developing countries. Good prenatal care, awareness of midwives / community nurses to refer these patients on time, and adequate intensive care can improve the outcomes of ARM surgery. Keywords: Sepsis, Imperforate anus, low birth weight, primary PSARP, cloaca and Pelvic divided colostomy