M N Asha

In a 5 1/2-year retrospective study of hospitalized children with osteomyelitis who had technetium bone scans, we found that 32 of 38 (84%) had increased radionuclide uptake, 4 (11%) had normal uptake and 2 (5%) had decreased uptake. The two patients with decreased uptake had a stormy course with extensive bone destruction and pathologic fractures in spite of prolonged courses of antibiotic therapy. Decreased uptake on bone scan in patients with clinical evidence of osteomyelitis could indicate a poor prognosis and early surgical drainage is indicated in order to decrease morbidity.

Differentiating acute cholestatic jaundice resulting from hepatic vasoocclusive crises and hepatitis in children with sickle cell disease can be difficult. Both conditions result in hyperbilirubinemia, mainly of the conjugated type, and in elevation of serum transaminases. Five children with sickle cell disease, acute severe cholestatic jaundice and negative serology for hepatitis A and B presented in good general condition, with modest elevation of serum transaminases, and had an early uneventful recovery. Five children with sickle cell disease and serologically proved hepatitis A infection were sicker, exhibited a similar elevation of bilirubin concentration with marked elevation of the serum transaminases and recovered more slowly. The clinical course and outcome of hepatitis A in children with sickle cell disease was similar to that of hepatitis A in normal children. Unlike early reports acute cholestatic jaundice in our patients with sickle cell disease, whether caused by hepatitis or by hepatic vasoocclusive crises, was found to be benign with an uneventful recovery.

BACKGROUND: A study of 30 surgically operated appendicular mass was conducted at SIMS and RC with respect to complication, hospital stay and recovery. METHOD: 30 patients were taken for case study who were surgically treated for appendicular mass soon after the diagnosis and assessed for recovery time, hospital stay and complications. CONCLUSION: Emergency appendicectomy to treat appendicular mass should be considered as an option as it decreases the hospital stay, avoids repeated exposure to risks involved in surgery as in interval appendicectomy and gives a better recovery as the foci of infection is removed.

A retained foreign body in the abdominal cavity following surgery is a continuing problem.Incidence of such accidental revelation of intra-abdominal foreign body reported in the literature is 0.3-1 % 1 .