Journal of the Indian Medical Association
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Pyogenic spinal epidural abscess Is an uncommon Infectious occurrence. Clinical prospects of pyogenic spinal epidural abscess are graver if not promptly diagnosed and treated appropriately. A case of spinal epidural abscess has been presented with sinus tract formation at L4-L5 level, of pyogenic aetiology that progressed to paraplegia over the course of the disease. ⋯ Histopathological analysis revealed the acute suppurative nature of the abscess. Citrobacter kasori was isolated on pus culture. Pyogenic epidural abscess with causative organism being Citrobacter kasori has least been documented.
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A two-year-old child presented with history recurrent attacks of stridor. Initially he was thought to have laryngomalasia and treated accordingly but the symptoms did not improve with age. The child was symptomatic only during episodes of respiratory tract infection. ⋯ CT angiography showed an incomplete double aortic arch. As the child was symptomatic only during intercurrent infections and there was no feeding difficulty, respiratory distress and growth problems conservative management was opted. Parents were advised to observe the patient and review after six months.
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The aim of present study is to report our experience concerning the effectiveness, quality of analgesia, ease of performance, complications and safety of spinal anaesthesia in children undergoing infra-umbilical surgery. An open, non-comparative study was performed on 40 children aged 5-15 years undergoing elective infra-umbilical surgery. After parents' written consent and premedication, spinal anaesthesia was induced with hyperbaric bupivacaine (5mg/ml), 0.4mg/kg for children up to 15 kg body weight and 0.3mg/kg for >15 kg via L3-L4 or L4-L5 interspace in lateral decubitus position. ⋯ The dose of intrathecal bupivacaine used was 4-9 mg. No evidence of cardiovascular instability, postdural puncture headache, transient neurological symptoms, urinary complication was observed. Spinal anaesthesia with hyperbaric bupivacaine using 26-gauge hypodermic needle provides safe and effective analgesia for paediatric infra-umbilical surgery with high success rate.