N Engl J Med 2004;350:684-93. Copyright © 2004 Massachusetts Medical Society. A 39-year-old man reports an eight-hour history of colicky pain in the right lower quadrant radiating to the tip of his penis. He had previously had a kidney stone, which passed spontaneously. Physical examination shows that he is in distress, is afebrile, and has tenderness of the right costovertebral angle and lower...

Intussusception is the invagination of one loop of intestine into another and presents with a syndrome of colicky pain and palpable mass and/or rectal bleeding. Due to the intermittent symptoms one could overlook adult idiopathic intussusception. Most of the cases present to the emergency room/outpatient clinic with the symptoms of intussusception such as acute abdominal pain and distention and...

A 20 years young male presented with history of pain right lower abdomen for 3 months. Pain was intermittent, colicky in nature. There was history of nausea and occasional episodes of vomiting. On detailed history he had undergone open appendectomy 3 months back but the symptoms persisted. Patient was evaluated with routine blood investigations, Ultrasound and CT scan abdomen which showed fluid...

abstract objective development is a complex process, completed over a specific period of time, through the maturation of the nervous system. it is affected by genetic, ethnic, nutritional, social, and economic factors; one of the environmental factors affecting the acquisition of motor skills in infants is the use of baby walkers. since this device is very commonly used for infants in our count...

backgroundbreastfeeding is a natural way to provide nutrients required for proper growth and development of infants. in view of that, it is of great importance to enhance the knowledge of mothers on exclusive breastfeeding in the first six months after birth and the time of starting complementary feeding. this study aimed to assess the training needs of mothers on exclusive breastfeeding, was c...

vitamin a is the generic name given to a group of fat-soluble compounds including retinol (the alcohol form), retinyl esters, retinaldehyde and retinol acid. deficiency, first recognized in 1912, can damage the epithelial cells lining the respiratory tract. it can also affect immunocompetence, the reproductive function, growth and vision. the dose of vitamin a for neonates is 5,000 iu given int...

A 27-year-old man presented with a two-week history of central colicky abdominal pain associated with loose stools. Further history revealed that he had been exposed to contaminated waters. Stool investigation by direct wet stool smears revealed the presence of Entamoeba histolytica and Blastocystis hominis cysts. A diagnosis of amoebiasis secondary to E. histolytica and concurrent B. hominis i...

A 56 year old woman was admitted to the clinic with severe colicky right upper abdominal pain. There was a three-week history of jaundice. Pathological biochemical laboratory results of her serum were as follows: direct bilirubin 4.53 mg/dl, total bilirubin 3.08 mg/dl, AST 45 U/L, ALT 72 U/L. Surgical treatment, cholecystectomy + choledochtomy + T-tube drainage, was performed. Exploration of th...

A 47 years old lady presented with repeated intermittent, colicky, left upper, and periumblical abdominal pain associated with nausea and vomiting since two years prior to admission. Each episode of the pain spontaneously subsided after bilious vomiting. The patient had no history of surgery, abdominal trauma or intra-abdominal infection, weight loss or previous history for small bowel obstruct...