ABSTRACT
Background: Pediatric surgical abdominal emergency is a serious condition with reported high mortality in Africa and Bugando Medical Centre in particular. This study aimed at understanding the clinical pattern and predictors of early outcome of pediatric surgical abdominal emergencies at Bugando Medical Centre. Methods: A longitudinal descriptive study involving 130 patients with PSAE at BMC from November 2020 to May 2021. Patients were fully investigated and operated as per standard guidelines. Structured questionnaire was used to collect data which were analysed using STATA version 13. A p-value of less than 0.05 was considered significant. Result: A Male: Female ratio of 1.7:1 was noted, the median age of patients was 3years majority presenting with abdominal distension (94.6%), abdominal pain (91.5%) and vomiting (76.2%). The leading cause of Paediatric surgical abdominal emergencies were intestinal obstruction (66.0%) and peritonitis (21.8%). Short hospital stay (61.5%) was the commonest outcome followed by prolonged hospital stay (38.5%), and death (19.6%). Adolescent age (p-value=0.022) and rural residence (p-value=0.042), were significantly associated with increased duration of hospital stay while hyponatremia (p-value= 0.001), hypokalaemia (p-value=0.001) and low haemoglobin level (p-value=0.05) were found to significantly predict mortality. Conclusion: Intestinal obstructions and peritonitis are the commonest cause of PSAE at BMC, often presenting with abdominal pain and distension. Majority of patients have a short hospital stay, but adolescence and rural residence are associated with increased length of hospital stay. Electrolyte imbalance is significantly associated with mortality which was found to be decreasing but remains high at BMC.

ABSTRACT
Background: Lactating adenoma is a rare benign breast tumor that occurs during pregnancy or breastfeeding. Excessive bleeding from such lesion during biopsy has been previously reported in several cases. This is the first report of excessive spontaneous bleeding from a lactating adenoma triggered by the onset of labor. Case Presentation: We report of a case of a 33 years old African woman pregnant at 38 weeks who presented to us complaining of a rapid enlargement of her right breast for 8 months with a prior history of a diagnosis of an ipsilateral breast fibroadenoma. Physical examination revealed a 15*15cm right breast swelling with a 3*4cm ulcer on the right lower inner quadrant which had indurated margins and a shallow floor, no palpable lymph nodes. Excessive spontaneous intractable bleeding occurred from the mass during labor to necessitate an emergency mastectomy. Histological analysis of the mass confirmed a lactating adenoma. Conclusion: Lactating adenomas often run a silent clinical course. Redistribution of blood volume in the breast blood vessels during labor and delivery coupled with tissue necrosis by the tumor can results in excessive spontaneous loss of blood from the affected breast to necessitate emergency mastectomy.

ABSTRACT
A cross sectional-community based study was conducted in Al-Salaam displaced people Camp to assess knowledge, attitudes and practices of mothers with under five years children towards diarrheal diseases, the study aimed to study knowledge, attitudes and practices of mothers with under five years children towards diarrheal diseases. 380 mothers with fewer than five children were selected using a systematic random sampling technique. The data collected through structured questionnaire designed to cover all research objectives and observations. The statistical Package for Social Science (SPSS) was used to analyze the data; the results were presented in figures. The study clarified that mothers have low knowledge regarding the possible causes of diarrheal diseasess. Large number of mothers (70.5%) believe that tooth loss is a major cause of diarrhea in children under five years old, regarding practices during diarrheal infections, 50.8% of mothers increased numbers of meals to their children. Very small numbers of mothers (28.2%) prepared oral rehydration salts solution correctly, most mothers believe in seeking health services when home management was failed, sanitation was very weak, the majority (78%) of residences were using shared toilets. The study recommended that the local health authorities should increase knowledge of mothers about diarrheal diseases and its management through health education sessions, provision of clean water and sanitation services.

ABSTRACT
Introduction: A breast abscess is a localised collection of pus within the breast that usually occurs as a complication of mastitis. Mastitis is an inflammation of breast tissue, which may or may not result from infection. Infective mastitis in lactating women is usually associated with Staphylococcus aureus (S. aureus), an organism which characteristically causes abscess development. Objectives: To report the incidence of breast abscess in lactating women. Materials and Methods: A randomised controlled trial and a survey study was carried out Dept. of Surgery, Sheikh Hasina Medical College and Hospital, Tangail, Bangladesh from January 2019 to December 2020. A total of 596 of 656 (91%) primiparous, Bangla-speaking women from a diverse range of backgrounds, including those receiving public clinic care, private care and birth centre care. An interview was conducted on breastfeeding at 24 months postpartum. Main outcome measures: Lactational mastitis and breast abscess. Results: One hundred and three women experienced mastitis. Three women developed a breast abscess: 0.4% of women who commenced breastfeeding (95% CI 0.14 – 0.98); 2.9% of women who took antibiotics for mastitis (95% CI 1.0– 6.7). Conclusion: Although many authors estimate that 11% of women with mastitis develop a breast abscess, the incidence of lactating breast abscesses appears to be lower than reported in the past. Our estimate is that 3% of women with mastitis will develop a breast abscess.