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Objective: To compare mean platelet volume in neonates with and without sepsis. Study Design: Cross-sectional study. Place and Duration of Study: Neonatal Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2017 to Jan 2018. Methodology: A total of 140 neonates of either gender with ages between 0-28 days, suspected of neonatal sepsis presenting with any two of the signs: a core body temperature of >38.5°C or <36°C at time of presentation, pulse rate beyond the range of 100-200 beats/minute, leukocyte count beyond the range of 4000 to 30,000/mm3 or >10% immature neutrophils on peripheral smear, tachypnea (>60 breaths/minute) and oxygen saturation (<90%) on the pulse oximeter, were included. Three ml of blood was drawn and sent for culture, while another 3ml of blood was sent for peripheral smear and mean platelet volume. Conclusion: Neonates having sepsis were found to have significantly raised mean platelet volume. As a result, mean platelet volume is available in complete blood counts without additional cost to prove cost-effective. [ABSTRACT FROM AUTHOR]

Abdominal pain has vast differentials and routine etiologies are diagnosed easily. The difficulty arises with an uncommon presentation. This is a case of 28 years old lady presenting to the emergency department of Holy Family Hospital, Rawalpindi with worsening abdominal pain, vomiting, and loose stools over 2 weeks. Abdominal examination and baseline laboratory workup (CBC, electrolytes, septic, renal, and liver profile) were inconclusive. Ultrasound of abdomen revealed matted gut loops with enlarged lymph nodes. CECT abdomen confirmed a non-differentiating tissue collection in the right iliac fossa. Later diagnosis of complicated gossybioma (retained gauze surrounded by fibrotic tissue with entero-enteric fistula and fecolith in appendix) was confirmed by laparoscopy that was surgically removed. Conclusion: Gossybioma is an infrequent but avoidable complication that needs to be considered by the surgeon meticulously especially by swab counting, avoiding staff change over during procedure, and considering in a follow-up visit. [ABSTRACT FROM AUTHOR]