PROGNOSTIC FACTORS DETERMINING MORTALITY IN SURGICAL NEONATES

Background: To assess the prognosis of surgical neonates at admission and the factors responsible for mortality in neonates.Material and Methods: A prospective study was conducted in a tertiary level hospital over 15 months and various clinical and biochemical parameters were collected and analyzed using STATA® and SPSS®.Results: On multivariate analysis of 165 neonates, early gestational age, respiratory distress and shock at presentation were the factors of poor prognosis in neonates. The factors could be related to poor antenatal care and sepsis acquired before transfer of the baby to the nursery. Conclusion: The improvement in antenatal care and asepsis during transfer and handling the babies is of utmost importance to improve the prognosis of surgical neonates

Epidermoid cyst of clitoris mimicking clitoromegaly

Clitoromegaly in pediatric and adolescent age group is usually indicative of a disorder of sexual differentiation. We report a girl child presenting with clitoral enlargement due to an epidermoid cyst. The cyst was excised with complete cosmetic recovery

Subcutaneous Bronchogenic Cyst

Bronchogenic cysts occur due to the anomalous development of the primitive tracheobronchial tree early in fetal life. They are usually present in middle mediastinum. Rarely, they have been found in other locations. We describe two patients with subcutaneous bronchogenic cysts located over manubrium sterni with special emphasis on the difficulties in pre-operative diagnosis. The two boys were managed by complete excision of the cysts. The children are well on follow-up

Testicular microlithiasis in a unilateral undescended testis: a rare phenomenon CASE REPORT

Abstract Testicular microlithiasis (TM) is a rare benign condition with presence of multiple small microcalcifications in the seminiferous tubules. Though the aetiology is unknown, TM has been described in association with a variety of urological conditions. We report the clinico-pathological features of a 12-year-old male child who underwent orchidectomy for undescended testis. Histopathological examination of the excised testis showed multiple small intratubular calcifications without any evidence of testicular neoplasia. TM is an unusual phenomenon that should be kept in mind while evaluating testicular biopsies. Though it behaves in a benign manner in most of the cases, patients with positive family history of testicular cancer should be followed-up for testicular tumour

Correlation of Glans-Urethral Meatus-Shaft scoring system for Hypospadias with Post-operative outcome

Background:There are numerous techniques for hypospadias repair and the outcome of urethroplasty depends on patient related factors and surgeon related factors. Currently there is no widely accepted scoring system for assessing the severity of hypospadias. Objective: Present study was aimed to classify the severity of hypospadias according to GMS score and correlate the score with post-operative complications. Methods:100 males with distal to mid-shaft hypospadias consecutively selected for Urethroplasty were included in this prospective study during September 2015 to March 2017. The Glans size/groove, Urethral plate width, location of meatus and severity of chordee were evaluated individually before reconstruction. After surgery and during follow-up visits, the subsequent transient and persistent complications were recorded. Results:The mean GMS score in group A, B and C was 4.78 (± 0.69), 8.19 (± 0.90) and 10.43 (± 0.51) respectively. In Group A, UC fistula was seen in 7.4% of patients whereas In Group B and Group C, UC Fistula was seen in 46.9% and 92.9% patients respectively. Meatalstenosis was not seen in patients in Group A and Group C patients. In Group B, meatal stenosis was seen in 15.6% patients. Glans Dehiscence was not seen in patients in Group A and Group C. In Group B, Glans Dehiscence was seen in 6.2% patients. Stricture Urethra was seen in 9.3% patients in group A . In Group B and Group C, Stricture Urethra was seen in 43.8% and 92.9% patients respectively. Conclusion: The Glans-Urethral Meatus-Shaft (GMS) classification provides a means by which hypospadias severity and reporting can be standardized, which may improve inter-study comparison of reconstructive outcomes. There is a strong correlation between complication risk and total GMS score

Epidermoid cyst of clitoris mimicking clitoromegaly

Clitoromegaly in pediatric and adolescent age group is usually indicative of a disorder of sexual differentiation. We report a girl child presenting with clitoral enlargement due to an epidermoid cyst. The cyst was excised with complete cosmetic recovery

Comparison of clinical outcome and anal manometry following laparoscopic-assisted anorectoplasty and posterior sagittal anorectoplasty in patients with high and intermediate anorectal malformation: A randomised controlled trial

Introduction: High and intermediate types of anorectal malformations (ARMs) may be managed by either open posterior sagittal anorectoplasty (PSARP) or by laparoscopic-assisted anorectoplasty (LAARP). Most of the literature favours one approach over the other based on retrospective analysis. We performed this study with the aim to compare the short-term outcomes of both procedures. Materials and Methods: All paediatric patients with high and intermediate ARM were enrolled and randomised into two groups: open PSARP group and LAARP group. Outcome parameters such as faecal continence using Kelly's scoring system, anal manometric parameters and post-operative complications were compared between the groups. Results: A total of 16 patients were included with equal distribution in the open PSARP and LAARP group. Patient's variables were comparable in both the groups. Five patients developed immediate post-operative complications, three in the LAARP and two in the open group. The mean Kelly's score was 3.63 ± 1.6 versus 2.57 ± 1.9 (P = 0.132) for LAARP and PSARP group, respectively. The mean resting pressure was 34.71 ± 6.26 cm of H2O and 35 ± 6.16 cm of H2O (P = 0.384) in LAARP and open group, respectively. Rectoanal inhibitory reflex was demonstrated in 6/7 patients in LAARP group and 5/7 patients in open group. Conclusion: Faecal continence in patients undergoing either of the procedure is comparable. However, wound-related complications are lesser in LAARP procedure