A retrospective (2004-2013) and prospective (2014-2015) study of new born with special reference to anorectal malformations over a period of 10 years at a tertiary care centre

Background:A surgical audit of neonates with anorectal malformation in advanced tertiary neonatal care unit.Methods: A retrospective (2004-2013) and prospective (2014-2015) audit of medical records of newborn with GIT disorders admitted in a tertiary care center of central India. The trends analyzed for the duration based on gender, region and birth weight and data base was generated depicting the burden of disease in the region. The data base for the prospective study was also compared with a tertiary center from Nigeria.Results:Total 3309 admission included 73.56% (2438) patients of GIT diseases. Congenital anomalies were the most common cause in each category, major part being anorectal malformation (727) and trachea-esophageal fistula (730). Out of 727 admissions, 651 neonates were operated & total 1194 deaths recorded during this audit year 2004 to July 2015. Majority of new born admitted with were low birth weight male from rural skirts of this region. 509 have associated anomalies and 218 isolated ARM.  Conclusions:There is significant increase in admissions in last decade with triple fold increase in GIT disorder and twice rate in anorectal malformation substantially increasing onwards. The quality of management has to continue further to achieve parity with international standards, as there is lack of antenatal screening and details of any antenatal checkup are scarce, for congenital anomalies at primary level. Early recognition, risk stratification of the baby and timely referral to higher pediatric surgery units is the way forward

Hemostasis during hypospadias surgery via topical application of feracrylum citrate: A randomized prospective study

Aim: Report of our experience with topical feracrylum citrate to minimize hemorrhage-related complications in pediatric hypospadiac patients. Materials and Methods : One hundred and fifty consecutive pediatric hypospadiac patients over 3 years (75 in study group and 75 controls - random allocation) were studied. One hundred milliliter of 1% feracrylum citrate solution was used in study cases and equivalent normal saline in controls. The parameters assessed were frequency of cauterizations, intraoperative blood loss, wound edema and postoperative complications. Results: Average number of cauterizations was 1.55 per patient in study group and 5.7 per patient among controls. Among cases, average number of blood soaked gauge pieces was 3.56 per patient, correlating with average intraoperative blood loss of 17.8 ml. In controls, average blood soaked gauge pieces were 6.2 per patient corresponding to an average blood loss of 31 ml. Postoperative hematoma was seen in 8% cases compared with 18% controls. Wound edema appeared in 13.3% cases and 47% controls. Postoperative complications were higher among controls. Conclusions: Feracrylum is an effective and safe topical hemostatic agent to minimize significantly diffuse capillary oozing and surface bleeding. It reduced the frequency of cauterization and tissue damage, intraoperative blood loss, postoperative hematoma, wound edema and postoperative complications

Isolation and HPLC method development of azafrin from <i>Alectra parasitica</i> var. <i>chitrakutensis</i>

<div><p>This study was undertaken to isolate and quantify azafrin in <i>Alectra parasitica</i> (Scrophulariaceae) rhizomes. A simple method for the isolation of carotenoid, azafrin, involves solvent extraction of the dried rhizome powder using a single solvent and further purification by recrystallisation. The structure of the compound was elucidated and confirmed by thin-layer chromatography, infrared spectroscopy, mass spectroscopy and nuclear magnetic resonance spectral analysis. A specific and rapid reversed-phase high-performance liquid chromatography (HPLC) method was developed for the analysis of azafrin. The method was validated for accuracy, precision, linearity and specificity. Validation revealed that the method is specific, accurate, precise, reliable and reproducible. The proposed HPLC method can be used for the identification and quantitative analysis of azafrin in <i>A. parasitica</i> rhizomes.</p></div

Failure of bronchoscopy in airway obstruction: A case series

Bronchoscopy in this modern era has proved its utility and superiority far beyond imagination and has surpassed and replaced the majority of the surgical procedures. However, there have been certain limitations to the applicability of this vital technique especially in a country where we face lack of proper equipments and trained personnel at all health centers. This case series with review of literature examines the spectrum of limitations of bronchoscopy and the rare cases encountered, which leads to the surgical alternatives for managing intrabronchial pathology based on relevant current literature

A retrospective (2004-2013) and prospective (2014-2015) study of new born with special reference to anorectal malformations over a period of 10 years at a tertiary care centre

Background:A surgical audit of neonates with anorectal malformation in advanced tertiary neonatal care unit.Methods: A retrospective (2004-2013) and prospective (2014-2015) audit of medical records of newborn with GIT disorders admitted in a tertiary care center of central India. The trends analyzed for the duration based on gender, region and birth weight and data base was generated depicting the burden of disease in the region. The data base for the prospective study was also compared with a tertiary center from Nigeria.Results:Total 3309 admission included 73.56% (2438) patients of GIT diseases. Congenital anomalies were the most common cause in each category, major part being anorectal malformation (727) and trachea-esophageal fistula (730). Out of 727 admissions, 651 neonates were operated &amp; total 1194 deaths recorded during this audit year 2004 to July 2015. Majority of new born admitted with were low birth weight male from rural skirts of this region. 509 have associated anomalies and 218 isolated ARM.  Conclusions:There is significant increase in admissions in last decade with triple fold increase in GIT disorder and twice rate in anorectal malformation substantially increasing onwards. The quality of management has to continue further to achieve parity with international standards, as there is lack of antenatal screening and details of any antenatal checkup are scarce, for congenital anomalies at primary level. Early recognition, risk stratification of the baby and timely referral to higher pediatric surgery units is the way forward

Epidemiological trends of pediatric trauma: A single-center study of 791 patients

Aim: To assess the various epidemiological parameters that influence the causation of trauma as well as the consequent morbidity and mortality in the pediatric age group. Materials and Methods: A prospective study of 791 patients of less than 12 years age, was carried out over a period of 1 year (August 2009 to July 2010), and pediatric trauma trends, with regards to the following parameters were assessed: Age group, sex, mode of trauma, type of injury, place where the trauma occurred and the overall mortality as well as mortality. Results: Overall trauma was most common in the school-going age group (6-12 years), with male children outnumbering females in the ratio of 1.9:1. It was observed that orthopedic injuries were the most frequent (37.8%) type of injuries, whereas fall from height (39.4%), road traffic accident (27.8%) and burns (15.2%) were the next most common modes of trauma. Home was found out to be the place where maximum trauma occurred (51.8%). Maximum injuries happened unintentionally (98.4%). Overall mortality was found out to be 6.4% (n = 51). Conclusions: By knowing the epidemiology of pediatric trauma, we conclude that majority of pediatric injuries are preventable and pediatric epidemiological trends differ from those in adults. Therefore, preventive strategies should be made in pediatric patients on the basis of these epidemiological trends