Primary intratesticular rhabdomyosarcoma: a rare aggressive childhood neoplasm

Testicular tumors are relatively uncommon in children. The tumors of germ cell origin are still frequently encountered. The pure embryonal rhabdomyosarcomas of testis, not associated with sarcomatous component of the germ cell tumor, is a very rare entity. It is a highly aggressive tumor of childhood and young adolescents. In testes, it arises commonly from paratesticular tissue; primary intratesticular being extremely rare. To the best of authors knowledge, only fifteen cases of primary pure intratesticular tumor have been reported in the literature so far. We report a case of eight-year-old child who presented with a progressive painless right testicular enlargement over two months. Ultrasonography showed a heterogenous intratesticular mass. High orchidectomy was performed. Histopathological examination of the specimen assisted with immunohistochemistry revealed embryonal rhabdomyosarcoma

Neonatal outcome of babies born with congenital anomalies after pediatric surgery

Background: Congenital anomalies are the major cause of adverse neonatal outcome and mortality.  Some congenital anomalies are correctable and there is immense role of pediatric surgery in treatment of these anomalies. The aim of this study was to determine the pattern of congenital anomalies and to evaluate clinical outcome of babies after surgical intervention. Methods: This hospital-based cross-sectional study was carried out in the Obstetrics and Gynecology department during the period of 1 year. All the delivered babies in this hospital during this period were examined by obstetricians and pediatricians for the presence of various congenital anomalies. Babies with correctable anomalies were operated by the Pediatric Surgery Department and outcome of babies at the time of discharge was included. Data were entered into a case record form and then in the excel sheet and were analyzed statistically. Results: During the study period, 1670 babies were delivered in our institution; of which, 32 babies had congenital malformations, giving the prevalence of 1.91%. The system involved predominantly was the gastrointestinal (GI) system (80%). Pregnancy with congenital malformation were associated with malpresentation, anemia and polyhydramnios. Overall, most babies operated for pediatric surgery had good outcome. Conclusions: Pre pregnancy high-dose folic acid supplementation, regular antenatal visits, and prenatal diagnosis are recommended for prevention, early detection and management of congenital anomalies. There is great importance of Level II and NT NB Scan. Pediatric surgery is a boon in babies with correctable anomalies

Duodenal perforation with Ascaris lumbricoides in a child: A case report

Gastrointestinal infestation with Ascaris lumbricoides is common in temperate and tropical countries. Although heavy worm infestation produces wide range of acute abdominal complications, duodenal perforation in association with ascariasis, especially in children, is rarely reported. We report a case of 5-year-old girl with duodenal perforation secondary to ascariasis

High anorectal malformation in a five-month-old boy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Anorectal malformation, one of the most common congenital defects, may present with a wide spectrum of defects. Almost all male patients present within first few days of life.</p> <p>Case presentation</p> <p>A five-month-old baby boy of Indian origin and nationality presented with anal atresia and associated rectourethral prostatic fistula. The anatomy of the malformation and our patient's good condition permitted a primary definitive repair of the anomaly. A brief review of the relevant literature is included.</p> <p>Conclusion</p> <p>Delayed presentation of a patient with high anorectal malformation is rare. The appropriate treatment can be rewarding.</p

Emphysematous epididymo-orchitis: A rare entity

Emphysematous epididymo-orchitis is a rare cause of an acute scrotum and is a surgical emergency. Diagnosis is clinically difficult, and sonography with a high-frequency probe is useful to pick up gas shadows in the scrotal wall or testicular substance. A diabetic patient presented with fever, urinary tract infection, and an acute scrotal swelling. The patient needed orchidectomy and scrotal debridement. As in emphysematous pyelonephritis, this condition occurs in diabetics, and patients may need surgery. There is a need to perform sonography in all diabetic patients with an acutely inflamed scrotum, because detection of gas shadows makes surgical intervention more likely

Congenital anterior urethral valves and diverticula: Diagnosis and management in six cases

Background: Anterior urethral valves (AUVs) are rare congenital anomalies causing lower urinary tract obstruction in children. Although they are referred to as valves, these obstructive structures often occur in the form of a diverticulum. The urethra in these cases shows saccular or bulbar dilatation known as anterior urethral diverticulum (AUD). They typically occur where there is a defect in the corpus spongiosum, leaving a thin-walled urethra. This segment of the urethra balloons out during voiding, simulating a mass that is sometimes visible along the ventral wall of the penis. The swelling is fluctuant and urine dribbles from the meatus on compression. The present study highlights the clinical approach in identifying the condition and its treatment options, especially for those, presenting with urethral diverticula. Materials and Methods: We have studied children with congenital anterior urethral valves and diverticula. Six patients of AUVs with diverticula were admitted during the period of 2000-2007 and were prospectively evaluated. The mean age of presentation was 16 months (15 days to 4 years). Straining at micturition and a palpable penile swelling were the most common presenting features. The diagnosis was established by voiding cystourethrogram (VCUG) and supported by ultrasonography (USG). All patients were treated with single-stage open surgical excision except one who died preoperatively due to urosepsis. Initial lay opening of the penoscrotal urethra and delayed repair were done in one patient. Results: The surgical outcome was successful in all but one patient, who died of delayed presentation with severe back pressure changes, urinary ascitis and urosepsis. On long-term follow-up, all patients demonstrated good stream of urine. The renal functions were normal and the patients had no evidence of urinary infections. Conclusion: We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms of general condition as opposed to patients of posterior urethral valves. The diagnosis is easily established by VCUG and the severity is revealed by a sonogram. Open surgical excision is the method of choice for patients with a urethral diverticulum; however, cystoscopic fulguration is also feasible in selected patients. The outcome is excellent with minimal morbidity and mortality

Congenital anterior urethral valves and diverticula: Diagnosis and management in six cases

<b>Background:</b> Anterior urethral valves (AUVs) are rare congenital anomalies causing lower urinary tract obstruction in children. Although they are referred to as valves, these obstructive structures often occur in the form of a diverticulum. The urethra in these cases shows saccular or bulbar dilatation known as anterior urethral diverticulum (AUD). They typically occur where there is a defect in the corpus spongiosum, leaving a thin-walled urethra. This segment of the urethra balloons out during voiding, simulating a mass that is sometimes visible along the ventral wall of the penis. The swelling is fluctuant and urine dribbles from the meatus on compression. The present study highlights the clinical approach in identifying the condition and its treatment options, especially for those, presenting with urethral diverticula.<b> Materials and Methods: </b> We have studied children with congenital anterior urethral valves and diverticula. Six patients of AUVs with diverticula were admitted during the period of 2000-2007 and were prospectively evaluated. The mean age of presentation was 16 months (15 days to 4 years). Straining at micturition and a palpable penile swelling were the most common presenting features. The diagnosis was established by voiding cystourethrogram (VCUG) and supported by ultrasonography (USG). All patients were treated with single-stage open surgical excision except one who died preoperatively due to urosepsis. Initial lay opening of the penoscrotal urethra and delayed repair were done in one patient. <b> Results: </b> The surgical outcome was successful in all but one patient, who died of delayed presentation with severe back pressure changes, urinary ascitis and urosepsis. On long-term follow-up, all patients demonstrated good stream of urine. The renal functions were normal and the patients had no evidence of urinary infections. <b> Conclusion: </b> We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms of general condition as opposed to patients of posterior urethral valves. The diagnosis is easily established by VCUG and the severity is revealed by a sonogram. Open surgical excision is the method of choice for patients with a urethral diverticulum; however, cystoscopic fulguration is also feasible in selected patients. The outcome is excellent with minimal morbidity and mortality

Diversity and distribution of vascular plants in BG and TLR, sites of Nanda Devi Biosphere Reserve, Western Himalaya.

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