Trans-anastomotic tube in esophageal atresia with trachea-esophageal fistula repair: how beneficial are they?

Background: Congenital esophageal atresia with tracheo-esophageal fistula is a common congenital anomaly facing at our centre. There is various proposed anastomotic technique to avoid post-operative complications. In our center, feeding has been conventionally initiated after a contrast esophagogram done at the seventh day post repair. The current study tried to assess the benefits and risks of initiation of early feeding in these patients by placement of a Tran’s anastomotic feeding tube during the repair.Methods: Twenty-five patients had a trans anastomotic feeding tube inserted during trachea esophageal fistula repair and were followed up for different outcomes.Results: Twenty-five patients were operated out of which were sixteen males and nine were females. Early complications of esophageal atresia surgery such as anastomotic leak, surgical site infection, pneumonia and sepsis occur in eight patients. All the complications were managed successfully conservatively, however, one patient died due to anastomotic leak and subsequent septicemia.Conclusions: We conclude that early tube feeding is safe and does not increase risks of anastomotic leaks. It also reduces the need of total parenteral nutrition bringing down the costs of procedure in developing nations.  

Physiological phimosis-the tincture of time

Background: Phimosis is one of the commonest presentations in the pediatric surgery outdoor. The main concern has been over avoidance of surgery in physiological phimosis. Different protocols have been proposed from time to time.Methods: An observational study was carried out in the pediatric surgery outdoor of SMS Medical College Jaipur, Rajasthan, India in 40 children aged 5 years or above who were treated for physiological phimosis by non-operative methods at some stage.Results: Ninety percent of the patients had resolution of phimosis by conservative means. The remaining patients were having difficulty in retraction, but no complications were identified in any patient.Conclusions: Phimosis is physiological and management should be restricted to reassurance in all cases that have no evidence of scarring or associated pathologies

Maternal vegetarian diet in pregnancy, a predisposition to hypospadias?

Background: Hypospadias constitutes one of the commonest surgically treated patient subset in a pediatric surgery set up. The causative factors have always been multifactorial. Maternal age and diet during pregnancy have been attempted to be correlated with the prevalence of hypospadias.Methods: The current study aims to find a correlation between the rises of hypospadias with increased maternal vegetarian diet taken during pregnancy. The mothers of patients presenting with hypospadias were allotted structured self-completed questionnaires. Obstetric history, dietary patterns and lifestyle information during pregnancy was obtained.Results: The mothers of patients presenting with hypospadias who had been on a vegetarian diet had an increased incidence of babies presenting with hypospadias as shown in the chart.Conclusions: Diet during gestation may play a role in the etiology of hypospadias. Although this study is limited by less number of cases, it does show the trend of increased incidence of hypospadias amongst vegetarian mothers

ISSN 2347-954X (Print) Peritoneal Dialysis Cannulations-Our Experience

Abstract: In our institute peritoneal dialysis (PD) catheter insertion in a patient with end-stage renal disease (ESRD) has been routinely accomplished by a surgeon under general anaesthesia. That procedure often introduces delays in starting dialysis of patients, by passing golden period of patients which has already been consumed in utilizing an operating room as well as anesthesia services. As peritoneal dialysis catheter cannulation is simple, safe and time saving access procedure. In this context, operating room facilities and staff and general anesthesia services are not required and catheter insertion can be performed in a procedure room using local anesthesia, thereby minimizing the time for starting dialysis and completely bypassing the mortality risk associated with general anesthesia