Post-operative sonological evaluation of pelvi-ureteric drainage of unilateral A-H pyeloplasty in children

Background: Pelvi-ureteric junction obstruction is the most common cause of pediatric hydronephrosis where A-H pyeloplasty with D-J stent is the established treatment option with a high success rate. We observed the predictive value of sonological parameters for early detection of postoperative obstruction at the new pelvi-ureteric junction in children following unilateral A-H pyeloplasty. Methods: This cross-sectional study included 12 children who underwent unilateral A-H pyeloplasty. Post-operative follow-up was done after D-J stent removal and completed within six months. Maximum antero-posterior pelvic diameter (APPD), cortical thickness (CT), and pelvi-cortical (P/C) ratio were compared. Results: Mean APPD was 32.7 mm at the day after removal of the stent, 24.4 mm at one month, and 19.7 mm at four months. Mean CT was 5.2 mm at the day after removal of the stent, 6.1 mm at one month and 8.0 mm at four months. P/C ratio was 8.3 mm at the day after removal of the stent, 5.2 mm at one month, and 3.4 mm at four months. Increased CT and reduced P/C ratio were significant at four months (P= 0.05). Conclusion: CT value and P/C ratio can be used as an early marker of success for pelvi-ureteric drainage following A-H pyeloplasty.

Vascularized dorsal dartos flap to prevent fistula in tubularized incised plate urethroplasty for primary distal and mid shaft hypospadias

The aim of the present study was to evaluate the importance of neourethral covering using vascularized dorsal flap for preventing fistula in Tabularized incised plate (TIP) urethroplasty. The study included 52 children (aged 2-10 years) who had hypospadias repaired including 44  with distal and 8  with mid shaft hypospadias. In all children, a standard tabularized incised plate urethroplasty was followed by reconstruction of new surrounding urethral tissue. A longitudinal dartos flap was harvested from excessive dorsal preputial and penile hypospadiac skin and transposed to ventral side by a buttonhole maneuver. It was sutured to the glans wings and the neomeatus and to the corpora covernosa over the neo-urethra. Thus the new urethra was completely covered with well-vascularzed subcutaneous tissue. At a mean follow-up of 18 months, the result was successful with no fistula or urethral stenosis, except 2 of the mid penile hypospadias. All patients had good functional and cosmetic results with straight penis and vertical slit shaped meatus at the tip of the penis. The 2 patients developed tiny fistula, which were closed spontaneously after meatal dilatation. In conclusion, urethral covering should be part of TIP urethroplasty. A dorsal well-vascularized dartos flap, button holed ventrally is a good choice for preventing fistula for distal and mid shaft hypospadias.

One stage transanal full thickness pull-through operation for rectosigmoid Hirschsprung's disease

The surgical management of Hirschsprung's disease (HD) has changed from the original staged operations to the latest introduced minimally invasive one stage techniques. One stage transanal full thickness Swenson-like procedure is a new concept of single stage procedure for HD. We reviewed the early outcome of one stage transanal Swenson-like pull-through operation for rectosigmoid HD. By using the transanal concept we choose to apply Swenson's principle in transanal dissection for the primary treatment of HD and describe technical aspects and impact on fecal and urinary function. We reviewed our series of HD patient who underwent one-stage transanal full thickness, Swenson-like rectosigmoid dissection, assessing for postoperative stricture or stenosis, anastomotic leak, enterocolitis, obstruction and long-term results for bowel and urinary function. Of 15 patients all had the transanal resection, the age of the patients ranged from 6 months to 5 years. The average length of resection was 20 ± 5 cm. Mean follow-up was 24 months. 10 patients were at least three years old at follow-up and were assessed for urinary and fecal continence. All had the voluntary bowel movement and urinary continence. Three patients had episodes of postoperative enterocolitis and two patients developed stenosis at the anastomotic site. Postoperative frequent bowel movement was present in all patients and continued for 2-8 weeks. In conclusion, our data support the fact that a modification of Swenson's original transabdominal dissection concept using the recently describe transanal approach is an excellent technique for HD and produces excellent long-term outcome for fecal and urinary function.

Post-operative sonological evaluation of pelvi-ureteric drainage of unilateral A-H pyeloplasty in children

Background: Pelvi-ureteric junction obstruction is the most common cause of pediatric hydronephrosis where A-H pyeloplasty with D-J stent is the established treatment option with a high success rate. We observed the predictive value of sonological parameters for early detection of postoperative obstruction at the new pelvi-ureteric junction in children following unilateral A-H pyeloplasty. Methods: This cross-sectional study included 12 children who underwent unilateral A-H pyeloplasty. Post-operative follow-up was done after D-J stent removal and completed within six months. Maximum antero-posterior pelvic diameter (APPD), cortical thickness (CT), and pelvi-cortical (P/C) ratio were compared. Results: Mean APPD was 32.7 mm at the day after removal of the stent, 24.4 mm at one month, and 19.7 mm at four months. Mean CT was 5.2 mm at the day after removal of the stent, 6.1 mm at one month and 8.0 mm at four months. P/C ratio was 8.3 mm at the day after removal of the stent, 5.2 mm at one month, and 3.4 mm at four months. Increased CT and reduced P/C ratio were significant at four months (P= 0.05). Conclusion: CT value and P/C ratio can be used as an early marker of success for pelvi-ureteric drainage following A-H pyeloplasty. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 58-61

Post-operative sonological evaluation of pelvi-ureteric drainage of unilateral A-H pyeloplasty in children

Background: Pelvi-ureteric junction obstruction is the most common cause of pediatric hydronephrosis where A-H pyeloplasty with D-J stent is the established treatment option with a high success rate. We observed the predictive value of sonological parameters for early detection of postoperative obstruction at the new pelvi-ureteric junction in children following unilateral A-H pyeloplasty. Methods: This cross-sectional study included 12 children who underwent unilateral A-H pyeloplasty. Post-operative follow-up was done after D-J stent removal and completed within six months. Maximum antero-posterior pelvic diameter (APPD), cortical thickness (CT), and pelvi-cortical (P/C) ratio were compared. Results: Mean APPD was 32.7 mm at the day after removal of the stent, 24.4 mm at one month, and 19.7 mm at four months. Mean CT was 5.2 mm at the day after removal of the stent, 6.1 mm at one month and 8.0 mm at four months. P/C ratio was 8.3 mm at the day after removal of the stent, 5.2 mm at one month, and 3.4 mm at four months. Increased CT and reduced P/C ratio were significant at four months (P= 0.05). Conclusion: CT value and P/C ratio can be used as an early marker of success for pelvi-ureteric drainage following A-H pyeloplasty. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(1): 58-61

Investigation of respiratory disease outbreaks of poultry in Bangladesh using two real-time PCR-based simultaneous detection assays

For rapid and sensitive pathogen screening from field outbreaks, molecular techniques such as qPCR-based simultaneous detections are efficient. Respiratory diseases are the most detrimental diseases to the poultry industry and need to be addressed because of their major economic losses. In the current study, we have applied two different detection assays: one for simultaneous detection of avian influenza virus (AIV; M gene) and subtyping (H5, N1, H9, N2) using TaqMan probe chemistry (TaqMan multitarget) and another for simultaneous detection of Newcastle disease virus (NDV), infectious bronchitis virus (IBV), and infectious laryngotracheitis virus (ILTV) using SYBR Green chemistry (SYBR Green multitarget). Two individual qPCRs were conducted for the detection of four pathogens. Surveillance of tissue (n = 158) and oropharyngeal swab (206) samples from multiple poultry flocks during the years April 2020–July 2022 applying the TaqMan and SYBR Green multitarget qPCRs revealed that 48.9% of samples were positive for respiratory infections, of which 17.2% were positive for NDV, 25.5% were positive for AIV, 9.9% were positive for IBV, and only a single positive (0.3%) for ILTV. Among the AIV, 35% were highly pathogenic subtype H5N1 and 65% were low pathogenic subtype H9N2. Co-infections of 2–3 respiratory viruses were also accurately detected. Respiratory viral pathogens are quite common in Bangladeshi poultry and can be successfully detected using multitarget simultaneous real-time quantitative polymerase chain reaction (RT-qPCR) assays like those adopted in the current study. Increased mass surveillance, along with the molecular characterization of the circulating respiratory viruses, is crucial to control the epidemic and subsequently save the Bangladeshi poultry industry

32-core inline multicore fiber amplifier for dense space division multiplexed transmission system

We present a high-core-count SDM amplifier, i.e. 32-core multicore-fiber amplifier, in a cladding-pumped configuration. An average gain of 17dB and NF of 7dB is obtained for -5dBm input signal power in the wavelength range 1544nm-1564nm