Abdominoperineal posterior sagittal anorectoplasty without protective colostomy in high arm pouch colon surgery

Background: In high anorectal malformations (ARM), surgical management includes initial colostomy at neonatal period followed by abdominoperineal posterior sagittal anorectoplasty (PSARP) without a protective colostomy. Aims and Objectives: The aims of this study were as follows: (i) To evaluate whether 2 stage PSARP gives better outcome for high ARM than three stage and (ii) to assess overall stay duration, cost incurred, and complications associated with two stage PSARP. Materials and Methods: A total 30 patients were studied. Fifteen patients with classical abdominoperineal PSARP with protective colostomy (three stages) constituting Group A studied retrospectively and 15 patients were studied in Group B who underwent neonatal colostomy followed by abdominoperineal PSARP without protective colostomy (Two stages). Comparative study was done between the two groups for a better choice of procedure in high ARM patients. Results: In Group A, blood transfusion required was more than Group B. Mean expense incurred in Group A was more than Group B. Complications in Group A occur in eight patients, whereas in Group B, complications occurred in six patients. Conclusion: Stages of high ARM and pouch colon are better alternative to three stages repair in all aspect

Humorous Masculinity

Perera S, Pathak DN, Sandhya AS, Adkar C. Humorous Masculinity. In: Humour and the Performance of Power in South Asia. Anxiety, Laughter and Politics in Unstable Times. London: Routledge India; 2021: 139-155.Stereotypical representations of socially marginalised groups have been historically used towards the ‘othering’ of certain communities. This chapter explores the use of humour in such representations to understand how laughter is performed to draw social boundaries with the marginalised other. The Indian male gaze cast upon the Nepali man is at the center of this discussion. We use the framework of the superiority theory of humour and problematise the ‘gaze’ to trace the impact of race relations embedded in colonial history and the present-day migrant-class status of the Nepali male subject, on his stereotypical portrayal. The arguments unravelling the imagination of this caricature are built upon examples from three distinct sites of humour. We begin with the examination of text-based jokes forwarded through mass-messaging platforms and then proceed to look at how these portrayals are captured in visual media and in the cinematic experience. Lastly, we analyse ‘cringe pop’ on social media in search of the Indian male gaze when the visibility of this stereotypical Nepali man has waned up to an extent. The gaze that is cast upon the subject of such humour is understood in terms of what becomes a hegemonic ideal of masculinity and the laughter that follows further legitimises this exercise of power

Perineal Accessory Scrotum with Congenital Lipoma: A Rare Case Report

A case of accessory scrotum in a 1-year-old boy is reported because of its rarity. A boy presented with a tumor mass attached with scrotum-like skin on its tip in the right side of perineum between the scrotum and anus. Both testes had descended into the scrotum. There was no other urological anomaly. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion accessory scrotum. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypothesis regarding etiology of accessory scrotum

Clinical evaluation of total intravenous anaesthesia using xylazine or dexmedetomidine with propofol in surgical management of canine patients

Aim: The aim was to evaluate and compare the clinico-physiological, hemodynamic and hematobiochemical effects in response to different total intravenous anaesthesia techniques using xylazine or dexmedetomidine with propofol in canine patients. Materials and Methods: Under a prospective randomized blinded clinical study, 12 apparently healthy adult dogs (14.27±3.2 kg) divided into two groups (n=6). Animals were administered with xylazine (0.5 mg/kg body weight IV) in X group or, dexmedetomidine (10 μg/kg body weight IV) in D group and propofol (as IV bolus till the induction and continuous IV infusion for maintenance). Clinical reflexes, physiological, hemodynamic parameters, were recorded at 5-min intervals. Blood was collected at zero, 30 and 60 min after initial injection for hematobiochemical evaluation. Statistical analysis was performed using analysis of variance, Duncan’s multiple range tests, paired - t-test and Kruskal–Wallis one-way test. Results: Animals showed quicker attenuation of all clinical reflexes in group D. Induction doses of propofol were 3.17±0.21 and 2.72±0.15 mg/kg and rate of infusion of propofol for maintenance of anaesthesia were 0.33±0.02 mg/kg/min and 0.35±0.02 mg/kg/min respectively in group X and D. Recovery was quicker in group D. There were no significant statistical differences in physiological, hemodynamic and hematobiochemical parameters in both the groups. There were no adverse effects after recovery. Conclusion: Both anesthetic protocols provided satisfactory immobilization, but dexmedetomidine-propofol combination may be preferred owing to slightly better degree of basal anaesthesia, lesser doses of propofol required for induction and maintenance of anaesthesia along with a lesser degree of respiratory depression. However, there was no clear preference for either of the protocol, and both appear suitable for canines