http://www.jiaps.com/currentissue.asp J Indian Assoc Pediatr Surg 2012 - 17(1) Journal of Indian Association of Pediatric Surgeons Medknow Publications0971-9261 Kirtikumar J Rathod Ram Samujh Sumeet Agarwal Ravi Prakash Kanojia Ujjawal Sharma Rajendra Prasad Original Article Journal of Indian Association of Pediatric Surgeons 2012 17(1):1-5doi:10.4103/0971-9261.91077 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91077 http://www.jiaps.com/text.asp?2012/17/1/1/91077 http://www.jiaps.com/text.asp?2012/17/1/1/91077171 1 5 http://www.jiaps.com/text.asp?2012/17/1/1/91077 Kirtikumar J Rathod, Ram Samujh, Sumeet Agarwal, Ravi Prakash Kanojia, Ujjawal Sharma, Rajendra Prasad

Journal of Indian Association of Pediatric Surgeons 2012 17(1):1-5

Aim: To study the role of urinary enzymes N-acetyl-b-glucosaminidase (NAG), alkaline phosphatase (AKP) and gamma glutamyl transferase (GGT) in the diagnosis and follow-up of patients with suspected pelviureteric junction obstruction (PUJO). Materials and Methods: A total of 70 patients, 29 managed conservatively (group A) and 41 managed by pyeloplasty (group B), were studied prospectively. A serial measurement of urinary enzymes NAG, AKP and GGT level was performed in both the groups. The mean levels of these urinary enzymes were compared between the two groups and among the patients of the same group at presentation as well as during follow-up. Results: There was a significant fall in the mean AKP level in patients managed conservatively at 8 months of follow-up. Similarly, in the operated group, there was a significant fall in the AKP levels at both 3 months and 8 months of follow-up. The mean level of GGT also showed a significant fall after 3 months of surgery but did not show further significant change at 8 months after surgery. The mean levels of NAG and GGT in the conservatively managed group were significantly low compared with that of patients requiring pyeloplasty at presentation as well as in the follow-up. The mean level of AKP was significantly low in the conservatively managed group when compared with the patients requiring surgery, but did not differ significantly in both the follow-ups after surgery. Conclusions: The level of urinary enzymes NAG, AKP and GGT are significantly high in the patients with hydronephrosis (HDN) requiring pyeloplasty when compared with the patients managed conservatively. The level of AKP significantly falls after pyeloplasty in the patients of HDN due to PUJO. There is a negative correlation with the preoperative level of enzyme NAG with split renal function in the patients of HDN requiring pyeloplasty.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/1/91077 Sivasankar Jayakumar Mohamed Marjan Key Wong Amman Bolia George K Ninan Original Article Journal of Indian Association of Pediatric Surgeons 2012 17(1):6-8doi:10.4103/0971-9261.91078 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91078 http://www.jiaps.com/text.asp?2012/17/1/6/91078 http://www.jiaps.com/text.asp?2012/17/1/6/91078171 6 8 http://www.jiaps.com/text.asp?2012/17/1/6/91078 Sivasankar Jayakumar, Mohamed Marjan, Key Wong, Amman Bolia, George K Ninan

Journal of Indian Association of Pediatric Surgeons 2012 17(1):6-8

Purpose: Proximal migration of the ureteric double J stent is a rare but known complication. We describe three cases where a minimally invasive technique for retrieval of displaced double J stents using Amplatz™ goose-neck snare was successful. Materials and Methods: A retrospective review of patients with displaced double J stent was carried out, in whom cystoscopy guided retrieval of double J stent was attempted with the help of Amplatz goose-neck snare under radiological control. Results: All three patients were under the age of 3 years. Two patients had migrated double J stent following pyeloplasty and in one patient the double J stent was displaced during a retrograde insertion of double J stent. In all cases, retrieval of displaced double J stent was successfully achieved using Amplatz goose-neck snare. There were no postoperative complications. Conclusion: Our method of retrieval of stent from renal pelvis is simple, safe and minimally invasive. This technique is a useful and safe alternative option for retrieval of proximally migrated double J stents in children.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/6/91078 Mainak Deb Suravi Mohanty Anuradha Ananthamurthy Isha Garg Kanishka Das Original Article Journal of Indian Association of Pediatric Surgeons 2012 17(1):9-15doi:10.4103/0971-9261.91079 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91079 http://www.jiaps.com/text.asp?2012/17/1/9/91079 http://www.jiaps.com/text.asp?2012/17/1/9/91079171 9 15 http://www.jiaps.com/text.asp?2012/17/1/9/91079 Mainak Deb, Suravi Mohanty, Anuradha Ananthamurthy, Isha Garg, Kanishka Das

Journal of Indian Association of Pediatric Surgeons 2012 17(1):9-15

Aim: To review the experience with the diagnosis and management of extragonadal germ cell tumors (GCT) with a subset analysis of those with atypical features. Materials and Methods: A retrospective chart review of patients of extragonadal germ cell tumors between 2000 and 2010 was carried out. Results: Fifteen children aged 7 days to 15 years (median, 1.5 years) were included. Three had an antenatal diagnosis (one sacrococcygeal, one retrobulbar, one retroperitoneal tumor) and were operated in the neonatal period. The locations were distributed between the retrobulbar area (1), anterior neck-thyroid gland (1), mediastinum (4), abdominothoracic extending through the esophageal hiatus (1), retroperitoneal (4) and sacrococcygeal (4). On histological examination, five harbored immature elements while two were malignant; the latter children received postexcision adjuvant chemotherapy. There was no mortality. At a median follow-up of 4.5 years (6 months to 8 years), 14/15 have had an event-free survival. One immature mediastinal teratoma that recurred locally 7.5 years after the initial operation was excised and adjuvant chemotherapy instituted. Conclusions: Extragonadal GCTs in children are uncommon and occasionally present with atypical clinical, radiological and histological features resulting in diagnostic and therapeutic dilemmas.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/9/91079 Anjan Kumar Dhua Satish Kumar Aggarwal Shandip Sinha Simmi K Ratan Original Article Journal of Indian Association of Pediatric Surgeons 2012 17(1):16-19doi:10.4103/0971-9261.91080 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91080 http://www.jiaps.com/text.asp?2012/17/1/16/91080 http://www.jiaps.com/text.asp?2012/17/1/16/91080171 16 19 http://www.jiaps.com/text.asp?2012/17/1/16/91080 Anjan Kumar Dhua, Satish Kumar Aggarwal, Shandip Sinha, Simmi K Ratan

Journal of Indian Association of Pediatric Surgeons 2012 17(1):16-19

Aim: To compare tunica vaginalis with dartos flap as soft tissue cover in primary hypospadias repair. Materials and Methods: 25 cases (age range: 12-132 months; all fresh cases) of primary hypospadias were prospectively repaired by tubularized incised plate (TIP)/TIP + graft urethroplasty using tunica vaginalis flap (TVF) as soft tissue cover to urethroplasty (group A). Their results were compared with another set (group B) of age- and anatomy-matched controls (25 patients operated during the previous 3 years) who had undergone TIP repair using dartos flap as soft tissue cover. Statistical analysis of results was done with Fischer's exact test. Results: Group A: No fistula, skin necrosis, meatal stenosis, urethral stricture. One case had partial wound dehiscence that resolved on conservative treatment with no sequelae. One case required catheter removal on 3 rd day because of severe bladder spasm. There was no testicular atrophy/ascent. Group B: 3 fistulae - all required surgery. There were three cases of superficial skin necrosis that healed spontaneously without sequel. There was no meatal stenosis/urethral stricture. The difference in fistula rate between both the groups, however, was not statistically significant (P = 0.4). Conclusion: TVF may have an edge over dartos fascia for soft tissue coverage of the neourethra.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/16/91080 Ravikumar Ramanathan Valkodai Rajamani Gurusami Vijayagiri Duraisami Original Article Journal of Indian Association of Pediatric Surgeons 2012 17(1):20-22doi:10.4103/0971-9261.91081 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91081 http://www.jiaps.com/text.asp?2012/17/1/20/91081 http://www.jiaps.com/text.asp?2012/17/1/20/91081171 20 22 http://www.jiaps.com/text.asp?2012/17/1/20/91081 Ravikumar Ramanathan Valkodai, Rajamani Gurusami, Vijayagiri Duraisami

Journal of Indian Association of Pediatric Surgeons 2012 17(1):20-22

Aim: Six children with adhesive obstruction in the postoperative period were treated with stenting the small bowel with long intestinal tube. Materials and Methods : In two children the stenting was done through jejunostomy, and in the other four through the base of appendix. Results: During a follow-up period of 2-14 years, there had been no recurrence. Conclusions: Use of an intraluminal tube stent in preventing recurrent small bowel obstruction due to adhesions is safe and effective when used on appropriately selected patients.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/20/91081 Biswanath Mukhopadhyay Ram M Shukla Madhumita Mukhopadhyay Kartik C Mandal Pankaj Haldar Abhijit Benare Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):23-25doi:10.4103/0971-9261.91082 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91082 http://www.jiaps.com/text.asp?2012/17/1/23/91082 http://www.jiaps.com/text.asp?2012/17/1/23/91082171 23 25 http://www.jiaps.com/text.asp?2012/17/1/23/91082 Biswanath Mukhopadhyay, Ram M Shukla, Madhumita Mukhopadhyay, Kartik C Mandal, Pankaj Haldar, Abhijit Benare

Journal of Indian Association of Pediatric Surgeons 2012 17(1):23-25

Human tail is a curiosity, a cosmetic stigma and presents as an appendage in the lumbosacral region. Six patients of tail in the lumbosacral region are presented here to discuss the spectrum of presentation of human tails. The embryology, pathology and treatment of this entity are discussed along with a brief review of the literature.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/23/91082 Mustafa T Gurbaz Ahmet Kazez Unal Bakal Tugay Tartar Fikret Ersoz Yunus Colakoglu Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):26-27doi:10.4103/0971-9261.91083 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91083 http://www.jiaps.com/text.asp?2012/17/1/26/91083 http://www.jiaps.com/text.asp?2012/17/1/26/91083171 26 27 http://www.jiaps.com/text.asp?2012/17/1/26/91083 Mustafa T Gurbaz, Ahmet Kazez, Unal Bakal, Tugay Tartar, Fikret Ersoz, Yunus Colakoglu

Journal of Indian Association of Pediatric Surgeons 2012 17(1):26-27

Congenital diaphragmatic hernia (CDH, Bochdalek type) is rarely seen in both members of identical twins. Herein, we report a 37 weeks' twins with CDH along with a brief review of the literature. Both the neonates survived.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/26/91083 Shivaji Mane Jamir Arlikar Nitin Dhende Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):28-30doi:10.4103/0971-9261.91084 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91084 http://www.jiaps.com/text.asp?2012/17/1/28/91084 http://www.jiaps.com/text.asp?2012/17/1/28/91084171 28 30 http://www.jiaps.com/text.asp?2012/17/1/28/91084 Shivaji Mane, Jamir Arlikar, Nitin Dhende

Journal of Indian Association of Pediatric Surgeons 2012 17(1):28-30

Choledochocele in a premature neonate who presented with obstructive jaundice and was managed surgically is reported. At 1-year follow-up, the child is asymptomatic.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/28/91084 Ranjan Dias Parackrama Dharmaratne Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):31-32doi:10.4103/0971-9261.91085 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91085 http://www.jiaps.com/text.asp?2012/17/1/31/91085 http://www.jiaps.com/text.asp?2012/17/1/31/91085171 31 32 http://www.jiaps.com/text.asp?2012/17/1/31/91085 Ranjan Dias, Parackrama Dharmaratne

Journal of Indian Association of Pediatric Surgeons 2012 17(1):31-32

We report a case of a 5-year-old boy who accidentally ingested a metal pin which was found inside the common bile duct on surgical exploration of duodenum and was removed through the ampulla of Vater. This is the first instance that an ingested metal pin in the common bile duct has been reported in the world literature.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/31/91085 Pavai Arunachalam VR Ravi Kumar Divya Swathi Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):33-36doi:10.4103/0971-9261.91086 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91086 http://www.jiaps.com/text.asp?2012/17/1/33/91086 http://www.jiaps.com/text.asp?2012/17/1/33/91086171 33 36 http://www.jiaps.com/text.asp?2012/17/1/33/91086 Pavai Arunachalam, VR Ravi Kumar, Divya Swathi

Journal of Indian Association of Pediatric Surgeons 2012 17(1):33-36

A case series of four patients who presented with large surface vascular tumors and low platelet count and their management is reported. Medical management was done with steroids, propranolol and vincristine in different combinations. The final response was excellent without surgery.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/33/91086 Biswanath Mukhopadhyay Ram M Shukla Madhumita Mukhopadhyay Kartik Chandra Mandal Dipankar Roy Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):37-39doi:10.4103/0971-9261.91087 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91087 http://www.jiaps.com/text.asp?2012/17/1/37/91087 http://www.jiaps.com/text.asp?2012/17/1/37/91087171 37 39 http://www.jiaps.com/text.asp?2012/17/1/37/91087 Biswanath Mukhopadhyay, Ram M Shukla, Madhumita Mukhopadhyay, Kartik Chandra Mandal, Dipankar Roy

Journal of Indian Association of Pediatric Surgeons 2012 17(1):37-39

A 7-year-old boy reported with endodermal sinus tumor of left testis, jejunal metastasis and intestinal obstruction. He was treated by high inguinal orchidectomy and resection of jejunal mass followed by chemotherapy.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/37/91087 Vidyanand P Deshpande BV Raghunath Yogesh K Sarin Shalini Sinha Case Report Journal of Indian Association of Pediatric Surgeons 2012 17(1):40-42doi:10.4103/0971-9261.91088 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91088 http://www.jiaps.com/text.asp?2012/17/1/40/91088 http://www.jiaps.com/text.asp?2012/17/1/40/91088171 40 42 http://www.jiaps.com/text.asp?2012/17/1/40/91088 Vidyanand P Deshpande, BV Raghunath, Yogesh K Sarin, Shalini Sinha

Journal of Indian Association of Pediatric Surgeons 2012 17(1):40-42

A 9-year-old boy presented with duodenal pancreatic rest causing obstruction and required surgical intervention. He had been treated at the age of 4 months for a choledochal cyst. Both choledochal cyst and heterotopic pancreas are entities that are commonly encountered in children, but the incidental presence of both the entities in the same child, albeit presenting metachronously, is extremely rare.]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/40/91088 Jigyasa Pandey Anand Pandey Jiledar Rawat Letter to the Editor Journal of Indian Association of Pediatric Surgeons 2012 17(1):43-43doi:10.4103/0971-9261.91089 Journal of Indian Association of Pediatric Surgeons 10.4103/0971-9261.91089 http://www.jiaps.com/text.asp?2012/17/1/43/91089 http://www.jiaps.com/text.asp?2012/17/1/43/91089171 43 43 http://www.jiaps.com/text.asp?2012/17/1/43/91089 Jigyasa Pandey, Anand Pandey, Jiledar Rawat

Journal of Indian Association of Pediatric Surgeons 2012 17(1):43-43

]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/43/91089 Akshay Kumar Saxena Letter to the Editor Journal of Indian Association of Pediatric Surgeons 2012 17(1):43-44Journal of Indian Association of Pediatric Surgeons http://www.jiaps.com/text.asp?2012/17/1/43/91090 http://www.jiaps.com/text.asp?2012/17/1/43/91090171 43 44 http://www.jiaps.com/text.asp?2012/17/1/43/91090 Akshay Kumar Saxena

Journal of Indian Association of Pediatric Surgeons 2012 17(1):43-44

]]> Thu,22 Dec 2011http://www.jiaps.com/text.asp?2012/17/1/43/91090