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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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   2012| October-December  | Volume 17 | Issue 4  
    Online since October 13, 2012

 
 
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ORIGINAL ARTICLES
Unsuspected invasive neonatal gastrointestinal mucormycosis: A clinicopathological study of six cases from a tertiary care hospital
Sushma Patra, Mukul Vij, Dinesh K Chirla, Narendar Kumar, Subash C Samal
October-December 2012, 17(4):153-156
DOI:10.4103/0971-9261.102329  PMID:23243366
Aim: To analyse the clinicopathological features of neonatal mucormycosis Materials and Methods: Retrospective analysis of cases of neonatal gastrointestinal mucormycosis. Results : There were six neonates with male: female ratio of 1:1. Except one all were preterm babies. The clinical presentation was abdominal distension in the majority. All were clinically diagnosed as either NEC or toxic megacolon with perforation. Neonatal gastrointestinal mucormycosis was not suspected clinically in any. All the children were explored immediately. Biopsy revealed transmural hemorrhagic necrosis/infarction of the intestinal wall with fungal hyphae. Conclusions: The physicians should have a high index of suspicion for gastrointestinal tract mucormycosis in neonates with metabolic disturbances who present with abdominal distension and pneumoperitoneum. Early diagnosis and aggressive medical and surgical treatment may improve the outcome of neonates with this potentially lethal invasive disease.
  3 2,547 149
CASE REPORTS
Scrotal phalloplasty: A novel surgical technique for aphallia during infancy and childhood by pre-anal anterior coronal approach
Minu Bajpai
October-December 2012, 17(4):162-164
DOI:10.4103/0971-9261.102335  PMID:23243368
All the currently known reconstructions for aphallia are carried out around puberty. We describe a novel technique as a temporizing procedure which would see the patient through childhood. This would not cause any hindrance while undertaking any of the other established procedures later on after puberty.
  2 9,983 173
Congenital giant megaureter with duplex kidney presenting as abdominal lump in a neonate
Venkatesh M Annigeri, Harihar V Hegde, Preetam B Patil, Anil B Halgeri, P Raghavendra Rao
October-December 2012, 17(4):168-170
DOI:10.4103/0971-9261.102339  PMID:23243370
A neonate with unilateral complete duplex system with congenital giant megaureter of the upper moiety presenting as abdominal lump is reported. A left upper moiety nephroureterectomy was performed. Such an anomaly with this presentation has not been reported in neonates.
  2 2,292 98
Traumatic diaphragmatic hernia: Management by video assisted thoracoscopic repair
Sandesh V Parelkar, Sanjay N Oak, Jiwan L Patel, Beejal V Sanghvi, Prashant B Joshi, Subrat K Sahoo, Nandita Sampat
October-December 2012, 17(4):180-183
DOI:10.4103/0971-9261.102345  PMID:23243375
Report of the use of video assisted thoracic surgery for traumatic diaphragmatic hernia repair in two children
  2 2,148 133
ORIGINAL ARTICLES
Outcome analysis of palatoplasty in various types of cleft palate
Venkatesh M Annigeri, Jai K Mahajan, Anu Nagarkar, Satinder P Singh
October-December 2012, 17(4):157-161
DOI:10.4103/0971-9261.102333  PMID:23243367
Aims: To analyse the factors affecting clinical and functional outcome of Veau-Wardill-Kilner palatoplasty in various types of cleft palate. Materials and Methods: Demographic data were retrieved from case records and a detailed speech, language and hearing and an orthodontic analysis were carried out prospectively. Results: Mean age at operation was 2.7 years; whereas mean age at the time of evaluation was 6 years. Most of the patients (43.3%, 13/30) had a bilateral cleft lip and palate. The postoperative fistula had developed in 31% (4/13) of the patients with bilateral clefts and in 17% (1/6) and 9% (1/11) of the patients with left unilateral and isolated cleft palate respectively (P<0.05). Eight per cent (2/24) of the patients operated before 2 years of age developed a fistula as compared to 66.6% (4/6) of the patients who had undergone a repair after 2 years of age (P<0.01). Severe speech abnormality was seen in 33.4% of the patients having postoperative fistula as compared to 16.6% of non-fistula patients (P<0.05). Derangement of speech was found in 66.6% of the patients who had undergone surgery after the age of 2 years as compared to the patients (13%, 3/24) undergoing correction before 2 years of age (P<0.05). Hearing loss was seen most commonly in patients with bilateral cleft palate as compared to the other varieties (P>0.05). Tympanic membrane (TM) abnormalities were also more common in bilateral cleft patients (P<0.05). Mean maxillary arch length, arch circumference and maxillary inter-canine and inter-molar width were significantly reduced as compared to the control group (P<0.001). Conclusions: Socially acceptable quality of speech can be achieved in more than 85% of the patients. The postoperative fistula is associated with poor speech; bilateral cleft and older age being the risk factors for fistula formation. Many patients require audiological surveillance even when asymptomatic. Maxillary growth is impaired in all the patients despite early surgery.
  2 2,942 192
Extrahepatic biliary atresia: Correlation of histopathology and liver function tests with surgical outcomes
Lucky Gupta, Siddhartha D Gupta, Veereshwar Bhatnagar
October-December 2012, 17(4):147-152
DOI:10.4103/0971-9261.102326  PMID:23243365
Aims: To correlate the age at surgery, liver function tests, and hepatic and portal tract histo-pathological changes with surgical outcome in the form of disappearance of jaundice in extrahepatic biliary atresia (EHBA). Materials and Methods : This is a retrospective study of 39 cases of EHBA. There were 19 males and 10 females. Kasai's portoenterostomy (KPE) along with liver biopsy was performed in these patients; for purpose of correlation this biopsy was considered to be the preoperative biopsy. These patients were divided into three groups based upon surgical outcome: (A) disappearance of jaundice; (B) initial disappearance of jaundice with recurrence after 3 months; and (C) persistence of jaundice. Postoperatively, liver function tests and liver biopsies were repeated at 3 months after the KPE. Results : There were 11 patients in group A (28%), 21 patients in group B (54%), and seven patients in group C (18%). The age at surgery was comparable in all the three groups. The postoperative levels of serum bilirubin, alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (GGTP) showed statistically significant improvement as compared with the preoperative levels in group A and B patients. Patients belonging to group C showed no improvement in the liver functions following surgery. The preoperative hepatic histopathological changes (hepatocellular alteration, cholestasis, bile ductular proliferation, and bile duct inflammation) showed a significant difference among the three groups; patients with lesser degrees of pre-existing histopathological changes had better outcome following surgery. Fibrosis was seen in all the three groups preoperatively but the difference was not statistically significant. Group C had significant fibrosis in more than 50% patients. Additional findings, viz. ductal plate malformation (9 patients, 23%) and giant cell transformation (19 patients, 49%) did not show any correlation with surgical outcomes. Conclusions : The liver function tests and the histopathological features appeared to affect the final surgical outcome of these patients. Higher degree of cholestasis, hepatocellular alteration, bile ductule proliferation, bile duct inflammation showed definite correlation with poor surgical outcome. High grade hepatic fibrosis and portal edema showed a trend towards poor outcome but did not achieve statistical significance.
  1 5,049 322
BOOK REVIEW
Balanche Aajar Va Shalyachikitsa
Bharati Kulkarni
October-December 2012, 17(4):186-186
  - 1,161 60
CASE REPORTS
Bladder augmentation: Distal ureterocystoplasty with proximal ureteric reimplantation: A novel technique
Ramesh Babu, Deepak Ragoori
October-December 2012, 17(4):165-167
DOI:10.4103/0971-9261.102337  PMID:23243369
A novel technique of bladder augmentation is reported, wherein the distal dilated ends of tortuous ureters were used for ureterocystoplasty while proximal remaining ureters reimplanted back into the native bladder.
  - 1,953 99
Bilateral hemorrhagic cystic adrenal neuroblastoma with liver and lymph nodal metastases in an infant
Prema Menon, Deepak Bansal, Soni Lyngdoh, Kirti Gupta, Kushaljit Sodhi
October-December 2012, 17(4):171-173
DOI:10.4103/0971-9261.102340  PMID:23243371
A 6-month-old boy presented with pallor, large left hypochondrial mass and hepatomegaly. Computerized tomography (CT) revealed cystic lesions in bilateral adrenals, liver and retroperitoneal lymph nodes and a lytic left femur lesion. There was hemorrhagic aspirate with round blue cells. Excised left sided mass with adjacent lymph nodes and biopsies of others confirmed well differentiated neuroblastoma. He received 4 cycles of chemotherapy with remaining lesions markedly reduced at 2 months CT scan. At 2 year follow up he is doing well.
  - 2,243 86
Successful management of auto knotted intravesical infant feeding tube by minimal invasive technique
Sidharth Khullar, Molay K Bera, Anup K Kundu, Dilip K Pal
October-December 2012, 17(4):174-175
DOI:10.4103/0971-9261.102341  PMID:23243372
We report a case of acute urinary retention due to intravesical auto knotting of infant feeding tube in a child treated successfully by endoscopic approach.
  - 1,747 112
Scrotoschisis: An extremely rare congenital anomaly
Ram M Shukla, Kartik C Mandal, Dipankar Roy, Mahadev P Patra, Biswanath Mukhopadhyay
October-December 2012, 17(4):176-177
DOI:10.4103/0971-9261.102342  PMID:23243373
A rare case of unilateral scrotoschisis in a full term infant delivered by Caesarean section is reported.
  - 3,057 121
Thoracic fetus in fetu
Ramesh K Reddy, Lavanya Kannaiyan, Srinivas Srirampur, Ramani Malleboyina, Gulam Mohammed Irfan, Hariprasad Sharab, Srinivas Kannepalli
October-December 2012, 17(4):178-179
DOI:10.4103/0971-9261.102344  PMID:23243374
A rare case of thoracic fetus in fetu is reported. Complete excision was curative.
  - 1,728 101
LETTER TO THE EDITOR
Locally invasive pulmonary inflammatory myofibroblastic tumors in children
Prema Menon
October-December 2012, 17(4):184-185
DOI:10.4103/0971-9261.102346  PMID:23243376
  - 1,688 69
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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

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