Background: Spinal dysraphism refers to a group of developmental abnormalities that affect the spinal cord and its surrounding structures. The main goals of treatment of spinal dysraphism are to prevent further damage to the spinal cord and to improve the patient's neurological function and quality of life.Aim of the Study: The aim of this study was to assess the management of spinal dysraphism .Methods: This cross-sectional study was conducted in Department of Pediatric Neuro Surgery, Bangladesh Shishu Hospital and Institute, Sher E Bangla Nagar, Dhaka 1207, Bangladesh, during the period from 1st April 2020 to 31st March 2021. Total 1052 patients were admitted under Neurosurgery department (SU IV) from them 93 patients had spinal dysraphism. After excluding patients with encephalocele, lipomeningocele, meningocele and DORB, total 60 patients with myelomeningocele were included in this study.Result: Majority of the subjects (71%) were less than a week old. there was a slight female preponderance (54%) among the study subjects. The most affected (83.33%) region of the spine among the study subjects was lumbosacral. The data showed that 65% of the study subjects had no lower limb movement, while 35% of them had slight movement. In the study, all study subjects had abnormal bowel and bladder habits. In the study, the majority (62%) had a moderate ventricular index level before operation. About 83.33% of the study subjects had a satisfactory outcome after the surgery, while 6.66% had poor outcomes, and 1.66% of the study subjects died after the surgery. The data showed that 80% of the study subjects had a severe Ventricular Index after two weeks of surgery, while 20% had a moderate Ventricular Index. The data also indicated that 85% of the study subjects had a healthy wound after surgery, while 15% had an unhealthy wound.Conclusion:From the findings of our study, it can be concluded that for improving the quality of life of the patients with spinal dysraphism, surgery is the prominent treatment accompanied by optimal post-operative care. Surgery of spinal dysraphism is associated with higher satisfactory rate and lower post-operative complications.

Background: Anorectal Malformation (ARM) is one of the common congenital anomalies in the world. There are various surgical options for management of ARM. Colostomy is usually performed as a first stage in a new born with high and intermediate variety of anorectal malformations. The aim of the study was to compare the clinical outcomes between divided and loop sigmoid colostomy for the management of anorectal malformations. Material and Methods: This prospective comparative study was conducted on 130 pediatric patients at the Faculty of Pediatric Surgery, Bangladesh Shishu Hospital and Institute, who were admitted with anorectal malformations (ARM) up to 7 days of age, from March 2018 to February 2021. Informed consent was obtained after proper counselling with the guardian. They were randomly assigned to the divided sigmoid colostomy group (group 1=65 neonates) and loop sigmoid colostomy group (group 2=65 neonates). The comparative parameters between two groups were the operation time, post-operative complications such as wound infection, skin excoriation, prolapse of colostomy, retraction of colostomy and parastomal hernia. All patients were followed up for 2 months post-operatively. Results: The mean age of the patients was 2.43±1.39days in group 1 and in group 2, the mean age was 2.61±1.73 days where majority of the patients were male. The statistical difference between the two groups regarding operation time was highly significant (0.0001). After operation, 26.15% patients developed skin excoriation in group 1 where in group 2, 29.23% patients developed skin excoriation. In group 1, 6.15% patients developed wound infection but none of them developed prolapse, retraction of colostomy and parastomal hernia. On the other hand, in group 2, 1.54% patient developed wound infection, 15.38% patients developed prolapse and 6.15% patients developed retraction of colostomy and no patient experienced parastomal hernia. The statistical difference between the two groups regarding prolapse of colostomy was significant (p=0.042). Conclusion: In our study, the frequency of different stoma-related problems was greater in the loop colostomy group, although being statistically insignificant. In the divided group, there was significantly less stoma prolapse. In light of these results, divided stoma should be suggested for newborns with ARM.

Introduction: Anorectal Malformation (ARM) is one of the common congenital anomalies in the world. Incidence worldwide is 1 in 3000 to 5000 live births. Anorectal malformation is a well-recognized condition since antiquity and represents a wide spectrum of defects. Anorecto-Vestibular fistula (ARVF) is the commonest ARM in female children. Recto‑Vestibular anus is the most common Anorectal Malformation (ARM) in female patients, in which rectum opens immediately behind the hymen in the vestibule. Aim of the Study: The aim of this study was to evaluate and compare the outcome between Trans- Fistula Anorectoplasty (TFARP) and Anterior Sagittal Anorectoplasty (ASARP) in the management of Recto-Vestibular Fistula (RVF) among neonates in a tertiary care hospital .Methods: This was a prospective comparative study and was conducted in the Faculty of Pediatric Surgery of Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh during the period from February 2017 to January 2021. In our study we took sixty (60) female neonates with vestibular fistula (VF). Among all neonates TFARP was done in 30 neonates and ASARP was done in 30 neonates for definitive correction of RVF. Result: In total 60 patients from both the groups completed the study. In our study we found the mean operation time in TFARP group and ASARP group was 65.97±4.63 minutes and 69.37±4.76 minutes. After operation, 60% neonates in TFARP group and 90% neonates in ASARP group developed complications. Most occurred complication was skin excoriation (20% & 26.67%) in TFARP & ASARP groups respectively. Wound dehiscence was noted significantly more in ASARP group. In TFARP group, 63.3% neonates had good, 33.3% neonates had fair and 3.3% neonates had poor functional score while in ASARP group, 56.7% neonates had good functional score & 43.3% neonates had fair functional score. Conclusion: In conclusion, we found that TFARP may provide the best postoperative cosmetic appearance, parent’s satisfaction, ..........

Introduction: Infantile hypertrophic pyloric stenosis (IHPS) is one of the most common surgical conditions of infancy. It`s prevalence ranges from 1.5 to 4 per 1000 live births. Different treatment modalities and procedures have been tried for the management of this common condition. Many innovations and approaches have been carried out for surgical management of IHPS. Open extramucosal pyloromyotomy, the original operation used to correct IHPS. Aim of the Study: The aim of this study was to evaluate and compare the outcome of Pyloromyotomy surgery among children with antibiotics or no antibiotics. Methods: This was a comparative study and was conducted in the Faculty of Pediatric Surgery of Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh during the period from January, 2020 to December, 2022. In our study we took 120 cases of Pyloromyotomy. All patients were randomized into two groups – Group A (Patients with antibiotics Ceftazidime) and Group B (Patients with no antibiotics). Periumbilical semicircular incision was made in all patients. Result: In total 120 patients from both the groups completed the study. In our study we found majority (67.5%) were less than 1 month & majority of our patients were male (75%) compared to female (25%). The Mean Age of group A & B was 33.5 ±11.2 & 32.1 ± 12.4 days respectively. Mean weight was 3.97 ± 0.8 & 4.02 ± 0.7 kg in group A & B respectively. Majority (13.33% & 10%) of patients had vomiting in group A & B respectively. Wound infection was 5% in group A & 6.67% in group B, stitch abscess was found 1.67% &1.67%, suture granuloma 5% & 1.67% in patients with antibiotics & no antibiotics respectively. Skin dehiscence was 6.67% in antibiotic group & 5% in no antibiotic group. Conclusion: In this study, we found major complications like wound infection, stitch abscess &skin dehiscence was present in our patients. However, there were no significant differences of these complications between antibiotic or no antibiotic .....

Background: Ventriculoperitoneal shunting is the main technique for extra-thecal cerebrospinal fluid (CSF) diversion. Even though VP shunts are the standard of care for many types of hydrocephalus, they tragically have many problems that require surgery more frequently than initial shunt insertions. The objective of this study was to analyze the hydrocephalic children who had undergone Ventriculo peritoneal shunt surgeries with regard to the etiology, clinical profile and complication. Methods: This is a prospective observational study that was conducted at department of Pediatric Neuro Surgery, Bangladesh Shishu Hospital & Institute (BSH&I) for a period of 5 years from January 2017 to January 2022. This study included 92 patients out of 240 patients of hydrocephalus (HCP) who underwent VP shunt placement and had complications. Results: A total of 92 patients (38.3%) out of 240 patients who presented with various patterns of complications over the period of the study were examined. The average age was 15.5±8.1 months, with 62 (67.4%) male and 30 (32.6%) female and mortality rate was 4.2%. 75 (81.5%) of the 92 patients experienced single complication, while the remaining 17(18.5%) had multiple complications. Forty-five (48.9%) patients had ventricular end malfunction and 26 (28.3%) patients had peritoneal end malfunction, 21(22.8%) patients had both ventricular and peritoneal end malfunction. Patient of early infective complications were 24(26.1%) and late infective complications were 6(6.5%). Moreover, numbers of early and late mechanical complication were 25(27.2%) and 37(40.2%) respectively. Conclusion: Pediatric patients frequently experience difficulties from VP shunts despite the best efforts of neurosurgeons worldwide to reduce these issues. A great care should be taken during insertion of the shunt system starting from scrubbing to avoid complications. Despite complications, the VP shunt remains the main surgical procedure used for hydrocephalus management.