Background: It is important to detect and manage hydronephrosis early for improved clinical outcomes. The objective of this study is to detect and manage the hydronephrosis which occurs antenatally.Methods: Hospital based cross sectional study was carried out in 20 cases of hydronephrosis in pregnant women as per the inclusion and exclusion criteria laid down for the present study. Patients with mild hydronephrosis were observed. Patients with PUJ obstruction underwent pyeloplasty. Patients with posterior urethral valves underwent cystoscopic dilatation. Patients with VUR were put on prophylactic antibiotic and observed. The patients were followed up post operatively with USG and DTPA scan as indicated.Results: Among the 20 cases with hydronephrosis, majority were males. All cases in terms of side affected were found to be equally distributed. Hydronephrosis was found to be mild in seven (35%) of the cases. Renal dysplasia and bilateral hydronephrosis were found to be the predictors of post natal pathology. Grade 3 and grade 4 were 40% each. There was no persistent case. The most common cause of hydronephrosis was transient hypertension in 5 (33.3%) of the cases.Conclusions: Mild hydronephrosis resolves early and there is no persistence. Renal dysplasia and bilateral hydronephrosis are the important predictors of the post natal hydronephrosis.
Background: Conditions which can be treated by surgery like biliary atresia etc., can lead to infantile jaundice. For better outcome it is important that the diagnosis be made quickly and precisely. There is danger of irreversible damage to the liver if prompt action is not taken. Here comes the role of diagnostic imaging which can help for prompt and precise diagnosis. This helps to act rapidly for the surgeon. The objective was to study the surgical problem of hepatobiliary and pancreatic disease in children.Methods: Hospital-based follow up study was carried out among 10 pediatric patients with surgical problems hepatobiliary and pancreatic diseases. After admission detailed history of all the cases were taken according to the proforma approved by the guide information regarding the age at presentation to hospital, gestational age, birth weight, age at onset of jaundice, nature of symptoms, duration of symptoms was obtained.Results: Out of the total cases, 50% constituted the biliary atresia cases followed by choledochal cyst in 30% of the cases. Chronic pancreatitis constituted 20% of the cases. In 20% of the patients the birth weight was less than two kg. All 5 patients had icterus. 3 patients had icterus. Ultrasound showed that the most common finding was hepatomegaly in 60% of the cases. All 5 patients had good uptake of radiotracer and excretion of radiotracer in intestine was poor in all 5 patients. The mean value of total bilirubin is 13.9.Conclusions: Early and rapid intervention in biliary atresia cases reduces morbidity and mortality.
Background: Hypospadias is a relatively common congenital defect of male external genitalia. It is present in approximately 1 in 300 males new born. The meatus may be located anywhere along the shaft of the penis from glans to scrotum or even perineum. The objective is to study the efficacy of MAGPI procedure in the management of hypospadias.Methods: Detailed case study was done as per the proforma, in majority of cases patient’s mother were informants, thorough clinical examination was done in all cases and looked for any congenital anomalies and family history was also taken, and any drugs intake was also taken. All the cases routine investigation was done like (Hb, BT, Ct, Wt). USG was done in required cases. Routine pre-operative preparation was done like keeping nil orally, preparing parts was done. The type of surgery for each patient was assessed after clinical examination of location of meatus: Anterior, Middle, and Posterior. On discharge, the patients and mothers were advised to bring their children for regular check up to hospital.Results: Most common position of hypospadias was glanular and coronal. The most common surgery performed was Snodgrass technique and for distal and mid penile hypospadias and MAGPI for glanular type of hypospadias. MAGPI procedure was most commonly performed for glanular and coronal type of hypospadias. Other minor Complication was wound infection and penile torsion of mild degree and was managed conservatively.Conclusions: There is significant difference in outcome of hypospadias surgery done by pediatric urologist and other surgeons.
Background: Pain in abdomen of chronic nature is common in children but being so common difficult to determine the exact cause. It has been estimated that around 2-4% of all the pediatric patients attend the outpatient department are due to pain in the abdomen that is of chronic nature in children. It has been seen that routine diagnostic and therapeutic procedures fail to make a justice of the diagnosis and management for the pain in the abdomen of chronic nature. The aim was to study the role of laparoscopy in children with chronic pain abdomen.Methods: Interventional follow up study was carried out among 19 children with pain in the abdomen of chronic nature. Detailed history pertaining to pain in the abdomen, history of surgical explorations was taken. As a part of the work up of a patient the investigations were done routinely. All children were evaluated by laparoscopy.Results: Majority of the children were in the age group of 11-12 years i.e. 42.1%. Male and female children were almost equal in distribution. USG was diagnostic in 9 patients (47.36%). Laparoscopy was diagnostic in all 18 other cases (95% cases). 73.68% had not complication after the procedure. Only four patients had fever after the surgery and only one patient had wound infection. Thus, overall the laparoscopic procedure was very successful. Laparoscopy and USG were equally effective in diagnosing inguinal hernia.Conclusions: Laparoscopy had better diagnostic value compared to ultrasonography. Laparoscopic intervention was successful with minimum complications.
Background: Conditions which can be treated by surgery like biliary atresia etc., can lead to infantile jaundice. For better outcome it is important that the diagnosis be made quickly and precisely. There is danger of irreversible damage to the liver if prompt action is not taken. Here comes the role of diagnostic imaging which can help for prompt and precise diagnosis. This helps to act rapidly for the surgeon. The objective was to study the surgical problem of hepatobiliary and pancreatic disease in children.Methods: Hospital-based follow up study was carried out among 10 pediatric patients with surgical problems hepatobiliary and pancreatic diseases. After admission detailed history of all the cases were taken according to the proforma approved by the guide information regarding the age at presentation to hospital, gestational age, birth weight, age at onset of jaundice, nature of symptoms, duration of symptoms was obtained.Results: Out of the total cases, 50% constituted the biliary atresia cases followed by choledochal cyst in 30% of the cases. Chronic pancreatitis constituted 20% of the cases. In 20% of the patients the birth weight was less than two kg. All 5 patients had icterus. 3 patients had icterus. Ultrasound showed that the most common finding was hepatomegaly in 60% of the cases. All 5 patients had good uptake of radiotracer and excretion of radiotracer in intestine was poor in all 5 patients. The mean value of total bilirubin is 13.9.Conclusions: Early and rapid intervention in biliary atresia cases reduces morbidity and mortality.
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