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To compare the results of the staged procedure (Group A) with the primary single stage posterior sagittal anorectoplasty (PSARP) procedure (Group B) for high and intermediate anorectal anomalies. Four hundred ninety cases of primary single stage procedure done over a period of seven years (1996-2003) were compared with 458 out of 763 cases of staged procedure (Historical control) that underwent all three stages done from 1989 to 1996. Two hundred cases that had been in regular follow up in Group A and 254 cases in Group B who had attained three years of age were evaluated for continence by Kelly's method. The approximate cost of treatment was also calculated. Continence was good in 90 cases (45%), fair in 66 cases (33%) and poor in 44 cases (22%) in Group A while it was good in 204 cases (80% ), fair in 38 cases (15%) and poor in 12 cases (5%) in Group B. In Group A, the mortality was high as only 40% cases completed all the three stages of operation. The mortality was 4.5% in Group B. Primary PSARP is recommended as the better treatment option for intermediate and high-anorectal anomalies with superior results in terms of morbidity, mortality, continence and cost.

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Onlay free preputial graft for mid and distal penile hypospadias Onlay free preputial graft for mid and distal penile hypospadias Onlay free preputial graft for mid and distal penile hypospadias Onlay free preputial graft for mid and distal penile hypospadias Onlay free preputial graft for mid and distal penile hypospadias ABSTRACT ABSTRACT ABSTRACT ABSTRACT ABSTRACTTubularized free preputial graft for hypospadias repair had been tried in the past and discarded due to high incidence of graft shrinkage causing stricture formation. We have tried to revive the technique using onlay method thus avoiding stricture formation. The technique was used in 33 subjects (Group A) and compared with 33 subjects in control group (Group B) in whom other techniques of urethroplasty were used. The study was a randomized controlled trial. The mean length of the free preputial graft was 22.06 + 4.68 mm (16-35 mm) and breadth was 9.0 + 1.32 mm (7-11 mm). Fistulae developed in 3 patients in group A out of which one healed spontaneously. In group B, 6 patients had fistula formation. Complications developed in 18% cases in group A and 50% cases in group B. There was significant difference between the cosmetic results (p < 0.05) with 58% excellent results in group A and 27% in group B. Free preputial graft onlay urethroplasty has better functional and cosmetic results. KEY WORDS: Hypospadias, Free preputial graft, Onlay urethroplastyHypospadiology is an over expanding field as none of the current methods of urethroplasty have been proved su perior over the others in terms of achieving the goal of excellent functional and cosmetic results. We have de scribed our experience with free inner preputial full thick ness onlay graft urethroplasty in mid and distal penile hypospadias and compared our results with currently used technique.

Early closure before 10 weeks of formation for NEC patients is associated with significant morbidity, increased ventilator requirements and chances of developing incisional hernia.

Although there is voluminous literature describing various aspects of hydatid disease in children, little attention has been paid to the small group of patients whose symptoms result in atypical presentation. This article addresses this problem, describing the features in ten children aged from 2 to 12 years. The sites of involvement were within a choledochal cyst (1). the pelvic cavity (1), the spleen (1), and transverse mesocolon. Albendazole was efficacious in the treatment of one recurrent case, as well as in preventing recurrence.