Background: Hypospadias constitutes one of the commonest surgically treated patient subset in a pediatric surgery set up. The causative factors have always been multifactorial. Maternal age and diet during pregnancy have been attempted to be correlated with the prevalence of hypospadias.Methods: The current study aims to find a correlation between the rises of hypospadias with increased maternal vegetarian diet taken during pregnancy. The mothers of patients presenting with hypospadias were allotted structured self-completed questionnaires. Obstetric history, dietary patterns and lifestyle information during pregnancy was obtained.Results: The mothers of patients presenting with hypospadias who had been on a vegetarian diet had an increased incidence of babies presenting with hypospadias as shown in the chart.Conclusions: Diet during gestation may play a role in the etiology of hypospadias. Although this study is limited by less number of cases, it does show the trend of increased incidence of hypospadias amongst vegetarian mothers.
The present study was conducted to compare the efficacy of Two hand sewn techniques of gut anastomosis (i.e. single and double layer). This prospective study was conducted in department of Surgery, JA Group of Hospitals, G.R.M.C Gwalior. 80 patients requiring intestinal anastomosis were included in this study from October 2011 to October 2012. In this study 43 single layer extramucosal and 37 conventional double layered anastomosis were observed and Comparison was made in terms of time required for anastomosis, anastomotic leak and other complications, and the cost incurred. Single layer anastomosis was performed with a continuous 2-0 polyglycolic acid suture & two layer anastomosis was constructed using 2-0 silk lembert suture for the outer layer & a continuous 2-0 polyglycolic acid suture for inner layer. 80 patients were subjected to intestinal anastomsis either single or double layer in emergency or electively by senior surgeon (Registrar or consultant). In 43 cases single layer anastomsis was done (18 emergency + 25 elective). In 37 cases double layer anastomosis was done (14 in emergency + 23 elective). In our study single layer anastomosis took 16-22 minutes whereas double anastomosis took 26-36 minutes. The average postoperative stay in hospital was 11.45 days for single layer and 13.45 days for double layer. The study shows that there was low incidence of anastomotic failure and setpic complications in single layer as compared with the double conventional methods of gut anastomosis. Hence the single layer anastomosis is safe and cost effective.
The foreign body ingestion is a rare cause of gastrointestinal perforation in children and is typically seen with sharp foreign bodies or button batteries. Herein, we report an 11-month old male baby who presented with obstructed umbilical hernia. Abdominal radiograph showed dilated small bowel loops, while ultrasonography and CT scan suggested presence of a foreign body. Laparotomy revealed obstructed umbilical hernia with a plum seed being stuck in the terminal ileum causing intestinal perforation. Resection and anastomosis of intestine was performed.
. Our study plan was approved by Ethical Committee of our institute 80 patients were included in this study who underwent gastrointestinal anastomosis whether elective or emergency irrespective of age and gender. A detailed history and relevant preoperative investigation like complete blood picture, liver function test, kidney function test, electrolyte were taken and intra-operative information was collected like peritoneal cavity contaminated or non-contamination, technique of anastomosis and indication of gastrointestinal anastomosis as well as post-operative information were also collected like pelvic collection wound dehiscence, burst abdomen, fecal discharge from the wound site. All these data were compared and analyzed with respect to their effect on the healing of wound and gastrointestinal anastomosis. The result revealed that age<20years, gender and technique, elective or emergency gastrointestinal anastomosis, diabetes mellitus, and tuberculosis had no effect on the healing of wound and gastrointestinal anastomosis whereas >60 years of age anaemia, hypoprotenemia, hyperbilirubin and malignancy, uremia and peritoneal contamination had impaired the healing of wound and anastomotic leak and there were statistically significant P value 0.04, 0.05, 0.04, 0, 05, 0.05, 0.04, 0.04. 0.003 Respectively.
Purpose: Pediatric patients represent nearly 10 percent of all trauma admissions in major trauma centers. The study attempts to study the different patterns of demography in patients suffering from trauma to the abdomen in a tertiary care hospital in a developing nation. Methods: The study was done in a tertiary care center over a duration of one year. The study was retrospective based on hospital records of the patients. The demographic parameters were studied and compared to available literature. Results: A total of 288 cases of blunt trauma to the abdomen were recorded in one year. The demographic trends with respect to the etiology, organ injured, management protocol and mortalities were comparable to standard literature. Conclusion: Pediatric trauma is a neglected topic in developing nations due to absence of infrastructure and trained personnel. The high incidence illustrates the need to have proper training programs and education in this stream.
INTRODUCTIONEsophageal atresia with tracheo-esophageal fistula is a common congenital anomaly at our center. Congenital tracheo-esophageal fistula can occurs due to non-fusion of the tracheo-esophageal ridges during embryological development. 1Presenting symptoms are excessive frothing from mouth, chocking and cyanosis.2 There are so many proposed classifications of esophageal atresia with tracheo-esophageal fistula like Vogt classification, gross classification and ladd classification. Other modified classifications are Waterson classification, holder classification, kluth classification etc. 3 We deal most common variety like, proximal esophageal atresia with distal tracheo-esophageal fistula. ABSTRACTBackground: Congenital esophageal atresia with tracheo-esophageal fistula is a common congenital anomaly facing at our centre. There is various proposed anastomotic technique to avoid post-op stricture. In this study we compare outcome of oblique and circular anastomosis technique at our centre. Methods: This study conducted in 60 cases of congenital esophageal atresia with tracheo-esophageal fistula, designed randomly in two groups. Oblique anastomosis in group A and Circular anastomosis in group B. The complications of anastomotic leaks, anastomotic narrowing with strictures and recurrent fistula were studied. Results: Anastomotic leak rate in case oblique anastomosis was 6.7% as compared to circular anastomosis was 16.7%. Stricture formation in oblique anastomosis was 13.3% in comparison to circular anastomosis there was 43.3% stricture formation. None of the cases required re-exploration in Oblique anastomosis, whereas two (6.7%) cases required re-exploration in circular anastomosis. Conclusions: Present study showed that oblique anastomotic technique is superior to circular anastomotic technique, in term of less stricture and leak rate.
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