Atul Meena - Academia.edu (original) (raw)

Papers by Atul Meena

Research paper thumbnail of Anorectal malformations in male monozygotic twins and review of literature

Journal of Indian Association of Pediatric Surgeons, 2022

Anorectal malformations (ARMs) are one of the common congenital gastrointestinal malformations wi... more Anorectal malformations (ARMs) are one of the common congenital gastrointestinal malformations with a prevalence of 0.2–0.6/1000 live births. There are only a few reported cases of familial ARMs in literature suggesting different patterns of inheritance. Among them, isolated ARMs in monozygotic twins are quite rare with significant male preponderance. Most of these ARMs are either of intermediate or low anomaly type. We reported two pairs of male monozygotic isolated ARMs from a tertiary care hospital in India and reviewed the literature in details adding to the total of nine pairs of twins till date.

Research paper thumbnail of Musculoskeletal and Esthetic Complications after Neonatal Thoracotomy: Revisited

Journal of Indian Association of Pediatric Surgeons, Jun 24, 2022

Research paper thumbnail of Comparative study of prevalence of hypothyroidism in cirrhotic patients and normal individuals

International Journal of Advances in Medicine

Background: Alcoholic cirrhosis has worse prognosis than primary billiary cirrhosis and cirrhosis... more Background: Alcoholic cirrhosis has worse prognosis than primary billiary cirrhosis and cirrhosis due to hepatitis. The risk of death due to all cause is increased 12-fold with cirrhosis. Alcoholic liver cirrhosis develops between 10-20% of individuals who drink heavily for a decade or more. Chronic hepatitis B is probably the most common cause of cirrhosis worldwide. The aim and objective of this study was to compare the prevalence of hypothyroidism between cirrhotic patients and normal healthy individuals.Methods: The present study constitutes of 50 patients with cirrhosis of liver who met our inclusion criteria. They were selected from the patients admitted in medical wards and gastroenterology ward of RNT medical college, Udaipur.Results: Majority of patients were of serum albumin level class III about 67%. Increased TSH level as compare to level of serum albumin in cirrhotic patients. When serum albumin level decreases then percent of TSH level increases. Majority of patients w...

Research paper thumbnail of Pediatric biliary calculus disease: clinical spectrum, predisposing factors, and management outcome revisited

Annals of Pediatric Surgery

Background Biliary calculus disease (BCD) is one of the most prevalent diseases and poses a signi... more Background Biliary calculus disease (BCD) is one of the most prevalent diseases and poses a significant burden to the health care system in adults. The prevalence of BCD in children and adolescents is about 0.1% and 0.6%, respectively. Although many factors have been attributed to BCD in children, exact etiopathogenesis is not clear. BCD has been extensively studied in adults, but not much literature is available in children. The current review was undertaken to study BCD in children focusing on the objectives like predisposing factors, various modes of presentation, and management outcome of BCD in children in the northern part of India. Results Out of 42 children, two children had a history of ceftriaxone therapy. Two underwent ileal resection. The mean reticulocyte count was 1.79%. None had G6PD deficiency or abnormal osmotic fragility test. Clinical presentation was right upper quadrant pain (n = 42, 100%), calculous cholecystitis (n = 8, 19.0%), and jaundice (n = 3, 7.14%). The...

Research paper thumbnail of A Rare Case of Pediatric Gastrointestinal Stromal Tumor

Telangana Journal of IMA, Oct 29, 2021

Research paper thumbnail of Effect of metformin on serum level of vitamin B12 and folate in patients of type-2 diabetes mellitus

International Journal of Advances in Medicine, 2021

Background: Several types of DM are caused by a complex interaction of genetic and environmental ... more Background: Several types of DM are caused by a complex interaction of genetic and environmental factors. Depending on the etiology of the DM, factors contributing to hyperglycaemia include- reduced insulin secretion, decreased glucose utilization, and increased glucose production.Objective of the current study was to study the effect of metformin on the level of vitamin B12 and folate in patients of type 2 DM.Methods: This is hospital based study before and after metformin therapy randomized controlled trial was conducted in medicine ward of M. B. hospital, Udaipur. Baseline serum vitamin B12 and folate level of all patients were measured and treatment with metformin 500 mg twice a day was given for 6 months. After 6 months serum vitamin B12 and folate level of all patients were re-evaluated.Results: There was a significant positive correlation (r=0.824, p<0.001) between decrease in vitamin B12 and decrease in folate level after metformin treatment. When analysis for change in v...

Research paper thumbnail of Delayed presentation of anorectal malformations in a tertiary care hospital in India

Pediatric Surgery International, 2021

To study delayed presentation of ARMs, management and its effect on surgical and functional compl... more To study delayed presentation of ARMs, management and its effect on surgical and functional complications. It is a retrospective study from March 2015 to March 2020. All the patients satisfying the criteria of delayed ARMs, i.e., presenting 7 days after birth were included. Information regarding type of ARM, mode of presentation, time of presentation, associated anomalies, management strategy, postoperative complications and functional outcome was noted. Minimum follow-up period was 6 months. Out of 102 patients with ARM, 44 patients presented late. Among the 44 patients, 9 were males and 35 were females. Associated comorbidities observed are low birth weight (n = 9) and preterm (n = 13). Associated anomalies observed were cardiac (n = 18), renal (n = 8), other gastrointestinal (n = 5) and skeletal (n = 1). (1) Male: rectourethral fistula—2 (staged repair), anal stenosis—3 (anoplasty) and anocutaneous fistula—4 (anoplasty). (2) Female: vestibular fistula: 15 (6 primary definitive su...

Research paper thumbnail of Abstracts for IAPSCON 2018

Journal of Indian Association of Pediatric Surgeons, 2019

Research paper thumbnail of Giant juvenile fibroadenoma in a young female-A diagnostic dilemma

Background: Fibroadenoma is the most common breast lesion among pediatric female population. A gi... more Background: Fibroadenoma is the most common breast lesion among pediatric female population. A giant fibroadenoma is rare, characterized by a rapidly growing tumor, with a mass >5 cm diameter in greatest dimension and/or weighing more than 500 gm. Phyllodes tumor range from benign to malignant. Both have similar presentation. Clinical Description: An 11-year-old girl presented with rapidly progressive, painless increase in the size of the left breast over 2 months. Local examination revealed a firm nontender mass involving the upper inner and outer quadrants of the left breast along with the retro-areolar region. The mass was mobile and measured approximately 11 cm × 10 cm. The overlying skin was normal, although with dilated veins and free from underlying mass. The clinical phenotype was suggestive a phyllodes tumor in view of rapid progression and large size. However, the ultrasonogram and fine-needle aspiration cytology favored a fibroadenoma. Management: It was decided to per...

Research paper thumbnail of Comparative study of single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for pediatric inguinal herniotomy

IP International Journal of Medical Paediatrics and Oncology, 2021

To compare single dose preoperative antibiotic versus five days antibiotic course in preventing s... more To compare single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for the pediatric inguinal herniotomy.The present study was conducted on 100 patients of elective inguinal herniotomy from January 2019 to April 2020 and compared on the basis of single dose preoperative antibiotic versus five days antibiotic course. All the patients were evaluated on the 3rd, 7th and 28th post-operative period and instructions were given to the guardians about wound care and to attend for early follow up if any signs & symptoms of wound infection appear.50% of the patients were treated with prophylactic single dose antibiotic, i.e. inj. Ceftriaxone (30 mg/kg/dose) at the time of induction only and rest 50% were treated with inj. Ceftriaxone(30mg/kg/dose) at the time of induction as well as postoperatively at night followed by four days of oral antibiotic with Syr/Tablet. Cephalexin (25mg/kg/day) three times daily for another 4 days.Surgical Site I...

Research paper thumbnail of Pediatric thoracoabdominal trauma: Experience from a tertiary care center

Journal of Indian Association of Pediatric Surgeons, 2019

Aim: The aim of this study is to assess the pattern and mode of thoracoabdominal trauma and anato... more Aim: The aim of this study is to assess the pattern and mode of thoracoabdominal trauma and anatomical organ involvement, type of management employed, and overall outcomes in the pediatric population. Materials and Methods: A retrospective study conducted at a tertiary hospital over a period of 38 months with a total of 198 pediatric patients <12 years of age with a history of abdominal and chest trauma between July 2014 and September 2017 were reviewed. Case files of all pediatric patients were evaluated. Information regarding age, sex, mechanism of injury, site of injury, mode of injury, nature of the injury, definitive treatment required, whether conservative or surgical and outcome of patients was evaluated. site of injury, mode of injury, nature of the injury, definitive treatment required, whether conservative or surgical and outcome of patients was evaluated. Results: A total of 198 patients of thoracoabdominal trauma patients were studied. The majority of pediatric thoracoabdominal trauma cases were observed in males (n = 128, 64.64%) and females comprise only 35.35% (n = 70). Fall was the most common mode of trauma (58.08%) followed by road traffic accidents (30.30%), thermal injuries (9.09%) assaults in order of decreasing trends. The abdomen was the most common anatomical site of the injury (45.95%) followed by combined thoracoabdominal trauma (32.32%) followed by thoracic trauma (21.71%). Among the thoracic trauma, the most common comprised the lung contusions (37.20%) followed by the lung laceration comprising (25.58%) and rib fractures comprised only 20.93%. Among the abdominal trauma, the most common organ of injury was the liver (36.26%) followed by splenic trauma in 19.78% of patients. Approximately, 85% of patients were managed conservatively, and only 15% required major surgical intervention in the form of laparotomy and repair of bowel perforation, thoracotomy and ligation of bleeding intercostal vessels, partial and total splenectomy, repair of the liver laceration, and nephrectomy for the patient of Grade 5 renal injury with expanding retroperitoneal hematoma. Three patients died, one of which was Grade 5 renal injury with expanding retroperitoneal hematoma, two others were cases of combined thoracoabdominal trauma with massive hemothorax and both liver and splenic injury. Conclusion: The study defines the pattern of thoracoabdominal trauma, mode of trauma, and the prevalence of different organs involved in both the chest and abdominal cavity. We concluded that main indications for performing an operative intervention included severe hemodynamic instability, pneumoperitoneum, massive pneumohemothorax with significant shift and definitive confirmation of oral contrast leak on computed tomography films. A detailed trauma registry in our set up seems important for managing pediatric thoracoabdominal trauma.

Research paper thumbnail of Sacrococcygeal teratoma in children: Single center experience

IP International Journal of Medical Paediatrics and Oncology, 2019

Introduction: Sacrococcygeal teratoma (SCT) represent the most common benign and malignant germ c... more Introduction: Sacrococcygeal teratoma (SCT) represent the most common benign and malignant germ cell tumors (GCT) in newborns and infants developing from primordial germ cells of the human embryo. Most of them are benign, however those presenting later in life and having major intra-pelvic component have greater malignant potential. Early and complete excision of the SCT has been the mainstay of successful management. The aim of this study is to describe the patient's details, management done, histopathology of the tumor, recurrence and the over all outcome of patients with SCT. Materials and Methods: Patients with histological diagnosis of sacrococcygeal teratoma during the period of January 2014 and October 2016 were included in this retrospective observational study. Data was collected regarding age, gender, mode of presentation, associated anomalies, Altman's classification, investigations, treatment modality, tumor histology according to type of tumour with margin of resection, and outcome of management. All the diagnosed cases of SCT presenting during the above duration were included for study. Results: Twenty eight patients were included in the study. Out of them 75% were females and 25% were males. 32.14% presented during neonatal period. 78.57% presented with external mass. The tumour was completely resected by sacral approach in 22 patients and by combined abdominosacral approach in 06 patients. Recurrence was detected in one patients (3.57%); with Altman types 1 mature teratoma. Patients were followed for a duration ranged between 1 months and 3 years. Conclusion: Early diagnosis and early complete enblock excision of the tumor with the coccyx was mainstay of treatment with good prognosis. Late presentation and the presence of malignant changes are associated with poor prognosis. Intraoperative spillage of the tumor should be avoided. Overall survival of SCT is high.

Research paper thumbnail of Trans-Anal Extrusion of Ventriculoperitoneal Shunt: An Unusual Complication

Journal of Case Reports, 2013

Ventriculoperitoneal (VP) shunt is the standard, time tested surgical procedure for the managemen... more Ventriculoperitoneal (VP) shunt is the standard, time tested surgical procedure for the management of hydrocephalus. Complications associated with VP shunt remain to be persistent problem in clinical setting. However, trans-anal extrusion of VP shunt is rare but well known entity. We are reporting one such case in a six year old male child.

Research paper thumbnail of Giant Epithelial Non-Parasitic Splenic Cyst

Journal of Case Reports, 2013

True non-parasitic splenic cysts are rare lesions of spleen seen generally in children and young ... more True non-parasitic splenic cysts are rare lesions of spleen seen generally in children and young adults. Various haematological and radiological investigations are required to confirm the diagnosis. Decision about the type of surgical procedure is based on the size of the cyst, its relationship to the splenic hilum and amount of normal remnant splenic tissue. We report here a case of large non-parasitic splenic cyst in a 7 year old male child.

Research paper thumbnail of A Rare Case of Oeis Complex

Journal of Case Reports, 2013

OEIS complex is a rare and complex anomaly of the genitourinary and intestinal tract. It includes... more OEIS complex is a rare and complex anomaly of the genitourinary and intestinal tract. It includes Omphalocele, Exstrophy of cloaca, Imperforate anus and Spinal defects. Cloacal exstrophy is considered the most severe ventral abdominal wall defect. The defect occurs due to failure of convergence of mesodermal migrations and inability of development of urorectal septum during embryonic life. The failure of these two events to occur manifests as exstrophy of bladder and bowel. Diagnosis is primarily based on the presenting features. Management requires initial resuscitation and stabilization followed by either single staged closure or multistage procedures by multidisciplinary surgical team. We are reporting a case of classical case of OEIS complex managed successfully at our center.

Research paper thumbnail of Delayed presentation of anorectal malformation for definitive surgery

Pediatric Surgery International, 2012

To retrospectively study the outcome of patients with anorectal malformations (ARM) presenting la... more To retrospectively study the outcome of patients with anorectal malformations (ARM) presenting late for definitive procedure. Patients with ARM presenting beyond 5 months of age managed from January 2008 to March 2012 were studied for clinical outcome. Ages at presentation varied from 5 months to 14 years, seven patients were older than 5 years of age. Of the 36 cases, 5 patients (3 boys and 2 girls) had presented with colostomy done elsewhere. Four patients had high anomalies. Of the 33 girls, 14 had rectovestibular fistula and 9 had anovestibular fistula. Bowel preparation with peglec was used in patients without colostomy. Preoperative retention enemas, laxatives and Hegar dilators were used for 3-11 days before surgery. On table irrigation was required in four. Patients without a covering colostomy were kept nil per oral for 5 days following surgery in prone/lateral position. Two patients had mild post-op wound infection, and were managed with local care. Delayed presentation of ARM especially in girls is quite common in developing countries. With proper perioperative care, these cases may be managed successfully with a single stage procedure in most cases. The mature tissue growth with age allows proper tissue dissection and good repair of the perineal body in girls.

Research paper thumbnail of Anorectal malformations in male monozygotic twins and review of literature

Journal of Indian Association of Pediatric Surgeons, 2022

Anorectal malformations (ARMs) are one of the common congenital gastrointestinal malformations wi... more Anorectal malformations (ARMs) are one of the common congenital gastrointestinal malformations with a prevalence of 0.2–0.6/1000 live births. There are only a few reported cases of familial ARMs in literature suggesting different patterns of inheritance. Among them, isolated ARMs in monozygotic twins are quite rare with significant male preponderance. Most of these ARMs are either of intermediate or low anomaly type. We reported two pairs of male monozygotic isolated ARMs from a tertiary care hospital in India and reviewed the literature in details adding to the total of nine pairs of twins till date.

Research paper thumbnail of Musculoskeletal and Esthetic Complications after Neonatal Thoracotomy: Revisited

Journal of Indian Association of Pediatric Surgeons, Jun 24, 2022

Research paper thumbnail of Comparative study of prevalence of hypothyroidism in cirrhotic patients and normal individuals

International Journal of Advances in Medicine

Background: Alcoholic cirrhosis has worse prognosis than primary billiary cirrhosis and cirrhosis... more Background: Alcoholic cirrhosis has worse prognosis than primary billiary cirrhosis and cirrhosis due to hepatitis. The risk of death due to all cause is increased 12-fold with cirrhosis. Alcoholic liver cirrhosis develops between 10-20% of individuals who drink heavily for a decade or more. Chronic hepatitis B is probably the most common cause of cirrhosis worldwide. The aim and objective of this study was to compare the prevalence of hypothyroidism between cirrhotic patients and normal healthy individuals.Methods: The present study constitutes of 50 patients with cirrhosis of liver who met our inclusion criteria. They were selected from the patients admitted in medical wards and gastroenterology ward of RNT medical college, Udaipur.Results: Majority of patients were of serum albumin level class III about 67%. Increased TSH level as compare to level of serum albumin in cirrhotic patients. When serum albumin level decreases then percent of TSH level increases. Majority of patients w...

Research paper thumbnail of Pediatric biliary calculus disease: clinical spectrum, predisposing factors, and management outcome revisited

Annals of Pediatric Surgery

Background Biliary calculus disease (BCD) is one of the most prevalent diseases and poses a signi... more Background Biliary calculus disease (BCD) is one of the most prevalent diseases and poses a significant burden to the health care system in adults. The prevalence of BCD in children and adolescents is about 0.1% and 0.6%, respectively. Although many factors have been attributed to BCD in children, exact etiopathogenesis is not clear. BCD has been extensively studied in adults, but not much literature is available in children. The current review was undertaken to study BCD in children focusing on the objectives like predisposing factors, various modes of presentation, and management outcome of BCD in children in the northern part of India. Results Out of 42 children, two children had a history of ceftriaxone therapy. Two underwent ileal resection. The mean reticulocyte count was 1.79%. None had G6PD deficiency or abnormal osmotic fragility test. Clinical presentation was right upper quadrant pain (n = 42, 100%), calculous cholecystitis (n = 8, 19.0%), and jaundice (n = 3, 7.14%). The...

Research paper thumbnail of A Rare Case of Pediatric Gastrointestinal Stromal Tumor

Telangana Journal of IMA, Oct 29, 2021

Research paper thumbnail of Effect of metformin on serum level of vitamin B12 and folate in patients of type-2 diabetes mellitus

International Journal of Advances in Medicine, 2021

Background: Several types of DM are caused by a complex interaction of genetic and environmental ... more Background: Several types of DM are caused by a complex interaction of genetic and environmental factors. Depending on the etiology of the DM, factors contributing to hyperglycaemia include- reduced insulin secretion, decreased glucose utilization, and increased glucose production.Objective of the current study was to study the effect of metformin on the level of vitamin B12 and folate in patients of type 2 DM.Methods: This is hospital based study before and after metformin therapy randomized controlled trial was conducted in medicine ward of M. B. hospital, Udaipur. Baseline serum vitamin B12 and folate level of all patients were measured and treatment with metformin 500 mg twice a day was given for 6 months. After 6 months serum vitamin B12 and folate level of all patients were re-evaluated.Results: There was a significant positive correlation (r=0.824, p<0.001) between decrease in vitamin B12 and decrease in folate level after metformin treatment. When analysis for change in v...

Research paper thumbnail of Delayed presentation of anorectal malformations in a tertiary care hospital in India

Pediatric Surgery International, 2021

To study delayed presentation of ARMs, management and its effect on surgical and functional compl... more To study delayed presentation of ARMs, management and its effect on surgical and functional complications. It is a retrospective study from March 2015 to March 2020. All the patients satisfying the criteria of delayed ARMs, i.e., presenting 7 days after birth were included. Information regarding type of ARM, mode of presentation, time of presentation, associated anomalies, management strategy, postoperative complications and functional outcome was noted. Minimum follow-up period was 6 months. Out of 102 patients with ARM, 44 patients presented late. Among the 44 patients, 9 were males and 35 were females. Associated comorbidities observed are low birth weight (n = 9) and preterm (n = 13). Associated anomalies observed were cardiac (n = 18), renal (n = 8), other gastrointestinal (n = 5) and skeletal (n = 1). (1) Male: rectourethral fistula—2 (staged repair), anal stenosis—3 (anoplasty) and anocutaneous fistula—4 (anoplasty). (2) Female: vestibular fistula: 15 (6 primary definitive su...

Research paper thumbnail of Abstracts for IAPSCON 2018

Journal of Indian Association of Pediatric Surgeons, 2019

Research paper thumbnail of Giant juvenile fibroadenoma in a young female-A diagnostic dilemma

Background: Fibroadenoma is the most common breast lesion among pediatric female population. A gi... more Background: Fibroadenoma is the most common breast lesion among pediatric female population. A giant fibroadenoma is rare, characterized by a rapidly growing tumor, with a mass >5 cm diameter in greatest dimension and/or weighing more than 500 gm. Phyllodes tumor range from benign to malignant. Both have similar presentation. Clinical Description: An 11-year-old girl presented with rapidly progressive, painless increase in the size of the left breast over 2 months. Local examination revealed a firm nontender mass involving the upper inner and outer quadrants of the left breast along with the retro-areolar region. The mass was mobile and measured approximately 11 cm × 10 cm. The overlying skin was normal, although with dilated veins and free from underlying mass. The clinical phenotype was suggestive a phyllodes tumor in view of rapid progression and large size. However, the ultrasonogram and fine-needle aspiration cytology favored a fibroadenoma. Management: It was decided to per...

Research paper thumbnail of Comparative study of single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for pediatric inguinal herniotomy

IP International Journal of Medical Paediatrics and Oncology, 2021

To compare single dose preoperative antibiotic versus five days antibiotic course in preventing s... more To compare single dose preoperative antibiotic versus five days antibiotic course in preventing surgical site infection for the pediatric inguinal herniotomy.The present study was conducted on 100 patients of elective inguinal herniotomy from January 2019 to April 2020 and compared on the basis of single dose preoperative antibiotic versus five days antibiotic course. All the patients were evaluated on the 3rd, 7th and 28th post-operative period and instructions were given to the guardians about wound care and to attend for early follow up if any signs & symptoms of wound infection appear.50% of the patients were treated with prophylactic single dose antibiotic, i.e. inj. Ceftriaxone (30 mg/kg/dose) at the time of induction only and rest 50% were treated with inj. Ceftriaxone(30mg/kg/dose) at the time of induction as well as postoperatively at night followed by four days of oral antibiotic with Syr/Tablet. Cephalexin (25mg/kg/day) three times daily for another 4 days.Surgical Site I...

Research paper thumbnail of Pediatric thoracoabdominal trauma: Experience from a tertiary care center

Journal of Indian Association of Pediatric Surgeons, 2019

Aim: The aim of this study is to assess the pattern and mode of thoracoabdominal trauma and anato... more Aim: The aim of this study is to assess the pattern and mode of thoracoabdominal trauma and anatomical organ involvement, type of management employed, and overall outcomes in the pediatric population. Materials and Methods: A retrospective study conducted at a tertiary hospital over a period of 38 months with a total of 198 pediatric patients <12 years of age with a history of abdominal and chest trauma between July 2014 and September 2017 were reviewed. Case files of all pediatric patients were evaluated. Information regarding age, sex, mechanism of injury, site of injury, mode of injury, nature of the injury, definitive treatment required, whether conservative or surgical and outcome of patients was evaluated. site of injury, mode of injury, nature of the injury, definitive treatment required, whether conservative or surgical and outcome of patients was evaluated. Results: A total of 198 patients of thoracoabdominal trauma patients were studied. The majority of pediatric thoracoabdominal trauma cases were observed in males (n = 128, 64.64%) and females comprise only 35.35% (n = 70). Fall was the most common mode of trauma (58.08%) followed by road traffic accidents (30.30%), thermal injuries (9.09%) assaults in order of decreasing trends. The abdomen was the most common anatomical site of the injury (45.95%) followed by combined thoracoabdominal trauma (32.32%) followed by thoracic trauma (21.71%). Among the thoracic trauma, the most common comprised the lung contusions (37.20%) followed by the lung laceration comprising (25.58%) and rib fractures comprised only 20.93%. Among the abdominal trauma, the most common organ of injury was the liver (36.26%) followed by splenic trauma in 19.78% of patients. Approximately, 85% of patients were managed conservatively, and only 15% required major surgical intervention in the form of laparotomy and repair of bowel perforation, thoracotomy and ligation of bleeding intercostal vessels, partial and total splenectomy, repair of the liver laceration, and nephrectomy for the patient of Grade 5 renal injury with expanding retroperitoneal hematoma. Three patients died, one of which was Grade 5 renal injury with expanding retroperitoneal hematoma, two others were cases of combined thoracoabdominal trauma with massive hemothorax and both liver and splenic injury. Conclusion: The study defines the pattern of thoracoabdominal trauma, mode of trauma, and the prevalence of different organs involved in both the chest and abdominal cavity. We concluded that main indications for performing an operative intervention included severe hemodynamic instability, pneumoperitoneum, massive pneumohemothorax with significant shift and definitive confirmation of oral contrast leak on computed tomography films. A detailed trauma registry in our set up seems important for managing pediatric thoracoabdominal trauma.

Research paper thumbnail of Sacrococcygeal teratoma in children: Single center experience

IP International Journal of Medical Paediatrics and Oncology, 2019

Introduction: Sacrococcygeal teratoma (SCT) represent the most common benign and malignant germ c... more Introduction: Sacrococcygeal teratoma (SCT) represent the most common benign and malignant germ cell tumors (GCT) in newborns and infants developing from primordial germ cells of the human embryo. Most of them are benign, however those presenting later in life and having major intra-pelvic component have greater malignant potential. Early and complete excision of the SCT has been the mainstay of successful management. The aim of this study is to describe the patient's details, management done, histopathology of the tumor, recurrence and the over all outcome of patients with SCT. Materials and Methods: Patients with histological diagnosis of sacrococcygeal teratoma during the period of January 2014 and October 2016 were included in this retrospective observational study. Data was collected regarding age, gender, mode of presentation, associated anomalies, Altman's classification, investigations, treatment modality, tumor histology according to type of tumour with margin of resection, and outcome of management. All the diagnosed cases of SCT presenting during the above duration were included for study. Results: Twenty eight patients were included in the study. Out of them 75% were females and 25% were males. 32.14% presented during neonatal period. 78.57% presented with external mass. The tumour was completely resected by sacral approach in 22 patients and by combined abdominosacral approach in 06 patients. Recurrence was detected in one patients (3.57%); with Altman types 1 mature teratoma. Patients were followed for a duration ranged between 1 months and 3 years. Conclusion: Early diagnosis and early complete enblock excision of the tumor with the coccyx was mainstay of treatment with good prognosis. Late presentation and the presence of malignant changes are associated with poor prognosis. Intraoperative spillage of the tumor should be avoided. Overall survival of SCT is high.

Research paper thumbnail of Trans-Anal Extrusion of Ventriculoperitoneal Shunt: An Unusual Complication

Journal of Case Reports, 2013

Ventriculoperitoneal (VP) shunt is the standard, time tested surgical procedure for the managemen... more Ventriculoperitoneal (VP) shunt is the standard, time tested surgical procedure for the management of hydrocephalus. Complications associated with VP shunt remain to be persistent problem in clinical setting. However, trans-anal extrusion of VP shunt is rare but well known entity. We are reporting one such case in a six year old male child.

Research paper thumbnail of Giant Epithelial Non-Parasitic Splenic Cyst

Journal of Case Reports, 2013

True non-parasitic splenic cysts are rare lesions of spleen seen generally in children and young ... more True non-parasitic splenic cysts are rare lesions of spleen seen generally in children and young adults. Various haematological and radiological investigations are required to confirm the diagnosis. Decision about the type of surgical procedure is based on the size of the cyst, its relationship to the splenic hilum and amount of normal remnant splenic tissue. We report here a case of large non-parasitic splenic cyst in a 7 year old male child.

Research paper thumbnail of A Rare Case of Oeis Complex

Journal of Case Reports, 2013

OEIS complex is a rare and complex anomaly of the genitourinary and intestinal tract. It includes... more OEIS complex is a rare and complex anomaly of the genitourinary and intestinal tract. It includes Omphalocele, Exstrophy of cloaca, Imperforate anus and Spinal defects. Cloacal exstrophy is considered the most severe ventral abdominal wall defect. The defect occurs due to failure of convergence of mesodermal migrations and inability of development of urorectal septum during embryonic life. The failure of these two events to occur manifests as exstrophy of bladder and bowel. Diagnosis is primarily based on the presenting features. Management requires initial resuscitation and stabilization followed by either single staged closure or multistage procedures by multidisciplinary surgical team. We are reporting a case of classical case of OEIS complex managed successfully at our center.

Research paper thumbnail of Delayed presentation of anorectal malformation for definitive surgery

Pediatric Surgery International, 2012

To retrospectively study the outcome of patients with anorectal malformations (ARM) presenting la... more To retrospectively study the outcome of patients with anorectal malformations (ARM) presenting late for definitive procedure. Patients with ARM presenting beyond 5 months of age managed from January 2008 to March 2012 were studied for clinical outcome. Ages at presentation varied from 5 months to 14 years, seven patients were older than 5 years of age. Of the 36 cases, 5 patients (3 boys and 2 girls) had presented with colostomy done elsewhere. Four patients had high anomalies. Of the 33 girls, 14 had rectovestibular fistula and 9 had anovestibular fistula. Bowel preparation with peglec was used in patients without colostomy. Preoperative retention enemas, laxatives and Hegar dilators were used for 3-11 days before surgery. On table irrigation was required in four. Patients without a covering colostomy were kept nil per oral for 5 days following surgery in prone/lateral position. Two patients had mild post-op wound infection, and were managed with local care. Delayed presentation of ARM especially in girls is quite common in developing countries. With proper perioperative care, these cases may be managed successfully with a single stage procedure in most cases. The mature tissue growth with age allows proper tissue dissection and good repair of the perineal body in girls.