Dr Shailesh Solanki - Academia.edu (original) (raw)
Papers by Dr Shailesh Solanki
Journal of Pediatric Surgery, Dec 1, 2022
Journal of Clinical and Diagnostic Research, 2013
Journal of Indian Association of Pediatric Surgeons, 2013
Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually as... more Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually asymptomatic but may have varied presentations. This survey was conducted to study the clinical profile and the challenges posed in the management of this entity. Retrospective analysis of 6 patients diagnosed to have crossed fused renal ectopia during 1997-2010. The diagnosis was confirmed during surgical exploration in one patient. In one patient it was detected on antenatal ultrasonography and in the other 4 patients it was detected during investigations for abdominal pain, abdominal mass, anorectal malformation and urinary tract infection. The left moiety was crossed and fused with the right moiety in 4 cases. Ultrasonography was found to be a good screening investigation with useful diagnostic contributions from CT scans, radionuclide scintigraphy and magnetic resonance urography. Micturating cystourethrography revealed presence of VUR in 4 cases, 3 of whom have undergone ureteric reimplantation. Two patients required pyeloplasty for pelviureteric junction obstruction; in one of these patients the upper ureter was entrapped in the isthmus. In one patient, a non-functioning moiety resulted in nephrectomy. All children were asymptomatic at last follow-up with stable renal functions. Crossed fused renal ectopia was detected in most patients during investigation for other problems. It was found more commonly in boys. The left moiety was crossed to the right in the majority of cases. Associated urological problems were found in most cases and required the appropriate surgical management.
Journal of Indian Association of Pediatric Surgeons, 2020
Background: Children with biliary atresia (BA) have impaired metabolism of trace elements (TEs) (... more Background: Children with biliary atresia (BA) have impaired metabolism of trace elements (TEs) (i.e., zinc, copper, selenium, and manganese), leading to an alteration in the serum levels. However, this alteration in serum level has any correlation with liver histopathological changes is not yet clear. Materials and Methods: This prospective study attempts to evaluate the preoperative serum levels of TE in comparison to controls and its correlation with liver histology in children with BA. Kasai portoenterostomy (KPE) and liver biopsy were performed in all cases. On liver histology, various parameters assessed and were graded according to predefined criteria. Serum levels of TE were determined again 12 weeks post-KPE and compared with the preoperative levels. Results: Mean(±standard deviation [SD]) preoperative serum Zn, Cu, Se, and Mn levels (in μg/dl) in BA patients were 41.6 ± 12.8, 130.6 ± 12.8, 50.0 ± 10.0, and 32.0 ± 20.0, respectively; in controls, these levels were 77.9 ± 13.7, 133.7 ± 13.7, 87.0 ± 13.0, and 8.0 ± 5.5, respectively. Mean postoperative levels in all patients were 68.5 ± 19.0, 91.7 ± 19.0, 79.0 ± 19.0, and 28.0 ± 12.0, respectively. Mean(±SD) postoperative serum Zn, Cu, Se, and Mn levels in BA patients with bile excretion were 73.8 ± 14.9, 83.6 ± 13.8, 85.0 ± 15.0, and 26.0 ± 10.0, respectively, whereas in those with no bile excretion, they were 40.6 ± 12.8, 134.0 ± 23.0, 49.0 ± 11.0, and 44.0 ± 16.0, respectively. In liver histology, specific parameters showed correlation with high Mn and low Zn levels. Conclusion: Serum TE levels are altered in children with BA and the establishment of successful biliary drainage may change the subsequent postoperative serum concentration. Serum Zn and Mn levels can signify specific histopathological liver changes and the extent of liver damage.
Urology Annals, 2015
Persistent Mullerian duct syndrome (PMDS), previously also known as hernia uteri inguinale is a r... more Persistent Mullerian duct syndrome (PMDS), previously also known as hernia uteri inguinale is a relatively rare variety of Disorder of sex development. Patients are phenotypically male and have 46 XY karyotype. As the name suggests Mullerian remnants (fallopian tubes [F. T.], uterus and the proximal vagina) are present in an otherwise normal male. The rudimentary vagina ends by opening into the prostatic utricle. Anatomically PMDS [Table 1] is divided into three categories. [1] In our case, the PMDS variety was of female type with bilateral cryptorchid testis, uterus and F. T. CASE REPORT This was a case of a 4-year-old child (reared as male) presented with bilateral undescended testis. On clinical
Journal of Indian Association of Pediatric Surgeons, 2022
Midline vascular abdominal wall lesions are likely to be mistaken for vascular malformations in y... more Midline vascular abdominal wall lesions are likely to be mistaken for vascular malformations in young children. We report a case of large yolk sac tumor located in the anterior abdominal wall just below xiphisternum in a 20-month-old girl diagnosed by raised serum alpha fetoprotein levels and fine-needle aspiration cytology. Preoperative chemotherapy helped in reducing its size allowing wide resection and primary wound closure. This case is reported for the unusual location and role of chemotherapy in management.
Journal of Indian Association of Pediatric Surgeons, 2021
Congenital salivary gland fistulas are uncommon. They develop as a result of abnormalities of the... more Congenital salivary gland fistulas are uncommon. They develop as a result of abnormalities of the first and second branchial arches. Operative and nonoperative methods of management have been described. We report two rare cases of congenital parotid fistula presenting to us in infancy that were managed surgically.
Journal of Pediatric Surgery, Nov 1, 2012
A 6-year-old boy presented with repeated attacks of fever, abdominal pain, and obstructive jaundi... more A 6-year-old boy presented with repeated attacks of fever, abdominal pain, and obstructive jaundice. Clinical examination and preoperative imaging suggested the diagnosis of a type I choledochal cyst. During surgery, a hydatid cyst was found occupying the head of pancreas, causing obstruction of the common bile duct. The authors emphasize that in endemic areas, hydatid cyst should be included in the list of conditions in the differential diagnoses of obstructive jaundice and cystic lesions located around the bilio-pancreatic junction in children.
Journal of clinical neonatology, 2020
Duodenal atresia (DA) is one of the most common sites of neonatal intestinal obstruction and is f... more Duodenal atresia (DA) is one of the most common sites of neonatal intestinal obstruction and is frequently associated with various other anomalies. An isolated variant of DA has a better prognosis. Some associated intestinal abnormalities are not compatible with survival and definitive surgery could not be offered; however, these associated anomalies can be identified during laparotomy only. We present the case of a neonate with DA associated with the absence of the entire small bowel and also discuss its relevant embryology and pathology.
European Journal of Pediatric Surgery, Mar 28, 2014
Background Inducible nitric oxide synthase (iNOS) has a significant role in ischemia reperfusion ... more Background Inducible nitric oxide synthase (iNOS) has a significant role in ischemia reperfusion (I-R) injury. I-R injury impairs the healing at the intestinal anastomotic site. This study was designed to assess the role of aminoguanidine (AG, a selective inhibitor of iNOS), in healing at the colonic anastomotic site after intestinal I-R injury in rats. Methods Female Wistar rats (n = 60) were divided into three groups. Group I (n = 15): sham operation, Group II (n = 15): I-R injury and anastomosis, and Group III (n = 30): I-R injury + anastomosis + AG-50 mg/kg. On the 7th postoperative day, relaparotomy was done and 4 cm of the colon with an intact area of the anastomosis was resected. Bursting pressure and histology at the anastomotic site were assessed. Results The bursting pressure was significantly higher in Group III. In addition, bridging parameters (i.e., mucosal continuity, muscular continuity, re-epithelization, and granulation tissue), collagen pattern, and collagen density were significantly better in Group III. While the polymorphonuclear density was higher in Group II, suggestive of delayed healing. Conclusion AG, by decreasing inflammation and increasing collagen content in an organized pattern, helped in preventing I-R injury at the site of colonic anastomosis in rats.
Journal of pediatric critical care, 2023
Journal of Postgraduate Medicine, Education and Research, 2020
Background: Coronavirus disease-2019 (COVID-19) outbreak has affected more than 100 countries wor... more Background: Coronavirus disease-2019 (COVID-19) outbreak has affected more than 100 countries worldwide with more than 100,000 cases, during the first week of March 2020. As there are no approved therapeutics or vaccines for the treatment/prevention of COVID-19 till date, awareness among healthcare workers (HCWs) about the disease, mode of transmission, safety precautions, and early diagnosis plays a great role. Aim and objective: To investigate the knowledge, perception, and practices among HCWs of pediatric surgery toward COVID-19. Materials and methods: A cross-sectional, web-based study was conducted among HCWs posted in the Department of Pediatric Surgery, PGIMER, during the first week of May 2020 who were supposed to be involved in the care of COVID-suspected or positive patients. A 26-item survey instrument was devised and circulated via e-mail. A Chi-square test was applied to know the levels of associations between variables, with p value < 0.05 set to be significant. Results: Of 100 responders, 98 responded to a question regarding common symptoms with fever (98%), dry cough (89.8%), and sore throat (81.6%). While asked about the situations of pediatric surgical relevance like the progression of severity, majority (75.8%) opted for difficulty in breathing, followed by persistent high fever (78.9%). Regarding routine practices, HCWs were aware of procedures such as endotracheal tube suctioning (99%), tracheal sample collection (90.9%), changing of ventilator tubings (78.8%), and chest physiotherapy (60.6%) which are liable for transmission. Vertical transmission through breast milk and immediate postpartum care of babies born to infected mothers were associated with inadequate knowledge. Conclusion: HCWs are high-risk group for COVID 19; only knowledge and training can help to prevent and contain the disease. HCWs involved in pediatric surgical specialty had accepted levels of perception. Regular scheduled educational and training programs are crucial to fight with this disease.
Journal of Indian Association of Pediatric Surgeons, 2020
Background: Congenital pouch colon (CPC) is a rare variant of anorectal malformation. In male pat... more Background: Congenital pouch colon (CPC) is a rare variant of anorectal malformation. In male patients, CPC communicates distally with the urogenital tract by a large fistula. The CPC cases which do not fulfill the criteria as mentioned in the classical description are reported along with the pertinent literature review. Materials and Methods: This was a retrospective study from January 2004 to December 2017 of male children with Type IV CPC. We evaluated clinical presentation, primary management, anatomical relationship, previous surgical intervention, definitive management, result, and outcome in terms of continence status on Templeton score. Results: Fifty-one children were included in the study among whom 36 children (Group 1) had a colovesical fistula and 15 children (Group 2) had no communication of the pouch with the genitourinary tract. In Group 2 children, the clinical presentations and management were varied: 4 underwent primary pull-through procedure, whereas 11 underwent staged procedure. Group 2 included three children in whom a narrow and thin-walled anal canal or anal canal with lower rectum was present, which was incorporated during the pull-through procedure. On continence assessment, only one child in Group 1 had “good” continence score compared to four children (three having anal canal) in Group 2. Conclusion: CPC Type IV can present without genitourinary tract communication (fistula), contrary to its emblematic description. Awareness about anatomical variations and adaptation of surgical technique accordingly is vital. The identification of the anal canal with or without the lower part of the rectum (even though apparently narrow and thin walled) and incorporation of this in bowel continuity lead to better outcomes in terms of continence.
Clinical Cancer Investigation Journal, 2014
Chemo ports (or totally implantable venous devices) are increasingly being used for venous access... more Chemo ports (or totally implantable venous devices) are increasingly being used for venous access for chemotherapy in cancer patients, especially in the pediatric age group. They improve the quality of life of children requiring long-term chemotherapy. Despite the advances made in the design, material of the catheter and the technique of insertion, various complications are associated with their use. Cardiac embolization of such a catheter is a life-threatening complication. We report, cardiac migration of a chemo port catheter 6 months post-insertion and discuss the diagnosis and management of this rare complication.
Journal of Indian Association of Pediatric Surgeons, 2015
Rectal duplication (RD) accounts for 5% of alimentary tract duplication. A varied presentation an... more Rectal duplication (RD) accounts for 5% of alimentary tract duplication. A varied presentation and associated anomalies have been described in the literature. Antenatal rupture of the RD is very rare. We present an unusual case of a ruptured RD associated with urogenital abnormalities in newborn male. We are discussing diagnosis, embryology, management and literature review of ruptured RD.
Indian Journal of Plastic Surgery, 2016
A newborn male presented within 12 h of birth with respiratory distress. On examination and worku... more A newborn male presented within 12 h of birth with respiratory distress. On examination and workup, he had palatoglossal fusion, cleft palate and hypoplasia of the cerebellar vermis. A 2.5 Fr endotracheal tube was inserted into the pharynx through nostril as a nasopharyngeal stent, following which his respiratory distress improved. Once child was optimised, then feeding was started by nasogastric tube and feeds were tolerated well. Elective tracheostomy and gastrostomy were done, followed by release of adhesions between the tongue and palate at a later stage. Review of literature suggests that palatoglossal fusion is uncommon and presents as an emergency. Mostly, these oral synechiae are associated with digital and/or cardiac anomaly. Other disorders associated with intra-oral synechiae include congenital alveolar synechiae, van der Woude syndrome, popliteal pterygium syndrome and oromandibular limb hypogenesis syndrome. The authors report a hitherto undescribed association of palatoglossal fusion with cleft palate and hypoplasia of the cerebellar vermis.
Journal of Indian Association of Pediatric Surgeons
Advances in pediatric surgery, 2022
African Journal of Paediatric Surgery
Introduction: The intraoperative anatomical findings (IOAF) of all ureteropelvic junction obstruc... more Introduction: The intraoperative anatomical findings (IOAF) of all ureteropelvic junction obstruction (UPJO) cases are not identical. Moreover, there is also controversy in the literature regarding histopathological (HP) findings in cases of UPJO. In the present study, we evaluated different IOAF and assessed their association with specific HP parameters. Materials and Methods: This was a cross-sectional study set-up, which was carried out in a tertiary care centre. Children with UPJO who underwent surgery between 2017 and 2020 were enrolled. The following IOAF were noted: Type of pelvis (extrarenal or intrarenal), insertion of the ureter (high or normal), presence of lower pole crossing vessel (CV), negotiation of UPJ segment with double J stent (3 Fr) and length of internal narrowing (LIN) at UPJ. The resected segment of UPJ was assessed at three levels (pelvis, UPJ and ureter) for various HP parameters including fibrosis, oedema, inflammation and smooth muscle hypertrophy (SMH). ...
Journal of Medicinal Plants Studies, 2022
Calotropis gigantea is a common plant that most known for their medicinal properties, various cat... more Calotropis gigantea is a common plant that most known for their medicinal properties, various categories of Phytochemical are present in this plant that have antibacterial, antifungal and anti allergic properties. In this study C. giganatea leaves is tested against selected bacteria to check the antibacterial activity. The ethanol extract of C. gigantea was tested against S. aureus, S. pyogens, S. typhi, P. aeruginosa for antibacterial testing. Antibacterial (Antimicrobial) testing is performed in vitro by Kirby-Bauer disc diffusion method in Muller Hinton agar. Extracts showing the antibacterial effects on selected tested organisms. Ethanol extracts show the maximum zone of inhibition against S. pyogens (20.5), lowest against P. aeruginosa (15.25). Minimum Inhibitory Concentration (MIC) was measured in mg/mL.
Journal of Pediatric Surgery, Dec 1, 2022
Journal of Clinical and Diagnostic Research, 2013
Journal of Indian Association of Pediatric Surgeons, 2013
Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually as... more Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually asymptomatic but may have varied presentations. This survey was conducted to study the clinical profile and the challenges posed in the management of this entity. Retrospective analysis of 6 patients diagnosed to have crossed fused renal ectopia during 1997-2010. The diagnosis was confirmed during surgical exploration in one patient. In one patient it was detected on antenatal ultrasonography and in the other 4 patients it was detected during investigations for abdominal pain, abdominal mass, anorectal malformation and urinary tract infection. The left moiety was crossed and fused with the right moiety in 4 cases. Ultrasonography was found to be a good screening investigation with useful diagnostic contributions from CT scans, radionuclide scintigraphy and magnetic resonance urography. Micturating cystourethrography revealed presence of VUR in 4 cases, 3 of whom have undergone ureteric reimplantation. Two patients required pyeloplasty for pelviureteric junction obstruction; in one of these patients the upper ureter was entrapped in the isthmus. In one patient, a non-functioning moiety resulted in nephrectomy. All children were asymptomatic at last follow-up with stable renal functions. Crossed fused renal ectopia was detected in most patients during investigation for other problems. It was found more commonly in boys. The left moiety was crossed to the right in the majority of cases. Associated urological problems were found in most cases and required the appropriate surgical management.
Journal of Indian Association of Pediatric Surgeons, 2020
Background: Children with biliary atresia (BA) have impaired metabolism of trace elements (TEs) (... more Background: Children with biliary atresia (BA) have impaired metabolism of trace elements (TEs) (i.e., zinc, copper, selenium, and manganese), leading to an alteration in the serum levels. However, this alteration in serum level has any correlation with liver histopathological changes is not yet clear. Materials and Methods: This prospective study attempts to evaluate the preoperative serum levels of TE in comparison to controls and its correlation with liver histology in children with BA. Kasai portoenterostomy (KPE) and liver biopsy were performed in all cases. On liver histology, various parameters assessed and were graded according to predefined criteria. Serum levels of TE were determined again 12 weeks post-KPE and compared with the preoperative levels. Results: Mean(±standard deviation [SD]) preoperative serum Zn, Cu, Se, and Mn levels (in μg/dl) in BA patients were 41.6 ± 12.8, 130.6 ± 12.8, 50.0 ± 10.0, and 32.0 ± 20.0, respectively; in controls, these levels were 77.9 ± 13.7, 133.7 ± 13.7, 87.0 ± 13.0, and 8.0 ± 5.5, respectively. Mean postoperative levels in all patients were 68.5 ± 19.0, 91.7 ± 19.0, 79.0 ± 19.0, and 28.0 ± 12.0, respectively. Mean(±SD) postoperative serum Zn, Cu, Se, and Mn levels in BA patients with bile excretion were 73.8 ± 14.9, 83.6 ± 13.8, 85.0 ± 15.0, and 26.0 ± 10.0, respectively, whereas in those with no bile excretion, they were 40.6 ± 12.8, 134.0 ± 23.0, 49.0 ± 11.0, and 44.0 ± 16.0, respectively. In liver histology, specific parameters showed correlation with high Mn and low Zn levels. Conclusion: Serum TE levels are altered in children with BA and the establishment of successful biliary drainage may change the subsequent postoperative serum concentration. Serum Zn and Mn levels can signify specific histopathological liver changes and the extent of liver damage.
Urology Annals, 2015
Persistent Mullerian duct syndrome (PMDS), previously also known as hernia uteri inguinale is a r... more Persistent Mullerian duct syndrome (PMDS), previously also known as hernia uteri inguinale is a relatively rare variety of Disorder of sex development. Patients are phenotypically male and have 46 XY karyotype. As the name suggests Mullerian remnants (fallopian tubes [F. T.], uterus and the proximal vagina) are present in an otherwise normal male. The rudimentary vagina ends by opening into the prostatic utricle. Anatomically PMDS [Table 1] is divided into three categories. [1] In our case, the PMDS variety was of female type with bilateral cryptorchid testis, uterus and F. T. CASE REPORT This was a case of a 4-year-old child (reared as male) presented with bilateral undescended testis. On clinical
Journal of Indian Association of Pediatric Surgeons, 2022
Midline vascular abdominal wall lesions are likely to be mistaken for vascular malformations in y... more Midline vascular abdominal wall lesions are likely to be mistaken for vascular malformations in young children. We report a case of large yolk sac tumor located in the anterior abdominal wall just below xiphisternum in a 20-month-old girl diagnosed by raised serum alpha fetoprotein levels and fine-needle aspiration cytology. Preoperative chemotherapy helped in reducing its size allowing wide resection and primary wound closure. This case is reported for the unusual location and role of chemotherapy in management.
Journal of Indian Association of Pediatric Surgeons, 2021
Congenital salivary gland fistulas are uncommon. They develop as a result of abnormalities of the... more Congenital salivary gland fistulas are uncommon. They develop as a result of abnormalities of the first and second branchial arches. Operative and nonoperative methods of management have been described. We report two rare cases of congenital parotid fistula presenting to us in infancy that were managed surgically.
Journal of Pediatric Surgery, Nov 1, 2012
A 6-year-old boy presented with repeated attacks of fever, abdominal pain, and obstructive jaundi... more A 6-year-old boy presented with repeated attacks of fever, abdominal pain, and obstructive jaundice. Clinical examination and preoperative imaging suggested the diagnosis of a type I choledochal cyst. During surgery, a hydatid cyst was found occupying the head of pancreas, causing obstruction of the common bile duct. The authors emphasize that in endemic areas, hydatid cyst should be included in the list of conditions in the differential diagnoses of obstructive jaundice and cystic lesions located around the bilio-pancreatic junction in children.
Journal of clinical neonatology, 2020
Duodenal atresia (DA) is one of the most common sites of neonatal intestinal obstruction and is f... more Duodenal atresia (DA) is one of the most common sites of neonatal intestinal obstruction and is frequently associated with various other anomalies. An isolated variant of DA has a better prognosis. Some associated intestinal abnormalities are not compatible with survival and definitive surgery could not be offered; however, these associated anomalies can be identified during laparotomy only. We present the case of a neonate with DA associated with the absence of the entire small bowel and also discuss its relevant embryology and pathology.
European Journal of Pediatric Surgery, Mar 28, 2014
Background Inducible nitric oxide synthase (iNOS) has a significant role in ischemia reperfusion ... more Background Inducible nitric oxide synthase (iNOS) has a significant role in ischemia reperfusion (I-R) injury. I-R injury impairs the healing at the intestinal anastomotic site. This study was designed to assess the role of aminoguanidine (AG, a selective inhibitor of iNOS), in healing at the colonic anastomotic site after intestinal I-R injury in rats. Methods Female Wistar rats (n = 60) were divided into three groups. Group I (n = 15): sham operation, Group II (n = 15): I-R injury and anastomosis, and Group III (n = 30): I-R injury + anastomosis + AG-50 mg/kg. On the 7th postoperative day, relaparotomy was done and 4 cm of the colon with an intact area of the anastomosis was resected. Bursting pressure and histology at the anastomotic site were assessed. Results The bursting pressure was significantly higher in Group III. In addition, bridging parameters (i.e., mucosal continuity, muscular continuity, re-epithelization, and granulation tissue), collagen pattern, and collagen density were significantly better in Group III. While the polymorphonuclear density was higher in Group II, suggestive of delayed healing. Conclusion AG, by decreasing inflammation and increasing collagen content in an organized pattern, helped in preventing I-R injury at the site of colonic anastomosis in rats.
Journal of pediatric critical care, 2023
Journal of Postgraduate Medicine, Education and Research, 2020
Background: Coronavirus disease-2019 (COVID-19) outbreak has affected more than 100 countries wor... more Background: Coronavirus disease-2019 (COVID-19) outbreak has affected more than 100 countries worldwide with more than 100,000 cases, during the first week of March 2020. As there are no approved therapeutics or vaccines for the treatment/prevention of COVID-19 till date, awareness among healthcare workers (HCWs) about the disease, mode of transmission, safety precautions, and early diagnosis plays a great role. Aim and objective: To investigate the knowledge, perception, and practices among HCWs of pediatric surgery toward COVID-19. Materials and methods: A cross-sectional, web-based study was conducted among HCWs posted in the Department of Pediatric Surgery, PGIMER, during the first week of May 2020 who were supposed to be involved in the care of COVID-suspected or positive patients. A 26-item survey instrument was devised and circulated via e-mail. A Chi-square test was applied to know the levels of associations between variables, with p value < 0.05 set to be significant. Results: Of 100 responders, 98 responded to a question regarding common symptoms with fever (98%), dry cough (89.8%), and sore throat (81.6%). While asked about the situations of pediatric surgical relevance like the progression of severity, majority (75.8%) opted for difficulty in breathing, followed by persistent high fever (78.9%). Regarding routine practices, HCWs were aware of procedures such as endotracheal tube suctioning (99%), tracheal sample collection (90.9%), changing of ventilator tubings (78.8%), and chest physiotherapy (60.6%) which are liable for transmission. Vertical transmission through breast milk and immediate postpartum care of babies born to infected mothers were associated with inadequate knowledge. Conclusion: HCWs are high-risk group for COVID 19; only knowledge and training can help to prevent and contain the disease. HCWs involved in pediatric surgical specialty had accepted levels of perception. Regular scheduled educational and training programs are crucial to fight with this disease.
Journal of Indian Association of Pediatric Surgeons, 2020
Background: Congenital pouch colon (CPC) is a rare variant of anorectal malformation. In male pat... more Background: Congenital pouch colon (CPC) is a rare variant of anorectal malformation. In male patients, CPC communicates distally with the urogenital tract by a large fistula. The CPC cases which do not fulfill the criteria as mentioned in the classical description are reported along with the pertinent literature review. Materials and Methods: This was a retrospective study from January 2004 to December 2017 of male children with Type IV CPC. We evaluated clinical presentation, primary management, anatomical relationship, previous surgical intervention, definitive management, result, and outcome in terms of continence status on Templeton score. Results: Fifty-one children were included in the study among whom 36 children (Group 1) had a colovesical fistula and 15 children (Group 2) had no communication of the pouch with the genitourinary tract. In Group 2 children, the clinical presentations and management were varied: 4 underwent primary pull-through procedure, whereas 11 underwent staged procedure. Group 2 included three children in whom a narrow and thin-walled anal canal or anal canal with lower rectum was present, which was incorporated during the pull-through procedure. On continence assessment, only one child in Group 1 had “good” continence score compared to four children (three having anal canal) in Group 2. Conclusion: CPC Type IV can present without genitourinary tract communication (fistula), contrary to its emblematic description. Awareness about anatomical variations and adaptation of surgical technique accordingly is vital. The identification of the anal canal with or without the lower part of the rectum (even though apparently narrow and thin walled) and incorporation of this in bowel continuity lead to better outcomes in terms of continence.
Clinical Cancer Investigation Journal, 2014
Chemo ports (or totally implantable venous devices) are increasingly being used for venous access... more Chemo ports (or totally implantable venous devices) are increasingly being used for venous access for chemotherapy in cancer patients, especially in the pediatric age group. They improve the quality of life of children requiring long-term chemotherapy. Despite the advances made in the design, material of the catheter and the technique of insertion, various complications are associated with their use. Cardiac embolization of such a catheter is a life-threatening complication. We report, cardiac migration of a chemo port catheter 6 months post-insertion and discuss the diagnosis and management of this rare complication.
Journal of Indian Association of Pediatric Surgeons, 2015
Rectal duplication (RD) accounts for 5% of alimentary tract duplication. A varied presentation an... more Rectal duplication (RD) accounts for 5% of alimentary tract duplication. A varied presentation and associated anomalies have been described in the literature. Antenatal rupture of the RD is very rare. We present an unusual case of a ruptured RD associated with urogenital abnormalities in newborn male. We are discussing diagnosis, embryology, management and literature review of ruptured RD.
Indian Journal of Plastic Surgery, 2016
A newborn male presented within 12 h of birth with respiratory distress. On examination and worku... more A newborn male presented within 12 h of birth with respiratory distress. On examination and workup, he had palatoglossal fusion, cleft palate and hypoplasia of the cerebellar vermis. A 2.5 Fr endotracheal tube was inserted into the pharynx through nostril as a nasopharyngeal stent, following which his respiratory distress improved. Once child was optimised, then feeding was started by nasogastric tube and feeds were tolerated well. Elective tracheostomy and gastrostomy were done, followed by release of adhesions between the tongue and palate at a later stage. Review of literature suggests that palatoglossal fusion is uncommon and presents as an emergency. Mostly, these oral synechiae are associated with digital and/or cardiac anomaly. Other disorders associated with intra-oral synechiae include congenital alveolar synechiae, van der Woude syndrome, popliteal pterygium syndrome and oromandibular limb hypogenesis syndrome. The authors report a hitherto undescribed association of palatoglossal fusion with cleft palate and hypoplasia of the cerebellar vermis.
Journal of Indian Association of Pediatric Surgeons
Advances in pediatric surgery, 2022
African Journal of Paediatric Surgery
Introduction: The intraoperative anatomical findings (IOAF) of all ureteropelvic junction obstruc... more Introduction: The intraoperative anatomical findings (IOAF) of all ureteropelvic junction obstruction (UPJO) cases are not identical. Moreover, there is also controversy in the literature regarding histopathological (HP) findings in cases of UPJO. In the present study, we evaluated different IOAF and assessed their association with specific HP parameters. Materials and Methods: This was a cross-sectional study set-up, which was carried out in a tertiary care centre. Children with UPJO who underwent surgery between 2017 and 2020 were enrolled. The following IOAF were noted: Type of pelvis (extrarenal or intrarenal), insertion of the ureter (high or normal), presence of lower pole crossing vessel (CV), negotiation of UPJ segment with double J stent (3 Fr) and length of internal narrowing (LIN) at UPJ. The resected segment of UPJ was assessed at three levels (pelvis, UPJ and ureter) for various HP parameters including fibrosis, oedema, inflammation and smooth muscle hypertrophy (SMH). ...
Journal of Medicinal Plants Studies, 2022
Calotropis gigantea is a common plant that most known for their medicinal properties, various cat... more Calotropis gigantea is a common plant that most known for their medicinal properties, various categories of Phytochemical are present in this plant that have antibacterial, antifungal and anti allergic properties. In this study C. giganatea leaves is tested against selected bacteria to check the antibacterial activity. The ethanol extract of C. gigantea was tested against S. aureus, S. pyogens, S. typhi, P. aeruginosa for antibacterial testing. Antibacterial (Antimicrobial) testing is performed in vitro by Kirby-Bauer disc diffusion method in Muller Hinton agar. Extracts showing the antibacterial effects on selected tested organisms. Ethanol extracts show the maximum zone of inhibition against S. pyogens (20.5), lowest against P. aeruginosa (15.25). Minimum Inhibitory Concentration (MIC) was measured in mg/mL.