ABSTRACT: This is a prospective study of 100 children (122 testes) of Cryptorchidism in whom the role of HCG in causing descent of Cryptorchid testis, making impalpable testis to become palpable and making orchidopexy easier and thus improving surgical outcome, has been evaluated. Among the 70 children (86 testes) treated with HCG, 32 were bilateral, 54 were unilateral; 38 testes were impalpable and 48 testes were palpable. The dose of HCG was 5000 IU in the age group of 1-6 years and 10,000 IU in the age group of 7-12 years given in weekly divided intramuscular injections. Patients were evaluated clinically for, descent, palpability and any complication. Among those patients who did not respond to HCG therapy, 30 patients were operated upon and the surgical outcome was compared with 30 patients who were operated without receiving HCG. In our study, descent occurred more in bilateral (50 percent) testis, as compared to unilateral (32 percent) UDT. The overall success rate was 38.3 percent. HCG was more effective in the age group 4-6 years (63 percent in B/L & 33 percent in U/L) than in 7-9 years (50 percent B/L & 35 percent U/L). We found that 47.3 percent impalpable UDT became palpable after HCG treatment. The best response was seen in palpable testis located prescrotally (72.7 percent) and in low canalicular testes (50 percent). Only 15.78 percent impalpable testis descended after HCG. At 4 months follow up, the success rate dropped to 30.2 percent as there was relapse in 7 testes. We found a statistically significant difference (P0.001) between surgical outcome in patients operated after receiving HCG and those operated without receiving HCG.

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ABSTRACT: To study the efficacy of intralesional bleomycin as a sclerosing agent for peripheral cystic hygromas, 15 patients were treated. Intralesional injection of bleomycin into the lymphangiomas was given at a dose not exceeding 0.5 mg per kg of body weight, at intervals of 2 weeks. The regression response of the swelling was graded as excellent (total disappearance), good ( 50 percent reduction), and poor ( 50 percent decrease). Reduction in the size of the mass was usually seen by 2 weeks to 6 months and the number of injections for each patient varied from 1-5. A significant reduction was seen in 86.7 percent (13 patients) and 53.3 percent (8 cases) of them showed complete disappearance. Eleven of the 12 cystic lesions showed excellent to good response. No significant complications were noted. The average follow-up period was 28 months (23-37 months).

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ABSTRACT: Aim: To develop the educational aids for parents of children having colostomy and test its effectiveness. Methods: Two educational aids in the form of booklet and a video film (computer disk) were developed and these were used to teach care of colostomy to parents (n = 120) of children having anorectal malformations or Hirschsprung's disease. Results: It was found that the developed educational aids were effective in order to provide knowledge and skill to the parents (p 0.05). Conclusions: There is a great need to develop the educational aids for parents, subsequently these can be used to teach procedures for long term home management of the children born with congenital anomalies.

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ABSTRACT: We report a 12-year old girl who presented with epigastric pain and vomiting. A diagnosis of 'Rapunzel syndrome' was made based on gastroscopy and barium meal findings. These are rare forms of trichobezoars which are known to extend from the stomach to as far as the transverse colon. The trichobezoar was extracted by gastrotomy and enterotomy.

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ABSTRACT: A 14-day old male baby presented with abdominal distension, constipation since birth and abnormal pigmentation. The perineum was normal. Plain X-ray abdomen in erect posture showed small bowel obstruction, Barium Enema did not show any transition zone, At laparotomy there was a transition zone in the ileum approximately 20 cm from the ileo-cecal junction and dilatation of the proximal intestine. Multiple seromuscular biopsies from the ileum, colon, rectum and appendix were taken; all were negativefor ganglion cells. Loop ileostomy was performed in the right lower quadrant of the abdomen.

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ABSTRACT: Trichobezoar is a known entity. Recurrent trichobezoar is extremely rare. We report our series of gastrointestinal bezoars seen during the past 10 years including a case of recurrent trichobezoar. We emphasize the need for treating the psychosocialaspect of the disease besides its surgical management.

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ABSTRACT: Venous cutdown cannulation is still occasionally required for vascular access. The authors describe the development and use of a vein pick designed for facilitating insertion of the venous catheter by a single person with minimum risk of disruptionof the vein.

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ABSTRACT: Background and Objectives: The study was aimed to compare the efficacy, duration and side effects of combination of bupivacaine 0.25 percent with low dose morphine 0.03 mg/kg and bupivacaine 0.25 percent alone injected into the caudal space for relief of postoperative pain in children undergoing various procedures. Methods: Eighty children aged between 1-10 years undergoing urogenital, orthopedic and lower abdominal general surgical procedures were studied. In 40 patients (Group I) bupivacaine alone and in another 40 patients (Group II) morphine (0.03 mg/ kg) mixed with bupivacaine was given caudally after induction of anesthesia. Patients were selected for each of these therapies by draw of random numbers. Results: The mean duration of analgesiawas 8.2 plus-minus 2.4 hours (range 5-12 hours) in bupivacaine group and 20.8 plus-minus 3.4 hours (range 12-26 hours) in morphine mixed with bupivacaine group. No serious side effect like respiratory depression or apnea was seen in any patient and there was no significant difference in the incidence of nausea, vomiting and urinary retention between the 2 groups. Conclusions: We conclude that low dose morphine (0.03 mg/kg) combined with 0.25 percent bupivacaine given caudally gave longer duration of analgesia in children undergoing urogenital, general surgical and orthopedic procedures without significant side effects.

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ABSTRACT: Gastric perforation in neonates is a rare, serious and life threatening problem. Etiology of gastric perforation has been described as being spontaneous and it is associated with a high mortality rate. We hereby present 2 cases of neonatal gastric perforation which were successfully managed by early resuscitation and primary repair.

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ABSTRACT: True Epignathus are extremely rare forms of teratoid tumors arising from the palate or pharynx in the region of the basisphenoid (Rathke's pouch) filling the buccal cavity and protruding from the mouth. This condition is associated with a high mortality rate due to severe airway obstruction especially in the neonatal period. This requires prenatal planning and prompt surgical treatment after birth. We describe a case where two swellings were arising from the tongue and oropharynx and was associated with cleft palate which we attempted to salvage with prompt surgery.

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ABSTRACT: We are presenting 2 patients-one with gastric trichobezoar and the other with Rapunzel syndrome. Both the patients were girls aged 9 years and 10 years respectively and were treated successfully.

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ABSTRACT: Laparoscopic pyloromyotomy is a well recognised procedure for infantile hypertrophic pyloric stenosis (IHPS). The authors present a new technique of using an indigenous endoknife for laparoscopic pyloromyotomy. This technique has been used successfully in ten infants and is safe and effective.

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