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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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   2009| April-June  | Volume 14 | Issue 2  
    Online since August 22, 2009

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Psychological issues in cleft lip and cleft palate
Avinash De Sousa, Shibani Devare, Jyoti Ghanshani
April-June 2009, 14(2):55-58
DOI:10.4103/0971-9261.55152  PMID:20671846
Vocational and social issues affect rehabilitation and development of patients with cleft lip and cleft palate. However, psychological problems like lowered self esteem and difficulties in social interaction have also been noted in them. Not many pediatric reconstructive surgery teams have a psychiatrist on their panel. It is likely that psychological problems are higher in incidence than literature actually suggests. Hence it is very essential that such cases are identified by the surgical team to maximize positive outcome of surgery and rehabilitation. This study discusses psychological issues revolving around cleft lip and cleft palate along with lacunae in many psychological research studies.
  30 10,480 676
Bilateral giant juvenile fibroadenoma of breasts
Madhumita Mukhopadhyay, Rishavdeb Patra, Sima Mondal, Asit Ghosh, AK Ray
April-June 2009, 14(2):68-69
DOI:10.4103/0971-9261.55156  PMID:20671850
An 11-year-old girl with rapidly enlarging bilateral breast lumps is reported. It was diagnosed as a case of juvenile fibroadenoma following fine needle aspiration cytology and confirmed on histopathological examination of the excised specimens.
  10 4,885 343
Is ligation of hernial sac during orchiopexy mandatory?
Veena Kumari, Nilay Biswas, Nilanjan Mitra, Hiralal Konar, Dipak Ghosh, Sukanta K Das
April-June 2009, 14(2):66-67
DOI:10.4103/0971-9261.55155  PMID:20671849
Aim: Traditionally, ligation of hernial sac during orchiopexy is considered mandatory to prevent postoperative development of hernia. A prospective study was carried out to see if it is actually required based on the fact that any peritoneal defect closes within 24 hours by metamorphosis of the in situ mesodermal cells. Methods: Fifty cases of undescended testis, age ranging from eight months to 12 years were enrolled. All of them underwent standard orchiopexy without ligation of the hernial sac. Results: Follow up of all cases ranged between 1.5 years to three years. Not a single case was reported with evidence of hernia. Conclusions: It is unnecessary to ligate the hernial sac during orchiopexy.
  8 3,946 316
Flexible ureterorenoscopy and laser lithotripsy in children
Wen-Chan Yeow, Richard Pemberton, Andrew Barker
April-June 2009, 14(2):63-65
DOI:10.4103/0971-9261.55154  PMID:20671848
Background: Flexible ureterorenoscopy (FUR) and laser lithotripsy (LL) are techniques used in the management of upper urinary tract disorders. These techniques, so far established in adults, are now being used in children as well. We report our experience with 26 cases of pediatric upper urinary tract disorders treated using these techniques. Methods: In the period from 1997 to 2006, FUR was performed in 26 children (14 males and 12 females) in the age group of three months to 15 years with a mean age of 8.2 years. Twenty five were stented prior to undergoing FUR and 24 presented with suspected upper tract stones (17 pelvicalyceal and seven midureteric). Two cases showed JJ stent migration post-pyeloplasty. Results: Eight cases involved diagnostic procedures. Six excluded the presence of renal calculi, one had focal medullary sponge kidney, and one had calcified papillae. There were 15 cases of therapeutic FUR. Of these, 12 had LL with only one had incomplete stone fragmentation which subsequently passed spontaneously. Other therapeutic procedures included removal of migrated JJ stents and FUR with the basket removal of a midureteric calculus. Three cases failed ureterorenoscopy due to technical difficulties. The overall success rate was 88.5% for FUR. Conclusion: FUR and LL are valuable minimally invasive techniques for the examination and treatment of pediatric upper urinary tract conditions. Preoperative stenting improves passage of the ureteroscope and with progressive miniaturization of instruments, the lower weight limit will decrease.
  4 4,051 253
Double aortic arches, esophageal atresia and tracheal compression
Yameen Majid, Monali Warade, Zarina Aziz, GA Karthik
April-June 2009, 14(2):70-72
DOI:10.4103/0971-9261.55157  PMID:20671851
We report a case of double aortic arch in a 12-month-old male infant well delineated on 64 slice computed tomography scan. It formed a complete vascular ring around the trachea compressing it. The symptoms resolved after surgical division of the ring.
  3 4,349 201
Anatomical basis for Wilms tumor surgery
RB Trobs
April-June 2009, 14(2):50-54
DOI:10.4103/0971-9261.55151  PMID:20671845
Wilms tumor surgery requires meticulous planning and sophisticated surgical technique. Detailed anatomical knowledge can facilitate the uneventful performance of tumor nephrectomy and cannot be replaced by advanced and sophisticated imaging techniques. We can define two main goals for surgery: (1) exact staging as well as (2) safe and complete resection of tumor without spillage. This review aims to review the anatomical basis for Wilms tumor surgery. It focuses on the surgical anatomy of retroperitoneal space, aorta, vena cava and their large branches with lymphatics. Types and management of vascular injuries are discussed.
  2 4,409 499
Embryogenesis of esophageal atresia: Is localized vascular accident a factor?
Hemonta K Dutta, Shree Harsh
April-June 2009, 14(2):73-75
DOI:10.4103/0971-9261.55158  PMID:20671852
Several theories on embryogenesis of esophageal atresia have been proposed, none could explain the whole spectrum of this anomaly. We report a new variant of esophageal atresia in which the two blind pouches were joined by an atretic band. Histology of the atretic part showed groups of striated muscle arranged haphazardly without any lumen. The existing theories on etiology of esophageal atresia cannot explain this variant. However, localized vascular accident during intrauterine life resulting in disturbances in regional microcirculation could be a possible factor as demonstrated by Louw and Barnard in relation to jejunoileal atresia. This is contrary to the current understanding that disproportionate growth of the horizontal esophageal folds results in esophageal atresia.
  1 3,184 235
Urethral substitution with ileum in traumatic bladder neck-vagina fistula
Lavanya Kannaiyan, Sudipta Sen
April-June 2009, 14(2):76-77
DOI:10.4103/0971-9261.55159  PMID:20671853
A five-year-old girl presented with post traumatic urinary incontinence secondary to rupture of the bladder neck into the vagina. Operative repair included a midline exposure with resection of the symphysis pubis, separation of the bladder neck from the vagina, repair of the torn bladder neck and urethral substitution with ileum. Normal continence and voiding was achieved.
  1 3,941 271
Pediatric urology: Development, eligibility, practice
M Bajpai
April-June 2009, 14(2):47-49
DOI:10.4103/0971-9261.55150  PMID:20671844
  1 3,789 330
Hirschsprung's disease diagnosis: Comparison of immunohistochemical, hematoxilin and eosin staining
Mehrdad Memarzadeh, Ardeshir Talebi, Masod Edalaty, Mehrdad Hosseinpour, Nasrin Vahidi
April-June 2009, 14(2):59-62
DOI:10.4103/0971-9261.55153  PMID:20671847
Background : The diagnosis of Hirschsprung's disease (HD) is based on the absence of ganglion cells. In hemotoxilin and eosin (H and E) as well as acetylcholine esterase staining there are limitations in the diagnosis of immature ganglion cells in neonates. Methods : In this prospective study, 54 biopsies taken from suspected HD patients (five mucosal specimens and 49 full thickness specimens) were studied. In the laboratory, after preparing sections of paraffin embedded tissues, H and E staining slides were compared with immunohistochemical (IHC) staining including: S100, NSE, CD117, CD56, Cathepsin D, Vimentin, BCL2, GFAP, Synaptophysin and chromogranin. Results : The study revealed 30 negative (absence of ganglion cells) cases (55.5%), 17 positive cases (31.04%) and seven suspected cases (12.9%) of ganglion cells on the H and E staining. On IHC staining with CD56 and Cathepsin D, all of the 17 positive cases detected through H and E, were confirmed for having ganglion cells and out of 30 cases reported negative on H and E staining, 28(93.3%) were reported negative and two (6.7%) positive by IHC staining. Of the seven suspected cases H and E staining), IHC staining detectedganglion cells only in five slides; two remained negative. Conclusions : IHC staining using CD56 and Cathepsin D improved the accuracy of diagnosis in HD when used in addition to H and E staining technique, especially for negative or suspicious slides.
  1 5,786 545
Bathing trunk nevus
AY Kshirsagar, KS Shukla, YP Nikam, RB Garg, TU Sholapurkar
April-June 2009, 14(2):78-78
DOI:10.4103/0971-9261.55160  PMID:20671854
  - 3,175 188
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  2005 - Journal of Indian Association of Pediatric Surgeons | Published by Wolters Kluwer - Medknow 

Online since 1st May '05