P. A. Shamsunnahar, A. Motaleb, B. Nasrin, F. Hossain, S. Mahmood, S. Begum
With the increasing use of antenatal sonography, fetal hydronephrosis has been reported more frequently. Hydronephrosis is one of the most commonly identified prenatal anomalies, and the severity may vary from mild to severe, depending on the underlying cause. Many cases resolve spontaneously before birth, but for those that do not, the additional prenatal evaluation can identify cases sufficiently severe to require fetal intervention to preserve renal function. The benefits of these interventions must be balanced against the significant risks of the procedures and their sequelae in long-term efficacy. Evaluation before and after birth is warranted, and factors such as cause, severity, and whether the condition is uni- or bilateral are used to formulate decisions about additional assessment and potential intervention. Here we report a case of bilateral hydronephrosis which was detected during pregnancy. After delivery right side spontaneously resolves but there was worsening of left hydronephrosis in follow up and He undergoes a left pyeloplasty at 6 months of age and does well post operatively. J. Paediatr. Surg. Bangladesh 5 (1): 36-38, 2014 (January)
{"title":"Fetal Hydronephrosis, A Case Report And Review of Literature","authors":"P. A. Shamsunnahar, A. Motaleb, B. Nasrin, F. Hossain, S. Mahmood, S. Begum","doi":"10.3329/JPSB.V5I1.23888","DOIUrl":"https://doi.org/10.3329/JPSB.V5I1.23888","url":null,"abstract":"With the increasing use of antenatal sonography, fetal hydronephrosis has been reported more frequently. Hydronephrosis is one of the most commonly identified prenatal anomalies, and the severity may vary from mild to severe, depending on the underlying cause. Many cases resolve spontaneously before birth, but for those that do not, the additional prenatal evaluation can identify cases sufficiently severe to require fetal intervention to preserve renal function. The benefits of these interventions must be balanced against the significant risks of the procedures and their sequelae in long-term efficacy. Evaluation before and after birth is warranted, and factors such as cause, severity, and whether the condition is uni- or bilateral are used to formulate decisions about additional assessment and potential intervention. Here we report a case of bilateral hydronephrosis which was detected during pregnancy. After delivery right side spontaneously resolves but there was worsening of left hydronephrosis in follow up and He undergoes a left pyeloplasty at 6 months of age and does well post operatively. J. Paediatr. Surg. Bangladesh 5 (1): 36-38, 2014 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"59 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124356111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antenatally Diagnosed Surgical Malformations - Who Should Decide","authors":"T. Siddiqui","doi":"10.3329/JPSB.V4I1.23926","DOIUrl":"https://doi.org/10.3329/JPSB.V4I1.23926","url":null,"abstract":"","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124377938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Rahman, M. Sajid, Abdullah Al Farooq, A. Bhuiyan, T. Chowdhury
Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. Although dyspnea is the commonest symptom, early diagnosis is difficult as chest radiography can diagnose only half of the cases. Prompt diagnosis and surgical repair is life saving. Patient may suffer from multiple associated injuries which is often fatal. A 8 years old boy was admitted with severe respiratory distress and restlessness follwing a history of landslide few hours back. He was pale, cyanosed with hypotension, tachycardia and sweating. Bruise noted over left upper abdomen and left lower chest wall. Surgical emphysema and restricted movement during respiration was noted in the left chest wall with absent breath sound. Abdomen was scaphoid having normal bowel sound. Resuscitation was started and insertion of left intercostal chest drain tube had failed to relieve respiratory distress. A portable chest radiograph showed the chest drain tube in abdomen with mediastinal shifting to opposite side and collapsed lung margin. Left dome of the diaphragm was not clearly visualized. Re institution of chest tube was planned for immediate relief and on withdrawal of the previous drain tube dragged the omentum with it. Then the diagnosis of diaphragmatic rupture was obvious. Laparotomy showed extensive tear of left hemidiaphragm with herniation of abdominal contents. Left costal margin was also torn but abdominal viscera were found intact. Repair was done with interrupted unabsorbable suture after keeping a chest drain tube. Post operatively the patient was kept in ward with adequate analgesia. Check X-ray on 1st post operative day, showed well expanded left lung. The patient had recovered well. Drain was removed on 3rd postoperative day and was discharged on 7th post operative day. High index of suspicion is needed for correct diagnosis. Outcome is satisfactory if treated in time without any associated injury. J. Paediatr. Surg. Bangladesh 3 (2): 81-84, 2012 (July)
{"title":"Diaphragmatic Rupture in a Boy Following Blunt Abdominal Trauma- A Case Report","authors":"M. Rahman, M. Sajid, Abdullah Al Farooq, A. Bhuiyan, T. Chowdhury","doi":"10.3329/JPSB.V3I2.23918","DOIUrl":"https://doi.org/10.3329/JPSB.V3I2.23918","url":null,"abstract":"Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. Although dyspnea is the commonest symptom, early diagnosis is difficult as chest radiography can diagnose only half of the cases. Prompt diagnosis and surgical repair is life saving. Patient may suffer from multiple associated injuries which is often fatal. A 8 years old boy was admitted with severe respiratory distress and restlessness follwing a history of landslide few hours back. He was pale, cyanosed with hypotension, tachycardia and sweating. Bruise noted over left upper abdomen and left lower chest wall. Surgical emphysema and restricted movement during respiration was noted in the left chest wall with absent breath sound. Abdomen was scaphoid having normal bowel sound. Resuscitation was started and insertion of left intercostal chest drain tube had failed to relieve respiratory distress. A portable chest radiograph showed the chest drain tube in abdomen with mediastinal shifting to opposite side and collapsed lung margin. Left dome of the diaphragm was not clearly visualized. Re institution of chest tube was planned for immediate relief and on withdrawal of the previous drain tube dragged the omentum with it. Then the diagnosis of diaphragmatic rupture was obvious. Laparotomy showed extensive tear of left hemidiaphragm with herniation of abdominal contents. Left costal margin was also torn but abdominal viscera were found intact. Repair was done with interrupted unabsorbable suture after keeping a chest drain tube. Post operatively the patient was kept in ward with adequate analgesia. Check X-ray on 1st post operative day, showed well expanded left lung. The patient had recovered well. Drain was removed on 3rd postoperative day and was discharged on 7th post operative day. High index of suspicion is needed for correct diagnosis. Outcome is satisfactory if treated in time without any associated injury. J. Paediatr. Surg. Bangladesh 3 (2): 81-84, 2012 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129604629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Laparoscopic surgery for acute appendicitis in children has been proposed to have advantages over conventional surgery. Introduction: Appendicitis is the most common surgical emergency in childhood. 1 For decades, Open appendectomy (OA) has been the standard treatment for all forms of appendicitis with excellent results. 2 Since its description in the early 1980s, laparoscopic appendectomy (LA) became an acceptable approach for simple appendicitis in children. 3, 4, 5 However, its role in the treatment of complicated appendicitis is controversial. Today, in developed countries about 8% of the population is appendectomized for acute appendicitis during their lifetime. 7 Materials and method : We are conducting a prospective comparative study with the intention to observe the outcome of 60 purposively selected patients of acute appendicitis in the Department of Pediatric Surgery, Dhaka Medical College & Hospital (DMCH), Dhaka, over a period of 12 months from October, 2013 to October, 2014. The patients are going to be divided into 2 groups by random sampling- Group A- OA Group (patients underwent open appendectomy) and Group B- LA Group (patients underwent laparoscopic appendectomy) for uncomplicated appendicitis. Children up to 14 years are planned to be selected as study subjects. All children are subjected to investigate for white blood cell (WBC) count, plain X- ray KUB region, urine R/E, preoperatively and to observe the amount of analgesics in postoperative pain management and cosmesis on first week, first month, and third month of operation. Structured questionnaire is used to collect information regarding pain, fever, other association preoperatively and operative procedure, duration of operation, per operative findings and post operative follow up. Informed written consent from parents or legal guardian is taken after describing the study objectives. Ethical clearance has been sought from the Ethical Committee of Dhaka Medical College. Results: Total 23 patients are studied till now, 16 in LA group and 7 in OA group. From this limited data we have seen that there is apparently minimum difference between two groups of study population regarding postoperative outcomes. Conclusion: This is an on-going study. Definite conclusion could not be drawn at this preliminary stage. Laparoscopic appendectomy for uncomplicated appendicitis in children is feasible and safe. It is associated with a significantly less use of post operative pain killer, lower incidence of wound infection, and reduced length of hospital stay when compared with patients who had open appendectomy. J. Paediatr. Surg. Bangladesh 5 (1): 25-29, 2014 (January)
{"title":"A COMPARATIVE STUDY BETWEEN THE OUTCOME OF LAPAROSCOPIC APPENDECTOMY AND OPEN APPENDECTOMY IN CHILDREN","authors":"N. Ferdous, A. Huq, K. Hasina, Masuda Khatun","doi":"10.3329/JPSB.V5I1.23886","DOIUrl":"https://doi.org/10.3329/JPSB.V5I1.23886","url":null,"abstract":"Background: Laparoscopic surgery for acute appendicitis in children has been proposed to have advantages over conventional surgery. Introduction: Appendicitis is the most common surgical emergency in childhood. 1 For decades, Open appendectomy (OA) has been the standard treatment for all forms of appendicitis with excellent results. 2 Since its description in the early 1980s, laparoscopic appendectomy (LA) became an acceptable approach for simple appendicitis in children. 3, 4, 5 However, its role in the treatment of complicated appendicitis is controversial. Today, in developed countries about 8% of the population is appendectomized for acute appendicitis during their lifetime. 7 Materials and method : We are conducting a prospective comparative study with the intention to observe the outcome of 60 purposively selected patients of acute appendicitis in the Department of Pediatric Surgery, Dhaka Medical College & Hospital (DMCH), Dhaka, over a period of 12 months from October, 2013 to October, 2014. The patients are going to be divided into 2 groups by random sampling- Group A- OA Group (patients underwent open appendectomy) and Group B- LA Group (patients underwent laparoscopic appendectomy) for uncomplicated appendicitis. Children up to 14 years are planned to be selected as study subjects. All children are subjected to investigate for white blood cell (WBC) count, plain X- ray KUB region, urine R/E, preoperatively and to observe the amount of analgesics in postoperative pain management and cosmesis on first week, first month, and third month of operation. Structured questionnaire is used to collect information regarding pain, fever, other association preoperatively and operative procedure, duration of operation, per operative findings and post operative follow up. Informed written consent from parents or legal guardian is taken after describing the study objectives. Ethical clearance has been sought from the Ethical Committee of Dhaka Medical College. Results: Total 23 patients are studied till now, 16 in LA group and 7 in OA group. From this limited data we have seen that there is apparently minimum difference between two groups of study population regarding postoperative outcomes. Conclusion: This is an on-going study. Definite conclusion could not be drawn at this preliminary stage. Laparoscopic appendectomy for uncomplicated appendicitis in children is feasible and safe. It is associated with a significantly less use of post operative pain killer, lower incidence of wound infection, and reduced length of hospital stay when compared with patients who had open appendectomy. J. Paediatr. Surg. Bangladesh 5 (1): 25-29, 2014 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124346412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The progress of neonatal surgery was reviewed from the viewpoint of the mortality curve (MC) based on the nationwide survey of neonatal surgery, which has been conducted by Japanese Society of Pediatric Surgeons once every 5 years since 1964. The mortality of major diseases was over 60% in 1960s, which has decreased to 20% or less for the last 50 years. The contributing factors in this drastic decrease must include progress of neonatal medicine, such as respiratory care, concentration of the cases, induction and spread of parenteral nutrition (PN) and education of pediatric surgeons (PS) through annual meetings of JSPS, specialist certification system, set-up of pediatric surgical sections in medical schools or children’s hospitals. The MC of intestinal atresia turned to rapid declining after the first success of PN in 1968 followed by rapid spread. The MC of congenital diaphragmatic hernia went upward at the first 4 surveys since 1973. This paradoxical shift could be explained by early diagnosis and prompt transportation to PS, or the more CDH were diagnosed earlier, the more sever or lethal cases were treated by PS. The MC of intestinal perforation (IP) turned to increasing in 1993 after long-term steady decline, because the more extremely-low-birth-weight newborns were saved, the higher incidence of IP characteristic of ELBWs was noticed. Omphalocele is the only one disease which MC showed increase for the last five years, which may be explained by the ethical consideration for antenatally diagnosed serious cases. A case of esophageal atresia was saved for the first time in 1960, or the mortality was 100% until that time, however, the MC declined to 60s% by 1964, and to 11% by 2008, due to all the effort by PS in Japan. Meanwhile, unfortunately, the MC cannot tell anything about postoperative functional achievement, mental development and long-term QOL.
{"title":"What we can read and what we cannot read in the mortality curve of the neonatal surgery - the progress of the neonatal surgery in Japan","authors":"A. Kubota","doi":"10.3329/JPSB.V5I1.23879","DOIUrl":"https://doi.org/10.3329/JPSB.V5I1.23879","url":null,"abstract":"The progress of neonatal surgery was reviewed from the viewpoint of the mortality curve (MC) based on the nationwide survey of neonatal surgery, which has been conducted by Japanese Society of Pediatric Surgeons once every 5 years since 1964. The mortality of major diseases was over 60% in 1960s, which has decreased to 20% or less for the last 50 years. The contributing factors in this drastic decrease must include progress of neonatal medicine, such as respiratory care, concentration of the cases, induction and spread of parenteral nutrition (PN) and education of pediatric surgeons (PS) through annual meetings of JSPS, specialist certification system, set-up of pediatric surgical sections in medical schools or children’s hospitals. The MC of intestinal atresia turned to rapid declining after the first success of PN in 1968 followed by rapid spread. The MC of congenital diaphragmatic hernia went upward at the first 4 surveys since 1973. This paradoxical shift could be explained by early diagnosis and prompt transportation to PS, or the more CDH were diagnosed earlier, the more sever or lethal cases were treated by PS. The MC of intestinal perforation (IP) turned to increasing in 1993 after long-term steady decline, because the more extremely-low-birth-weight newborns were saved, the higher incidence of IP characteristic of ELBWs was noticed. Omphalocele is the only one disease which MC showed increase for the last five years, which may be explained by the ethical consideration for antenatally diagnosed serious cases. A case of esophageal atresia was saved for the first time in 1960, or the mortality was 100% until that time, however, the MC declined to 60s% by 1964, and to 11% by 2008, due to all the effort by PS in Japan. Meanwhile, unfortunately, the MC cannot tell anything about postoperative functional achievement, mental development and long-term QOL.","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114703273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miraculous birth: Standing at just 3’5"(104.14cm) tall, 28 years old proportionate dwarf lady weighing 20 kg was succeeded in giving birth to a girl at 36+ weeks of pregnancy by cesarean section in June, 2013 making her the smallest woman ever reported to give birth to apparently healthy looking, and average-sized female baby in Bangladesh. Detailed clinical examination of the neonate performed by the neonatologist revealed no obvious external congenital anomalies and infantogram after 6 weeks also revealed normal study. J. Paediatr. Surg. Bangladesh 4 (2): 72-75, 2013 (July)
{"title":"Successful Pregnancy in a DWARF : A Rare Case Report","authors":"N. Yusuf, H. Akter, Ahmed Ali, L. Rahman","doi":"10.3329/JPSB.V4I2.23942","DOIUrl":"https://doi.org/10.3329/JPSB.V4I2.23942","url":null,"abstract":"Miraculous birth: Standing at just 3’5\"(104.14cm) tall, 28 years old proportionate dwarf lady weighing 20 kg was succeeded in giving birth to a girl at 36+ weeks of pregnancy by cesarean section in June, 2013 making her the smallest woman ever reported to give birth to apparently healthy looking, and average-sized female baby in Bangladesh. Detailed clinical examination of the neonate performed by the neonatologist revealed no obvious external congenital anomalies and infantogram after 6 weeks also revealed normal study. J. Paediatr. Surg. Bangladesh 4 (2): 72-75, 2013 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"34 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120982409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Bacterial infection is a frequent complication following operations in the gastrointestinal tract. Despite prophylactic administration of antibiotics the incidence of postoperative infections ranges from 10%30% in resection surgery. 1 Most infections are caused by bacteria of enteric origin. 2 In spite of restricted use of prophylactic antibiotics, the emergence of antibiotic resistance has increased significantly.3 Probiotics when consumed in adequate amounts, confer a health benefit on the host. In vitro, studies suggest that probiotics potentially act favorably on the host through several different mechanisms. They have an antimicrobial effect. Furthermore, administration of probiotics suppresses growth of potentially pathogenic microorganisms, e.g., E. coli and Enterobacteriaceae. The effects of these agents may go beyond the gastrointestinal tract to distant areas, such as the urogenital and respiratory mucosa. It has been hypothesized by several authors that these characteristics can be used in a clinical setting of preoperative prophylaxis for reduction of postoperative infections. Preoperative antibiotic prophylaxis constitutes more than 10% of antibiotic usage in surgery and a reduction could lead to a reduced pressure on development of antibiotic resistance. It may therefore be of interest to study if probiotics may be used in the preoperative preparation of patients undergoing gastrointestinal operations. Objective: The overall objective of this study is to evaluate the effectiveness of probiotics as prophylaxis for post operative infections in under-5 children undergoing gastrointestinal surgery. Materials and methods: We are conducting a prospective comparative study with the intention to observe the postoperative periods of 60 purposively selected patients of gastrointestinal surgery in the Department of Pediatric surgery, Dhaka Medical College Hospital (DMCH), Dhaka, over a period of 18 months from October, 2013 to March, 2015. The patients are going to be divided into 2 groups by random sampling- Group A (Control group- without probiotics) and Group B (Study group- with probiotics). Under-5 children are planned to be selected as study subjects. All children are subjected to investigate for white blood cell (WBC) count and Creactive protein (CRP) preoperatively and on 5 th postoperative day (POD) in addition to routine investigations. Structured questionnaire is used to collect information regarding fever, surgical site infection, WBC and CRP count before operation and 5 days after operation (i.e. on 5 th POD). Informed written consent from parents or legal guardian is taken after describing the study objectives. Ethical clearance has been sought from the Ethical Committee of Dhaka Medical College Results: Total 8 patients are studied till now, 4 in each group. From this limited data we have observed that there has been apparently minimum difference between the cases and controls regarding postoperative infections. Dis
{"title":"Use of Probiotics as Prophylaxis for Postoperative Infections of Under- 5 Children Following Gastrointestinal Surgery","authors":"Sm Sabbir Enayet, K. Hasina, Abdul Hanif Tablu","doi":"10.3329/JPSB.V4I2.23936","DOIUrl":"https://doi.org/10.3329/JPSB.V4I2.23936","url":null,"abstract":"Background: Bacterial infection is a frequent complication following operations in the gastrointestinal tract. Despite prophylactic administration of antibiotics the incidence of postoperative infections ranges from 10%30% in resection surgery. 1 Most infections are caused by bacteria of enteric origin. 2 In spite of restricted use of prophylactic antibiotics, the emergence of antibiotic resistance has increased significantly.3 Probiotics when consumed in adequate amounts, confer a health benefit on the host. In vitro, studies suggest that probiotics potentially act favorably on the host through several different mechanisms. They have an antimicrobial effect. Furthermore, administration of probiotics suppresses growth of potentially pathogenic microorganisms, e.g., E. coli and Enterobacteriaceae. The effects of these agents may go beyond the gastrointestinal tract to distant areas, such as the urogenital and respiratory mucosa. It has been hypothesized by several authors that these characteristics can be used in a clinical setting of preoperative prophylaxis for reduction of postoperative infections. Preoperative antibiotic prophylaxis constitutes more than 10% of antibiotic usage in surgery and a reduction could lead to a reduced pressure on development of antibiotic resistance. It may therefore be of interest to study if probiotics may be used in the preoperative preparation of patients undergoing gastrointestinal operations. Objective: The overall objective of this study is to evaluate the effectiveness of probiotics as prophylaxis for post operative infections in under-5 children undergoing gastrointestinal surgery. Materials and methods: We are conducting a prospective comparative study with the intention to observe the postoperative periods of 60 purposively selected patients of gastrointestinal surgery in the Department of Pediatric surgery, Dhaka Medical College Hospital (DMCH), Dhaka, over a period of 18 months from October, 2013 to March, 2015. The patients are going to be divided into 2 groups by random sampling- Group A (Control group- without probiotics) and Group B (Study group- with probiotics). Under-5 children are planned to be selected as study subjects. All children are subjected to investigate for white blood cell (WBC) count and Creactive protein (CRP) preoperatively and on 5 th postoperative day (POD) in addition to routine investigations. Structured questionnaire is used to collect information regarding fever, surgical site infection, WBC and CRP count before operation and 5 days after operation (i.e. on 5 th POD). Informed written consent from parents or legal guardian is taken after describing the study objectives. Ethical clearance has been sought from the Ethical Committee of Dhaka Medical College Results: Total 8 patients are studied till now, 4 in each group. From this limited data we have observed that there has been apparently minimum difference between the cases and controls regarding postoperative infections. Dis","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134296376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neuroblastoma in neck is a very rare presentation. The age range of neuroblastoma is broad, but only 10% of cases are reported in people older than 5years of age, and is most commonly diagnosed in children before age of 5years (with highest incidence in the first year of life), being slightly more common in boys. The girl child reported in our case, being mere 7 years old, presented with bilateral hard neck swellings, was not clinically suspected of this rare presentation, until Immunohistochemistry confirmed the diagnosis. This report underscores the need for prompt evaluation of patients (especially children) with common symptoms and uncommon presentation of the disease entity. J. Paediatr. Surg. Bangladesh 3 (2): 88-91, 2012 (July)
{"title":"NEUROBLASTOMA NECK IN A 7-YEAR-OLD GIRL: A VERY RARE PRESENTATION","authors":"R. Shah, Sk. Nurul Fattah Rumi","doi":"10.3329/JPSB.V3I2.23924","DOIUrl":"https://doi.org/10.3329/JPSB.V3I2.23924","url":null,"abstract":"Neuroblastoma in neck is a very rare presentation. The age range of neuroblastoma is broad, but only 10% of cases are reported in people older than 5years of age, and is most commonly diagnosed in children before age of 5years (with highest incidence in the first year of life), being slightly more common in boys. The girl child reported in our case, being mere 7 years old, presented with bilateral hard neck swellings, was not clinically suspected of this rare presentation, until Immunohistochemistry confirmed the diagnosis. This report underscores the need for prompt evaluation of patients (especially children) with common symptoms and uncommon presentation of the disease entity. J. Paediatr. Surg. Bangladesh 3 (2): 88-91, 2012 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125919131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Begum, S. Mahmood, Salma Akhter Munmun, Haque, K. Nahar, Shiuly Chowdhury
Objectives : To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women. Methods : It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death). Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021). Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death. J. Paediatr. Surg. Bangladesh 4 (2): 44-49, 2013 (July)
{"title":"Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy","authors":"N. Begum, S. Mahmood, Salma Akhter Munmun, Haque, K. Nahar, Shiuly Chowdhury","doi":"10.3329/JPSB.V4I2.23937","DOIUrl":"https://doi.org/10.3329/JPSB.V4I2.23937","url":null,"abstract":"Objectives : To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women. Methods : It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death). Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021). Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death. J. Paediatr. Surg. Bangladesh 4 (2): 44-49, 2013 (July)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116783624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Inflammatory myofibroblastic tumour (IMT) occurring at intraabdominal sites in children has rarely been described. Inflammatory pseudotumour is a soft tissue lesion that may be confused with a sarcoma. It is abbreviated as IMT. Inflammatory myofibroblastic tumour, also known as soft tissue tumours, atypical fibromyxoid tumours, pseudosarcomatous fibromyxoid tumour, plasma cell granuloma, pseudosarcomatous myofibrotic proliferation, post-operative spindle cell nodules. In this paper, we describe a case of inflammatory myofibroblastic tumour (IMT) with an unusual constellation of clinical, pathological findings. A 10-year-old girl had an 7-cm intraabdominal mass accompanied by severe anemia, fever, constipation, weight loss, thrombocytosis, elevated erythrocyte sedimentation rate. Laparotomy was performed. The final pathologic diagnosis was IMT. At the most recent follow up (12months) after excision of the tumour, the patient was symptom-free and there was no evidence of tumour recurrence. J. Paediatr. Surg. Bangladesh 3 (1): 47-50, 2012 (January)
{"title":"Inflammatory Myofibroblastic Tumour in Antimesenteric Border of Descending Colon of Children: A Case Report","authors":"S. Islam, A. Morshed, A. Islam","doi":"10.3329/JPSB.V3I1.23908","DOIUrl":"https://doi.org/10.3329/JPSB.V3I1.23908","url":null,"abstract":"Inflammatory myofibroblastic tumour (IMT) occurring at intraabdominal sites in children has rarely been described. Inflammatory pseudotumour is a soft tissue lesion that may be confused with a sarcoma. It is abbreviated as IMT. Inflammatory myofibroblastic tumour, also known as soft tissue tumours, atypical fibromyxoid tumours, pseudosarcomatous fibromyxoid tumour, plasma cell granuloma, pseudosarcomatous myofibrotic proliferation, post-operative spindle cell nodules. In this paper, we describe a case of inflammatory myofibroblastic tumour (IMT) with an unusual constellation of clinical, pathological findings. A 10-year-old girl had an 7-cm intraabdominal mass accompanied by severe anemia, fever, constipation, weight loss, thrombocytosis, elevated erythrocyte sedimentation rate. Laparotomy was performed. The final pathologic diagnosis was IMT. At the most recent follow up (12months) after excision of the tumour, the patient was symptom-free and there was no evidence of tumour recurrence. J. Paediatr. Surg. Bangladesh 3 (1): 47-50, 2012 (January)","PeriodicalId":137868,"journal":{"name":"Journal of Paediatric Surgeons of Bangladesh","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124058988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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