/pdf/pathology-and-genetics-of-tumours-of-the-digestive-system-3xy9cwrc3c.pdf

Pathology and genetics of tumours of the digestive system

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140673699030469.pdf

Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India.

Pathology and genetics: Tumours of the digestive system

The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis

The operative treatment of pectus excavatum.

In the period 1972–81, 572 hydrocephalic children were treated using the Upadhyaya shunt valve, One hundred and seventys-even of these patients needed a total of 350 shunt revisions. Indications for revisions were; shunt blockage 245 (70% of total revisions) shunt infections 40 (11.5%) catheter disconnections/fractures 19 (5.5%) and intvacranial hemorrhage 9 (2.5%). Intracranial bleeds were more commonly seen in hydrocephalus associated with tuberculous meningitis and were invariably fatal. Infrequent complications were CSF leak, shunt extrusion, valve incompetence, pulmonary hypertension and pleural effusion. Thirty-nine patients died. Overall results of the Upadhyayay shunt valve compare favourably with other reported series.

Complications of cerebrospinal fluid shunts

Objective
To evaluate the outcome of children with antenatally detected unilateral pelvi-ureteric junction obstruction (PUJO).

Long term outcome of management of antenatally diagnosed pelvi-ureteric junction obstruction.

The issues of sexual function and fertility are becoming relevant in patients with posterior urethral valves (PUV), as more of them reach adulthood. To evaluate the semen of post-pubertal patients with PUV as a determinant of future fertility, all such patients (age >16 years) attending the follow-up urology clinic of our department from 1985 to December 1999 were contacted. Of the nine patients contacted, eight agreed to form the study group. All eight patients were asked to provide a post-masturbation semen sample and urine. Semen was analysed for pH, viscosity, liquefaction time, sperm morphology, sperm count, motility, and agglutination. The patients ages ranged from 16 to 21 years (mean 17.5 years). One patient with chronic renal failure awaiting a renal transplant refused to give a semen sample; two tried but failed to ejaculate on three consecutive visits. Their urine was negative for sperm. Of the five patients who gave semen, the liquefaction time was high in two. pH ranged from 7.2 to 8, sperm counts were 24-80 million. None of the patients had oligospermia. Abnormal sperm agglutination was present in four cases; a higher percentage of immotile sperm was also present in four. Semen abnormalities in the form of increased liquefaction time, abnormal sperm agglutination, and a high percentage of immotile sperm were thus seen in the present study. The bearing of these findings on subsequent sexual function and fertility remains a matter of speculation.

Semen analysis in post-pubertal patients with posterior urethral valves: a pilot study.

Objective: To study the incidence and type of musculoskeletal and aesthetic abnormalities after thoracotomy in children. Materials and Methods: Children below 12 years of age who had undergone thoracotomy for any condition and have at least 2 years follow up were included in the study. Detailed assessment of the patients included: history and general examination, clinical examination of chest and musculoskeletal system, X-ray chest including bilateral shoulders [antero-posterior (AP), lateral, oblique], X-ray whole spine (AP, lateral, right and left side bending AP view). Results: Fifty-two pateints were recruited.The incidences of various clinically and radiologically assessed musculoskeletal and aesthetic abnormalities observed were: winging of scapula (5.7%), ipsilateral elevation of shoulder (5.7%), fixation of skin cicatrix to bony thorax (7.7%), maldevelopment of pectoral muscles (11.5%), asymmetry of the level of nipples (1.9%), rib fusion (5.7%), crowding of ribs (9.6%), mediastinal shift (3.8%), decreased space available for lungs (3.8%), Scoliosis with Cobb's angle >10 0 (1.9%). Conclusions: The incidences of musculoskeletal and aesthetic abnormalities after posterolateral thoracotomies in children were low. Longer follow up of patients after thoracotomy is needed to pick up these abnormalities as the children grow.

A survey of musculoskeletal and aesthetic abnormalities after thoracotomy in pediatric patients

Introduction: Females with Krickenbeck low-type anorectal malformations - vestibular fistula (VF) and perineal fistula (PF) - are managed either by a primary definitive or conventional three-staged approach. Ultimate outcome in these children may be affected by wound dehiscence leading to healing by fibrosis. Most of the literature favors one approach over other based on retrospective analysis of their outcomes. Whether a statistically significant difference in wound dehiscence rates between these approaches exists needed to be seen. Materials and Methods: A randomized controlled trial for girls Results: Of the 64 children randomized, 54 (84%) had VF. Both groups were comparable in demography, clinical profile and age at surgery. The incidence of wound dehiscence (39.4% vs. 18.2%; P = 0.04), immediate postoperative complications (51.5% vs. 12.9%; P = 0.001), and early postoperative complications (42.4% vs. 12.9%; P = 0.01) was significantly higher in Group I as compared to Group II. Six of 13 children (46.2%) with dehiscence in Group I required a diverting colostomy to be made. Conclusions: Females with VF or PF undergoing primary definitive procedure have a significantly higher incidence of wound dehiscence (P = 0.04), immediate (P = 0.001) and early postoperative complications (P = 0.01).

Primary definitive procedure versus conventional three-staged procedure for the management of low-type anorectal malformation in females: A randomized controlled trial

Veereshwar Bhatnagar

Papers

Complications of cerebrospinal fluid shunts

Long term outcome of management of antenatally diagnosed pelvi-ureteric junction obstruction.

Semen analysis in post-pubertal patients with posterior urethral valves: a pilot study.

A survey of musculoskeletal and aesthetic abnormalities after thoracotomy in pediatric patients

Primary definitive procedure versus conventional three-staged procedure for the management of low-type anorectal malformation in females: A randomized controlled trial