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Background: The aim of the present study was to evaluate the indications, complications and outcome of colostomy in newborn patients.Methods: This is a descriptive, retrospective study carried out in the Department of Pediatric surgery, Gandhi Medical College Bhopal to evaluate acceptance and outcome of colostomy in newborn over a one year period from March 2018 to March 2019. All newborn with diagnosis of anorectal malformation, Hirshsprungs disease and other emergency conditions underwent transverse loop colostomy by expert and trained pediatric surgeon.Results: Out of 40 patients operated complications of colostomy was seen in 18 (45%) patients. Most common complication was skin excoriation in 08 patients (20%), bleeding from stoma site in 02 (05%) cases. Stoma prolapse occurred in 02 (05%) patients. Wound infection, dehiscence, stomal stenosis and parastomal hernia was seen in one patient each 2 (2.5%). 2 (0.5%) patient died due to multiple congenital anomalies.Conclusions: Colostomy in children is associated with significant morbidity in developing country. To minimize these problems, the pediatric surgeon should focus on the management and early closure of a colostomy.

Introduction: A debate still exists in literature whether to ligate the indirect hernia sac during herniotomy in orchiopexy and hernia surgery. The study is designed with the aim to evaluate whether the ligation of hernial sac during orchiopexy is necessary to prevent the development of postoperative hernia. Material and Methods: This prospective study was conducted in 25 children with an age range of 6 months to 15 years with a diagnosis of palpable undescended testis. Of the 25 cases, 19 were unilateral and 6 were bilateral cases. Of the 19 unilateral undescended testis, 8 were right-sided and 11were left-sided. All children underwent open orchiopexy without the ligation of the hernia sac. Results: Clinically and radiologically all the patients were followed up to a period of two years. No evidence of inguinal hernia was detected during the follow-up in any patient. Conclusion: According to this study ligation of hernial sac is not necessary during orchiopexy and leaving the remnant stump open is safe with no recurrence.

BACKGROUND:Cervical cancer is the second most common cancer among women globally and a leading cause of death due to cancer among women. If diagnosed earlier, it has a high cure rate but advanced disease is frequently incurable with very unpleasant consequences. MATERIAL AND METHODS: This was a cross sectional study done on a group of 50 women. A detailed clinical history of each patient was taken. The patients were made to lie in dorsal lithotomy position and per speculum examination was done. After evaluating the cervix, Paps smear was taken for cytology with Ayers spatula from ectocervix after rotating at 360 degree and spread on 2 glass slides to prepare thin films and kept in koplin jar and sent for cytology reporting. The patients were then subjected to colposcopy and punch biopsy. RESULTS: On comparison with biopsy cervix as gold standard for detection of CIN, cytology had shown Sensitivity 57.14%, Specificity 88.88%, NPV84.21%, PPV 66.66%, whereas colposcopy had shown Sensitivity 80%, Specificity 80%, NPV 94.11%, PPV 50%. CONCLUSION:In developing countries like India, cytology, a low cost and easily accessible test, is the most logical screening modality although it has very low sensitivity but detection rates could be further improved using liquid cytology and use of endocervicalcytobrush. Colposcopy with high sensitivity is although an important adjunctive screening modality but requires expertise and training for interpretation and is costly.

BACKGROUND: Malaria is commonly associated with various degrees of haematological complications most frequently with anaemia and thrombocytopenia. However there are contrasting reports about frequency of thrombocytopenia in P. vivax infection. MATERIAL AND METHODS: A total of 140 patients were included in the study. The details of the patients history along with their clinical features, laboratory reports were recorded in a standard proforma. Sample of venous blood were collected for haematological examination like Haemoglobin, total and differential count and platelet count, which was done under automated cell counter. RESULTS: Out of 140, there were 119(85%) patients who had thrombocytopenia, of them 75(54%) patients had mild, 38(27%) patients had moderate and 6(4%) patients had severe thrombocytopenia., 30(21%) out of 140 patients had leucopenia. Significant inverse association was seen between degree of parasitemia and platelet count. CONCLUSION: Various theories have been postulated for the cause of thrombocytopenia in P. Vivax infection but none of them is conclusive. Frequency or severity of thrombocytopenia doesn't appear to be any particular strain of plasmodium infection.

BACKGROUND: Vitamin B12 (Cobalamin) plays an important role in DNA synthesis and neurologic function. Deficiency can lead to a wide spectrum of hematologic and neuropsychiatric disorders that can often be reversed by early diagnosis and prompt treatment. MATERIAL AND METHODS: Cross sectional descriptive study carried out in Medicine department, SMIMER, Surat during the period from June 2009 to December 2010. 30 patients whose Serum Vitamin B12 level

BACKGROUND: Abdominal Tuberculosis remains a major health problem in the developing countries especially in Indian subcontinent. Abdominal tuberculosis is a disease which has no clear clinical features even after a complete range of investigations. Thus, a high index of clinical suspicion is required to establish a diagnosis. Tuberculosis of GI tract accounts for 50% of all gastrointestinal cases. MATERIAL AND METHOD: The study was conducted in the Department of Surgery, Chirayu Medical College and hospital Bhopal from January 2011 to August 2013 to assess the clinical presentation management and outcome of abdominal tuberculosis. All patients with clinical features suggestive of abdominal tuberculosis were included in the study. Records of the patients were retrieved and reviewed to measure parameters of age, gender, socio-economic status, mode of presentation, operative findings, hospital stay and complications. The diagnosis of abdominal tuberculosis was confirmed by histopathology. RESULTS: A total of 51 patients were included in the study. Out of these, 26 patients (62%) were male and 25 patients (38%) were female. 21 patients (41.17 %) presented with acute while 30 patients (58.82 %) presented with chronic onset of disease. Intestinal obstruction was seen in 11 (21.56%) patients and perforation peritonitis was present in 10(19.60%) patients. Subacute intestinal obstruction was seen in 23(45.09%) cases. 4 patients (7.8%) presented with mass in right iliac fossa. 27 patients (52.94%) were treated conservatively while rest of them 24 (47.0%) underwent laparotomy. Grossly ileum was involved in 17 cases (9perforation and 8 stricture).During hospital course, 15 (29.41%) patients had post operative wound infection, 2(3.92%) had burst abdomen and 1(1.90%) had faecal fistula. Histopathological confirmation of tuberculosis was done in 72.54 % of cases. All patients were prescribed anti tuberculosis drugs for 12 months duration. Mean hospital stay was16 ± 14.67 days. CONCLUSION: Abdominal tuberculosis is a disease that is frequently overlooked, with consequent delay in treatment. As a treatable condition, abdominal TB should be considered early in the differential diagnosis of abdominal symptoms in our country. Failure to recognise this disease early may lead to increase morbidity and mortality, as many of the patients need surgical intervention and prolonged hospitalization in addition to chemotherapy with anti tuberculosis drugs.

BACKGROUND: Since 1990 laparoscopic cholecystectomy is the gold standard treatment for symptomatic gall stones disease. The aim of this study was to evaluate the results of three port laparoscopic cholecystectomy in symptomatic patients with gall stones in terms of conversion rate, length of hospital stay, post operative complications, morbidity and mortality. METHODOLOGY: The retrospective study was carried out in Department of Surgery at Chirayu Medical College and Hospital, Bhopal. All the patients who underwent laparoscopic cholecystectomy in the department of surgery from (May2011- April 2013) were reviewed from department records. Patients with co morbidities, altered Liver function test and obstructive jaundice were excluded from the study. Demographics with patient details, conversion to open, complications of anaesthesia and surgery were reviewed from clinical notes, and department register. Data was analysed using SPSS-18 and results were compared with international studies. RESULTS: Out of 200 patients174 were females (87%) and 26(13%) males. The mean age of patients was 40.47±12yrs, the youngest patient was10 yrs old and oldest patient was 80 yr old. Mean operative time was 50min±11.16 min. The conversion rate in our series was 6(3.0%) cases; Port site wound infection was seen in 6 (3%) patients. There was no bile duct injury, major haemorrhage or bowel injury necessitating opening surgery. On follow up no patient had post operative abdominal abscess, port site hernia or post operative bile duct stricture, there was no mortality in our study. CONCLUSION: Laparoscopic cholecystectomy with three ports is effective & safe modality to treat gall stones. Good training careful case selection, initial learning curve, meticulous technique, well trained team and high standard equipments are of paramount importance to ensure good results.

BACKGROUND: With over 130,000 deaths annually, India has overtaken China for the world worst Road traffic accidents rate. OBJECTIVE: To assess the pattern of external injuries and various associated factors among RTA victims admitted in a tertiary care setting. MATERIAL AND METHODS: This is a hospital-based prospective study conducted in a tertiary care setting in Bhopal, India from May 2011 to June, 2013. All subjects were road traffic accident victims admitted in Chirayu Medical College and hospital Bhopal. RESULTS: Among the total 1000 RTA victims there were 818 (81.80%) male and 182 (18.20%) females. The highest number of victims (615, 61.50%) belongs to 15-35 years of age group. Rate of accident was slightly higher on weekends i.e. Sunday (18.5%) and Saturday (18%). Among the various injuries, the limbs and the face were the commonly affected areas to suffer external injury. CONCLUSION: The study highlighted interaction of several factors like lack of experience of drivers, low awareness of safety measures, narrow, broken and ill- illuminated roads, excessive speed with overloaded vehicles responsible for road traffic accidents.

Purpose: To study the role of B-scans ultrasound in detection of posterior segment pathology in hyper mature cataract cases. Material and method: This study was conducted in Department of Ophthalmology, Chirayu Medical College and Hospital, Bhopal from October 2012 to October 2014.The study included 400 patients of dense cataract evaluated with high resolution ultrasonography for posterior segment lesions. Results: The cases were divided according to age ranging from 0-80 years. Male predominance was seen with sex ratio 1.38:1 (M:F). Loss of vision and redness of eye were the leading symptoms. Posterior staphyloma was seen in 15 (3.52%) cases, Vitreous hemorrhage in 7 (1.64%), Vitreous membrane in 5 (1.20%), Chorioretinal Thickening in 6 (1.41%), and Retinal detachment 4 (0.94%) cases. Out of 400 patients 79 (19.6%) were having ocular and systemic risk factors like hypertension, diabetes, raised IOP, uveitis, myopia. Conclusion: From, the present study it was noted that B-scan is very efficient tool in diagnosing various ocular abnormalities. B-scan can categorize the lesions in the posterior chamber well, depending on the echotexture and anatomy. Preoperative posterior segment evaluation with ultrasound in patients with dense cataract can be used to detect pathologies that may influence the surgical strategy and the postoperative visual outcomes.

Ventriculo-peritoneal (VP) shunting used in the treatment for hydrocephalus is associated with several complications. Mechanical failure of shunt is the commonest complication of all. Visceral/bowel perforation is an unusual but serious complication of VP shunting. This article reports our experience in the management of ten children who had VP Shunt catheter protrusion from anus. This is a retrospective study of ten patients who had VP shunt catheter protrusion from anus, admitted in the department of paediatric surgery between Jan 1996 and Dec 2005. The records of above ten cases were reviewed for their clinical presentation and management, etc. We had performed 398 VP shunt operations in the last 10 years. Two hundred and seventy one (68.09%) VP Shunts were done for congenital hydrocephalus of which 164 were done in infancy/neonatal period and 107 VP shunts were done in the age group of >1-12 years. One hundred and twenty-seven (31.90%) VP shunt operations were done for patients who had hydrocephalus as a complication following tubercular meningitis (TBM). Out of 398 VP shunts, ten patients (2.51%) had protrusion of the distal end of peritoneal catheter from anus without causing/leading to peritonitis. We observed a 08.29% mortality of all VP shunt operations. Protrusion of VP shunt catheter per rectum can occur without producing peritonitis. Formal exploration and localization of entry of VP shunt catheter in bowel is not mandatory. Mini laparotomy and revision of peritoneal part of shunt can be done if there is no shunt infection.

A full term female baby of 2.3 kg was born to a Gravida I Para 0, 22-years- old mother on June12, 2006. She was brought to us one hour after birth. The pregnancy and hospital delivery were uneventful. There was no history of infection, intake of any teratogens, drugs or exposure to radiation, etc. in antenatal period. Clinical examination revealed peripheral cyanosis with heart rate of 146/min and respiratory rate of 48/min. Her heart was lying outside the thoracic cavity and apex of the heart was pointing anterio -superiorly . The heart had pericardial covering and coronary and few great vessels could be seen [Figure 1]. She also had associated right­sided complete cleft lip and cleft palate, cystic hygroma at right side neck of 4 x 3 cm in size. Syndactyly of little, ring, and middle fingers of right hand also present [Figure 2]. Investigations revealed no diaphragmatic hernia. After mobilization of skin around the heart, it was easily reposited within the thoracic cavity and skin closure was done. She died 2 hours after operation due to cardiac arrest. W e presumed that our patient also had intrinsic cardiac defects, echocardiography nor post-mortem examination was done.

due to obstructed labour on A ugust 27, 2006. Antenatal history was nothing significant. He weighed 2.5 kg including placenta, which was adherent to his head. A preterm, eight hour-old male with cranio-facial Also evident were associated exencephaly and cleft of deformities was born normally at a hospital to a GP lip and palate on the right side [Figure 2]. He also had

Aim : The aim of this study was to analyze the clinical and management aspect of congenital pouch colon. Materials and Methods : This retrospective study was carried out on 40 cases of congenital pouch colon managed in the department of paediatric surgery from 01, January 2000 to 31, December 2005. Results : The incidence of congenital pouch colon (CPC) in the present study was 11.290 % (40 of 354) of all anorectal malformations (ARM) and 19.60% (40 of 204) of high ARM. Of these 40 cases of CPC included in the study, 82.5% were male and 17.5% were female. The average age of presentation to hospital was 3.36 days with a range of 1-11 days; of these 25% patients were admitted with poor general condition. Preoperative diagnosis of CPC was possible in 75% of cases in our study. 60% ( n =24) of cases had incomplete pouch colon (Type III and IV) while 40% ( n =16) had complete pouch colon (Type I and II). Right transverse colostomy was done in 16 patients and colostomy at descending colon just proximal to pouch in two patients for incomplete (Type III and IV) CPC as a primary initial procedure. Ileostomy was done in 14 patients and window colostomy in three patients for complete (Type I and II) CPC. As definitive procedures, pouch excision and abdomino-perineal pull-through of colon was done in 17 patients, coloplasty and abdomino-perineal pull-through of coloplasty colon was done in four patients and pouch excision and abdomino-perineal pull-through of terminal ileum in four patients in our series. None of our patients underwent primary single stage procedure. Conclusion: (1) CPC comprises 11.290 % of all ARM and 19.60% of high ARM. (2) Right transverse colostomy was opted for incomplete pouch colon, while Ileostomy and window colostomy were opted for complete pouch colon as initial surgical procedures. (3) Staged surgical procedures for management of CPC were well tolerated in our series.

A Prune Belly syndrome with VATER/VACTERL association is an extremely rare. They are either stillborn or die within few days of life, only few such cases have been reported in literature. We are presenting here a male neonate of Prune Belly syndrome associated with incomplete VACTERL with brief review of literature.