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An experiment was under taken at the Agricultural College farm, Bapatla during two consecutive years of rabi 2016-17 and 2017-18. The crop growth stages of maize are dependent on various morphological, anatomical and physiological parameters. The experiment was laid out in randomized block design with six maize hybrids viz., 900M Gold, DKC 9142, DKC 9120, DKC 9081, DKC 9042 and Pinnacle in four replications. CGR and NAR was found to be the highest at 57 to 63 DAS among all the hybrids during both the seasons where CGR was found to be the highest DKC 9142 followed by Pinnacle which were at par with each other. Whereas, pinnacle recorded highest NAR followed by DKC 9142. Among all the hybrids, RGR was found to be maximum at 50 to 56 DAS coinciding with reproductive primordial development. The yield and yield attributing characters such as length of the cob, number of rows per cob, number of kernels per row, 100 seed weight and the total kernel yield showed significant variation among the hybrids where the highest yield was obtained in pinnacle (9641.41 kg ha-1) and DKC 9142 (9243.9 kg ha-1).

Objective To report our experience with endoscopic management of vesicoureteral reflux (VUR) by injection of a tissue bulking substance - Dextranomer/ hyaluronic acid co-polymer at vesicoureteric junction. Design Retrospective analyses of case records. Setting Pediatric Surgery department in a tertiary care government Institute. Participants 500 children (767 renal units) consecutively referred to the out-patient department with vesicoureteral reflux noted on micturating cysto-urethrogram (MCU) over a period of 13 years (2004-2016). Intervention Preoperative VUR grading and renal scars on radionuclide scans were documented. Dextranomer hyaluronic acid copolymer was injected through a cystoscope at the vesicoureteral junction as a day care procedure under short anesthesia. Patients were followed (average duration 27.3 mo) with clinical assessment, periodic urine cultures and renal scans. Main outcome measure Cessation of VUR and symptomatic relief / clinical success postoperatively at 3 months. Results Complete symptomatic relief was obtained in 482 (96.4%) patients. In 681 units where MCU was available, 614 (90%) units showed resolution of VUR. Conclusions Endoscopic injection of tissue bulking substances at vesicoureteric junction to stop VUR seems to be an effective intervention.

We report a case of a 1-month-old boy with a cystic swelling in the occipital region without intracranial communication, called atretic cephalocoele. We discuss clues to the diagnosis of atretic cephalocoeles. We also discuss common clinical findings and a possible mechanism by which these lesions develop.

In this work, the biocompatibility and antibacterial activities of novel SnO2 nanowire coatings prepared by electron-beam (E-Beam) evaporation process at low temperatures were studied. The nanowire coatings were characterized by scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX), and X-ray diffraction (XRD) methods. The results of in vitro cytotoxicity and cell proliferation assays suggested that the SnO2 nanowire coatings were nontoxic and promoted the proliferation of C2C12 and L929 cells (> 90% viability). Cellular activities, cell adhesion, and lactate dehydrogenase activities were consistent with the superior biocompatibility of the nanowire materials. Notably, the nanowire coating showed potent antibacterial activity against six different bacterial strains. The antibacterial activity of the SnO2 material was attributed to the photocatalytic nature of SnO2. The antibacterial activity and biocompatibility of the newly developed SnO2 nanowire coatings may enable their use as coating materials for biomedical implants.

Background Primary surgical repair forms the definitive treatment of esophageal atresia. Long-term survival rates and patient morbidity after repair still remains a problem especially in developing countries. Postoperative morbidity depends on the incidence of anastomotic leak, gastroesophageal reflux, strictures, and recurrent fistula formation. Purpose To describe the frequency of different findings at fluoroscopic evaluation of postoperative esophagus in children following repair for esophageal atresia with or without tracheo-esophageal fistula. Material and Methods Hospital records and upper gastrointestinal contrast studies of 210 patients following repair for esophageal atresia with or without a tracheo-esophageal fistula were reviewed by two pediatric radiologists. All children underwent surgery in the first few days of life (days 1–6). Fluoroscopic contrast study was performed at various intervals after surgery in children with suspected complications or feeding difficulties. Results Images from upper gastrointestinal contrast studies of 210 patients (126 boys, 84 girls) were evaluated and recorded. Findings were recorded as normal postoperative appearances (37.1%) and complications/sequelae, which included strictures (33.8%), minor and major leaks (11.9%), reflux (13.8%), motility problems (7.1%), persistent fistula (3.8%), diverticulae formation (4.7%), and hiatus hernia (2.1%). Conclusion Strictures, leaks, and reflux are the most common complications of esophageal atresia repair. Knowledge of various postoperative appearances would be useful for planning an appropriate management strategy in these children.

Blunt trauma represents a major cause of death in children. The incidence of renal arterial injuries in these cases is less than 1%. Traumatic renal artery occlusion is a rare occurrence in the pediatric age group. However, there is lack of information on the exact incidence and results of the management of these rare cases in the pediatric age group. We report herein a case and we review the available literature of this severe injury in the pediatric age group.

Purpose: The aim of this study was to evaluate the potential use of multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and to compare its findings with fibreoptic/rigid bronchoscopy or surgery. Patients and methods: A total of 43 children (15 girls, 28 boys) with clinically suspected bronchial obstruction underwent contrast enhanced MDCT, using an age- and weight- adjusted low dose protocol. Post-processing was performed and VB and multiplanar reformations (MPR) were obtained at the same sitting. Findings obtained at MDCT and VB were compared with fibreoptic/rigid bronchoscopy and surgery. Results: Obstructive pathology was found in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumour in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts/tumours) of the tracheobronchial tree in 10 children. In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT-VB and bronchoscopy/surgery, however, in one child with endobronchial obstruction caused by tracheitis, low dose MDCT-VB was normal, but bronchoscopy revealed granularity and plaques. Conclusion: MDCT-Virtual bronchoscopy is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and external compression and has the advantage of looking beyond stenosis. Its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, it fails to disclose exact nature of obstructing pathology.

A 12 yr old girl with type 1 diabetes presented in ketoacidosis and consolidation of left lower lobe along with left pleural effusion. A diagnosis of mucormycosis was made on smear examination of an exudative pleural aspirate. Left lower lobe lobectomy was performed along with drainage of pleural collection with tube thoracostomy. Worsening respiratory distress postoperatively due to increase in empyema fluid necessitated a second surgery. Pleuropulmonary involvement as seen in this patient is an extremely rare occurrence possibly related to the propensity of mucor to invade blood vessels rather than extend outwardly into pleural cavity.

Background: Liver space-occupying lesions (SOLs) in the pediatric population form a unique and distinct spectrum as compared with those in the adult population. There are no large studies available in the English literature regarding fine needle aspiration cytology (FNAC) in pediatric liver SOLs. Aim: This study was done to familiarize with the cytomorphological features of these distinctive benign and malignant lesions of liver and to determine the specificity, sensitivity, and diagnostic efficacy of FNAC. Methods: A total of 41 FNACs from pediatric liver SOLs were reviewed, and the diagnoses were correlated with clinical and radiological findings, histopathological diagnoses, and/or follow-up information. These were categorized into malignant, benign, and indeterminate groups. Results: There were 20 malignant lesions that included hepatoblastoma (7), hepatocellular carcinoma (4), undifferentiated embryonal sarcoma of liver (3), and metastases (6). The 12 benign lesions included abscess (8), 1 case each of mesenchymal hamartoma, focal nodular hyperplasia, hydatid cyst, and tuberculosis. In the overall FNAC performance calculation, the specificity of FNAC was 100%, sensitivity 95%, positive predictive value 100%, negative predictive value 92.3%, and diagnostic accuracy 96.9%. Conclusion: The recognition of the distinct cytomorphological features of pediatric focal liver lesions, in conjunction with the clinical data and radiological findings, make FNAC a useful primary diagnostic modality in these unique and distinctive lesions.

This paper presents a comparative prospective study of three modalities of surgical treatment for extrahepatic portal hypertension in children: central splenorenal shunt after splenectomy (CSS), side-to-side lienorenal shunt (SSLR) without splenectomy, and splenectomy and gastroesophageal devascularization (SGD). In an 18-month period, 27 procedures were performed: 10 CSS, 10 SSLR, and seven SGD. The outcomes were evaluated by fall in portal pressures, hematological parameters, shunt patency, splenic regression, and disappearance of esophageal varices. All three procedures were comparable in the fall of portal pressure after surgery. The average blood loss and operating time were statistically significant in favor of SSLR compared with CSS. At 3-month follow-up, shunt patency was confirmed by duplex Doppler study in all the patients in the SSLR group and in nine out of 10 patients in the CSS group. In the CSS and SGD groups, hypersplenism resolved in all the patients. In the SSLR group, blood counts improved in only five out of eight affected children. No patient re-bled during a follow-up of 3-5 years. There were no cases of hepatic encephalopathy or overwhelming postsplenectomy sepsis. In conclusion, CSS is useful when there is a large spleen, severe hypersplenism, and a shuntable splenic vein. SSLR is suitable when there is only mild splenomegaly, mild hypersplenism, and a shuntable splenic vein. Splenectomy and devascularization is the choice when there is no shuntable splenic vein.

This is a prospective study of 20 cases of posterior urethral valves (PUV) presenting between the ages of 12 days and 5.5 years (median 15 months) in order to determine the incidence and progress of vesicoureteric reflux (VUR), hydronephrosis (HN), and renal functional status. The efficacy of fulguration as the sole modality of treatment for PUV was assessed in terms of improvement or disappearance of VUR over a 6-month follow-up period. VUR was present in 60% of the patients, being unilateral in 41.7%. Out of 19 renal units with VUR, reflux subsided in 31.5% by 3 months and 78.94% by 6 months. The blood urea and serum creatinine levels, which were raised in 50% of the patients at presentation, came down to normal by 6 months in all the cases. Improvement in glomerular filtration rates (GFR) was noted in all the children at each follow-up and was found to be statistically significant ( p0.01). HN was present in all the patients at presentation and was bilateral in 90%. It decreased significantly during the follow-up period, though its complete disappearance was seen only in one case. Vesicoureteric reflux dysplasia syndrome (VURD) was present in two cases. Our study showed that VUR disappeared in a majority of the cases by 6 months once adequate urethral patency was restored, although hydronephrosis persisted.

Two rare cases of completely isolated duplication cysts are reported. A large but asymptomatic tubular cyst hanging from a narrow pedicle arising from the base of the terminal ileal mesentery was removed in a 6-day-old boy along with correction of associated malrotation. Multiple isolated duplication cysts located in the thorax and abdomen were excised in a 10-week-old infant. Both children remained asymptomatic after surgery.

A high divided sigmoid colostomy has been recommended for staged management of high anorectal malformation. We audited our cases of neonatal colostomy for high anorectal malformation to assess its effectiveness. A retrospective study was carried out of all surgical newborns admitted with high imperforate anus as the single diagnosis at our centre between December 1998 and December 2000. Morbidity and mortality were analysed after retrospective stratification into two groups (group A: birth weight2.5 kg; group B: birth weight2.5 kg). The chi square test was used to test the statistical significance in terms of outcome in the two groups. Overall mortality was 16%. Group A consisted of 34 babies: 30 with divided sigmoid colostomy and four with transverse loop colostomy. One baby with a divided sigmoid colostomy died from wound complications and septicaemia (mortality 2.9%). All four babies with transverse loop colostomy done under local anaesthesia survived, despite being sick on arrival. Group B consisted of 16 babies: 15 with sigmoid colostomy and one with transverse loop colostomy, with seven deaths (44%). None of the five babies with transverse loop colostomy done under local anaesthesia died, despite being sick on arrival, whereas all eight babies who died had undergone sigmoid colostomy under general anaesthesia. The difference in the outcomes of babies in groups A and B is highly significant ( p.01). Sick, small (2.5 kg) and septic babies arriving late to the unit do not appear to tolerate general anaesthesia and divided sigmoid colostomy well, despite that procedure's long-term advantages. Divided sigmoid colostomy has produced excellent results in babies2.5 kg, but in the context of the developing world and limited critical care availability, transverse loop colostomy under local anaesthesia may save lives.

A 10-month-old boy with isolated congenital microgastria is reported. This is an extremely rare condition with only 2 previous similar case reports. The patient was treated successfully with early gastric augmentation. Although the embryologic origin of this anomaly was widely believed to be in the fourth week of gestation, the anatomic features in the current case point to the arrest of development at least after the eighth week of fetal life.

The aim of this study was to evaluate the potential use of multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation of tracheobronchial patency in children with suspected bronchial obstruction and to compare its findings with fibreoptic/rigid bronchoscopy or surgery.A total of 43 children (15 girls, 28 boys) with clinically suspected bronchial obstruction underwent contrast enhanced MDCT, using an age- and weight- adjusted low dose protocol. Post-processing was performed and VB and multiplanar reformations (MPR) were obtained at the same sitting. Findings obtained at MDCT and VB were compared with fibreoptic/rigid bronchoscopy and surgery.Obstructive pathology was found in 26 children, which included endoluminal foreign body, mucus plugs in 13 children, endobronchial tumour in three children and extrinsic compression (lymph node, aberrant Vessels, mediastinal cysts/tumours) of the tracheobronchial tree in 10 children. In 17 children, no obstructive lesion was identified. Excellent positive correlation was obtained, between MDCT-VB and bronchoscopy/surgery, however, in one child with endobronchial obstruction caused by tracheitis, low dose MDCT-VB was normal, but bronchoscopy revealed granularity and plaques.MDCT-Virtual bronchoscopy is useful in evaluating bronchial stenosis and obstruction caused by both endoluminal pathology and external compression and has the advantage of looking beyond stenosis. Its main application lies in providing the exact location of suspected foreign body, prior to bronchoscopy. However, it fails to disclose exact nature of obstructing pathology.

In pediatric surgical practice, finding of the vermiform appendix in an inguinal hernia sac is not that uncommon; however, a perforation is rare. There are only a few case reports of a perforated appendix with periappendicular abscess in the inguinal hernial sac in a neonate. We report an unusual case of inguinal hernia containing a perforated appendix that was clinically mimicking testicular torsion of the undescended testis.

Buts: Cette etude a ete realisee pour determiner si les enfants avec une hypertension portale extra hepatique amelioraient leur croissance et leur qualite de vie apres une chirurgie elective. Patients et Methodes: Tous les patients avec une hypertension portale extra hepatique qui ont subi une chirurgie d'Avril 1999 a Mars 2002 etaient etudies. La taille et le poids avant et apres la chirurgie etaient convertis en Z scores pour etude comparative. La qualite de vie etait appreciee par les modifications en terme de scolarite, d'activite physique, de vie sociale et le retentissement economique sur la famille. Resultats: A la fin d'une periode minimum de surveillance de 1 an, parmi les trente enfants, 50% et 76% montraient une amelioration en terme de poids et de taille respectivement, compare a leur score pendant qu'ils etaient traites medicalement. Z score en dessous de - 2 DS pour le poids et le taille etaient vus chez 57% et 37 % des patients avant la chirurgie et seulement chez 40% et 20% a la fin de la periode de suivi, qui allait de 1 a 4 ans. L'amelioration en taille et poids etait plus importante chez ceux qui avaient subi une splenectomie avec une devascularisation ou un shunt spleno-renal central compare a ceux qui avaient subi un shunt spleno-renal sans splenectomie. Les enfants qui manquaient l'ecole lors de la surveillance medicale commencaient une scolarite apres la chirurgie. Il y avait une amelioration des performances scolaires et de l'activite physique chez 85% des patients. L'amelioration de la personnalite etait vue chez 73% des patients. Le cout de la chirurgie etait le tiers de ce qui avait ete depense pendant la surveillance medicale. Conclusion: Les parametres de croissance s'ameliorent de maniere significative chez l'enfant apres intervention chirurgicale pour hypertension portale. L'amelioration des performances scolaires de l'activite physique et de la vie sociale etait notee chez la majorite des patients. Comme dans un pays en voie de developpement, la chirurgie est aussi plus efficace sur le plan economique.

Sir,Labial adhesions (vaginal synechiae) are a commonproblem encountered in general pediatric but there are alot of misconceptions regarding the etiology andmanagement. We had a similar case where a case of labialadhesion was misdiagnosed as case of vaginal agenesis. Athree-year-old girl was referred by local practitioner withcomplaints of absent vagina and burning micturition. Thechild also had dribbling of urine on standing up aftermicturition. The child was advised, apart from a urineroutine urine examination, a urine culture, anultrasonography of the pelvis and a micturatingcystourethrography to rule out genitourinaryabnormalities. On local examination the child was foundto have adhesion of the labia minora which lead to thecomplete closure of the introitus and child voided from asmall orfice at the posterior aspect of introitus near theposterior fourchette (Fig. 1). The urine culture was sterile.These adhesions were lysed in the out patient departmentusing a blunt artery forceps after local application of 5%lidocaine ointment and it revealed a normal urethral andvaginal orifices. The child started on a regimen ofestrogen cream application for three weeks. The child isasympomatic after three months of follow up with norecurrence.occur much later.

The purpose of this study was to determine the major factors influencing the survival of babies with anorectal malformation (ARM) during the primary management in the neonatal period in a tertiary referral center. The outcome of 125 neonates with ARM, treated in a single hospital during a 2-year period, was analyzed retrospectively with particular reference to birth weight, time of arrival, and the type of ARM, including pouch colon and major associated anomalies, to see whether any of them had a significant effect on initial survival. High ARM (HARM) was present in 75, low ARM (LARM) in 36, and pouch colon in 14 babies. There were a total of 28 deaths (22%). In babies with isolated HARM weighing2.5 kg and brought to the hospital within the first 48 h of life, the survival was 100%, which dropped to 80% when brought later than 48 h. Of the babies with birth weight2.5 kg and isolated HARM but who were brought to the hospital within the first 48 h of life, 80% survived, whereas of those reaching the hospital after 48 h, only 55% survived. Two babies with pouch colon and two of the four babies with LARM and associated anomalies died. In the HARM group, of the 31 babies with major associated anomalies, only 37% with birth weight2.5 kg and 58% with birth weight2.5 kg survived. Low birth weight, major associated anomalies, and delay in referral were the three important factors that influenced the outcomes of babies with ARM during the neonatal period.

Purpose: This is a report of 4 patients with long gap/pure esophageal atresia, who, after an initial gastrostomy and cervical esophagostomy at birth, were treated with a new technique called fundal tube esophagoplasty. Methods: The technique consisted of mobilization of the distal esophageal stump, division of the left gastric artery, and mobilization of upper half of stomach. Both walls of the stomach were incised in the region of the fundus starting on the lesser curvature in such a way that a tube was created out of the fundus, and the native esophageal stump appears to be an extension of this neoesophagus. This neoesophagus was brought to the neck by the retrosternal route and in a second stage, esophago-esophageal anastomosis was made. Thal's fundoplication was added in 2 cases. Results: All the stages have been completed successfully in 4 babies. They have been followed up for periods ranging from 8 to 24 months after restoration of esophageal continuity. All the children are thriving. Conclusions: Fundal tube esophagoplasty (1) serves to provide a neoesophagus of natural caliber, (2) utilizes native esophagus in reconstruction, (3) does not produce a space-occupying problem in the mediastinum, and (4) preserves the gastric reservoir function. In this early experience, it appears to fulfill all the requirements of a good esophageal substitute.

Background/Purpose: It is well realized that Anderson-Hyne's pyeloplasty fails to improve the drainage pattern and renal functional parameters in a few cases of hydronephrosis because of pelviureteric junction (PUJ) obstruction. The purpose of this study is to delineate the lower extent of the abnormally innervated pelviureteric junction by S-100 immunohistochemistry, which requires surgical removal. Methods: Thirty pelviureteric junction (PUJ) specimens were analyzed by histology and by S-100 immunohistochemistry after serial sectioning of the resected ureter and compared with the variables age, calyceal separation, parenchymal thickness, differential renal function, glomerular filtration rate (GFR), and the measured constricted ureteral segment on gross examination. Results: No significant correlation was noted ( P > .05) when the histology was analyzed to find any association with any of the variables studied. The length of the visible constricted segment ranged from 2 mm to 15 mm (mean, 5.37 mm). The abnormally innervated segment was much longer than the length of the visible constricted segment in 24 and of the same length in 5 specimens. However, in 1 case, the abnormal innervation segment was shorter than the macroscopic constriction by 3 mm. The maximum difference in length between the visible constriction and the lower limit of defective innervation was 8 mm. Conclusions: The abnormally innervated ureteral segment below the PUJ in hydronephrosis is longer than the visible constricted segment at the time of surgery, and the ureter should be excised at least 8 mm or more beyond the visible lower limit of the constricted segment in cases of Anderson-Hyne's pyeloplasty.

Infants with anorectal anomaly have a high risk of having other congenital anomalies, but associated gastrointestinal tract anomalies are quite rare. Malrotation of gut is rarely associated with anorectal anomaly. We report two such cases of anorectal malformation with malrotation of gut. The high index of suspicion, diagnostic difficulty and surgical management with avoidance of appendicectomy in these neonates is discussed.

Local or systemic application of testosterone is reported to stimulate penile growth. Intramuscular testosterone has been found to be effective in 50% of patients; however, variable results have been reported with topical testosterone. The current study is an attempt to compare the efficacy of intramuscular versus topical testosterone application.A total of 26 consecutive patients with hypospadias and small penis (2SD for given age) were studied prospectively. These patients were recruited alternately into group A or group B. Each group consisted of 13 patients. In group A, penile growth was accomplished by topical application of testosterone (Testoviron, oily solution containing testosterone propionate, 25 mg, and testosterone enanthate, 110 mg, equivalent to about 100 mg of testosterone, Schering, Germany) with a dose of 2 mg/kg/wk, for 3 weeks. While in group B, testosterone (same preparation as above) was administered by intramuscular injection weekly for 3 consecutive weeks. Penile length, diameter, and secondary effects were recorded before, during, and 3 weeks after the therapy by a single observer.Significant penile growth (P.01) was noticed in both the groups of patients when compared with pretherapy with maximum response observed during the third week of therapy (reaching from an average pretherapy length of 2.0 cm and 1.8 cm to 3.18 cm and 3.11 cm posttherapy in group A and B patients, respectively). Seven patients in each group had growth of at least 50% compared with the initial size. The basal serum testosterone was within the normal range in both the groups. During therapy the serum testosterone was elevated above the basal level in all patients, but within the normal range except in 2 patients of group A. In these 2 children the serum testosterone level crossed the normal range. Linear growth did not alter significantly for the chronological age. Two patients of group A went on to have pubic hair, one of them had elevated testosterone level above the normal range. There was a surge in serum testosterone in all children, although significant penile enlargement was observed in 60% children in group A and 75% in group B.Although the desired therapeutic effect of testosterone was achieved in both the groups, this study failed to show any significant difference between the 2 routes of administration. However, in group A, (topical) serum testosterone crossed the normal range in 15% of patients and was associated with significant reversible side effects.

Although Meckel’s diverticulum is the most common vitellointestinal duct (VID) anomaly, patent vitellointestinal duct (PVID) is the most common symptomatic embryological defect. Patient may present with the anomaly itself or due to complications like intestinal obstruction secondary to volvulus, intussusception or adhesions. Prolapse occurs if the diverticulum is wide-mouthed enough to allow bowel to come out or due to increased intra-abdominal pressure like cry or cough. Bowel prolapse through PVID is rare and double prolapse of proximal as well as distal loop in a newborn is extremely rare. Omphalocele with prolapsing bowel through PVID as found in our index case is even rarer in literature. The pediatric surgeon should be familiar with these varied manifestations in the newborn because the prolapsed bowel can progress to gangrene and complications if not identified and operated upon early.

A case of congenital ectopic scrotum in neonatal period is described. The ectopic scrotum was located in the right inguinal area and the left hemiscrotum was found in normal location and each hemi-scrotum contained their testis. The neonate also had imperforate anus as low anorectal malformation with spinal abnormalities (hemi-sacrum and hemi-pelvis), right knee flexion contracture and right club foot. The embryological explanation in the literature of ectopic scrotum and its associated anomalies is discussed.

The present prospective study focuses on the effect of transurethral fulguration (TUF) and vesicostomy on the renal functions and somatic growth in posterior urethral valves (PUV). 37 consecutive neonates were diagnosed and treated for PUV with vesicostomy (18 patients) and TUF (19 patients). Postoperative stable creatinine values, renal function and somatic growth were recorded. Standard anthropometric techniques and standard statistical methods were used to compute distance statistics for body weight and crown-heel length at age intervals of 3 months for the first year. The distance values of body weight and crown-heel length of these groups of children were less than the 5th percentile of the National Centre For Health Statistics (NCHS) and healthy Punjabi infants showing growth retardation in the first year of life. Pre- and postoperative mean serum creatinine of the fulguration group was 1.5 ± 1.5 mg/dl and 0.8 ± 0.3 mg/dl and for vesicostomy it was 2.4 ± 2.2 mg/dl, and 0.9 ± 0.7 mg/dl respectively. The babies of the fulguration group showed better growth attainments than the babies of the vesicostomy group at the end of one year. At the end of one year, babies of the fulguration group had a similar growth velocity compared to the vesicostomy group, though in general they showed retarded growth compared to healthy counterparts. The modality of treatment chosen did not seem to affect the renal functions or somatic growth in the short-term follow-up. L'etude est focalisee sur les effets de la fulguration trans-uretrale (TUF) et la vesicostomie sur les fonctions renales et la croissance dans les valves de l'uretre posterieur (PUV). 37 nouveau-nes consecutifs ont ete diagnostiques et traites pour PUV avec vesicostomie (18 patients) et TUF (19 patients). Les valeurs post-operatoires de la creatinine, la fonction renale et la croissance somatique etaient analysees. Les techniques anthropometriques standard et les methodes statistiques standard etaient utilisees pour analyser la croissance a des intervalles de 3 mois pendant la premiere annee. Les valeurs du poids dans ce groupe de patients etaient inferieures au 5 eme percentile du National Centre For Health Statistics (NCHS). Le niveau de la creatinine serique pre et post-operatoire dans le groupe traite par fulguration etait de 1,5 ± 1,5 mg/dl et 0,8 ± 0,3 mg/dl et pour ceux traites par vesicostomie, il etait de 2,4 ± 2,2 mg/dl, et 0,9 ± 0,7 mg/dl respectivement. Les enfants du groupe traite par fulguration montraient une meilleure croissance que les bebes traites par vesicostomie a la fin de la premiere annee. A la fin de la premiere annee, les bebes du groupe traites par fulguration ont une croissance comparable a ceux traites par vesicostomie, quoiqu'en general ils montrent un retard de croissance par rapport aux enfants sains. Le choix de la modalite therapeutique ne semble pas affecter la fonction renale et la croissance somatique a court terme. Este estudio prospectivo se centra en el efecto de la fulguracion transuretral (TUF) y la vesicoostomia en la funcion renal y en el crecimiento somatico en pacientes con valvulas de uretra posterior. Se diagnosticaron y trataron consecutivamente 37 recien nacidos con PUV mediante vesicostomia (n = 18) y TUF (n = 19). Se obtuvieron valores estables postoperatorios de creatinina, funcion renal y crecimiento somatico. Se usaron metodos antropometricos y estadisticos estandar cada 3 meses durante el primer ano con el fin de comparar el peso y la talla. Los valores de peso y talla de estos ninos eran inferiores al percentil 5 del Centro Nacional para Estadistica de Salud (NCHS) para ninos del Punjab. La creatinina serica media pre y postoperatoria en el grupo fulgurado fue de1.5 ± 1.5 mg/dl y 0.8 ± 0.3 mg/dl y para los que tuvieron vesicostomia 2.4 ± 2.2 mg/dl y 0.9 ± 0.7 mg/dl. Los ninos en el grupo de fulgurados tuvieron mejor crecimiento que los que se trataron con vesicostomia al final del primer ano. Al final del primer ano los ninos con fulguracion de las valvulas tenian velocidad de crecimiento similar a los del grupo con vesicostomia pero en general tenian crecimiento retardado en comparacion con los normales. La modalidad de tratamiento elegido no parece afectar a la funcion renal o al crecimiento somatico en el seguimiento a corto plazo. Die vorliegende Studie untersucht die Wirkung der transurethralen Kauterisierung von posterioren Urethralklappen sowie der Vesikostomie im Hinblick auf die Nierenfunktion und das Korperwachstum. 37 Neugeborene wurden prospektiv behandelt, wobei 18 Kinder eine Vesikostomie und 19 eine Kauterisierung ihrer Urethralklappen erhielten. Die postoperativen Kreatininwerte, die Nierenfunktion und das Korperwachstum wurden uberpruft. Hierbei wurden standardisierte anthropometrische Untersuchungsmethoden und statistische Evaluierungen vorgenommen, um Korpergewicht, Scheitel-Fus-Langen und die Altersintervalle von 3 Monaten bis zum 1. Lebensjahr zu uberprufen. Korpergewicht und Scheitel-Fersen-Lange lag in den unterschiedlichen Gruppen der Kinder unter der 5. Perzentile des National Centre for Health-Statistics (NCHS) und gesunder Punjabi-Kinder. Das bedeutet eine Wachstumsretardierung innerhalb des 1. Lebensjahres der untersuchten Patienten. Die pra- und postoperativen Serum-Kreatinin-Werte der elektroresezierten Patientengruppe betrugen 1,5 ± 1,5 mg/dl und 0,8 ± 0,3 mg/dl. In der Vesikostomiegruppe lagen die Werte bei 2,4 ± 2,2 mg/dl und 0,9 ± 0,7 mg/dl. Die Kinder in der Elektroresektionsgruppe zeigten am Ende des 1. Lebensjahres eine bessere Anpassung an das normale Korperwachstum als Kinder der Vesikostomiegruppe. Im Allgemeinen zeigten die Kinder am Ende des 1. Lebensjahres sowohl in der Koagulationsgruppe wie nach Vesikostomie eine ahnliche Wachstumsgeschwindigkeit. Diese war allerdings im Hinblick auf das gesunde Vergleichskollektiv verzogert. Die Behandlungsform scheint daher die Nierenfunktion und das somatische Wachstum, zumindest bei Kurzzeituntersuchungen, nicht wesentlich zu beeinflussen.

An association of coronal hypospadias with meatal stenosis and anterior urethral valves is described in this report. A combination of double obstruction in anterior urethra may overshadow the expression of proximal one.

Various lesions present as interlabial masses in young girls, including prolapsed ectopic ureterocele, urethral prolapse, paraurethral cyst, hydrometrocolpos and rhabdomyosarcoma. The urethral meatus surrounds the prolapsed mass in ectopic ureterocele, as opposed to being centrally located in urethral prolapse and eccentrically located in paraurethral cyst. Renal ultrasonography will reveal typical findings of a duplex system and dilated upper pole in ectopic ureterocele. Hydrometrocolpos presents with bulging of an intact hymen and often an abdominal mass. Rhabdomyosarcoma presents as a grape-like mass, and caution must be exercised in differentiating this mass from a urethral polyp, which is usually a single pedunculated structure.1 We report a case of urethral polyp in a female newborn.

Anomalous junction of pancreatobiliary ducts (AJPB) is known to be associated with choledochal cyst and gallbladder cancer. This report describes our experience with eight patients with AJPB, six of whom were diagnosed at endoscopic retrograde cholangiography and two at transhepatic cholangiography. Four of the patients with AJPB had an associated congenital choledochal cyst, two had a normal biliary tree and one each had inspissated bile syndrome and cholangiocarcinoma. The last two associations have not been previously described. It is felt that the clinical spectrum of AJPB may unfold further with the widespread use of the cholangiographic techniques.

During the last 4 yr, fine-needle aspiration cytology (FNAC) has been employed in 1,474 patients in 0-15-yr age group at our institute. Of these, 245 patients were found to have malignant disease, including primitive neuroectodermal tumors, hepatoblastoma, nephroblastoma, sarcoma, and epithelial malignancies. Four metastases from medulloblastoma and two each from astrocytoma and meningioma were confirmed without open biopsy. FNAC interpretation was easy when cytologic findings were correlated with relevant clinical and radiologic data.