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Sarmah U, Kurup BG, Prabhat D, Pereira C, Karkera P, Tiwari Y. Head Scarf Pin in the Airway and Challenges in Rigid Bronchoscopy: A Case Series. Indian J Otolaryngol Head Neck Surg 2024; 76:1214-1219. [PMID: 38440526 PMCID: PMC10908949 DOI: 10.1007/s12070-023-04223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 03/06/2024] Open
Abstract
Accidental Foreign body aspiration, especially sharp metallic objects may lead to life threatening complications. A metallic object is identified readily on a Xray chest or CT chest and helps us in ascertaining its location. A straight pin with blunt head in the shape of pearl is used in wearing a head scarf also known as hijab to hold it in place. The head scarf pin (hijab pin) if accidentally aspirated into the airway may lead to grave complications. Hence timely intervention with suitable instrumentation is essential to prevent any lethal complications. We have reported four different cases of adolescent females who had accidentally aspirated hijab pin and challenges faced by us during removal.
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Affiliation(s)
- Utpal Sarmah
- Department of Pediatric Otorhinolaryngology, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra 400012 India
| | - Bala Gopal Kurup
- Department of Pediatric Otorhinolaryngology, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra 400012 India
| | - Divya Prabhat
- Department of Pediatric Otorhinolaryngology, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra 400012 India
| | - Carlton Pereira
- Department of Pediatric Otorhinolaryngology, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra 400012 India
| | - Parag Karkera
- Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra 400012 India
| | - Yogesh Tiwari
- Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Parel, Mumbai, Maharashtra 400012 India
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Pandrowala A, Desai M, Madkaikar M, Kulkarni S, Shobhavat L, Mishra J, Jain S, Chandane P, Sehgal K, Chavan S, Karkera P, Bendre P, Thanky A, Rao S, Prabhu S, Bodhanwala M, Agarwal B, Hiwarkar P. Changing outcomes of stem cell transplantation in primary immunodeficiencies: Results from a tertiary-care charitable trust hospital in Mumbai. J Allergy Clin Immunol Glob 2023; 2:100105. [PMID: 37779531 PMCID: PMC10509861 DOI: 10.1016/j.jacig.2023.100105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/06/2023] [Accepted: 01/20/2023] [Indexed: 10/03/2023]
Abstract
Background Hematopoietic stem cell transplantation in primary immunodeficiency disorders has come a long way since the first transplant in 1968. In India, pediatric stem cell transplantation long-term survival outcomes range from 62.5% to 75%, compared to 90% in high-income countries. Objective We present single-center data of primary immunodeficiency transplants with immune-reconstitution evaluation after transplantation from a charitable trust hospital. Methods Retrospective data of children transplanted for primary immunodeficiency disorders from March 2019 to March 2022 in a newly established transplant unit were collected. Data of pretransplant infections and comorbidities, surveillance for carbapenem-resistant Enterobacteriaceae, transplant characteristics, donor source, graft-versus-host disease, posttransplant infections, immune reconstitution, overall survival at 1 year, and immunodeficiency-free survival were collated. Results Twenty-one patients underwent transplantation for primary immunodeficiency disorders. The median age at transplantation was 3 years and 5 months (range, 7 months to 17 years). Seventy-five percent of the cohort had organ involvement, with lung being the most common organ involved, followed by central nervous system. Fifty-two percent of children had peritransplant infections, with most of them recognized at the pretransplant assessment. Among 20 of 21 children with engraftment, 94% had complete chimerism initially, with 33% developing mixed chimerism over time. The median duration of immunosuppression was 3 months after transplantation, and only 1 child required systemic graft-versus-host disease treatment for more than a year. Immune-reconstitution showed good T-cell recovery at 3 months and naive T-cell production at 6 months. There was no regimen-related or sepsis-related mortality. Overall survival of the cohort was 95% at 1-year follow-up. Immunodeficiency-free survival was 86% after a median follow-up of 20 months. Conclusions Immunodeficiency-free and graft-versus-host disease-free survival can be achieved in the majority of children with primary immunodeficiencies using enhanced supportive care and the latest transplantation algorithms.
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Affiliation(s)
- Ambreen Pandrowala
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Mukesh Desai
- Department of Inborn errors of Immunity, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Manisha Madkaikar
- Department of Pediatric Immunology and Leukocyte Biology, ICMR–National Institute of Immunohaematology, KEM Hospital, Mumbai, India
| | - Shilpa Kulkarni
- Department of Paediatric Neurology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Lakshmi Shobhavat
- Department of Intensive Care, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Jayashree Mishra
- Department of Paediatric Cardiology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Shreepal Jain
- Department of Paediatric Cardiology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Parmarth Chandane
- Department of Paediatric Pulmonology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | | | - Saroj Chavan
- Department of Paediatric Radiology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Parag Karkera
- Department of Paediatric Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Pradnya Bendre
- Department of Paediatric Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Ameet Thanky
- Department of Physiotherapy, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Sudha Rao
- Department of Paediatrics, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Shakuntala Prabhu
- Department of Paediatrics, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Minnie Bodhanwala
- Department of Paediatrics, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Bharat Agarwal
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Prashant Hiwarkar
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
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Pandrowala A, Sharma AN, Mudaliar S, Chavan S, Karkera P, Bendre P, Ganatra P, Bodhanwala M, Agarwal B, Hiwarkar P. Haploidentical hematopoietic cell transplant for severe aplastic anemia in children with carbapenem-resistant enterocolitis. Pediatr Hematol Oncol 2022; 39:762-768. [PMID: 35502913 DOI: 10.1080/08880018.2022.2062079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ambreen Pandrowala
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Ajay Narayan Sharma
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Sangeeta Mudaliar
- Department of Pediatric Haematology-oncology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Saroj Chavan
- Department of Pediatric Radiology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Parag Karkera
- Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Pradnya Bendre
- Department of Pediatric Surgery, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Parth Ganatra
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Minnie Bodhanwala
- Department of Pediatrics, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Bharat Agarwal
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India.,Department of Pediatric Haematology-oncology, Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Prashant Hiwarkar
- Department of Blood and Marrow Transplantation, Bai Jerbai Wadia Hospital for Children, Mumbai, India
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Karkera P, Mohan P, Singal A. A New Approach for Machine Learning Algorithm to Generate Automated Diet Plan for Indian Children Age 2 To 12 Years. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Munghate G, Karkera P, Chavan S, Raj A, Bodhanwala M, Bendre P. Solitary hamartomatous duodenal polyp in an infant. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kesan K, Kothari P, Gupta R, Gupta A, Karkera P, Ranjan R, Mutkhedkar K, Sandlas G. Closure of large meningomyelocele wound defects with subcutaneous based pedicle flap with bilateral V-Y advancement: our experience and review of literature. Eur J Pediatr Surg 2015; 25:189-94. [PMID: 24683103 DOI: 10.1055/s-0034-1368796] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Meningomyelocele is a defect of the spinal cord, vertebrae, and the overlying skin and is the most common form of open spinal dysraphism. Rapid closure of the back defect in the early postnatal period is mandatory to reduce the frequency of infection-related complications of the central nervous system. Majority of the cases present with small defects, which can be closed primarily, with or without subcutaneous dissection. However, direct closure is not possible in 25% of the cases. Different types of local flaps (skin or muscle flaps) are widely used for covering the skin defects; and with varying results. PATIENTS AND METHODS A prospective nonrandomized study was conducted in the department of pediatric surgery at a tertiary hospital, from September 2007 to October 2011. Overall 35 patients with large meningomyelocele defects that could not be closed primarily were included in the study. All patients were treated using subcutaneous tissue based pedicle flap with bilateral V-Y advancement. RESULTS There were 27 neonates, 7 infants, and 1 child, with a male:female ratio of 1.19:1. There were 3 thoracolumbar, 14 lumbar, 14 lumbosacral, 3 sacral, and 1 multiple meningomyelocele defects with an average size of 8.5 cm (range 6.5-11 cm). Average intraoperative blood loss was 8 mL (range 6-10.5 mL). Average operative time which included flap reconstruction time, after closure of dura, was 38.6 min. Total seven patients had wound complications viz. fat necrosis (n = 2), flap necrosis (n = 2), hematoma (n = 1), cerebrospinal fluid leak followed by wound dehiscence (n = 1), wound infection which led to meningitis (n = 1). Average healing time for flap repair was 7.52 days. Overall 80% (n = 28) of the patients had good flap texture and contour with satisfactory cosmesis. CONCLUSION Closure of large meningomyelocele wound defects with subcutaneous based pedicle flap with bilateral V-Y advancement is an effective technique. The main advantages of this technique are its simplicity, short operative time, good tolerance, early healing, and good cosmetic outcome with an excellent flap texture and contour match with minimal complications.
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Affiliation(s)
- Krushnakumar Kesan
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Paras Kothari
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Rahul Gupta
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Abhaya Gupta
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Parag Karkera
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Ritesh Ranjan
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Kedar Mutkhedkar
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Gurusev Sandlas
- Department of Paediatric Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
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Kesan K, Gupta R, Gupta A, Kothari P, Ranjan R, Mudkhedkar K, Karkera P. Solitary crossed renal ectopia with vesicoureteric reflux presenting with impaired renal function in a neonate. J Clin Neonatol 2013; 2:140-2. [PMID: 24251260 PMCID: PMC3830151 DOI: 10.4103/2249-4847.120004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Solitary crossed renal ectopia (SCRE) is an exceedingly rare anomaly of the urinary tract. So far, only 34 cases have been reported in the literature. It usually presents after infancy. Most of these cases are diagnosed incidentally while patients are undergoing evaluation for associated genitourinary, cardiovascular, hematological or vertebral abnormalities. We report the first case of SCRE presenting in neonatal age with impaired renal function and vesico-ureteric reflux.
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Affiliation(s)
- Krushnakumar Kesan
- Department of Pediatric Surgery, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
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Kesan K, Gupta A, Gupta RK, Kothari P, Ranjan R, Karkera P, Mudkhedkar K. Gluteal flap for omphalocele repair in a case of epigastric heteropagus: A novel approach for surgical management. Indian J Plast Surg 2013; 46:127-9. [PMID: 23960319 PMCID: PMC3745099 DOI: 10.4103/0970-0358.113731] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Epigastric heteropagus is an extremely rare congenital anomaly, in which there is asymmetrical conjoined twinning, with the parasitic twin attached to the epigastrium. A 2-day-old male, with epigastric heteropagus and omphalocele, was operated in our institution. After excision of the parasitic twin, omphalocele was covered with a gluteal skin flap available from the parasitic twin. Post-operative course was uneventful, except for infection along the edges of the skin flaps, which was managed conservatively. Only 44 cases of epigastric heteropagus twins have been reported previously in world literature. We present a novel surgical approach for the repair of the omphalocele in a case of epigastric heteropagus twins, probably the 45(th) case to be reported in the world literature.
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Affiliation(s)
- Krushnakumar Kesan
- Department of Pediatric Surgery, LTMMC and LTMGH, Sion, Mumbai, Maharashtra, India
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Kesan K, Gupta A, Gupta R, Kothari P, Ranjan R, Karkera P, Mudkhedkar K. Palmoplantar keratoderma and pleomorphic adenoma of submandibular salivary gland: A rare association in a pediatric patient. Clin Cancer Investig J 2013. [DOI: 10.4103/2278-0513.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kesan K, Gupta A, Gupta RK, Kothari P, Ranjan R, Karkera P, Mudkhedkar K. Missed duodenal web with foreign body impaction in an operated case of midgut malrotation with Down′s syndrome - A diagnosis delayed by endoscopy. Journal of Digestive Endoscopy 2013. [DOI: 10.1055/s-0039-1700262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
ABSTRACT“Always look for duodenal obstruction in a case of malrotation”, this dictum has to be followed. The patient was operated for midgut malrotation at day 2 of life followed by foreign body removal by upper gastrointestinal endoscopy at 2 years of age. We report atwo and half year male child with Down′s syndrome who presented to us with history suggestive of recurrent upper gastrointestinal tract obstruction. During surgery a post sphincteric duodenum web was confirmed and foreign body (berry seed) which had impacted proximal to it was removed. The web was excised and the duodenum, split longitudinally, sutured transversely. The postoperative course was uneventful and patient is asymptomatic at follow up. This case illustrates that diagnosis was delayed for 2 years after initial presentation in early neonatal age. (Dig Endosc 2013;4(1):10–12)
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Affiliation(s)
| | - Abhaya Gupta
- Department of Pediatric Surgery, LTMMC & LTMGH, Sion, Mumbai, India
| | | | - Paras Kothari
- Department of Pediatric Surgery, LTMMC & LTMGH, Sion, Mumbai, India
| | - Ritesh Ranjan
- Department of Pediatric Surgery, LTMMC & LTMGH, Sion, Mumbai, India
| | - Parag Karkera
- Department of Pediatric Surgery, LTMMC & LTMGH, Sion, Mumbai, India
| | - Kedar Mudkhedkar
- Department of Pediatric Surgery, LTMMC & LTMGH, Sion, Mumbai, India
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Abstract
Aim: To study the clinical outcome of shunt surgeries in children suffering from hydrocephalus. Methods: A prospective study of 50 children with hydrocephalus who underwent a ventriculo-peritoneal shunt insertion over a period of two years. These patients were then followed up for shunt related complications, shunt revisions and outcome. Results: Twenty six of the 50 patients (52%) suffered from complications. The most common complications were shunt blockage (n=7) and shunt infection (n=6). These complications necessitated repeated shunt revisions. Conclusions: Infective complications of hydrocephalus are more likely to leave behind an adverse neurological outcome in the form of delayed milestones and mental retardation.
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Affiliation(s)
- Ashraf Ahmed
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal General Hospital, Sion, Mumbai, India
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Abstract
CONTEXT Lymphangiomas are developmental anomalies presenting mainly in the first two years of life. Surgical excision has been the mainstay of treatment; however a potentially disfiguring surgery along with presence of important structures in the vicinity and infiltration into surrounding structures makes the dissection difficult. AIMS To study the safety and efficacy of Bleomycin as a sclerosing agent for lymphatic malformations in children. SETTINGS AND DESIGN Prospective non comparative nonrandomized trial. MATERIALS AND METHODS The study was carried out in 15 children between Day 5 of life to 12 years of age who presented between May2008 to May 2009. Bleomycin aqueous solution was injected intralesionally at a dose not exceeding 0.6 to 0.8 mg. /kg Body wt. The response to therapy was monitored clinically by measuring the length, breadth and area as well as by measuring the two largest perpendicular dimensions. The response was graded as excellent [total disappearance], good [>50% reduction] and poor [<50% decrease]. Those patients with diffuse lymphangiomas associated predominantly with hemangiomatous malformations, mediastinal, spinal or retroperitoneal extensions, visceral lymphangiomas, those with infections were excluded from the study. STATISTICAL ANALYSIS USED None applicable. RESULTS The reduction in the size of the mass usually took between two weeks to ten months. The average duration of follow up has been ten months. A significant response was seen in 8 out of the fifteen [53.33%] patients. 5 patients [33.33%] patients showed a good response to therapy and achieved >50% reduction in the size of their swellings. 2 patients [13.33%] showed a poor response to therapy and achieved less than 50% reduction in the size of the swelling. Complications of the therapy were few and far between. 2 patients developed fever after injection, one patients reported a transient increase in size of swelling, 2 patients have developed discoloration of the overlying skin and are currently being followed up for final outcome. None of the patients developed leucopenia or leukocytosis. All of the complications were managed with conservatively. Patients are on long term follow up to evaluate long term effects, if any.
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Affiliation(s)
- Gursev Sandlas
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and General Hospital, Sion, Mumbai, India
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Abstract
Gastrointestinal perforation in neonates with anorectal malformations is extremely uncommon. Delayed patient presentation is an important factor that demands special attention. We present a neonate with anorectal malformation and meconium peritonitis following spontaneous bowel perforation. A day 1 neonate was referred with features suggested of peritonitis. After adequate resuscitation and drainage under local anesthesia, patient was successfully operated for a sigmoid perforation and is now awaiting definitive surgery for the anorectal malformation.
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Affiliation(s)
- Gursev Sandlas
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal General Hospital, Mumbai, India.
| | - Paras Kothari
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal General Hospital, Mumbai, India
| | - Dinesh Sarda
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal General Hospital, Mumbai, India
| | - Parag Karkera
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal General Hospital, Mumbai, India
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Sandlas G, Kothari P, Karkera P, Gupta A. Bleomycin: A worthy alternative. Indian J Plast Surg 2011. [DOI: 10.1055/s-0039-1699479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
ABSTRACT
Context: Lymphangiomas are developmental anomalies presenting mainly in the first two years of life. Surgical excision has been the mainstay of treatment; however a potentially disfiguring surgery along with presence of important structures in the vicinity and infiltration into surrounding structures makes the dissection difficult. Aims: To study the safety and efficacy of Bleomycin as a sclerosing agent for lymphatic malformations in children. Settings and Design: Prospective non comparative nonrandomized trial. Materials and Methods: The study was carried out in 15 children between Day 5 of life to 12 years of age who presented between May2008 to May 2009. Bleomycin aqueous solution was injected intralesionally at a dose not exceeding 0.6 to 0.8 mg. /kg Body wt. The response to therapy was monitored clinically by measuring the length, breadth and area as well as by measuring the two largest perpendicular dimensions. The response was graded as excellent [total disappearance], good [>50% reduction] and poor [<50% decrease]. Those patients with diffuse lymphangiomas associated predominantly with hemangiomatous malformations, mediastinal, spinal or retroperitoneal extensions, visceral lymphangiomas, those with infections were excluded from the study. Statistical analysis used: None applicable. Results: The reduction in the size of the mass usually took between two weeks to ten months. The average duration of follow up has been ten months. A significant response was seen in 8 out of the fifteen [53.33%] patients. 5 patients [33.33%] patients showed a good response to therapy and achieved >50% reduction in the size of their swellings. 2 patients [13.33%] showed a poor response to therapy and achieved less than 50% reduction in the size of the swelling. Complications of the therapy were few and far between. 2 patients developed fever after injection, one patients reported a transient increase in size of swelling, 2 patients have developed discoloration of the overlying skin and are currently being followed up for final outcome. None of the patients developed leucopenia or leukocytosis. All of the complications were managed with conservatively. Patients are on long term follow up to evaluate long term effects, if any.
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Affiliation(s)
- Gursev Sandlas
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and General Hospital, Sion, Mumbai, India
| | - Paras Kothari
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and General Hospital, Sion, Mumbai, India
| | - Parag Karkera
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and General Hospital, Sion, Mumbai, India
| | - Abhaya Gupta
- Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and General Hospital, Sion, Mumbai, India
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Kothari P, Sarda D, Sandlas G, Karkera P. Resorption of distal appendix: A rare complication after Mitrofanoff′s appendicovesicostomy. Urol Ann 2009. [DOI: 10.4103/0974-7796.56039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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