1
|
Tyagi N, Pandey A, Parihar A, Verma S, Pant N, Kumar P, Singh S, Rawat J. Analysis of the Efficacy of Elastography in Comparison with Dynamic Renal Nuclear Scintigraphy in the Evaluation of Unilateral Pelvi-Ureteric Junction Obstruction. J Pediatr Surg 2024; 59:605-609. [PMID: 38142192 DOI: 10.1016/j.jpedsurg.2023.11.017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/20/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION In hydronephrosis due to pelviureteric junction obstruction (PUJO), an obstruction to urine flow may lead to increased pelvic pressure, which may cause interstitial fibrosis and renal impairment. Recently, there have been reports on renal pelvic assessment using ultrasound elastography (USE). This study was conducted to see if USE can evaluate PUJO and if it can be correlated to the findings of the dynamic renal nuclear scan. MATERIAL AND METHODS In this observational study, only patients with unilateral PUJO underwent acoustic radiation force impulse (ARFI) elastography. A rectangular region of interest (ROI) measuring 5 × 10 mm was positioned on the cortex region of the upper, mid, and lower poles of the affected kidney. Three valid measurements were obtained, from which a mean value was calculated. A dynamic renal nuclear scan using Technetium-99m ethylene dicysteine (EC or TC99 m EC) was obtained and split renal function (SRF) was used for comparison. RESULTS In the group of 20 patients, the mean age was 3.37 years. The mean SRF of the affected kidney was 26.65 %, and the corresponding USE value was 0.45 kpa. The Spearman's rho correlation coefficient for SRF and USE was 1 and 0.672, respectively (p = 0.001). Elastography was not feasible if SRF was less than 20 %. CONCLUSION USE may be able to comment on the renal functional status of hydronephrosis. If USE is reported as non-feasible, it may suggest that renal function is grossly compromised. It may serve as an alternative diagnostic modality for renal functional evaluation. LEVEL OF EVIDENCE Level II, Prospective Cohort Study.
Collapse
Affiliation(s)
- Nirpex Tyagi
- Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India
| | - Anand Pandey
- Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India.
| | - Anit Parihar
- Department of Radiodiagnosis, King George's Medical University, Lucknow 226003, UP, India
| | - Shashwat Verma
- Department of Nuclear Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow 226010, UP, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India
| | - Piyush Kumar
- Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India
| | - Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow 226003, UP, India
| |
Collapse
|
2
|
Rawat J, Singh S, Tyagi N, Pant N. Retrieval of a retained umbilical vein catheter at 6 months. BMJ Case Rep 2023; 16:e254380. [PMID: 37963667 PMCID: PMC10649496 DOI: 10.1136/bcr-2022-254380] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Umbilical venous catheterisation is carried out for the care of neonates who have very low birth weight and are critically ill. It is uncommon for catheter fragments to become fractured and retained. Here, we describe a case of a retained fractured umbilical vein catheter in an infant. An endovascular procedure to retrieve a catheter is the usual management option when the catheter has been accidentally cut and has moved proximally into a major vessel or inside the heart. It is rare to need open exploration and retrieval.
Collapse
Affiliation(s)
- Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nirpex Tyagi
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
3
|
Singh S, Rawat J, Pant N. Rare case of superior vesical fissure with hypospadias: variants of classic bladder exstrophy. World J Pediatr Surg 2023; 6:e000552. [PMID: 37215245 PMCID: PMC10193042 DOI: 10.1136/wjps-2022-000552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Affiliation(s)
- Sudhir Singh
- Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jiledar Rawat
- Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Pant
- Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
4
|
Pandey A, Srivastava A, Pant N, Singh S, Rawat J. Intralesional steroid in the era of propranolol for infantile hemangioma-Do we need it? J Plast Reconstr Aesthet Surg 2023; 77:117-122. [PMID: 36566639 DOI: 10.1016/j.bjps.2022.11.038] [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: 12/30/2021] [Revised: 10/06/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Despite its effectivity, there are reports of poor response to propranolol in the treatment of infantile hemangioma (IH). The literature is limited to the type of IH that fails to respond to propranolol. This study was conducted to analyze which types of hemangiomas respond poorly to propranolol and the effects of intralesional triamcinolone (IL TMC) in them. MATERIAL AND METHODS In this prospective cohort study, IH was classified as superficial, deep, and mixed. The clinical details were recorded. Propranolol was started in the patients at a dose of 1 mg/kg/day and increased to 2-3 mg/kg/day. The response to the treatment was evaluated as excellent, good, poor, and no response. IL TMC was given in the non-responding group at a dose of 1-2 mg/kg at one-month interval for a total of six doses after stopping propranolol. RESULTS Ninety-six patients (median age, 7 months; M/F = 2:1) were treated. Superficial hemangioma was present in 40 (41.7%), deep in 10 (10.4%), and mixed in 46 (47.9%) patients. The response was statistically better if initiated within four months of age. It was not influenced by the sex, number, site, or size. The response was statistically better in superficial hemangioma. IL TMC was administered in the 16 patients. The response was good or excellent in 10 patients. CONCLUSION Propranolol will be used as a first-line drug for IH. All superficial IHs are likely to respond. There will be a possibility of non-responding mixed or deep IH. Use of IL TMC seems reasonable for IH not responding to propranolol.
Collapse
Affiliation(s)
- Anand Pandey
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, UP, India.
| | - Anurag Srivastava
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, UP, India
| | - Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, UP, India
| |
Collapse
|
5
|
Shandilya G, Pandey A, Pant N, Singh G, Kumar A, Rawat J. Evaluation and management of "low" anorectal malformation in male children: an observational study. Pediatr Surg Int 2022; 38:337-343. [PMID: 34705061 DOI: 10.1007/s00383-021-05035-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE ARM with perineal fistula has been traditionally defined as low ARM (LARM). This study was conducted to evaluate LARM in male patients with an emphasis on the role of various factors on the outcome and follow-up of them. MATERIALS AND METHODS It was a retrospective cohort study. The clinical presentation, associated anomalies, and complications were assessed. The operative procedures included cutback anoplasty and others. The patients were followed in the outpatient department. The complications were assessed and managed accordingly. RESULTS During the study period of 8 years, 301 patients were admitted. The complaints included absent or abnormal anal opening, abdominal distension, constipation, and peritonitis. Most of the children (n = 214) presented in the neonatal period. The most common clinical presentation was the perineal fistula. The most common associated anomaly was urologic. Fourteen patients were referred from other centers after complications. The most common problem in follow-up was constipation. CONCLUSION LARM in male patients may have a diverse presentation. The associated anomalies need proper assessment. Awareness may avoid delayed presentation and unwanted complications. When managed by an expert, the condition can be effectively managed. Regular follow-up is important.
Collapse
Affiliation(s)
- Gaurav Shandilya
- Department of Pediatric Surgery, King George's Medical University, Lucknow, UP, 226003, India
| | - Anand Pandey
- Department of Pediatric Surgery, King George's Medical University, Lucknow, UP, 226003, India.
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, UP, 226003, India
| | - Gurmeet Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, UP, 226003, India
| | - Akhilesh Kumar
- Department of Pediatric Surgery, King George's Medical University, Lucknow, UP, 226003, India
| | - Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, UP, 226003, India
| |
Collapse
|
6
|
Tyagi N, Kureel S, Gupta A, Singh G, Rai R, Pant N. Study the Possibility of Creating Mucosal Valve Mechanism at Ureteric Orifice without Obstructing the Urine Outflow but Preventing the Urine Backflow into the Ureters. J Indian Assoc Pediatr Surg 2022; 27:462-465. [PMID: 36238334 PMCID: PMC9552644 DOI: 10.4103/jiaps.jiaps_143_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 03/14/2022] [Accepted: 04/16/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To study the possibility of creating mucosal valve mechanism at ureteric orifice without obstructing the urine outflow but preventing the urine backflow into the ureters. MATERIALS AND METHODS Ethical waiver was obtained from the institutional ethical committee. Prospective experimental study was conducted on the post-mortem specimen of intact bladder with urethra and bilateral ureters retrieved from the already slaughtered lamb available in the meat market. Feeding tube inserted via urethral opening into the bladder lumen and bladder inflated with saline demonstrated no reflux of urine via transverse cut opening of ureters. Bladder lumen opened, ureteric orifices incised backwards to eliminate the obliquity. After closing the bladder opening, saline inflation test demonstrated bilateral reflux of saline via cut openings of bilateral ureters. Bladder was re-opened. The upper limb of horizontal U started 10 mm lateral and 8 mm above the refluxing ureteric orifice. Distal most curvature of horizontal U was kept 5 mm medial to ureteric orifice continuing along the lower limb of horizontal U terminating 10 mm lateral and 8 mm below the refluxing ureteric orifice, mucosal flaps from superior and inferior incision mobilized and edges joined to cover the ureteric orifice creating a flap valve mechanism. Influx of saline via cut end of ureters demonstrated no obstruction. Bladder was closed. Saline inflation test and contrast study demonstrated abolition of reflux on flap side and persistence of reflux on another side. RESULTS Five such experiments were conducted. On the side where the valve was created, Vesicoureteral reflux was abolished in four but in one minimal reflux still persisted. CONCLUSION Creating a mucosal flap valve around the ureteric orifice can prevent reflux in 80% of cases without obstruction and without the necessity of ureteric mobilization or creating submucosal tunnel.
Collapse
Affiliation(s)
- Nirpex Tyagi
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India,Address for correspondence: Dr. Nirpex Tyagi, King George's Medical University, Lucknow, Uttar Pradesh, India. E-mail:
| | - Shiv Kureel
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Archika Gupta
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gurmeet Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rahul Rai
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
7
|
Rawat J, Singh S, Pant N, Gupta SK. An extremely rare case of diphallia with high anorectal malformation with perineal lipoma. j-pucr 2021. [DOI: 10.14534/j-pucr.2021267549] [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: 11/06/2022] Open
|
8
|
Rawat J, Singh S, Pant N, Gupta SK. An extremely rare case of diphallia with high anorectal malformation with perineal lipoma. j-pucr 2021. [DOI: 10.14534/j-pucr.2021.250] [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: 11/06/2022] Open
|
9
|
Pant N, Singh S, Singh G, Kumar A, Rai RK, Rawat J, Wakhlu A. The wandering ventriculoperitoneal shunt and the scope of its salvage. Childs Nerv Syst 2021; 37:2613-2618. [PMID: 33963923 DOI: 10.1007/s00381-021-05198-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/30/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Distal shunt tube migration following ventriculoperitoneal (VP) shunt placement in children is mostly managed by an initial shunt diversion/removal and subsequent replacement. Lately, shunt salvage is being used as an alternative in certain conditions. We have focused on the situations where one can consider or disregard shunt salvage in such cases. METHOD A retrospective study of children treated for distal shunt migration following VP shunt placement between January 2013 and December 2019. RESULT Seventeen children were managed for over 7 years. These included cutaneous extrusions (n = 4), hollow viscus perforation (n = 6), inguinal hernias (n = 5), and umbilical extrusion (n = 2). The surgical treatment varied from a cutaneous wound closure (with a tube in situ), temporary external shunt diversion, and laparotomy with shunt reposition into the peritoneal cavity. Shunt salvage was possible in three cases, whereas in 2 cases even though shunt salvage was possible, it was not feasible due to a short residual shunt length. CONCLUSION VP shunt salvage is possible in certain cases of distal shunt migration with a functional uninfected shunt. Small cutaneous extrusions can be covered by a local skin flap. Also, one should consider the residual intraperitoneal shunt length before its salvage in small children.
Collapse
Affiliation(s)
- Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gurmeet Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Akhilesh Kumar
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rahul Kumar Rai
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashish Wakhlu
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
| |
Collapse
|
10
|
Pant N, Singh S, Pandey A, Wakhlu A. Isolated Penile Injury in Boys: Accident, Negligence, or Abuse? J Indian Assoc Pediatr Surg 2021; 26:177-181. [PMID: 34321789 PMCID: PMC8286029 DOI: 10.4103/jiaps.jiaps_85_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/27/2020] [Accepted: 08/08/2020] [Indexed: 02/05/2023] Open
Abstract
Aim: The aim of the study was to highlight the etiology, spectrum of presentation, and management of isolated penile trauma in boys. Methods: A retrospective review of boys treated for isolated penile trauma between January 2015 and June 2019 at a tertiary-level hospital. Results: Nine children were admitted over 4½ years. Etiology: The mechanism of penile injury (PI) was penile hair tourniquet (n = 5), postcircumcision (n = 2), dog bite (n = 1), and scald injury (n = 1). Extent of injury includes complete urethral transection at corona (n = 4); loss of urethral plate in a case of hypospadias (n = 1); complete loss of glans (n = 1); penile transection at corona (n = 1); total penile amputation (n = 1); and deep partial-thickness burns of penile shaft and adjacent suprapubic skin (n = 1). Management: One patient absconded. The remaining patients were managed as follows: calibration of urethral meatus (n = 1); penile burn was managed with dressing and antibiotics; coring of glans with urethral end–end anastomoses (n = 4); Bettocchi's quadrangular lower abdominal flap phalloplasty (n = 1); and Bracka's staged urethroplasty (n = 1). Complications include wound infection following trauma (n = 4), postsurgical infection (n = 3), urethrocutaneous fistula (n = 2), and reapplication of penile hair tourniquet (n = 1). Conclusion: Isolated PI in boys is not uncommon. Most are preventable if the parents are apprized and watchful. The clinician should also be vigilant regarding child maltreatment. A staged approach tailored to the type of injury provides a satisfactory outcome.
Collapse
Affiliation(s)
- Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anand Pandey
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashish Wakhlu
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
11
|
Abstract
Tourniquet syndrome is a rare condition where a tourniquet applied to an appendage leads to an obstructed blood flow and subsequent ischemic injury. Meningomyelocele and meningocele are common birth defects, and involvement of meningocele in tourniquet syndrome is never mentioned in the literature. We managed a 10-day-old male child presenting with infected lumber meningocele with a tourniquet tied at its base. It is being presented with review of relevant literature.
Collapse
Affiliation(s)
- Akhilesh Kumar
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, India.
| | - Anand Pandey
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, India
| | - Ashish Wakhlu
- Department of Pediatric Surgery, King George's Medical University, Lucknow, 226003, India
| |
Collapse
|
12
|
Khan NA, Pant N, Gupta A, Anand R, Yadav PS, Chadha R, Choudhury SR. Radiologic Evaluation of Uterovaginal Abnormalities in Girls with Congenital Pouch Colon. J Indian Assoc Pediatr Surg 2019; 24:104-108. [PMID: 31105395 PMCID: PMC6417060 DOI: 10.4103/jiaps.jiaps_33_18] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background/Purpose: The radiologic investigations of 25 girls with congenital pouch colon (CPC), managed over 17 years, were retrospectively reviewed. In 13 girls who form the study group, the investigations provided information about the anomalous uterovaginal (UV) anatomy and these findings were studied. Materials and Methods: Age at presentation was 2 months to 10 years. The subtypes of CPC were Type I (n = 2), Type II (n = 9), and not recorded (n = 2). All patients had a double vagina and a unicornuate uterus on each side in the pelvis. The radiologic studies, performed at varying periods after surgery, included an intravenous urogram (IVU) (n = 4), micturating cystourethrogram (MCU) (n = 3), distal ileostogram/colostogram (n = 6), and magnetic resonance imaging (MRI) (n = 7). Results: IVU and MCU showed retrograde filling of the vaginas with contrast during micturition with a small-capacity urinary bladder and a relatively open bladder neck. The two vaginas were quite apart, but symmetrical in appearance and position. A distal dye study showed filling of the colonic pouch, its terminal fistula, and the two vaginas in six patients. Opacification of the bladder was seen in 3/6 girls, including one girl with left-sided Grade IV vesicoureteral reflux. MRI (n = 7) showed a monocornuate uterus on each side in the pelvis. The upper vaginas on each side were apart, being widely apart (n = 5) and somewhat closer (n = 2). The lower vaginas were closer with an intervaginal septum. Other findings were a widely open bladder neck and urethra in two girls with urinary incontinence and visualization of the terminal fistula of the colonic pouch (n = 2). The lumbosacral spine was normal in all patients. Conclusions: In girls with CPC, retrograde reflux of contrast into the vaginas during a distal dye study or an IVU/MCU may provide useful details of the anatomy of the vaginas. An MRI scan is recommended as essential for comprehensive evaluation of the anomalous UV anatomy.
Collapse
Affiliation(s)
- Niyaz Ahmed Khan
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Nitin Pant
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Amit Gupta
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Rama Anand
- Department of Radiology, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Partap Singh Yadav
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Rajiv Chadha
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Subhasis Roy Choudhury
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| |
Collapse
|
13
|
Rai SP, Singh D, Saini R, Rathore DS, Kumar S, Jain SK, Pant N. Possibility of Hydrological Connectivity between Manasarovar Lake and Gangotri Glacier. CURR SCI INDIA 2019. [DOI: 10.18520/cs/v116/i7/1062-1067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
14
|
Abstract
Context: While most of the females with anorectal malformations (ARMs) present in either neonatal period or early infancy, a small percentage presents in their adolescence. Aim: The aim is to study the causes of delay in presentation, management, and postoperative outcome in these cases. Settings and Design: This is a retrospective observational study conducted in the Department of Paediatric Surgery, King George's Medical University, Lucknow. Subjects and Methods: Records of females with ARM managed in one unit of the department from 2010 to 2015 were scrutinized. Of these, record of females who primarily presented in adolescence was reviewed. Data regarding the demographics, clinicoradiological presentation, management, postoperative stay, and follow-up were analyzed. Causes for delay in presentation were looked for. Statistical Analysis Used: Statistical analysis used was not required. Results: Out of 627 cases of ARM managed over 5 years, ten girls (5.3%) presented between 12 and 18 years (average 14.4 years). Main reasons for the delay in presentation were misinformation, illiteracy, and poverty. These comprised of anovestibular fistula (n = 5), anterior ectopic anus (n = 3), perineal canal (n = 1), and rectovestibular fistula (n = 1). Three (30%) girls had no problem apart from an abnormal anal orifice. Five (50%) girls had constipation as a major additional symptom. Four cases had a normal to mildly enlarged rectum on contrast study, whereas the rectum was moderately to hugely dilated in the remaining six cases. Six cases were managed with posterior sagittal anorectoplasty while an anterior sagittal anorectoplasty was done in four. Minor wound dehiscence developed in two cases. There was no mortality. In a mean follow-up of 16 months (8–26), constipation and soiling were seen in 5 (50%) girls. The overall outcome in these girls was satisfactory. Conclusion: Presentation of females with ARM in adolescence is not uncommon in the third world. A primary pull through is possible in these girls with mild-to-moderate rectal dilatations. A diverting colostomy before pull through is always a safe option in cases with severely dilated rectum and also otherwise. Moreover, a greater awareness regarding these malformations in the general public is required.
Collapse
Affiliation(s)
- Jiledar Rawat
- Department of Paediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Paediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Pant
- Department of Paediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
15
|
Pant N, Singh S, Rawat J, Kureel SN, Wakhlu A. Atresia of the Colon: Etiological Aberrations, Clinical Observations, and Challenges in Management. J Neonatal Surg 2018. [DOI: 10.21699/jns.v7i2.743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: The objective of this study is to review the clinicoradiological profile, scheme of management and the outcome in cases of colonic atresia (CA), and ascertain an optimal approach for the treatment of CA to minimize morbidity and mortality. Design and Setting: This was a retrospective observational study carried out at a tertiary health‑care center. Duration: Total of 6 years duration (January 2011–December 2016).Materials and Methods: A retrospective analysis of 10 patients of CA managed over a 6- year period. Data related to demographics, clinical presentation, associated anomalies, radiologic, intraoperative findings, postoperative stay, complications, and outcome were analyzed.Results: There were three cases of Type II atresia involving terminal ileum, cecum, and adjacent colon. Three cases had proximal ascending colon atresia (Type IIIa [n = 2]; Type I [n = 1]) Type I [n=1], and two cases of type IIIa atresia of the hepatic flexure. Two babies had atresia involving the sigmoid colon; one had Type II atresia, while we were unable to assign a type to the other within the prevailing classification. Seven babies were initially treated with a stoma either in the ileum (n = 3), hepatic flexure (n = 2), and sigmoid colon (n = 2), whereas three were treated with a primary anastomoses. Cases treated with a primary anastomoses had lesser morbidity and a better outcome than those with an ileal or ascending colon stoma.Conclusion: Contrary to the theory of an acute antenatal vascular accident, CA may rarely result from a gradual, sequential obliteration of mesenteric vasculature. Primary anastomosis should be contemplated in proximal CA wherever possible as stomal complications, especially high stoma output can result in considerable morbidity.
Collapse
|
16
|
Singh S, Rawat J, Pant N, Singh S. Prune-Belly syndrome with VACTERL association: A rare case. J Clin Neonatol 2018. [DOI: 10.4103/jcn.jcn_25_18] [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
|
17
|
Singh S, Pant N, Rawat JD. Ingested Pin Causing Acute Appendicitis In A Child. APSP J Case Rep 2017. [DOI: 10.21699/ajcr.v8i4.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Ingested foreign body (FB) can occasionally lodge into the vermiform appendix leading to its inflammation. A 4-year-old girl presented with features of acute appendicitis. On X ray abdomen a metallic pin was seen in right lower abdomen. Patient had open appendicectomy and a metallic pin was found penetrating both walls of appendix near its tip. Postoperative recovery was uneventful.
Collapse
|
18
|
Singh S, Pant N, Rawat JD, Dheer Y. Mucosal Irregularity on Gastric Contrast Study in a Case of Carmi Syndrome. J Neonatal Surg 2017; 6:54. [PMID: 28770151 PMCID: PMC5538618 DOI: 10.21699/jns.v6i2.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/19/2016] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, India
| | - J D Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, India
| | - Yadvendra Dheer
- Department of Pediatric Surgery, King George's Medical University, Lucknow, India
| |
Collapse
|
19
|
Pant N, Chaturvedi CV, Chaturvedi GD. Thermal Pressure Coefficient, Internal Pressure and Solubility Parameter of Hard Sphere Fluids. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1983-26463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
20
|
Abstract
Type V is the rarest form of congenital pouch colon with only four cases reported till date. We report this anomaly in a 6-month-old boy. He was managed successfully with excision of distal pouch and coloplasty of proximal pouch along with abdominoperineal posterior sagittal anorectoplasty. We recommend preservation of proximal pouch in such cases.
Collapse
Affiliation(s)
- J D Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Digamber Chaubey
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
21
|
Abstract
Congenital ranula is rare. We report a large, symptomatic, congenital plunging ranula associated with a salivary gland cyst in the neck. To the best of our knowledge, this is the first such reported case. Even though both the cysts had their origin from the sublingual gland, only the cervical cyst had a capsular covering. Herniation of a part of the immature sublingual gland anlage through a congenital mylohyoid defect, its separation, and subsequent maturation could explain this occurrence.
Collapse
Affiliation(s)
- Nitin Pant
- Department of Paediatric Surgery, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Ajay Kumar Verma
- Department of Paediatric Surgery, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Tanvir Rashan Khan
- Department of Paediatric Surgery, King Georges Medical University, Lucknow, Uttar Pradesh, India
| | - Ashish Wakhlu
- Department of Paediatric Surgery, King Georges Medical University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
22
|
Singh S, Pant N, Kumar P, Pandey A, Khan TR, Gupta A, Rawat J. Migration of Ventriculoperitoneal Shunt into a Hernia Sac: An Unusual Complication of Ventriculoperitoneal Shunt Surgery in Children. Pediatr Neurosurg 2016; 51:154-7. [PMID: 26872356 DOI: 10.1159/000442179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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] [Received: 08/03/2015] [Accepted: 11/04/2015] [Indexed: 02/05/2023]
Abstract
We report 2 cases of ventriculoperitoneal (VP) shunt migration into an inguinal hernia sac. In both cases hernia manifested itself on the right side in late infancy. We attempted to analyse the anatomical and mechanical factors leading to shunt migration as seen in the X-rays of our cases.
Collapse
Affiliation(s)
- Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, India
| | | | | | | | | | | | | |
Collapse
|
23
|
Chadha R, Khan NA, Shah S, Pant N, Gupta A, Choudhury SR, Debnath PR, Puri A. Congenital pouch colon in girls: Genitourinary abnormalities and their management. J Indian Assoc Pediatr Surg 2015; 20:105-15. [PMID: 26166979 PMCID: PMC4481620 DOI: 10.4103/0971-9261.159015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 11/29/2022] Open
Abstract
Aims: To discuss the assessment and management of genitourinary (GU) tract abnormalities in 21 girls with Types I-III congenital pouch colon (CPC), studied over a period of 10 years. Materials and Methods: Assessment included clinical and radiological assessment, examination under anesthesia (EUA), endoscopy of the lower GU tract, and evaluation of the surgical findings, operative procedures for the GU anomalies, and the results of management. Results: Initial examination of the external genitalia showed a “clover-leaf” appearance (n = 6) and a single perineal opening (n = 6). In 9 patients, the openings of the urethra and double vagina were seen, of which a vestibular fistula was seen in 5 and an anterior perineal fistula in 1. Seventeen patients (81%) had urinary incontinence (UI) - partial in 10, and complete in 7. Renal function tests, X-ray sacrum, and abdominal US were normal in all patients. Micturating cystourethrogram (n = 9) showed a wide, bladder neck incompetence (BNI) with reduced bladder capacity in seven patients. EUA and endoscopy revealed a septate vagina in all patients and the urethral opening at a “high” position (n = 14) or at a relatively normal or “low” position (n = 7). In 8 patients, the intervaginal septum was thick and fleshy. Endoscopy showed a short, wide urethra, an open incompetent bladder neck, poorly developed trigone, and reduced bladder capacity in the patients with UI. The fistula from the colonic pouch opened in the proximal urethra (n = 4), high in the vestibule (n = 3), low in the vestibule (n = 8), perineum just posterior to the vestibule (n = 1), and undetermined (n = 5). Vaginoscopy (n = 8) showed normal cervices in all and cervical mucus in 4 patients. The subtypes of CPC were Type I CPC (n = 4), Type II CPC (n = 16), and Type III CPC (n = 1). All 21 patients had uterus didelphys. In four patients with UI, during tubular colorraphy, a segment of the colonic pouch was preserved for later bladder augmentation if required. A Young-Dees bladder-neck repair (BNR) was performed in four older girls for treatment of UI, with marked improvement in urinary continence in two girls, some improvement in one girl with complete urinary incontinence, and minimal improvement in one child. Division of the intervaginal septum was performed in three girls. Conclusions: GU abnormalities in girls with CPC need to be assessed and managed by a tailored protocol. UI is frequent, and its correction may require BNR. A segment of the colonic pouch can be preserved for possible future bladder augmentation. All girls have a septate vagina, often widely separated, and uterus didelphys. Gynecologic assessment and monitoring is required throughout adult life. Considering the wide opening of the vestibule, surgical management of the urogenital component by division of the intervaginal septum and if required, the vagino-fistula septum on each side results in a normal or a hypospadiac urethral opening and an adequate vaginal inlet.
Collapse
Affiliation(s)
- Rajiv Chadha
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Niyaz Ahmed Khan
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Shalu Shah
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Nitin Pant
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Amit Gupta
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Subhasis Roy Choudhury
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Pinaki Ranjan Debnath
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | - Archana Puri
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| |
Collapse
|
24
|
Kishor Shinde N, Jhanwar P, Pant N, Roy Choudhury S, Chadha R. Congenital Pouch Colon with Double Meckel's Diverticulum in a Patient with Persistent Cloaca. J Neonatal Surg 2015; 4:10. [PMID: 26023534 PMCID: PMC4420408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 12/27/2014] [Indexed: 11/01/2022] Open
Affiliation(s)
| | | | | | | | - Rajiv Chadha
- Correspondence: Dr. Rajiv Chadha, G-123 Vikaspuri, New Delhi-110018, India. E-mail:
| |
Collapse
|
25
|
Shinde NK, Jhanwar P, Pant N, Choudhury SR, Chadha R. Congenital Pouch Colon with Double Meckel’s Diverticulum in a Patient with Persistent Cloaca. J Neonatal Surg 2015. [DOI: 10.47338/jns.v4.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Please see Fulltext
Collapse
|
26
|
Pant N, Kumar G, Upadhyay AD, Gupta YK, Chaturvedi PK. Correlation between lead and cadmium concentration and semen quality. Andrologia 2014; 47:887-91. [PMID: 25228328 DOI: 10.1111/and.12342] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2014] [Indexed: 11/28/2022] Open
Abstract
There are contrary reports of association of lead and cadmium with the decline in semen quality. This study evaluates whether seminal lead (Pb) and cadmium (Cd) at environmental concentration are associated with altered semen quality. We conducted a study of healthy fertile and infertile men 20-43 years of age attending the Andrology Laboratory of Reproductive Biology Department for semen analysis. The semen analysis was carried out according to the WHO 2010 guidelines. Seminal lead and cadmium were estimated by ICP-AES. The lead and cadmium values were significantly higher in infertile subjects. A negative association between seminal lead or cadmium concentration and sperm concentration, sperm motility and per cent abnormal spermatozoa was found. This study shows that exposure to Pb (5.29-7.25 μg dl(-1) ) and cadmium (4.07-5.92 μg dl(-1) ) might affect semen profile in men. Age, diet, smoking and tobacco chewing habits may have an influence on the increase in exposure to Pb and Cd in the individual subjects.
Collapse
Affiliation(s)
- N Pant
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| | - G Kumar
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - A D Upadhyay
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Y K Gupta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | - P K Chaturvedi
- Department of Reproductive Biology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
27
|
Pant N, Aggarwal SK. Extraperitoneal Pelvic laparoscopic disconnection of accessory urethra from normal urethra in a case of urethral duplication. J Indian Assoc Pediatr Surg 2014; 19:115-7. [PMID: 24741219 PMCID: PMC3983764 DOI: 10.4103/0971-9261.129611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/12/2022] Open
Abstract
We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space. The remaining distal mucosa was ablated using monopolar cautery.
Collapse
Affiliation(s)
- Nitin Pant
- Department of Pediatric Surgery, Maulana Azad Medical College and associated Lok Nayak and GB Pant Hospitals, New Delhi, India
| | - Satish Kumar Aggarwal
- Department of Pediatric Surgery, Maulana Azad Medical College and associated Lok Nayak and GB Pant Hospitals, New Delhi, India
| |
Collapse
|
28
|
Pant N, Aggarwal SK, Ratan SK. Laparoscopic repair of hernia in children: Comparison between ligation and nonligation of sac. J Indian Assoc Pediatr Surg 2014; 19:76-9. [PMID: 24741209 PMCID: PMC3983771 DOI: 10.4103/0971-9261.129597] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: The essence of the current techniques of laparoscopic hernia repair in children is suture ligation of the neck of the hernia sac at the deep ring with or without its transection. Some studies show that during open hernia repair, after transection at the neck it can be left unsutured without any consequence. This study was aimed to see if the same holds true for laparoscopic hernia repair. Materials and Methods: Sixty patients (52 boys and eight girls, 12-144 months) with indirect inguinal hernia were randomized for laparoscopic repair either by transection of the sac alone (Group I) or transection plus suture ligation of sac at the neck (Group II). Outcome was assessed in terms of time taken for surgery, recurrence, and other complications. Result: Thirty-eight hernia units in 28 patients were repaired by transection alone (Group I) and 34 hernia units in 29 patients were repaired by transection and suture ligation (Group II). Three patients were found to have no hernia on laparoscopy. Recurrence rate and other complications were not significantly different in the two groups. All recurrences occurred in hernias with ring size more than 10 mm. Conclusion: Laparoscopic repair of hernia by circumferential incision of the peritoneum at the deep ring is as effective as incision plus ligation of the sac.
Collapse
Affiliation(s)
- Nitin Pant
- Assistant Professor of Paediatric Surgery, Lady Hardinge Medical College, New Delhi, India
| | - Satish Kumar Aggarwal
- Director Professor of Paediatric Surgery, Maulana Azad Medical College, New Delhi, India
| | - Simmi K Ratan
- Associate Professor of Paediatric Surgery, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|
29
|
Choudhury SR, Debnath PR, Pant N, Chowdhary L. Congenital immature teratoma of the retroperitoneum. J Neonatal Surg 2013; 2:33. [PMID: 26023453 PMCID: PMC4422277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 04/14/2013] [Indexed: 11/04/2022] Open
Abstract
Congenital teratomas occur in extragonadal locations, the commonest site being the sacrococcygeal region. This report describes a rare case of antenatally detected, large, immature retroperitoneal teratoma. The diagnostic and therapeutic challenges of dealing with such a case have been discussed and the relevant literature reviewed. The recurrence of the tumor after gross surgical removal indicates a definitive role of administering chemotherapy in such a case.
Collapse
|
30
|
Abstract
Congenital teratomas occur in extragonadal locations, the commonest site being the sacrococcygeal region. This report describes a rare case of antenatally detected, large, immature retroperitoneal teratoma. The diagnostic and therapeutic challenges of dealing with such a case have been discussed and the relevant literature reviewed. The recurrence of the tumour after gross surgical removal indicates a definitive role of administering chemotherapy in such a case.
Collapse
|
31
|
Pant N, Singh V, Chadha R, Parakh A, Puri A, Choudhury SR. Hair strands within a congenital H-type tracheoesophageal fistula. Indian J Pediatr 2013; 80:78-9. [PMID: 22454212 DOI: 10.1007/s12098-012-0743-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 03/15/2012] [Indexed: 10/28/2022]
|
32
|
Pant N, Grover JK, Madan NK, Chadha R, Agarwal K, Choudhury SR. Completely isolated enteric duplication cyst associated with a classic enterogenous duplication cyst. J Indian Assoc Pediatr Surg 2012; 17:68-70. [PMID: 22529551 PMCID: PMC3326825 DOI: 10.4103/0971-9261.93966] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
This report describes an 18-month-old boy with a completely isolated duplication cyst (CIDC) of the ileum associated with another classic enteric duplication cyst in the adjacent bowel and presenting as an acute abdomen due to torsion of the pedicle of the CIDC. Cysts excision was curative.
Collapse
Affiliation(s)
- Nitin Pant
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | | | | | | | | | | |
Collapse
|
33
|
Pant N, Choudhury SR, Gupta A, Yadav PS, Grover JK, Chadha R. Umbilical signs of peritoneal tuberculosis in children. Indian J Pediatr 2012; 79:1192-6. [PMID: 22231768 DOI: 10.1007/s12098-011-0643-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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] [Received: 05/12/2011] [Accepted: 11/30/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To report the observation of involvement of the umbilicus with alteration of its morphology in association with peritoneal tuberculosis. METHODS This is a retrospective observational case series of abdominal tuberculosis (ATB) in children, treated in the department of pediatric surgery of a tertiary-care children's hospital in the period from January 2004 through April 2010. RESULTS Out of a total of 38 cases of ATB in children, 22(57.9%) were of the peritoneal type, 14(36.8%) were of the intestinal type, and 2(5.3%) involved the mesenteric lymph nodes. Of the patients manifesting with peritoneal tuberculosis, 11 cases (50%) had involvement of the umbilicus with changes in the umbilical shape and appearance. In seven cases the umbilicus was found retracted and transversely oriented (a slit-like "smiling" appearance) with loss of the umbilical hollow. In two cases there was puckering of the umbilicus. Other findings included umbilical erythema with inflammation in one patient and a fecal fistula at the umbilicus in another patient. While seven cases responded to treatment with antituberculous therapy (ATT), four cases underwent surgery (two laparotomy and two laparoscopy). Findings were similar in all four patients, consisting of adhered dilated bowel loops studded with tubercles which also covered the parietal peritoneum and the falciform ligament. All four cases responded to postoperative ATT. CONCLUSIONS Morphological changes of the umbilicus can provide an additional clue to the diagnosis of peritoneal tuberculosis in children.
Collapse
Affiliation(s)
- Nitin Pant
- Department of Pediatric Suregery, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, India
| | | | | | | | | | | |
Collapse
|
34
|
Yadav PS, Pant N, Chadha R, Choudhury SR. Oesophageal atresia and tracheoesophageal fistula with right pulmonary agenesis and duplication of the azygos vein. Arch Dis Child 2012; 97:513. [PMID: 22123734 DOI: 10.1136/archdischild-2011-301248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 11/03/2022]
Affiliation(s)
- Partap Singh Yadav
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, Bangla Sahib Marg, New Delhi 110001, India
| | | | | | | |
Collapse
|
35
|
Borkar NB, Pant N, Ratan S, Aggarwal SK. Laparoscopic Repair of Indirect Inguinal Hernia in Children: Does Partial Resection of the Sac Make Any Impact on Outcome? J Laparoendosc Adv Surg Tech A 2012; 22:290-4. [DOI: 10.1089/lap.2011.0259] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nitinkumar B. Borkar
- Department of Pediatric Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Nitin Pant
- Department of Pediatric Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Simmi Ratan
- Department of Pediatric Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Satish K. Aggarwal
- Department of Pediatric Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| |
Collapse
|
36
|
Abstract
Clitoromegaly in pediatric and adolescent age group is usually indicative of a disorder of sexual differentiation. We report a girl child presenting with clitoral enlargement due to an epidermoid cyst. The cyst was excised with complete cosmetic recovery.
Collapse
Affiliation(s)
- Satish Kumar Aggarwal
- Department of Pediatric Surgery, Maulana Azad Medical College and Associated Lok Nayak and GB Pant Hospitals, New Delhi, India
| | | | | |
Collapse
|
37
|
Puri A, Choudhury SR, Yadav PS, Grover JK, Pant N, Chadha R. Congenital pouch colon and segmental dilatation of the colon: A report of two unusual cases. J Indian Assoc Pediatr Surg 2011; 16:61-3. [PMID: 21731234 PMCID: PMC3119939 DOI: 10.4103/0971-9261.78133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 11/27/2022] Open
Abstract
This report describes two unusual cases of anorectal malformation. The first had a type III congenital pouch colon with a colovesical fistula. In the other very similar case, segmental dilatation of the colon was present along with penoscrotal hypospadias and, distally, a length of normal colon ending in a rectourethral fistula. In both patients, the appendix was short, stubby and a Y-shaped duplication of the normal colon was present just proximal to the dilated segment of colon.
Collapse
Affiliation(s)
- Archana Puri
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi - 110 001, India
| | | | | | | | | | | |
Collapse
|
38
|
Abstract
PURPOSE We report 18 years' experience of traumatic urethral strictures in boys with emphasis on recurrent strictures. MATERIALS AND METHODS Thirty-four boys with pelvic fracture urethral strictures underwent 35 repairs: 23 in the primary group (initial suprapubic cystostomy, but no urethral repair) and 12 in the re-do group (previously failed attempt(s) at urethroplasty elsewhere). The median age at operation and stricture length was 8.4 years and 3 cm in the primary and 9 years and 5.4 cm in the re-do group, respectively. Anastomotic urethroplasty was performed wherever possible, or failing this a substitution urethroplasty. Median follow up was 9 years for primary group and 8 years for re-do group. RESULTS Primary group: urethroplasty was successful in 22/23, with 10 by perineal and 13 by additional transpubic approach. Two have stress incontinence. Erectile function is unchanged in all and upper tracts are maintained. One had recurrent stricture. Re-do group (12 including 1 recurrence from primary group): anastomotic urethroplasty was done in 5 and substitution urethroplasty in 7. Patients needing substitution had long stricture (>5 cm), stricture extending to distal bulb, or high riding bladder neck. All patients are voiding urethrally. Two patients with substitution required dilatation for early re-stenosis. One appendix substitution required delayed revision. Two have stress incontinence. Erectile function was unaffected. Upper tracts are maintained. CONCLUSIONS Anastomotic urethroplasty was successful in over 95% of primary cases. In re-do cases it was viable in only 41% of cases; the rest required substitution urethroplasty. Urethral substitution also gave acceptable results.
Collapse
|
39
|
Aggarwal SK, Sinha SK, Ratan SK, Dhua A, Pant N, Borkar N, Nirwal G. Laparoscopic or laparoscopic-assisted pelvic surgery in small infants: our experience. J Laparoendosc Adv Surg Tech A 2011; 21:543-8. [PMID: 21391829 DOI: 10.1089/lap.2010.0521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective of this study was to review our experience of laparoscopic (LA) or laparoscopic-assisted pelvic surgery (LAPS) in small infants. MATERIALS AND METHODS The medical records of 35 patients who underwent an LA or LAPS between January 2007 and June 2010 were studied and 21 patients who were younger than 1 year or whose weight was less than 10 kg were included. Indications, procedures, results, and complications were analyzed. RESULTS The indications of surgery and procedures done were impalpable undescended testes (7 cases--3 single-stage orchidopexy and 4 Fowler Stephen stage I ligation of testicular vessels), Hirschsprung's disease (HD; 5 cases--all laparoscopic-assisted transanal pull-through), anorectal malformation (ARM; 3 cases--all laparoscopic-assisted pull-through), disorders of sexual differentiation (3 cases--1 herniotomy and 2 gonadal biopsy), sacrococcygeal teratoma (1 case--laparoscopic mobilization of pelvic component and posterior sagittal excision), and ovarian mass (2 cases; laparoscopic oophorectomy). There were 14 males, 4 females, and 3 of indeterminate sex. All procedures could be successfully completed without conversion. There was no anesthesia-related complication or need for postoperative ventilatory support. There were no immediate procedure-related complications. One female child with ARM had rectal mucosal prolapse; 1 HD case had rectovaginal fistula that healed following fecal diversion. The major advantages of laparoscopy in different indications were magnified access into the depth of pelvis and early frozen section biopsies in HD, accurate placement of neoanus in the center of muscle complex in ARM, early ligation of vessels and avoidance of laparotomy in sacrococcygeal teratoma, ease of decision making and better mobilization of vessels in undescended testes, and diagnostic accuracy and therapeutic procedure in ambiguous genitalia. CONCLUSION Laparoscopic pelvic surgery in small infants is a safe procedure with advantage of magnification, access, and cosmesis.
Collapse
Affiliation(s)
- Satish Kumar Aggarwal
- Department of Pediatric Surgery, Maulana Azad Medical Collage and Lok Nayak Hospital, New Delhi, India.
| | | | | | | | | | | | | |
Collapse
|
40
|
Chawla HM, Kumar S, Pant N, Santra A, Sriniwas K, Kumar N, Black DS. Synthesis and evaluation of deep cavity imidazolyl calix[n]arenes. J INCL PHENOM MACRO 2011. [DOI: 10.1007/s10847-010-9921-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
41
|
Pant N, Pant AB, Shukla M, Mathur N, Gupta YK, Saxena DK. Environmental and experimental exposure of phthalate esters: The toxicological consequence on human sperm. Hum Exp Toxicol 2010; 30:507-14. [DOI: 10.1177/0960327110374205] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rapid industrialization and urbanization release several chemicals such as phthalates into the environment and cause adverse effects on reproductive system, mainly endocrine disruption, testicular injury and decline in semen quality in humans. There are no reports in extrapolating of the epidemiological data with in vitro findings. Our study show the correlations between in vivo studies and in vitro data for the effect of phthalate esters. Healthy human males, in the age group 21 to 40 years, visiting Chhatrapati Sahuji Maharaj Medical University (CSMMU), Lucknow, as part of infertility investigation, were recruited as volunteers. Semen analysis was performed according to the WHO guidelines. Phthalate esters were analyzed by high-performance liquid chromatography (HPLC) and cell viability by MTT assay. In the in vitro studies, sperms were exposed to highest concentration in semen samples (5—10 times higher) for a period ranging between 30 min and 96 hours. An inverse relationship with sperm motility in epidemiological studies was concurrent by significant dose-and time-dependent decrease in the sperm motility under in vitro environment after 12-hour exposure. Cytotoxicity was observed only with the highest concentration after 96 hours of exposure. There are a significant correlation between phthalate ester diethylhexyl phthalate, di-n-butyl phthalate (DEHP and DBP) and sperm motility both in vitro and in vivo conditions. Additionally, in vitro experiments conducted not only adjunct to the existing in vivo data but also specify the effect of specific toxicants (DEHP and DBP) on sperm motility and viability. Results show the decrease in motility of sperms under in vitro conditions at the maximum range of in vivo measured levels and 5- or 10-folds higher to that found in human semen samples.
Collapse
Affiliation(s)
- N. Pant
- Indian Institute of Toxicology Research, Lucknow, (Council of Scientific & Industrial research, New Delhi, India),
| | - AB Pant
- Indian Institute of Toxicology Research, Lucknow, (Council of Scientific & Industrial research, New Delhi, India)
| | - M. Shukla
- CSM Medical University, Lucknow, India
| | - N. Mathur
- Indian Institute of Toxicology Research, Lucknow, (Council of Scientific & Industrial research, New Delhi, India)
| | - YK Gupta
- All India Institute of Medical Sciences, New Delhi, India
| | - DK Saxena
- Indian Institute of Toxicology Research, Lucknow, (Council of Scientific & Industrial research, New Delhi, India)
| |
Collapse
|
42
|
Chawla H, Pant N, Srivastava B. Synthesis and characterization of linear molecular assembly of crystalline calix[4]arenes dithianes. Tetrahedron 2008. [DOI: 10.1016/j.tet.2008.07.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
43
|
Abstract
OBJECTIVE To study the clinical presentation, management and results of treatment of 41 consecutive cases of choledochal cyst (CC) managed from 1999 to 2006. METHODS The age of the patients ranged from 20 days to 11 years. Eleven cases were 1 year or less in age (infantile group) and 30 patients were more than 1 year old (classical pediatric group). Children less than 1 year old presented with jaundice (72%), hepatomegaly (54%) and clay-colored stools (63%); whereas those above one year in age presented with pain (83.3%) and jaundice (47.6%). Three cases had biliary perforation with localized or generalized biliary peritonitis. Ultrasonography (US) diagnosed/suggested CC in all 41 patients, however, contrast-enhanced computed tomographic (CECT) scan (n=12), radionuclide DISIDA scan (n=5) and magnetic resonance cholangiopancreatogram (MRCP) (n=3) also contributed to the diagnosis. 19 patients, including 4 from the 'infantile' group, had significant dilatation of intrahepatic biliary ducts. RESULTS Nine patients from the 'infantile' group had cystic type I CC (type Ic), while 2 patients had fusiform dilatation of the common bile duct (type If disease). In contrast, 21 of the older patients had type If disease while 9 had type Ic disease. Operative management included primary complete excision of the cyst with a Roux-en-Y hepaticodochojejunostomy (HDJ) (n=32), Lilly's modification of submucosal resection with a HDJ (n=8) and cyst excision with a hepaticodochoduodenostomy (HDD) (n=1). All 3 patients with biliary perforation had primary excision of the CC with a HDJ. Unusual operative findings included accessory hepatic ducts (n=2), anteriorly placed common or right hepatic arteries (n=3) and partially or completely blocked proximal extrahepatic bile ducts (n=3). There were 2 postoperative deaths, one had cirrhotic liver disease with portal hypertension, the other had deep icterus with poor general condition. Both patients succumbed to overwhelming sepsis. One patient required reexploration and refashioning of the HDJ for biliary leak. Short-term follow-up was satisfactory in all 39 patients. CONCLUSION Infants with CC constitute a distinct group with regard to clinical presentation and the pathological should be kept in mind while evaluating neonates and infants with cholestatic jaundice and older children with recurrent abdominal pain. Primary excision of the cyst with a HDJ provides satisfactory results in the management of the vast majority of cases of CC including those in infants, massive CC and in the presence of biliary perforation and peritonitis.
Collapse
Affiliation(s)
- Atul Mishra
- Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran Children's Hospital, New Delhi, India
| | | | | | | |
Collapse
|
44
|
Chakrabarti A, Chawla H, Pant N, Singh SP, Upreti S. Synthesis of conformationally diverse tetrathiacalix[4]arene(amido)crowns and tetrathiacalix[4]arene amides with pendant amine functions. Tetrahedron 2006. [DOI: 10.1016/j.tet.2006.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
45
|
Abstract
[reaction: see text] A facile synthesis of bisformylated calix[4]arenes via ipso substitution of p-tert-butylcalix[4]arenes through treatment with hexamethylenetetramine/trifluoroacetic acid is described. Under identical conditions, p-tert-butylcalix[4]arene tetramethyl ether 4 gives proximally substituted bisformylated derivative 4a in a pinched cone conformation.
Collapse
Affiliation(s)
- H M Chawla
- Department of Chemistry, Indian Institute of Technology, Hauz Khas, New Delhi.
| | | | | | | |
Collapse
|
46
|
van der Vaart JM, Pant N, Wolvers D, Bezemer S, Hermans PW, Bellamy K, Sarker SA, van der Logt CPE, Svensson L, Verrips CT, Hammarstrom L, van Klinken BJW. Reduction in morbidity of rotavirus induced diarrhoea in mice by yeast produced monovalent llama-derived antibody fragments. Vaccine 2006; 24:4130-7. [PMID: 16616802 DOI: 10.1016/j.vaccine.2006.02.045] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Revised: 02/13/2006] [Accepted: 02/14/2006] [Indexed: 10/24/2022]
Abstract
Apart from the use of oral rehydration solution, there are currently no treatment modalities for rotavirus induced diarrhoea, which is particularly relevant to developing countries. Fragments derived from llama heavy chain antibodies were previously shown to be highly stable, efficiently produced in yeast and exhibiting high epitope specific affinity. We now aim to demonstrate that these antibody fragments are capable of reducing morbidity of rotavirus induced diarrhoea. Here we show the isolation of rotavirus specific antibody fragments and their capability of reducing the morbidity of rotavirus induced diarrhoea in vivo in mice. They could provide a treatment modality for the moderation of human rotavirus infections having a significant impact on the course of an often fatal childhood disease.
Collapse
Affiliation(s)
- J M van der Vaart
- Unilever R&D Vlaardingen, Olivier van Noortlaan 120, 3133 AT Vlaardingen, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Chakrabarti A, Chawla H, Francis T, Pant N, Upreti S. Synthesis and cation binding properties of new arylazo- and heteroarylazotetrathiacalix[4]arenes. Tetrahedron 2006. [DOI: 10.1016/j.tet.2005.10.073] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
48
|
|
49
|
|
50
|
Srivastava N, Roy A, Pant N, Nagpal H, Vohra CR, Bhaskarwar AN. Pollution preventing microemulsion inks. Chem Eng Sci 2005. [DOI: 10.1016/j.ces.2004.10.029] [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: 10/25/2022]
|