scholarly journals Transanal Endorectal Pullthrough for Hirschsprung’s Disease Without Frozen-Section Biopsy Facility

2014 ◽  
Vol 4 (2) ◽  
pp. 84-87
Author(s):  
Kamal M Choudhury ◽  
Md Abu Jafor ◽  
Safiruddin Ahmed
Keyword(s):  
Transition Zone ◽  
Average Length ◽  
Frozen Section ◽  
Oral Feeding ◽  
College Hospital ◽  
X Ray ◽  
Naked Eye ◽  
Satisfactory Outcome ◽  
Pull Through ◽  
Operative Recovery

Objective: The purpose of this study was to evaluate results of treatment of patients with Hirschsprung’s disease (HPD) by transanal endorectal pull-through (TEPT) in a setting where frozen-section biopsy facility was not available.Methods: From November 2001 to September 2007, fortytwo patients with HPD had undergone TEPT in Rajshahi Medical College Hospital (RMCH) and at various clinics in Rajshahi. The age of the patients ranged from 7 days to 12 years. In all cases, the extent of aganglionosis was limited to recto-sigmoid region and was assessed by the three classical features of contrast enema namely spastic aganglionic zone, transition zone (TZ) and proximal dilated zone (PDZ). During operative pull-through, transition zone (TZ) and proximal dilated zone (PDZ) were identified by naked eye and correlated with x-ray findings. Eleven patients had colostomy fashioned prior to the TEPT procedure. Followup was done for 14 to 58 months (mean 36 months).Result: Thirty-nine patients had satisfactory outcome without any complication. The mean operative time was 100 minutes. The average length of resected gut was 22 cm. Post-operative recovery was smooth and oral feeding was resumed after a mean period of 48 hours. Of the eleven children with colostomy, 6 were older than 10 years with huge megacolon, and the remaining five had their colostomy done at the referring hospital. In 4 patients out of 42, naked eye assessment of the TZ and PDZ and their correlation with the x-ray features were not possible. In such situation, a few cm more of the proximal ganglionic gut from PDZ was resected. Three children out of 42 developed complications; postoperative enterocolitis in two and intra-abdominal bleeding from sigmoid mesocolon in one. There was no incidence of cuff abscess, anastomotic leak, retained segment, encopresis or constipation.Conclusion: The minimal invasive procedure TEPT involves less time with trifle morbidity and offers rapid recovery with shorter hospital stay. The functional outcome is also excellent with small complication rate. The naked eye correlation of the morbid features of rectum and colon in HPD with classical x-ray features is reasonably consistent and TEPT can safely be performed where frozen-section facility is not available.Birdem Med J 2014; 4(2): 84-87

scholarly journals Neonatal Abdominal Surgery, Our Experiences of 179 Cases

2019 ◽  
Vol 13 (2) ◽  
pp. 82-84
Author(s):  
Amal Chandra Paul ◽  
Md Kamrul Hassan ◽  
Md Mizanur Rahman Shibly ◽  
AA Chowdhury
Keyword(s):  
Abdominal Surgery ◽  
Postoperative Mortality ◽  
Oral Feeding ◽  
College Hospital ◽  
Term Survival ◽  
Female Ratio ◽  
X Ray ◽  
Medical College ◽  
Superficial Wound ◽  
Substantial Risk

This is a retrospective study carried out in the Department of Pediatric Surgery, Faridpur Medical College Hospital and in Dr. Zahed Children Hospital at Faridpur, during the period of May 2002 to may 2016. Total 179 neonates were treated by laparotomy for intestinal obstruction after clinical diagnosis and resuscitation. The male to female ratio was 4:5. Most of the patients presented within 02 -25 days of age. In all cases diagnosis was done on history, clinical examination and investigations. The investigations were plain x-ray abdomen in all cases and contrast x-ray upper GIT in 10 cases and enema x-ray in 11 cases and sonogram in 15 cases. Serum electrolytes were not estimated in all patients. There were 34 postoperative mortality. We did loop diversion for 81 cases those who were in potential risk to develop septicemia. Oral feeding started at 3rd postoperative day in diversion cases and 4th postoperative day in resection and end to end anastomosis cases. Superficial wound infection was encountered in 39 cases. Anorectal malformation, IHPS, Exomphaious, Gastroschisis were not included in this study. Long term survival of neonatal abdominal surgery are excellent, however patients have substantial risk to develop intra-abdominal complications. Faridpur Med. Coll. J. Jul 2018;13(2): 82-84

Reoperation for Hirschsprung Disease: Pathology of the Resected Problematic Distal Pull-Through

2012 ◽  
Vol 15 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Alexander Coe ◽  
Margaret H. Collins ◽  
Taiwo Lawal ◽  
Emily Louden ◽  
Marc A. Levitt ◽  
...  
Keyword(s):  
Transition Zone ◽  
High Power ◽  
Ganglion Cells ◽  
Frozen Section ◽  
Hirschsprung Disease ◽  
Postoperative Outcome ◽  
Surgical Removal ◽  
High Power Field ◽  
Pull Through ◽  
Poor Outcomes

Hirschsprung disease, which consists of aganglionosis of the rectum and sometimes more proximal bowel, requires surgical removal of the aganglionic bowel and creation of ganglionated neorectum using proximal normally innervated bowel. The border between aganglionic and ganglionic bowel is irregular; the transition zone features variable quantities of ganglion cells and numerous large nerves. We report the histopathology of pull-through bowel segments resected because of poor postoperative outcome from 30 patients (22 boys, 8 girls). The most common indication for reoperation was severe constipation/obstruction. Transition zone (bowel with at least two nerves ≥40 μm diameter per 400× high-power field, and ganglion cells) or aganglionic bowel (bowel with at least two nerves ≥40 μm per high-power field diameter, but without ganglion cells) was found in 19/30 (63%) resections. In colons resected because of familial adenomatous polyposis, rare high-power fields showed two enlarged nerves; the mean age of those patients (135 ± 49.4 months) was significantly higher than that of the patients undergoing redo pull-through surgery (67.9 ± 42.8 months). Additional pathology included stricture and enterocolitis. Although there are multiple causes for poor outcomes following surgical therapy for Hirschsprung disease, abnormal innervation of the bowel used for pull-through is common. We recommend that intraoperative consultation at primary pull-through procedure include frozen section evaluation of the circumference of the bowel to be used for pull-through to confirm histologically the presence of both ganglion cells and normal-caliber nerves. The criteria used in this study are most suitable for infants and young children.

scholarly journals Choledochal Cyst Coexisting with Gallbladder Carcinoma - An Uncommon Case Report

2017 ◽  
Vol 16 (4) ◽  
pp. 602-605
Author(s):  
Jahangir Hossain Bhuiyan ◽  
Mohibul Aziz ◽  
Omar Faruk ◽  
Mahbub Hasan
Keyword(s):  
Choledochal Cyst ◽  
Gallbladder Carcinoma ◽  
Medical Science ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Abdominal Ultrasound ◽  
Low Grade ◽  
College Hospital ◽  
Medical College ◽  
Operative Recovery

Choledochal Cyst is a relatively rare condition. Even rarer is a choledochal cyst in association with a gallbladder carcinoma. This study reports a rare case of choledochal cyst coexisting with gallbladder carcinoma in a Bangladeshi patient. A 35 year old lady presented at IBN Sina Medical College Hospital, Kallyanpur, Dhaka with the history of recurrent right upper quadrant abdominal pain from childhood, which became severe for last 4 days before admission. The pain was colicky in nature and radiated to the back. Episodes were associated with low-grade fever, anorexia as well as vomiting. The preoperative diagnosis was made by abdominal ultrasound and MRCP. Exploratory laparotomy, enbloc cholecystectomy with excision of the choledochal cyst and roux-en-Y hepaticojejunostomy was also done. Post operative recovery was uneventful. Patient was followed up for six months and no obvious complication was noticed. Early suspicion of this rare pancreato-billiary disease is important because surgical treatment is the only way to avoid the complications of the disease.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.602-605

scholarly journals Ewing's sarcoma of rib

2018 ◽  
Vol 50 (1-2) ◽  
pp. 41-43
Author(s):  
Sk Moazzem Hossain ◽  
Farjana Kabir ◽  
SM Kamal ◽  
Debasish Kumar Ghosh
Keyword(s):  
Pleural Effusion ◽  
Chest Wall ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Bone Tumour ◽  
Mass Lesion ◽  
College Hospital ◽  
X Ray ◽  
Medical College ◽  
First Rib

Ewing's sarcoma is an uncommon malignant bone tumour occuring in children, adolescents and young adults. We report a case of a 13 year old male admitted to Khulna Medical College Hospital with history of pain and swelling in chest wall for two weeks. Earlier chest X-ray showed a mass lesion in the left upper part of chest wall and erosion of first rib. Subsequent X-ray revealed left sided massive pleural effusion. CT scan revealed a mass lesion in the left upper part of chest wall originated from left first rib and left sided pleural effusion. FNAC from the mass lesion revealed features suggestive of Ewing's sarcoma. Patient was treated with chemotherapy and after first cycle there was significant improvement of all the signs and symptoms.Bang Med J (Khulna) 2017; 50 : 41-43

scholarly journals Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

2015 ◽  
Vol 4 (1) ◽  
pp. 11-18
Author(s):  
Tahmina Hossain ◽  
Md Ashraf Ul Huq
Keyword(s):  
Inguinal Hernia ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Oral Feeding ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
Laparoscopic Procedures ◽  
Surgical Conditions ◽  
Care Surgery

Purpose: Laparoscopy is gaining popularity over laparotomy in various surgical conditions. Now a day, an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically. The aim of this study was to assess the safety and feasibility of laparoscopy in children.Materials and Methods: This retrospective study was carried out in the Department of Pediatric Surgery of Dhaka Medical College Hospital over a period of 52 (Fifty two) months from June 2009 to August 2013. A total of 123 patients were operated laparoscopically up to 12 years of age for different surgical conditions. Data was collected from the hospital records and analyzed retrospectively.Results: Out of these 123 laparoscopically performed cases, Appendectomy was performed in 39 cases, closure of internal inguinal ring for Inguinal Hernia was done in 36 patients, 20 patients underwent Cholecystctomy, 16 patients had laparoscopic procedures for impalpable Undescended Testis (UDT), 5 patients were operated for Adnexal Mass of which one case was converted into open procedure due to technical difficulties and 1 for Pancreatic Pseudo cyst. Diagnostic Laparoscopy was performed for 2 patients with Biliary Atresia and 4 patients for Ambiguous Genitalia. Median age of the patients was 6.08 years (ranging from 2 months to 12 years of age). The length of post operative hospital stay was 2-3 days. All the laparoscopic procedures for Inguinal Hernia and impalpable UDT were performed as day care surgery. Operative and post operative complications were minimal. Other advantages of the laparoscopic procedures were smaller incisions, incidental diagnosis of other associated pathology, lesser post operative pain, earlier oral feeding, quicker mobilization and a better cosmetic result.Conclusion: With the recent development of laparoscopic surgical techniques and equipments, laparoscopic surgical procedures are becoming popular day by day and can be performed safely for both diagnostic and therapeutic purposes in pediatric surgical patients.J. Paediatr. Surg. Bangladesh 4(1): 11-18, 2013 (January)

scholarly journals Technique of neo-pharynx reconstruction with supra-clavicular artery island flap in a case of pharyngeal stricture

2021 ◽  
Vol 7 (5) ◽  
pp. 878
Author(s):  
Viresh Arora ◽  
Bhushan Kathuria ◽  
Madhuri Arora
Keyword(s):  
Myocutaneous Flap ◽  
Oral Feeding ◽  
Island Flap ◽  
Second Primary ◽  
Cutaneous Fistula ◽  
Regional Flap ◽  
Satisfactory Outcome ◽  
Supraclavicular Artery Island Flap ◽  
Limited Height

<p class="abstract">Pharyngeal stenosis frequently occurs after laryngectomy or laryngo-pharyngectomy, more commonly in patients complicated with a post-operative pharyngo-cutaneous fistula. Oral feeding becomes challenging, restricted to liquids. In such cases, dilatations can be futile if there is a complete stricture necessiating surgery. We present a case of 72 -year-old man who underwent total laryngectomy with partial pharyngectomy with pectoral major myocutaneous flap reconstruction for second primary of hypopharyngeal T3N0M0, after primary laryngeal T1N0M0 treated with RT presented with nearly 4 cm pharyngeal stricture causing him absolute dysphagia. Multiple dilations failed to create adequate passage, pharyngeal stricture was then excised, and a neopharynx was constructed with supraclavicular artery island flap. The outcome was uneventful with restoration of normal pharyngeal permeability and swallowing by 12<sup>th</sup> post-operative day. Post-operative follow-up after 8 months remained satisfactory. Resection of limited height pharyngeal stenosis can be successfully performed as end-to-end anastomosis whereas reconstruction of a long segment pharyngeal stricture utilizing a loco-regional flap gives satisfactory outcome.</p>

scholarly journals Surface Study of CuO Nanopetals by Advanced Nanocharacterization Techniques with Enhanced Optical and Catalytic Properties

Nanomaterials ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 1298 ◽  
Author(s):  
Muhammad Arif Khan ◽  
Nafarizal Nayan ◽  
Shadiullah Shadiullah ◽  
Mohd Khairul Ahmad ◽  
Chin Fhong Soon
Keyword(s):  
Photoelectron Spectroscopy ◽  
Catalytic Properties ◽  
Average Length ◽  
Tem Analysis ◽  
X Ray ◽  
Surface Study ◽  
Transmission Electron ◽  
One Step ◽  
Controlled Morphology ◽  
Xrd Patterns

In the present work, a facile one-step hydrothermal synthesis of well-defined stabilized CuO nanopetals and its surface study by advanced nanocharacterization techniques for enhanced optical and catalytic properties has been investigated. Characterization by Transmission electron microscopy (TEM) analysis confirmed existence of high crystalline CuO nanopetals with average length and diameter of 1611.96 nm and 650.50 nm, respectively. The nanopetals are monodispersed with a large surface area, controlled morphology, and demonstrate the nanocrystalline nature with a monoclinic structure. The phase purity of the as-synthesized sample was confirmed by Raman spectroscopy and X-ray diffraction (XRD) patterns. A significantly wide absorption up to 800 nm and increased band gap were observed in CuO nanopetals. The valance band (VB) and conduction band (CB) positions at CuO surface are measured to be of +0.7 and −1.03 eV, respectively, using X-ray photoelectron spectroscopy (XPS), which would be very promising for efficient catalytic properties. Furthermore, the obtained CuO nanopetals in the presence of hydrogen peroxide ( H 2 O 2 ) achieved excellent catalytic activities for degradation of methylene blue (MB) under dark, with degradation rate > 99% after 90 min, which is significantly higher than reported in the literature. The enhanced catalytic activity was referred to the controlled morphology of monodispersed CuO nanopetals, co-operative role of H 2 O 2 and energy band structure. This work contributes to a new approach for extensive application opportunities in environmental improvement.

scholarly journals Evidence for the stability of ultrahydrous stishovite in Earth’s lower mantle

2019 ◽  
Vol 117 (1) ◽  
pp. 184-189 ◽  
Author(s):  
Yanhao Lin ◽  
Qingyang Hu ◽  
Yue Meng ◽  
Michael Walter ◽  
Ho-Kwang Mao
Keyword(s):  
Transition Zone ◽  
Lower Mantle ◽  
Water Reservoir ◽  
Weight Percent ◽  
X Ray Diffraction ◽  
X Ray ◽  
Mineral Components ◽  
The Stability ◽  
Stability Of Water

The distribution and transportation of water in Earth’s interior depends on the stability of water-bearing phases. The transition zone in Earth’s mantle is generally accepted as an important potential water reservoir because its main constituents, wadsleyite and ringwoodite, can incorporate weight percent levels of H2O in their structures at mantle temperatures. The extent to which water can be transported beyond the transition zone deeper into the mantle depends on the water carrying capacity of minerals stable in subducted lithosphere. Stishovite is one of the major mineral components in subducting oceanic crust, yet the capacity of stishovite to incorporate water beyond at lower mantle conditions remains speculative. In this study, we combine in situ laser heating with synchrotron X-ray diffraction to show that the unit cell volume of stishovite synthesized under hydrous conditions is ∼2.3 to 5.0% greater than that of anhydrous stishovite at pressures of ∼27 to 58 GPa and temperatures of 1,240 to 1,835 K. Our results indicate that stishovite, even at temperatures along a mantle geotherm, can potentially incorporate weight percent levels of H2O in its crystal structure and has the potential to be a key phase for transporting and storing water in the lower mantle.

A study of NH3-N and P refixation by struvite formation in hybrid anaerobic reactor

2004 ◽  
Vol 49 (5-6) ◽  
pp. 207-214 ◽  
Author(s):  
J.J. Lee ◽  
C.U. Choi ◽  
M.J. Lee ◽  
I.H. Chung ◽  
D.S. Kim
Keyword(s):  
Removal Efficiency ◽  
Ammonia Nitrogen ◽  
Magnesium Ions ◽  
Nitrogen And Phosphorus ◽  
X Ray ◽  
Naked Eye ◽  
N Removal ◽  
Magnesium Salts ◽  
Main Components ◽  
P Removal

This research is concerned with the removal of ammonia nitrogen and phosphorus in foodwaste by crystallization. Reductions have been achieved by struvite formation after the addition of magnesium ions (Mg2+). Magnesium ions used in this study were from magnesium salts of MgCl2. The results of our analysis using scanning electron microscopy and energy dispersive X-ray analysis showed that the amount of struvite in precipitated sludge grew enough to be seen with the naked eye (600-700μm). EDX analysis also showed that the main components of the struvite were magnesium and phosphorus. NH3-N removal efficiency using MgCl2 was 67% while PO4-P removal efficiency was 73%. It was confirmed that nitrogen and phosphorus could be stabilized and removal simultaneously through anaerobic digestion by Mg, NH3 and PO4-P, which were necessary for struvite formation.

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