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Introduction: Colorectal carcinoma (CRC) accounts for <1% of all the neoplasms of children. Unfavorable histology and delayed diagnosis often result in poor outcome. This study aimed to investigate the clinical characteristic and prognosis of pediatric patients with CRC. Materials and Methods: A retrospective review of medical records of all patients diagnosed of CRC between 2015 and 2020 was performed. Data regarding gender, age, location, and histopathology were collected. Results: Seven children (5 males and 2 females) were included in the study. Age ranged between 8.6 and 11.8 years. Abdominal pain was the most common symptom. The duration between onset of symptoms to the diagnosis ranged from 5 days to 8 months. Right-sided tumors were more common than the left side. Histopathological examination showed mucinous adenocarcinoma in four/seven patients and signet cell variant was seen in 2/7. Immunohistochemistry was positive for cytokeratin and beta-catenin, however, all microsatellite instability markers were found negative. Despite surgical treatment and chemotherapy, four of our cases faced mortality and one patient was lost to follow-up. Conclusion: CRC can present in first decade of life and often misdiagnosed. Pediatric CRC has distinct tumor biology and shares a poor prognosis. Paucity of literature from the Indian subcontinent should urge further clinicopathological trials for establishing etiology and for refining treatment recommendations in these children.

Introduction: Incidence of pediatric urolithiasis has increased over the last few decades. Procedures such as extracorporeal short wave lithotripsy, percutaneous nephrolithotripsy, and ureterorenoscopic lithotripsy are not widely available for pediatric age group in many developing countries. It is desirable that advantages of minimally invasive surgery be offered to selected cases with urolithiasis. Materials and Methods: All patients with pediatric upper tract urolithiasis managed laparoscopically from January 2015 to April 2020 were retrospectively reviewed. Results: A total of 38 patients were included. The mean age of the patients was 8 ± 2.85 years. Thirty-four patients (renal and upper ureteric) were managed through retroperitoneal approach, while those with lower ureteric calculi (n = 4) were approached transperitoneally. A total of eight patients required conversion to open technique. The stone clearance rate was 79% by laparoscopic approach alone. There were no procedure-related complications. Conclusion: Our study suggests that laparoscopic management for pediatric upper tract urolithiasis is a radiation-free, single-time curative treatment and is feasible in centers where facilities for other endoscopic procedures are unavailable.

Introduction: Prostatic utricles (PUs) are the remnants of Mullerian ducts found in the male posterior urethra. Enlarged symptomatic utricles are known to be associated with hypospadias. There is a dearth of literature defining an enlarged utricle and also its clinical significance. Aims: The aim of this study was to describe anatomical difference of PUs of cases with severe hypospadias and also to find their clinical significance if any. Materials and Methods: A prospective study was carried out, and all patients with proximal hypospadias were enrolled. Cystoscopy was performed in all cases. Symptomatology, size, and location of PU were recorded. PU of >0.5 cm was considered enlarged. Results: In the present series, a total of 70 cases were included over a period of 2 years. Enlarged utricle was found in 47/70 (67.14%) on cystoscopy. They were wide-mouthed and negotiated 9 Fr/11 Fr cystoscope with ease. Recurrent epididymo-orchitis, recurrent urinary tract infection, and obstructive features were the most common complications requiring intervention. Conclusions: PUs in boys with hypospadias are enlarged as well as wide-mouthed. Most of these remain asymptomatic, but few of them carry the potential of complications. Cystoscopy helps in direct visualization of utricular anatomy, so it should be a preferred investigating modality for investigating a PU.

Grossly, the appendix was gray-white, pale, edematous, and friable [Figure 1]a. Histopathological examination showed mucosal ulceration along with extensive areas of transmural inflammation and focal enzymatic necrosis with nuclear debri [Figure 1]b, [Figure 1]c, [Figure 1]d. Numerous trophozoites of Entamoeba histolytica were seen within the lumen as well as invading the muscular layer of the appendix [Figure 2]a. Many of these showed erythrophagocytosis [Figure 2]b. At places, the trophozoites were seen infiltrating into the small vessels as well [Figure 2]c. Periodic acid–Schiff stain highlighted the trophozoites. [1],[2] On literature review, reported mean age is 23.5 years with fewer than five cases in children ([3] The exact cause of inciting appendicitis in parasitic infestations is not clear because the vast majority of these cases (80%) are asymptomatic in endemic regions. Complications such as perforation, liver abscess, abdominal sepsis, fulminant colitis, and colonic fistulae have been reported more commonly in amoebic appendicitis (25.4%–30.7%) as compared to nonamoebic appendicitis (1%–5%).

Background: Mortality in surgical neonates contributes to neonatal mortality rates. The study was conceptualized to study clinical and nonclinical factors affecting mortality in surgical neonates so that timely intervention could result in improved survival of the neonates. Materials and Methods: The study was initiated after approval from the institutional ethics committee and included 120 surgical neonates over a period of 18 months after obtaining consent from the parents/caregivers. Predesigned pro forma was used to record the details of antenatal care received, place of birth, travel history, maternal education and gestational age, and clinical condition at the time of admission. Values of biochemical tests such as serum electrolytes, serum creatinine, and arterial blood gasses were recorded. The need of inotrope support, blood or blood product transfusion, and postoperative ventilator support and intensive care unit (ICU) care was recorded. The results of the two groups, i.e., survivals and mortality, were compared. Outcome was recorded as mortality at 30 days or earlier. Results: Irrespective of the surgical condition, the survival rate was significantly better in those babies who weighed more than 2.5 kg at the time of admission, had capillary refill time of <3 s, had serum ionized calcium levels more than 1 mmol/L, and did not require inotropes, blood or blood product transfusion, and postoperative ICU care and ventilator support. The place of birth, educational status of the mother, gestational age, and distance traveled for care had no statistically significant effect on survival. Conclusion: There is a statistically significant correlation between the survival of the babies who weighed more than 2.5 kg and are more physiologically preserved at the time of admission. Mortality rates can be decreased by timely interventions to reduce the need of inotropes, blood or blood products, and ICU care and ventilator support during their postoperative recovery.

Renal cholesteatoma or keratinizing desquamative squamous metaplasia is infrequent in adults and rare in children. We report a case of renal cholesteatoma in a 4-year-old male child who was referred to us as a case of multiple renal calculi with hydronephrosis. We also discuss his management with a review of relevant literature.

Foreign body ingestion is common in infants and young children and they pass spontaneously in most of the cases. Magnetic foreign bodies, though not very common, require early intervention to avoid severe gastrointestinal complications. We report a case of multiple magnet ingestion who presented with peritonitis.

Objective To assess the long-term urinary continence of patients operated for isolated female epispadias using novel approach of distal urethral lengthening along with the incorporation of deeper periurethral muscles over the native urethra. Occurrence of UTI and stress incontinence too were assessed as secondary outcomes. Methodology All girls diagnosed with isolated female epispadias, who underwent epispadias repair, and completed follow-up period of minimum 2 years, were included in this study. Their long-term continence was assessed using a validated questionnaire. The study group patients underwent distal urethroplasty using hairless skin of mons along with incorporation of deep periurethral tissue. Bladder neck reconstruction was added in initial patients with minor variant (type 2 of Davis classification) and in patient with cleft extending till bladder neck (type 3 of Davis classification). Five of the patients with type 2 defects were managed only with urethroplasty. Results At a mean follow up of 7.4years all patients with type 2 epispadias (Davis classification) are continent and void on desire. None of them are having UTI or stress incontinence. Patient with type 3 epispadias is incontinent with dry interval of less than 30 min and awaiting augmentation cystoplasty. Conclusion Simple urethral reconstruction with inclusion of hairless skin over mons and deeper peri-urethral soft tissue might be sufficient to restore sphincteric function in minor variants of isolated female epispadias. More extensive procedures may be reserved for the most severe cases.

Key Clinical Message To rule out underlying developmental brain defects such as schizencephaly, pediatric seizures necessitate a thorough examination. Adults who receive a diagnosis later in life may face severe management and prognosis difficulties. To avoid underdiagnosis of developing brain abnormalities, imaging should be a part of the workup for pediatric seizures. Imaging is critical to the diagnosis and therapy of such cases. Closed‐lip schizencephaly with the absence of the septum pellucidum is a rare congenital malformation of the brain that can be associated with a variety of neurological conditions. We report the case of a 25‐year‐old male with left hemiparesis who presented with recurrent seizures from childhood, poorly controlled with medications, and increased tremors. He has been taking anticonvulsant for the last 7 years and is under symptomatic management. Magnetic resonance imaging of the brain revealed closed‐lip schizencephaly with absent septum pellucidum. Normal MRI at the level of optic nerve.