Gowri Shankar

Skip segment Hirschsprung’s disease: a case report and novel management technique

Abstract Skip segment Hirschsprung’s disease is a condition where an area of normally ganglionated intestine is interspersed proximally and distally by aganglionic segments. The occurrence of skip segment has no clear embryological explanation, contrary to the present concept of failure of cranio-caudal migration of neural crest-derived cells in Hirschsprung’s disease. Only 25 case reports have been published in literature so far and this is possibly the first to be reported from Asia. We report one such case with novel surgical management.

Complications of chemoport in children with cancer: Experience of 54,100 catheter days from a tertiary cancer center of Southern India.

Background: Chemoport is an essential part of the management of children with cancer and provides long-term venous access. There are few studies from resource poor countries reporting complications of chemoport. Aims: This study was aimed at describing the complications of chemoport in patients with cancer. Materials and Methods: This retrospective observational study analyzed 200 patients <15 years of age who underwent chemoport insertion. The medical records of these patients were reviewed for the patient characteristics, diagnosis, nature of port use, port-related complications and their management. Results: A total of 209 ports were implanted in 200 patients and 24 ports were removed due to port-related complications. There were 122 boys and 78 girls whose ages ranged from 4 months to 13 years (median age 2.5 years). About72% of patients were <2 years old. The cumulative duration of catheterization was 54,100 days. Of 209 ports, there were 36 complications that led to the removal of 21 ports. Port-related infection was the most common infection observed in our study (0.66/1000 catheter days and 11.9%). Mechanical complications were seen in 9 patients. Venous thrombosis and skin necrosis occurred in one patient each. Conclusions: Use of chemoport is safe and is a boon for children with cancer in developing countries with incidence of complications similar to Western countries. Although use of chemoport is associated with complications, they are easily managed. With stringent catheter care by trained personnel, some complications can be prevented.

Process Optimization on Hardness of Precipitation Hardened Al6061 Alloy using Design of Experiments

Aluminium is ranked after iron and steel in the metal market. Aluminium 6061 alloy has been selected by many designers and engineers for different kind of applications. Further, its strength can be improved by cold working, refinement of grains, precipitation and dispersion hardening. In this work, trials are conducted for the investigation of the effects due to age hardening parameters like, solutionizing time, temperature and time for aging on hardness of 6061 Aluminium alloy using Design of Experiments. The response is predicted by using linier regression model. From the results it can be perceived that, the ageing temperature and aging time have a substantial effect on the response whereas, solutionizing time does not have a significant effect. For a specific set of parameters the hardness is improved from 50 to 74 BHN, resulted in an increase in hardness by about 50%.

Ruptured rectal duplication with urogenital abnormality: Unusual presentation

Rectal duplication (RD) accounts for 5% of alimentary tract duplication. A varied presentation and associated anomalies have been described in the literature. Antenatal rupture of the RD is very rare. We present an unusual case of a ruptured RD associated with urogenital abnormalities in newborn male. We are discussing diagnosis, embryology, management and literature review of ruptured RD.