Pavai Arunachalam

A prospective comparison of tissue glue versus sutures for circumcision

Abstract.The safety of wound closure with tissue glue after surgery has been well established. The efficacy of its use in circumcision is poorly documented. The aim of this study was to carry out a comparative study of tissue glue versus suture closure after circumcision. The duration of the operative procedure, pain score, cosmesis and postoperative complications were evaluated. There were no complications in either group. There was no statistically significant difference in the pain score in both groups. However the mean time taken for tissue glue was 16.6 minutes and the mean time taken for sutures was 23.7 minutes. (p < 0.0001) which was statistically significant. The cosmetic appearance was found to be superior in the tissue glue group as there were no suture marks on the join of the shaft skin and foreskin base.

Recurrent plunging ranula

We report two cases of plunging ranula, which had recurred after marsupialization. Both were successfully treated by removal of the ipsilateral sublingual gland. A brief review of the literature regarding the treatment options is presented.

Kasabach-Merritt syndrome with large cutaneous vascular tumors

A case series of four patients who presented with large surface vascular tumors and low platelet count and their management is reported. Medical management was done with steroids, propranolol and vincristine in different combinations. The final response was excellent without surgery.

The use of ureteral stents and suprapubic catheter in vesicoureteric reflux surgery

The use of ureteric stents in reimplantation surgery is important. The younger the patient, the more important the stenting of ureters post reimplantation becomes, because even minimal oedema following surgery will produce ureteric obstruction unless stents are in place. JJ stents are now the preferred method of choice in ureteric reimplantation surgery, but in the past the patient required another admission to hospital and general anaesthetic to have the stents removed endoscopically. We describe a technique whereby the stents are attached to the suprapubic catheter and are therefore removed prior to the patient’s discharge from hospital, thus obviating the need for a second admission and second anaesthetic for the stent removal. We have studied 23 patients with this technique and find that it is a reliable and safe method to use.

Adenomatous hyperplastic polyp of the gall bladder associated with cholelithiasis in a child

Abstract. Polyps of the gall bladder are uncommon conditions in children. We present a case report of a 14-year-old girl who had calculous cholecystitis and an adenomatous hyperplastic polyp of the gall bladder. She was treated by laparoscopic cholecystectomy.

Classical cloacal exstrophy with intravesical phallus

Penile abnormalities such as epispadias, diphallia, asymmetry, and aphallia have been reported with cloacal exstrophy. The presence of intravesical phallus with cloacal exstrophy is presented with a review of literature.

Open and Endoscopic Management of Fourth Branchial Pouch Sinus - Our Experience

Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children. Methods The study involved performing a retrospective review of five cases in PSG Institute of Medical Sciences & Research. All cases were evaluated radiologically and with Direct Rigid hypopharyngoscopy. Definitive surgery was performed, including hemithyroidectomy. Results The patients consisted of five children, two boys and three girls. All of them presented with recurrent episodes of neck infection. Investigations performed included computed tomography (CT) fistulography, rigid hypopharyngoscopy and ultrasound, which were useful in preoperatively delineating pyriform sinus fistulous tract. All patients underwent neck exploration with excision of the fistulous tract and hemithyroidectomy. Upon follow-up, all patients are asymptomatic. Conclusions Recurrent neck abscesses in a child should alert the clinician to the possibility of a fourth branchial arch anomaly; therefore, children with this condition require a complete evaluation so the anomaly can be ruled out.

Congenital Melanocytic Nevi: Catch Them Early!

We report a 2-week-old neonate with a large congenital melanocytic nevus over face treated with surgical curettage followed by a combination of carbon dioxide laser and Q-switched neodymium-doped yttrium aluminum garnet lasers. The results were satisfactory with near complete resolution after 1 year of age. This case is reported to emphasize the timely management and the importance of curettage prior to development of rete ridges.

Accessory scrotum in the perineum.

A case of accessory scrotum in a 2-day-old male infant is reported because of its rarity. An overview of sequences during the normal development of male external genitalia has been provided and the deranged mechanism resulting in this anomaly has been reviewed with hypotheses regarding etiology of accessory scrotum.

Ex-utero intrapartum treatment in the Indian scenario: Anesthetic challenges and positioning.

Ex-utero intrapartum treatment (EXIT) is performed for fetuses diagnosed with large neck masses. A case report of a fetus diagnosed with a large cystic hygroma and cord around the neck who was delivered by EXIT is presented. The airway challenges and optimal positioning is discussed.