Background: Circumcision is a widely performed surgical procedure. Though it is a simple operation, oftentimes a number of complications are encountered. Among them post-circumcision pain and bleeding are of paramount concern. These may cause apprehension in the parents as well as in patients. Surgical procedure of circumcision should, therefore, be pain-free and devoid of complication as much as possible.Methods: In this prospective randomized doubnle blind observational study, we had compared two commonly practiced technique of circumcision and evaluated the outcomes in regard to post circumcision pain and complications, and overall cosmesis. The study was carried out in 100 boys randomly allocated in two groups from July 2016 through June 2017.Result: The results revealed that the modified sleeve method in which the frenular artery of penis was preserved was associated with significantly less post circumcision pain and fewer complications. In addition, boys who underwent modified sleeve method exhibited better overall cosmesis.Conclusion: It could be reasonably inferred that preservation of frenular artery during circumcision reduces post circumcision pain and complications and provides better cosmesis.Birdem Med J 2018; 8(2): 145-150

The traditional practice of post operative starvation after gut resection and primary anastomosis has been recently challenged. Contrary to wide spread opinion, evidence from clinical studies suggest that initiating feeding early is advantageous in postoperative patients. Various clinical trials have shown that early enteral feeding helps in the reduction of post operative ileus, anxiety and hospital stay. The purpose of this study was to compare the effects of early and traditional feeding, and was conducted among patients who underwent gut resection and primary end to end anastomosis. The study population (n=50) was divided into two arms. Arm-A (n=25) was given feeding after passage of flatus, stool when bowel sound was present, usually within second to fourth post operative day. Arm-B (n=25) was given early enteral feeding, started within 16-24 hours, in the first Post operative day (POD) after removal of the naso gastric tube. There were no statistically significant variations in age, sex, bodyweight, average hemoglobin level, antibiotics, and suture materials used in both arms. Post operative hospital stay was 9.09 days in Arm-A and 5.42 days in Arm-B. It was significantly low (P < 0.05) in Arm-B. The complications after operation were also low in Arm-B. Early enteral feeding can help to decrease the negative impact of the metabolic response to injury. It also stimulates restoration of the barrier functions of the intestine, improve the return of the functions and reduce the duration of post operative ileus and hence reduce the risk of serious complications.DOI: http://dx.doi.org/10.3329/jpsb.v2i1.15142 Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 7-11