Introduction: Patients with congenital neonatal intestinal obstruction are the main bulk of neonatal surgical departments. The incidence is approximately 1 in 1500-2000 live birth. Commonly caused by anorectal malformation (ARM), intestinal atresia, hirschsprungs disease (HD), meconium ileus, malrotation of gut, volvulus neonatorum, necrotizing enterocolitis (NEC) and rarely bands adhesion. These patients presented with vomiting, gradual abdominal distension and delayed or no passes of meconium. Usually, an abdominal radiograph is all that is necessary to make the diagnosis, since the gas pattern is distinctive and often will be a clue to the site of obstruction. The aim of the study is to detect the type of congenital neonatal intestinal obstruction, initial surgical approaches, and their outcome in our hospital. Materials and methods: This is a retrospective study conducted at the division of pediatric surgery in Bangladesh Shishu hospital & institute, Dhaka, Bangladesh. The study period was 2 years from January 18 to December 19. All the neonates who underwent surgery for congenital neonatal intestinal obstruction were included. In this study only initial diagnosis, surgical procedure and outcome were included. Results: Our surgical department operated on a total of 246 neonates with congenital neonatal intestinal obstruction during this study period. Out of them, 139(56.50%) patients were male and 107 (43.50%) were female. The male-female ratio is 1.3:1. Gestational age was varied from 31 weeks to 40 weeks (Mean 36.2 weeks). Birth weight was from 1300 gm to 3800 gm (mean 2100gm). The most common cause of intestinal obstruction was ARM 72(29.27%), followed by hirschsprungs disease 53(21.54%), atresia 41(16.67%), meconium ileus 37(15.04%), malrotation of gut 28(11.38%) and other like bands adhesion, etc 15(6.09%). In case of atresia ileal atresia was common 16(39.02%) then jejunal 13(31.70%) and duodenal 9(21.95%). Only 3(7.31%) colonic atresia was found. ........

Introduction: Burn is a complex disease process, a trauma to physique as well as psyche. Visible disfigurement caused by burns translates into an altered pattern of socialization which in turn can have serious psychological ramifications. Patients with burns require immediate specialized care in order to minimize morbidity and mortality. So, the important part of the management of burns is wound management. Objectives: To assess the efficacy of topical heparin and silver sulfadiazine cream in burn wound management. Methods: Prospective comparative interventional study was carried out at the Department of Burn & Reconstructive Surgery, Faculty of Paedicatric Surgery, Bangladesh Shishu Hospital and Institute. A total 42 patients were included in this study after fulfilment of all selection criteria during the study period. Patients were randomly selected into two groups. In group A (n=21) patients were treated with topical heparin and in group B (n=21) patients were treated with silver sulfadiazine cream. Results: The mean pain relief time was 1.76±0.54 days in group A and 5.52±0.98 days in group B. The difference was statistically significant (p<0.05). The mean wound healing time was 4.62±0.86 days in group A and 8.0±1.97 days in group B. The difference was statistically significant (p<0.05). The mean hospital stay was 5.57±0.75 days in group A and 8.10±1.97 days in group B. The difference was statistically significant (p<0.05). Conclusion: Topical use of heparin is safe and more effective than silver sulfadiazine cream in the management of second-degree burns in children.

Background: Posterior sagittal anorectoplasty (PSARP), popularized by de Vries and Peña has become the standard technique for the management of anorectal malformations (ARM). Before 1980, the anatomy of these defects was not known, and the surgical procedure involved several blind steps. In the posterior approach, surgical exposure became available and exposure to the anatomic features of these defects has led to a better understanding of the basic anatomy of ARM. Objectives: To evaluate the early postoperative outcome of posterior sagittal anorectoplasty for high and intermediate variety anorectal malformation. Methods: Quasi experimental study was carried out in the Faculty of Paediatric Surgery, Bangladesh Shishu Hospital and Institute. A total 15 patients were included in this study after fulfillment of all selection criteria during the study period. In this study, 11 (73.3%) patients were intermediate variety and 4(26.7%) patients were high variety anorectal malformation. Results: This study showed that only 1(6.7%) patient had wound infection and wound dehiscence. Total 8 (53.3%) patients had 1-5 bowel movement per day with 07(46.7%) patient had no soiling. 07(46.7%) patients had no constipation and 8(53.4%) patient had constipation. Among the constipation patient, 7(46.7%) were managed by changing diet and 1(6.7%) were managed by laxative. Conclusion: Constipation is the major complication after posterior sagittal anorectoplasty but in experts’ hands, till now, it is a good option for high and intermediate variety anorectal malformation.

Background: In the absence of any postnatal trauma, birth fractures are those that are identified within the first week of life. Infant birth-related injuries are generally infrequent and are caused by trauma during delivery, especially when the infant is particularly large or presented breech. Methods: This investigation was a retrospective cross-sectional study carried out at Bangladesh Shishu Hospital & Institute, Dhaka, in the department of Burn & Reconstructive Surgery. The study was carried out between June 2015 and July 2020. The study used a 21 neonates as sample basis. Result: In this retrospective study, the gestational age of 1 patient was 35 Weeks and followed by two were 36 weeks, 4 were 37 weeks, 6 were 38 weeks, 5 were 39 weeks, and 3 were 40 weeks. 11(52%) were female and 10(48%) were male. Majority 13(62%) patients fracture were right site and 8(38%) were left. 13 newborns, or 61.9% of them, were weighted ≥2500 g. Nine infants (42.9%) were delivered vaginally, while 12 (57.1%) underwent Caesarean sections. When the fetus was presented, it was cephalic in seven cases (33.3%) and breech in fourteen (66.7%). Depending on the fracture's location and angulation, the appropriate treatment option was chosen. Femoral shaft fractures were treated in a toe-groin cast, 5(23.8%), while subtrochanteric fractures were treated by strapping 16(76.2%) of the thigh to the abdomen. Conclusion: Even though femoral fractures now are uncommon, but after birth they should be watched for, especially in challenging caesarean sections.

Background: Children are mostly affected in burn injury at our country like other low and middle income countries (LMICs). Approximately 90% of the burns occur in under developed countries, which generally lack the necessary infrastructure to reduce the incidence and severity of burns. Objectives: This study was done to investigate the pattern of burn cases admitted to Dhaka Shishu (Children) Hospital (DSH). Methods: This was a retrospective study conducted over the period of one year from January 2019 to December 2019 at Dhaka Shishu (Children) Hospital, Dhaka, Bangladesh. The data was collected from the patients record section of the hospital. Patients characteristics (e.g. age, sex), causes and severity of injury, outcome, hospital stay and seasonal variation were analized in this study. Results: A total of 91 patients were admitted during study period of one year. This study consisted of 53 male patients (58.24%) and 38 female patients (41.76%) with male to female ratio of 1.3:1. The most frequently hospitalized burn patients were in the age group 3-5 years, which accounted for 30.77% of patients. Burns were more common during winter season followed by autumn season, with 43 cases (47.25%) and 18 cases (19.78%) respectively. The highest number of admissions was during the month of December. Scald burn was the most common cause of burn injury in our study which accounted for 83 cases out of 91 cases (91.2%). Flame burn occured in 3(3.29%) patients. There were 2 cases of electric burn and 2 cases of contact burn during this study period. One patient was with chemical burn. Scald burn was the most common cause of burn injury in this study which accounted for 83 cases out of 91 cases (91.2%). Flame burn occured in 3(3.29%) patients. There were 2 cases of electric burn and 2 cases of contact burn during this study period. One patient was with chemical burn. Conclusion: The most frequently hospitalized burn patients were in the age group 3-5 years and more common during winter season. Most of the burn occured in children are scald in our country due to accidental fall of worm liquid. Superficial epidermal and dermal burns are treated conservatively, but deep burns may require surgical treatment. DS (Child) H J 2020; 36(2): 134-137