Aim:To investigate the correlation between the status of interstitial cells of Cajal (ICC) in ureteropelvic junction (UPJ) and the resected ureteric margin and the postoperative outcome of Anderson-Hynes pyeloplasty in UPJ obstruction (UPJO) and to compare the ICC in the UPJ and the resected margin of the normal ureter.Materials and Methods:An observational study was conducted over a period of 2 years at the Department of Pediatric Surgery at Niloufer Institute of Women and Child Health. Children with intrinsic UPJO who underwent Anderson-Hynes dismembered pyeloplasty were included in the study. Six months postoperatively, the patients were divided into two groups based on diuretic isotopic renogram using technetium-99m-labeled diethylene triaminepentaacetic acid. Group 1 comprised patients with good surgical outcome. Group 2 comprised patients with a poor outcome. The histologic specimens were evaluated for ICC, and the immunohistochemical findings were correlated with the outcome.Results:Twenty-five patients were included in this study (19 male and 6 female). Seventy-six percent of patients were under the age of 1 year. Group 1 had 23 cases and Group 2 had 2 cases. Out of the two patients with a poor outcome, one had negative grading at the UPJ and one had positive grading. Both these patients had a negative grading at the lower resected margins. More number of patients (24%) had +++ grading at the lower resected margin when compared to the UPJ (8%).Conclusion:This is the first study which correlates the status of ICC in UPJ with the outcome of pyeloplasty in pediatric patients. Both the cases with bad outcome had no ICC at the lower margin of the resected specimen and one case had no ICC at the UPJ. There is a statistically significant difference (P = 0.001) in the number of ICC at the UPJ and the resected margin.

BACKGROUNDImaging studies done in the postoperative Anorectal Malformation patients serve for the evaluation of the associated malformations and for the assessment of the causes for fecal incontinence including the complications of surgery. The objective of the study was to assess status of fecal continence in postoperative Anorectal malformation by correlating clinical evaluation with Magnetic Resonance Imaging (MRI) findings and to compare Kelly's score of continence with MRI scoring.

Background: Anorectal malformations (ARM) are one of the common congenital abnormalities in a pediatric surgical unit. Urological anomalies occur frequently with ARM and the incidence increases with increasing complexity of ARM having dramatic impact on quality of life. Aims and Objectives: This study is done with an objective to know the incidence of various urological anomalies in ARM and comparing our observation with existing literature. Materials and Methods: This is a retrospective study conducted in Pediatric Surgical unit, Gandhi Medical College and Hospital, Secunderabad, from January 2017 to December 2021 based on the records of 45 patients who were diagnosed to have ARM with urological anomalies. Incidence of urological anomalies in ARM is studied with respect to demographic data and pattern of coexistence. Results: Total number of ARM cases noted during the period of study was 101, of which 45 cases had associated urological anomalies and these 45 cases were taken in this study. The overall incidence of urological anomalies was 42.5%. The incidence of urological anomalies was significantly swelled up in high ARM when compared with low lesion. Vesicoureteric reflux and hydroureteronephrosis were the most common anomalies observed in our study. Conclusion: The high incidence of associated urological anomalies necessitates standardized protocol of investigating all ARM patients as it is an important cause of morbidity and mortality. Early diagnosis warrants timely intervention and prevents upper urinary tract deterioration.

Background: Malrotation commonly presents in neonates with bilious vomiting. It may also present in post neonatal age group with vague symptoms such as chronic abdominal pain, vomiting, and failure to thrive. These indistinct symptoms also result in delay of diagnosis. Aims and Objectives: This study is done with an objective to know whether age of presentation in malrotation determines morbidity and mortality. Materials and Methods: This is a retrospective study conducted in Gandhi medical college and Hospital, Hyderabad, from 2017 to 2020, based on the records of 50 patients who were diagnosed to have malrotation. The differences in clinical presentations, diagnosis, management, and outcomes were analyzed with respect to age. Results: Children who presented in neonatal period had classical symptoms (P<0.00001) and early diagnosis (P<0.0239). Children who presented later (>1 month of age) had higher incidence of atypical symptoms (P<0.00001) and delay in diagnosis (P<0.0239) compared to neonatal age group. Plain X-ray abdomen is readily diagnostic in neonatal age group (P<0.0004) and diagnosis was confirmed by contrast study, whereas in older children, plain abdomen X-ray findings were not always distinct and most of them needed contrast series to reach definitive diagnosis. The incidence of bowel gangrene and mortality was not statistically significant (P value of 1) between neonatal and post neonatal groups. Conclusion: In post neonatal age group, lack of classical presentation may lead to difficulty in diagnosing malrotation, but may not have significant difference in terms of morbidity and mortality. Considering malrotation early in differential diagnosis leads to timely intervention even in older age group children.

Teratomas are a conglomerate of heterogenous cells arising from totipotent germ cells. Cervical teratomas occur 1 per 20,000 to 40,000 live births constituting 1.6-9.3% of all paediatric teratomas. They can present antenatally with cervical mass or polyhydramnios and postnatally with respiratory distress and facial disfigurement. Complete excision of the tumour prevents malignant transformation. Timing of the surgery is based on severity of airway compromise. Surgical outcome and survival depend on pre-existing pressure effects, operative injuries to the vital structures and also co-existing comorbidities. One such complicated case of giant cervical teratoma is described here.