Background: Constipation is a worldwide problem among children. Functional constipation (FC) is the most common type of chronic constipation in children comprising 95% of them.Objectives: To study the socio-demographic characteristics and risk factors of FC in children. Method:This was a single centre, case-control study; 165 patients, ages ranging from early infancy to 17 years, who were suffering from FC were recruited for six months and they were age and sexmatched with 165 healthy controls. Using a questionnaire, data were gathered from those individuals and their caregivers regarding sociodemographic characteristics, dietary history, psychological insults, family history and socioeconomic status. All patients were examined abdominally and rectally.Results: Mean age of patients under study was 3.7 ± 3.3 years, and males were more affected than females. The male to female ratio was 2.3:1. The mean age at onset of the development of constipation among our cohort was 2.3 years. Male gender, prematurity, low birth weight, formula feeding during infancy, low fibre diet, positive family history of constipation, low socioeconomic status and illiteracy of the mother were all risk factors of FC and the association was highly significant. There was no association between type of residency or bodyweight with risk of FC. Fear of using the toilet was the most common underlying psychological insult. Hard stool was the most frequent presentation of our cohort followed by _________________________________________

Background A prospective study was conducted on 65 cases with distal hypospadias operated using the urethral mobilization technique between July 2017 and December 2019. Patients with proximal hypospadias and those with distal hypospadias, but with a hypoplastic urethra, were excluded from the study. In this technique, the urethral tube was mobilized proximally in a ratio of 3–4:1 (the ratio of mobilized urethral length to the initial distance between the native meatus and the tip of the glans) then positioned distally after creating wide glans wings. The aim of this study was to assess the outcome of the urethral mobilization technique in distal hypospadias in our center. Results The age of patients was ranged 9 months to 7 years old (mean 37.5 months); 17 (26%) cases were already circumcised. During the postoperative follow-up, 62 (95.4%) patients had a good caliber neomeatus with a good and straight urinary stream; the remaining 3 (4.6%) cases developed meatal stenosis which responded well to urethral dilatation. One (1.5%) patient had a minor retraction of neomeatus but remained within the glans and not requiring further intervention. Four (6%) cases developed minor hematoma which was resolved on conservative measures. Six (9.2%) patients developed minor wound infection which was treated with daily dressing and antibiotic coverage. Conclusion The urethral mobilization technique is a good choice for repairing distal hypospadias especially for boys who are previously circumcised as the preputial flap is not required in this technique. It provides good cosmetic and functional results, with a fewer complication rate.

Background: Neonatal tumors comprise about 2% of all pediatric malignancies, with neuroblastoma having the highest incidence. Neuroblastoma involving the adrenal medulla and sympathetic ganglia is the most typical scenario in infancy, while the pelvic variant is rare. We report this case because of the unusual and rare presentation of neuroblastoma in a newborn baby mimicking sacrococcygeal teratoma. Case Presentation: A newborn male baby presented with a firm sacral mass, about 5 x 7 cm, with normal overlying skin. MRI revealed an intrapelvic mass extending to the sacral region encasing the coccyx. After preparation, complete tumor excision was performed, and the diagnosis of neuroblastoma was confirmed by histological and immunohistochemical study. Conclusion: Primary neonatal neuroblastoma presenting as a sacrococcygeal mass is a rare and atypical clinical finding of neuroblastoma. It is hard to diagnose this sort of tumor preoperatively unless the mass is subjected to histological and immunohistochemical analysis after tumor excision.

Background: H-type rectourethral fistula is a rare variant of anorectal malformation that affects male neonates. It is usually associated with anal stenosis but with a normal anal position and shape, so it is difficult to be diagnosed early after birth. We present this case to evaluate the functional outcome of this rare anomaly in a male patient and compare it with other reported cases with different ages at diagnosis. Case Presentation: A nine-month-old infant presented with recurrent attacks of urinary tract infection and failure to thrive. After proper evaluation, the diagnosis of an H-type rectourethral fistula with anal stenosis was confirmed, and a diverting double-barreled colostomy was performed as an initial procedure. Posterior sagittal anorectoplasty with ligation and division of fistula was successfully done, followed by colostomy closure. Now the patient is five years old and is continent for urine and stool. Conclusions: The diagnosis of H-type rectourethral fistula with anal stenosis is challenging to physicians, and a high index of suspicion is required to reach the diagnosis as the anal opening had a normal shape and location. If this condition is diagnosed and treated early, these patients will have an excellent functional prognosis, as the muscle complex and anal sphincter are well developed.

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