Background: Primary vesical stones are common in children in underdeveloped and developing countries. The treatment options available for managing bladder calculi include transurethral cystolithotripsy, open cystolithotomy and shock wave lithotripsy (SWL). Although the majority of vesical calculi in adults can be treated by transurethral lithotripsy, this procedure is restricted in children due to the narrow caliber of the urethra. For this reason, percutaneous cystolithotripsy (PCCL) is a good choice as a safe and effective method for the treatment of bladder stones in children. Aim of the Study: The study was aimed to evaluate outcome of PCCL in pediatric population coming with vesiculolithiasis in our center. Materials and Methods: Pediatric age group patients diagnosed as vesical calculus were undertaken for PCCL. Ten patients who presented between November 2014 to December 2015, were included. The procedure was done under general anesthesia. After performing cystoscopy, suprapubic puncture was made and tract dilated upto 26 Fr. Nephroscope was used for visualization and pneumatic lithotripsy for fragmentation of the stone followed by removal of st nd all fragments. Perurethral and suprapubic catheters were placed at the end to be removed on 1 and 2 post operative day, respectively. Results: Median age of the patients was 5.5 (3-13) years. Majority were male patients from hilly region of western Nepal. Mean stone size was 15 mm. All patients were rendered stone free with average operative time of 32.2 minutes. Except one minor complication of mucosal injury patients were discharged after mean hospital stay of 3.9 days. Conclusion: Percutaneous suprapubic lithotripsy is a safe and effective method for the treatment of bladder stones in children. It is fast and associated with negligible complications.

Background: Resection and anastomosis of small bowel is one of the common surgical procedure encountered in routine and emergency cases. There are various techniques of anastomosing the resected intestine. Objectives: To know the efficacy of single layer anastomosis over double layer anastomosis in terms of anastomotic leakage, wound infection, mortality and time consumed. Methods:A comparative cross sectional analytical study was carried out at department of General Surgery at Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal from January 2013 to December 2013. Altogether 62 patients who underwent resection and anastomosis of small bowel were considered for this study . Patients who were included in this study were equally divided into two groups. Group A (n=32) underwent single layer anastomosis and group B (n=30) were subjected to double layer anastomosis. In both the groups anastomotic leakage, wound infection, mortality and time consumed were recorded and compared. Results: Altogether 62 patients were included in the study. The study showed anastomotic leakage 3 (9.37%) in Group A and 2 (6.67%) in Group B. Wound infection was 6 (18.75%) in Group A and 4(13.33%) in Group B and mortality was observed in only 1(3.12%) patient in Group A due to uncontrolled sepsis. There was no statistical difference between the two groups in anastomotic leakage, wound infection and mortality as shown by respective p (0.696, 0.562, 0.329) values. However the time required for single layer bowel anastomosis was less in comparison to double layer bowel anastomosis. Conclusion: Based on our data, the technique of single layer of bowel anastomosis does not increase the rate of anastomotic leakage, wound infection and mortality however time required for anastomosis is less as compared to double layer anastomosis. Therefore this study concludes that there is no added benefit of double layer of anastomosis over single layer bowel anastomosis.

Introduction: Electrocautery has been widely used except for the skin incisions; this is because of the fear of scarring of skin, post operative pain, poor wound healing and wound infection in view of devitalisation of tissues. Although still not very popular, yet the use of diathermy instead of scalpel for making skin incision and underlying tissue dissection is gradually gaining wide acceptance. The purpose of this study was to compare the scalpel incision with electrocautery incision over skin in patients undergoing hernia repair. Aims and Objectives: To compare the skin wound made by the diathermy and scalpel with a view in; intraoperative incisional time, post operative pain, requirement of analgesia and the quality of wound healing. Material and Methods: This is hospital based comparative study, undergone elective inguinal hernia repair in the department of general surgery at Nepalgunj medical college teaching hospital, Kohalpur from the period of July 2015 to January 2016. Group A, contained 30 patients who underwent skin incision with scalpel and Group B, also contained 30 patients who underwent skin incision with electrocautery. These groups were compared and statistical analysis using SPSS (version 20) was done and p value 0.05 was taken as significant. Results: Compared with a scalpel incision, cutting diathermy resulted in significantly shorter incision time (p <0.002). The two groups did not differ in relation to post operative pain and the post operative analgesics requirements. The postoperative complications viz, seroma and purulent collections were in both the groups though the hematoma collection was seen more in scalpel skin incision. Conclusion: Skin incision made by cutting diathermy was less time taking and there was no appreciable differences in postoperative pain, the requirements of analgesia and the rate of wound complications like seroma, and purulent collection, though the hematoma was seen more in scalpel skin incision. So the use of diathermy for making skin incision is as safe as the use of scalpel in patients undergoing inguinal hernia repair.

Introduction: Face and neck burn deformity is the most common deformity after deformity of hand. Flame burn and chemical burn are the common causes for the all types of burn contractures. Burn contractures involving the anterior neck represent a surgical problem for the Plastic surgeons. Objective: To evaluate the outcome of patients who underwent reconstructive surgery for face and neck burn deformity. Materials and method: The study was conducted in the department of surgery in plastic surgery unit, NGMC between February 2013 to June 2015. During this period 36 patients underwent reconstructive surgery. Result: In 36 patients, there were 12 males and 24 females. The age of patients ranging from 11 years to 56 years. The overall results were satisfactory in 34 cases and not satisfactory in 2 cases, The clinical satisfaction degree was 94.44% in overall evaluation. The average follow up period was from 3 months to 1 year. Conclusion: Among the different types of contractures, neck contractures are also very frequently treated. Common surgical procedure is release of contracture and application of skin graft, the other techniques are applied like expanded or without expansion island flaps, free flaps. Finally the main objective of the different surgical approaches is to obtain the better functional and aesthetical result.

Not available.