Introduction: Birth defects are one of the most common causes of disability in developed and developing countries. Birth defects are structural or functional anomalies, including metabolic disorders, which are present at the time of birth. Although the worldwide incidence of birth defects is estimated at 3-7%, the rate varies widely between countries. In this paper, we categorized the birth defects most commonly seen in Bangladesh and their outcome. We hope to use this information to guide the strategies used to manage these problems. Materials and Methods: This hospital based, descriptive study was done in the Department of Pediatric Surgery in Chittagong Medical College and Hospital from January 2008 to December 2012. Records of all patients with birth defects in our hospital and departmental database were reviewed. Types of birth defects, age, sex, surgery performed and outcome were analyzed in patients admitted during this period. Data were analyzed by SPSS 17. Statistical analysis was performed by the chi-square test and mean and percentage values were calculated. P<0.05 was considered to be statistically significant. Results: During this five year period, there were 5661 patients of birth defects admitted in this department. Of these, 5156 had a single congenital anomaly and 505 had multiple congenital anomalies. The male to female ratio was 2.1: 1. Birth defects comprised 44.61% of all Pediatric surgical admissions and 0.90% of total hospital admissions. The gastrointestinal system was the most common organ system involved, followed by the genitourinary system. Inguinal hernias were the most common gastrointestinal abnormality and hypospadias were the most common genitourinary case. A total of 3921 operations were performed for birth defects, representing 69.26% of total admission for birth defects. Most operations were done for gastrointestinal and genito-urinary defects. Inguinal herniotomy was the most commonly performed operation followed by laparotomy for various indications. There were 225 deaths for birth defects. While this is only 3.97% of all admissions for birth defects, this represents 51.49% of all (pediatric) deaths during the study period. The most common cause of death was anorectal malformations followed by gastroschisis. Conclusion: The study helps assess the burden of birth defects in the Bangladeshi society. There is a need for more extensive, nationwide screening studies to determine the birth prevalence, types and distribution of birth defects in Bangladesh.

Objective: The aim of the study is to evaluate the role of spongiosal tissue with dartos flap coverage for preventing Urethrocutaneous Fistula (UCF) formation in the Snodgrass technique. 19 patients, shallow in 13 patients and no groove noticed in 3 patients. Sixteen patients had narrow urethral plate (<8mm) and 19 patients had adequate urethral plate (>8mm). patients (14.28%), meatal stenosis in two patients (5.71%), and partial glanular dehiscence in one patient. Materials and Methods: It is a prospective study, performed on 35 patients of mid penile and distal hypospadias aged 15 months to 144 months who underwent urethroplasty in the Snodgrass technique using spongiosal tissue and dartos flap for neourethral coverage. Results: Among 35 patients, Age ranged from 15 months to 144 months (mean 85.94 months). Chordee was corrected by penile degloving alone in 11 patients, partial mobilization of urethral plate with spongiosum in 20 patients and 4 patients required dorsal plication. Glans groove was deep in Urethrocutaneous Fistula (UCF) was encountered in five Conclusions: Approximation of spongiosal tissue along with dartos flap as the intermediate layer for neourethral coverage reduces fistula formation.

Objective: The aim of this study was to evaluate the efficacy and complications of different techniques in the treatment of choledochal cyst in children.Materials and methods: Data was collected retrospectively from 32 patients with choledocal cyst (type I), managed in the

Background: Urethrocutaneous fistula is the most prevalent complication after urethroplasty. Many methods have been developed for correction, and the best technique is determined based on the size, location, and number of fistulas, as well as the status of the surrounding skin. Objective: To compare the outcome of local dartos flap and tunnelled tunica vaginalis coverage in cases of repair of urethrocutaneous fistula. Materials and Methods: In the period of 2015-2018, 51 patients with 51 fistulas with an average age of 81.3 months (range 21-156 months) were classified into coronal-19, distal penile-11, mid penile-14, proximal penile-5 and penoscrotal-2. Thirty six patients were repaired with local dartos flap coverage and 15 patients were repaired with tunnelled tunica vaginalis coverage. Results: The repair was successful in all patients of tunica vaginalis coverage but 7 patients of dartos flap coverage developed recurrent fistulas (p value 0.066). There was no patient of scrotal complications. There were no statistically significant differences regarding age (p=0.83), location of fistula (p=0.40), size of fistula (p=0.29). Conclusions: Though the result of this study with such a small sample was not statistically significant, tunica vaginalis coverage seems to be better than dartos flap coverage in preventing recurrence. Bang Med J (Khulna) 2019; 52 : 3-6

Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of gastric outlet obstruction in infants with a prevalence of 1.5 to 4.0 per 1000 live births. It has been suggested that the incidence is increasing. USG is the most useful method for diagnosis supplanting physical examination and pyloromyotomy is the time honored treatment option. A retrospective review of the patients of IHPS admitted in the department of Pediatric Surgery, Chittagong Medical College Hospital (CMCH) Chittagong, Bangladesh from January 2008 to December 2012 was done. Help was also taken from yearly departmental audits of 2008 to 2012. Data were analyzed with regard to occurrence, seasonal variation, gender variation, presentation, diagnosis, treatment and outcome. Statistical analysis was performed by the chi-square test, and mean and percentage values were calculated. P<0.05 was considered to be statistically significant. There were 42 patients of IHPS. Age range was 5 days to 1 year 8 months with mean age of 79 days. Male to Female ratio was 2.5:1. There was no significant difference between the rate of occurrence of IHPS and gender (P=0.5). There were 2 peaks on seasonal variations of IHPS during summer and winter but quarterly distribution was not statistically significant. Nonbilious vomiting was the most common clinical presentation and USG was the most useful investigation. Pyloromyotomy was done in all patients and persistent vomiting (24%) was the most common complication. The occurrence of IHPS was 0.29% of all admissions. There was no significant gender or seasonal variations. USG has replaced clinical examination as the most effective tool for diagnosis. Ramstedt pyloromytomy is still the choice of treatment on the basis of outcome. JCMCTA 2013 ; 24 (2): 9-13