Per rectal bleeding is a frequently encountered clinical complaint in routine medical/surgical practice in paediatric patients. It has different aetiology in both extremes of age. This study was carried out in an attempt to find out causes, presentation and the proper management that can be offered to the affected infants and children.This retrospective study was carried out from January 2012 to December 2014 in the department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. All patients presenting with the complaint of per rectal bleeding were included. But patients who needed emergency surgical intervention were excluded from this study. The data were reviewed for gender, age, causes of rectal bleeding and type, number, site, recurrence rate and the modality of treatment employed in children having colorectal polyp. Technetium-labeled red blood cells scans was used for the diagnosis of Meckel's Diverticulum. Complete blood picture and routine stool examination were done for all cases.Most polyp cases were diagnosed with digital rectal examination (DRE). Colonoscopy was performed for some cases in the Paediatric Gastroenterology Department of BSMMU. Also all the rectal polyps and colonic mucosal biopsies taken during colonoscopy submitted to histopathological examination. Per rectal bleeding was the chief complaint in 326 (1.5%) patients Out of 21,533 patients presenting to the outpatient department of Paediatric Surgery of BSMMU, Dhaka, Bangladesh over a period of three years. In this study, it was reviewed 326 patients, among them 208 (63.89%) were boys and 118 (36.19%) were girls. The male female ratio was 1.8:1. The ages ranged from 14 months to 14 years (mean age: 5.8years) at diagnosis. The most common aetiology was juvenile polyps which were found in 209 (64.11%) of the cases. It was to be found that anal fissure in 33 (10.12%) patients, rectal prolapse in 27 (8.2%) patients, non-specific colitis in 15 (4.60%) patients, Meckel's Diverticulitis in 3 (0.9%) patients, juvenile polyposis coli in 5 (1.5%) patients and familial adenomatous polyposis coli (FAP) in 4 (1.2%) patients. However, the cause of per rectal bleeding remained unknown suspecting chronic constipation in 30 (9.20%) patients. No statistically significant differences were observed between males and females as well as different age groups regarding the means of the underlying causes of per rectal bleeding in children(p > 0.05). The prevalence of anal fissure in less than 2 years old patients and juvenile polyps in the 2-6 years old patients were significantly higher than the other causes (p < 0.001). Other causes of per rectal bleeding prevailed in children were more than 2 years old. Colorectal polyps are common causes of per rectal bleeding in children. Proper physical examination including DRE along with the colonoscopy promotes both rapid and accurate diagnosis and the opportunity for immediate therapeutic measures.

Introduction: Popular Swenson's pull through (1948) is still the most commonly practiced 'Gold Standard' of operative treatment for rectosigmoid hirschsprung's disease (HD). But minimally invasive transanal endorectal pull through (TERPT) is now being increasingly practiced worldwide for its treatment in many centers. Here we are describing our comparative experience between TERPT and Swenson's pull through, at Dhaka Shishu Hospital to show the per-operative advantages of the former over the latter. Materials and methods: It is a prospective study at Dhaka Shishu Hospital during January 2000 to December 2001 in 32 (age, body weight and resected Rectosigmoid length matched) biopsy confirmed patients of HD divided into two Groups: Gr. A (na = 16) and Gr. B (nb = 16) patients who underwent TERPT and Swenson's pull through respectively. Unpaired 't' and χ2 (with Yate's correction) tests were used for statistical analysis whereas operative duration, volume of blood loss and transfusion requirements were used as parameters of the study. Results: For study Group A (TERPT) - operative time, volume of blood loss and transfusion requirement were significantly lesser (P < 0.01, P < 0.001 and P < 0.001 respectively) than the control Group B (Swenson's procedure). Conclusions: Through this small comparative study, TERPT was found to be more advantageous than the Swenson's pull through procedure in terms of operative duration, blood loss and transfusion requirement. Key words: TERPT; Swenson's; Compare. DOI: 10.3329/bjch.v31i1.6068 Bangladesh Journal of Child Health 2007; Vol.31(1-3): 12-15

Keywords: Analgesic; Children; Post-operativeOnline: 29-1-2009DOI: 10.3329/bmrcb.v34i3.1860Bangladesh Med Res Counc Bull 2008; 34: 109-111

Abstract:Objective: The aim of this study is to evaluate the management of inguinal hernias in children as a day case surgery in elective basis. Overall, there were 13 (9.2%) sliding hernias. Among them in five case of boys four (80%) patients contents were cecum and one (20%) patient was sigmoid colon. In case of girls, contents were ovaries in all eight patients.

Inadequate postoperative pain control causes significant morbidity and mortality. ht the presets mum in the paediatric surgery department the effective pain control is am mandardkert For this reason this study was undertaken to find out the degree of effective postoperative pain control in children by using Visual Analogue Scale iVA.St It was a crospsemional study for two years. Sample sine was 90 with a mean age of 8.7 years. Patients were selected from the Department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU). Dhaka; Bangladesh Institute of Child Health & Dhaka Shishu Hospital HliCH &DSH). Dhaka; and Dhaka Medical College hospital (DMC111. Dhaka. Children aged five to 12 years receiving postoperative analgesics were included in this study. All of them were mentally healthy. well responsive and cmoperative. Patients were selected in such a way that neither thee hod any malignant disease nor were they stoffernsg front any chronic pain or postoperative pain due to magical wound sepsis. Postoperative pain was measured by VAS from the first postoperative day to the seventh postoperative day and was graded by she Sriwatanakars method. It vans Plod that difference in pain scams were statistically nowsigo0ficant among the three institutes front the first postoperative day to the seventh postoperative day. Patients experienced moderate pain up to the third postoperative day, mild pain up to the fifth postoperative day and. ome pain up to the sowsh postoperative day. Postoperative pain was mu effectively controlled by currently used analgesics in paediatric surgery departments in these hospitals. So so find at the degree of effrctice postoperative pain control in children fierther study should be carried 0111 with large number of patients in different mares of Bangladesh.