An 11 months old male child, with congenital HCP presented with extrusion of shunt tube form the anus after defecation. He was managed by VP shunt 8 months back; 6 months later lower end was revised for obstruction. Lower end of shunt exteriorized and the distal end was cut and pulled out per rectally. Later ETV done patient discharged uneventfully.Key words: VP Shunt, Trans anal, Extrusion, Management, Outcome. Bang. J Neurosurgery 2022; 11(2): 138-140

Background: Spinal dysraphism, one of the most common birth defects, has been estimated to occur annually in more than 320,000 infants worldwide. Lipomyelomeningocele (LipoMMC) is a closed neural tube defect in which the surface lipomatous tissue is attached to the spinal cord. LipoMMC results from premature disjunction of the epithelial ectoderm from the neural ectoderm at a gestational age of 18–28 postovulatory days.Both genetic and environmental factors are suggested to have important roles in the occurrence of neural tube defects. In addition, variables such as vitamin B 12 deficiency, maternal hyperinsulinemia,maternal dietary glycemic intake, maternal obesity and use of antiepileptic medications during pregnancy have been suggested as risk factors for spinal dysraphism. Objective:The aims and objectives of this study was to see the epidemiology of Lipomyelomeningocelein our population. We shall also compare our result with other previous study result. Materials and method: It is a retrospective study. Cases were obtained from a NINS Pediatrics neurosurgery electronic registry (emrbd.com). The study was carried out at Department of Paediatrics Neurosurgery, NINS&H, and DhakafromNovember 2017 to till date.Subjects was included from a NINS Pediatrics neurosurgery electronic registry.Structured questionnaire was used to collect the necessary information. Risks and benefits of this study were explained to the patient and patient’s legal guardian/ parents in an easily understandable local language. Conclusion: In this study the majority of cases were female. Environmental factors also appear to be associated with lipomyelomeningocele risk factor. Additional studies needed to establish the environmental risk factor associated with LipoMMC. Bang. J Neurosurgery 2021; 11(1): 25-29

Submission of an original paper with copyright agreement and authorship responsibility.I (corresponding author) certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (wherever applicable), as well as the writing of the manuscript, to take public responsibility for it. I believe the manuscript represents valid work. I have reviewed the final version of the manuscript and approve it for publication. Neither has the manuscript nor one with substantially similar content under my authorship been published nor is being considered for publication elsewhere, except as described in an attachment. Furthermore I attest that I shall produce the data upon which the manuscript is based for examination by the editors or their assignees, if requested.Thanking you.

Submission of an original paper with copyright agreement and authorship responsibility.I (corresponding author) certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (wherever applicable), as well as the writing of the manuscript, to take public responsibility for it. I believe the manuscript represents valid work. I have reviewed the final version of the manuscript and approve it for publication. Neither has the manuscript nor one with substantially similar content under my authorship been published nor is being considered for publication elsewhere, except as described in an attachment. Furthermore I attest that I shall produce the data upon which the manuscript is based for examination by the editors or their assignees, if requested.Thanking you.

Background: Guillain-Barre syndrome (GBS) is the leading cause of acute flaccid paralysis in children. This study was aimed to compare the clinical spectrum and shortterm outcome of children with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) subtypes of GBS in children. Methods: The study was a prospective cohort study done in a tertiary neurology hospital for 3 years. Children under 18 years of age fulfilling the Brighton diagnostic criteria for GBS were enrolled in the study. Based on the nerve conduction study, patients were subclassified as AIDP, AMAN, AMSAN, and others. Finally, a comparison was done in children with AIDP and AMAN subtypes. Results: A total of 102 children have fulfilled the Brighton diagnostic criteria of GBS during that study period. Among them, 83 children were included in the final analysis as NCS findings suggestive of AIDP and AMAN were found in 29(28.43%) and 54(52.94%) of cases respectively. No patient died in this cohort and follow-up was done at 3 months after discharge. A comparison of clinical data between the two groups revealed similar clinical features in most of the cases. The mean age difference between the two groups was statistically significant and AIDP was found to be more frequent in the 1-5 years age group. There was a significant association between gastroenteritis and AMAN subtypes. On symptom analysis, pain and tingling sensation were found predominantly in AMAN subtypes. Children having AMAN variants developed respiratory distress more than AIDP. Assisted ventilation were needed in 14.45% of cases and the majority of them were from the AMAN group. The mean duration of hospital stay and the mean disability scores at three months after discharge were significantly higher in the AMAN group. Conclusions: AMAN was the commonest GBS subtypes in children. AIDP was more frequent in the younger age group. Children with AMAN appeared to have higher short-term morbidity and slower recovery than those with AIDP. Bang. J Neurosurgery 2022; 11(2): 94-100