There are some common genetic heritages between human and mammals. Human tail, though rare is one of the most noticeable. Till the date, around 60 cases reported in the literature. A true human tail is a benign vestigial caudal cutaneous structure composed of adipose, connective tissue, muscle, vessels and nerves. A true human tail can be distinguished from a pseudotail as the latter is commonly associated with underlying spinal dysraphism, which requires specialised management. We report a case series of four caudal appendages. Two clients were infants, while others two were toddler and presented with cutaneous appendage arising from the lumbosacral region. Out of four, only one had associated spinal dysraphism and neurological manifestation while others did not have spinal dysraphism and neurological manifestation. The appendage was removed by the surgical excision. Clinicians should emphasise the use of ’true tail’ and ’pseudo-tail’ as the specific disparate terms as the clinical, radiological and histological findings of these conditions differs significantly, along with the management strategies and outcomes.

Background: The incidence of hypospadias with cryptorchidism is about 6-31.6%. Current management recommendations are that undescended testis beyond three months needs surgery between 6-12 months of age. Proximal hypospadias and cryptorchidism overlap with disorders of sex development and endocrine problem. The aim of this study was to assess the outcome of surgical management of hypospadias with cryptorchidism, at selected centers in Dhaka, Bangladesh. Methods: This prospective study was conducted in the Department of Pediatric Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from January,2018 to January, 2022. In this study, we included 70 diagnosed cases of hypospadias with cryptorchidism presented as ambiguous genitalia who underwent surgery. Results: Mean age at surgery was 4.6±1.4 years and majority (91.4%) were male. Associated renal anomalies were absent in 81.4% cases, symptomatic renal anomalies were present in 11% cases, severe chordee was 37%. Abnormal hemiscrotum was 10% and normal hemiscrotum was 1.4%. Hernia with cryptorchidism was present in 30 % cases. Testosterone was normal in 94.3% patients, estrogen and progesterone was elevated in 5.7% patients. After operation, male was 94.3% and female was 2.9%, chordee condition was corrected in 81.4% and urine passed through tip of penis in 84.3% patients. Conclusions: We found that surgery is simple, safe, and effective in the treatment of patients with hypospadias and cryptorchidism with satisfactory functional results, normal physical health status, improved quality of life, satisfying psychological support and probably less pain.

Background: Hypospadias is a congenital defect involving the male urethra characterized by the absence of urethral meatus at its normal position. This anomaly is usually associated with the ventrally deficient but dorsally hooded skin. In some cases, the penis is ventrally curved. Surgery is the option for this defect. So many procedures have been developed but none is free from the development of urethrocutaneous fistula. Now-a-days, the popular Snodgrass procedure is widely practiced but still fistula occurs. Many factors are thought to be responsible for it. The most important one is defective ventral penile skin which is deficient of vascular and collagen tissues. To minimize these deficient factors, a dorsal vascular preputial flap is transferred ventrally (modified) to reduce fistula formation further. A comparative study was disigned to determine the role of dorsal vascular flap.Methods: The prospective observational study was conducted in the department of pediatric surgery, Bangabandhu Sheikh Mujib medical university, Dhaka, Bangladesh since February 2017 to May 2021.Results: A total of 40 patients with distal penile hypospadias were included in this study. They were divided into Group A and group B, 20 for each. Snodgrass procedure was for Group A and the modified Snodgrass procedure was done for group B. The outcome of both the groups was determined in terms of fistula formation. Seven patients in group-A and one patient in group B developed fistula. The results were analyzed and were found statistically significant.Conclusions: Modified Snodgrass urethroplasty has a better outcome.

Background: The most common paediatric disorder among boy is undescended testis (UDT) which is usually identified during birth and these patients require proper treatment at the appropriate time due to increased risk of torsion, infertility, testicular cancer and associated inguinal hernia(>90%) as well as for cosmetic purposes. Objective: The purpose of this study was to determine side, palpability, age at presentation, associated anomalies and treatment plan in our institution. Methodology: This retrospective study was carried out in the department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2017 to June 2019. Results: In this study 1.08% (213 children had UDT out of total paediatric outdoor 19803 patients) boys had UDT. They were aged from 7 months to 15 years (mean 5.61±3.81 years) at presentation. Only 16 (7.5%) patients presented within the 1 years of age in this study. 51.8% of patients presented at the age of >1yrs-5yrs. > 5yrs-10yrs of age was 33.5% cases and 13.6% of patients presented as late as 10yrs to 15 yrs. Unilateral UDT was found in 184 (86.4%) patients and bilateral was in 29(13.6%) patients. Right- sided unilateral UDT was in 112(52.6%) patients, left -sided unilateral UDT was in 72 (33.8%) patients. Palpable testis was found in 178(83.6%) patients and non-palpable found in 35(16.4%) patients. Associated anomalies of UDT were seen in 64(30%) patients. Hypospaedias was in 19(08%) patients and intersex disorders were in 15 (07%) patients. Orchidopexy was done in 192(90.1%) cases and orchidectomy was done only in 4(1.9%) cases. No testis was found in17 (08%) cases. Conclusion: UDT is one of the commonest disorders of paediatric age group. Very important issue is the early diagnosis and treatment of this anomaly. To treat the UDT in proper time help to optimize testicular function, earlier diagnosis of testicular malignancy, give cosmetic benefits and to prevent complications such as a clinical hernia or torsion. Journal of National Institute of Neurosciences Bangladesh, July 2021, Vol. 7, No. 2, pp. 173-176

Peutz-Jeghers syndrome (PJS) is a rare hamartomatous polyposis of the gastrointestinal GI) tract, sometimes associated with pigmentation around lips and oral mucosa. The case of a 4-year-old girl who presented with duodenal obstruction is reported. Along with multiple small polyps in the duodenum, a large polyp was found to be the cause of the duodenal obstruction. Histologically most of the polyps were hamartoma. PJS is a rare autosomal dominant disease. Most patients have recurrent episodes of polyposis in the gastrointestinal tract causing gastrointestinal obstruction as well as these patients have an increased risk of both gastrointestinal and non-gastrointestinal malignancy and need regular screening.