Patients In Pediatric Age Group Research Articles

Pattern of skin disorders among pediatric age group cases attending a tertiary health care center

<p class="abstract"><strong>Background:</strong> Skin diseases among the pediatric age group people are more common and it contributes to significant burden to health sectors. Also, the pattern of skin diseases changes consistently with reference to place and time. Hence the present study was conducted to assess the pattern of skin diseases in pediatric age group patients attending a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> The cross-sectional study was conducted by the department of Dermatology, Venereology and Leprosy at Sri Muthukumaran Medical College Hospital and Research Institute, among the pediatric age group patients attending the outpatient department, during the month of October to December 2019. A total of 412 pediatric age group patients with skin disorder were included in the study. The study was conducted using a proforma with the clinical history and diagnosis of the participants. Data was entered in Microsoft excel and data analysis was done using SPSS version 17.<strong></strong></p><p class="abstract"><strong>Results:</strong> The common skin disorders reported in this study includes infections (34.7%) followed by dermatitis (32.3%), infestations (11.4%), miliaria (8.3%), popular urticaria (7.5%) and urticaria (6.1%). Among the infections fungal, bacterial and viral pathogens contributes to 16.3%, 10.9% and 7.5% of cases, respectively. Also 11.2% of cases were found to be infested with scabies (9.2%) and pediculosis (2.2%).</p><p class="abstract"><strong>Conclusions:</strong> Skin disorders in the pediatric age group are common and showing increasing trend. Hence health education of the parents and the school children about good nutrition, hygiene practices, and proper hydration of skin can be promoting in order to reduce the burden of skin disorders.</p>

An observational study to determine the incidence and the clinico-epidemiologic profile of dengue fever in paediatric age group presenting to a tertiary care centre in Western Rajasthan, India

Background: Dengue remains major public health concern because of the expanding geographic distribution of both the virus and the mosquito vector. Aims and objectives was to determine the incidence of dengue fever in paediatric age group presenting to a tertiary care centre in Western Rajasthan and to evaluate the clinico-epidemiologic profile of these children.Methods: This is observational epidemiological study on patients of pediatric age group, over a period of one year.Results: A total of 210 ELISA positive cases, comprising of 55% males and 45% female (Male to female ratio of 1.2:1) were enrolled. In this study most (44.7%) were age group of 10-18 years, 80% patients from urban area, 93.8%. admitted between the months of September to December, 70.95% presented between 3rd to 5th days of their illness, 48 (22.86%) were tourniquet test positive at the time of admission with fever being most common (95.23%) presenting symptom, followed by headache (60%) and vomiting (55%). Almost all (99.52%) had thrombocytopenia (34.2% of them had severe thrombocytopenia), most (85%) had a hospital stay of less than a week, 98.10% patients required fluid therapy for less than 5 days. and a mean of 3.41±2.60 days were required by these patients to recover from significant thrombocytopenia. Here 22% (46) patient’s required ICU care, with shock being main indication for ICU admission, followed by requirement of blood product transfusion (73%). Bleeding manifestations were seen in 73(34%) patients, commonest being the epistaxis in 40 patients (55%).Conclusions: Incidence of dengue was 0.42% with 32.38%patients were IgG ELISA positive also.

Role of Tissue Doppler in Early Detection of Left Ventricular Dysfunction in ? Thalassemic Patients of Pediatric Age Group

Role of Tissue Doppler in Early Detection of Left Ventricular Dysfunction in ? Thalassemic Patients of Pediatric Age Group

Clinical Characteristics and Safety of Plasma-Derived C1-Inhibitor Therapy in Children and Adolescents with Hereditary Angioedema—A Long-Term Survey

Plasma-derived C1-inhibitor (pdC1-INH) is a first-line therapy for hereditary angioedema (HAE) with C1-inhibitor deficiency (C1-INH-HAE) in pediatric patients. We intended to study the clinical characteristics and safety of treatment with pdC1-INH in this population. In the prospective, long-term survey, real-world data on pdC1-INH (Berinert, CSL Behring) use in pediatric patients, diagnosed and followed up at our Angioedema Reference Center, were analyzed for the period from 1986 to2018. A total of 70 pediatric patients (31 boys and 39 girls) experienced a total of 3009 HAE attacks. The most common location of HAE attacks was subcutaneous. HAE attacks of any location were more frequent in girls versus boys, except for genital edema. Among the 70 patients, 37 received pdC1-INH for 456 HAE attacks, or as prophylaxis (69 vials). On average, 14.2 vials were administered per patient. The distribution of pdC1-INH use in the different age groups was as follows: no use (0-1 years), 0.11 vials/year (1-3 years), 0.7 vials/year (3-6 years), 1.26 vials/year (6-12 years), and 1.28 vials/year (12-18 years). No systemic allergic reactions, viral transmission, development of anti-C1-INH antibodies, or thromboembolic events occurred in relation to treatment with this drug. We confirmed that the clinical manifestations and the use of pdC1-INH are different in the various age groups of pediatric patients with C1-INH-HAE. Our long-term survey shows that the use of pdC1-INH is safe in this patient population.

EPIDEMIOLOGICAL PATTERNS OF PEDIATRIC ORTHOPEDIC TRAUMA IN A DISTRICT HOSPITAL IN MIZORAM, INDIA

Background and Objective: The objective of the study was to document the epidemiological patterns of significant pediatric orthopedic trauma in a district hospital in Mizoram, India. The information so collected may be used as baseline data in health-care planning and resource mobilization in areas where workforce and resources are limited, especially in the orthopedic specialty. Materials and Methods: A retrospective analysis of 570 pediatric age group patients, attending accident and emergency services at district level hospital from January 2013 to December 2017 was done. Significant traumatic orthopedic trauma, defined as fractures, dislocations, and ligaments injuries for this study, was taken into account. Record was analyzed for age, sex, type, and mode of injuries and seasonal variations. Results: A total of 431 (75.61%) patients attending orthopedics emergency had significant trauma. This accounted for 23.68% of all orthopedics emergency cases in a calendar year. The male-to-female ratio was 2.75:1 and injuries were predominantly high in 5–8 years of age. Injury pattern is similar to other reported series while the mode of injuries is significantly different from those in Western world. Conclusion: Pediatric orthopedic traumas do well with early intervention. Proper referral system is the need of the hour. Supportive health-care policy and decision-making based on epidemiological trends of injuries would result in favorable outcome of such management.

Clinicoepidemiological study of prevalence and pattern of dermatoses among patients of pediatric age group in southeast region of Rajasthan

Background: Pediatric dermatoses present as one of the most common clinical entities in dermatology clinics. They differ in clinical presentation and management from adults. Their prevalence and pattern differ from region to region due to several factors such as environmental, social, genetic, and cultural. Aims and Objective: The aim of the study was to determine the prevalence and pattern of various dermatoses among children of the age group 0–18 years in Southeast region of Rajasthan. Materials and Methods: Our study included 1000 cases of 0–18 years age group attending the dermatology outpatient and inpatient department of Government Medical College and attached group of hospitals, Kota. It was carried out from December 2017 to September 2018 (10 months). Appropriate history was taken, and a complete thorough examination was done as required. Relevant investigations were done, and all the findings were recorded in predesigned pro forma. Results: Our study included 560 males and 440 females of 1000 with the male-to-female ratio of 1.272:1. There were 553 urban and 447 rural participants. The patients were subgrouped in the age group of 0–1 year, 1–7 years, 8–12 years, and 13–18 years. The most prevalent dermatoses in 0–1 year age group were eczematous disorders (31.91%). Viral infections were predominant in 26.08% and 23.47% in the age groups of 1–7 years and 8–12 years, respectively. The most common dermatoses in the age group of 13–18 years were disorders of sweat and sebaceous glands (20.15%). Conclusion: Our study demonstrates variability of dermatoses among pediatric patients according to their age groups. This information should contribute to raising the awareness of pediatricians and dermatologists regarding the most common dermatological diagnosis in those patient populations.

Magnitude and associated factors of acute post streptococcal glomerulonepheritis among pediatric patients in aksum public hospitals, tigray, Ethiopia

Objective: Acute post streptococcus glomerulonephritis is reported from all over the world with higher rates among children than in adults. The objective of this study was to assess the magnitude and associate factors of acute post streptococcal glomerulonephritis among pediatric patients in Aksum city public hospitals, Tigray, Ethiopia. Methods: Institution based cross sectional study was conducted to retrieve data from 384 medical records of pediatric patients admitted to pediatric wards of Aksum city public hospitals between 2016 and 2018. The collected data were entered in to SPSS version 21 database for analysis. Finally, multivariate logistic regression was employed to identify determinants of adverse birth outcome at P value<0.05. Results: Acute post streptococcal glomerulonephritis was diagnosed in 31.51% of pediatrics patients. Nutritional status [AOR=2.37, 95%CI (1.28–4.41)], previous history of sore throat and skin infection [AOR=7.23; 95%CI (1.12–46.50)], duration of sore throat infection [AOR=0.35; 95%CI (0.18–0.66)], and season of infection [AOR=9.93; 95%CI (4.78–20.62)] were factors significantly associated with the development of acute post streptococcal glomerulonephritis among children. Conclusion: There is high burden of acute poststreptococcal glomerulonephritis among pediatric age group patients in Aksum public hospitals. Focus should be given to the early diagnosis and treatment of streptococcal pharyngitis.

The incidence of rotavirus infection compared to bacterial infections in different age groups of pediatric patients with gastroenteritis

Abstract Rotavirus is the important cause of acute gastroenteritis in pediatric patients. The aim of the present research was to determine the incidence of rotavirus infections in infants and children up to seven years of age in the town of Niš. Seasonal prevalence of rotavirus-associated acute gastroenteritis was also evaluated. An enzyme immunoassay (RIDASCREEN® Rotavirus; R-Biopharm AG, Darmstadt, Germany) was used to detect rotavirus in the stool specimens of 1,156 patients (newborns up to 7 years of age) presenting with gastroenteritis. Identification of bacteria and yeasts was performed by classical methods. The overall incidence of rotavirus in examined children was 5.97%. Among 144 hospitalized children, rotavirus infection was diagnosed in 28 (19.44%). In 1,012 children treated in outpatient setting for diarrheal diseases, rotaviruses were found in 41 (4.05%). The highest incidence of rotavirus infection was among the patients of one year of age. Among 1,156 pediatric children tested, bacterial pathogens were found in 6.31% and the most frequently isolated pathogens were Campylobacter spp. and Salmonella enteritidis. The highest prevalence of GE was recorded in the colder season, peaking in April (15.94%). Rotaviruses are an important factor in the etiology of the acute diarrheal diseases, especially in children hospitalized during the winter/spring season.

Pediatric Brainstem Gliomas: An Institutional Experience.

Objective:The aim of this study was to analyze the clinical profiles and outcomes of pediatric brainstem gliomas treated at our institute.Methodology:We reviewed the files of 18 pediatric age group patients diagnosed with brainstem glioma at our institution. The following variables were recorded: age, sex, duration of symptoms, date of diagnosis, main clinical symptoms, Karnofsky performance status score, magnetic resonance imaging findings, histopathology findings, details of the treatment given, disease progression, and date of mortality/last follow-up. This data were then transferred to SPSS version 23 which was used for further analysis.Results:The mean age of our cohort was 8.6 years (range 3–15). There were 11 (61.1%) males and 7 (38.9%) females. There were 16 (88.9%) patients with diffuse intrinsic pontine gliomas (DIPGs), 1 (5.6%) patients with exophytic medullary gliomas, and 1 (5.6%) patient with midbrain/tectal glioma. Mean overall survival (OS) was 9.7 months. Mean progression-free survival (PFS) was 6.3 months. All patients with DIPG eventually passed away from their disease. Patients with DIPG who received radiotherapy had a longer OS and PFS than those who did not (9.8 and 6 months vs. 3.4 and 2.4 months). Diagnostic latency >1 month was found to have a statistically significant longer progression-free interval.Conclusion:DIPGs in the pediatric population have a poor prognosis. Radiotherapy serves to increase survival time but is not curative.

A death calls from unsafe heights. a study of factors influencing the outcome of surgically treated pediatric head trauma patients in baghdad

Pediatric head injury accounts for a large number of admissions in emergency rooms, it is a major cause of morbidity and mortality in children over 1 year of age. The aim of this study is to assess the outcome of surgically treated pediatric patients with head trauma in Baghdad. Patients and methods : This prospective cross sectional study was conducted in neurosurgery hospital in Baghdad including fifty two patients of pediatric age group from 1 year to 14 years old with surgically operated head trauma, in the period from 1/10/2014 till 1/10/2015. All the patients were received; examined and managed properly and followed up till 6 months after surgery. The outcome was truly affected by the mechanism of injury (p=0.001), falls from heights was the most common mechanism and it was significantly related to mortality, it also increased the rate of disability, while it had no significance regarding a good functional recovery. There were associated orthopedic injuries which also affected the outcome significantly (p=0.01) increasing the mortality and disability. The outcome was truly affected by pediatric coma scale (p=0.001), functional recovery was increased with higher score and mortality increased with lower score, and disability increased in both severe and moderate scores. Pediatric trauma score had a significant effect on the outcome (p=0.001), in score (less than 0) it increased the mortality, in score(0-5) morbidity was increased. Falls from heights are the most common mechanism of pediatric head trauma and greatly affect the outcome. Concomitant orthopedic injuries are associated with poor outcome. pediatric coma scale, pediatric trauma score are significant tools in predicting outcome.

Endoscopic endonasal surgery for sinonasal polyposis: a comparative study between general versus local anesthesia regarding compliance of surgery and patients\u2019 acceptance

IntroductionOne of the most common inflammatory mass lesions of the nose are nasal polyps, which affect up to 4% of the population. Endoscopic surgery under local anesthesia may allow for a day-care surgical procedure for the patient; however, extensive procedures, revision surgeries, and uncooperative, and pediatric age group patients will warrant the use of general anesthesia. The aim of this study is to compare the efficacy of local versus general anesthesia for endoscopic surgical treatment of sinonasal polyposis during operation as well as during early and late postoperative periods together with patient’s acceptance for surgery.Patients and methodsA total of 60 patients with sinonasal polyposis were divided randomly into two groups. Group 1 underwent endoscopic nasal surgery under local anesthesia and group 2 underwent endoscopic nasal surgery under general anesthesia.ResultsMost of the patients who were operated under local anesthesia showed good acceptance for surgery, short time of surgery, and less bloody field than those who were operated under general anesthesia (the P value was significant regarding bleeding and time during surgery under local anesthesia).ConclusionSurgery of sinonasal polyposis under local anesthesia is an effective method for the treatment of nasal polyposis as regards patient acceptance for the surgery, time of surgery with very good surgical field, and less cost procedures.

Management of Inguinal Hernia in Pediatric Age Group

Introduction: Incidence of indirect inguinal hernias in premature infants is reported to be as high as 30% with male predominance. Typically, inguinal hernia repairs are done under general anesthesia which has a high risk of post-operative complications, especially in the premature infant. The purpose of this study was to compare outcomes between early (neonatal) and delayed (older) inguinal hernia repair. Method: This is a prospective study in the department of pediatric surgery in alkhansaa Teaching Hospital Mosul / Iraq during a period from Jul 2018 to Dec 2019. All children with inguinal hernia were selected for the study and divided in two groups, those below one month and those above. Surgery is performed under general anesthesia with extracanalicular approach. Post-operative complications were observed and finally decided to discharge once patient is fit for discharge on the same day. Results: During the 18 months' period, we underwent 93 inguinal hernia repair those babies were divided into two groups, neonatal group (23 neonates) and older group (70 babies). The gender distribution ratio is 7.8 male :1 female. The side distribution among those babies in the neonatal group were 14,6 and 3 as right, left and bilateral respectively. In the neonatal group there were 9 babies presented with incarceration two (8.6%) of them shows testicular infarction and necrosis which necessitate excision at exploration while the other one atrophied in the period of follow up. We do not record any anesthetic complications or mortality in neonatal group in our period of study. Conclusion: Extracanalicular approach under general anesthesia is easy, safe, can be used for pediatric patients in neonatal age group with indirect inguinal hernia; with minimal complications, low recurrence rate.

Functional outcome of elastic intramedullary nailing of forearm fractures in children using pin leverage technique

<p class="abstract"><strong>Background:</strong> There is a recent trend towards elastic intramedullary nailing in fixation of pediatric forearm bone diaphyseal fractures. But in children we should always attempt closed reduction and immobilsation in a moulded plaster cast. Irreducible, open fractures and those that get redisplaced in moulded plaster cast need operative fixation with intramedullary nailing. Our aim was to know the outcome of tens nailing in such fractures.</p><p class="abstract"><strong>Methods:</strong> We studied functional and radiological outcome of elastic intramedullary nailing by pin leverage technique in forearm fractures in 34 children. The study was done at a tertiary care centre in Uttrakhand, India from May, 2016 to July, 2018. Inclusion criteria were closed forearm fractures; diaphyseal fractures; age 1 to 19 years. Exclusion criteria were open type 2 and type 3 Gustillo-Anderson fractures; metaphyseal, epiphyseal forearm fractures; age >19 years; pathological fractures.<strong></strong></p><p class="abstract"><strong>Results:</strong> Closed reduction and percutaneous pin leverage technique for reduction was successful in all but 4 patients where limited open reduction was used for reduction of fracture fragments. All fractures united radiologically between 7 to 13 weeks with mean distribution of 9.2 weeks. For functional outcome we used modified Price and Daruwala’s score. 28 patients showed excellent results and 6 patients showed good results. All our patients had radiological union in mean of 9.2 weeks (7-13 weeks).</p><p><strong>Conclusions:</strong> Fixation with intramedullary TENS nailing is an effective and affordable way of treating patients in paediatric age group.</p>

Role of Secondary Endoscopic Third Ventriculostomy in Children: Review of an Institutional Experience

Background: Endoscopic third ventriculostomy (ETV) has become a standard and safe procedure for obstructive hydrocephalus. ETV can also play an important role in children presenting with shunt malfunction with an added advantage of shunt independence. Secondary ETV can be defined as either a redo endoscopic ventriculostomy done after primary ETV stoma closure or that done in cases presenting with shunt malfunction. Objective: The aim of our study was to evaluate the role of secondary ETV in the pediatric age group patients. Methods: This is a retrospective analysis of 36 children (<18 years) who underwent ETV after shunt malfunction and 4 children with ETV done after previous ETV stoma closure from 2004 until 2018. In all patients, the obstructive pattern suggesting aqueduct outflow obstruction was observed on MRI. Patients were followed up for a mean period of 4.25 years. Results: ETV was considered successful if the patient avoided a shunt insertion later on in their life. Considering this definition, a success rate of 72% was observed with secondary ETV for shunt malfunction whereas a success rate of 75% was observed after primary ETV failure without any major side effects in any of the patients. Conclusion: ETV can be considered a primary treatment modality in children with shunt malfunction and has a good success rate in cases presenting with closure of previously performed ETV stoma.

Comparative Study of Spinal Anaesthesia Versus Caudal Anaesthesia in Lower Paediatric Age Group Patients Undergoing Elective Infraumbilical Surgery

Comparative Study of Spinal Anaesthesia Versus Caudal Anaesthesia in Lower Paediatric Age Group Patients Undergoing Elective Infraumbilical Surgery

Enhanced Healing and Bone re-Modelling by Low-Level Laser Therapy for Rapid Pain Control in Pediatric Fractures

Objective The current clinical case series assess the clinical outcome of the use of low-level laser in the treatment of painful pediatric fractures not solidly consolidated and re-modelled after casting for a standard of 4-6 weeks Materials and Methods The patient cohort consisted of 17 consecutive unselected patients in pediatric age group with delayed fracture consolidation and/or undesirable angulation despite casting for a standard period of 4-6 weeks in whom the parents refused any surgical intervention and/or bone grafting options. All subjects were referred from other medical centers after inadequate healing of the fracture ends upon repeating the x ray after the cast was off at the 4-6 weeks mark. Low-level laser therapy (LLLT) on alternate days for 8weeks in upper limb fracture cases, and 12 weeks in lower limb fracture cases were administered with a view of enhancing bone healing and/or re-modelling since both previous clinical and basic science studies on LLLT showed a stimulatory effect on fracture healing. Results All patients had solid union, mean time for union for upper and lower limb fractures were 6 and 10 weeks respectively. The calculated p value is statistically significant at p &lt; 0.05. No patient defaulted follow up. All parents were satisfied with the clinical and radiological result of the LLLT treatment. Conclusion LLLT was found not only to enhance bone healing potential but in fact improved bone re-modelling when used in the proper wavelength and energy density in pediatric upper and lower limbs fractures, thereby also rapidly resolve the intolerable pain in paediatric fracture population

Distribution of Pediatric Surgical Cases Over Five Years in a Tertiary Hospital

Background: Health care providers have given their efforts to reduce the rate of child mortality and morbidity, throughout the world. But inadequate amount of knowledge about the demand of pediatric surgical care lagging us behind to achieve our goal. The study was conducted to observe the distribution of pediatric surgical cases over five years in the study site. Materials and methods: It was a descriptive type of observational study. Data was extracted from record book of surgical procedures done in Department of Pediatric Surgery, Bangabandhu Memorial Hospital (BBMH) Chattogram, over a period of 5 years, from January 2013 to December 2017. Written permission was taken from the hospital authority prior to data collection. Descriptive data analysis was done by Microsoft Excel (Version 2013). Results: Out of total 2977 cases, 10-15 years age group had a predominance of 828 cases and the least was more than 15 years age group (672 cases). A male predominance was observed, with 65% of all cases (Total- 1935 cases) while female patients comprised rest of it. Male female ratio was 1.86: 1. Over 5 years period appendicectomy (497) circumcision (530) herniotomy (425) rectal polypectomy (255) showed abundant number covering majority of the surgical procedures. On the contrary, splenectomy with cholecystectomy was the least performed surgery (5) mostly done for haemolytic disease of newborn (Thalassemia). Conclusion: To deal with huge amount of surgical patients of pediatric age group an organized effort is required to ensure proper environment and resources to facilitate optimal implementation of surgical care to the future generations of a country.&#x0D; JCMCTA 2018 ; 29 (2) : 47-52

An Echocardiographic Evaluation of Dilated Cardiomyopathy in a Tertiary Care Hospital

Cardiomyopathies are diseases of heart muscle that may originate from genetic defects, cardiac myocyte injury or infiltration of myocardial tissues. Dilated cardiomyopathy is the most common phenotype and is often a final common pathway of numerous cardiac insults. Mostly it remains unknown in the absence of echocardiography, histopathology and genetic evaluation. Though common it is underdiagnosed with not much of data available in our setup. This study was analytical cross-sectional study of hospital data on Echocardiographic findings in 65 patients of DCM visiting cardiology unit for Echocardiographic evaluation from 1st of February to 31st July 2018 for the period of six months in Shree Birendra Hospital, a tertiary care military hospital at Chhauni, Kathmandu. Pediatric age group patients and those who refused to give consent were excluded. Data obtained were entered in Microsoft Excel 2010 and analyzed by IBM SPSS 21. Among 65 patients enrolled 40 (61%) were male and 25 (39%) female with male to female ratio of 1.6:1. Elderly people (61-75 years) with an average age of 65 were commonly involved and they presented mostly with congestive heart failure, 32 (49%). Echocardiographic evaluation showed 36 (55%) with mildly dilated Left Ventricle (5.6-6.0cm). Majority had reduced Left ventricular systolic function with an average Ejection fraction (EF) of 39.6%. No significant difference between male and female with the average EF% (P=0.990) and there was no significant relation between age and average EF% (P=0.091). Dilated Cardiomyopathy is the commonest cardiomyopathy phenotype mostly presenting with congestive heart failure. It is often underdiagnosed in our part of the world, however echocardiography will easily detect the condition.

Utility of Mitrofanoff as bladder draining tool: A single center experience in pediatric patients.

Mitrofanoff procedure has been employed commonly as bladder draining tool in patients unable to do clean intermittent self catheterization through native urethera. Single centre experience of pediatric age group patients undergoing Mitrofanoff procedure has been presented here. It was a retrospective study of 29 children who underwent continent catheterizable conduit (CCC), from January 2009 till March 2017. Charts were reviewed for age, gender, presenting complaints, need for augmentation cystoplasty, Mitrofanoff channel source such as appendix or ileal patch, duration of surgery in minutes, hospital stay in days, per operative and postoperative complications. Preoperative evaluation of the children was done by doing complete blood picture, serum electrolytes, and renal function tests. Radiological evaluation included ultrasound kidney,ureter and bladder, voiding cystourethrography, urodynamic analysis and a nuclear renal scan with 99m Technetium dimercapto-succinic acid or MAG-3 scan. The abdominal end of the conduit was brought through the abdominal wall, and a stoma was fashioned by the V-quadrilateral-Z technique. Twenty nine children having mean age of 9.54±4.88 years underwent CCC. There were 19 males (65.51%) and 10 females (34.48%). Children who underwent CCC included 18 children having neurogenic bladder, 2 cases of urethral trauma/stricture 3 patients with history of posterior uretheral valve and 6 patients with exstrophy bladder. Augmentation cystoplasty plus mitrofanoff was done in 18 children while only mitrofanoff in 11 children. Stuck catheter was seen in one patient which was removed successfully via normal urethral route under general anesthesia. Stomal stenosis in first year was noted in 4 patients (13.79%). Continent catheterizable conduit based on Mitrofanoff principle have durable outcome over long term follow up in terms of urinary continence and complications.

Quality of Life and Behavioural Assessment in Post-adenotonsillectomy Cases of Paediatric Age Group.

Adenotonsillectomy is a widely practiced surgical intervention to manage obstructive sleep apnoea syndrome (OSAS) in the paediatric age group. We conducted a prospective, non randomised, interventional study among 40 patients in paediatric age group (2-18years) suffering from adenotonsillar hypertrophy with an indication of adenotonsillectomy based on American Academy of Otolaryngology-Head and Neck Surgery criteria. Care givers completed the obstructive sleep apnoea 18 (OSA 18) quality of life (QoL) survey and Rutter Children's Behaviour Questionnaire (RCBQ) before adenotonsillectomy as well as 6months after surgery. We found that mean score of OSA 18 and total RCBQ decreased significantly 6months after surgery. The mean score of OSA 18 (4.12 ± 1.4) and total RCBQ score (20.5 ± 2) significantly reduced to 1.19 ± 0.12 and 7.4 ± 2.55 (p < 0.0001), respectively, after surgery. There was significant improvement in all the domains of OSA 18 score after intervention including sleep disturbance (mean score change 2.56, p < 0.0001), physical suffering (2.99, p < 0.0001), emotional distress (2.71, p < 0.0001), daytime problems (2.56, p < 0.0001), caregiver concerns (3.76, p < 0.0001). We also observed that QoL as well as behaviour was independent of age and gender of patients. This study demonstrates significant score changes across all questionnaire domains, comparing pre and post operative data indicating an improvement in their quality of life and behaviour. Hence, we advocate that adenotonsillectomy may be considered as an effective treatment in properly selected patients with OSAS.