Browsing by Author "Shiv Prasad Sharma"

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A Clinicopathological Study to Assess the Role of Intralesional Sclerotherapy Following Propranolol Treatment in Infantile Hemangioma
(Scientific Scholar LLC, 2021) Rakesh Kumar; Preeti Tiwari; Vaibhav Pandey; Amrita Ghosh Kar; Narendra Tiwary; Shiv Prasad Sharma
As propranolol has emerged as first-line therapy for problematic infantile hemangioma, the number of non-responders and partial responders to propranolol therapy is also increasing. Aims: The study was conducted to evaluate the response of intralesional bleomycin, triamcinolone, and a combination of both as second line of treatment for the residual hemangioma following propranolol therapy Settings and Design: A prospective comparative study was conducted in patients who were either non-responders or partial responders to previous propranolol treatment. Materials and Methods: The patients randomly received injection bleomycin, injection triamcinolone, and combination of both bleomycin and triamcinolone. The response to treatment was recorded clinically by using photographs. The pathological response was assessed by calculating pre-treatment and post-treatment microvessel density in biopsy of lesion from the non-cosmetic sites using immunohistochemistry. Statistical Analysis Used: χ2 test was used to test the association between the variables. The utility of microvessel diameter (MVD) in terms of clinical response to the therapy was predicted by using receiver operating characteristic (ROC) curve. Results: Out of the 134 patients, 42 received bleomycin and 44 received triamcinolone and were treated with a combination of both. The overall clinical response was better in the combination group compared with the bleomycin group (P = 0.018) and triamcinolone group (P = 0.0005), respectively, after 6 months of follow-up. There was no difference in clinical response between the triamcinolone and bleomycin groups. Change in MVD correlated with the clinical response. Conclusion: The combination of bleomycin and triamcinolone is effective and safe for the treatment of residual hemangioma. © 2022 Journal of Cutaneous and Aesthetic Surgery.
A Laryngeal web with tracheo-esophageal fistula: Anaesthesiologist skating on a thin ice; [Trakeo-ozofageal fistullu bir laringeal web: ince bir buz uzerinde paten yapan anestezist]
(Anestezi Dergisi, 2022) Amrita Rath; Abha Singh; Reena; Pragya Shukla; Sarita Choudhary; Shiv Prasad Sharma; Kairi Dibo
Tracheo-esophageal fistula (TEF) in association with subglottic laryngeal web is a rare entity. Often the diagnosis of laryngeal web in the presence of TEF is missed and it is identified during intubation attempts. The triad of neonatal age, TEF and laryngeal web can even cause the most experienced anaesthetists concern about the mortality and morbidity that may develop due to the inability to secure the airway. In this case report, we aimed to share our experience on the airway management of a newborn with laryngeal web. © 2022 Anestezi Dergisi. All rights reserved.
A new anatomic variant of urethral duplication
(Elsevier Inc., 2018) Sarita Chowdhary; Shiv Prasad Sharma
[No abstract available]
A novel manoeuvre in a case of foreign body esophagus: An unusual management of a usual presentation
(Central Society of Egyptian Anaesthesiologists, 2016) Mridul Dhar; Ram Badan Singh; Pushkar Ranjan; Shiv Prasad Sharma; Vishal Krishna Pai
Introduction Although considered to be a safe and uneventful procedure, retrieval of a foreign body from the esophagus can occasionally lead to complications such as perforation, fistula, and mediastinitis, especially with sharp objects such as pins or bones. Milder objects such as coins and marbles are usually managed conservatively but sometimes may require general anaesthesia for retrieval. Although less traumatic to the mucosa, a smooth round foreign body such as a marble is difficult to extract with routine grasping instruments like a Magill forceps. Case We describe a case of an eight year old male child, who presented to the emergency department with history of ingesting a marble, and a novel yet simple manoeuvre, to minimise chances of downward displacement and maximise chances of successful and atraumatic extraction with minimal manipulation of trachea and esophagus. © 2016
Basic Principles of Pediatric Surgical Oncology: What Radiologist Should Know
(Springer Science+Business Media, 2025) K. Sharma; Sarita Chowdhary; Shiv Prasad Sharma; Ishan Kumar
Radiologists are integral members in the multidisciplinary care of pediatric oncology patients. Their expertise in diagnostic imaging, including X-rays, ultrasounds, MRIs, and CT scans, is essential for accurate diagnosis and treatment planning. Interpretation and diagnosis of pediatric surgical imaging require a comprehensive understanding of imaging algorithms to navigate between various tumors. The location, size, and characteristics of these abnormalities are crucial in determining the type and extent of the cancer. Surgical planning is predominantly guided by resectability and stage of tumor. Further, imaging plays a crucial role in assessing the treatment response as well as long-term surveillance of tumor. This review explores the treatment guidelines and protocols of common pediatric surgical tumors. A concise algorithms to various pediatric surgical tumors have been provided to give insight into the integrated treatment approach with approximate timelines. © 2025 The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
Clinical spectrum of neural tube defects with special reference to karyotyping study
(2012) Vijayendra Kumar; Anutosh Singh; Shiv Prasad Sharma; Arvind Srivastava; Ajit Saxena; Ajay Narayan Gangopadhyay
Background: Neural tube defects are common congenital malformations of the central nervous system. Despite years of intensive epidemiological, clinical, and experimental research, the exact etiology of NTD remains rather complex and poorly understood. The present study attempted to look into the association of occurrence of NTD with reference to folic acid levels, along with karyotyping status. Materials and Methods: Detailed history was taken with emphasis on age of the baby and mother, parity, antenatal folic acid intake. Five milliliters of blood was drawn from all the babies and their mothers and divided equally in preheparinized vials (for karyotyping) and plain vials (for folic acid estimation). The total duration was 2 years. Results: The total number (n) in the study group was 75. The folic acid level was less in affected babies and their mother when compared to matched controls. Chromosomal defect was observed in nine of the 75 patients. Karyotyping defects were higher in children born to mothers of the age group 31-40 years and when their birth order was second. Conclusion: Folic acid supplementation needs to be continued to prevent the occurrence of NTD, and the perinatal identification of NTD should alert one to the possibility of chromosomal abnormalities and prompt a thorough cytogenetic investigation and genetic counseling.
Clinico-immunological response to intratumoral versus intravenous neoadjuvant chemotherapy in advanced pediatric solid malignancies
(Georg Thieme Verlag, 2013) Vijayendra Kumar; Nandini Ramaswami; Anand Pandey; Ram Chandra Shukla; Maloy Ranjan Sen; Shiv Prasad Sharma; Dinesh Kumar Gupta; Ajay Narayan Gangopadhyay
Background: There is minimal literature on the use of intralesional chemotherapy in the pediatric age group. We undertook this present study to evaluate the two modalities (intratumoral and intravenous) of giving chemotherapy in terms of toxicity of chemotherapy, hematological parameters, efficacy of chemotherapy in reduction in volume of the tumor as well as resectability of tumor with special emphasis on immunological parameters. Materials and Methods: Advanced cases of Wilms′ tumor and Neuroblastoma were included in the study. Intratumoral chemotherapy was given through 25 G spinal needle under aseptic precautions and ultrasound guidance in the same dose as in systemic chemotherapy. Intravenous group was given chemotherapy in the usual way. Reassessment was carried out after every course of chemotherapy. Results: Group A included 16 cases of Wilms′ tumor and 6 cases of neuroblastoma. In group B, there were 14 cases of Wilms′ tumor and 8 of neuroblastoma. Vomiting, diarrhea, mucositis, and thrombophlebitis were more common in the intravenous group (P<0.05). The fall in Immunoglobulin A, Immunogloblulin G, Immunoglobulin M, and T-cell rosetting was more common in the intravenous group (P<0.05). Seventy percent of patients had completely resectable tumor at the end of 6 doses of intratumoral chemotherapy as compared to 50% resectability in the intravenous group (P<0.05). Conclusion: Intratumoral chemotherapy, besides causing less of the adverse effects and increasing the resecability rate, also causes less suppression of the immune system. This may be offered as an alternative safe and effective modality of treatment for advanced solid tumors.
Conservative management of ulcerated haemangioma - Twenty years experience
(2009) Anand Pandey; Ajay Narayan Gangopadhyay; Shiv Prasad Sharma; Vijayendra Kumar; Saroj Chooramani Gopal; Dinesh Kumar Gupta
Ulceration is the most common complication of haemangioma and occurs in 5-15% of cases. The present study was carried out to evaluate the clinical features of ulcerated haemangioma and efficacy of the management protocol adopted by us over a period of 20 years. All patients with ulcerated haemangioma were evaluated on the basis of age at presentation, sex, rural or urban distribution and site of haemangioma. Treatment included application of topical antibiotic and systemic antibiotic and analgesic for pain. The total number of patients was 608. The male to female ratio was 1: 2·28. The rural:urban distribution was 2·43:1. The most common site of involvement was head and neck. Mean age of patients was 5·60 ± 2·44 months. Mean size of haemangioma and ulceration was 47·30 ± 20·67 cm2 and 7·49 ± 4·52 cm2, respectively. The mean time for ulcer healing was 40·06 ± 19·41 days. Ulcer size of more than 10 cm2 took more time to heal. Response to treatment was satisfactory. Ulcerated haemangioma usually occurs before completion of 1 year of age; hence, every patient with haemangioma needs careful attention. Adequate treatment and regular follow up brings satisfactory response in the patients. © 2009 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Decortication through muscle-sparing axillary skin crease incision (MSASCI) in late paediatric empyema thoracic
(Springer India, 2015) Vaibhav Pandey; Ajay Narayan Gangopadhyay; Dinesh Kumar Gupta; Shiv Prasad Sharma; Vijayendar Kumar
Introduction: Video-assisted thoracoscopic surgery (VATS) is a less invasive and preferred modality for early stages of empyema (American Thoracic Society, Am Rev Respir Dis 85:935–6, 1962). Still, in the late organising phase, thoracotomy and decortication is the treatment of choice (American Thoracic Society, Am Rev Respir Dis 85:935–6, 1962). We aimed to evaluate the results of decortications through muscle-sparing axillary skin crease incision (MSASCI) in paediatric empyema thoracic. Methods: A prospective study was conducted between July 2011 and June 2013 including 28 patients of empyema thoracic in late organising phase. Decortication was performed through MSASCI in all cases. Utility of incision was assessed in terms of intra-operative exposure, access to all the lobes, size and visibility of scar. Result: Adequate exposure was possible in all cases. Complete excision of thickened parietal pleura with stripping of visceral peel was possible in all the cases with the release of entrapped lung. A chest tube was removed after a mean of 6.67 ± 4.62 days (5–14 days). Three patients had air leak. There were no other complications. All children had good lung expansion on chest radiography at 4 weeks. Scar was hardly visible in normal position in follow up. Conclusion: Muscle-sparing axillary skin crease incision is a good alternative to classical thoracotomy for decortication in paediatric age group for patients with organised empyema. © 2015, Indian Association of Cardiovascular-Thoracic Surgeons.
Endoscopic Third Ventriculostomy in Infants Less than One Year of Age: A Short Series of 14 Cases
(S. Karger AG, 2021) Sarita Chowdhary; Shyamendra Pratap Sharma; Pranaya Panigrahi; Manoj Kumar Yadav; Shiv Prasad Sharma
Background: Endoscopic third ventriculostomy (ETV) is currently considered as an alternative to cerebrospinal fluid (CSF) shunt systems in the treatment of obstructive hydrocephalus. This procedure allows the CSF to drain in the basal cisterns and reabsorbed by arachnoid granulations, and avoiding implantation of exogenous material. Aims and Objectives: The purpose of this study was to assess the success rate of ETV in infants less than 1 year of age with congenital noncommunicating hydrocephalus. Material and Methods: This study was a 2-year prospective study from August 2017 to July 2019. ETVs were performed in 14 patients younger than 1 year with diagnosis of noncommunicating hydrocephalous. A failure was defined as the need for shunt implantation after ETV. Phase-contrast MRI of the brain was done after 6 months to see patency of ETV fenestration and CSF flow through ventriculostomy. Results: ETV was tried in 18 patients and successfully performed in 14 patients. Out of the 14 patients, shunt implantation after ETV was performed in 3 patients (failed ETV). In the successful cases, etiology was idiopathic aqueductal stenosis in 8, shunt complications in 2, and 1 case was a follow-up case of occipital encephalocele; the mean age was 7.7 months (range 3-12). In the 3 failed cases, etiology was aqueductal stenosis, mean age was 7.6 months (range 3-11). In all ETVs, failed patients MPVP shunting was done. Follow-up of nonshunted patients was done from 6 to 24 months (mean 15 months). There was no mortality or permanent morbidity noted following ETV. Conclusion: ETV is a good surgical procedure for less than 1-year-old children. © 2021 S. Karger AG. All rights reserved.
Minimizing the postoperative complications of severe hypospadias using a simple technique
(2012) Vijayendra Kumar; Ram Avtar Rathore; Ajay Narayan Gangopadhyay; Dinesh Kumar Gupta; Shiv Prasad Sharma
Background The aim of this study was to decrease complication rates in proximal hypospadias surgery. Methods A simple method of stenting using a polypropylene stent has been developed for the most severe form of hypospadias during the period from January 2008 to January 2011 in the Department of Pediatric Surgery. The total number of patients was 46. The patients were classified into group 1 (n= 23), in which a polypropylene stent was used, and group 2 (n= 23), in which a polypropylene stent was not used. Results In group 1, complications occurred in three patients (13.04%), whereas in group 2 it occurred in 12 patients (52.2%). The difference in the total number of complications between groups was highly significant (< 0.001). In group 1, no patient needed redo surgery, and in group 2 four patients (17.39%) needed redo surgery (< 0.05). All other patients responded to repeated dilatation in the follow-up. Conclusion Although the sample size was small, this simple modification can decrease the complication rate significantly in the most severe form of hypospadias. Ann Pediatr Surg 8:32-34 © 2012 Annals of Pediatric Surgery.
Modified laparoscopic excision of choledochal cyst: Technique and early results
(Wolters Kluwer Medknow Publications, 2021) Vaibhav Pandey; Vivek Srivastava; Pranay Panigrahi; Rakesh Kumar; Shiv Prasad Sharma
Background: Choledochal cyst is a common congenital anomaly requiring surgical treatment. Nowadays, laparoscopic excision is the preferred approach. We studied a modification in the classical laparoscopic approach to facilitate the dissection of a cyst. Materials and Methods: A prospective comparative study was done on 42 Type I choledochal cyst children. One group was operated by classical laparoscopic technique, while the other group was operated by modification of classical technique by deliberately opening the cyst wall and dividing the cyst into two hemi-cups, followed by dissection and excision. The intraoperative and postoperative parameters were assessed in both the groups. Results: The age, gender ratio, clinical presentation, and cyst diameter were comparable in both the groups. There was a significantly higher success rate (95.7% vs. 73.7%, P = 0.042) and lesser time for cyst excision (96.43 ± 12.15 vs. 120.91 ± 17.38 min P < 0.001) in the modified technique when compared to the classical technique. Further in three patients, it was possible to convert the classical procedure to a modified technique and complete the cyst excision. The postoperative outcomes were similar in both the groups. Conclusion: The modified laparoscopic excision shortens the operative time with higher success rate and comparable short-term morbidity vis-a-vis classical laparoscopic technique. © 2021 Journal of Indian Association of Pediatric Surgeons.
Nanoparticles: a new frontier in neurodegenerative disease therapy
(Frontiers Media SA, 2025) Vipin Kumar; Shiv Prasad Sharma; Anchal Pratap Singh
Nanoparticle-based drug delivery systems, such as liposomes, polymeric micelles, dendrimers, and other nanosized carriers, have emerged as promising strategies to improve the targeted delivery of therapeutic agents to the brain. These nanoparticles can be engineered to encapsulate drugs, facilitating their passage across the BBB, enabling localized treatment of the regions affected by neurodegeneration. Nanoparticles are characterized by their small size, large surface area, and possibility of functionalization, which allows them to be useful in many areas, including improved bioavailability, decreased systemic side effects, and improved therapeutic efficacy. Additionally, nanoparticles may also be surface-modified with appropriate ligands like antibodies, peptides, or small molecules, which exhibit specific interactions with receptors or cellular targets associated with the disease process. Such targeting has the potential to make targeted drug delivery possible, allowing therapeutic factors that can damage the healthy part of the brain to be delivered only to the diseased region. Furthermore, probable treatments for neurodegenerative diseases are also reviewed with the potential for complexation of different therapeutic agents, including small molecules, proteins, RNA, lipid nanoparticles and gene therapies with nanoparticle-based systems. 2025 Kumar, Sharma and Singh.
Neonatal necrotising fasciitis - Varanasi experience
(2008) Ajay Narayan Gangopadhyay; Anand Pandey; Vijay Dutt Upadhyay; Shiv Prasad Sharma; Dinesh Kumar Gupta; Vijayendra Kumar
Neonatal necrotising fasciitis (NNF) is a rare and fatal disorder. Successful outcome depends on timely intervention. This paper presents single-centre experience of presentation, management and outcome of the condition. Fifteen patients of NNF were managed during the study period of 5 years. Parameters studied were age, sex, site of involvement and treatment. Treatment included intravenous (i.v.) antibiotics and conservative surgery. Age of presentation was 10-28 days. Male to female ratio was 2:1. Neck and scalp were the commonest site (53.3%). Culture reports were unimicrobial in 66% with predominance of Staphylococcus species. Predisposing factors included rural environment (100%), malnourishment (60%), boils (40%) and scratch injury (13%). Forty per cent had idiopathic NNF. Wound healing was by secondary intention in 46.6% and skin grafting in 53.3%. Overall survival was 80%, while the premature had poorer outcome. NNF is a serious disorder. Early treatment with i.v. antibiotics and supportive measures followed by debridement improves survival. © 2007 Blackwell Publishing Ltd and Medicalhelplines.com Inc.
Novel technique of repair of large tracheo-esophageal fistula following battery ingestion in children: Review of two cases
(Springer Verlag, 2014) Vaibhav Pandey; Ajay Narayan Gangopadhyay; Dinesh Kumar Gupta; Shiv Prasad Sharma; Vijayendar Kumar
Surgical repair of acquired tracheo-esophageal fistula may result in tracheal stenosis or esophageal stricture. We used fistula with esophageal cuff as flap to repair the tracheal defect. Esophageal repair was performed by rotating ends through 90° in opposite direction. This technique offers excellent repair in a single stage. © Springer-Verlag 2014.
Ovotesticular Disorder of Sex Development in a Tertiary Care Center in North India: A Single‑center Analysis over a 5‑year Period
(Wolters Kluwer Medknow Publications, 2023) Sarita Chowdhary; Maneesha Upadhayaya; Gunjan Rai; Manpreet Kaur; Nitish Kumar Singh; Kanika Sharma; Ritesh Yadav; Bitan Naik; Shiv Prasad Sharma; Royana Singh
Background: Disorders of sexual development (DSD) encompass a group of congenital conditions characterized by diverse genotypic and phenotypic variations. Ovotesticular (OT) DSD is a distinctive subtype within this spectrum. Among the array of DSD, OT-DSD stands as one of the most infrequent anomalies, with reported prevalence rates as scarce as 1 in 83,000. This study aims to elucidate the clinical, hormonal, cytogenetic, surgical, and histopathological characteristics of OT disorder of sex development (OT-DSD) within a tertiary center in North India. Methodology: A retrospective analysis was conducted, involving a comprehensive review of records pertaining to OT-DSD patients from the years 2018 to 2022, all of whom were incorporated into the study. Results: The mean age of presentation in this study was 10 years, spanning from 6 to 15 years. Predominantly, the affected individuals were male, with a solitary patient representing the female category. Clinical manifestations displayed a spectrum encompassing genital ambiguity, inguinal swelling, and primary amenorrhea. The karyotypes observed were 46,XX in four patients and 46,XY in one patient. A holistic assessment, inclusive of clinical evaluation, hormonal assays, pelvic ultrasonography, and surgical intervention when necessary, was administered to all patients. Among these cases, three patients were reared as males, their gender assignment driven by external genital appearance and sociocultural influences. Notably, none of the patients manifested gonadal tumors during the course of the study. Conclusion: In cases of ambiguous genitalia, the consideration of OT-DSD should be integral to the differential diagnosis, underscoring the significance of heightened clinical awareness and informed decision-making. © 2023 National Journal of Clinical Anatomy | Published by Wolters Kluwer - Medknow.
Primary Eosinophilic Gastritis in a Child with Gastric Outlet Obstruction
(Springer New York LLC, 2016) Richa Katiyar; Shashikant C. U. Patne; Vinod Kumar Dixit; Shiv Prasad Sharma
A 3-year-old girl presented with multiple episodes of vomiting, fever, and hematemesis for the past 2 months. Except for hemoglobin, her rests of the laboratory tests were unremarkable. Her barium X-ray showed absence of the duodenal bulb and the C-loop. Her endoscopy showed deformed stomach with multiple ulcers and diverticuli. The gastric outlet was not visualized. Distal gastrectomy with gastro-duodenal anastomosis was performed. Histopathological findings revealed transmural dense infiltrates of eosinophils, consistent with eosinophilic gastritis. © 2016, The Society for Surgery of the Alimentary Tract.
Role of urinary transforming growth factor beta-b1 and monocyte chemotactic protein-1 as prognostic biomarkers in posterior urethral valve
(Wolters Kluwer Medknow Publications, 2020) Pranay Panigrahi; Sarita Chowdhary; Shyamendra Pratap Sharma; Rakesh Kumar; Neeraj Agarwal; Shiv Prasad Sharma
Background: Posterior Urethral Valves (PUV) are the most common cause of congenital LUT obstruction in males. Biomarkers of glomerular or tubular injury may be of particular value in predicting the need for surgical intervention or in tracing progression of chronic kidney disease. Measurement of biomarker in urine is relatively easy. Aim: To evaluate the changes in values of urinary Transforming Growth Factor Beta 1(TGF-B1) and Monocyte Chemotactic Protein (MCP-1) before and after valve ablation and its prognostic value in Posterior urethral valve. Material and Method: This prospective study was conducted from September 2016 to August 2018. The study group included 20 consecutive male babies with the diagnosis of PUV treated and followed up versus equal numbers of age matched control without any renal or urinary tract disease. Pre-operative urine samples were collected in Operative room. Cystoscopy and valve ablation was done. Follow up was done clinically by urinary stream and radiologically with VCUG. Follow-up was planned at 1 month, 3 months and 6 months following cystoscopic valve ablation. All collected urine samples were centrifuged at 10,000 rpm for 20 minutes. Supernatant was collected and two divided aliquots were stored at -200c to be thawed on the day of assay. Optical density of each well was recorded at 450 nm and 540 nm A p-value of <0.05 was considered to be statistically significant. Result and Discussion: Out of 20 cases of PUV, 14 (70%) cases were 1st born males of their family. The median age at the time of valve ablation in PUV cases was 2.5 (1.20-3.87) years.. Most common symptoms are fever and UTI. The preoperative median serum creatinine level was 1.65 mg/dl(1.22-2.42) pre-ablation, and fall significantly after ablation. Median eGFR level (calculated) was 25.635 (16.38-35.40) and after 6 months was 71.490 (45.44-96.93). Preoperative median MCP1 in PUV cases was 147.2 (82.8-512.5) and significant difference was also found in 1st, 3rd and 6th months after surgery (p<0.001, p=0.004 and p=0.002).Preoperative median TGF-B1 level was 197.8 pg/ml (79.9-386.4). There was no statistically significant change in TGF-B1 level at preoperative to 1 month and preop to 3 months after surgery but at 6 months after surgery the median TGF-B1 level significantly decreased as compared with preoperative TGF-B1 level. Conclusion: TGF β1 and MCP1 can be considered as prognostic urinary biomarkers in patients of PUV and can be used to specify and counsel patient's attendant regarding possibility of ESRD and need for further intervention. © 2020 Journal of Indian Association of Pediatric Surgeons.
Sandwich therapy in the management of propranolol resistant infantile hemangioma of the lip
(Elsevier Masson s.r.l., 2022) Preeti Tiwari; Vaibhav Pandey; Rathindra Nath Bera; Narendra Tiwary; Akash Mishra; Shiv Prasad Sharma
Rationale: Propranolol has evolved as a first line management of infantile haemangiomas. Nevertheless, the resistance to propranolol has warranted alternative treatment modalities. We hypothesize that combination of medical and surgical therapy (sandwich therapy) to be beneficial in the management. Methods: Patients were divided into three groups (total=31), Group A (bleomycin sclerotherapy), Group B (surgical group), Group C (sandwich therapy). A p value <0.05 was taken as significant. Results: In Group A 54.5% of patients had excellent response, 27.3% partial response and 18.2% had no response. Comparing cosmetic outcome, 25% of patients in Group B and 16.7% of patients in Group C had excellent upshot. On the contrary 18.2% of patients in bleomycin had unsatisfactory and 18.2% had poor cosmetic outcome. Sandwich therapy was cosmetically more acceptable than Bleomycin sclerotherapy (p- value = 0.049). In terms of recurrence, sandwich therapy differed significantly from surgical therapy with fewer recurrences (p-value= 0.049). Conclusion: Sandwich therapy is superior to bleomycin sclerotherapy in terms of cosmetic outcome and has fewer recurrences compared to surgical group and requires single stage resection. However, further studies with the help of Doppler ultrasound are required in this regard. © 2022 Elsevier Masson SAS
Single stage management of a unique variant of congenital pouch colon with triplet fistula and normal anus
(Wolters Kluwer Medknow Publications, 2015) Vaibhav Pandey; Ajay Narayan Gangopadhyay; Dinesh Kumar Gupta; Shiv Prasad Sharma
Congenital pouch colon (CPC) in the female patient presents with highly variable and anomalous anatomy. We herein report the first case of CPC with uterus didelphys having normal anal opening, H-type vestibular fistula, two other fistulous communications between pouch colon and two vagina managed in a single stage with excellent postoperative outcome.