44 research outputs found
Pleomorphic lipoma of the neck in an infant: A rare clinical entity
No full textLipomas are rare in the pediatric age group. A 10-month-old male child presented with an asymptomatic neck mass which was evaluated and excised completely. Histopathology was consistent with pleomorphic lipoma, not previously reported in children
Single-stage transanal endorectal pull-through for Hirschsprung's disease: A retrospective study of surgico-pathological correlations and technical considerations
No full textBackground: Transanal endorectal pull-through (TEPT) is a well-established operation for the management of rectosigmoid and short-segment Hirschsprung's disease (HD). A well-performed contrast enema (CE) is an essential road map for the surgeon when attempting the TEPT. We looked at the surgicopathological–radiological correlations and technical considerations of this procedure and discussed our experience over a decade. TEPT essentially relies on radiological mapping of the disease correlating with intraoperative and pathological findings. Some investigators opine that the radiological correlation of the transition zone (rTZ) with the pathological transition zone (pTZ) is accurate whereas others disagree. We review our experience in managing HD patients with TEPT, in terms of pre-operative workup and operative and pathological considerations. Materials and Methods: A retrospective study was done in a single unit, from January 2010 to January 2020. Forty-seven patients who met the inclusion criteria such as short-segment HD and uncomplicated HD underwent CE before surgery. The patients included in the review underwent a primary TEPT. For each patient, we identified the radiological transition zone (rTZ) on the contrast enema, the gross transition zone (gTZ) on intraoperatively visual examination, the frozen section transition zone (fTZ) on intraoperative analysis of the frozen section specimens (fTZ), and the pathological transition zone (pTZ) on permanent paraffin blocks of the specimens. We determined the strength of correlation of the rTZ, the gTZ and the fTZ with reference to the pTZ. Results: Forty-seven patients underwent single-stage transanal pull-through. There were 40 males. There were 8 neonates, 20 infants and 19 children (>12 months of age). The mean age at diagnosis was 8.7 days (3–20 days) for the neonates, 5.11 months (2–12 months) for the infants and 4.3 years (1.5–9 years) for children. In our study, 85% correlation was noted between the rTZ and the pTZ (τb = 0.362, P = 0.006). There was an excellent correlation between the intraoperative gTZ, fTZ and the pTZ in all patients except one (97.8%, τb = 0.942, P < 0.001). Conclusions: The TEPT is a feasible option to manage carefully selected patients with rectosigmoid HD. The presence of robust support from pathology and a properly carried out CE are essential parameters to be considered before successfully undertaking these operations. The functional outcomes of TEPT are comparable with other procedures for HD with the added advantage of it being a scar-less and a stoma-less approach
A rare cause of right iliac fossa pain
No full textA child with torsion of appendix epiploicae presenting as acute right iliac fossa pain in abdomen is reported
Does all small bowel intussusception need exploration?
No full textSmall bowel intussusception (SBI) in infants and children are ususally associated with a lead point. With increased use of radiological investigations, more idiopathic SBIs are identified. As reduction by hydrostatic or air enema are less successful in these cases, most of them require surgical exploration in children. However, now many cases of SBI have been found to reduce spontaneously. We report two cases of SBI with spontaneous reduction and review the literature for the management guidelines
IFRS for SMEs: A New Zealand perspective
No full textThe International Accounting Standards Board (IASB) in its concern to reduce the burden of compliance with the International Financial Reporting Standards (IFRS) has released its draft IFRS for small and Medium-sized Enterprises (IFSME). The draft proposes reporting standards for non-publicly accountable entities that produce general purpose financial reports. This paper presents the background to the introduction of IFSME, introduces the IASB proposal, outlines the New Zealand (NZ) financial reporting concessions (viz. The exempt company system and the differential reporting framework), and examines the implications of adoption for NZ. It is considered that few entities would be affected by the IFSME, the production and maintenance of a ‘small book’ would be costly, and report preparers need to be cognisance of both the IFRS and the IFSME. The users of financial information, identified by the IASB, rely on other forms of information in NZ to make investment and monitoring decisions. The IFSME appears redundant in the light of the existing frameworks for concessions. Further, it appears that second-class accountants and entities could emerge if the IFSME were adopted. The author concludes that the IFSME is not appropriate for NZ application and should be rejected
Scrotal abscess with a rare cause
No full textA 4-year-old boy presented with a short history of right-sided acute scrotal pain and swelling. At exploration, pus was found in the hemiscrotum but no local cause could be found. Further exploration showed the pus coming through a patent processus vaginalis from a collection in the right iliac fossa secondary to acute appendicitis
An Unusual Case of Erb’s Palsy in a Neonate: A Case Report
No full text Erb’s palsy occurs in neonates following traumatic delivery, where excessive traction on the neck stretches these nerve roots. Nonobstetric causes of Erb’s palsy are rare in neonates. The authors report the presentation of a female neonate with Erb’s palsy following a postero-lateral thoracotomy. The infant underwent surgery on day 3 of life for esophageal atresia and presented with right upper limb weakness on day 21 of life. She demonstrated features of Erb’s palsy with normal higher mental functions. An electromyography and nerve conduction study confirmed Erb’s palsy. The surgical procedure in the index case did not involve the brachial plexus. However, her right upper limb was positioned hyperabducted during the intraoperative period, which possibly had led to the palsy. The key message of this report is that prolonged stretching of the brachial plexus roots during surgery of the neck and thorax can be an important nonobstetric cause of Erb’s palsy in neonates </jats:p
Crossover Upper Pouch in Type C Esophageal Atresia: An Uncommon Variant Causing Diagnostic Dilemma
No full textEsophageal atresia with tracheoesophageal fistula (EA-TEF) is a well-known congenital anomaly and Type C variety of gross classification is the most common. Even for Type C variety, anatomy of upper pouch and lower pouch is not always the same. We are presenting three cases of Type C EA-TEF with unusual anatomy. In this type, upper pouch crosses over the lower pouch for a significant length. The cases are described here to highlight this variant of Type C EA-TEF which produces diagnostic dilemma. An early diagnosis of this variant, prevents morbidity and mortality.</jats:p
Fine structure in the A – X system of aluminium monochloride molecule, determination of dissociation energy by predissociation
No full textThe rotational structure of the A — X system of aluminium monochloride molecule has been photographed in the third order of a 10.6 meter concave grating spectrograph with 0.22 Å/mm dispersion in order to obtain precise molecular constants. The rotational predissociation observed in the bands involving V = 9 and 10 vibrational levels of the excited state has been used to determine the precise value of the dissociation energy which comes out to be 5.26 ± 0.01 eV. The nature of the predissociating state has also been discussed
Fine structure in the A – X system of aluminium monochloride molecule, determination of dissociation energy by predissociation
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