Notes

Epidemic and Features involving Psoriasis in Romania-First Review throughout General Population.
To compare the outcomes in children who underwent emergency surgery and those who underwent percutaneous drainage for appendicular abscess.

In this prospective study, 45 children of appendicular abscess detected on ultrasonogram (USG) were included in the study. The following characteristics were registered age, gender, the time from onset of symptoms to seeking care, pain, vomiting, fever and general peritonitis; white blood cell count. The size, location of the abscess was noted on USG. After the diagnosis, we divided the patients into two groups based on the type of management. Patients who underwent emergency surgery and appendectomy (Group 1) which composed of twenty patients (14 males and six females) with their ages ranged from 3 to 18 years, and patients treated with ultrasound-guided percutaneous drainage and interval appendectomy (Group 2) which composed of 25 patients, (15 males and ten females) with their ages ranged from 2 to 18 years.

Group 1 included twenty patients and Group 2 included 25 patients. In Group 1, on USG the average size of the abscess was 7.2 ± 2.5 cm. After the surgery regained their functional recovery during a mean period of 3.2 ± 1 days. In Group 2, on USG average abscess size was 6.8 ± 2.4 cm. After the procedure regained their functional recovery on the second day. No major complications were noted in Group 2. On the contrary, 12 patients (60%) of Group 1 show complications in the form of wound infection in eight children and wound dehiscence in four children.

USG-guided percutaneous drainage was safe and effective way of management of appendicular abscess.
USG-guided percutaneous drainage was safe and effective way of management of appendicular abscess.
Appendicitis is the commonest and most frequently misdiagnosed acute abdominal surgical illness in the paediatric population worldwide. The aim of this study is to evaluate the role of coagulation profile in acute appendicitis (AA) in children.

we retrospectively collected data of patients submitted to appendectomy from 2011 to 2017. According to histopathology, patients were divided into three groups not histologically confirmed AA (NAA), simple AA (SAA) and complicated AA (CAA). White blood cell (WBC) count, relative neutrophilia (Neutr%), C-reactive protein (CRP), prothrombin time ratio (PTratio), activated partial thromboplastin time ratio (APTTratio) and fibrinogen (Fib) were compared among groups.

Three hundred and seven patients were included 57 NAA, 184 SAA and 66 CAA. WBC was significantly different among groups CAA (mean 16.67 × 10
/ml), SAA (14.73 × 10
/ml, P= 0.01) and NAA (10.85 × 10
/ml, P< 0.0001). Significant differences were found for Neutr% (mean CAA 81.14 vs. SAA 77.03 P= 0.006, vs. NAA 63.86 P< 0.0001) and CRP (mean NAA 2.56, SAA 3.26, CAA 11.58, P< 0.0001). PTratio and Fib increased with the severity of AA receiver operator characteristic curves were similar for CRP (0.739), Fib (0.726), WBC (0.746) and Neutr% (0.754), while for PTratio and aPTTratio were 0.634 and 0.441, respectively.

extrinsic coagulation pathway is altered in AA, especially in CAA. Coagulation can be useful in the diagnostic and perioperative anaesthetic management of AA in children. Fib seems to have the highest accuracy.
extrinsic coagulation pathway is altered in AA, especially in CAA. Coagulation can be useful in the diagnostic and perioperative anaesthetic management of AA in children. Fib seems to have the highest accuracy.
Breast masses occur infrequently in children and adolescents. Most of these masses have proved that benign and conservative approach is the management of choice. Consequently, imaging has become crucial. The knowledge of the ultrasonographic features of childhood and adolescent breast masses is needed for age appropriate medical care.

The aim of this study was to describe and document the ultrasonographic spectrum of breast masses in children and adolescents (0-19) years seen in the Ahmadu Bello University teaching hospital, Zaria.

A 2-year retrospective review of breast sonograms of 25 consecutively presenting children and adolescents (3 males and 22 females) who had palpable breast masses. Ultrasound scans were performed with a Mindray Machine DC-8 using the linear transducer at 7.5-12 MHz transducer frequency. Histopathological confirmation of the solid masses was also obtained. The statistical analysis of the data collected was done using the SPSS software version 20 (SPSS Inc., Chicago, IL, USA).

need for unnecessary invasive procedures which should be reserved for only deserving cases.
We had done this study for TEF with Anorectal malformation and TEF with no Anorectal malformation in terms of age, sex, surgical outcomes and mortality.

This was a retrospective review of cases with clinical data (from April 2012 to April 2017). The participants of this study were 236 patients who had been diagnosed and managed for ARM. Among these patients, 25 patients associated with EA were selected as the subject patient group.

The incidence of tracheoesophageal fistula with ARM was 11.1%. The study has more male preponderance. All cases are of Type c except two cases of Type a. According to the classifications of ARMs, there were two cases with rectourethral fistula and eight cases with rectoperineal fistula and covered anus in the males. In females, there was a varied distribution of seven cases. There was one case (4%) presenting as a part of the Vertebral anorectal malformation cardiac tracheoesophageal renal and limb anomalies (VACTERL) association, which is the representative example of a complex anomaly. Most of the cases died due to cardiac problem and pneumonitis (due to delayed presentation).

The study concludes the experience of EA (±fistulae) with ARM, their distribution, incidence and outcome of the tertiary care centre.
The study concludes the experience of EA (±fistulae) with ARM, their distribution, incidence and outcome of the tertiary care centre.
Oesophageal colonic interposition in oesophageal atresia (OA) patients is almost exclusively done as a staged operation with an initial oesophagostomy and gastrostomy followed by the definitive surgery months later. This study presents a series of patients in whom a cervical oesophagostomy was not performed before the substitution surgery.

Records of EA patients were evaluated for those who underwent colon interposition without cervical oesophagostomy.

There were five patients three with pure EA and two with proximal tracheo-oesophageal fistula. A delayed primary repair could not be performed because of intra-abdominally located distal pouch. The mean age at the time of definitive operation was 5.54 (±2.7) months and the mean weight was 6.24 (±1.3) kg. A right or a left colonic segment was used for interposition keeping the proximal anastomosis within the thorax. The post-operative results were quite satisfactory within a median follow-up period of 33.2 months.

Avoiding cervical oesophagostomy and its inherent complications and drawbacks is possible in a subset of patients with long-gap EA who underwent colonic substitution surgery. This approach may be seen as an extension of the consensus that the native oesophagus should be preserved whenever possible, because it uses the native oesophagus in its entirety.
Avoiding cervical oesophagostomy and its inherent complications and drawbacks is possible in a subset of patients with long-gap EA who underwent colonic substitution surgery. This approach may be seen as an extension of the consensus that the native oesophagus should be preserved whenever possible, because it uses the native oesophagus in its entirety.
The Sociétè Internationale d'Oncologie Pédiatrique advocates for neoadjuvant chemotherapy in the management of nephroblastoma. Postoperatively, histological findings are used to assign risk classification to resected tumours. The aim of this study is to compare the response demonstrated by pre-operative imaging to the amount of necrosis seen on histology postoperatively.

About 33 patients with nephroblastoma over a 10 year period had adequate imaging and histology records for this study. Three methods were used to assess tumour change following neoadjuvant therapy and were compared with histological records. 1. An estimation of necrosis, 2. Surface areas of apparent necrosis within the tumour measured on static imaging, 3. The change in volume of the mass. Pearson coefficient was calculated to measure the correlation between histologically observed necrosis and radiological changes. Results were considered significant if P< 0.05.

There was no correlation between radiological changes on pre-operative stological risk classification of a nephroblastoma based on the changes demonstrated on non-contrasted magnetic resonance imaging or computed tomography preoperatively.[This corrects the article DOI 10.4103/0973-1482.188431].Epidermoid cysts of the spinal cord without spinal dysraphisms are rare lesions and intramedullary cysts are still rarer. Approximately only over 60 cases are reported in literature worldwide. Magnetic resonance imaging is the imaging modality of choice for the diagnosis of these lesions. Management of these lesions is by total surgical excision, although at times, it is not possible due to adherence of the capsule to the parenchyma of the spinal cord which may be the cause of recurrence. To our knowledge, this is the second case of recurrent intramedullary epidermoid cyst of spinal cord. selleckchem We report a case of intramedullary epidermoid cyst which recurred after 7 years following near-total excision of tumor at our institute.Extramammary Paget's disease (EMPD) of the penis is a rare, intraepidermal adenocarcinoma. We describe the case of a 60-year-old male who presented with an erythematous plaque on his penis, previously treated with various topical and oral drugs. Punch biopsy from the lesion revealed the diagnosis of EMPD. Early diagnosis and treatment is necessary for this rare neoplastic condition.Pineal gland metastasis accounts for approximately 0.4% of all intracranial metastases from lung primary. Our patient was a 60-year-old female presenting with intermittent headache and altered sensorium. Magnetic resonance imaging brain showed a 21 mm × 18 mm × 16 mm pineal lesion with obstructive hydrocephalus. She underwent endoscopic third ventriculostomy and drainage. Fluorodeoxyglucose-PET showed a left lung primary tumor with nodal metastasis and solitary pineal gland metastasis. Biopsy of lung lesion revealed poorly differentiated non-small-cell carcinoma which was treated with focal pineal radiation and chemotherapy. This patient's presentation is unique because she presented with pineal symptoms rather than lung symptoms. Pineal gland metastasis from lung primary is mostly associated with small-cell carcinoma histology, but this patient had a non-small-cell carcinoma of lung primary. The age above 60 years is in favor of a metastatic lesion to the pineal gland. Our experience suggests that systemic evaluation of all patients presenting initially with an isolated pineal gland tumor is mandatory.We present here a case of a 35-year-old woman diagnosed with primary neuroendocrine carcinoma of the breast (NECB) - small cell type. We discuss the importance of histological and molecular criteria for primary neuroendocrine mammary neoplasm, established by the World Health Organization in 2003 and 2012. We present information about differential diagnosis, prognostic factors, surgical treatment, adjuvant treatment, and novel therapies for primary NECB. Although this disease is not so uncommon but it is highly underreported and with consistent diagnostic criteria, surgeons should be able to keep this entity as differential diagnosis to enable them a timely treatment.
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