ABSTRACT
Undescended Testis [UDT] or Cryptorchidism is the most common genital problem encountered in paediatrics. Untreated UDT/cryptorchidism clearly has deleterious effects on the testis over time. In Gezira National Center for Pediatrics Surgery [GNCPS] UDT/Cryptorchidism had been treated since early 80s. During this period no study was taken to evaluate this condition. This is a retro-prospective descriptive study done over a 2 year period from Oct 2009 to Oct 2011 including all patients with UDT operated on in the GNCPS. Patients were evaluated regarding the age at presentation, age at surgery, site of the UDT, location of the testes, investigations done and treatment modality. A total of 232 children underwent orchidopexy for UDT in GNCPS, 81.5% of those patients were older than 2 years. Bilateral cases were 16.8%. Nonpalpable testes found in 36.6% of cases. Dartos pouch fixation was used in 79.8% of the cases. the majority of children with UDT presented at an age older than two year which reflect the delay in diagnosis due to lack of adequate neonatal examination
ABSTRACT
Sixty three patients admitted to the Gezira National Center of Pediatric Surgery with snake bite were analyzed. All patients were envenomed and the snake was positively identified. In 39 patients [61.9%] the offending snake was [washash] [Echis carinatus] and in 24 patients [38.1%] [Abdafan] [atractaspis microlepidata was identified. All patients were from rural Gezira where children are actively involved in agriculture and harvesting. The median age group was 9.3 years. Females were equally involved as males. The mean time elapsed since the bite was 56 hours. Quicker arrival at hospital was seen in severe envenomation. Fifty patients had already received native remedies which was observed to increase the local wound complications. Most bites [79%] occurred in the leg .The majority of the bites occurs in the early rainy summer months. All patients presented initially with progressive painful swelling. Local necrosis was observed in seventeen patients [26.9%]. Fourteen patients [22.2%] developed compartment syndrome and three patients [4.76%] developed fingertip gangrene, one patient [1.6%] developed extensive bilateral common iliac vein thrombosis. D1C developed in 21 patients [33.3%]. Two patients [3.2%] of theses developed intracranial haemorrhage. Four patients [6.3%] with local necrosis presented few month later with extensive chronic osteomyelitis.Treatment options included cardiovascular support, local wound debridement, fasciotomy and minor amputation. Patients with DIC were managed with fresh frozen plasma, blood transfusion and heparin. Antivenin was not administered to our patients. All patients eventually recovered except one child [1.6%] who succumbed of massive intracerebral haemorrhage