ABSTRACT
Objective?The word “telemedicine” literally translates to “healing at a distance.” In the current scenario of the coronavirus disease 2019 (COVID-19) pandemic and shut outpatient department, the patients are facing difficulty in consultation. This article evaluated the use of telemedicine in the management of pediatric surgical patients. Materials and Methods?In this observational cohort study, from April 2020 to August 2020, all patients who took advice on phone/WhatsApp were assessed for addressing their complaints. The data was collected and analyzed. Result?A total of 307 patients were provided consultation via telecommunication. The male to female ratio was 2.3:1. Fifty-six (18.2%) patients called on an emergency basis, while the remaining 251 (81.8%) patients called for nonemergency or routine problems. Of these, attendants of 25 (8.14%) patients were not able to state the situation adequately. They were called to the department. Of these, 11 (3.5% of total) patients were admitted. One-hundred and eighty-three (59.6%) patients were in the department's follow-up, while the remaining 124 (40.4%) were new patients. The attendants of 296 (96.4%) patients were satisfied by using this modality of consultation. Conclusion?In the current scenario, telecommunication may help us to avoid unnecessary travel to the hospital. It may be helpful to deal with minor clinical complaints and evaluating for an emergency.
ABSTRACT
Developing countries. To propose a operative classification of Chordee without hypospadias [CWH] with its management. Tertiary referral centre; Retrospective study from January 2000 to January 2011. Total 26 patients were classified peroperatively into sixtypes [A: Cutaneous chordee[rightwards arrow] Degloving skin and dartos [1/26]; B: Fibrous chordee[rightwards arrow] chordectomy [4/26];C: Corporocavernosalchordee[rightwards arrow] Corporoplasty +/- Urethral mobilization [4/26]; D: Urethral tethering with Hypoplastic urethra[rightwards arrow]Urethral mobilization +/- urethral reconstruction because of hypoplastic urethra [14/26]; E: Congenital short urethra[rightwards arrow] excision of urethra from the meatus and urethroplasty [2/26]; and F: Complex chordee[rightwards arrow] Degloving +/- Corporoplasty +/- urethroplasty [1/26 patients].The follow-up over 6 months to 9 years were analyzed. SPSS soft ware version 17.0 for Windows. The mean age of surgery was 5.33 +/- ?0.11 years. The success rate defined on uroflowmetry and voiding cystourethrography was 65.6%. The coronal urethra-cutaneous fistula developed in 26.9% [7/26] [including 7.7% [3/26] of associated metal stenosis]. The urethral stricture developed in 3.8% [1/26]. CWH needs stepwise surgical management. The operative classification may help in better understanding and management of this difficult entity. Meticulous tissue handling and urethroplasty is needed for good and promising results
Subject(s)
Humans , Male , Penile Diseases/surgery , Hypospadias , Disease Management , Urethra/abnormalitiesABSTRACT
One of the rare complications of choledochal cysts is rupture. In majority of the cases, the cause of rupture is unknown. Reconstructive surgery is the treatment of choice. We describe three patients with choledochal cyst rupture, who were admitted with acute abdomen. Diagnosis of biliary ascites with peritonitis was made in all the three patients. At surgery, two patients underwent T-tube placement, and definitive repair was done electively. One patient underwent definitive repair of ruptured choledochal cyst, but died due to septicemia. External bile drainage would be safer in emergency condition.
ABSTRACT
Spontaneous perforation of extrahepatic bile duct is rare. The cause is idiopathic once trauma and choledochal cyst are ruled out. The condition presents a diagnostic dilemma. Preoperative recognition is necessary as early surgical intervention gives excellent prognosis. We report clinical observations made in three cases with acute presentations. Diagnosis is to be suspected by the presence of jaundice after an initial anicteric period of good health with biliary ascites. This is confirmed by bilious abdominal paracentesis, signs of peritonitis and absent free gas on X ray. The constellation of these three findings was constant in three patients. The presented paper highlights the same as reliable clues to diagnosis.
Subject(s)
Abdomen, Acute/etiology , Bile Duct Diseases/diagnosis , Bile Ducts, Extrahepatic , Cholangiography , Drainage , Female , Humans , Male , Rupture, SpontaneousABSTRACT
A rare case of 10-year-old female child with recurrent trichobezoar stomach is reported, which presented with features of gastric outlet obstruction with perforation.