Guide wire dilatation of anastomotic strictures secondary to surgical repair of esophageal atresia

To evaluate the efficacy of esophageal guide wire dilatation of stricture after surgical treatment of esophageal atresia. This prospective and descriptive study was carried out at Department of Pediatric Surgery, The children's hospital, Pakistan Institute of Medical Sciences [PIMS], Islamabad from January 2008 to December 2011. It included 23 patients, 15 males and 8 females, aged one month to 3 years with esophageal stricture secondary to esophageal atresia who underwent guide wire esophageal dilatation with savary Gilliard Dilators. All procedures were performed under general anesthesia. Associated gastroesophageal reflux [GER]. was noted in 13 patients. Dilatation relieved the stricture in all patients over a follow-up period varying from 3 months to 3 years. Only two patients developed esophageal perforation, which was treated conservatively. Guide wire dilatation is a safe and effective method of treatment in the management of strictures secondary to surgical repair of esophageal atresia

Frequency of congenital anomalies in Southern Punjab

To determine the pattern of major congenital malformations in neonates admitted in Nishtar Hospital Multan and evaluate their early outcome. Descriptive study. This study was conducted at the Department of Anatomy, in collaboration with department of Gynaecology and Obstetrics and department of Paediatrics Nishtar Medical Institution Multan from March to August 2012. A total of 431 neonates were admitted in Paediatric Wards including those referred from outside and from Labour Room of Nishtar Hospital. Children with major congenital malformations were identified by clinical examination and confirmed by appropriate radio-diagnostic methods. These neonates were immediately referred to the surgical team for intervention. A total of 57 neonates with congenital malformations were admitted during the study period. Thirty one were males and, 26 females. Fetal anomalies were diagnosed correctly in 17 cases out of a total of 19 inborn deliveries on maternal ultrasound while it was missed in one fetus and incorrectly diagnosed in one case. A total of 48 patients had surgery out of which 4 [8.3%] died in the neonatal period. Five cases were booked for elective surgery beyond the neonatal period. Out of 4 neonates with congenital heart disease one case was referred outside, one neonate died preoperatively while 2 infants were managed conservatively. Due to detection of fetal anomalies, early surgical intervention, and intensive neonatal care, most infants can be rescued after a successful primary operation