Urinary tract and other associated anomalies in newborns with esophageal atresia

Esphageal atresia is often associated with other anomalies. Hereditary and environmental factors may influence the incidence of associated anomalies, particularly of the urogenital system. WE had 63 neonates with esophageal atresia admitted to 2 centers in Hamadan, Iran, from 2002 to 2008. They were 38 girls [60.3%] and 25 boy [39.7%]. Tracheoesophageal fistula was present in 54 neonates [85.7%], and other associated anomalies in 10 [15.9%]. Cardiac anomalies were found in 7 neonates; anorectal anomalies, in 4; urinary tract anomalies, in 2; and limb anomaly, in 1. Urinary tract anomalies [3.2%] were bilateral polycystic kidney in 1 neonate and unilateral hydronephrosis due to ureteropelvic junction obstruction in another. Both neonates with urinary tract anomalies were female and both had tracheoesophageal fistula, as well. Many of associated congenital abnormalities influence the management protocol of esophageal atresia, and therefore, should be detected as soon as possible after birth

Lubrication of circumcision site for prevention of meatal stenosis in children younger than 2 years old

Circumcision is one of the most common surgical operations throughout the world, and meatal stenosis is one its late complications. We evaluated the topical use of a lubricant jelly after circumcision in boys in order to reduce the risk of meatal stenosis. A randomized control trial was performed, in which 2 groups of boys younger the 2 years old underwent circumcision according to the sleeve method. The parents in the study group were instructed to use petroleum jelly on the circumcision site after each diaper change for 6 months. In the control group, no topical medication was used. The children were followed up regularly and evaluated for meatal stenosis, bleeding, infection, and recovery time. A total of 197 boys in each group completed the study. None of the children in the study group but 13 [6.6%] in the control group developed meatal stenosis [P < .001]. Infection of the circumcision site was seen in 3 [1.5%] and 23 [11.7%] children of the lubricant and control groups, respectively [P < .001], and bleeding was seen in 6 [3.0%] and 37 [18.8%], respectively [P < .001]. The mean time of recovery in the lubricant group was 3.8 +/- 1.2 days, while it was 6.9 +/- 4.2 days in the control group [P = .03] Based on the findings of this study, it seems logical to use a lubricant jelly for reducing postcircumcision meatal stenosis and other complications