Colgajo de túnica vaginal en la prevención de fístulas postoperatorias tras reparación de hipospadias severos: ¿ha terminado la búsqueda del Santo Grial? / The tunica-vaginalis flap to prevent postoperative fistula following severe hypospadias repair: Has the search for Holy Grail ended?

Introducción: La fístula posterior a la reparación del hipospadias sigue siendo un desafío para el hipospadiólogo, por lo que se han desarrollado diversas técnicas. Sin embargo, la incidencia de la fístula postoperatoria se encuentra entre el 10 y el 30%, y aumenta de acuerdo con la severidad del hipospadias. Hemos realizado un estudio para evaluar la eficacia del colgajo de túnica vaginal en la prevención de la formación de fístulas tras la reparación de casos severos de hipospadias.Materiales y métodosSe realizó un estudio observacional en un centro terciario entre 2008 y 2017. El estudio incluyó a niños con hipospadias severos (proximal, penoescrotal, escrotal y perineal). En todos los pacientes se usó un colgajo de túnica vaginal para reforzar la uretroplastia. Todos los pacientes recibieron seguimiento durante al menos un año tras finalizar el tratamiento.ResultadosSe incluyó un total de 210 pacientes en el estudio. Se realizó reparación en 2 etapas de Bracka en 180 pacientes con hipospadias penoescrotal o un meato aún más proximal. Los 30 pacientes restantes con hipospadias proximales se sometieron a la reparación de Snodgrass de una sola etapa. Cuatro (2%) pacientes desarrollaron fístulas, todos después de la reparación en 2 etapas, y la mitad de ellos requirieron corrección quirúrgica. Dos (1%) pacientes tuvieron un fallo parcial de la reparación y se sometieron a una reparación residual a los 6 meses.ConclusiónEl colgajo de túnica vaginal es un excelente refuerzo en la reparación de hipospadias severos. Es fácilmente accesible, sencillo de extraer, y su buena vascularización ayuda a reducir significativamente la incidencia de fistulización postoperatoria. (AU)

Introduction: Fistula following hypospadias repair remains a bane for the hypospadiologist resulting in the evolution of various techniques. Despite all these, the incidence of postoperative fistula varies between 10 to 30% and it increases with the severity of the hypospadias. Hence, a study was conducted to evaluate the efficacy of tunica vaginalis flap in preventing fistula formation following severe hypospadias repair.Materials and methodsAn observational study was carried out in a tertiary center between 2008 and 2017. The study included children with severe hypospadias (proximal penile, penoscrotal, scrotal, and perineal). In all the patients, a tunica-vaginalis flap was used to buttress the urethroplasty. All the patients were followed up for at least a year after the completion of treatment.ResultsA total of 210 patients were included in the study. Bracka's 2-stage repair was performed in 180 patients who had either penoscrotal hypospadias or a meatus even more proximal. The rest 30 patients with proximal penile hypospadias underwent a single-stage Snodgrass repair. Four (2%) patients developed a fistula, all following 2-stage repairs, and half of them required surgical repair. Two (1%) patients had a partial breakdown of repair and underwent a residual repair after 6 months.ConclusionThe tunica-vaginalis flap is an excellent buttress in severe hypospadias repair. It is readily available, easy to harvest, with its good vascularity helps to significantly reduce the incidence of postoperative fistula. (AU)

The tunica-vaginalis flap to prevent postoperative fistula following severe hypospadias repair: Has the search for Holy Grail ended?

INTRODUCTION: Fistula following hypospadias repair remains a bane of the hypospadiologist resulting in the evolution of various techniques. Despite all these, the incidence of postoperative fistula varies from 10 to 30% and it increases with the severity of the hypospadias. Hence, a study was conducted to evaluate the efficacy of tunica vaginalis flap in preventing fistula formation following severe hypospadias repair. MATERIALS AND METHODS: An observational study was carried out in a tertiary center between 2008 and 2017. The study included children with severe hypospadias (Proximal penile, Penoscrotal, scrotal, and Perineal). In all the patients, a Tunica-Vaginalis flap was used to buttress the urethroplasty. All the patients were followed up for at least a year after the completion of treatment. RESULTS: A total of 210 patients were included in the study. Bracka's two-stage repair was performed in 180 patients who had either Penoscrotal hypospadias or a meatus even more proximal. The rest 30 patients with proximal penile hypospadias underwent a single-stage Snodgrass repair. Four (2%) patients developed a fistula, all following two-stage repairs, and half of them required surgical repair. Two (1%) patients had a partial breakdown of repair and underwent a residual repair after six months. CONCLUSION: The Tunica-Vaginalis flap is an excellent buttress in severe hypospadias repair. It is readily available, easy to harvest, with its good vascularity helps to significantly reduce the incidence of postoperative fistula.

The tunica-vaginalis flap to prevent postoperative fistula following severe hypospadias repair: Has the search for Holy Grail ended? / Colgajo de túnica vaginal en la prevención de fístulas postoperatorias tras reparación de hipospadias severos: ¿ha terminado la búsqueda del Santo Grial?

INTRODUCTION: Fistula following hypospadias repair remains a bane for the hypospadiologist resulting in the evolution of various techniques. Despite all these, the incidence of postoperative fistula varies between 10 to 30% and it increases with the severity of the hypospadias. Hence, a study was conducted to evaluate the efficacy of tunica vaginalis flap in preventing fistula formation following severe hypospadias repair. MATERIALS AND METHODS: An observational study was carried out in a tertiary center between 2008 and 2017. The study included children with severe hypospadias (proximal penile, penoscrotal, scrotal, and perineal). In all the patients, a tunica-vaginalis flap was used to buttress the urethroplasty. All the patients were followed up for at least a year after the completion of treatment. RESULTS: A total of 210 patients were included in the study. Bracka's 2-stage repair was performed in 180 patients who had either penoscrotal hypospadias or a meatus even more proximal. The rest 30 patients with proximal penile hypospadias underwent a single-stage Snodgrass repair. Four (2%) patients developed a fistula, all following 2-stage repairs, and half of them required surgical repair. Two (1%) patients had a partial breakdown of repair and underwent a residual repair after 6 months. CONCLUSION: The tunica-vaginalis flap is an excellent buttress in severe hypospadias repair. It is readily available, easy to harvest, with its good vascularity helps to significantly reduce the incidence of postoperative fistula.

Seasonal variation of the prevalence of cymothoid isopod Norileca indica (Crustacea, Isopoda), parasitizing on the host fish Rastrelliger kanagurta collected from the Southwest coast of India.

Parasitological investigations on the occurrence of isopod parasites in fishes collected from off Cochin coast along Southwest India was carried out for a period of 1 year from January 2018 to December 2018. Altogether 20 species of fishes were analysed from 12 families including Scombridae, Carangidae, Clupeidae, Nemipteridae, Hemiramphidae, Belonidae, Menidae, Priacanthidae, Sphyraenidae, Stromateidae, Coryphaenidae. Infestation of Norileca indica was noticed only in the host fish Rastelliger kanagurta. Totally 619 specimens of R. kanagurta were examined for the presence of isopod parasite, N. indica. Among those, one hundred and seventy five specimens were found to be infested by N. indica. Overall prevalence, mean intensity and abundance were found to be 28.27%, 1.21, and 0.342 respectively. Highest prevalence of infestation, mean intensity and abundance were recorded in the month of August 2018.

Screening and Characterization of Cold-Active ß-Galactosidase Producing Psychrotrophic Enterobacter ludwigii from the Sediments of Arctic Fjord.

Low-temperature-tolerant microorganisms and their cold-active enzymes could be an innovative and invaluable tool in various industrial applications. In the present study, bacterial isolates from the sediment samples of Kongsfjord, Norwegian Arctic, were screened for ß-galactosidase production. Among the isolates, KS25, KS85, KS60, and KS92 have shown good potential in ß-galactosidase production at 20 °C. 16SrRNA gene sequence analysis revealed the relatedness of the isolates to Enterobacter ludwigii. The optimum growth temperature of the isolate was 25 °C. The isolate exhibited good growth and enzyme production at a temperature range of 15-35 °C, pH 5-10. The isolate preferred yeast extract and lactose for the maximum growth and enzyme production at conditions of pH 7.0, temperature of 25 °C, and agitation speed of 100 rpm. The growth and enzyme production was stimulated by Mn2+ and Mg2+ and strongly inhibited by Zn2+, Ni2+, and Cu+. ß-Galactosidases with high specific activity at low temperatures are very beneficial in food industry to compensate the nutritional problem associated with lactose intolerance. The isolate exhibited a remarkable capability to utilize clarified whey, an industrial pollutant, for good biomass and enzyme yield and hence could be well employed in whey bioremediation.

Anti-inflammatory activities of aqueous/ethanol and methanol extracts of Perna viridis Linn. in mice.

Anti-inflammatory effect of the edible mytilid bivalve Perna viridis was evaluated using formalin, carrageenan and dextran-induced paw oedema in mice. The whole mussel tissue without shell was first extracted with ethyl acetate and then successively with methanol and water:ethanol, 7:3 (aqueous/ethanol). Three doses (100, 500 and 1,000 mg/kg) of the extracts (methanol and aqueous/ethanol) were administered orally prior to the injection of inflammatory agents. The inflammation induced by formalin was inhibited by the administration of both extracts for 7 days and the activity was found to be higher for methanol than aqueous/ethanol extract. A dose-dependent reduction in paw thickness was observed for carrageenan-induced paw oedema on treatment with methanol and aqueous/ethanol extracts which was comparable to the standard drug diclofenac. The effect of extracts on dextran-induced oedema was less than that produced by the other two inflammatory stimulants.

Characterization of biological activity of Scatophagus argus venom.

Scatophagus argus of the family Scatophagidae inflicts painful wounds in fishermen while handling it. The venom induces prominent local tissue damage characterized by pain, edema and necrosis. The pathogenesis of acute muscle damage in gastrocnemius muscle induced by S. argus venom was studied in mice. The inflammatory response induced by S. argus venom in the mice hind paw was studied measuring paw edema. Intramuscular injection of S. argus venom induced motoxicity. The effect of S. argus venom on the cellular components of inflammatory response was investigated. Venom from S. argus were quantitatively analyzed for enzymic and biochemical activity. The biochemical changes induced by the sublethal concentration of S. argus venom and histopathological studies of effect of venom on mice were carried out. Venom induced a rapid increment in serum creatine kinase (CK) and lactate dehydrogenase (LDH) showing the myotoxicity of venom. Concomitant with this a reduction of muscle CK and LDH activity was observed, where as no increment in muscle lactate was detected. Our findings showed that the edematic activity was dose dependent and remained significantly elevated over 48 h after injection. Administration of S. argus venom caused a significant cell accumulation of neutrophils in to peritoneal cavity as well as foot pad up to 24h with maximal being at 4-6h. The venom components analyzed showed the presence of phosphodiesterase, acid phosphatases, alkaline phosphatases, proteinase, and caseinolytic activity. SDS PAGE revealed the presence of major and minor protein bands between 6.5 and 68 kDa. The biochemical changes induced by the sublethal concentration of S. argus venom showed reversible changes in the hematological (blood cell count, hematocrit, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin and platelet count) parameters which were significantly altered at 6 and 24h (GLM repeated measures p<0.05). Serum enzymes such as AST, ALT, ACP, ALP, LDH and urea were altered significantly which in turn confirmed the damage of vital organ tissue.

Biological and biochemical properties of Scatophagus argus venom.

Scatophagus argus of the family Scatophagidae inflicts painful wounds in fishermen during handling. The clinical picture is characterized by excruciating and persistent local pain disproportionate to the size of injury, redness, swelling and a throbbing sensation that extends to the limbs, followed by dizziness. The biological properties of the S. argus venom were studied to assess its risk and lethal factors with regard to human welfare. In contrast to other fish venoms, S. argus showed relatively low LD50 (9.8 mg/kg via i.p.). Haemolytic activity in human erythrocytes was recorded. Platelet lysis expressed as LDH activity of lysed cells was dose dependent. S. argus venom failed to induce any clot in human plasma. No PLA(2) activity was found in S. argus venom. Mild proteolytic activity was observed. The injection of venom in mice produced lesions and nociception, which were not inhibited by antihistamine pheniramine maleate, suggesting that histamine was not involved in the inflammatory process. The increase in serum creatine kinase activity indicated myotoxicity. Cytotoxicity on HeLa cells was observed. The spectrum of activity in experimental animals of S. argus crude venom resembles those of other fish venoms previously studied and well correlated to the systemic manifestations that are described for S. argus envenomation.

Renal Lysosomal Functions on Exposure to Scatophagus argus Venom in Experimental Mice.

ABSTRACT Scatophagus argus venom was extracted by homogenization and centrifugation. The lysosome-enriched fraction of mice kidney was isolated by differential centrifugation. To study the effect of S. argus venom on lysosomal membrane stability, acid phosphatase and cathepsin D, the two marker enzymes for lysosome, were assayed. In the renal lysosomal enriched fraction incubated with different concentrations of venom and at various time intervals, in vivo and in vitro studies were done. Studies reveal that with increasing concentration of venom and time, the activity of the enzymes increased, which showed that the membrane integrities decreased for both in vitro and in vivo studies. The activity of the enzymes acid phosphatase and cathepsin D showed a dose-dependent relationship with S. argus venom.

Does diagnostic delay lead invariably to damage in episodic pelvi-ureteric junction obstruction?

OBJECTIVE: To determine the relationship between the length of history and renal function in patients with symptomatic pelvi-ureteric junction (PUJ) obstruction in childhood. PATIENTS AND METHODS: The study included 41 children with symptomatic PUJ obstruction. The duration and details of their symptoms were recorded and the differential renal function estimated by isotopic renography. RESULTS: The median (range) duration of symptoms was 24 (0.25-84) months; there was no statistically significant relationship between the duration of symptoms and differential function at presentation (P=0.148). CONCLUSION: There is no correlation between the duration of symptoms and renal function in children with PUJ obstruction. A delay in diagnosis cannot be directly linked to permanent renal compromise.

Colorectal cancers in children without any predisposing factors. A report of eight cases and review of the literature.

Carcinoma of the colon is usually associated with conditions such as familial adenomatous polyposis, and ulcerative colitis. Primary carcinoma of the colon is very rare in children. A series of eight children with primary carcinoma of the colon is presented. The commonest symptom was right iliac fossa pain. All children had poorly differentiated, highly aggressive tumours. In spite of surgery and adjuvant treatment, the survival was dismal with all the children dying within one year of presentation.

Occurrence of infection by the cestode Grillotia in Persian Gulf fish.

A cystic condition of the peritoneum of tuna fish (Thunnus thynnus) caught from the Persian Gulf is described. Parasitologic examination established widespread infection by the cestode Grillotia. An account is given of the taxonomic position of this genus.