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Biomedical subjects

Amar A Shah

Publications and source records attributed to Amar A Shah.

9 recordsLinked to original sources

Neonatal genital reconstruction in penile agenesis by anterior sagittal anorectovaginourethroplasty.

Penile agenesis is a rare anomaly, occurring once in every 30 million births. Early gender reassignment and genital reconstruction helps the family to accept the child's altered gender and to reduce psychological problems. In the past, multiple operations were carried out to form feminized external genitalia. This report describes a single-stage gender reassignment and genital reconstruction by anterior sagittal anorectovaginourethroplasty in a neonate with penile agenesis.

Humans↗

Imperforate anus with rectopenile fistula.

We report a 9-month-old child with anorectal anomaly which was surgically treated in the neonatal period for a colostomy and was referred to us for a definitive procedure. The child had features suggestive of low anorectal abnormality; however, investigations indicated that he had a supralevator type of imperforate anus associated with a rectopenile subcutaneous fistula. The surgical treatment of this infant is discussed.

Anus, Imperforate↗

Staged laparoscopic-assisted pull-through for Hirschsprung's disease.

The authors report 3 cases of Hirschsprung's disease that were treated by laparoscopic-assisted transanal pull-through after a colostomy already had been performed. Two of these patients presented with severe enterocolitis, and a primary laparoscopic-assisted single-stage transanal pull through was not feasible. The third patient had a colostomy performed and was referred to us for a definitive procedure. Many centers over the world now perform laparoscopic-assisted single-stage pull-through as a primary modality of management for Hirschsprung's disease. But for a country like India, where patients with Hirschsprung's disease present or are referred late and frequently with enterocolitis, performing a primary procedure is not possible in all cases. However, this has been used as the definitive procedure after performing a diverting colostomy and histopathologic determination of the length of the aganglionic bowel. The procedure gives excellent results and permits early postoperative feeding, early hospital discharge, and good cosmetic results.

Anal Canal↗

Down syndrome with transient myeloid leukemia and urological abnormality.

Among the various anomalies associated with Down syndrome, leukemia is quite common. The variant transient myeloid leukemia is seen almost exclusively in the Down syndrome patients. On the other hand, urological anomalies are infrequently found both in the Down syndrome and leukemia patients. We report a case who had the rare combination of a urological anomaly along with Down syndrome and transient myeloid leukemia.

Down Syndrome↗

Thoracoscopy in management of empyema thoracis in children.

The usual treatment for empyema in children varies from a simple thoracocentesis to thoracotomy and open decortication. We studied the role of thoracoscopy in the management of empyema thoracis in 10 immunocompetent children after failure of medical management. All children recovered well with an early removal of intercostal tube and reduced postoperative hospital stay and showed complete resolution of empyema on follow up. Thoracoscopy has come as a new ray of hope for the patients with empyema, with the advantages of complete evacuation, minimal pulmonary dysfunction, reduced pain and hospital stay.

Child, Preschool↗

Laparoscopy in diagnosis of prolonged neonatal jaundice.

When managing neonatal jaundice, there is no single test or imaging modality that can reliably define biliary atresia and neonatal hepatitis. Early diagnosis is an important step for surgical success in extra hepatic biliary atresia. In many situations, exploratory laparotomy and operative cholangiography may be needed to settle the definitive diagnosis, with the risk of having negative exploration in those high risk patients with medical etiology. The use of laparoscopy may help in avoiding unnecessary exploration for such group of patients and arriving at a definite diagnosis. Six patients with conjugated hyperbilirubinemia were evaluated with a diagnostic laparoscopy, laparoscopic cholangiography and liver biopsy. Three of the six patients were diagnosed to have neonatal hepatitis and so an unnecessary laparotomy was avoided in these cases.

Cholangiography↗