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Kanishka Das

Publications and source records attributed to Kanishka Das.

7 recordsLinked to original sources
PubMed2005

Hemihypertrophy, renal dysplasia and benign nephromegaly.

Hemihypertrophy is associated with malignant visceral abdominal neoplasms in childhood. Benign nephromegaly and nephroblastomas are both known to occur with hemihypertrophy; however, association with renal dysplasia has not previously reported. We describe an infant presenting with recurrent haematuria who had segmental hemihypertrophy, ipsilateral renal dysplasia and contralateral benign nephromegaly. Although debated, renal dysplasia may predispose to and predate malignant change. Rational management and optimal surveillance of renal dysplasia and benign nephromegaly in hemihypertrophy is discussed.

Abnormalities, Multiple↗
PubMed2004

Traumatic posterior urethral disruptions in boys: experience with the perineal/perineal-transpubic approach in ten cases.

The management of traumatic posterior urethral disruption in children has ranged from primary realignment/repair to delayed urethroplasty. The operative approach may be perineal or transpubic; the advocates of either cite comparable outcome. The anatomic considerations in a child differ from the adult and the management is individualized. We present our experience with the perineal/perineal-transpubic approach in the management of traumatic posterior urethral disruptions in ten boys. A preliminary suprapubic cystostomy was followed by a delayed urethroplasty after comprehensive investigations to delineate the pathoanatomy of the disruption. The urethroplasty began with a perineal exposure and progressed to varying extents to achieve a satisfactory urethral anastomosis. Four cases of bulbomembranous disruption were repaired by perineal approach, whereas six cases of prostatomembranous disruption required a perineal-transpubic approach. Permutations of operative techniques (circumurethral mobilization, corporeal separation/urethral rerouting, pubectomy and omentoplasty) were used. The follow-up assessed micturition patterns, urinary continence and penile erections. At a mean follow-up of 5 years (1.5-12 years), all ten boys void in a good stream and are continent. All have normal penile erections, posture and gait. The paper discusses the rationale and outcome of our management.

Child↗
PubMed2004

Undescended testes.

Undescended testis or cryptorchidism is a common problem encountered in children. Despite the abundant literature on the pathology and management of undescended testis, it is the subject of numerous misgivings and controversies. The article reviews available literature on the entity and their relevance in clinical practice.

Child↗
PubMed2004

Aspiration of a tracheostomy tube flange.

Foreign body aspiration is a common pediatric emergency. Aspiration of a metallic tracheostomy tube flange into the left main bronchus and the resultant subacute respiratory distress is presented. Being the only case of its kind in reported pediatric literature, a review of the etiology, clinical presentation and prevention of this accident is appended.

Bronchi↗
PubMed2003

Pyeloplasty in infancy.

OBJECTIVE: The advent of routine maternal ultrasound has increased the number of neonates diagnosed to have ureteropelvic junction obstruction. Though the debate concerning its ideal management continues, recent years have witnessed reports on pyeloplasty in infancy. This study presents the feasibility and outcome of pyeloplasty in neonates and infants from a single centre. METHODS: The authors examined the records of 40 neonates and infants (46 renal units) who underwent pyeloplasty for ureteropelvic junction obstruction since 1988. Patient characteristics, clinical presentation, investigations, associated anomalies, age at surgery, operative technique and outcome were evaluated. RESULT: The mean and median age at surgery was 3.5 and 2.5 months respectively, and mean postoperative hospital stay six days. Associated anomalies were found in 27% of infants and in some they influenced the outcome. In 72%, no stent or nephrostomy was used. However, all had a closed perinephric drain. There was no mortality in this series. Complications (8.7%) comprised anastomotic leak in three and anastomotic stricture in one unit. In 35 of 38 renal units, improved drainage and recovery of differential function was confirmed on postoperative renogram. CONCLUSION: Where indicated, pyeloplasty in the neonate and infant will be readily adopted by specialists for the select few it would benefit. It is hoped that all those involved in the care of these infants will take cognisance of this fact to ensure early optimal management of ureteropelvic junction obstruction.

Drainage↗
PubMedDate not supplied

A modified technique for the diagnosis of Hirschsprung disease from rectal biopsies.

BACKGROUND: A diagnosis of Hirschsprung disease requires the demonstration of acetylcholinesterase fibres on frozen sections obtained from snap frozen biopsies of the rectum. This histochemical technique is generally not available in laboratories in developing countries. We improvised on the methodology of tissue preservation to make the staining technique more user-friendly, economical and reliable in demonstrating acetylcholinesterase activity in fresh rectal mucosal biopsies for the diagnosis of Hirschsprung disease. METHODS: Between June 1999 and May 2002 fresh rectal biopsies from 40 suspected cases of Hirschsprung disease were processed for routine frozen section (not snap frozen by liquid nitrogen) and stained by the Karnovsky and Roots method. These sections were assessed for the staining pattern of acetylcholinesterase fibres. The thickness of the nerve fibres and muscularis mucosa was assessed morphometrically. These were compared with biopsies obtained from 6 age-matched controls undergoing surgery for unrelated complaints. RESULTS: The sections stained for acetylcholinesterase by this improvised method of tissue fixation were good and crisp. A definite diagnosis of Hirschsprung disease was made in 25 cases and intestinal neuronal dysplasia in 1. The remaining 14 cases showed an equivocal staining pattern with no hypertrophic nerve bundles, thus excluding a diagnosis of Hirschsprung disease. The mean thickness of the submucosal nerve trunks measured in these enzyme-stained sections was found to be inversely proportional to the mean thickness of the muscularis mucosa. CONCLUSION: Our study on cryostat-cut sections suggests an inverse relationship between the thickness of the muscularis mucosa and the calibre of the nerve trunk--thinner the nerve trunk, thicker the muscularis mucosa and vice versa. Also, routine frozen sections, instead of snap frozen ones taken from a fresh rectal biopsy and stained by the Karnovsky and Roots method for acetylcholinesterase activity, are reliable for the diagnosis of Hirschsprung disease and are within the capability of a simple histopathology laboratory in a developing country.

Acetylcholinesterase↗