Management of Post-traumatic and Iatrogenic urethrocutaneous fistula in children (a case series of seven patients).

This is a retrospective study of seven patients with post-traumatic and iatrogenic urethrocutaneous fistula of penile urethra, excluding complication of hypospadias surgery. It was conducted in the Paediatric Surgery Department, Jinnah Hospital Lahore from June 2014 to January 2017. The patients ages ranged from three to twelve years. All the patients were managed by repairing the fistula in three layers electively at 3 months from the date of initial presentation. They remain well with no complaints except one with a recurrence. The complications of circumcision can be avoided by preventing circumcision by non-doctors and quacks.

The outcome of combination of low dose oral prednisolone with propranolol for the treatment of infantile haemangioma.

OBJECTIVE: To determine the outcome of combination of low dose oral Prednisolone with oral propranolol for the treatment of infantile hemangioma. METHODS: The patients fulfilling the inclusion criteria were registered through outpatient department. Diagnosis was confirmed clinically and on Color Doppler ultrasonography (CD). All the patients were given oral prednisolone in a dose of 1mg/kg/day and propranolol in a dose of 0.5mg/kg/day twice a day and increased up to 1.5mg/kg/day BID within three days with close monitoring of heart rate, blood pressure and blood glucose as inpatient. Treatment was given for three months then titered down for two weeks before cessation of treatment. The follow-up of patients were performed at 7(th) day, at 1(st) month and finally at 3(rd) month. Treatment compliance was checked during each visit along with outcome parameters i.e. response which was excellent, good, moderate slight improvement and no effect. All the information's were collected. Data was analyzed by using SPSS version 10. RESULTS: Out of total 73 patients, 36.99% (n=27) were one year of age, 32.88% (n=24) were two years of age and 30.13% (n=22) were three years of age, mean± SD: 1.96±0.54 years, 53.42% (n=39) were male and 46.58% (n=34) were females, frequency of response of the treatment was recorded as 56.16% (n=41) had excellent, 23.29% (n=17) had good, 15.07% (n=11) had moderate response, 4.11% (n=3) had slight improvement and 1.37% (n=1) had no effect while frequency of acceptable outcome revealed as acceptable in 79.45% (n=58) while 20.55% (n=15) had not acceptable outcome. CONCLUSION: The frequency of acceptable outcome of combination of low dose oral Prednisolone with oral propranolol for the treatment of infantile hemangioma is higher.