Management of bilateral congenital choanal atresia.

This study was conducted to adopt better management technique for better outcome of bilateral congenital choanal atresia. Six consecutive neonates with bilateral congenital choanal atresia were included in this study. Emergency and elective management was done in various ways. Postoperative outcome was assessed clinically and endoscopically. Surgical management was done in two approaches. Three done in endoscopic transnasal approach and another 3 in transpalatine approach. Patient with endoscopic approach recovered earlier with minimum morbidity. Application of mitomycin-c minimizes granulation tissue and adhesions. Management of bilateral congenital choanal atresia is better by endoscopic transnasal approach with application of mitomycin-c.

A 9 years boy with MEN-2B variant of medullary thyroid carcinoma.

To highlight a rare disease like multiple endocrine neoplasia (MEN)-2B variant of medullary thyroid carcinoma and to optimize the management option in such cases, we present a nine year old boy with thyroid swelling, cervical lymphadenopathy and thick lips. His calcitonin level was raised. Investigation's results of the boy were as following fine needle aspiration cytology (FNAC) was medullary carcinoma of thyroid, preoperative calcitonin was >2000pg/ml, post operative histopathological report was medullary carcinoma. Total thyroidectomy with aggressive initial neck surgery may reduce the recurrence and increase better prognosis and survival rate. Calcitonin is used as diagnostic and follow-up marker.

Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients.

Midline ventral hernias are common. Tension-free mesh repair of ventral hernias is becoming popular due to the high recurrence rate with conventional techniques. We have used an open intraperitoneal technique using the Bard Ventralex hernia patch in midline ventral hernias (

A missing tongue stud: an unusual appendicular foreign body.

Appendicitis caused by foreign bodies after body piercing is rare. Previous reports have described a variety of foreign bodies that were either found incidentally in the appendix or were felt to be responsible for appendicitis. We report a case where a patient known to have previously ingested a "tongue stud" after a tongue piercing presented with chronic right iliac fossa pain. The missing "tongue stud" had impacted in the appendix and was successfully removed by laparoscopic appendicectomy with resolution of patient's symptoms. We review the literature covering the clinical management of patients presenting with foreign bodies in the appendix.

A simple technique to control iatrogenic solid organ injury haemorrhage.

Haemostasis from iatrogenic solid organ injury can be difficult to achieve. We describe the use of oxidized regenerated cellulose (Surgicel) and a Hanna-Belfast suction diathermy device to control minor solid organ haemorrhage

The incidentally discovered asymptomatic adrenal tuberculous mass mimicking malignancy.

Tuberculous adrenal mass without any tuberculous changes in other sites is a rare entity. In this study we describe such a case. A male patient of 47 years with 6 months history of anorexia and weakness was presented. Ultrasonography and computed tomography revealed a mass in the right adrenal gland. It was mistaken as a malignant neoplasm and the diagnosis was confirmed by surgical exploration.