Background: Congenital pouch colon, also known as congenital short colon or “Pouch colon syndrome”, is a rare condition that occurs in association with anorectal malformations; colon is either partially or completely replaced by pouch-like dilatation and communicates with the urogenital tract by means of a fistula. This anomaly is exclusively seen in Northern parts of India with only a few cases reported from elsewhere.Case Presentation: A 1-day old neonate was presented with abdominal distension due to lack of passage of meconium. Clinical and radiological investigations revealed ano-rectal malformation. Incidental findings were left sided renal agenesis and right sided anorchia. Laparotomy revealed congenital pouch colon which was dealt accordingly. The baby is now healthy and awaiting further reconstructive surgery.Conclusion: Although urogenital anomalies are not uncommon with congenital pouch colon, the finding of renal agenesis with unilateral anorchia is quite rare.

Congenital pouch colon (CPC) is an unusual condition in imperforate anus (IA), usually of high variety. This malformation is mostly reported from India, where it comprises about 7% of all anorectal malformations. In this anomaly, the normal colon is very short or absent and is replaced by a pouch like dilatation that usually communicates through a fistula with genitourinary tract or persistent cloaca. We are reporting on three cases of newborns (2 females, and 1 male) with this anomaly diagnosed during September 2001 to September 2004. These three cases comprise less than 3% of all cases of IA during this time period. The two girls had anorectal agenesia, short segment of colon and a pouch with vaginal fistula and persistent cloaca (Type II). Colon in the third case was replaced by a dilated pouch that communicated with a wide fistula to the bladder (Type I). This is very important for pediatric surgeons to be aware of the features of this condition to allow for proper diagnosis and surgical management.

Introduction: Although Duplication anomalies are common in the Gastro-intestinal tract, appendicular anomalies are rare with variable anatomy. we describe a series of appendicular duplication cases managed at a tertiary care center. Materials and Methods: Data regarding the clinical features, associated anomalies and management of cases of appendicular duplication at a tertiary care center from January, 2019 to December, 2020 were collected retrospectively and analyzed. Results: Four children with appendicular duplication were managed during this period,three neonates presented with high anorectal malformation and type two pouch colons with a large colovesical fistula. They had a single caecum with two separate appendices symmetrically on either side (type B1). They were managed by division of colo-vesical fistula, mobilization of colonic pouch after limited pouchoplasty and anoplasty as a single stage procedure. None of the appendix was removed. In one of these cases, bilateral ureters were dilated. The fourth case presented as a 3-year-old with pain abdomen and during surgery for suspected appendicitis, partial duplication of inflamed appendix was found (type A). Appendicectomy relieved this child of his symptoms. All patients are doing well on follow-up. Conclusion: The position, anatomy and associated anomalies of appendicular duplication can be variable complicating its presentation and management.

Objectives: Possible serotonergic modulation of acute peripheral inflammation was investigated in rat adopting air pouch as an experimental model. Methods: Air pouch type carrageenan-induced inflammation model on the back of the male Wistar rats was used. Injection of carrageenan solution into an air pouch induced gradual increases in the pouch fluid volume and leukocytes accumulation in the pouch exudates as well as granulation tissue weight. Granisetron (12.5, 25, 50, 100, 200, 400 & 800mg) was injected at the same time as the carrageenan. Results: Granisetron (50, 100 & 200, 400 mg) was found to inhibit the number of white cells in the exudates at 6 hours after the carrageenan injection significantly (from 119.6 ± 7.8 million in control group to 62.5 ± 6.7 million , 69.5 ± 9.8 million, 82.5 ± 4.8 million and 86.3± 6.3 million respectively). The pouches fluid volumes were decreased significantly by doses of 12.5mg (3.6± 0.1ml), 25mg (3.4 ± 0.1ml), 100mg (3.6 ± 0.2 ml), 400mg (3.7 ± 0.1ml), 800mg (3.6 ± 0.1ml) of granisetron compare to control (4.1 ± 0.08ml). Tissues weight at 6 hr after carrageenan injection was increased by doses of 12.5 mg (5.04 ± 0.6 g) , 25 mg (3.06 ± 0.5 g) and 800 mg (4.7 ± 0.2 g) and was decreased with 100 mg granisetron (1.3 ± 0.2 g) significantly compare to control group (5.04 ± 0.6 g). Conclusion: The study confirms that the serotonergic system is capable of modulating peripheral inflammation via 5HT3 receptors.

Background: The aim of this study was to evaluate the effects of neostigmine on inflammatory parameters and histopathological changes of granulation tissue. Methods: The Air Pouch model was developed in six groups of male Wistar rats. Briefly, the rats were anesthetized, and then 20 ml and 10 ml of sterile air were injected subcutaneously (SC) on the back of the animals on days 0 and 3, respectively. On day 6, inflammation was induced by injection of 2 ml of carrageenan 1% into pouches. Normal saline as control and neostigmine (35, 70, 140, 200, and 310 μ g/kg) was administered intraperitoneally (IP) concurrently with carrageenan. After 6 hours, the rats were sacrificed; pouch fluid was collected to determine exudate volume and the number of accumulated cells. The pouches were dissected out and weighed, and histopathological characteristics were evaluated. Findings: Neostigmine (70 μ g/kg) reduced leukocyte accumulation (P < 0. 050), exudate volume (P < 0. 001), and granulation tissue weight (P < 0. 001) compared to the carrageenan control group. Inflammatory parameters were increased by neostigmine 200 μ g/kg (P < 0. 050). The results of histopathological studies of granulation tissue showed that higher doses of neostigmine provided more anti-inflammatory effects. Conclusion: From this study, it may be concluded that in the air pouch inflammatory model, neostigmine at different doses has different effects on peripheral inflammation. These effects are likely mediated by regulatory effects of the agent on the immune system.

Gutkha—a mixture of crushed areca nut, tobacco, catechu, paraffin wax, slaked lime, and flavoring agents—is a wellknown smokeless tobacco product associated with a high risk of oral submucous fibrosis and oral cancer. 1-4 Recognizing its carcinogenic potential, the Government of India banned the manufacture, sale, and distribution of Gutkha in 2012 under the Food Safety and Standards (Prohibition and Restrictions on Sales) Regulation, 2011 issued by the Food Safety and Standards Authority of India (FSSAI). 5 This landmark decision aimed to protect public health and curb the alarming rise in oral cancer cases linked to smokeless tobacco use.

Introduction: The surgical treatment of bladder extrophy presents a major problem, particularly in delayed admitted cases and in those with a small bladder plate as well as failed cases of bladder extrophy closure. Materials and Methods: In a study on fourteen out of the thirty cases of bladder extrophy, a rectosigmoid pouch was separated from the colon; the ureters were then implanted in the pouch with colon pull-through inside the reconstructed bladder (“ rectosigmoid pouch” ) with complete separation of urine and stool. The operation was carried out in 3 stages. Of these 14 patients only seven underwent the 3 stages. Result: In the follow-up study after 20-40 years, of the seven patients that underwent all three stages, all of them were enjoying an active life with satisfactory growth and development. Conclusion: In the absence of any better options for the treatment of bladder extrophy, the above mentioned operative procedure can be recommended as it is safe and satisfactory with relatively good long term results. This paper was presented at the 8th Annual Meeting of the German Association of Pediatric Surgeons in Jenna, Nov. 17-19, 2011, Section “ Pediatric Urology.