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.

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.

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.