CONGENITAL EXTROPHY OF BLADDER 

DR ANIL S. NELIVIGI                                                                                                       DR. MANJUNATH (Pediatric  surgeon)

DR. SUNILKUMAR P.D

DR. SACHIN S. NIMBARGI

DR. LOKESH NAIK G.

 Properly the extrophy epispadias complex is a rare congenital anomaly occurring one in every 40000-50000 live births with 2:1 male :female ratio. The diagnosis involves the spectrum of anomalies of the lower abdominal wall, bladder, anterior bony pelvis and external genitalia. It occurs due to failure of the abdominal wall to close during fetal development and results in protrusion of the posterior bladder wall through the lower abdominal wall. Treatment is with surgical correction of the defect but patients can still have long term issues with urinary tract infections and sexual dysfunction.

We operated on a case of congenital extrophy of bladder with urologic and orthopedic reconstruction procedures. The male child was 3yrs old with neglected total extrophy of bladder and pubic diastasis. The operating team consisted of orthopedic and pediatric surgeons. First the bilateral iliac osteotomy was done and anterior diastasis was closed and fixed with stainless steel wire augmented with external fixator frame through  both iliac wings. This was followed by the reconstruction of urethra, bladder and closure of anterior abdominal wall and urine was rerouted externally through drain tubes. Patient still requires multiple surgeries for reconstruction of ureters and external genitalia in near future.

Pre operative                   Post operative                          Post operative x ray 

DEPARTMENT OF PHYSIOLOGY

NAME OF STAFF MEMBER:  Dr. CHANDRASHEKHAR KARPOOR.

DESIGNATION: ASSISTANT PROFESSOR. 

DETAILS OF RESEARCH PAPERS PRESENTED AT CONFERENCE: 

1] Secretor   status among North and South Indian population   at   50^th National conference of APPI [Golden APPICON 2005] held at Bangalore in December 2005. 

2] Distribution   of Blood groups among patients with Diabetes Mellitus and their secretor status at PSI National Conference, Faridabad, in December  2007. 

3] Physiological   profile   of Elite Wrestlers   at 54^th National conference of APPI [APPICON 2008], held at   Mangalore in December 2008. 

RESEARCH PAPERS PUBLISHED: 

Original articles accepted for publication:  

1.     Study of secretors and non-secretors in normal healthy population Its forensic implication in human identification.

2.     Animal and human experiments in medical curriculum: Students attitudes and ethical issues.

3.     Correlation of handgrip strength and handgrip endurance with body weight and lean body mass in young male wrestlers. 

Review articles accepted for publication: 

1.     Aluminium  and Alzheimers Disease An Overview.

2.     Umami: The fifth taste sensation.

3.     Yawning: Its Physiological and clinical perspectives.

 LYTIC LESION IN PROXIMAL FEMUR : A CASE REPORT

 Dr. Karibasappa A.G.,Dr.Ramesh Pujar,

Dept of orthopaedics

SSIMS & RC, Davangere. Karnataka India.

Abstract

Osteolysis may be evident in innumerable  neoplastic, infectious, traumatic,vascular,congenital and articular disorders.An accurate history  and a  complete  physical  examination   are first steps in evaluating  a  patients  with  osteolytic l esions:  patients  age  at presentation, how  lesion  was  discovered,  location  of  the lesion,radiographic appearance of the lesion and number of lesions present.

We are presenting a case of osteolytic lesion in the proximal femur-FIBROUS DYSPLASIA. This patient underwent curettage,internal fixation and bone grafting.

INTRODUCTION

Osteolytic lesion of the proximal femur is not uncommon.It occurs in all age  group  due   to  various  conditions. The  clinical   presentation  also varies  from  case  to  case depending on the destruction of the bone at particular level.Very often the  patient  has  vague pain in the hip region with radiation   of pain  to the knee joint.The patient is often treated as fibromyalgia  syndrome   some time  and  till  patient  present  with   a pathological fracture in the later stage.In this paper we are presenting a case of fibrous dysplasia of the proximal femur

Fig1:pre operative x-rays showing lytic lesion in the proximal femur(R)

FIG 2: Post operative x-ray

35 years  old   lady  presented  with   pain in  the  right    hip for two months.It was insidious in onset and dull aching in nature.There was no history of trauma. Clinically tenderness was present over the hip joint line   and   over   the  greater trochanteric  region.  Movements  were terminally painful  and  restricted.  Routine  blood  investigations were with  in the  normal  limits.   X-ray  was   and  there was single osteolytic lesion present in the   metaphyseal  region   extended  from  tip  of  the greater trochanter to the lesser trochanter. Clinically and radiologically we could not come to definitive conclusion.FNAC was done and it was inconclusive.  A window was made in the anterior cortex over the lesion and  5 ml of clear straw coloured  fluid was aspirated. Cavity was filled with greyish friable material which was cureted completely and sent for histopathlogical examination. Now  the  lesion  was  fixed  with   fibular strut graft and a cancellos screw and the cavity was filled with cancellos bone harvested from the iliac crest. Histopathology revealed a fibrous dysplasia.

DISCUSSION

Fibrous dysplasia is uncommon in this age group. Its a benign condition and the most common complication is pathological fracture which is very difficult to treat.In this setting surgery is indicated to make a tissue diagnosis and prophylactic fixation of the lesion.