Detection of Cytomegalovirus in Liver Tissue by Polymerase Chain Reaction in Infants With Neonatal Cholestasis.

Aim: Cytomegalovirus (CMV) is associated with neonatal cholestasis (NC). Diagnosis of CMV infection is most often based on either positive blood CMV IgM or CMV blood polymerase chain reaction (PCR). Isolation of CMV in liver tissues in patients with NC has rarely been reported.

Management of Congenital Diaphragmatic Hernia in Newborn - Paradigm Shift and Ethical Issues.

Management of congenital diaphragmatic hernia (CDH) begins soon after it is detected, whether antenatally or postnatally. Assessment of the severity of the condition, associated congenital anomalies, maternal health and related issues, weight of the fetus/baby, mode of delivery, timing of delivery, immediate appropriate management of the baby with CDH at birth, appropriate utilization of available treatment modalities as well as infrastructure of the treating institute have an impact on the outcome of the neonate. Survival without significant long-term/permanent morbidity is considered as good outcome.

Hemophagocytic Lymphohistiocytosis (HLH) in Children Presenting as Liver Disease.

Hemophagocytic lymphohistiocytosis (HLH) is a rare acute hyperinflammatory condition presenting with high fever, pancytopenia, splenomegaly with the pathologic finding of hemophagocytic lymphohistiocytosis in bone marrow and other tissues. Predominant hepatic manifestations at presentation are rare. We report a series of three cases which showcase the spectrum of liver disease as presentation in hemophagocytic lymphohistiocytosis.

Liver Abscesses and Hyper IgM Syndrome.

Hyper IgM (HIGM) syndrome is an immunodeficiency that can lead to liver disease in more than 80% of affected males by an age of 20 years. Hepatitis, sclerosing cholangitis, and hepatocellular malignancies are common among them. We encountered two cases in children of less than 12 years who presented with typical manifestations of liver abscess and were later detected to have a concomitant underlying HIGM syndrome.

Pyloric Atresia Type II.

Successful management of a neonate with type II pyloric atresia is reported and the relevant literature has been briefly reviewed.

Utility of Tc99m-Mebrofenin hepato-biliary scintigraphy (HIDA scan) for the diagnosis of biliary atresia.

Aim: To determine the utility of Tc99m-Mebrofenin hepato-biliary scintigraphy (HIDA scan) for diagnosis of biliary atresia in patients with neonatal cholestasis.

Methods: Our study involves the retrospective analysis of 46 patients with neonatal cholestasis who underwent HIDA scans at the Pediatric Hepatobiliary Clinic, BJ Wadia Hospital for Children from May 2005 to July 2007. Biliary atresia (BA) was diagnosed on the basis of intra-operative cholangiogram.

Biliary atresia and cytomegalovirus and response to valganciclovir.

Biliary atresia has been commonly reported with cytomegalovirus (CMV) infection. CMV positive patients may present with a later onset however long term outcome is similar to non-CMV patients. There are very few case reports of role of antivirals in CMV and biliary atresia.

Extracranial malignant germ cell tumors.

The outstanding clinical trials undertaken for the management of pediatric extracranial malignant germ cell tumors (GCTs) in the developed world in the last three decades has led to excellent longterm outcomes. The scenario in developing country like India is different; results are poor owing to multiple factors such as delayed presentation, misdiagnosis, and early abandonment of the therapy. The authors address here several aspects of this heterogeneous group of malignant tumors in children and adolescents such as the different staging systems, the risk stratification, the guidelines to treatment modalities, the outcome and prognostication.

Wilms' tumor- roadmaps of management.

The management of Wilms' tumor emerging of the outstanding clinical trials undertaken in the developed world in the last four decades has led to excellent longterm outcomes. The scenario in developing country like India is different; late presentation with massive tumors and advanced stage, lacunae in staging, nonavailability of pediatric medical oncologists and poor follow-ups are common. A comprehensive summary of available therapeutic modalities is provided here along with clear roadmaps of management of Wilms' tumor as per Société Internationale d'Oncologie Pédiatrique (SIOP) and National Wilms' Tumor Study Group/Children's Oncology Group (NWTSG/COG) protocols in simple tabulated form.

Proceedings of tumor board meeting.

The Tumour Board Meeting was held on August 16, 2011, in the Seminar Hall at B.J. Wadia Hospital for children.

Neuroblastoma: a review of management and outcome.

Solid tumors in children are a major cause of death in the developed countries and now even in the developing countries. Of these tumors, neuroblastoma, the most common tumor in children, despite extensive and on-going research and clinical trials still remains an enigma. About 50 % of children with neuroblastoma overall succumb to the disease.

Neonatal hepatitis with toxoplasmosis.

Congenital toxoplasmosis may be subclinical, or may present with multisystem involvement. Most of the symptomatic cases have either ocular or neurological manifestations. A case of congenital toxoplasmosis presenting as isolated hepatitis is reported.

An audit of malignant solid tumors in infants and neonates.

Background: To audit the demographics, outcome and factors affecting long-term survival in infants and neonates with solid tumors.

Material And Methods: Retrospective case series was performed for 13 years. Demographics, surgical notes, treatment protocols and outcome details were reviewed.

Evolving biliary atresia with cytomegalovirus.

Multiple studies have been conducted to demonstrate the role of viruses in causing biliary atresia. Although cytomegalovirus (CMV) is known to cause intrahepatic bile duct destruction, its role in biliary atresia is not proven. We report two cases of CMV infection, initially presenting with intrahepatic cholestasis, who subsequently developed biliary atresia.

Scope and limitations of minimal invasive surgery in practice of pediatric surgical oncology.

Management of Solid tumors in children needs a comprehensive multimodality protocol based treatment plan. Open surgical removal of the tumors occurring in any of the sites such as abdomen, thorax, chest wall, HFN (head, face, neck), brain and extremities, is the option which has been traditionally practiced even in the present era and in most of the centers. Nevertheless with the advances in science and technology and with ever increasing usage and expertise of laparoscopy in children, it's application has extended to treatment of solid tumors in children.