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Aims and Objectives: This study aims to study the variation in the expression of CD117-positive interstitial cells of Cajal-like cells (ICC-LC) across the upper urinary tract region in children presenting with pelvic-ureteric junction obstruction (PUJO) and its association with renal functional and sonological parameters of patients. Materials and Methods: A prospective observational study was done on 20 children with congenital PUJO who underwent dismembered pyeloplasty. All children underwent renal sonography (anteroposterior pelvic diameter [APPD], pelvicalyceal ratio [P/C ratio], Mid polar renal parenchymal diameter [MPPD]) and functional imaging scan (LLEC scan or DTPA scan). Three specimens were taken intraoperatively from above PUJ, at the level of PUJ, and below PUJ. Those were examined immunohistochemically using CD117 to count ICC-LC using standard criteria. Variation in the expression of CD117-positive ICC-LC was correlated with the abovestated parameters. Results: The number of CD117-positive ICC-LC showed a continuous decreasing trend above downward. P/C ratio and APPD showed a parallel trend with ICC-LC distribution, whereas split renal function (SRF) showed an inverse relationship with the expression of ICC-LC. Children with lesser severity of obstruction (APPD <30 mm and SRF >40%) showed a uniform decreasing trend in the number of CD117-positive ICC-LC across PUJ. Children with more severe obstruction (APPD >30 mm and SRF <40%) showed a decrease in the expression of ICC-LC up to the level of PUJO followed by a sudden relatively increased expression of ICC-LC below the obstruction. Conclusion: The expression of ICC-LC shows a uniformly decreasing trend across obstruction when the severity of obstruction is less. Resurgence in the number of ICC-LC below PUJ in subjects with severe obstruction hints at the emergence of a new pacemaker area below severely blocked PUJ akin to that seen in complete heart block patients and deserves early attention. [ABSTRACT FROM AUTHOR]

Aims: To compare operating time, early complication(s) and outcome of Gross & Ferguson and Mitchell-Banks repair techniques in children with congenital inguinal hernia. Materials and Methods: A prospective randomized study including boys aged 1-12 years, was conducted over one year. The patients were allocated in two interventional groups based on the repair viz. Gross and Ferguson and Mitchell-Banks group. After hernia repair, the patients were followed up on the day of surgery and at one week for early complications. Results: Fifty patients were enrolled. Mean operating time in Mitchell-Banks technique was significantly more than Gross and Ferguson technique (p=0.00012). The incidence of fever in two groups was similar. Scrotal edema was statistically significant in MB group on both Post-Operative Day -1 and 7 (p=0.023 and p=0.034). No patient in either group had wound infection or scrotal hematoma on POD-1. One subject (2%) had scrotal hematoma in MB group on POD-7. A total of 12 subjects (24%) had Surgical Site Infection on POD-7. There was statistically higher incidence of SSI on Day-7 in GF group (32%) as compared to MB group (16%) (p=0.018). Conclusion: GF technique had lesser operating time, less incidence of scrotal edema and hematoma though higher rate of surgical site infections. In this respect, GF technique can be used as a simple and safe procedure. [ABSTRACT FROM AUTHOR]