Medical Specialties Commons^™

Spectral Changes Caused By Radiofrequency Ablation Of Cardiac Tissue, Mohammed Aljishi, Huda Asfour, Luther Swift, Narine Muselimyan, Marco A. Mercader, Narine Sarvazyan

GW Research Days 2016 - 2020

New diagnostic catheters can be developed by delivering and acquiring light through a small fiberoptic bundle. This can provide a useful real time feedback guidance to observe tissue damage caused by thermal injury used to treat cardiac arrhythmias. Yet, little is known about the exact spectral changes caused by radiofrequency ablation (RFA) in different types of cardiac tissue. We hypothesized that the most sensitive optical ranges for characterizing thermal injury can be revealed by comparing spectral information from different areas of the heart before and after RF ablation. Freshly excised porcine hearts were used to acquire and analyze excitation emission …

Otolaryngology For Internal Medicine: Increasing Exposure To Otolaryngology Using Computer Assisted Instruction, Arielle Thal, Philip Zapanta

GW Research Days 2016 - 2020

It has been well identified in previous literature that there is a lack of otolaryngology teaching for general practitioners. There is not currently a standardized curriculum for otolaryngology in undergraduate medical education or during residency for those pursuing a general field such as Emergency Medicine, Internal Medicine, Pediatrics or Family Medicine. While the need for more exposure to otolaryngology within these fields has been well documented, as 25% of primary care complaints are otolaryngology related, little has been done to identify the best method for educational intervention. Important topics for inclusion in such a curriculum have been identified and methods …

Volume Averaging Of Spectral-Domain Optical Coherence Tomography Impacts Retinal Segmentation In Children, Carmelina Trimboli-Heidler, Kelly Vogt, Robert A. Avery

GW Research Days 2016 - 2020

Purpose: To determine the influence of volume averaging on retinal layer thickness measures acquired with spectral-domain optical coherence tomography (SD-OCT) in children.

Methods: Macular SD-OCT images were acquired using three different volume acquisition settings (i.e., ART 1, 3, and 9 volumes) in children enrolled in a prospective OCT study. Total retinal, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer, and outer plexiform layer thicknesses were measured around an ETDRS grid using beta version automated segmentation software for the Spectralis. The magnitude of manual segmentation required to correct the automated segmentation was classified as …

Medical Student Competency In Wound Care Guidelines, Sophia Akhiyat, Sean Mcnish, Kara S. Couch, Victoria K. Shanmugam

GW Research Days 2016 - 2020

Chronic wounds that have failed to heal after 3 months of appropriate wound care affect approximately 6.5 million people in the US with a prevalence of 1% and costs estimated at $25 billion per year. Medical students currently receive limited wound care training, yet to effectively manage chronic wounds, providers must both understand the biology of healing, and also remain up-to-date with wound care guidelines published by the Agency for Healthcare Research and Quality (AHRQ). The purpose of this student-led project was to investigate medical students' knowledge and comfort with wound care guidelines.

Severity Of Pain Is Not Associated With Urgency Of Diagnosis In Ed Patients With Abdominal Pain, Ryan Brunetti, Caitlin David, Lorna Richards, Melissa J. Mccarthy, Andrew C. Meltzer

GW Research Days 2016 - 2020

Background

Abdominal Pain is the most common cause of visits to US Emergency Departments (EDs) and the causes range from urgent to non-urgent diagnoses. Distinguishing urgent versus non-urgent causes of abdominal pain is done through the use of clinical exam, lab studies and diagnostic imaging such as CT scans. There are no validated clinical decision rules to assist physicians in discriminating urgent from non-urgent causes of abdominal pain or which patient needs a CT scan. There is controversy regarding the use of CT scans for patients with abdominal pain due to the increased cost, radiation exposure and length of stay. …

Identifying Venous Thromboembolism In Cancer Patients Using Veterans Affairs Administrative Data, Noah Ravenborg, Najeebah A. Bade, Dalia Abdelaziz Mobarek

GW Research Days 2016 - 2020

Identifying Venous Thromboembolism in Cancer Patients Using Veterans Affairs Administrative Data

Noah Ravenborg1, Najeebah A. Bade, M.D.2, Dalia Abdelaziz Mobarek, M.D.1, 2, 3

1 George Washington University School of Medicine and Health Sciences, Washington, D.C. 2 Department of Medicine, Section of Hematology, Veterans Affairs Medical Center, Washington, D.C., 3 Department of Medicine, Section of Hematology & Medical Oncology, George Washington University Medical Center, Washington, D.C. Noah Ravenborg Cell phone: (310)-804-0848, Email: [email protected], MS2

IMPORTANCE: The validity of administrative data in identifying diagnoses within the Veterans Affairs (VA) database, including viral hepatitis, cirrhosis, H. pylori, and cancer metastasis has been reported. …

Comparing Emergency Department Resident And Patient Perspectives On Costs In Emergency Care, Stefanie Gilbert, Leana S. Wen, Jesse M. Pines

GW Research Days 2016 - 2020

Objectives: Costs of care are increasingly important in healthcare policy and, more recently, clinical care in the Emergency Department (ED). We compare ED resident and patient perceptions surrounding the costs of emergency care, compliance, communication, and education.

Methods: We conducted a mixed methods study using surveys and qualitative interviews in a single, urban academic ED. The first study population was a convenience sample of adult patients (>17 years of age), and the second was ED residents training at the same institution. Participants answered open- and closed-ended questions on costs, cost-related compliance, and communication. Residents answered additional questions …

Is Androgen Excess Masked In Alopecia Areata Patients: A Retrospective Data Analysis Of 1,587 Patients, G. Cheyana Ranasinghe, Melissa Piliang, Wilma Bergfeld

GW Research Days 2016 - 2020

Studies on the pathophysiology and comorbidities associated with alopecia areata (AA) are limited. The purpose of this study was to determine the prevalence of androgen excess in AA and its subtypes, in relation to demographics and comorbidities. Medical records of 1,587 Patchy AA, AT, AU, and ophiasis patients seen in the Department of Dermatology at the Cleveland Clinic Foundation in Ohio between 2005 and 2015 were reviewed. Out of this cohort, 226 patients met the inclusion criteria. There is evidence that patients with AA had significantly greater prevalence of polycystic ovary syndrome (PCOS) than the general population (p<0.001). Androgen excess was identified in 42.5% (n=96) of the 226 patients with AA or any subtype (p<0.001). The androgen excess group was significantly more likely to present with irregular menses, hirsutism, adult acne, PCOS, and/or ovarian cysts (p<0.001). This study was limited by being retrospective. Our study demonstrated that AA is associated with androgen excess.

Is The Force Awakened? Publication Trends In Oncology Big Data As Phase Ii Cancerlinq Is Launched, Hind Rafei, Benjamin Viernes, Angelike P. Liappis, Dalia Abdelaziz Mobarek

GW Research Days 2016 - 2020

Background: The American Society of Clinical Oncology launched CancerLinQ project in 2010 to provide real-time data collection, mining and visualization, clinical decision support, and quality feedback. Creation of a big data software platform is currently underway to power the CancerLinQ in the phase II of the project. This would allow for evidence driven practice and rapid learning for cancer care providers. Additionally, adequate knowledge about the utility of Big Data to encourage provider utilization in high Impact Factor (IF) journals is needed. We aimed to assess trends and quality of Big Data published in Oncology.

Methods: Peer-reviewed English …

Micro-Rna And Mrna Profiles Associated With Ectopic Germinal Center Formation In Thymus Samples Of Patients With Autoimmune Myas, Manjistha Sengupta, Bi-Dar Wang, Norman H. Lee, Gary Cutter, Linda Louise Kusner, Henry J. Kaminski

GW Research Days 2016 - 2020

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder caused by antibodies directed against proteins present at the post-synaptic surface of neuromuscular junction (NMJ). A characteristic pathology of patients with early onset MG is thymic hyperplasia with ectopic germinal centers (GC). However, mechanisms that trigger and maintain thymic hyperplasia are poorly characterized. Micro-RNAs (miRNA) are small, non-coding RNAs that are increasingly appreciated to be involved in the pathology of several autoimmune diseases. In order to determine the central mechanisms involved in the pathology, thymus samples from MG patients were assessed by histology and grouped based on appearance of GC compared to …

Perioperative Aspirin Recommendations In Children With Fenestrated Fontan Undergoing Adenotonsillectomy, Mariam Ashraf, Pamela A. Mudd, Jamie Mcelrath Schwartz, Karen Thompson

GW Research Days 2016 - 2020

Objective: Pediatric patients who have undergone the Fontan procedure are often on a long term aspirin regimen which can complicate perioperative management. In high risk procedures such as adenotonsillectomy, hemorrhage can be a significant complication and aspirin use may increase the risk. There is a need for evidence-based protocol on how to manage aspirin intake in the perioperative period for Fontan patients. We report the case of a patient with Fontan palliation who underwent adenotonsillectomy and presented with postoperative hemorrhage.

Methods: PubMed was searched for guidelines, case reports, and reviews on pediatric Fontan patients, adenotonsillectomy, and perioperative aspirin …

Emil Zuckerkandl, M.D. (1849-1910): Bridging Anatomic Study And The Operating Room Table., Leah Winer, Md, Pankhuri Jha, Scott W. Cowan, Md, Charles J. Yeo, Md, Scott D. Goldstein, Md

Department of Surgery Gibbon Society Historical Profiles

In the mid-19th century, the Vienna School of Anatomy was at the epicenter of the rapidly growing field of anatomy. One of the school’s most distinguished professors, Hungarian-born anatomist Emil Zuckerkandl was instrumental in transforming anatomy from a descriptive science to one of practical and clinical value. A prolific researcher interested in nearly all areas of morphology and most famously, the chromaffin system, Zuckerkandl’s discoveries from more than a century ago still provide a foundation for surgeons to this day.

Imparting Research Ethics In Emergency Medicine-A Perspective From The Developing World, Shahan Waheed, Muhammad Akbar Baig, Asad Mian

Department of Emergency Medicine

No abstract provided.

Molecular Analyses Of Circadian Gene Variants Reveal Sex-Dependent Links Between Depression And Clocks, S-Q Shi, M. J. White, H. M. Borsetti, Julie S. Pendergast, A. Hida, C. M. Ciarleglio, P. A. De Verteuil, A. G. Cadar, C. Cala, D. G. Mcmahon, R. C. Shelton, S. M. Williams, C. H. Johnson

Biology Faculty Publications

An extensive literature links circadian irregularities and/or sleep abnormalities to mood disorders. Despite the strong genetic component underlying many mood disorders, however, previous genetic associations between circadian clock gene variants and major depressive disorder (MDD) have been weak. We applied a combined molecular/functional and genetic association approach to circadian gene polymorphisms in sex-stratified populations of control subjects and case subjects suffering from MDD. This approach identified significant sex-dependent associations of common variants of the circadian clock genes hClock, hPer3 and hNpas2 with major depression and demonstrated functional effects of these polymorphisms on the expression or activity of the hCLOCK …

Effects Of Bupivacaine Infiltration On Postoperative Tramadol Consumption In Elective Day Care Unilateral Inguinal Hernia Repair, Rehan Muhammad Qureshi, Fauzia Anis Khan

Department of Anaesthesia

Objective: To determine the difference in analgesic requirement in terms of mean postoperative narcotic consumption and mean postoperative pain score in patients undergoing unilateral inguinal hernia repair with or without bupivacaine infiltration as day-care patients.Methods: The randomised controlled trial was conducted at Aga Khan University Hospital, Karachi, from June to December 2011, and comprised patients who were randomly divided into groups A and B. Tramadol 1.5 mgkg-1 was used as intraoperative analgesia. At the time of closure of surgical incision, 20ml of bupivacaine 0.25% plain was infiltrated in the subcutaneous tissue sub-facially and in the deeper layers along the incision …

Oncolog, Volume 61, Number 03, March 2016, Bryan Tutt, Sarah Bronson, Jill Delsigne, K Werner

OncoLog MD Anderson's Report to Physicians (All issues) Archives

• Innovations Decrease Toxic Effects of Radiation Therapy for Mediastinal Tumors from Hematological Malignancies: Anterior mediastinal masses caused by lymphoma or leukemia can be difficult to treat because sensitive tissues in the area are vulnerable to damage from radiation therapy. To treat these tumors while sparing healthy tissue, radiation oncologists at The University of Texas MD Anderson Cancer Center use a combination of advanced technologies and new techniques.
• Transoral Robotic Surgery Enables Less Toxic Treatment of Early Throat Cancers: For decades, many patients with hard-to-reach throat cancers received high-dose radiation and chemotherapy, with their often severe toxic effects, because conventional surgery …

Role Of Heme Oxygenase-1 In The Pathogenesis And Tumorigenicity Of Kaposi's Sarcoma-Associated Herpesvirus, Lu Dai, Jing Qiao, David Nguyen, Amanda P. Struckhoff, Lisa Doyle, Karlie Bonstaff, Luis Del Valle, Chris Parsons, Bryan P. Toole, Rolf Renne, Zhiqiang Qin

School of Medicine Faculty Publications

Kaposi's Sarcoma-associated Herpesvirus (KSHV) is the etiologic agent of several malignancies, including Kaposi's Sarcoma (KS), which preferentially arise in immunocompromised patients such as HIV+ subpopulation and lack effective therapeutic options. Heme oxygenase-1 (HO-1) has been reported as an important regulator of endothelial cell cycle control, proliferation and angiogenesis. HO-1 has also been found to be highly expressed in KSHV-infected endothelial cells and oral AIDS-KS lesions. We previously demonstrate that the multifunctional glycoprotein CD147 is required for KSHV/LANA-induced endothelial cell invasiveness. During the identification of CD147 controlled downstream genes by microarray analysis, we found that the expression of HO-1 is significantly …

Fear Conditioning And Extinction In Youth With Obsessive-Compulsive Disorder, Joseph F. Mcguire, Scott P. Orr, Monica S. Wu, Adam B. Lewin, Brent J. Small, Vicky Phares, Tanya K. Murphy, Sabine Wilhelm, Daniel S. Pine, Daniel Geller, Eric A. Storch

Psychology Faculty Publications

BACKGROUND: Fear acquisition and extinction are central constructs in the cognitive-behavioral model of obsessive-compulsive disorder (OCD), which underlies exposure-based cognitive-behavioral therapy (CBT). Youth with OCD may have impairments in fear acquisition and extinction that carry treatment implications. We examined these processes using a differential conditioning procedure.

METHODS: Forty-one youth (19 OCD, 22 community comparisons) completed a battery of clinical interviews, rating scales, and a differential conditioning task that included habituation, acquisition, and extinction phases. Skin conductance response (SCR) served as the primary dependent measure.

RESULTS: During habituation, no difference between groups was observed. During acquisition, differential fear conditioning was observed …

Clinical Presentation Of Ovarian Tumors, Qamarunissa Muhabat, Fakharunissa Waheed, Waqar Unissa, Nigar Jabeen

Department of Obstetrics & Gynaecology

Ovarian malignancy is a serious disease affecting women of all ages, more so above 50 years, and they are still difficult to treat, partly because no truly effective therapy has yet been developed although presentation is often vague and non-specific, the symptoms are definitely present. It is important to recognize the symptoms so far, there is no test yet available, which is truly specific and suitable for screening and early detection of epithelial ovarian carcinoma. So, it is concluded that for prognosis and patient survival, early detection and treatment is mandatory.

Novel Bone-Targeting Agent For Enhanced Delivery Of Vancomycin To Bone, Zaineb A. F. Albayati, Manjula Sunkara, Suzannah M. Schmidt-Malan, Melissa J. Karau, Andrew J. Morris, James M. Steckelberg, Robin Patel, Philip J. Breen, Mark S. Smeltzer, K. Grant Taylor, Kevyn E. Merten, William M. Pierce, Peter A. Crooks

Saha Cardiovascular Research Center Faculty Publications

We examined the pharmacokinetic properties of vancomycin conjugated to a bone-targeting agent (BT) with high affinity for hydroxyapatite after systemic intravenous administration. The results confirm enhanced persistence of BT-vancomycin in plasma and enhanced accumulation in bone relative to vancomycin. This suggests that BT-vancomycin may be a potential carrier for the systemic targeted delivery of vancomycin in the treatment of bone infections, potentially reducing the reliance on surgical debridement to achieve the desired therapeutic outcome.

Primary Hepatic Carcinoid Tumor With Poor Outcome, Om Parkash, Adil Ayub, Buria Naeem, Sehrish Najam, Zubair Ahmed, Wasim Jafri, Saeed Hamid

Section of Gastroenterology

Primary Hepatic Carcinoid Tumor (PHCT) represents an extremely rare clinical entity with only a few cases reported to date. These tumors are rarely associated with metastasis and surgical resection is usually curative. Herein, we report two cases of PHCT associated with poor outcomes due to late diagnosis. Both cases presented late with non-specific symptoms. One patient presented after a 2-week history of symptoms and the second case had a longstanding two years symptomatic interval during which he remained undiagnosed and not properly worked up. Both these cases were diagnosed with hepatic carcinoid tumor, which originates from neuroendocrine cells. Case 1 …

A Randomised Controlled Trial Comparing The Effect Of Adjuvant Intrathecal 2 Mg Midazolam To 20 Micrograms Fentanyl On Postoperative Pain For Patients Undergoing Lower Limb Orthopaedic Surgery Under Spinal Anaesthesia, Francis Codero, Vitalis Mung’Ayi, Sharif Thikra

Anaesthesiology, East Africa

Background: Intrathecal adjuvants are added to local anaesthetics to improve the quality of neuraxial blockade and prolong the duration of analgesia during spinal anaesthesia. Used intrathecally, fentanyl improves the quality of spinal blockade as compared to plain bupivacaine and confers a short duration of post-operative analgesia. Intrathecal midazolam as an adjuvant has been used and shown to improve the quality of spinal anaesthesia and prolong the duration of post-operative analgesia. No studies have been done comparing intrathecal fentanyl with bupivacaine and intrathecal 2 mg midazolam with bupivacaine.

Objective: To compare the effect of intrathecal 2mg midazolam to intrathecal 20 micrograms …

Role Of Slit2 In Reducing Complications After Surgical Brain Injury, Prativa Sherchan

Loma Linda University Electronic Theses, Dissertations & Projects

Surgical brain injury (SBI) is the inadvertent injury to brain tissue at the perisurgical site which occurs due to neurosurgical maneuvers such as incision, retraction, and electrocoagulation that can result in post-operative complications. Blood brain barrier (BBB) disruption and neuroinflammation are major pathophysiological consequences after neurosurgical injury. Blood brain barrier dysfunction leads to increased influx of water and plasma proteins as well as peripheral immune cell infiltration into the brain parenchyma that further potentiates brain edema and worsens post-operative neurological function. Activated resident immune cells and infiltrated peripheral immune cells release inflammatory mediators and promote oxidative stress and cell death …

Relationship Between Visual Prostate Score (Vpss) And Maximum Flow Rate (Qmax) In Men With Urinary Tract Symptoms, Mazhar A. Memon, Hammad Ather

Department of Surgery Docs

Abstract

OBJECTIVE:

To evaluate correlation between visual prostate score (VPSS) and maximum flow rate (Qmax) in men with lower urinary tract symptoms.

MATERIAL AND METHODS:

This is a cross sectional study conducted at a university Hospital. Sixty-seven adult male patients>50 years of age were enrolled in the study after signing an informed consent. Qmax and voided volume recorded at uroflowmetry graph and at the same time VPSS were assessed. The education level was assessed in various defined groups. Pearson correlation coefficient was computed for VPSS and Qmax.

RESULTS:

Mean age was 66.1±10.1 years (median 68). The mean voided volume …

Acute Myocardial Infarction Complicated By Cardiogenic Shock: An Algorithm Based Ecmo Program Can Improve Clinical Outcomes., Shinya Unai, Md, Daizo Tanaka, Md, Nicholas Ruggiero, Md, Hitoshi Hirose, Md, Nicholas C. Cavarocchi, Md

Department of Surgery Faculty Papers

Objective: Extracorporeal membrane oxygenation (ECMO) in our institution resulted in near total mortality prior to the establishment of an algorithm-based program in July 2010. We hypothesized that an algorithm based ECMO program improves the outcome of patients with acute myocardial infarction complicated with cardiogenic shock.

Methods: Between March 2003 and July 2013, 29 patients underwent emergent catheterization for acute myocardial infarction due to left main or proximal left anterior descending artery occlusion complicated with cardiogenic shock (defined as systolic blood pressure < 90mmHg despite multiple inotropes, +- balloon pump, lactic acidosis). Of 29 patients, 15 patients were before July 2010 (Group 1, old program), 14 patients were after July 2010 (Group 2, new program).

Results: There were no significant differences in the baseline characteristics, including age, sex, coronary risk factors …

Evaluations Of Neurologists By Their Patients And Residents Are Inversely Correlated, Michael R. Dobbs, Jonathan H. Smith

Neurology Faculty Publications

Objective and Background: We hypothesized that evaluation scores for attending neurologists by patients and residents would parallel one another. Additionally, we hypothesized that provider productivity would be also be associated with performance evaluations by patients and residents. Methods: In a university neurology department, we collected individual Clinician and Group Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores and standardized resident evaluation scores (n = 22 faculty members). We performed bivariate analysis of doctor–patient satisfaction versus resident evaluation scores. Results: Attending neurologists with higher patient satisfaction received lower resident evaluation scores (P < .05). There seem to be disproportionate neurologists with low evaluations not meeting clinical productivity targets. Conclusion: Finding a significant inverse correlation …

Iron Deficiency Anemia Among Women Of Reproductive Age, An Important Public Health Problem: Situation Analysis, Minaz Mawani, Savera Aziz Ali, Gulshan Bano, Sumera Aziz Ali

Section of Internal Medicine

Background: Iron deficiency is a major cause of anemia and is more prevalent in developing countries, posing additional burden on health care systems, in the presence of scarcity of resources. The high-risk group consists of females and children but comparatively it is higher in females due to physiological reasons. Multiple factors can predict anemia, which in turn leads to various adverse outcomes.

Objective: The purpose of this literature review was to review and synthesize the findings from literature about the burden, causes, outcomes and important interventions of iron deficiency anemia for developing countries.

Methods: An extensive literature review was carried …

Aneurysm In The Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery Variant: Case Report And Review Of Literature, Saad Akhtar, Abdul Azeem, , Amyna Jiwani, Gohar Javed

Department of Surgery Docs

Abstract

INTRODUCTION:

There are variations in the anatomy of the vertebrobasilar system amongst which the Anterior Inferior Cerebellar Artery-Posterior Inferior Cerebellar Artery (AICA-PICA) variant is thought to have a prevalence of 20-24% (based on retrospective studies). Despite this, aneurysms of the AICA-PICA variant are rare. We present a case of an AICA-PICA aneurysm and discuss its presentation and management, along with a review of literature.

PRESENTATION OF CASE:

We describe the case of a 35 year old female who presented with signs of meningismus. On the basis of radiological imaging it was initially misdiagnosed as a thrombosed arteriovenous malformation (AVM). …

Is Laparoscopic Pyeloplasty A Comparable Option To Treat Ureteropelvic Junction Obstruction (Upjo)? A Comparative Study, Mazhar Ali, Syed Raziuddin Biyabani, Rajab Ghirano, Wajahat Aziz, Khurram Mutahir Siddiqui

Department of Surgery Docs

Objective: To compare laparoscopic with open pyeloplasty.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised records of patients who underwent surgical correction of ureteropelvic junction obstruction between during January 2008 and December 2012. Patients with laparoscopic pyeloplasty were placed in group 1 and those with open pyeloplasty in group 2.The groups were compared for operative time, hospital stay, perioperative complications, blood loss, duration of surgery, outcome and follow-up. Data was analysed using SPSS 19.
Results: Of the 73 patients, 29(40%) were in group 1, and 44(60%) in group 2. A crossing vessel could be …

Functional Outcome Of Anorectal Malformations And Associated Anomalies In Era Of Krickenbeck Classification, Saqib Hamid Qazi, Ahmad Vaqas Faruque, Muhammad Arif Mateen Khan, Umama Saleem

Department of Surgery Docs

Abstract

OBJECTIVE:

To describe the management and functional outcome of anorectal malformations and associated anomalies according to Krickenbeck classification.

STUDY DESIGN:

Case series.

PLACE AND DURATION OF STUDY:

The Aga Khan University Hospital, Karachi, from January 2002 to December 2012.

METHODOLOGY:

Anorectal anomalies were classified according to Krickenbeck classification. Data was collected and proforma used regarding the primary disease associated anomalies, its management and functional outcome, according to Krickenbeck classification. Cases included were: all those children with imperforate anus managed during the study period. Qualitative variables like gender and functional outcome were reported as frequencies and percentages. Quantitative variables like …