Pub Date : 2024-09-01Epub Date: 2024-09-09DOI: 10.4103/jiaps.jiaps_187_24
Rasiklal S Shah
{"title":"Safety of Women Health-care Workers at the Workplace Especially of Whistleblowers.","authors":"Rasiklal S Shah","doi":"10.4103/jiaps.jiaps_187_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_187_24","url":null,"abstract":"","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"29 5","pages":"398-399"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_35_24
Saurav Srivastava, A. Sinha, Sourav Jana, Utkarsh Shukla
{"title":"Ectopic Testis Near Anterior Superior Iliac Spine: A Diagnostic Dilemma","authors":"Saurav Srivastava, A. Sinha, Sourav Jana, Utkarsh Shukla","doi":"10.4103/jiaps.jiaps_35_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_35_24","url":null,"abstract":"","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"18 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_30_24
Rahul Gupta, Jayant Radhakrishnan
ABSTRACT Cloacal malformations are rare and are typically reported in females. There are a few scattered reports in males. It is not clear why they are so rare in males since both sexes negotiate this stage of embryonal development. The present study aims to share our experience and review all the cases of persistent cloaca and cloacal variants in males reported in the literature. The male cloaca is defined as a single common channel of varying lengths with separate inlets for the urinary tract (urethra) anteriorly and the rectum posteriorly at its cranial end and with a solitary perineal orifice/opening for external drainage. We also carried out an electronic literature search for cloaca, persistent cloaca, common cloaca, cloacal dysgenesis, cloacal malformation, cloacal membrane agenesis, urorectal malformation sequence, rectourinary perineal fistula, sirenomelia, and caudal regression syndrome. After eliminating other cloacal anomalies and persistent cloaca in females, we found a total of 22 males with persistent cloaca or cloacal variant reported in the literature. In addition, we are adding two cases we have managed since our previous report. An effort should be made to search for the presence of the common channel in male patients with a single perineal opening. Recognition of the anomaly, width of the common cloacal channel, location of the rectal pouch with relation to the sacrum or pubis, status of the spine and sacrum, and nature of the anal sphincter are vital pieces of information to successfully manage the anomaly. It would be worthwhile if future reports on the subject also include long-term information about urinary and fecal functions and continence.
{"title":"Persistent Cloaca and Cloacal Variants in Males: Qualitative Review of a Neglected Anomaly","authors":"Rahul Gupta, Jayant Radhakrishnan","doi":"10.4103/jiaps.jiaps_30_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_30_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Cloacal malformations are rare and are typically reported in females. There are a few scattered reports in males. It is not clear why they are so rare in males since both sexes negotiate this stage of embryonal development.\u0000 \u0000 \u0000 \u0000 The present study aims to share our experience and review all the cases of persistent cloaca and cloacal variants in males reported in the literature.\u0000 \u0000 \u0000 \u0000 The male cloaca is defined as a single common channel of varying lengths with separate inlets for the urinary tract (urethra) anteriorly and the rectum posteriorly at its cranial end and with a solitary perineal orifice/opening for external drainage. We also carried out an electronic literature search for cloaca, persistent cloaca, common cloaca, cloacal dysgenesis, cloacal malformation, cloacal membrane agenesis, urorectal malformation sequence, rectourinary perineal fistula, sirenomelia, and caudal regression syndrome.\u0000 \u0000 \u0000 \u0000 After eliminating other cloacal anomalies and persistent cloaca in females, we found a total of 22 males with persistent cloaca or cloacal variant reported in the literature. In addition, we are adding two cases we have managed since our previous report.\u0000 \u0000 \u0000 \u0000 An effort should be made to search for the presence of the common channel in male patients with a single perineal opening. Recognition of the anomaly, width of the common cloacal channel, location of the rectal pouch with relation to the sacrum or pubis, status of the spine and sacrum, and nature of the anal sphincter are vital pieces of information to successfully manage the anomaly. It would be worthwhile if future reports on the subject also include long-term information about urinary and fecal functions and continence.\u0000","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"12 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_52_24
Rajib Bora, Sheetal Upreti, Gaurav Saxena, S. Neogi, S. Ratan
ABSTRACT The association is defined as two or more malformations with unclear relationships, which do not fit the criteria of a syndrome. This case report presents a rare finding of tubular colonic duplication in association with Mayer–Rokitansky–Küster–Hauser syndrome in an adolescent girl. The patient presented with gastrointestinal bleeding and abdominal pain, necessitating surgical intervention. The successful excision of the duplicated segment highlights the importance of prompt diagnosis and treatment in such cases.
{"title":"A Novel Association of Colonic Duplication with Mayer–Rokitansky–Kuster–Hauser Syndrome in an Adolescent Girl","authors":"Rajib Bora, Sheetal Upreti, Gaurav Saxena, S. Neogi, S. Ratan","doi":"10.4103/jiaps.jiaps_52_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_52_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 The association is defined as two or more malformations with unclear relationships, which do not fit the criteria of a syndrome. This case report presents a rare finding of tubular colonic duplication in association with Mayer–Rokitansky–Küster–Hauser syndrome in an adolescent girl. The patient presented with gastrointestinal bleeding and abdominal pain, necessitating surgical intervention. The successful excision of the duplicated segment highlights the importance of prompt diagnosis and treatment in such cases.","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"79 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_1_24
Ramyasree Bade, N. Peters, Joseph L Mathew, I. Sen, J. K. Mahajan
ABSTRACT Congenital extrahepatic portosystemic shunts (CEPS) are rare anomalies connecting the portal system to the inferior vena cava. This report discusses a 10-year-old boy with Type II c CEPS, presenting cyanosis and dyspnea. Surgical ligation resulted in significant improvement in symptoms. Early identification and intervention are crucial, necessitating a protocolized approach.
摘要 先天性肝外门静脉分流（CEPS）是连接门静脉系统和下腔静脉的罕见畸形。本报告讨论了一名患有 II c 型 CEPS 的 10 岁男孩，他出现发绀和呼吸困难。手术结扎后症状明显改善。早期识别和干预至关重要，因此必须采用规范化的方法。
{"title":"Surgically Correctable Central Cyanosis: Congenital Extrahepatic Portosystemic Shunt in a Child","authors":"Ramyasree Bade, N. Peters, Joseph L Mathew, I. Sen, J. K. Mahajan","doi":"10.4103/jiaps.jiaps_1_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_1_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 Congenital extrahepatic portosystemic shunts (CEPS) are rare anomalies connecting the portal system to the inferior vena cava. This report discusses a 10-year-old boy with Type II c CEPS, presenting cyanosis and dyspnea. Surgical ligation resulted in significant improvement in symptoms. Early identification and intervention are crucial, necessitating a protocolized approach.","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"11 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_248_23
Avilash Sahu, M. Zameer, C. Vinay, S. Rao, Ashley D'cruz
ABSTRACT Tunnelled catheters improve venous access in haematological diseases and malignancies, but are associated with complications. We prospectively analysed the episodes of CABSI and its associated risk factors. To study the incidence and risk factors for CABSI in children with tunnelled central venous catheters (both Hickmans and Chemoports). This is a prospective observational study done at our institute. Children under the age of 18 who underwent insertion of a Hickman or Chemoport from March 2018 to Dec 2022 were enrolled. Episodes of CABSI were noted and its risk factors were analysed. In total, 258 catheters were inserted in 250 children. Age ranged from 1 month to 18 years (median 67 months) with 60% being boys. A total of 152 Hickmans, 106 chemoports were inserted. Indications for insertions were for requirement of BMT and chemotherapy in majority of cases. CABSI were seen in 28.6% of catheters. Younger children (< 4years), Neutropenia (counts < 1000) and use of TPN were significantly associated with CABSI(p value<0.05).Infection was more with externalized catheters (Hickman) than implantable ports (Chemoports) but was not statistical significant(p value>0.05). Almost 30% of catheters with CABSI required removal because of florid sepsis. Others could be salvaged with aggressive antibiotics. CABSI is a serious complications related to tunnelled catheter. Smaller children (<4 years), neutropenia and usage of TPN is a risk factor for development of CABSI. It can be treated with appropriate antibiotics and required removal in almost a third of all the cases.
{"title":"Catheter-associated Bloodstream Infection in Children with Tunneled Central Venous Catheters: A Single-center Experience","authors":"Avilash Sahu, M. Zameer, C. Vinay, S. Rao, Ashley D'cruz","doi":"10.4103/jiaps.jiaps_248_23","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_248_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Tunnelled catheters improve venous access in haematological diseases and malignancies, but are associated with complications. We prospectively analysed the episodes of CABSI and its associated risk factors.\u0000 \u0000 \u0000 \u0000 To study the incidence and risk factors for CABSI in children with tunnelled central venous catheters (both Hickmans and Chemoports).\u0000 \u0000 \u0000 \u0000 This is a prospective observational study done at our institute. Children under the age of 18 who underwent insertion of a Hickman or Chemoport from March 2018 to Dec 2022 were enrolled. Episodes of CABSI were noted and its risk factors were analysed.\u0000 \u0000 \u0000 \u0000 In total, 258 catheters were inserted in 250 children. Age ranged from 1 month to 18 years (median 67 months) with 60% being boys. A total of 152 Hickmans, 106 chemoports were inserted. Indications for insertions were for requirement of BMT and chemotherapy in majority of cases. CABSI were seen in 28.6% of catheters. Younger children (< 4years), Neutropenia (counts < 1000) and use of TPN were significantly associated with CABSI(p value<0.05).Infection was more with externalized catheters (Hickman) than implantable ports (Chemoports) but was not statistical significant(p value>0.05). Almost 30% of catheters with CABSI required removal because of florid sepsis. Others could be salvaged with aggressive antibiotics.\u0000 \u0000 \u0000 \u0000 CABSI is a serious complications related to tunnelled catheter. Smaller children (<4 years), neutropenia and usage of TPN is a risk factor for development of CABSI. It can be treated with appropriate antibiotics and required removal in almost a third of all the cases.\u0000","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_83_24
S. Ratan, S. Neogi, Md Fahim Ahmad, Kanishka Das, Vijaya Raman, P. Bendre, A. Banerjee, Shilpa Sharma, Himanshu Acharya, Vikesh Agrawal, Ramesh Babu
ABSTRACT Of late, there are many legal representations from select quarters to halt all medical interventions in children with differences of sex development (DSD). In this survey on management decisions in DSD, we distil the views of Indian stakeholders: parents, physicians, and grown-up patients with DSD on their management decisions to identify decisional satisfaction or gender dysphoria. The survey domains included the patient demographics, final diagnosis, decision on the sex of rearing, surgical interventions, opinion of the stakeholders on the preferred age of sex assignment, final sex of rearing, and agreement/disagreement about sex assignment (gender dysphoria). A total of 106 responses were recorded (66% parents, 34% grown-up patients aged 12–50 years). Among parents, 65/70 (95%) preferred the sex to be assigned soon after birth. All grown-up patients preferred sex to be assigned soon after birth. Regarding decisions on surgery, 74% of physicians and 75% of the grown-up patients felt parents should be allowed to decide interventions. Among Indian parents, 90% felt they should have the right to decide surgery in the best interest of their child for a safe social upbringing. Overall, gender dysphoria among Indian DSD patients was <1% (1/103, 0.97%). The predominant preference and opinion of major Indian stakeholders (physicians, parents, and grown-up DSD patients) support the existing approach toward DSD management, including early sex assignment and necessary medical intervention.
{"title":"A Pilot Survey of Indian Stakeholders: Parents, Doctors, and Grown-Up Patients of Disorders of Sexual Differentiation on Management Decisions and Associated Gender Dysphoria","authors":"S. Ratan, S. Neogi, Md Fahim Ahmad, Kanishka Das, Vijaya Raman, P. Bendre, A. Banerjee, Shilpa Sharma, Himanshu Acharya, Vikesh Agrawal, Ramesh Babu","doi":"10.4103/jiaps.jiaps_83_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_83_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Of late, there are many legal representations from select quarters to halt all medical interventions in children with differences of sex development (DSD). In this survey on management decisions in DSD, we distil the views of Indian stakeholders: parents, physicians, and grown-up patients with DSD on their management decisions to identify decisional satisfaction or gender dysphoria.\u0000 \u0000 \u0000 \u0000 The survey domains included the patient demographics, final diagnosis, decision on the sex of rearing, surgical interventions, opinion of the stakeholders on the preferred age of sex assignment, final sex of rearing, and agreement/disagreement about sex assignment (gender dysphoria).\u0000 \u0000 \u0000 \u0000 A total of 106 responses were recorded (66% parents, 34% grown-up patients aged 12–50 years). Among parents, 65/70 (95%) preferred the sex to be assigned soon after birth. All grown-up patients preferred sex to be assigned soon after birth. Regarding decisions on surgery, 74% of physicians and 75% of the grown-up patients felt parents should be allowed to decide interventions. Among Indian parents, 90% felt they should have the right to decide surgery in the best interest of their child for a safe social upbringing. Overall, gender dysphoria among Indian DSD patients was <1% (1/103, 0.97%).\u0000 \u0000 \u0000 \u0000 The predominant preference and opinion of major Indian stakeholders (physicians, parents, and grown-up DSD patients) support the existing approach toward DSD management, including early sex assignment and necessary medical intervention.\u0000","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"13 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_232_23
V. Chandrasekharam, Ramesh Babu, D. A. Prasad, Ravula Satyanarayana
ABSTRACT To compare the accuracy of unaided visual inspection (UVI) to Software App measurement (SAM) of penile curvature (PC) during hypospadias surgery. Seven clinical pictures of PC (15°–60°) taken during hypospadias repair were shared with 300 members of the Society of Pediatric Urology (India). The respondents were asked to assess the angles by UVI and indicate their preferred correction method of that PC. For each picture, the angles of curvature estimated by UVI were compared with the objective angle measured using an app (SAM), which was considered an accurate estimation. Statistical analysis was done using software; P<0.05 was considered as statistically significant. Ninety-one of 101 (90%) respondents preferred UVI to measure PC during hypospadias surgery. For 6/7 pictures, <40% of participants estimated the angle correctly by UVI (P < 0.001), with the difference in estimation being 3.6°–14.9°. For pictures with PC >30°, the error in UVI estimation was >10°, with no correlation between the accuracy of UVI estimate and surgeon experience. A significant proportion of surgeons chose the incorrect option for PC correction, which was the lowest (69%) for PC 35.8°. Most surgeons preferred UVI to assess PC; UVI is an erroneous technique to measure PC angle, especially in the PC range 30°–60°, where the error was >10°. Most errors were an underestimation of the PC, irrespective of surgeon experience. There was a significant error in the choice of technique for PC correction for a PC of 35°. These results strongly support the objective assessment of PC using SAM during hypospadias repair.
摘要 比较尿道下裂手术中阴茎弯曲度（PC）的辅助目测（UVI）和软件应用程序测量（SAM）的准确性。 我们与印度小儿泌尿外科学会的 300 名会员分享了尿道下裂修补术中拍摄的 7 张 PC（15°-60°）临床图片。受访者被要求通过 UVI 对角度进行评估，并指出其首选的 PC 矫正方法。对于每张图片，UVI 估测的曲率角度与使用应用程序（SAM）测量的客观角度进行比较，后者被认为是准确的估测结果。使用软件进行了统计分析；P30°时，UVI 估计值的误差大于 10°，UVI 估计值的准确性与外科医生的经验没有相关性。相当一部分外科医生在 PC 矫正时选择了错误的选项，其中 PC 35.8°的错误率最低（69%）。 大多数外科医生倾向于使用 UVI 评估 PC；UVI 是一种错误的 PC 角度测量技术，尤其是在 PC 30°-60° 范围内，误差大于 10°。无论外科医生的经验如何，大多数错误都是低估了 PC 角。在 PC 为 35° 时，PC 矫正技术的选择存在重大误差。这些结果有力地支持了在尿道下裂修复过程中使用 SAM 对 PC 进行客观评估。
{"title":"Unaided Visual Inspection for Assessment of Penile Curvature in the Clinical Setting of Hypospadias Surgery: Survey of Members of Society of Pediatric Urology (India)","authors":"V. Chandrasekharam, Ramesh Babu, D. A. Prasad, Ravula Satyanarayana","doi":"10.4103/jiaps.jiaps_232_23","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_232_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 To compare the accuracy of unaided visual inspection (UVI) to Software App measurement (SAM) of penile curvature (PC) during hypospadias surgery.\u0000 \u0000 \u0000 \u0000 Seven clinical pictures of PC (15°–60°) taken during hypospadias repair were shared with 300 members of the Society of Pediatric Urology (India). The respondents were asked to assess the angles by UVI and indicate their preferred correction method of that PC. For each picture, the angles of curvature estimated by UVI were compared with the objective angle measured using an app (SAM), which was considered an accurate estimation. Statistical analysis was done using software; P<0.05 was considered as statistically significant.\u0000 \u0000 \u0000 \u0000 Ninety-one of 101 (90%) respondents preferred UVI to measure PC during hypospadias surgery. For 6/7 pictures, <40% of participants estimated the angle correctly by UVI (P < 0.001), with the difference in estimation being 3.6°–14.9°. For pictures with PC >30°, the error in UVI estimation was >10°, with no correlation between the accuracy of UVI estimate and surgeon experience. A significant proportion of surgeons chose the incorrect option for PC correction, which was the lowest (69%) for PC 35.8°.\u0000 \u0000 \u0000 \u0000 Most surgeons preferred UVI to assess PC; UVI is an erroneous technique to measure PC angle, especially in the PC range 30°–60°, where the error was >10°. Most errors were an underestimation of the PC, irrespective of surgeon experience. There was a significant error in the choice of technique for PC correction for a PC of 35°. These results strongly support the objective assessment of PC using SAM during hypospadias repair.\u0000","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"48 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_53_24
P. Goel, Vikesh Agrawal, Ramesh Babu Srinivasan
ABSTRACT The aim of this study was to propose Management, Outcome, Risk, and Expectation (MORE) as a risk based stratification to aid in antenatal parental counseling and decision making through a systematic review of published literature. A Preferred Reporting Items for Systematic Reviews and Meta Analyses compliant systematic review was conducted to include articles that covered antenatal counseling of pediatric surgical conditions. The following information was solicited for each anomaly: primary organ syste*-m of involvement, single or multi system anomaly, natural history of the disease, standard management of the anomaly, need for antenatal intervention, and whether the anomaly requires any alteration in the obstetric management. Twenty two studies were identified fulfilling the inclusion criteria, between 1993 and 2023. Only two studies were found to have GRADE A recommendation and Level I evidence. Most of the studies were review articles/ survey, and 6 studies were found to be retrospective observational studies. Based on the analysis of the solicited information, the anomalies were stratified into a group subsequently maturing them into a simplified MORE classification scheme which stressed the importance of Management (10, 45.45%), Outcome (9, 40.90%), Risk (9, 40.90%), and Expectation (10, 45.45%) categories during antenatal counseling. MORE classification of fetal structural anomalies is a simple but comprehensive framework to assist the physicians and other medical personnel antenatal parental counseling and decision making.
摘要 本研究旨在通过对已发表的文献进行系统性回顾，提出将管理、结果、风险和预期（MORE）作为一种基于风险的分层方法，以帮助产前父母咨询和决策。本研究采用系统综述和元分析的首选报告项目进行系统综述，以纳入涉及小儿外科疾病产前咨询的文章。针对每种异常征集了以下信息：受累的主要器官系统、单系统或多系统异常、疾病的自然史、异常的标准管理、产前干预的必要性以及异常是否需要改变产科管理。符合纳入标准的研究有 22 项，时间跨度为 1993 年至 2023 年。只有两项研究获得了 GRADE A 级推荐和 I 级证据。大部分研究为综述性文章/调查，6 项研究为回顾性观察研究。根据对所征集信息的分析，异常情况被分为一组，随后将其成熟化为简化的 MORE 分类方案，该方案强调产前咨询中管理（10，45.45%）、结果（9，40.90%）、风险（9，40.90%）和预期（10，45.45%）类别的重要性。MORE 胎儿结构异常分类法是一个简单而全面的框架，有助于医生和其他医务人员进行产前咨询和决策。
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Pub Date : 2024-07-01DOI: 10.4103/jiaps.jiaps_6_24
Kokilavani Mahalingam, Lakshmi Sundararajan
ABSTRACT The aim of the study was to highlight the pathology, clinical spectrum, and approach considerations in abdominoscrotal hydrocele (ASH). Our study included eight children with ASH from 2015 to 2022. The demographics, clinical presentation, investigations, operative details, and postoperative outcome were collected retrospectively from case files. The age of presentation ranged from 11 months to 2½ years. Six lesions were on the right side and two were on the left side. One child presented with an acute scrotum and underwent emergency inguinal exploration, revealing hemorrhagic fluid after trauma. Others presented with tense inguinoscrotal swelling, which was fully reducible but refilled promptly after emptying. Preoperative ultrasound showed the abdominal component in 50%, while others were detected intraoperatively. All of them were approached inguinally, and the hydrocele sac was traced proximally to the abdominal component through the internal ring. This was drained and a partial excision of the extraperitoneal sac was done. An additional patent processus vaginalis (PPV) was identified in 87%, dissected up to the deep ring, and ligated. On follow-up, there was no recurrence. ASH is an uncommon condition that should be identified and dealt with appropriately. Physical examination and ultrasonography are usually sufficient for diagnosis. The inguinal approach is a safe, simple method and an extension of the standard operation for the hydrocele. One must keep in mind to explore for an additional narrow PPV to prevent the recurrence of hydrocele.
{"title":"Abdominoscrotal Hydrocele - Considerations","authors":"Kokilavani Mahalingam, Lakshmi Sundararajan","doi":"10.4103/jiaps.jiaps_6_24","DOIUrl":"https://doi.org/10.4103/jiaps.jiaps_6_24","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 The aim of the study was to highlight the pathology, clinical spectrum, and approach considerations in abdominoscrotal hydrocele (ASH).\u0000 \u0000 \u0000 \u0000 Our study included eight children with ASH from 2015 to 2022. The demographics, clinical presentation, investigations, operative details, and postoperative outcome were collected retrospectively from case files.\u0000 \u0000 \u0000 \u0000 The age of presentation ranged from 11 months to 2½ years. Six lesions were on the right side and two were on the left side. One child presented with an acute scrotum and underwent emergency inguinal exploration, revealing hemorrhagic fluid after trauma. Others presented with tense inguinoscrotal swelling, which was fully reducible but refilled promptly after emptying. Preoperative ultrasound showed the abdominal component in 50%, while others were detected intraoperatively. All of them were approached inguinally, and the hydrocele sac was traced proximally to the abdominal component through the internal ring. This was drained and a partial excision of the extraperitoneal sac was done. An additional patent processus vaginalis (PPV) was identified in 87%, dissected up to the deep ring, and ligated. On follow-up, there was no recurrence.\u0000 \u0000 \u0000 \u0000 ASH is an uncommon condition that should be identified and dealt with appropriately. Physical examination and ultrasonography are usually sufficient for diagnosis. The inguinal approach is a safe, simple method and an extension of the standard operation for the hydrocele. One must keep in mind to explore for an additional narrow PPV to prevent the recurrence of hydrocele.\u0000","PeriodicalId":16069,"journal":{"name":"Journal of Indian Association of Pediatric Surgeons","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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