bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors affecting the use of improved chickpea seed among smallholder farmers in Gondar Zuria Woreda, Ethiopia
Authors: Asegie A. M. , Giziew A. , Ayalew D.
Published: September 2023

Purpose: The use of improved seeds is one of the most important factors among the others to increase the production and productivity of crops. However, the use of improved chickpea seeds by smallholder farmers remains low. These resulted in lower productivity of chickpea by smallholder farmers. The factors contributing to the low rate of use of improved chickpea seed in the study area are to be analyzed. Research Method: To achieve the objective of the study, a multi-stage sampling technique was employed. The sample size was determined using the Yamane formula, and 140 sampled households were randomly selected. A proportionate sample  of the population was used to determine the size of sample from each kebele . These data were analyzed using descriptive statistics and a binary logistic regression model.  Findings: The results revealed that 55.71% of respondents are users of improved chickpea seeds. The logistic regression result shows that the use of improved chickpea seed by smallholder farmers is determined by the availability and price of improved seeds, size of land holdings, participation in a field visit, frequency of extension service, proximity to the market, and attractiveness of the market price. The marginal effect result indicates that a unit change in access to improved seeds, participation in a field visit, land size, and seed cost increases the probability of using improved chickpea seed by 40.76%, 11.86%, 11.26%, and 4.27% respectively, among others.  Research Limitations: The study was conducted in one geographical area using cross-sectional data. This finding does not show the trends of adoption in the study area or its implications in different parts of the region. Originality/Value: The findings of the study are novel and relatively new to the given geographical area. This study reported specific and new findings on factors that affect the use of improved chickpea seeds in the study area. The findings are important as a source of information for decision-makers, development practitioners, and researchers.
Knowledge, Attitude, and Practices of Swine Farmers related to Livestock Biosecurity: A Case Study of African Swine Fever in Vietnam
Authors: Na L. , Thuy N. N. , Beaulieu A. , Hanh T. M. D. , Anh H. H.
Published: September 2023

Purpose: African Swine Fever (ASF), one of the world’s most contagious and deadly livestock infectious diseases, was introduced to Vietnam in 2019 and has since become one of the biggest threats to the country’s porcine industry. To this day, very little is known about the major drivers of ASF outbreaks – in particular, the generally low levels of biosecurity found on smallholder farms in Vietnam. The main objective of this paper is to assess the knowledge disparities, diverging attitudes, and different practices among smallholder pig farming households that influence the adoption, implementation, and continuation of ASF biosecurity measures in Vietnam.
Research Method: Structured questionnaire surveys were conducted to 183 smallholder pig farming households in December 2020 in four districts of Dong Nai, the largest pig production province in Vietnam. The determinants of farmers’ knowledge and attitude toward ASF were estimated using an ordinal probit regression; a panel-data probit regression approximated the probability of farmers adopting biosecurity measures.
Findings: It was found that, prior to the first outbreaks of ASF in Vietnam in 2019, surveyed pig farmers generally had an inadequate level of knowledge about ASF to be able to successfully prevent and control the disease’s spread. Rather, farmers only managed to significantly improve their understanding of ASF after outbreaks had begun. Model estimates indicate that a better understanding of ASF ultimately helped improve farmers’ attitudes toward ASF biosecurity measures. Additionally, farmers with previous experience in dealing with other livestock infectious disease outbreaks were, in most cases, found to be more willing to implement ASF biosecurity measures. Together, deeper understanding of ASF and more positive attitudes towards ASF prevention and control measures contributed to an overall increase in the likelihood of farmers adopting and implementing appropriate ASF biosecurity practices.
Originality/ Value: This paper highlights the need for improved community education campaigns in efforts to prevent and contain ASF outbreaks, as well as the need for increased financial assistance and support for swine farmers to enable them to adopt effective biosecurity practices.
Memory T Cells in the Immunoprevention of Cancer: A Switch from Therapeutic to Prophylactic Approaches
Authors: Mittra Siddhesh , Harding Shane M , Kaech Susan M
Published: September 2023

Cancer immunoprevention, the engagement of the immune system to prevent cancer, is largely overshadowed by therapeutic approaches to treating cancer after detection. Vaccines or, alternatively, the utilization of genetically engineered memory T cells could be methods of engaging and creating cancer-specific T cells with superb memory, lenient activation requirements, potent antitumor cytotoxicity, tumor surveillance, and resilience against immunosuppressive factors in the tumor microenvironment. In this review we analyze memory T cell subtypes based on their potential utility in cancer immunoprevention with regard to longevity, localization, activation requirements, and efficacy in fighting cancers. A particular focus is on how both tissue-resident memory T cells and stem memory T cells could be promising subtypes for engaging in immunoprevention.
Efficacy and safety of postoperative levothyroxine sodium tablets for improving serum thyroid hormone levels and tumor marker levels in patients with thyroid tumors
Authors: Hao Dingji , Tian Linxiao , He Haoting , Zhu Congru , Guo Lili , Zhang Keao , Zhang Jie
Published: September 2023

Levothyroxine tablet has been used for improving serum thyroid hormones. Despite its efficacy, there has been a persistent recurrence. We aimed to evaluate the efficacy of levothyroxine regimen (administered as sodium tablets or liquid) therapy, including the regime in combination with other thyroxine hormones, to determine its effectiveness and safety regarding thyroid tumor patient outcomes. An electronic search of the online databases (PubMed, EMBASE, and Web of Science) was performed in duplicate independently by two authors (SSK and LPY) to identify any potential studies published in the English language from January 2002 to October 2022. The records were retrieved using keywords and MeSH terms. The Cochrane risk of bias tool in the Review Manager (RevMan software version 5.4.) was used to evaluate the risk of bias in the included studies.  A total of 18 quality studies were reported on levothyroxine tablets. Results showed that liquid levothyroxine was more efficient than tablet levothyroxine. Further results showed that levothyroxine in combination with L-T3 or I-131 was more effective than L-T4 tablet monotherapy for improving thyroid cancer hormones. Levothyroxine tablet monotherapy is less efficient than liquid levothyroxine and/or levothyroxine combined therapy. This research recommends future research using larger randomized controlled studies.
Current practice pattern among anaesthesiologists for difficult airway management: A nationwide cross-sectional survey
Authors: Govardhane Balasaheb T , Shinde Apurva D , Gehdoo Raghubirsingh P. , Arora Sanya
Published: September 2023

Background and Aims:

The practice patterns for airway management vary among anaesthesiologists, depending on various setups and geographical divides. This survey assessed practice patterns in unanticipated difficult intubation and cannot intubate or cannot ventilate (CICV) situations/complete ventilation failure among Indian anaesthesiologists’.

Methods:

A validated questionnaire of 22 items related to practice preferences for airway management among anaesthesiologists was sent to Indian Society of Anaesthesiologists members online through Google Forms and distributed manually to delegates in continuing medical education programme.

Results:

A total of 535 responses were obtained and analysed. In unanticipated difficult laryngoscopy and intubation, the order of preference for alternative airway devices was video laryngoscope (VL, 60.1%), intubating laryngeal mask airway/laryngeal mask airway (23.5%), fibreoptic bronchoscope (13.5%) and optical stylets (1.2%). Advanced difficult airway devices were unavailable in most nursing homes and government non-teaching hospitals. Seventy per cent of respondents experienced CICV situations at least once, most during head and neck surgeries. In CICV situations, the order of choice for the front-of-neck airway access was cricothyroidotomy (CT) by narrow bore cannula (48.9%), tracheostomy by the surgeon (30%), Seldinger CT (12.5%), open surgical CT (5.4%) and scalpel bougie CT (3.2%).

Conclusion:

The VL was the most preferred airway rescue device in unanticipated difficult intubation, and intravenous catheter cricothyroidotomy was the most selected technique in CICV situations.
Prediction of the difficult airway by pre-operative ultrasound-based measurement of airway parameters: A prospective observational study
Authors: Waindeskar Vaishali , Padala Sri Rama Ananta Nagabhushanam , Jain Shikha , Kiran Molli , Mandal Pranita , Pakhare Abhijit P.
Published: September 2023

Background and Aims:

Ultrasonography has emerged as a new airway assessment tool. However, its role in predicting difficult airways needs to be explored. This study aimed to evaluate the accuracy of pre-operative ultrasound assessment of the neck in predicting difficult airways in patients undergoing elective surgery under general anaesthesia.

Methods:

One hundred and fourteen adult patients undergoing elective surgeries under general anaesthesia were enrolled in this study. In the pre-operative room, upper airway ultrasound measurements of the neck were obtained, namely, distance from skin to the hyoid bone, distance from skin to the thyroid isthmus and thickness of the base of the tongue. Clinical airway assessment details were noted from the pre-anaesthetic evaluation form. The airway management technique was noted. Receiver operating characteristic curves were used to assess the diagnostic value of these upper airway ultrasound measurements in predicting difficult airways.

Results:

The distance from the skin to the thyroid isthmus in the difficult airway group (0.37 ± 0.133 cm) was significantly higher than in the non-difficult group (P = 0.007). It appeared to be a better predictor of difficult airways and correlated better with clinical tests among the measured ultrasound parameters. The body mass index was significantly higher in the difficult airway group (P = 0.009).

Conclusion:

Considering the difference in means between the two groups, distance from the skin to the thyroid isthmus should be explored as a potential predictor of a difficult airway in studies with a larger sample size.
Assessment of macular visual functions in patients with risk for obstructive sleep apnea syndrome
Authors: Subramanian Brughanya , Asokan Rashima , Ganesan Suganeswari
Published: September 2023

Purpose:

To study and compare the macular visual functions among the subjects with and without risk for Obstructive Sleep Apnea Syndrome.

Methods:

Prospective case–control study involving 20 cases and 17 controls. Subjects were classified as cases with the presence of snoring and controls in the absence of it. Cases were administered with a standardized Berlin Questionnaire and were grouped as high risk and low risk based on their scores. Color discrimination, contrast sensitivity, and photo stress recovery test were measured following a comprehensive eye examination. Body mass index and neck circumference were also measured.

Results:

There were 13 subjects in the high-risk category, 7 subjects in the low-risk category, and 17 subjects in the control group. The total error score in color discrimination was significantly different among high risk (112 ± 84.17), low risk (74 ± 43.98), and controls (56 ± 39.43) (P = 0.04) whereas, contrast sensitivity (P = 0.897), visual acuity (P = 0.95), and photo stress recovery test (P = 0.32) did not show any significant difference.

Conclusion:

High-risk category subjects showed poor color discrimination than controls hence, these individuals must undergo a detailed ophthalmic examination with a color discrimination test and must be evaluated in a sleep clinic.
Case series on scleral patch graft for peripheral corneal perforations
Authors: Datta Ditsha , Sharma Shweta
Published: September 2023

Scleral patch grafting is very commonly in use for ophthalmic conditions like scleral melting post pterygium surgery, immune or infection-related scleral melt, localized staphyloma-related scleral thinning, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera graft for corneal perforations, but these techniques have become obsolete now due to improvement in eye banking facilities across the country, eye donation awareness leading to easy accessibility to corneal donor tissue. However, under emergency conditions in case of unavailability of corneal donor tissue the technique of scleral patch grafts can be used as a decent alternative to corneal patch grafts. The scleral patch graft is equivalently sturdy and provides tectonic/therapeutic bridging over the perforation to help salvage the eye. In this case series, we have described three cases, two of whom had peripheral corneal perforations due to aggressive corneal ulcerations refractory to medical management. The last case had posterior corneal abscess with thinning which was also refractory to treatment; hence, scleral grafting (unavailability of therapeutic corneal graft) was performed to manage the case.
Study of risk factors in the development of retinopathy of prematurity in late preterms
Authors: Chandra Silni , Ravi Aparna , Sija S. , Prabhu Padma B.
Published: September 2023

Context:

In India, late preterm babies are susceptible to retinopathy of prematurity (ROP). This study is done to assess the incidence of ROP and also to analyze the risk factors involved in the development of ROP in preterm babies between 34 and 36 weeks of gestation.

Aims:

Risk factor analysis of ROP in late preterm babies.

Settings and Design:

This is a prospective observational study done in a tertiary-level multispecialty hospital between January 2020 and January 2022.

Materials and Methods:

Two hundred and eleven preterm babies born between 34 and 36 weeks of gestation were included in the study. Their systemic comorbidities were identified after reviewing their hospital records. They were followed up till their retina reached maturity.

Statistical Analysis:

It was carried out using SPSS software version 17.

Results:

The incidence of ROP was 6.2%. Twelve (92.3%) babies belonged to type 2 ROP. All these babies had a spontaneous resolution of ROP and did not require any intervention. One (7.7%) baby born at 36 weeks of gestation with a birth weight of 1.5 kg, presented at 52 weeks of gestation with Stage 5B of ROP in both eyes. Using univariate regression analysis, SGA status, pleural effusion, chylothorax, congestive cardiac failure, congenital diaphragmatic hernia, hypoxic–ischemic encephalopathy, and any intervention were found to be statistically significant. On multivariate analysis, SGA status and hypoxic–ischemic encephalopathy were statistically significant.

Conclusions:

All preterm babies born before 37 weeks of gestation should have at least one ROP screening to prevent the development of sight-threatening ROP.
Knowledge of the importance of Vitamin A and awareness of its deficiency among parents of preschool children: A hospital-based study
Authors: Davalbhakta Samira , Shitole Satish
Published: September 2023

Purpose:

The prevalence of Vitamin A deficiency (VAD) is the highest in India among the South Asian countries. Suspected causes for this are insufficient dietary intake, lack of education, and a poor monitoring and surveillance system. Awareness regarding VAD is a must, especially among the parents of preschool children who are the most susceptible to its adverse effects. We aimed to assess the knowledge of Vitamin A, analyze awareness of its deficiency, and study the practice of prophylaxis against VAD among the parents of preschool children.

Materials and Methods:

This cross-sectional study involved 385 participants (Cochran’s formula). Guardians or parents of children in the preschool age group were included. A scoring system was applied to the questionnaire distributed to each participant to objectively assess the answers.

Results:

243/385 (63.12%) of the participants had heard of Vitamin A. Of those who had heard of the vitamin, 111/243 (45.68%) were not aware of a single source of Vitamin A. The mean score obtained for the assessment of VAD was 3.29/11, which indicates a low score. Section B assessed the knowledge on VAD, and the mean score obtained was 3.29/11. All 385 respondents were assessed on the consumption of Vitamin A-rich foods. Of these, 160 (41.56%) demonstrated an average practice, or a score between 7 and 10. Very good practice was demonstrated by only 18 (4.68%).

Conclusion:

Overall, a low level of awareness of Vitamin A and its deficiency exists among the population. Despite this, an average practice of Vitamin A food consumption was demonstrated.
Knowledge among patients about postoperative home self-care following cataract surgery in Northern and Western India
Authors: Kumar S. G. Prem , Chavan Shobhana , Ranpise Dhanaji , Vishwakarma Pankaj , Kurian Elizabeth
Published: September 2023

Purpose:

Inadequate knowledge of patients regarding postoperative home self-care can result in numerous complications and poor visual outcomes. We investigated the knowledge levels of patients on home self-care precautions postdischarge and suggested ways to improve these.

Materials and Methods:

This cross-sectional study used a random sample from six partner hospitals in north and west India. Patient’s knowledge regarding postoperative home self-care was assessed in three domains (i) general eye care precautions (GECP), (ii) eye cleaning procedures (ECP), and (iii) instilling medications in the eye (IME). Data were collected using a structured questionnaire.

Results:

A total of 616 patients provided interviews and visual acuity (VA) assessments. The median ages were 65 and 63 years for males and females, respectively. Postsurgery, an overwhelming number had either very good or good VA (91.2%). Overall, the knowledge levels were “moderately adequate” for GECP at 57.9%. However, “inadequate” knowledge levels were found pertaining to ECP and IME domains with 69.8% and 84.3%, respectively. With multiple logistic regression, female patients (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8–4.2) were significantly more likely to have moderate to adequate knowledge of GECP. Those attending both the postoperative review visits were significantly more likely to have moderate to adequate knowledge of ECP (OR 2.4, 95% CI 1.3–4.4) and IME (OR 1.5, 95% CI 0.8–2.7), respectively.

Conclusion:

Knowledge levels were moderately adequate for GECP, while inadequate for ECP and IME domains, respectively. Strategies to improve patient participation in postoperative review visits and improve patient education modalities are recommended and discussed.
Demystifying the role of the Mantoux test in ocular tuberculosis
Authors: Moreker Mayur R. , Bansal Avya , Jaggi Sunila , Shah Sonali , Sakle Asmita , Moreker Shilpa R.
Published: September 2023

Context:

The diagnosis and management of ocular tuberculosis (OTB) is largely a mystery, and the fact that it is a great imitator of various ocular pathologies adds to the difficulty in the diagnosis of patients.

Aims:

The aim of this study was to assess the role of the Mantoux test in the diagnosis of OTB.

Settings and Design:

This was a retrospective chart review of patients who were diagnosed to have and treated as OTB in 1 year at our tertiary care center in Western India.

Methods:

The study population included 34 patients who presented to us and were diagnosed to have OTB, using standards published by the Department of Health Research, Ministry of Health and Family Welfare, Government of India, and the Indian Council of Medical Research.

Results:

A total of 34 patients were diagnosed to have OTB in the study period of 1 year between January 1, 2021, and December 31, 2021. Of these 34 patients; 14 were male and 20 were female. The Mantoux test had been done in 32/34 patients. It was positive in 26 patients and negative in six patients. Looking specifically at the six patients in whom the Mantoux was negative, apart from having ocular signs of tuberculosis (TB), they had positive findings suggestive of old/active TB on contrast-enhanced chest computed tomography scan. Of the 34 patients, only five patients were treated based only on the clinical signs of OTB with only a positive Mantoux test, but even they all showed a response to treatment.

Conclusions:

There is a definite role of the Mantoux test when interpreted considering the clinical phenotype and radiology findings in OTB.
Concurrent Placement of the Testicular Prosthesis in Children Following Orchiectomy/Testicular Loss
Authors: Santhanakrishnan Ramesh , Konamme Vinay Kumar , Saroja Murali Govindappa
Published: September 2023

Introduction:

Testis is essential for male sexual hormone production, fertility, and psychological well-being of a male. In the unfortunate event of testicular loss, placement of a testicular prosthesis perhaps will offer a sense of well-being, improved body image, and overall confidence in the growing child.

Aims:

The aim is to evaluate the feasibility and assessment of outcomes following concurrent placement of testicular prosthesis in children following orchiectomy.

Materials and Methods:

This is a cross-sectional study conducted by reviewing the reports of patients who underwent simultaneous insertion testicular prosthesis following orchiectomy for various indications between January 2014 and December 2020 at tertiary hospitals in Bengaluru. Children <18 years were included in this study. A transscrotal approach was preferred in cases where a transscrotal orchiectomy was done. Transinguinal approach was preferred in children undergoing prosthesis insertion as an isolated procedure. The size of the prosthesis was chosen based on the age of the child and the size of the scrotum. Outcomes were assessed on follow-up.

Results:

A total of 29 children underwent prosthesis insertion (25 unilateral and four bilateral). The mean standard deviation age was 5.58 (3.92) years. The indications for prosthesis insertion were cryptorchidism with atrophic testis (22), torsion (3), Leydig cell tumor (2), and severely virilized Congenital adrenal hyperplasia (CAH) (2). Of these, three children (9%) had complications (wound gaping in two and wound infection in one) that needed removal of the implant. The mean duration of follow-up was 49.23 months. All the parents reported a good outcome, and none of the children who underwent prosthesis placement needed a change during this follow-up.

Conclusion:

Concurrent placement of a testicular prosthesis is technically easy and a safe procedure, achieves satisfactory cosmetic appearance with minimal morbidity.
Feasibility of Enhanced Recovery after Surgery in Pediatric Colostomy Reversal
Authors: Uday Bhaskar M. N. S. , Sundararajan Lakshmi
Published: September 2023

Aim:

Enhanced recovery after surgery (ERAS) are multimodal perioperative pathways that have shown improved outcomes. ERAS after colostomy reversal has shown promising results in adults and few pediatric studies. We report our experience using ERAS for a colostomy reversal.

Materials and Methods:

A retrospective analysis of children in whom ERAS was used during colostomy reversal between May 2016 and 2019 was carried out. ERAS protocol in our study included avoiding mechanical bowel preparation (MBP), oral liquid diet upto 3 h preoperatively, usage of regional anesthesia, minimal handling of bowel intraoperatively, using nonopioid analgesics for pain relief, early initiation of feeding on the first postoperative day, early discharge once full feeds are established. Outcomes analyzed are the duration of hospital stay and complications, including readmissions. Requirement for opioids and anti-emetics are noted. The outcomes are compared with traditional care pathways (TCP), which use MBP, overnight fasting, opioid analgesia, and delayed feeding. A total of 48 are included in the study, with 13 cases using ERAS and TCP in 35 cases.

Statistical Analysis Used:

Nonparametric Mann–Whitney U-test was used.

Results:

In the ERAS group, the mean length of hospital stay (LOS) postoperatively was 3.7 days (2–5 days) as opposed to 7.2 days (5–11 days) in TCP. There was only one child with complications in the ERAS group, while 9 cases in TCP had complications, though none of them required operative intervention. There was the requirement of anti-emetic in only one child in the ERAS group.

Conclusion:

ERAS for colostomy reversal is feasible in the pediatric population. For successful implementation, all personnel involved in the care of the child need to be educated about the protocol. It reduces LOS and complications.
A Female Infant with Rectovestibular Fistula and Imperforate Hymen
Authors: Khedkar Kiran , Lamture Yashwant R , Lohia Sham , Tayade Harshal Atul
Published: September 2023

In a female neonate with anorectal malformation (ARM), the diagnosis is usually simple. But when there are two openings in the introitus and absent anal opening at the normal site, the scenario poses a diagnostic challenge. Careful and detailed evaluation of anomaly is therefore necessary before planning definitive correction. Imperforate hymen, although is not commonly associated with ARM should always be kept in mind as a differential diagnosis and other vaginal anomalies like Mayer–Rokitansky–Küster–Hauser syndrome should be ruled out before definitive surgical correction.
Bilateral Synchronous Robotic-Assisted Adrenalectomies in a Patient of Bilateral Pheochromocytoma and Von Hippel–Lindau Disease – A Rewarding Approach
Authors: Pokharkar Ashitosh D. , Kandpal Deepak K. , Aditya M. , Batra Chandar M. , Chowdhary Sujit K.
Published: September 2023

Hypertensive crisis is rare in children. Among the rarest causes leading to this acute crisis, is bilateral adrenal tumour as a part of a syndrome, Von Hippel Lindau syndrome. The treatment is based on the excision of the adrenal tumour followed by long term surviellence. The authors present a case where conventional imaging with ultrasound and contrast enhanced CT scan demonstrated a right side adrenal tumour with raised catecholamines. The small left side tumour got missed on conventional imaging and got picked up on DOTA scan. The persistence of hypertension in post operative period can be related to such hidden functioning tumours. In view of the size of tumour & raised dopamine associated with high incidence of malignancy, robotic surgery was used for bilateral adrenal tumour excision which confirmed the diagnosis of Pheochromocytoma (PCC).
Mucocele Arising from the Submandibular Gland Presenting as Neck Swelling
Authors: Chatterji Probal , Rastogi Rajul , Jain Akshay , Choudhary Somya , Jain Nitanshi
Published: September 2023

Mucoceles rarely involve major salivary glands. Very few cases involving the submandibular gland have been reported to date. A young male child presented with diffuse, soft, and painless swelling of the left submandibular region. Investigations suggested mucocele of the submandibular salivary gland. The mucocele was excised along with the left submandibular gland. Recovery was uneventful.
Outcomes of Early Oral Feeding Compared to Delayed Feeding in Children after Elective Distal Bowel Anastomosis
Authors: Jayakumar T. K. , Rathod Kirtikumar J. , Eradi Bala , Sinha Arvind
Published: September 2023

Background:

Conventionally, oral feeds after distal bowel anastomosis surgery (ileostomy/colostomy closure) are delayed until after bowel peristalsis is established. The safety of an early feeding regimen is not established in children. This study compared early feeding regimens with delayed feeding in children undergoing elective intestinal anastomosis surgeries.

Materials and Methods:

In this retrospective multicentric cohort study, children undergoing elective distal bowel anastomosis surgery were divided into Group A (oral feeds allowed within 6 h) and Group B (delayed feeds). The two groups were compared for the incidence of abdomen distension, vomiting, surgical site infection, duration of analgesia, length of hospital stay, and readmission rate.

Results:

During the study, 58 patients were included: Group A (n = 26) and Group B (n = 32). The duration of analgesia (1.9 vs. 4.01 days) and length of hospital stay (3.38 vs. 5.0 days) were significantly less in Group A. Abdominal distension (7.7% vs. 15.6%), vomiting (11.5% vs. 15.6%), surgical site infection rate (3.8% vs. 12.5%), and readmissions (0% vs. 3.1%) were less in Group A, but statistically not significant.

Conclusion:

Early feeding after the elective restoration of distal bowel continuity can be safely practiced in the pediatric population. It is associated with a reduced need for analgesia and shorter hospital stay.
Intestinal Bowel Lengthening within the First 6 Months of Life
Authors: Zulli Andrea , Coletta Riccardo , Aldeiri Bashar , Morabito Antonino
Published: September 2023

Background:

Management of short bowel syndrome in children has been surrounded by much debate with timing of the lengthening procedure still controversial. Early bowel lengthening procedure (EBLP) has been defined as any bowel lengthening procedure performed before 6 months of age. The purpose of this paper is to report the institutional experience in EBLP and to review the literature on this subject to identify common indications.

Methods:

An institutional retrospective analysis of all the intestinal lengthening procedures was performed. Furthermore, an Ovid/Embase search regarding children who underwent bowel lengthening in the past 38 years was conducted. Primary diagnosis, age at procedure, type of procedure, indication, and outcome were analyzed.

Results:

Ten EBLP were performed in Manchester from 2006 to 2017. Median age at surgery was 121 days (102–140), preoperative small bowel (SB) length was 30 cm (20–49) while postoperative SB length was 54 cm (40–70), with a median increased bowel length of 80%. Ninety-seven papers were reviewed, with more than 399 lengthening procedures performed. Twenty-nine papers matched criteria with more than 60 EBLP were observed of which 10 were performed in a single center from 2006 to 2017. EBLP was performed due to SB atresia, to excessive bowel dilatation or failure to enteral feeds, at a median age of 60 days (1–90). Serial transverse enteroplasty was the most frequent procedure used lengthening the bowel from 40 cm (29–62.5) to 63 cm (49–85), with a median increased bowel length of 57%.

Conclusions:

This study confirms that no clear consensus on indication or timing to perform early SB lengthening is reported. According to the gathered data, EBLP should be considered, only in cases of actual necessity after review of qualified intestinal failure center.
Defining the Indications of PATIO Technique for Urethrocutaneous Fistula Repair
Authors: Choudhury Prativa , Phugat Shivani , Jain Vishesh , Yadav Devendra Kumar , Dhua Anjan Kumar , Verma Vivek , Verma Ajay , Anand Sachit , Singh Sanchita , Goel Prabudh
Published: September 2023

Introduction:

Despite the advancements in technique and technology, urethrocutaneous fistula (UCF) formation continues to be the most common complication after hypospadias repair.

Objective:

The objective of the current synthesis is to define the indications of PATIO technique for UCF repair.

Materials and Methods:

The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Ovid, Embase, Web of Science, and Google Scholar were interrogated for studies presenting primary data upon UCF repair by the PATIO technique. Data analysis was performed on MedCalc and R software.

Results:

Eighteen studies were identified relevant to the current context: inversion of UCF tract has been described in 13 and ligation in 5. There were 2 duplications (abstract and manuscript). The overall success for PATIO is 88.2% (314/356). The success rate was variable between classic PATIO (inversion at 87.2%), ligation-inversion at 86.9%, and ligation alone at 88.9%. The success rate was not improvised upon by supplementing inversion of UCF tract with ligation (p = 0.957) or addition of a waterproofing layer (p = 0.622). PATIO has been used for single or multiple UCFs post hypospadias repair, genital piercing, and genitoplasty in cis- or transgender population for UCF up to 5 mm in size. The success rates were best for UCF <2 mm and worst for those approaching 5 mm. The results were, however, unaffected by the location of UCF along the penile shaft. Besides, the use of urethral catheter is optional and may be eliminated with shorter hospitalization.

Conclusions:

PATIO repair may be considered for repair of UCFs (a) with diverse etiologies, (b) located anywhere along the penile shaft included coronal UCF, (c) preferably <4 mm in size, (d) single or multiple in number; multiple PATIOs may be done in the same setting, (e) in patients unwilling for prolonged hospitalization, (f) in patients unwilling for a urethral catheter, and (g) in hypospadias cripples wherein mobilization of distant tissues such as tunica vaginalis flap or a buccal mucosal graft may be required for supplementing the UCF repair.
Can Neonatal Pull-Through Replace Staged Pull-Through for the Management of Anorectal malformation? a Systematic Review and Meta-Analysis
Authors: Manchanda Vivek , Kumar Parveen , Jadhav Avinash , Goel Akhil Dhanesh
Published: September 2023

Anorectal malformations (ARMs) are managed classically in three stages – colostomy at birth, anorectal pull-through after 2–3 months, and stoma closure. Single-stage pull-through has been contemplated in neonatal age aimed to reduce the number of procedures, better long-term continence, the better psycho-social status of the child, and reduced cost of treatment, especially in resource-strained countries. We conducted a systematic review comparing neonatal single-stage pull-through with stage pull-through and did a meta-analysis for the outcome and complications. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PubMed and Scopus databases were searched and RevMan 5.4.1 was used for the meta-analysis. Fourteen comparative studies including one randomized controlled trial were included in the systematic review for meta-analysis. The meta-analysis included 1845 patients including 866 neonates undergoing single-stage pull-through. There was no statistically significant difference for the occurrence of surgical site infection (odds ratio [OR] 0.82, 95% confidence interval [CI]: 0.24–2.83), urinary tract injury (OR 1.82, 95% CI: 0.85–3.89), rectal prolapse (OR 0.98, 95% CI: 0.21–5.04), anal stenosis/stricture, voluntary bowel movements (OR 0.97, 95% CI: 0.25–3.73), constipation (OR 1.01, 95% CI: 0.61–1.67), soiling (OR 0.89, 95% CI: 0.52–1.51), mortality (OR 1.19, 95% CI: 0.04–39.74), or other complications. However, continence was seen to be better among patients undergoing neonatal pull-through (OR 1.63, 95% CI: 1.12–2.38). Thus, we can recommend single-stage pull-through for managing patients with ARMs in the neonatal age.
Delayed Presentation of Malrotation
Authors: Menghwani Himanshu , Piplani Rajat , Yhoshu Enono , Jagdish B. , Sree Balija Satya
Published: September 2023

Background:

Intestinal malrotation is a congenital anomaly resulting from abnormal or incomplete rotation and fixation of the midgut during embryogenesis. It commonly presents in the neonatal period (75%) with sudden onset bilious vomiting and rarely beyond infancy (<10%).

Aim:

The aim of the study was to highlight the clinical features, radiological findings, and treatment outcomes of patients with malrotation presenting beyond infancy.

Materials and Methods:

Eleven consecutive cases of delayed presentation of malrotation presented over a period of 5 years (2017–2021). Data were analyzed retrospectively.

Results:

Out of the 11 patients, four were female and seven were male. The age of patients ranged from 14 months to 18 years. Patients beyond infancy present usually with diffuse pain abdomen compared to neonates which present with sudden onset bilious vomiting and therefore difficult to diagnose. Five patients had associated abnormalities such as intussusception or nutcracker syndrome or mesenteric cyst or jejunal stricture or mesenteric lymphadenopathy along with malrotation. Patients underwent ultrasonography, upper gastrointestinal contrast study, and contrast-enhanced computed tomography abdomen to confirm the diagnosis. All patients underwent the Ladd procedure with four requiring resection anastomosis and one requiring excision of the mesenteric cyst. Eight out of eleven patients had favorable outcomes, two develop adhesive intestinal obstruction and required re-exploration, and one had persistent complaints of hematochezia.

Conclusion:

Malrotation beyond infancy is a rare diagnosis. Malrotation in older children is usually not suspected because of the wide range of symptoms. A high index of suspicion on ultrasound or computed tomography is required to demonstrate the reversal of superior mesenteric artery and superior mesenteric vein position and related conditions. Early intervention and treatment can prevent catastrophic events such as intestinal volvulus and intestinal ischemia in these patients.
Labial Lipoblastoma in an Infant
Authors: Mukherjee Raktim , Bhattacharyya Sanghamitra , Chatterjee Uttara
Published: September 2023

Lipoblastoma and lipoblastomatosis are benign fatty tumors of soft tissues that are unique to childhood. Occurrence of lipoblastoma in the labial region is infrequent and can cause diagnostic dilemma. Awareness about this entity is important to avoid hazardous treatment in young children. Here, we present a case of labial lipoblastoma in a 2-year-old child along with its differential diagnosis.
A Rare Case of Premenarchal Ovarian Abscess Presenting as an Acute Abdomen
Authors: Jagdish B. , Yhoshu Enono , Sree Balija Satya , Sharma Gaurav , Menghwani Himanshu
Published: September 2023

Ovarian abscesses are usually seen in females of reproductive age group. They may occur secondary to urinary tract infections, pelvic inflammatory diseases, or gastrointestinal infections. They are uncommon in premenarchal females. They can be either managed conservatively with antibiotics and analgesics or may require surgery. In this case report, we present the case of a 6-year-old female who presented to us with an acute abdomen, which was diagnosed as a case of ovarian abscess and improved on exploration and drainage.
Infantile Tubercular Endobronchial Polypoid Obstructive Lesion
Authors: Konamme Vinay Kumar , Gowrishankar B. C. , Babu M. Narendra
Published: September 2023

Endobronchial tuberculosis is reported in 18% of adults and 30%–60% of children with primary pulmonary tuberculosis. We are reporting two infants who presented with nonspecific respiratory symptoms due to an obstructive tubercular polypoid mass which was detected on computed tomography. Bronchoscopy showed a pale friable polypoid lesion in the bronchus causing a luminal obstruction. The biopsy of the lesion was suggestive of tuberculosis. On treatment with antitubercular medications, both the babies improved and remained asymptomatic on long-term follow-up.
Breast cancer detection via wavelet energy and feed-forward neural network trained by genetic algorithm
Authors: Wang Jiaji
Published: September 2023

Enhancing the precision of breast cancer detection is the primary objective of this investigation, given its status as the most prevalent cancer among women worldwide. Timely identification of breast cancer can significantly improve the likelihood of successful diagnosis. To achieve this, we propose a innovative way that combines wavelet energy and a feedforward neural network. Our method employs the genetic algorithm and undergoes 20 iterations of 10-fold cross-validation for robustness. Via utilizing wavelet energy as a feature extractor and a feedforward neural network as the classifier, our method outperforms three alternative algorithms.
Innovation of Ideological and Political Education Based on Artificial Intelligence Technology with Wireless Network
Authors: Tang Chuanwen
Published: September 2023

INTRODUCTION: To apply artificial intelligence technology to ideological and political education in colleges and universities, as well as to combine artificial intelligence technology with ideological and political education in colleges and universities, it is necessary that wireless networks have complete coverage. OBJECTIVES: How can ideological and political education in universities and colleges be merged with artificial intelligence? How can artificial intelligence be used to support progressive political education at the college level? Starting with these issues, this paper will focus on the development of ideological and political education in colleges and universities as its main research question and refer to artificial intelligence technology as a method of ideological and political education in colleges and universities supported by wireless networks. METHODS: By examining the characteristics of artificial intelligence and ideological education in colleges and universities, and combining the poor immediacy and weak timeliness of information dissemination, as well as the low degree of identification of student groups with the theoretical courses of ideological education in the field of ideological education under the view of artificial intelligence, to explore the path of innovation of ideological education, RESULTS: In order to adapt to the demands of AI technology and improve people's capacity to use AI learning software, we need start with educators and educated individuals. Additionally, the government should encourage the development of artificial intelligence technologies financially and technically. Finally, it examines how civic education in colleges and universities could be improved through the use of artificial intelligence. This would allow civic education to benefit from the advantages of AI technology. CONCLUSION: In order to support the positive and healthy development of political education courses in colleges and universities across the nation, this paper encourages the creation of concepts and methods for teaching politics in higher education institutions.
Algorithmic Translation Correction Mechanisms: An End-to-end Algorithmic Implementation of English-Chinese Machine Translation
Authors: Shi Lei
Published: September 2023

INTRODUCTION: Machine translation is a modern natural language processing research field with important scientific and practical significance. In practice, the variation of languages, the limitation of semantic knowledge, and the lack of parallel language resources limit the development of machine translation.
OBJECTIVES: This paper aims to avoid duplicating neural networks during the learning process and improve the ability to generalize complex neural network machine translation models with limited resources.
METHODS: Textual material in the source language was studied, and a suitable textual material representation model was used to express complex, high-level, and abstract semantic information. Then, a more efficient neural network machine translation integration model was developed based on the control of written data and algorithms.
RESULTS: Data mining must be applied to complex neural network machine translation systems based on transfer learning to standardize finite neural network models.
CONCLUSION: Neural network-based embedded machine translation systems based on migration training require a small number of labelled samples to improve the system's permeability. However, this adaptive migration learning region approach can easily lead to over-learning problems in neural network machine translation models, thus avoiding excessive correspondences during the learning process and improving the generalization ability of the translation model with limited neural network resources.
Layered Screening and Contact-Limiting Interventions Are Necessary to Reduce SARS-Cov-2 Outbreak Risks in Large Urban Jails
Authors: Sakrejda Krzysztof , Zawitz Chad , Weinstein Robert A. , Trick William , Rafinski Joshua , Broen Kelly , Steinberg Hannah , Popovich Kyle J. , Zelner Jon
Published: September 2023

Highly transmissible infections with short serial intervals, such as SARS-Cov-2 and influenza, can quickly overwhelm healthcare resources in institutional settings such as jails. We assessed the impact of intake screening measures on the risk of SARS-CoV-2 outbreaks in this setting. We identified which elements of the intake process created the largest reductions in caseload. We implemented an individual-based simulation representative of SARS-Cov-2 transmission in a large urban jail utilizing testing at entry, quarantine, and post-quarantine testing to protect its general population from mass infection. We tracked the caseload under each scenario and quantified the impact of screening steps by varying quarantine duration, removing testing, and using a range of test sensitivities. We repeated the simulations under a range of transmissibility and community prevalence levels to evaluate the sensitivity of our results. We found that brief quarantine of newly incarcerated individuals separate from the existing population of the jail to permit pre-quarantine and end-of-quarantine tests reduced SARS-CoV-2 caseload 30–70% depending on test sensitivity. These results were robust to variation in the transmissibility. Further quarantine (up to 14 days) on average created only a 5% further reduction in caseload. A multilayered intake process is necessary to limit the spread of highly transmissible pathogens with short serial intervals. The pre-symptomatic phase means that no single strategy can be effective. We also show that shorter durations of quarantine combined with testing can be nearly as effective at preventing spread as longer-duration quarantine up to 14 days.