bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Anterior Sagittal Anorectoplasty Shift from Staged to Single-stage Procedure for Low Anorectal Malformations in Female Children: Our Initial Experience in Single Centre
Authors: Wani Ab. Hamid , Singh Narinder , Singh Gurbir , Parihar Satish 
Published: September 2024

Abstract

Background:
Anorectal malformation (ARM) is a common congenital anomaly found in the paediatric age group. Previously, the repair of the vestibular fistula (VF) was performed as three-stage procedure with initial colostomy followed by a definite procedure and, lastly, colostomy closure. At present, a single-stage procedure is preferred, especially in lower anomalies owing to the convenient and time-saving approach.

Objective:
The clinical profile and outcome of ASARP for treatment of ARM in females (vestibular anus and perineal fistula).

Methods:
A retrospective analytical study was conducted at Government Medical College, Jammu. A total of 60 patients were included in the study.

Results:
Most of the patients were in the age group of 1–5 years (30%), followed by 6 months–1 year age group (25%). Forty-five (75%) females had VF while 15 (25%) had perineal fistula. Intraoperative complication was vaginal tear seen in 6 (10%) patients followed by rectal tear seen in 3 (5%) patients. Early post-operative complications were seen in 9 (15%) patients. Wound infection was the most common complication seen in 5 (8.3%) patients, wound dehiscence in 3 (5%) patients and retraction of rectum in 1 (1.6%) patient. Late post-operative complications were seen in 24 (40%) patients. Perineal excoriation was the most common complication seen in 6 (10%) patients, constipation seen in 5 (8.3%) patients, anal stenosis in 4 (6.6%) patients and mucosal prolapse in 4 (6.6%) patients.

Conclusion:
The single-staged ASARP procedure resulted in satisfactory outcomes. It is an excellent procedure for females with VF and perineal fistula. Appropriate selection, preparation of patient, optimal correction with minimal sphincter damage and needful post-operative care of wound give excellent cosmetic and functional outcomes in terms of continence. It also decreases the burden on treating the surgeon, family and psychological stress on the patients and parents.
Firearm Injuries in Children: Four-year Experience from a Rural Tertiary Care Centre of Northern India
Authors: Chaudhary Amit , Rahman Rafey Abdul , Alim Muniba , Gupta Umesh Kumar , Gupta Survesh Kumar 
Published: September 2024

Abstract

Background:
Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing.

Aim:
The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India.

Materials and Methods:
This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre-hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed.

Results:
Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%).

Conclusion:
The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country-made gun was the most common firearm causing injury in children.
Clinical, Histologic, and Therapeutic Pattern of Posterior Fossa Tumors in Children in Cameroon: A Cross-sectional Study
Authors: Figuim Bello , Nassourou Oumarou Haman , Nchufor Ndouh Roland , Nicaise Ewane Khadije Gael , Orlane Ndome Toto , de Paul Djientcheu Vincent 
Published: September 2024

Abstract

Introduction:
Posterior fossa tumors are significant in pediatric neurooncological populations due to their frequency and morbimortality. We convey a 10-year experience managing pediatric posterior fossa tumors at two reference centers in Cameroon.

Materials and Methods:
We conducted a cross-sectional study with data collected retrospectively in the Neurosurgery Department of the Central and General Hospitals of Yaounde from January 2010 to December 2019. Included in the study were all patients aged 0–15 years who underwent surgery for posterior fossa tumors.

Results:
We retained 43 pediatric posterior fossa tumor files, representing 47.89% of pediatric brain tumors. The male/female sex ratio was 0.86, with a mean age of 6.93 ± 4.345 years. The predominant clinical presentations were headaches + vomiting (97.7%), visual impairment (67.4%), and altered consciousness (14%). The vermis was the most frequent site affected (46.5%). Hydrocephalus was found to be associated with the tumor in 30 patients (69.8%). Tumor excision was total in 90.7% of cases, with cerebrospinal fluid diversion performed within the surgery in 83% of cases. Pilocytic astrocytomas represented 37.2%, medulloblastomas 30.25%, ependymomas 6.9%, and brainstem gliomas 4.6%. The postoperatory mortality rate was 20.9%. The survival rate at 5 years for medulloblastomas was 43%.

Conclusion:
Pediatric posterior fossa tumors are frequent. Pilocytic astrocytomas are the most common histologic type, followed by medulloblastomas. Radical surgery is the leading standard of care. Adjuvant treatment remains limited.
Patent Urachus with Patent Vitellointestinal Duct: A Rare Simultaneous Occurrence
Authors: Dudhani Shreyas , Bachagala Keerthana , Suman Bijay Kumar , Rashi Rashi , Sinha Amit Kumar 
Published: September 2024

Abstract
A large number of congenital anomalies often involve the umbilicus. This is a report of two such anomalies together in an infant. The child had a mass protruding from the umbilicus since birth. The urachus was noted to be patent on voiding cystourethrogram. On exploration, a patent vitellointestinal duct was also noted. Resection and anastomosis was done for the vitellointestinal duct, and the urachus was excised close to the dome of the bladder. Histopathological examination confirmed a tube lined by intestinal epithelium and the urachal remnant showing a dense fibrous tube-like structure. The omphalo-mesenteric vessels are located between the urachus and the patent vitellointestinal duct, and care should be taken while incising or dissecting in this region to prevent bleeding.
An Unusual Variant of Mid-penile Hypospadias with Intact Prepuce and Patulous Urethra – Addition of a Drop to the Sea of Hypospadias Variants
Authors: Prakash Divya , Singh Sunita , Kapoor Rohit , Dixit Rini 
Published: September 2024

Abstract
Hypospadias is one of the most common and extensively studied pathology of paediatric surgery. Although a plethora of research articles describing hypospadias and its variants exist, new variants are often encountered and they never cease to surprise us. We, in our case, are trying to add a drop to the sea of variants of hypospadias. A 2-year-old boy was brought with an abnormally large and patulous urethral opening at the mid-penile region with intact prepuce and chordee. In this case report, we will review the available literature on this rare variant and discuss its management.
Combined Upper Fornix Transconjunctival and Endoscopic Transnasal Approach for Frontoethmoidal Osteoma with Orbital Extension - A Case Report
Authors: Suwa Takahisa , Kitaguchi Yoshiyuki , Maeda Yohei , Morimoto Takeshi , Nishida Kohji 
Published: September 2024

Abstract

Rationale:
Intraorbital osteomas are incidentally found and occasionally require surgical treatment. Depending on their localisation, a single technique may not provide a sufficient surgical field.

Patient Concerns:
We report a 16-year-old male with a left upper medial palpable mass.

Diagnosis:
Computed tomography revealed a dense bony mass extending from the ethmoid sinus to the superior wall of the frontal sinus, with protrusion into the orbital cavity.

Treatment:
The combination of upper fornix transconjunctival and endoscopic transnasal approaches was chosen for the surgical removal procedure.

Outcomes:
The two-pathway approaches resulted in the clear removal of the mass. Post-operative recovery was rapid, although a slight restriction of the inferomedial duction remained at three months.

Take-away Lessons:
This combination of techniques can provide a wide surgical field for the resection of frontoethmoidal osteomas with orbital extension.
Quality of sleep in doctors posted in rural areas
Authors: Bhardwaj Vibhuti , Gohri Jay , Sharma Dhruv Kodan , Sahana K. S. , Hegde Saurish , Doddaiah Sunil Kumar 
Published: September 2024

Abstract

Introduction:
Among medical students, sleep is subjected to various obstacles such as curriculum and postings. Sleep is also influenced by sociodemographic factors but the intersectionality theory shows that multiple social factors within a person can influence health and behavior. Rural postings are another factor. We aim to explore the above in the study.

Materials and Methods:
It is a cross-sectional study done among 199 medical students across the country. We used a standardized Pittsburgh Sleep Quality Index questionnaire and analyzed the data using SPSS software. The Chi-square test for associations between various demographic factors and sleep indicators.

Results:
About 71.9% of the participants were interns. Only 37.2% of the participants reported good sleep in rural areas. There was a statistical significance between sleep quality and the duration it takes to fall asleep, waking up in the middle of the night, and duration of stay in rural areas.

Conclusion:
Good sleep is a crucial factor in keeping the human body working efficiently and functioning well. The main issues such as hectic academic schedules, lack of infrastructure, and flexibility in their allowances, especially during their residency, training will help to improve their sleep and in turn their quality of work.

The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement.
Efficacy of dexamethasone as adjunctive therapy in the treatment of parapneumonic pleural effusion in children
Authors: Hassan Hala M. , El-Razik Ahmed M.A. , El-Tomey Mohamed A. , Harkan Ahmed I. 
Published: September 2024

Background
Parapneumonic effusion (PPE) occurs as a complication in around 13% of instances of community-acquired pneumonia.

Aim
To assess the effect of dexamethasone as an adjunctive therapy in the treatment of PPEs in children.

Patients and methods
This is a double-blinded, parallel-group, placebo-controlled, randomized clinical trial carried out on 60 children aged from 1 to 13 years with pneumonia complicated by PPEs. Patients were randomly divided into two equal groups (with the usual treatment in the form of double antibiotics given to all) and either intravenous dexamethasone at a dose of 0.25 mg/kg every 12 h for 3 days (group A) or intravenous saline every 12 h for 3 days as placebo (group B).

Results
Duration of hospitalization, chest tube insertion, and number of patients referred to the pediatric intensive care unit were significantly lower in group A than in group B (P=0.007, P<0.001 and P=0.025, respectively). Normal PPE was significantly higher in group A than in group B (P=0.025) after 2 weeks, and small PPEs were significantly higher in group A than group B (P=0.008) on the 7th day. Fluid thickness by chest ultrasound on the 7th day was significantly lower in group A than in group B (P=0.016).

Conclusion
Dexamethasone was an effective adjunctive therapy for PPEs in children.
Association between endometrial polyps and chronic endometritis
Authors: Elaal Yara H.A. , Aglan Diaa M. , Salem Hesham A.A. 
Published: September 2024

Background
Chronic endometritis (CE) is a persistent inflammatory disorder of the endometrium. It is now diagnosed by observing the presence of plasma cell infiltration in the stromal tissue of the endometrium.

Aim
This study aimed to examine the potential correlation between endometrial polyps (EPs) and CE.

Patients and methods
This prospective cohort study was carried out on 60 women, aged from 20 to 50 years old, diagnosed to have EP by three dimensional transvaginal ultrasound with color doppler, during a diagnostic workup for abnormal uterine bleeding, infertility, or accidentally discovered by ultrasound.

Results
Suspicious manifestation of CE in patients with EP as (hyperemia and stromal oedema) was significantly higher in patients with CE than patients without CE (P value<0.001) by hysteroscopy. Regarding histopathology, simple EP was present in 33 (55%) patients, Adenomyomatous polyp was present in eight (13.33%) patients, angiofibromatous polyp was present in one (1.67%) patients and polypoid endometrial hyperplasia was present in 18 (30%) patients. regarding the relation between EP and CE 15 (25%) patients had CE by histopathology.

Conclusions
In pCE, -menopausal women identified with EP by three dimensional transvaginal ultrasonography, CE and EPs may be dependent and two phases of the same pathogenic process. Either single or many EPs positively correlate with CE. CE prevalence was comparable for single- and multiple-polyp individuals.
Three-dimensional ultrasound versus magnetic resonance imaging in the diagnosis of placenta accreta spectrum
Authors: Fouda Aya R. , Emam Haitham H.E. , Aglaan Diaa M. , Ageez Mai N. 
Published: September 2024

Background
Placenta accrete spectrum (PAS), is an increasing obstetric issue. The prevalence of PAS has fundamentally increased because of the global increase in cesarean section (CS) rates over the past few decades. To diagnose PAS in utero.

Aim
This study aimed to assess and compare the diagnostic accuracy of two imaging modalities: magnetic resonance imaging (MRI) and three-dimensional (3D) ultrasound (US).

Patients and methods
This prospective observational study included 60 pregnant women between the ages of 21 and 43 who were between 26- and 38 weeks’ gestation and met the clinical criteria of having had placenta previa central and prior uterine surgery (such as cesarean section, myomectomy, or curettage). 3D US and MRI were performed on each patient.

Results
3D US can significantly diagnose accurately compared with clinical diagnosis (P value <0.001) with 100% sensitivity, 72.7% specificity, 86.4% positive predictive value (PPV), 100% negative predictive value (NPV), and 90% accuracy, area under the curve=0.864. MRI can significantly diagnose accurate compared with Clinical diagnosis (P value <0.001) with 97.4% sensitivity, 63.6% specificity, 82.2% PPV, 93.3% NPV, and 85% accuracy, area under the curve= 0.805.

Conclusions
MRI and 3D US were observed to be able to diagnose PAS prenatally with no difference between them and the clinical diagnosis (intraoperative findings). However, 3D US exhibited increased sensitivity, specificity, PPV, NPV, and accuracy compared with MRI.
Soluble fms-like tyrosine kinase-1 as a predictive marker for iron overload in adult patients with transfusion-dependent beta-thalassemia major
Authors: Abozeid Samah F. , Elkholy Rasha A. , Elbedewy Tamer A. , Seliem Mahmoud F. 
Published: September 2024

BackgroundThe excessive iron accumulation has been identified as a contributing factor in the development of several issues in individuals with beta thalassemia, as those affecting the heart, liver, and endocrine glands. Soluble fms-like tyrosine kinase-1 (sFLT-1) belongs to the family of vascular endothelial growth factor receptors and acts as an inhibitor of signaling mediated by vascular endothelial growth factor and placental growth factor. The condition of iron excess has been associated with the potential to induce low-grade inflammation. The observed inflammatory condition is noteworthy due to the shown ability of sFLT-1 to stimulate a pro-inflammatory reaction. Consequently, this phenomenon could clarify the association between iron overload, inflammation, and elevated sFLT-1 levels in individuals with thalassemia.AimThe purpose of this work was to assess role of sFLT-1 as a predictive marker for iron overload in adults with transfusion-dependent beta-thalassemia major (BTM).Patients and methodsForty-five transfusion-dependent BTM patients were recruited and divided into 15 poor-chelated individuals with levels of serum ferritin more than 2500 ng/ml and 30 well-chelated individuals with levels of serum ferritin less than 2500 ng/ml. Serum sFLT-1 was measured using the enzyme-linked immunoassay technique.ResultsSerum sFLT-1 was substantially greater in the poor-chelated beta thalassemia compared with well chelated. sFLT-1 at a cutoff-value of 8.09 pg/ml had a high-diagnostic efficacy to differentiate poor chelated from the well-chelated group.ConclusionElevated sFLT-1 levels may act as a biomarker for poor iron chelation in transfusion-dependent BTM patients.
The role of application of topical hyaluronic acid after tonsillectomy operation
Authors: Hagras Yomna A. , El Naggar Ahmed A. , Erfan Fatthe A. , Amer Mohamed A.R. 
Published: September 2024

Background
Tonsillectomy is the most common throat surgery performed during childhood.

Aim
This study aimed to assess the results of using topical hyaluronic acid (HA) after a tonsillectomy.

Patients and methods
This prospective randomized controlled study was carried out on 70 patients aged 7–12 years. In each patient HA in a gel form was applied to one side of the tonsillar bed (application side), and the other side was considered as control side, first intraoperative, then at the third, fifth, and eighth postoperative days, pain score assessment was done by Arabic numerical pain rating scale and visual analog scale (VAS) at the third, fifth, eighth, and 14th postoperative days.

Results
Pain scores by both the Arabic numerical pain rating scale and VAS at the third, fifth, eighth, and 14th postoperative days were less on HA application sides rather than control sides in all patients (P<0.001). Pain reduction according to the pain rating scale on the application side on 14th postoperative day was 100% but on the control side was 87%. Pain reduction, according to VAS on the application side was 100%, and the control side was 91% (P<0.001). There was a significant reduction in pain scores in both sides starting from the third postoperative day, but pain scores at the application side were significantly lower than on the control side (P<0.001).

Conclusion
HA has a significant role in reducing pain after tonsillectomy operation and accelerates patient recovery after tonsillectomy operation.
Desafíos del derecho procesal constitucional
Authors: Vargas Gálvez Mercedes Analucia 
Published: September 2024

PROBLEMA: desafíos del derecho procesal constitucional. OBJETIVO: determinar los desafíos del derecho procesal constitucional MÉTODO: mediante la lectura de textos se utilizó la metodología de la síntesis. RESULTADOS: el derecho procesal de los derechos humanos como disciplina autónoma; Luego de definir el derecho procesal, el derecho constitucional y el derecho internacional, se puede concluir que el derecho procesal de los derechos humanos se conceptualiza como aquella regulación a través de la cual cada Estado regulará la reclamación en beneficio de las personas que exigen la efectiva implementación de sus derechos humanos. CONCLUSIÓN: De hecho, cuando los tratados no lo prevén, el control de la práctica se justifica sobre la base del fortalecimiento de la autoridad de la Corte Interamericana de Justicia y de la Convención de San José y, en última instancia, de los derechos humanos interamericanos. sistema, todo lo cual se basa en cambios en la interpretación de la Convención implementados a través de la Corte Interamericana de Justicia, cuyo éxito dependerá de si dichos controles se reflejan en la práctica jurídica, del valor intrínseco de las decisiones dictadas por la Corte, si es razonable, apropiada y útil, inspirará un desempeño ejemplar), y la voluntad de la Corte Suprema, los Tribunales y los Tribunales Constitucionales estatales de seguir estos estándares.
On the periodization of Сhina's foreign policy
Authors: Портяков В.Я. 
Published: September 2024

В статье рассмотрены различные варианты периодизации внешней политики Китайской Народной Республики. В их числе: периодизация, предложенная М.С. Капицей, периодизация американского китаеведа Д. Шамбо, два варианта периодизации китайских авторов. С их учетом предложен собственный вариант периодизации: 1949—1959, 1960—1969, 1970—1978, 1979—1989, 1989—2002, 2002—2013, 2012—2024. Дается характеристика наиболее важных качественных особенностей каждого этапа.
The article considers various options for the periodization of the foreign policy of the People's Republic of China. Among them are: the periodization proposed by M.S.Kapitsa, the periodization of the American sinologist D. Shambaugh, two variants of the periodization of Chinese authors. Taking these into account, a proprietary version of periodization is proposed: 1949—2959, 1960—2969, 1970—2978, 1979—2989, 1989—2002, 2002—2013, 2012—2024. The characteristics of the most important qualitative features of each stage are given.