bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anatomical and Morphological Variations in the tendons Constituting the Pes Anserinus of Knee with its Clinical Significance: A Human Cadaveric Study
Authors: Joshi Meghana Harshadbahi , Ravat Minal K , Vaniya Vasant H 
Published: May 2024

Context:
Pes anserinus (PA) includes conjoined tendinous insertion of the sartorius, gracilis, and semitendinosus muscles. Each tendon can have individual insertions attached nearly in a linear arrangement. The presence of accessory tendons, bands, and structures constituting in forming PA shows high variability and has been reported clinical importance in harvesting PA graft and tendon reconstruction procedure.

Aim:
The present study aimed to macroscopically observe anatomical and morphological variations in the structures constituting in the insertion of the PA tendon and establish its clinical significance.

Subjects and Methods:
A total of ninety cadaveric lower limbs including both sexes dissected to observe variations in the structures forming PA at the anteromedial surface of the upper part of the tibia.

Statistical Analysis Used:
The descriptive statistical analysis was done.

Results:
PA was constituted of sartorius, gracilis, and semitendinosus tendons in all the specimens. The most common pattern observed was monotendinous-sartorius, gracilis, and semitendinosus in 67 (74.44%) limbs. The semimembranosus and tibial collateral ligament participation was observed in 5 (5.55%) and 2 (2.22%) limbs, respectively. The accessory band of sartorius and semitendinosus was observed in 2 (2.22%) and 14 (15.55%) limbs, respectively.

Conclusions:
PA in the medial side of the knee is a common injury site. The presence of any accessory structures or bands within can handicap graft harvesting since the gracilis and semitendinosus tendons are routinely harvested for the reconstruction procedure. Furthermore, present anatomical knowledge can be helpful to surgeons for preoperative radiological examination and to avoid complications during transplant graft surgeries of the knee.
Prevalence Rates of Tuberculosis, Human Immunodeficiency Virus, and Hepatitis B and C among Migrant Workers in Jordan
Authors: Khader Yousef , Warrad Nathirah , Maiteh Sudi 
Published: May 2024

Abstract

Introduction:
Migration across national borders is an influential factor of consideration in the control of infectious diseases. Therefore, including migrants in surveillance and screening programs as well as linkage to care is mandatory to meet the public health targets of countries and regions. This study aimed to determine the prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among migrant workers applying for work permits in Jordan during the period 2018–2020. The findings of this study are expected to guide health policy to prevent the spread of infectious diseases in Jordan.

Methods:
During the period 2018–2020, 439,622 migrant workers underwent routine testing for TB, HIV, and hepatitis B and C. Demographic, laboratory, and clinical data for those migrants were retrieved from the Directorate of Chest Diseases and Immigrants Health records. The overall prevalence of the mentioned diseases as well as by subgroups was calculated.

Results:
The prevalence rates of TB and HIV among migrants were 54 per 100,000 migrants (11 per 100,000 male migrants and 138 per 100,000 female migrants, P < 0.001) and 21 per 100,000 (11 per 100,000 male migrants and 41 per 100,000 female migrants, P < 0.001), respectively. The prevalence of hepatitis B was 10 per 1000 migrants (12 per 1000 male migrants and 7 per 1000 female migrants, P < 0.001) and the prevalence of hepatitis C was 37 per 1000 (51 per 1000 male migrants and 10 per 1000 female migrants, P < 0.001). The prevalence of all studied conditions varied significantly according to gender, age, occupation, and country of origin.

Conclusions:
The prevalence rates of TB, HIV, HBV, and HCV were generally higher among migrants than Jordanians. Evidence-based health policies need to be drafted that aim to address migrant workers health care to ensure the lowest possible risk from infectious diseases to the people of Jordan is maintained. The study findings can inform the formulation of immigration and public health policies, including screening requirements for migrant workers, health insurance provisions, labor regulations, and support services for those with these conditions.
Clinical Profile of Paediatric Hemangiomas, Response to Oral Propranolol, and Comparison of Intralesional Bleomycin and Triamcinolone in Propranolol Non Responders at a Tertiary Care Center in North India
Authors: Yadav Gulab Dhar , Verma Shraddha , Varshney Ashish , Deb Adiveeth 
Published: May 2024

Background:
A paradigm shift has occurred regarding the treatment of cutaneous hemangiomas over the last few years, from an open surgical approach to a conservative or minimally invasive approach. There are various treatment modalities described, and response to them is variable and unpredictable. This study was conducted to study the clinical profile of children with uncomplicated cutaneous hemangiomas, their response to oral propranolol, and compare intralesional bleomycin and intralesional triamcinolone among nonresponders to propranolol.

Materials and Methods:
A trial was conducted among 158 children <12 years with cutaneous hemangiomas from January 2019 to October 2020 in Kanpur, Uttar Pradesh. Based on the response to propranolol, partial/nonresponders were later assigned randomly to either receive intralesional bleomycin (n = 30) or intralesional triamcinolone (n = 29). Response to treatment and complications were assessed in two groups. All children were followed up for 6 months.

Results:
Of 158 children, complete response to propranolol was found in 99 (62.7% [95% confidence interval (CI): 54.6%–70.1%]) children. Partial and no response was found in 33 (20.9% [95% CI: 15.0%–28.2%]) and 26 (95% CI: 16.5% [11.2%–23.4%]) children, respectively. In the bleomycin group, 66.7%, 23.3%, and 10.0% of patients showed excellent, good, and poor response, respectively, and in the triamcinolone group, 27.6%, 24.1%, and 48.3% showed excellent, good, and poor response, respectively (P = 0.002). However, there was no significant difference between them in terms of complications.

Conclusion:
Intralesional bleomycin was found to be a better drug in terms of response compared to triamcinolone. There are no significant differences in complications between them. Further studies are needed to further evaluate the combined efficacy of bleomycin with triamcinolone and other treatment modalities.
Thoracoscopic Resection of Pulmonary Lesions in Israel
Authors: Seguier-Lipszyc Emmanuelle , Rothenberg S. , Mei-Zahav Meir , Stafler Patrick , Zeitlin Yelena , Samuk Inbal , Peysakhovich Yuri , Kravarusic Dragan 
Published: May 2024

Background:
Most congenital pulmonary airway malformations (CPAMs) are detected antenatally. The majority of newborns are asymptomatic. Patients are prone to subsequent respiratory complications and to a lesser extent malignant transformation remains concerning. In Israel, until 2013, pediatric surgeries were performed by thoracotomy. To minimize its morbidity, we introduced thoracoscopy using a mentorship approach. We present our experience with thoracoscopic resections coordinated by the mentorship of a pediatric worldwide leader in his field and compare our results with resections performed by thoracotomy.

Materials and Methods:
A retrospective review of records of children operated between 2013 and 2020 was conducted. Data were compared using t-test for quantitative variables.

Results:
Fifty patients were operated by thoracoscopy with a median age of 4 years, a thoracoscopic lobectomy performed in 68%. There was no conversion with a median length of stay (LOS) of 3½ days. Thirty patients were operated by thoracotomy by a thoracic surgeon with a median age of 3.5 years. A lobectomy was performed in 87% with a median LOS of 7 days.

Conclusions:
Thoracoscopic lobectomy is a technically demanding procedure with a long learning curve, strongly related to the low volume of cases. The role of a mentorship program in acquiring those surgical skills is crucial through standardization of the technique applied and supervised by the mentor. Early thoracoscopy for congenital pulmonary lesions at an early age can be achieved with a low conversion rate and minimal complications creating a change in the paradigm of practice when considering surgery for CPAM in Israel.
Role of Ultrasonography and Inflammatory Markers in Predicting Complicated Appendicitis
Authors: Banerjee Arka , Ratan Simmi K. , Neogi Sujoy , Goswami Binita , Dixit Rashmi , Panda Shasanka Shekhar 
Published: May 2024

Aim:
The aim is to compare the diagnostic accuracy of laboratory investigations and ultrasonography (USG) in distinguishing complicated appendicitis (C-AA) from uncomplicated appendicitis (UC-AA).

Materials and Methods:
Forty-six children who underwent appendicectomy at our center between November 2018 and July 2020 were included. Based on intraoperative findings, they were divided into two groups – complicated (perforated, gangrenous, or associated with fecal peritonitis; n = 18) and UC-AA (n = 28). USG findings and inflammatory markers were compared in both groups at admission.

Results:
At admission, the mean values for total leukocyte count (TLC) (16090.56 vs. 11739.29 per mm3), high sensitivity C-reactive protein (hsCRP) (35.8 vs. 31.62 mg/L), and procalcitonin (PCT) (3.83 vs. 1.41 ng/mL) were significantly higher in C-AA. Visualization of a blind tubular aperistaltic structure was the only sonographic sign showing statistical significance – significantly lower in C-AA (50% vs. 90%). Independent predictors of C-AA were – duration of symptoms >48 h (odds ratio [OR] 6.3), free fluid/loculated collection in right iliac fossa (OR 3.75), TLC >11000/mm3 (OR 3.6), hsCRP >35 mg/L (OR 6.0), PCT >0.6 ng/mL (OR 4.02), and nonvisualization of appendix on USG (OR 8.33). Biochemical factors were sensitive (89%) and specific (55%) in differentiating C-AA from UC-AA but the addition of sonological parameters significantly improved the specificity of predicting complicated AA to 61% (P = 0.0036).

Conclusion:
Combining laboratory data with sonological findings significantly improves the predictive value for differentiating C-AA from UC-AA and can help decide operative approach and prognosticating.
Morbidity and mortality of necrotizing fasciitis and their prognostic factors in children
Authors: Singh Dilip Kumar , Kapoor Rohit , Yadav Partap Singh , Saxena Sonal , Agarwal Kiran , Solanki Ravi S. , Gupta Amit , Choudhury Subhasis Roy , Chadha Rajiv 
Published: May 2024

Background
This is a prospective study of the clinico-etiologic profile and factors affecting outcomes in 40 children managed for necrotizing fasciitis (NF).

Materials and Methods:
Demographic details, clinical characteristics, and laboratory parameters were recorded, and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated. Primary outcome (survival vs. nonsurvival) was noted, and prognostic factors were identified.

Results:
Initiating factors included boils (45%), i.v. cannula extravasations (22.5%), and blunt trauma (17.5%). Lesion (s) were predominantly on the lower limbs (35%) and trunk (25%). Twenty-two patients (55%) had <5% body surface area (BSA) involved. Severely deranged clinical and laboratory parameters were common. Ultrasound localized fluid collections. Pus cultures showed methicillin-resistant Staphylococcus aureus (52.5%), methicillin-sensitive S. aureus [27.5%], and polymicrobial growth (20%). Blood culture was positive in 24 patients (60%). Most isolates were sensitive to clindamycin and amoxy-clavulanate. Prognostic factors for mortality (n = 6; 15%) included categorization as “Sick,” BSA involvement >10%, thrombocytopenia, raised serum creatinine, late debridement, and polymicrobial blood culture isolates. All six nonsurvivors had a LRINEC score of ≥8 and positive blood cultures. Six patients (20.7%) developed unsightly scars and 5 (17.24%) contractures across joints.

Conclusions:
Pediatric NF has significant morbidity and mortality. Patients with adverse prognostic factors can benefit from early referral to a facility with a critical care unit. Adequate wound management is essential to minimize residual deformity.
An exploratory study on pediatric inguinal hernia videos on the youtube platform
Authors: Sehgal Mehak , Jain Divya , Goel Prabudh , Jain Vishesh , Yadav Devendra Kumar , Verma Vivek , Dhua Anjan Kumar 
Published: May 2024

Aim
A study was conducted to explore the characteristics of the videos on pediatric inguinal hernia repair on YouTube and compare the most popular videos (MPV) with the least popular ones in terms of educative value vis-a-vis their popularity.

Materials and Methods:
The term “Pediatric inguinal hernia repair” was searched for on YouTube on August 15, 2021, with the filter set to “view rate.” Pertinent data were collected from the 50 MPV and the 50 least popular videos (LPV) and then compared. The h-index and affiliation of the surgeon were obtained from the Scopus database, and their affiliation was further categorized as academic or nonacademic.

Results:
One hundred and seventy-five videos were found with median views of MPV: LPV being 9270 (interquartile range [IQR] – 12099):127 (IQR – 194), respectively (P < 0.0001). Most of the videos in the MPV and LPV groups were uploaded from the United States of America (USA) (MPV – 17 and LPV – 13) and India (MPV – 15 and LPV – 15). The MPV were on YouTube for a median duration of 3.1 (IQR – 5.5) years as compared to 1.2 (IQR – 2.3) years for the LPV (P < 0.0001). Ninety-two surgeons were identified. The median h-index of the surgeons of MPV was 3 (IQR – 12) in comparison to 1 (IQR – 10) of LPV (P = 0.13). The ratio of academic versus nonacademic affiliation among MPV and LPV was almost equal in both the groups.

Conclusions:
On either end of the spectrum of popularity, the majority of the pediatric inguinal hernia videos on YouTube were surgical videos uploaded from the USA and India. The educative value of these videos was found to be low and widely dispersed. Surgeons from both academic and nonacademic affiliations had contributed similarly.
Our Neonatal Surgery Experiences in Somalia
Authors: Kart Yeliz , Ugur Cüneyt 
Published: May 2024

Purpose:
The aim of this study is to report surgical outcomes of the neonates who have undergone various surgical procedures.

Materials and Methods:
In this retrospective study, 39 neonates who have undergone a surgical procedure in Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, between October 2018 and March 2019 were included. Data regarding age, gender, diagnosis, surgical procedure, length of hospital stay, mortality, and cause of mortality were recorded.

Results:
Of 39 neonates, 12 were female (30.7%) and 27 were male (69.3%). The mean age of the neonates at admission was 7.7 ± 7.6 days (1–30 days) days. The most common diagnoses were anal atresia (n = 12, 30.8%), esophageal atresia (n = 9, 23.1%), and pyloric stenosis (n = 5, 12.8%). The most common surgical procedures were colostomy creation (n = 10, 25.6%), esophageal anastomosis (n = 9, 20.5%), primary closure of anterior abdominal wall defects including bladder exstrophy (n = 6, 15.4%), and pyloromyotomy (n = 5, 12.8%). Mortality rate was 17.9%, and mortality causes were sepsis (n = 4, 57.1%) and congenital heart disease (n = 3, 42.9%). Neonates with the highest mortality by underlying primary surgical diagnosis were esophageal atresia (n=4, 57.1%).

Conclusion:
The mortality rate from the surgical procedures of the neonates in Somalia is extremely high when compared with the developed countries. Employment of experienced pediatric surgeons and well-trained nurses, strict attention to the sanitary measures and shortening the time from birth to presentation might improve the surgical outcomes of the neonates in Somalia.
Correlation of the Position of the Anal Dimple with the Caudal Termination of the Striated Muscle Complex in Patients with Anorectal Malformations
Authors: Kumar Amit , Bangar Vipan , Khan Niyaz Ahmed , Patel Jigar N. , Gupta Amit , Yadav Partap Singh , Chadha Rajiv , Choudhury Subhasis Roy 
Published: May 2024

Background:
In children with anorectal malformations (ARM), the vertical fibres of the striated muscle complex (SMC) are believed to be located within the limits of the anal dimple (AD).

Methods:
Forty five cases of ARM underwent posterior sagittal anorectoplasty (PSARP), median age 8.5 months. During PSARP the anterior, posterior limits and midpoint of the AD and SMC were marked. The location of AD was correlated with SMC.

Results:
A ‘well developed’ AD and SMC was seen in 80 % and 86.7 % patients respectively. The mean width of the AD and SMC was more in females than in males (20.96 vs. 18.98 mm and 14.24mm vs. 13.45mm respectively). In 36 cases (80 %), across the spectrum of ARM, the SMC was posterior in relation to the AD. In 7 cases (15.5 %) it correlated in position with the AD and in 2 cases (4.44 %), it was anterior to the AD.

Conclusions:
In the majority of cases AD and SMC were ‘well developed’ and the location of the SMC does not correlate with that of the AD. This has significant practical value in the important step of optimizing the placement of the rectum through the center of the SMC during repair.
Does Early Upper Tract Diversion and Delayed Undiversion in Megaureters Secondary to Severe Posterior Urethral Valves Lead to Better Renal Outcomes?
Authors: Prathap Somnath , Narayanan Sarath Kumar 
Published: May 2024

Background:
There are conflicting reports for the management of severe posterior urethral valve (PUV) after ablation. The primary objective was to assess the renal outcomes using the estimated glomerular filtration rate (eGFR) and secondary outcomes in severe PUVs who underwent early partially diverting reduction ureterostomy (PDRU) and a delayed undiversion protocol.

Materials and Methods:
This 10-year retrospective study reviewed the records of 1094 boys with PUV, where severe PUV cases were treated with early PDRU (324 surgeries). We then analyzed those patients who completed the early diversion and delayed undiversion protocol. The long-term renal outcomes using eGFR and antero-posterior diameter (APD) were compared at various time points using appropriate statistical methods.

Results:
Of the 171 severe PUV patients who underwent PDRU, 31 completed undiversion and 26 (47 renal units) were analyzed after exclusions. The mean age (standard deviation) at presentation was 1.46 ± 4.1 months. Thirty-two units were refluxing and 15 were nonrefluxing megaureters. PDRU was closed at a mean age of 3.9 years and had a mean duration of follow-up of 6.4 years. The mean eGFR increased from a minimum of 10.78 ± 10.25 at baseline and remained stable at 28.69 ± 18.89 after closure of both stoma. Similarly, mean APD decreased from 12.07 ± 6.79 at the diagnosis to 7.00 ± 6.20. Three patients (3 renal units) required revision of the stoma for stenosis and 1 patient had a parastomal hernia that was repaired at the time of undiversion.

Conclusions:
In severe PUVs, early PDRU with delayed undiversion is a reliable surgical option that may ensure better renal outcomes in the long-term. Nonrefluxing renal units recover better than the refluxing. APD measurements also are shown to improve favorably.
Clinical Profile of Acute Pancreatitis in Children and Adolescents from a Single Center in Northern India
Authors: Mirza Nida , Mehta Sagar , Kumar Karunesh , Malhotra Smita , Sibal Anupam 
Published: May 2024

Introduction:
There has been an increase in incidence of pancreatitis in children all over the world; studies in developed countries shown multiple etiological factors such as drugs, infections, trauma, anatomic abnormalities, and/or genetic pancreatitis in children; however, there are sparse data from the developing countries. This study was undertaken to determine the characteristics of Indian children with acute pancreatitis (AP), mainly the clinical features, etiology, complication, association, genetic factors, and outcome and recurrence.

Methods:
We performed a retrospective study of all patients under the age of 18 years, who had a final diagnosis of pancreatitis admitted at our center between 2017 and 2019.

Results:
During the 3-year period from 2017 to 2019, 40 patients were admitted at our center with AP. We found a definite etiology in 62.5% cases of patients, which were broadly grouped into seven etiologies: structural, genetic, drug induced, concurrent illness, cholelithiasis related, metabolic, and autoimmune. Recurrence of acute episodes was noted in 13 patients (32.5%). Of these, 11 were found to have a genetic mutation, underlying structural abnormality, or concurrent illness. In our study, we found that 23 patients (57.5%) had mild AP, while 14 patients (35%) had moderately severe pancreatitis; however, 3 patients (7.5%) had severe AP.

Discussion:
We found that most cases of pancreatitis in children were of mild severity, and the etiology was quite different than adults, and most cases of acute recurrent pancreatitis have a definite etiology of either genetic mutation or structural anomaly.
Dynamics of Urine Electrolytes in Term Neonates during the 1st Week of Life
Authors: Ho Sheng-Yuan , Wang Kai-Li , Fan Hueng-Chuen , Ding Jhao-Jhuang 
Published: May 2024

Background:
Urine electrolyte assessment is vital for diagnosing and managing neonatal conditions. However, the challenge of urine collection in neonates has resulted in a lack of standardized urine electrolyte reference values.

Aim:
This study seeks to explore the reference levels and potential trends in serum and urine electrolytes to better understand how the kidneys handle these substances.

Methods:
Healthy neonates were prospectively enrolled following normal births. Using biochemical methods, blood and urine samples were collected and analyzed on the 1st and 5th postnatal days. Statistical analysis was performed using descriptive statistics and the Wilcoxon matched-pairs signed-rank test.

Results:
This prospective study enrolled 55 healthy neonates. Significant changes in serum electrolyte concentrations were observed between the 1st and 5th days after birth. Notably, sodium, creatinine, urea nitrogen, and uric acid levels decreased, whereas potassium, calcium, and phosphate levels increased. Urine analysis revealed significant increases in the tubular maximum phosphate reabsorption per glomerular filtration rate and decreases in the fractional excretion of potassium and uric acid by Day 5.

Conclusion:
This study challenges prevailing assumptions about the stability of neonatal urine electrolytes and highlights dynamic changes in the first postnatal week. These insights lay the groundwork for further research into electrolyte disorders in newborns and have potential implications for improving neonatal care practices.