bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fifty Most Influential Articles on Anorectal Malformations
Authors: Dhua Anjan Kumar , Kumar Vipan , Mishra Ashwani Kumar , Jain Vishesh , Yadav Devendra , Bajpai Minu , Agarwala Sandeep , Goel Prabudh 
Published: May 2024

Background:
With the global assimilation of “publish and perish” culture into institutional academics, there has been an exponential rise in the publication numbers. There are ~2500 PUBMED entries related to “anorectal malformation (ARM).” The young clinician in his pursuit to translate experimental research to bedside often finds himself lost “in the midst of plenty.” This bibliometric analysis has been conducted to codify the seminal work on ARM for future reference and pay tribute to the most impactful articles.

Materials and Methods:
Thomson Reuters Web of Science citation indexing database and research platform was used to retrieve the most cited articles in ARM using appropriate search strings. The characteristics (name of authors, the total number of authors, the title of publication, journal of publication, year of publication, etc.,) of the 50 top-cited articles were analyzed.

Results:
The analysis revealed that the Journal of Paediatric Surgery was leading the choice of journal for publication. While most of the publications originated from the United States of America, Alberto Pena was the most influential author. The most studied topic was on associated malformations, and the most common study design was cohort studies.

Conclusion:
The approach of citation analysis provided us an opportunity to retrieve the most influential articles on ARM. The trends in research in ARM have also been analyzed, spreading over five decades.
Evaluation of Complication Rates of Free Flap Reconstruction in Pediatric Patients
Authors: Allam Omar , Shah Rema , Cadwell Joshua B. , Dinis Jacob , Peck Connor , Junn Alexandra , Gowda Arvind , Alperovich Michael 
Published: May 2024

Introduction:
While there is extensive literature investigating surgical outcomes in free flaps for adults, there is a dearth of information on the efficacy of flap use in the pediatric population. This study is the first to measure complication rates following pediatric free flap reconstruction on a national level.

Methods:
All pediatric free flap cases between 2012 and 2018 were identified and stratified by type of flap using current procedural terminology codes assigned to the primary procedure in the National Surgical Quality Improvement Program database. Each entry included the recipient location of the flap, postoperative complications, and demographics. Chi-square analysis was used to compare complication rates across various flap groupings. In addition, univariate and multivariate analyses were used to identify independent predictors of flap complications or failure.

Results:
Multivariate regression analysis demonstrated that compared to bone flaps, there is increased risk of nonbleeding complications in skin (Odds Ratio (OR) =7.7, P = 0.029), muscle (OR = 10.6, P = 0.012), and osteocutaneous flaps (OR = 10.8, P = 0.018). Flap of the trunk (OR = 40.9, P = 0.003) and upper extremities (OR = 32.9, P = 0.041) had a higher odds of bleeding complications compared to head-and-neck flaps. Regression analysis also showed that older age is associated with bleeding complications, with patients aged 5–11 years (OR = 38.5, P = 0.027) and 12–17 years (OR = 30.6, P = 0.038) having greater rates compared to patients under the age of 2. The pediatric flap reoperation rate was found to be 3.6%–4.7%, with the highest flap anastomotic complication rate in the head-and-neck region (6.9%–8.0%).

Conclusion:
Free flap reconstruction across flap type, anatomic location, and age ranges are safe and efficacious in the pediatric population.
Sequelae of Corrosive Injury in Children
Authors: Radhakrishna Veerabhadra , Kumar Nitin , Gadgade Bahubali Deepak , Vasudev Raghunath Bangalore , Alladi Anand 
Published: May 2024

Aim:
This study aims to determine the sequelae of corrosive ingestion in children.

Methods:
A retrospective study was conducted in the Department of Pediatric Surgery at a Tertiary Center. The children presenting between January 2015 and December 2020 with a history of ingestion of caustic agents were included in the study.

Results:
A total of 26 children were included in the study. The children with suicidal attempts were significantly older than those who ingested the corrosive agents accidentally (14.2 ± 1.9 years vs. 6 ± 3.3 years; P < 0.01; Student's t-test). Sixteen (62%) children had esophageal strictures, 8 (31%) had pyloric strictures, and a child (4%) had both esophageal and gastric strictures. Eight (31%) children required an initial feeding jejunostomy and 6 (23%) required a feeding gastrostomy as they had significant weight loss on presentation. Eleven (65%) esophageal strictures responded to the dilatation regimen and are symptom-free on follow-up. Three (18%) children with esophageal stricture underwent esophageal replacement. Eight (31%) children had a pyloric stricture and all of them were treated with a modified Billroth I gastro-duodenostomy. The children who presented after 2 months were found to have a significantly increased need for esophageal replacement (3/9 vs. 0/17; P = 0.03; Fischer's exact test).

Conclusion:
The corrosive ingestion in children is associated with higher morbidity. The sequelae include esophageal and antro-pyloric strictures. A feeding gastrostomy or jejunostomy was required in more than half of the patients. The children presenting after 2 months of ingestion were associated with an increased need for esophageal replacement.
Fibromatosis colli
Authors: Sabounji Salsabil Mohammad , Gueye Doudou , Fall Mbaye , Ndour Oumar , Ngom Gabriel 
Published: May 2024

Aims
The aim is to identify the epidemiological, diagnostic, therapeutic, evolutionary aspects, and risk factors related to the occurrence of this condition.

Subjects and Methods:
It was a retrospective and descriptive study of a series of 26 cases of fibromatosis colli collected over a period of 3 years (from January 1, 2017 to December 31, 2019). We studied the following parameters: frequency, age, sex, delay of consultation, motive of consultation, gravidity, parity, type of delivery, notion of birth trauma, birth weight, examination findings, ultrasound results, type of treatment, and evolutionary modalities. The data were collected from patients' files. The analysis was done on Excel 2016.

Results:
The frequency was 6.5 cases/year. The mean age was 2.1 months. The average delay of consultation was 6.3 weeks. A notion of obstetrical trauma was found in 16 cases (61.5%). Primiparity was noted in 15 cases (57.5%). Associated torticollis was noted in 03 cases. Cervical ultrasonography was performed in all cases (n = 26/26) enabling diagnostic confirmation. Surveillance was the main treatment (84.6%). After a mean follow-up of 20.8 months, evolution was favorable in the majority of patients. The average time of complete regression of the mass was 3.8 months.

Conclusions:
Rare condition of the newborn and infant for which the diagnosis is clinical and the confirmation is based on ultrasound. The management is simple and based on surveillance. The evolution is most often toward spontaneous regression.
Transcutaneous electrical nerve stimulation in management of neurogenic bladder secondary to spina bifida
Authors: Pattanshetti Swapnil , Mahajan Jai Kumar , Saxena Somya , Saxena Akshay 
Published: May 2024

Aims
To assess the role of transcutaneous electrical nerve stimulation (TENS), alone or in combination with anticholinergic drugs in the management of neurogenic bladder (NB) in spina bifida (SB).

Materials and Methods:
All the consecutive patients, visiting outpatient clinic between July 2017 and December 2018, who were toilet trained and at least 1 year post-SB surgery with clinical and/or urodynamic evidence of NB, were included in the study. Out of 65 patients, 40 fulfilled the inclusion criteria and were randomised into: group A (ten patients, placebo TENS with anticholinergic agents), Group B (14 patients, TENS therapy with placebo medications) and Group C (16 patients, TENS therapy with anticholinergic medications). All the patients maintained a voiding diary and underwent assessment before and after the intervention. The study was approved by the Institutional Ethics Committee.

Results:
The presenting symptoms were urinary incontinence (100%), increased frequency (45%), straining during micturition (22.5%), urgency (22.5%), and hesitancy (30%). The demographic parameters were comparable in all the groups. After group specific intervention, the wet episodes/day significantly improved in Group C (P = 0.001). Similarly, the mean wet days/week also improved significantly in Group C (6.5–4.37 days/week, P = 0.01). Out of 40 patients, 29 had abnormal findings on ultrasonography before the start of the therapy. Following intervention, only two patients in Group C showed normalization of findings. On Urodynamic studies, detrusor pressure (Pdet max) decreased in all the groups; however, the patients in Group C, showed the maximum reduction (56.6 ± 11–30 ± 6.7 cm H2O). Similarly compliance (9.4 to 14.5 cm H2O, P = 0.02) and bladder capacity (68%–88% of EBC, P = 0.001) also improved significantly in Group C as compared to other 2 groups Overall, nine patients (Group A, B, and C = 1, 3, and five patients, respectively) showed detrusor instability, while post therapy, only one patient (Group B) had unstable bladder. Maximum decrease in postvoid residue (mean) was also observed in Group C (77–41 ml, P = 0.01).

Conclusions:
The application of TENS in NB secondary to SB is effective and its application led to improvement in symptoms, decrease in the wet episodes/day, maximum detrusor pressure, instability, bladder compliance, and capacity. TENS therapy in combination with anticholinergic agents had a better outcome as compared to monotherapy with either of the two modalities.
Case of Botryoid Rhabdomyosarcoma Mimicking Biliary Hydatid Disease
Authors: Akbar Suha Mohammad , Tudu Harish Chandra , Mohanty Subrat Kumar , Mishra Amaresh , Mohanty Sruti 
Published: May 2024

ABSTRACT
Hepatobiliary rhabdomyosarcoma (RMS) is a soft tissue malignant musculoskeletal tumor of the biliary tract. It is rare tumor, mostly seen in children and mimics common benign biliary condition. Here, we present a case of 1 year 9 months child of biliary RMS who presented with obstructive jaundice and diagnosed after biopsy. This case highlights the unusual childhood malignancy of bile duct RMS in obstructive jaundice with atypical imaging findings.
Mortality prediction score for Hirschsprung's disease-associated enterocolitis
Authors: Shah Harooni Syed Asif , Prasad G R , Danda Gayatri Reddy , Naureen Mahera 
Published: May 2024

INTRODUCTION
Enterocolitis associated with Hirschsprung's disease is a fatal and serious complication. Number of scoring systems are in vogue to grade the severity of Hirschsprung's disease associated with enterocolitis (HDAEC), but none of these scoring systems help predict mortality. Hence, we attempt to develop a mortality prediction model (MPM) for HDAEC.

Materials and Methods:
A retrospective analysis of all cases of HDAEC encountered was analyzed. We also used the parameters of Elhalaby et al. for data collection. A total number of 71 cases were analyzed with regard to mortality in relation to each parameter. Sensitivity and specificity were calculated by statistician, and based on these values, a scoring model was proposed. All those with predicted mortality were given score 2 and those who did not were given score 1.

Results:
A total score of more than 16 predicted mortality, a score of <10 predicted survival, and a score between 11 and 15 predicted survival with morbidity.

Conclusion:
A MPM for HDAEC is being proposed.
Acinar Cell Carcinoma of the Uncinate Process of the Pancreas in a Child Managed Sans Whipple's Procedure-a Rare Case Scenario
Authors: Goel Tanvi , Anand Sachit , Dhua Anjan Kumar , Kakkar Aanchal , Agarwala Sandeep , Bhatnagar Veereshwar 
Published: May 2024

ABSTRACT
Acinar cell carcinoma (ACC) is a rare malignant tumor of the pancreas. A 10-year-old girl presented with a large tumor arising from the pancreatic head. Excision sans Whipple's procedure was performed. Histopathology revealed it as ACC. In the context of this case, this rare tumor is being reported to highlight that such tumors arising from the head of the pancreas can be managed successfully without always resorting to a Whipple's procedure.
Duodenal and Pyloric Web in Children
Authors: Solanki Shailesh , Menon Prema , Dogra Shivani , Samujh Ram 
Published: May 2024

Background:
Duodenal and pyloric web (DW/PW) can present at any age, symptoms depend upon the location of the web along with the presence and size of the opening in the web. The surgical management is not straightforward always. Here, in this study, we aim to assess clinical characteristics, management, and outcome of children with DW/PW.

Materials and Methodology:
This was a retrospective study from 2005 to 2019, and data were collected from record registers. All children of DW/PW presented between this duration were included in this study.

Results:
A total of 45 patients (age range = 1 day to 11 years) included in the study, 40 had DW while 5 had PW. Seven patients were diagnosed antenatally and 20 patients had associated congenital anomalies. Most patients presented with vomiting either bilious or nonbilious. Plain X-ray was sufficient for the diagnosis in 60% of patients, the rest diagnosed on contrast study. The web excision and pyloroplasty were done for PW. The web excision and Heineke-Mikulicz type enteroplasty was the preferred surgery for DW but some patients were required Kimura's duodeno-duodenostomy. For postoperative nutrition, enteral feeding was established through the placement of a feeding tube beyond anastomosis. Ten patients died due to septicemia and associated anomalies. Four patients had a minor leak which was managed by conservative means. Four patients required redo surgery, adhesive obstruction was the most common indication. During follow-up, all 35 patients were doing well with no major complaints.

Conclusion:
DW/PW has different presentations as compared to other intestinal atresia and can present at any age. A contrast study confirms the diagnosis when plain X-ray is inconclusive. Associated anomalies and septicemia are the poor prognostic indicators. Postoperative enteral feeding helps in maintaining adequate nutrition and improves the outcome even in children with a minor anastomotic leak.
Electronic Medical Record System-Based Teleconsultations in Pediatric Surgery
Authors: Anand Sachit , Dhua Anjan Kumar , Singh Apoorv , Subramonian Nellai Krishnan , Verma Ajay , Jain Vishesh , Yadav Devendra Kumar , Mitra Aparajita , Agarwala Sandeep , Goel Prabudh , Bajpai Minu 
Published: May 2024

Background:
There has been a dramatic effect of the coronavirus disease 2019 pandemic on the daily health-care services. The era of physical consultations is slowly being replaced with teleconsultation, and this current pandemic has tipped the scales further. This study highlights the preliminary experience in providing teleconsultation to pediatric surgical patients at a tertiary care hospital in north India.

Materials and Methods:
A retrospective analysis of the electronic medical record system records of the patients undergoing teleconsultation at the authors’ department between the June 26, 2020 and the September 26, 2020 was performed. The data were categorized on the basis of the type of consultation (urgent, semi-urgent, or routine) and the type of intervention. A comparison with the data from the corresponding months of 2019 was also performed.

Results:
A total of 261 teleconsultations were conducted during the study period, with a success rate of 69% (181/261). Of these, 96% (171/178) were follow-up patients and 56% (99/178) presented with genitourinary complaints. After triaging, only 10% (18/178) of the patients required urgent medical/surgical attention.

Conclusion:
In the current as well as postpandemic phase, teleconsultation can act as a potent triaging tool and can help in better utilization of resources alongside helping in the maintenance of social distancing by decreasing the number of physical visits to the hospital.
Pediatric Neuroblastoma - Impact of Nutritional Status on Complications and Outcomes
Authors: Nandan Ruchira , Sharma Shilpa , Bajpai Minu , Jain Vishesh , Goel Prabudh , Yadav Devendra Kumar 
Published: May 2024

Aim:
The aim is to study the impact of nutritional status on outcomes and treatment-related complications in patients of neuroblastoma.

Materials and Methods:
Anthropometry (height, weight, weight for height [in <5 years], mid-arm circumference [MAC] [in <5 years], and body mass index [BMI]), hemoglobin level, and serum albumin level were recorded.

Results:
Twenty-four neuroblastoma patients, 16 males and 8 females, with a mean age of 42.7 months were treated and followed up over a period of 0.03–170 months. Of 24 patients, 16 survived (complete response - 9, partial response - 2, no response - 2, progressive disease - 3). Height <2 standard deviation [SD] was seen in 12.5% (3/24). Mortality and complications were found in 66.7% (2/3) and 100% (3/3), respectively. Weight <2SD was seen in 37.5% (9/24). Mortality and complications were found in 33.3% (3/9) and 67% (6/9), respectively. Weight for height <2 SD was seen in 35% (7/20). Mortality and complications were found in 42.9% (3/7) and 71.4% (5/7), respectively. MAC <2 SD was seen in 15.8% (3/19). Mortality and complications were found in 66.7% (2/3) and 66.7% (2/3). BMI <2SD was seen in 29.2% (7/24). Mortality and complications were found in 42.8% (3/7) and 28.6% (2/7). Anemia was seen in 62.5% (15/24), of which nine survived. Complications were seen in 58.3% (14/24) (P = 0.001). Hypoproteinemia was seen in 20.8% (5/24). Mortality and complications were 40% (2/5) and 80% (4/5).

Conclusion:
Neuroblastoma has poor outcome in Indian children, and there does not appear to be a major role played by nutrition in determining the response to treatment and survival.
Early Feeding versus Traditional Feeding in Children with Ileostomy Closure
Authors: Gil-Vargas Manuel , Saavedra-Pacheco Mary Sol , Coral-García Miguel Ángel 
Published: May 2024

Context:
Elective intestinal anastomosis is a frequently used surgical procedure in pediatric surgery.

Aims:
This study aimed to compare postoperative complications and hospital stay in children who underwent ileostomy closure with early feeding in the 1st 24 h versus those in whom the oral route was initiated traditionally.

Settings and Design:
Observational, comparative, cross-sectional, ambispective, and single-center study that included pediatric patients who had undergone ileostomy closure from January 2017 to August 2019.

Materials and Methods:
Data were analyzed in SPSS. Statistical analysis was used: the variables were analyzed using the Chi-square test or Fisher's exact test when the former could not be applied.

Results:
They were divided into the following two groups: group 1 included patients who started the oral route early (n = 25) and Group 2 included patients who started the oral route late (n = 20). The average in-hospital stay for Group 1 was 5.48 days and that for Group 2 was 8.35 days. In Group 1, the oral route was started with a mean of 9.32 h and in Group 2 at 146.4 h. Those in Group 1 at 32.9 h presented their first evacuation and Group 2 at 131.45 h. Group 1 reached their normal diet on average at 79.96 h and Group 2 at 172.8 h.

Conclusions:
This comparison between early oral feeding and traditional oral feeding suggests that various benefits exist when enteral nutrition is initiated early after ileostomy closure in pediatric patients. The benefits and importance of initiating early oral feeding in adults have been reported, but there are few studies on pediatric populations
Mesenteric Injury in Blunt Abdominal Trauma in Children
Authors: Singh Amit Kumar , Bais Prateek Singh , Chand Karunesh , Dey Santosh 
Published: May 2024

Objective:
There is an increasing trend of observational, nonsurgical management of abdominal injuries in children. We analyzed the feasibility and outcome of our management protocol in managing cases of the mesenteric injuries in blunt trauma abdomen in pediatric age group.

Methods:
Single-center retrospective analysis of pediatric trauma case records from July 2018 to March 2020 was performed.

Results:
Thirty-four cases of blunt abdominal trauma of whom 13 had mesenteric injuries were reviewed. The male-to-female ratio was 2.2:1, and the mean age was 9.11 ± 4.90 years. Mesentery of the small bowel was the most commonly injured segment and treatment consisted of repair of mesenteric tear, resection, and anastomosis with or without stoma formation.

Conclusions:
Isolated mesenteric injury of all grades should be managed either with diagnostic laparoscopy or laparotomy irrespective of hemodynamic status.
Yolk Sac Tumor of the Cervix in an Infant
Authors: Narasimhan Swati , Arul Janani , Swaminathan Rajendran , Agarwal Prakash 
Published: May 2024

ABSTRACT
A 5-month-old child presented with vaginal bleeding and found yolk sac tumor of the uterine cervix. She attained complete remission only with chemotherapy and on follow-up for more than a year. We report this for the unusual age and feasibility of avoiding surgery in selected cases.
A Novel Technique of SMA Massage with Systemic Fibrinolytic Therapy in Ischemic Midgut Volvulus
Authors: Giriradder Vandana Basappa , Jadhav Vinay , Anilkumar P. L. , Babu M. Narendra 
Published: May 2024

Purpose:
Midgut volvulus is a surgical emergency requiring immediate intervention. Intestinal ischemia of the midgut as a consequence of volvulus from malrotation is a fateful event with high mortality and significant morbidity even in survivors. Derotation followed by correction of malrotation is the procedure of choice though has significant morbidity if intestinal reperfusion was not successful. A combined treatment to restore intestinal perfusion based on the digital massage of the superior mesenteric artery after derotation and systemic infusion of fibrinolytic has been previously reported with success but underused. Here, we report three such cases of midgut malrotation with severe intestinal ischemia due to volvulus.

Materials and Methods:
A retrospective analysis of three confirmed cases of midgut malrotation with volvulus managed with emergency laparotomy, derotation, and Superior Mesenteric Artery (SMA) massage with systemic fibrinolytic therapy, followed by correction of malrotation was evaluated.

Results:
There was dramatic improvement in intestinal perfusion noted in all three patients inspite of delayed presentation. 2 out of 3 patients on follow up are doing well with adequate weight gain while 1 patient succumbed due to sepsis.

Conclusion:
Critical intestinal ischemia due to mesenteric thrombosis can persist after derotation of midgut volvulus and can lead to devastating consequences. The use of digital massage of SMA to disrupt the thrombus along with fibrinolytic therapy though reported is underutilized. Hence, awareness of this management and usage needs to be re-emphasized.