bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastrointestinal Duplications
Authors: Gupta Rahul , Kumar Ajay , Agrawal Liladhar , Bhandari Anu , Gupta Arun Kumar , Goyal Ram Babu 
Published: September 2023

ABSTRACT

Context:
Gastrointestinal (GI) duplications are rare congenital malformations with diverse presentations. They usually present in the pediatric age, especially in the first 2 years of life.

Aims:
To present our experience with GI duplication (cysts) at a pediatric surgery tertiary care teaching institute.

Settings and Design:
It is a retrospective observational study undertaken in the department of pediatric surgery at our center between 2012 and 2022 for GI duplications.

Materials and Methods:
All children were analyzed for their age, sex, presentation, radiological evaluation, operative management, and outcomes.

Results:
Thirty-two patients were diagnosed with GI duplication. Slight male predominance was present in the series (M: F ≈ 4:3). Fifteen (46.88%) patients presented in the neonatal age group; 26 (81.25%) patients were under 2 years. In the majority of cases (n = 23, 71.88%), the presentation was acute onset. Double duplication cysts on opposite sides of the diaphragm were present in one case. The most common location was ileum (n = 17), followed by gallbladder (n = 6), appendix (n = 3), gastric (n = 1), jejunum (n = 1), esophagus (n = 1), ileocecal junction (n = 1), duodenum (n = 1), sigmoid (n = 1), and anal canal (n = 1). Multiple associations (malformations/surgical pathologies) were present. Intussusception (n = 6) was the most common, followed by intestinal atresia (n = 5), anorectal malformation (n = 3), abdominal wall defect (n = 3), hemorrhagic cyst (n = 1), Meckel's diverticulum (n = 1), and sacrococcygeal teratoma (n = 1). Four cases were associated with intestinal volvulus, three cases with intestinal adhesions, and two with intestinal perforation. Favorable outcomes were present in 75% of cases.

Conclusion:
GI duplications have varied presentations depending on site, size, type, local mass effect, mucosal pattern, and associated complications. The importance of clinical suspicion and radiology cannot be underrated. Early diagnosis is required to prevent postoperative complications. Management is individualized as per the type of duplication anomaly and its relation with the involved GI tract.
Incarcerated Littre's Hernia in a Neonate Presenting as Enteroscrotal Fistula
Authors: Gupta Rahul , Mathur Praveen 
Published: September 2023

ABSTRACT
A 27-day-old male neonate, presented with feculent discharge from the scrotum. Operative findings revealed incarcerated right inguinal hernia with perforated Meckel's diverticulum as its content, leading to enteroscrotal fistula. Resection of the Meckel's diverticulum and end-to-end ileoileal anastomosis was performed along with repair of inguinal hernia from within the abdominal cavity. The outcome was favorable. Enteroscrotal fistula due to incarceration of inguinal hernia is a rare presentation. We are adding to the literature, an extremely rare case of incarcerated Littre's hernia in the right inguinal region presenting as enteroscrotal fistula in a neonate.
Pediatric Colonic Anastomosis
Authors: Ghosh Arindam , Biswas Somak Krishna , Ghosh Tapanjyoti , Basu Kalyani Saha , Biswas Sumitra Kumar 
Published: September 2023

Background:
Enhanced recovery after surgery (ERAS) protocols after colorectal surgery focused on reduced bowel preparation, standardized feeding schedule, earlier return of bowel function, and earlier resumption of normal activities. ERAS in pediatric surgical practice is not well established. The present study aims to present the results of two colonic anastomosis techniques of interrupted single-layered closure: Halsted (Horizontal Mattress) and Matheson (serosubmucosal or appositional extramucosal) along with two different methods of colostomy wound closure and their influence on the adoption of ERAS protocol of early feeding and early discharge.

Materials and Methods:
This single institute-based randomized control study was conducted in a tertiary care facility in Kolkata for 2.4 years. Patients were chosen randomly for serosubmucosal (Group I) and full-thickness (Group II) anastomosis.

Results:
Among total of 91 patients (Group I–43 and Group II–48), Return of bowel sounds and passage of bowel averaged 1.51 ± 0.51 and 1.91 ± 0.55 days in Group I and 1.91 ± 0.57 and 3.9 ± 0.66 days in Group II, respectively. Postoperative hospital stay averaged 5.88 ± 1.12 days in Group I and 8.9 ± 1.17 days in Group II. Overall 15 (16.48%) patients had complications among which SSI (Suprficial surgical site infection) and minor leaks (Group I–3 and 1 and Group II–5 and 3, respectively) which were treated conservatively (Clavien–Dindo Grade-I) and three major leaks under Group II requiring surgical intervention (Clavien–Dindo Grade-III).

Conclusion:
This study concludes that the technique of colostomy closure in the form serosubmucosal closure helps in the implementation of ERAS protocol by producing early bowel movement, early initiation of food, and less postoperative complications.
Retrospective Analysis of the Outcome of Stoma Closure in Children without Preoperative Mechanical Bowel Preparation
Authors: Saxena Rahul , Bhatt Somya , Pathak Manish , Goel Akhil D , Rathod Kirtikumar J , Sinha Arvind , Nayak Shubhlaxmi R. , Jadhav Avinash S. 
Published: September 2023

Introduction:
Stoma closure is one of the most frequently performed surgical procedures by pediatric surgeons worldwide. In this study, we studied the outcome of children undergoing stoma closures without mechanical bowel preparation (MBP) in our department.

Materials and Methods:
This is a retrospective observational study of children <18 years undergoing stoma closure from 2017 to 2021. The primary endpoints were surgical site infection (SSI), incisional hernia, anastomotic leak, and mortalities. The categorical data are expressed in percentages and the continuous data are in medians and interquartile ranges. The postoperative complications were classified according to the Clavien–Dindo system.

Results:
A total of 89 patients underwent stoma closure without bowel preparation during the study. The anastomosis leak and incisional hernia were seen in one patient each. The SSIs occurred in 23 patients (25.9%), which were superficial in 21 and deep in 2 patients. The Clavien–Dindo Grade III complications occurred in 2 (2.2%) patients. The median duration to start feeds and pass first stools was significantly longer in patients with ileostomy closure (P = 0.04 and 0.001, respectively).

Conclusion:
The outcome of stoma closures without MBP was favorable in our study and hence it can be suggested that the use of MBP in colostomy closures can be safely avoided in children.
Case Report of Primary Synovial Sarcoma of the Thyroid Gland
Authors: Lekshmi R. , Gupta Sweety , Pabi Shreeya , Mandal Shreyosi , Singh Ashok , Agarwal S. P. , Gupta Manoj 
Published: September 2023

ABSTRACT
Primary synovial sarcoma of the thyroid gland is extremely rare, aggressive, and has a dismal prognosis. We report the case of a 15-year-old male who presented with a progressively increasing neck mass, which was excised and the histopathological and immunohistochemical study suggested biphasic synovial sarcoma of the thyroid gland which was confirmed by synovial sarcoma translocation. There are 14 cases of primary synovial sarcoma of the thyroid reported in the literature so far. This study aimed to document the occurrence of synovial sarcoma histology at an unusual anatomical location with a review of the literature on this rare entity.
A Cost-effectiveness Model Comparing Urinary Biomarkers with Diuretic Renogram in Diagnosing Ureteropelvic Junction Obstruction in Children
Authors: Sangeetha Geminiganesan , Babu Ramesh 
Published: September 2023

Background and Aims:
In this cost-effectiveness model, we compared the cost-effectiveness of commonly used urinary biomarkers with conventional diuretic renogram (DR) in diagnosing ureteropelvic junction obstruction (UPJO). We hypothesized that urinary biomarkers are as effective as DR.

Methods:
We used incremental cost-effectiveness ratio (ICER) as a tool for our cost-effectiveness analysis model. The cost of biomarker assay and renogram were sourced from the same center while the accuracy data of DR and urinary biomarkers from the relevant pubications.

Results:
As the accuracy of individual biomarker increased, the ICER also got better. As a panel of biomarker was introduced, the ICER went to the negative range suggesting cost saving as well. ICER of most urine biomarkers is currently less expensive and less effective. When a biomarker panel was applied ICER became more expensive and effective. With higher samples, test running cost is likely to go down in future and thus biomarkers are likely become less expensive and more effective.

Conclusions:
Individual urine biomarkers are currently less expensive and less effective compared to DR in predicting UPJO. In future, biomarker panel is likely to be more cost-effective and reduce the need for invasive renogram thus reducing the radiation exposure.
A Randomized Control Trial to Evaluate the Effect of Local Instillation of Mitomycin-C at the Porta after Kasai Portoenterostomy in Patients of Biliary Atresia
Authors: Solanki Shailesh , Kanojia Ravi Prakash , Gupta Pramod Kumar , Singhai Palak , Lal Sadhna Bhasin , Mahajan Jai Kumar 
Published: September 2023

Background:
Kasai portoenterostomy (KPE) is the initial treatment for biliary atresia (BA). Even after initial jaundice clearance, a significant number of children presented with the reappearance of symptoms due to ongoing fibrosis involving porta and intrahepatic ducts. Mitomycin-C (MMC) is an antifibrotic agent, and the study hypothesized that local application of MMC at porta can decrease fibrosis, which can improve jaundice clearance and lead to better native liver survival (NLS).

Materials and Methods:
This prospective randomized control trial included children with BA, who were allocated to groups A or B. The patients in both groups underwent standard KPE; in addition, a 5 French infant feeding tube (IFT) was placed near the porta through the Roux limb in Group B children. During the postoperative period, MMC was locally instilled over the porta in Group B children through IFT. Postoperative jaundice clearance and NLS were assessed and compared.

Results:
A total of 27 children were enrolled in the study, 16 in Group A and 11 in Group B. Both groups were comparable preoperatively. Although the NLS was not statistically significant in Group B, the survival was quite higher, that was 91%, 81%, and 73% at 6 months, 1 year, and 2 years, respectively, compared to 63%, 50%, and 38% in Group A.

Conclusion:
Children in Group B clinically showed an early jaundice clearance and a better trend of serial bilirubin levels as well as longer NLS than Group A, but it was not statistically significant. The procedure was technically easy, and no complication was encountered related to surgical technique or MMC instillation.
Evaluation of Clinical Outcomes in Children with Intrahepatic Cholestasis Postpartial External Biliary Diversion
Authors: Nasr El-Din Hadeer Mohamed , Yassin Noha Adel , EL Koofy Nehal M , Obeida Alaa , Kaddah Sherif Nabhan , Eltagy Gamal Hassan , Mohamed Wesam 
Published: September 2023

Background:
Severe pruritus caused by progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome (AGS) is refractory to medical treatment. Surgical interruption of the enterohepatic circulation is considered the mainstay of alleviating distressing symptoms and delaying cirrhosis.

Aim and Objectives:
This study aims to evaluate the short-term effect of partial external biliary diversion (PEBD) on pruritus, liver disease progression, patient's growth, and quality of life.

Material and Methods:
This prospective cohort study enrolled children with PFIC and AGS from July 2019 to July 2021, whose guardians consented to the PEBD procedure. A standard surgical approach was performed by a single surgeon. Outcomes were measured subjectively and objectively pre- and post-procedure using the pruritus 5-D itching score, Paediatric Quality of Life Inventory scale (PedsQL), growth parameters, bile acids level, and liver function tests. Patients’ follow-up period ranged from 6 to 12 months.

Results:
Seven patients had PEBD procedure; five with PFIC and two with AGS. A significant improvement was detected in the 5-D itching score (p-value < 0.001), PedsQL (p-value < 0.001), and bile acids level (p-value 0.013). The preexisting growth failure was ameliorated. The downward trend in the bilirubin level was not significant. No influential difference in the other liver function tests occurred. No intra-operative complications encountered. Only one case had a post-operative stoma prolapse which was managed surgically.

Conclusion:
PEBD procedure could be considered as an effective and safe treatment options for intractable pruritus in patients with PFIC or AGS, providing preserved synthetic liver functions.
Voiding Pressures in Boys
Authors: Vaze Poonam Guha , Saha Subhasis , Sinha Rajiv 
Published: September 2023

Introduction:
Invasive urodynamics (UDS) is a standard investigation in children. Studies measuring voiding pressures in children use varied nomenclatures and quote a wide range of voiding pressures. Thus, voiding pressures in children are not considered reliable and they do not find any place in the pediatric diagnostic armamentarium. On the contrary, adult studies have well-defined nomograms and standard values which make voiding studies indispensable in the diagnosis of voiding dysfunctions in adults. The difference primarily lies in the uniformity of parameters assessed in adults and the contrasting heterogeneity in the pediatric literature.

Objective:
The objective of this study was to study the voiding parameters observed during UDS in boys.

Study Design:
We retrospectively reviewed the pressure flow data obtained during conventional invasive UDS in 106 neurologically normal boys (6 months–16 years) who had different indications for urodynamics. The values of Pdetmax and PdetQmax were analyzed and compared with the existing data of pressure flow studies in children.

Results:
Pdetmax decreased with age whereas PdetQmax was independent of age. The difference between the values of Pdetmax and PdetQmax was more in the younger kids. The wide range of voiding detrusor pressure (Pdet) in the existing pediatric literature is similar to the values of Pdetmax observed in our study, whereas the value of PdetQmax is much lower.

Discussion:
The values of Pdetmax observed in this study are similar to the values of “maximum Pdet during voiding” documented in previous studies and are determined by detrusor contractility and functional/dynamic contraction of outflow during voiding. PdetQmax has been documented in very few pediatric studies and is significantly less than Pdetmax. Further prospective studies are needed to corroborate UDS findings with radiologic/cystoscopic findings to create nomograms of voiding parameters in children.

Conclusion:
Existing literature on pediatric voiding studies mentions voiding pressures during variable phases of void (usually Pdetmax) and the values have been very heterogeneous, making voiding pressure-flow studies unreliable in children. PdetQmax values are much lower than values quoted as “standard” pressures and are age independent. The use of PdetQmax instead of PdetMax may make voiding pressures in children more reproducible and informative.
Proyecto de profundizacion en la educacion media en el Colegio Heladia Mejia: Avances y perspectivas
Authors: Sáenz Suárez Homero , Niño Cubillos Claudia Leonor , Fino Moreno Flor Maximima , Ojeda Zambrano Milton Jimmy , Otálora García Bárbara 
Published: September 2023

Este artículo en la modalidad de experiencia educativa presenta algunas consideraciones sobre los avances, luego de ocho años de implementación del proyecto LIDERAZGO PARA GESTION DE PROYECTO DE VIDA SOSTENIBLE que orienta el núcleo de profundización de educación media en el colegio Heladia Mejía IED. El acompañamiento pedagógico integral y oferta diversa en las asignaturas Emprendimiento, Investigación, Matemáticas Financieras y Fundamentos de Mecatrónica, teniendo como pilares las competencias del siglo XXI, habilidades socioemocionales y los ODS, con exitosa aplicación del ABP ha permitido a los estudiantes de grados 10 y 11 el desarrollo de proyectos articulados con las cuatro asignaturas, que constituyen su trabajo de grado, que además de aportar avances en ciencia y tecnología, facilitan la articulación con la educación superior y/o el mundo laboral. Esto ha contribuido a la formación de jóvenes con calidad humana, que construyendo su proyecto de vida trascenderán en la sociedad como ciudadanos competentes.
El ser humano producto de la evolución y referente para la transformación histórico social
Authors: Vera Vélez Diego Patricio , Aguilar Floralba 
Published: September 2023

Este artículo en modalidad ensayo analiza al ser humano como producto evolutivo, viajero que aborda la nave del tiempo, recorriendo épocas y contextos con una larga trayectorita hasta llegar a nuestros días. El objetivo de este trabajo, es mostrar una visión panorámica de los antecedentes, factores y procesos de la evolución y al ser humano como referente de conocimiento, pensamiento y acción. El trabajo fue realizado siguiendo el método heurístico que consiste en encontrar e indagar en documentos o fuentes históricas la información necesaria para los procesos investigativos; y el método hermenéutico que explica, traduce e interpreta las relaciones existentes entre un hecho y el contexto en el que acontece. La exposición se desarrolla en cuatro apartados: el primer apartado, plantea el desarrollo de la evolución y expone sus precedentes y factores desde la filosofía de Lamarck y Darwin; el segundo apartado, esboza el pensamiento metafísico de Klages y el pensamiento historicista de Dilthey en el desarrollo de la historia; el tercer apartado, expone las acciones del ser humano como producto del pensar y el conocer; y finalmente el último apartado, plantea la realidad actual del ser humano, y sus desafíos en el largo proceso histórico-evolutivo.
Análisis sobre el aprendizaje y adaptación de estudiantes del nivel medio superior de la UAC en tiempos de pandemia
Authors: Bojórquez Maria Alejandra Sarmiento , Rosado Juan Fernando Casanova , González Mayte Cadena 
Published: September 2023

Es un hecho que hoy los niños y los jóvenes de México están en casa, los profesores también como mucha otra gente. Las escuelas están cerradas y la educación está bajo el control muchas veces de los papás y del autoaprendizaje de los jóvenes. Es un auténtico examen para todo sistema educativo, mientras que los profesores se preocupan por adaptarse y transformar la enseñanza, capacitarse y cambiar la forma de enseñar, los programas de estudio, las estrategias, etc., se han olvidado de algo esencial, ¿será que los alumnos tienen todo lo necesario para recibir esta enseñanza? El objetivo de esta investigación es analizar y reflexionar si han aprendido a distancia los estudiantes de nivel medio superior de la UAC, y si lograron adaptarse ante este reto a distancia. Se realizó un cuestionario diagnóstico de 30 ítems vía email, aplicado a 289 estudiantes. En los resultados se observó que el 90.3% (260) afirma siempre cuenta con un dispositivo para su educación online y el 9.7% (29) solo a veces. Un dato relevante es cuando se preguntó si se sienten cómodos y adaptados ante esta nueva modalidad online y en una escala de uno a 5 (totalmente) afirmaron que el 21.1% totalmente, el 81% escogieron escala 4 y 3 y el 16.3% el 6.6% las últimas escalas. Por último, un dato importante es la pregunta de qué tanto te gustaría seguir tomando en línea y se observó que el solo el 8.7% le gustaría mucho, el 33.3% si les gusta, al 26.4% le es indiferente la modalidad, al 22.2% le gusta poco, pero al 9.4% no le gusta nada. Es un hecho que a nadie nos gusta los cambios abruptos, estos cambios no fueron planeados y controlados en muchos aspectos, sin embargo podemos concluir que el esfuerzo hecho por muchos docentes rindió frutos y este periodo nos preparó a todos tanto estudiantes, docentes y autoridades para avanzar y transformar nuestra enseñanza virtual y que poco a poco se logre mejoras sin descuidar que nuestra población estudiantil pueda seguir adaptándose y aprendiendo cada día más con obstáculos o sin ellos.
Evaluasi Pemahaman Tentang Kewirausahaan Studi Kasus Mahasiswa Universitas Dharma Andalas
Authors: Chairoel Lucy , Hastini Lasti Yossi , Fitri Mellyna Eka Yan 
Published: September 2023

ABSTRACT
Entrepreneurial knowledge is important for anyone who is running a business as well as who is going to run a business. One measure of entrepreneurial knowledge is an understanding of the definition of entrepreneurship. The importance of understanding the definition of entrepreneurship because the definition of entrepreneurship provides a basic understanding of the concept, purpose, nature, and type of entrepreneurship. As one of the Private Universities in Padang City, Dharma Andalas University also needs to evaluate the implementation of entrepreneurial education through entrepreneurial knowledge that has been obtained by students in entrepreneurship courses which are compulsory subjects of the University. This study aims to determine the success of entrepreneurial education in providing knowledge about entrepreneurship and entrepreneurs from a definition perspective. This research uses qualitative methods. The selected informants are Dharma Andalas university students from all Study Programs who have participated in the Entrepreneurship course by selection through quota sampling. Data collection techniques using unstructured interviews are then analyzed using a coding process. From the results of the analysis, it is known that students' understanding of entrepreneurship is still not good.
Keyword: Entrepreneurship; Understanding of Entrepreneurship; Entrepreneurial education

ABSTRAK
Pengetahuan kewirausahaan penting bagi siapa saja yang sedang menjalankan bisnis maupun yang akan menjalankan bisnis. Salah satu ukuran tentang pengetahuan kewirausahaan adalah pemahaman tentang definisi kewirausahaan. Pentingnya memahami definisi kewirausahaan karena definisi kewirausahaan memberikan pemahaman dasar tentang konsep, tujuan, sifat, dan jenis wirausaha. Sebagai salah satu Perguruan Tinggi Swasta di Kota Padang, Universitas Dharma Andalas juga perlu melakukan evaluasi pelaksanaan entrepreneurial education melalui pengetahuan kewirausahaan yang telah diperoleh mahasiswa dalam matakuliah kewirausahaan yang menjadi mata kuliah wajib Universitas tersebut. Penelitian ini bertujuan untuk mengetahui keberhasilan entrepreneurial education dalam memberikan pengetahuan tentang kewirausahaan dan pengusaha dari pespektif definisi. Penelitian ini menggunakan metode kualitatif. Informan yang dipilih adalah mahasiswa universitas Dharma Andalas dari semua Program Studi yang telah mengikuti matakuliah Kewirausahaan dengan pemilihan melalui quota sampling. Teknik pengambilan data dengan menggunakan wawancara tidak terstrukturyang kemudian dianalisis menggunakan proses coding. Dari hasil analisis diketahui bahwa pemahaman mahasiswa tentang kewirausahaan masih kurang bagus

Kata kunci: Kewirausahaan; Pemahaman tentang Kewirausahaan; Entrepreneurial education