African journal of paediatric surgery : AJPS最新文献

{"title":"Efficacy of Adenoidectomy versus Tympanostomy on the Otitis Media with Effusion: A Systematic Review and Meta-Analysis.","authors":"Abdullah A Alamri, Hosam A Amoodi, Shahad A Alsubaie, Areej A Alsehly, Razan O Alshuaibi, Leena A Alotaibi, Sahar J Almaghrabi, Sarah F Mozahim, Naif F Mozahim, Albaraa Tonkal","doi":"10.4103/ajps.ajps_144_22","DOIUrl":"10.4103/ajps.ajps_144_22","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to investigate the current evidence on the efficacy of tympanostomy and adenoidectomy in children with otitis media with effusion in comparison with tympanostomy alone following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.</p><p><strong>Materials and methods: </strong>We completed a comprehensive search of PubMed, Web of Science, Scopus and Cochrane Library databases for relevant studies published in the literature with no date restrictions. We collected the results of the databases search and removed duplicated studies by Rayyan QCRI and EndNote Software X8. We used an Excel sheet for screening titles and abstracts, full text and data extraction. For quality assessment, we used Cochrane Handbook of Systematic Reviews of Interventions 5.1.0 using the quality assessment table provided in Part 2 and Chapter 8.5, and quantitative data synthesis was done using Review Manager (RevMan) software version 5.4.</p><p><strong>Results: </strong>The literature search showed 1510 studies, of which five studies were included in data synthesis. The study measured the effect through number of acute otitis media (AOM) episodes, cumulative number of AOM episodes, siblings with Otitis media (OM), hearing level hearing loss scale of the left, and right ears. The pooled effect estimates showed significant difference between tympanostomy with adenoidectomy versus tympanostomy alone in hearing level hearing loss scale of both ears (SMD -0.17, 95% CI [-0.29, -0.05], P -value=0.005). However, the pooled results were not heterogeneous ( P < 0.25, I2 = 24%).</p><p><strong>Conclusions: </strong>Tympanostomy with adenoidectomy improves hearing compared to tympanostomy alone, but both treatments have similar effects on ear infection rates. Further research with larger samples is needed to confirm these findings and assess long-term benefits.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 4","pages":"236-241"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectus Muscle Flap-augmented Closures in Wide-gap Exstrophy Bladder.","authors":"Mir Fahiem-Ul-Hassan, Vinay Jadhav, Raashid Hamid, Gowhar Mufti, Narendrababu Munianjanappa, Murali Saroja","doi":"10.4103/ajps.ajps_142_22","DOIUrl":"10.4103/ajps.ajps_142_22","url":null,"abstract":"<p><strong>Background: </strong>Wound dehiscence is one of the main complications in complete primary repair of exstrophy (CPRE). In our pediatric urology unit, we have switched to the use of inferior epigastric artery based rectus abdominis flap cover for abdominal wall closure in addition to measures like osteotomy and postoperative hip spica.</p><p><strong>Aim: </strong>to assess the efficacy of Recus abdominis flap in prevenion of wound dehisence.</p><p><strong>Methods: </strong>This study was conducted from June 2014 to June 2021 comparing two groups of the patients; group I consisted of thirty patients of CPRE with rectus flap repair of abdominal wall (CPRE-RF) and group II consisted of thirty patients with CPRE without rectus flap. Clinical and surgical details, including the outcome with regards to wound dehiscence and continence, were recorded.</p><p><strong>Results: </strong>The mean age of the patients in CPRE-RF was 5 months and that with only CPRE was 4.6 months. Mean pubic diastasis in Group l was 4.8± 1.07 cm and that of Group II was 4.6±1.3 cm. None of the patients in CPRE-RF had wound dehiscence or bladder prolapse while as 6 patients in CPRE alone had wound dehiscence and 1 had bladder prolapse. This difference was statistically significant. Primary bladder continence was achieved in 4 patients in CPRE-RF and 3 patients in CPRE group. Hypospadias had almost similar occurrence in the two groups. One patient in each group had bladder neck fistula.</p><p><strong>Conclusion: </strong>Use of rectus muscle flap in complete Primary Repair ofExtrophy bladder helps in prevention of wound dehiscence and contributes in achievement of final goal of continence in wide gap pubic diatasis.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 4","pages":"263-266"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presacral Keratinous and Dermoid Cyst Masquerading as Meningocele - A Rare Case Report.","authors":"Lucky Gupta","doi":"10.4103/ajps.ajps_153_22","DOIUrl":"10.4103/ajps.ajps_153_22","url":null,"abstract":"<p><strong>Abstract: </strong>Presacral tumours are rare developmental tumours associated with midline closure defects. A fifteen-month-old girl presented with pain in the lower abdomen and dysuria. After examination, the child underwent investigations and was diagnosed as a presacral mass with intergluteal extension and caudal mass in the subcutaneous tissue of the left gluteal region. Complete excision of mass along with coccygectomy was done. Histopathology showed presacral as a keratinous cyst and gluteal as a dermoid cyst. Later on, the child also developed a left facial dermoid cyst which was also excised.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":"21 4","pages":"271-272"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11493232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible Endoscopic Management of Tracheo-oesophageal Magnet Foreign Bodies with Acquired Fistula in a Toddler.","authors":"Mohamed Jallouli, Ehab Nicolas Zoriquat, Terez Boshra Kamel","doi":"10.4103/ajps.ajps_50_23","DOIUrl":"10.4103/ajps.ajps_50_23","url":null,"abstract":"<p><strong>Abstract: </strong>Aerodigestive foreign bodies (FBs) aspiration is a common problem in children; however, simultaneous aerodigestive localisation is rare. Ingestion of multiple magnetic FBs can lead to serious complications, especially tracheo-oesophageal fistula and recurrent chest infections. These depend on the duration of foreign-body ingestion/aspiration, prompt intervention and adequate technique for foreign-body retrieval. A 1.8-year-old female child was found to have two magnetic FBs lodged simultaneously in the oesophagus and trachea. The magnetic FBs in the aerodigestive tract in children were removed in the same session using flexible endoscopes.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scrotoschisis: Management Challenges and Review of Literature.","authors":"Tunde Talib Sholadoye, Halima Oziohu Aliyu, Suleiman Baba, Philip Mari Mshelbwala, Emmanuel Adoyi Ameh","doi":"10.4103/ajps.ajps_122_23","DOIUrl":"https://doi.org/10.4103/ajps.ajps_122_23","url":null,"abstract":"<p><strong>Abstract: </strong>Scrotoschisis (extracorporeal testicular ectopia) is a rare congenital defect of the scrotal sac associated with the extrusion of one or both testicles. The exact mechanism causing the anomaly is largely unknown. This is a report of two infants aged 3 and 4 days, respectively, presented with infected unilateral extracorporeal testicular ectopia. Both infants had orchidopexy and repair of the scrotal defect following debridement of the infected defects and administration of broad-spectrum parenteral antibiotics. The infants have remained well at 3 years of follow-up. The isolated unilateral disease was described by several authors. Delayed presentation in scrotoschisis results in superimposed infection which complicates surgical management resulting in a prolonged hospital stay.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde Progression of Inner Preputial Skin to Overcome Skin Shortage in Cases of Congenital Buried Penis.","authors":"Chandra Shekhar Singh, Vijayamahantesh S Kunnur, G Shantala, S K Anil Kumar","doi":"10.4103/ajps.ajps_119_23","DOIUrl":"10.4103/ajps.ajps_119_23","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to report our experience in the treatment of congenital buried penis using a simplified technique of retrograde progression of inner preputial skin for reconstruction and overcome skin shortage.</p><p><strong>Methods: </strong>This is a retrospective multi-institutional study conducted in the Department of Pediatric Surgery, I Q City Medical College and Hospital, Durgapur, West Bengal, India, and the Department of Paediatric Surgery, Rajiv Gandhi Super Specialty Hospital/Raichur Institute of Medical Sciences, Raichur, Karnataka, India, over a period of 3 years (from March 2019 to February 2022). A total of 14 cases of primary congenital buried penis were operated in the specified period. Age of the patients ranged between 8 months and 9 years. Retrograde progression of the inner preputial skin to provide coverage to the dorsal aspect of penile shaft and ventral transposition of the dorsal penile skin to cover the ventral penile shaft was used as a standard procedure for skin coverage.</p><p><strong>Results: </strong>All patients had good-to-excellent outcomes with uniformly improved visualisation of penile shaft post-operatively. There were no significant post-operative complications apart from mild oedema which subsided over a period of 3 weeks. Genital hygiene had significantly improved in all the patients as a result of uninterrupted urinary stream.</p><p><strong>Conclusion: </strong>Retrograde progression of the inner preputial skin may be used as an effective technique to provide skin coverage to the penile shaft for reconstruction of congenital buried penis. It provides good functional and cosmetic results with adequate parental and patient satisfaction with minimal complications.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Firearm Injuries in Children: Four-year Experience from a Rural Tertiary Care Centre of Northern India.","authors":"Amit Chaudhary, Rafey Abdul Rahman, Muniba Alim, Umesh Kumar Gupta, Survesh Kumar Gupta","doi":"10.4103/ajps.ajps_135_23","DOIUrl":"https://doi.org/10.4103/ajps.ajps_135_23","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Anterior Subscapularis Release for Adduction and Medial Rotation Shoulder Contracture in Neonatal Brachial Plexus Palsy.","authors":"Mohamed El Mahdi Boubkraoui, Hajar Rouaghi, Yassine Cherqaoui, Chafik Bjitro, Mustapha Aboumaarouf, Abdelmounim Cherqaoui","doi":"10.4103/ajps.ajps_132_23","DOIUrl":"https://doi.org/10.4103/ajps.ajps_132_23","url":null,"abstract":"<p><strong>Introduction: </strong>Adduction and medial rotation shoulder contracture are prevalent in unresolved neonatal brachial plexus palsy (NBPP). Various surgical options exist, including open anterior subscapularis release, to address this condition. This study assessed the outcomes of this procedure.</p><p><strong>Materials and methods: </strong>This cross-sectional, observational study focused on a cohort of children aged over 12 months who underwent open anterior subscapularis release to remedy residual shoulder contracture from upper or global NBPP over 11 years. The Mallet score was utilised to appraise deficits in shoulder function.</p><p><strong>Results: </strong>The study included 32 patients. The sex ratio was 0.78. The median age at surgery was 36 months (25; 56). The right side was affected in 75% of cases. The median improvement in the Mallet score after subscapularis release was 4 (2; 6). This enhancement was statistically significant (P < 0.001), with a median follow-up duration of 78 months (72; 82). There was a substantial increase in shoulder abduction (P < 0.001) and lateral rotation (P < 0.001). Hand-to-mouth (P < 0.001) and hand-to-head (P < 0.001) manoeuvres exhibited significant enhancement. The hand-to-spine manoeuvre did not show a substantial alteration. A significant correlation was found between the injury severity and the enhancement of the Mallet score post-surgery (P = 0.009).</p><p><strong>Conclusion: </strong>Open anterior subscapularis release yielded significant mid-term functional enhancements in shoulder motion, with no modification in medial rotation. Improvements were observed even in children beyond 4 years of age, with those having more severe injuries showing greater functional recovery.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Interstitial Cells of Cajal in Congenital Ureteropelvic Junction Obstruction.","authors":"Sanjib Kumar Meher, Pradeep Kumar Jena, Prasanta Kumar Tripathy, Lity Mohanty, Pramod Kumar Mohanty, Kaumudee Pattnaik","doi":"10.4103/ajps.ajps_68_23","DOIUrl":"10.4103/ajps.ajps_68_23","url":null,"abstract":"<p><strong>Background: </strong>Although congenital ureteropelvic junction (UPJ) obstruction is the most common cause of neonatal hydronephrosis, aetiopathogenesis is still inconclusive. Recently, the paucity of interstitial cells of Cajal (ICC) at the narrow adynamic part of UPJ has been implicated as a causative factor.</p><p><strong>Materials and methods: </strong>This prospective study was conducted between October 2019 and March 2022 to find out the density of ICC by the immunohistochemical method using CD117 (c-kit) antibody, in resected segments of UPJ in obstruction patients and in renal tumour patients as control. ICC/high power field (hpf) was also studied from the margins of the resected segment in the obstruction group. The pre-operative and post-operative sonographic and renal scintigraphic features were compared.</p><p><strong>Results: </strong>The median age of patients in the study group (n = 25) was 36 months and in the control group was 39 months. The mean ICC/hpf at the stenotic part of UPJ in the study group was 3.56 ± 1.26 and in the control group was 12.56 ± 1.89 (P = 0.0001). ICC density from the proximal and distal margins of the resected segment was 11.12 ± 2.12 and 11.68 ± 1.62, respectively (P < 0.001). The post-operative antero-posterior diameter of the renal pelvis and differential renal function showed significant improvement in comparison to the pre-operative value (P = 0.0045 and 0.0005, respectively).</p><p><strong>Conclusions: </strong>The significant decrease in the density of ICC at the stenotic part of UPJ compared to controls suggests a pacemaker role of these cells in ureteral peristalsis and the aetiopathogenesis of UPJ obstruction. Histopathological analysis of ICC should not only be limited to the stenotic part of UPJ but also should focus on the anastomosed ends of the ureter, which reflects post-pyeloplasty outcome.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patent Urachus with Patent Vitellointestinal Duct: A Rare Simultaneous Occurrence.","authors":"Shreyas Dudhani, Keerthana Bachagala, Bijay Kumar Suman, Rashi Rashi, Amit Kumar Sinha","doi":"10.4103/ajps.ajps_78_23","DOIUrl":"10.4103/ajps.ajps_78_23","url":null,"abstract":"<p><strong>Abstract: </strong>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.</p>","PeriodicalId":72123,"journal":{"name":"African journal of paediatric surgery : AJPS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}