Minu Bajpai

• All India Institute of Medical Sciences

Cloacal exstrophy is a rare condition, in the spectrum of the exstrophy–epispadias complex. There is an exposed bladder and cecal plate with prolapsed ileocecal junction and an omphalocele. The pubic bone is widely separated, which leads to the clitoris and phallus being spaced apart, creating challenges in its reconstruction. It is known to be ass...

Objective Many neonatal units have started using Chlorhexidine gluconate for neonatal skin antisepsis. However, there is in-vitro evidence of inhibition of neurite growth. The current study aimed to compare two methods of its local application, for the extent of systemic absorption and antiseptic efficacy. Study design Parallel group, blinded, ran...

A BSTRACT During face mask ventilation, invariably, some air enters the esophagus rather than the airways; this results in gastric insufflation while the esophagus is intact or loss of tidal volume in patients with a cervical esophagostomy (Cx-esophagostomy). Objective The objective of the study was to report the indigenous use of an electrocardio...

Isolated liver lobe devascularization is a very rare case, with conflicting literature regarding management. We describe a very unusual case of traumatic isolated right lobe devascularization of the liver with its attendant management challenges. An eight-year-old boy with a history of road traffic accidents presented with abdominal pain. Although...

Objective To summarize the available evidence and to quantitatively evaluate the global results of different waterproofing layers in substantiating the UCF repair. Material and methods After defining the study protocol, the review was conducted according to the PRISMA guidelines by a team comprising experts in hypospadiology, systematic reviews an...

Objective A systematic review and meta-analysis of the studies evaluating the utility of the Testicular Work-up for Ischemia and Suspected Torsion (TWIST) score in establishing or excluding the diagnosis of testicular torsion (TT) is herewith presented in an attempt to quantify the available evidence. Methods The study protocol was outlined in adv...

Background Urinary NGAL (neutrophil gelatinase-associated lipocalin) levels have been shown to predict renal damage in various medical conditions. The present study was conducted to study the role of urinary NGAL levels in children with bladder exstrophy–epispadias complex post single-stage total reconstruction (SSTR) as markers of early renal func...

Anorectal malformations (ARMs) encompass a complex spectrum of congenital anomalies and H/N type anorectal malformations are extremely rare. In the presence of colostomy, an augmented pressure colostogram with or without retrograde or micturating cystourethrogram is the investigation of choice. Transperineal ultrasound is an imaging technique that...

Objectives: The aim of our study was to describe the scintigraphic patterns of 99mTc-pertechnetate uptake in patients who were referred to the department of nuclear medicine for evaluating and diagnosing ectopic gastric mucosa in foregut and midgut duplication cysts. Materials and methods: This hospital-based, retrospective cum prospective resea...

Background: In this study, we aim to review the outcomes of children with Wilms tumor (WT) operated through the minimally invasive surgery (MIS) approach at our center. We also intend to highlight essential surgical steps during laparoscopic excision of large WTs. Methods: This retrospective study included children with unilateral WT who had underg...

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are a common cause of end-stage renal disease in children. While certain nephrogenic genes have been incriminated in these malformations, data to identify the frequency of gene polymorphisms in Asian Indian children with CAKUT are scarce. This study was done to identify the ef...

Background and Objectives: While laparoscopic appendectomy is standardized, techniques for appendiceal stump closure and mesoappendix division remain variable. Novel vessel sealing techniques are increasingly utilized ubiquitously. We sought to systematically summarize all relevant data and to define the current evidence on the safety and utility o...

Gastric surface mucosal cells are responsible for the uptake and secretion of 99mTcO4, a feature that has been used in imaging heterotopic gastric mucosa. We used the same principle to look for gastric mucosal viability in this case of pure esophageal atresia admitted for cervical stomal closure after a previous isoperistaltic gastric tube (IGT) re...

Background The Indian Council of Medical Research (ICMR) played a crucial role in streamlining testing and diagnosis, formulating guidelines, and devising management strategies during the COVID-19 pandemic. Additionally, ICMR designed and developed a comprehensive data management tool for collecting testing data in a standardized format from all la...

Several substitutes, including gastric transposition, colonic interposition, reverse gastric tube (RGT), etc., have been described for esophageal replacement in children and adolescents. However, the search for the ideal esophageal substitute continues due to adverse events associated with these procedures. This report presents our technique for cr...

Aim: The aim of our study is to present our experience in the management and outcome of Wilms tumor with intracaval thrombus. Materials and methods: All children with Wilms tumor with intracaval thrombus who presented to us from July 2000 to December 2017 were reviewed retrospectively. We evaluated the tumor stage, management, and outcomes in th...

Purpose To systematically summarize all relevant data and to define the current evidence on the utility of Pentraxin-3 (PTX3) as a biomarker for acute appendicitis (AA) in children. Methods This review was conducted in accordance with the PRISMA guidelines. PubMed, Embase, Scopus, and Web of Science databases were systematically searched for studi...

Background: Acute appendicitis in the pediatric population remains a diagnostic challenge for clinicians. Despite many biochemical markers, imaging modalities and scoring systems, initial misdiagnosis and complication rates are high in children. This suggests the need for investigations directed towards new diagnostic tools to aid in the diagnosis....

Background: Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects. Aims: We aimed to evaluate dura-to-cord (DTC) distance from computerized tomography (CT) images of thoracolumbar spine in pediatric age group...

Background: Mean Platelet Volume (MPV) has been suggested as a biomarker for acute appendicitis (AA) in the adult population. The utility of MPV in pediatric AA remains vague. This systematic review and meta-analysis aimed to systematically summarize and compare all relevant data on MPV as a diagnostic biomarker for AA in children. Methods: Databas...

Purpose The choice of Esophageal replacement (ER) depends on surgeons’ preference and patients’ anatomical condition. A cross-sectional study was done to compare the long-term outcomes of two methods of ER, Gastric transposition (GT) and Colonic interposition (CI). Methods Children who had undergone ER from January 1997 to December 2017 with a min...

Objective: The aim of this study was to evaluate the outcomes of single-stage transvestibular and Foley’s assisted epispadias repair (STAFER) technique in girls with incontinent epispadias. Methods: The records of all girls who had undergone epispadias repair and bladder neck plication via the STAFER technique over a four-year study period (January...

Background: Differentiation of neonatal cholestasis into neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA) is essential to formulate the treatment plan; promptness is indispensable for optimal outcomes. The clinical and nonoperative algorithms lack precision; the gold standard investigations (liver biopsy or per-operative cholangiogr...

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 record...

Lipoblastoma is a rare benign mesenchymal tumour derived from embryonic white fat tissue. Lipoblastoma generally occurs in children less than 3 years of age, and fewer than 200 cases have been reported in the English literature. There are hardly a dozen reports describing intrathoracic and thoracic involvement. We report a case of a 7-year-old boy...

Background: Patients with asymptomatic prenatally diagnosed hydronephrosis may progress to needing surgery; no biomarker supporting the identification of these cases is currently available. The aim of the study was to assess the role of Plasma Renin Activity (PRA) as a discriminatory factor to identify patients with asymptomatic prenatally diagnos...

Introduction: The extraction of smooth spherical objects is challenging as they are difficult to grasp within the jaws of the forceps and tend to slip distally. Objective: The authors herein have shared their experience with the use of a Fogarty catheter (FC) for safe extraction of smooth and spherical “foreign body (FB) with a hole.” Materials and...

Asopa used the transverse preputial skin as a single-stage correction of proximal hypospadias based on the superficial dorsal vessels of the penis. To avoid torsion, Asopa described the double-faced preputial island flap. Here, he used the adjacent skin flap covering the mucosal flap of the neourethra. Both flaps are based on the superficial dorsal...

Background: The available endoscopic techniques for ureterocele decompression include laser puncture (LP), electrosurgical incision (ES), and cold-knife incision. This systematic review was performed to compare the efficacy of LP versus ES techniques with special emphasis on de novo VUR. Methods: Four databases were systematically searched by the a...

Choledochal cyst of the cystic duct is a rare anomaly; broadly classified, the pathology may either present as a solitary anomaly or with concomitant involvement of other parts of the biliary tree. In the absence of standard guidelines for surgical planning, the definitive management is based on the experience shared in the literature in the form o...

The rarity, diverse clinical presentation, relatively featureless sonography, and diagnostic dilemma associated with pilomatrixomas may trigger anxiety and call for unwarranted investigations. The authors have shared their experience in two consecutive cases to generate awareness for such lesions.

Objective. This systematic review and meta-analysis aimed to define the current evidence and systematically summarize the relevant data regarding the utility and safety of hyperbaric oxygen therapy (HBOT) as an adjunctive treatment in complicated re-operative cases of hypospadias. Method. The authors systematically searched the PubMed, EMBASE, Web...

Background: Haemangiomas are a source of concern to the parents. It has long been advised to plan a conservative management and counsel the attendants in various literatures owing to the spontaneous regression in these cases. We tried to find out the role of conservative management in our setup. The objective of this study was to assess the effect...

Pediatric handlebar injuries are a separate subset of unintentional injuries that need to be treated with a high degree of suspicion. They can be associated with varying underlying injuries which are often underestimated and cannot be predicted based on the external sign alone, thus leading to delayed diagnosis with missed injuries. In case 1, a 7-...

Isolated renal mucormycosis is rare in children. A case of 3-month-old infant presenting with right-sided flank lump and fever is being reported. Investigations revealed a nonfunctioning right kidney with intrarenal abscesses and a low percent-frequency of T-cells. He made an uneventful recovery following surgery and systemic antifungal therapy. Co...

Ectopic scrotum is a rare form of congenital scrotal anomaly that is rarely encountered in pediatric surgical practice. Herein, we report an infant with a unilateral ectopic suprainguinal scrotum associated with undescended testis and multicystic dysplastic kidney. The case is reported in view of rarity of this anomaly in the general pediatric popu...

Pyoscrotum is rarely encountered in neonates and is secondary to a local pathology such as neglected torsion or epididymo-orchitis. Pyoscrotum from an intra-abdominal pathology is possible in the presence of a patent processus vaginalis and has been rarely reported in the context of acute appendicitis. We report our experience with a case of antena...

Esophageal atresia-tracheoesophageal fistula (EA-TEF) is one of the common congenital anomalies occurring in newborns. Over the last eight decades, various technical modifications have been proposed in the surgical repair of EA-TEF. Preservation of azygos vein is one such modification that has gained considerable attention. However, a consensus sta...

Background This cross-sectional study aimed to determine the influence of genetic polymorphism in two renin-angiotensin system (RAS)-candidate genes on urinary trefoil family factor 3 (TFF3) levels in children with congenital anomalies of kidney and urinary tract (CAKUT).Methods The study included fifty children with CAKUT (PUV, VUR, and PUJO) and...

Background A significant proportion of children require multiple surgeries for successful repair of hypospadias. This is not only a source of a financial burden to the family but also causes long-term social and psychosexual issues. Tissue sealant application can provide additional coverage to the suture line and subsequently prevents operative fai...

Objective To evaluate whether 1% aqueous chlorhexidine gluconate (CHG) when compared with 2% aqueous chlorhexidine gluconate is non-inferior for neonatal skin antisepsis. Design Parallel, blinded, non-inferiority randomised trial. Setting Level III, academic, neonatal intensive care unit. Patients Infants born at 26 0/7 to 42 6/7 weeks of gestat...

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.

Objectives Accurate delineation of anatomy in children with ambiguous genitalia early in life is important. This commonly involves conventional fluoroscopic genitogram (traumatic to the child) and magnetic resonance imaging (MRI) examination (involves sedation). In this study, our objectives were twofold: (1) to describe the findings on transperine...

Aim: The objective was to identify, analyze, and categorize the characteristics (the type of article, country of origin, institution, authorship, topic, and the number of citations) of the articles published in the Journal of Indian Association of Pediatric Surgeons (JIAPS) from 2008 to 2017, with particular focus on the top ten-cited articles. Mat...

Background Children with congenital anomalies of kidney and urinary tract (CAKUT) are at high risk of progressive deterioration of kidney function and further developing stage 5 chronic kidney disease (CKD 5), even after a successful surgery. This prospective study was designed to determine whether urinary biomarkers can predict progressive deterio...

Background Orchiopexy for cryptorchidism is one of the common day-care surgeries performed by pediatric surgeons across the globe. Although majority of the surgeons reposition the testis into a sub-dartos pouch, the practice of taking an additional transparenchymal anchoring suture is often debated. The potential risks include impaired spermatogene...

PurposeThe safety of laparoscopic management of pediatric intra-abdominal tumors is often questioned. We analysed our ongoing experience with intra-abdominal tumors managed laparoscopically at our institute from July 2013 onwards.Methods Total 21 children (12 males, 9 females) who presented to us with pediatric intra-abdominal tumors were included....

Context: Stage IV Wilms tumor is associated with poor prognosis, and recent changes in management have been suggested based on genetic markers and response to chemotherapy in this subgroup of patients. Objective: The objective was to evaluate the outcomes of children with Stage IV Wilms tumor who were managed with the AIIMS-WT-99 protocol. Mate...

Segmental ileal dilatation is an uncommon cause of neonatal intestinal obstruction. This report highlights a rare combination of abnormal distribution of muscles in the muscularis propria and partial loss of interstitial cells of Cajal as causative factors for segmental intestinal dilatation.

The last century has witnessed unmatched advances in understanding of disease processes, surgical skills, and medical technology thereby enhancing our ability to add years to life. However, these advances have introduced newer subsets of problems; infectious complications related to therapeutic interventions being the most prominent amongst them. T...

Chylous ascites is a rare but well-known complication following surgeries involving extensive dissection of the retroperitoneal structures. It is noticed in children primarily after oncological resections. Meanwhile, conservative treatment is paramount in its management; refractory cases generally require an aggressive approach. A rare case of refr...

Background: The use of animal models for biomedical research provides us with a convenient and feasible route to establish causal relationships by recapitulating the temporal sequence of events in a controlled environment with a potential to manipulate the variables at multiple levels including genetic, protein, physiological or environmental. Obje...

Isolated asternia is a rare congenital anomaly. Management of the defect is challenging. A rare case of isolated asternia in a newborn is being reported.

Introduction: Pelvi-ureteric junction obstruction (PUJO) is one of the most common conditions presenting to a pediatric urologist. As laparoscopic or robotic-assisted pyeloplasty, either transperitoneal or retroperitoneal, involves intracorporeal suturing skills and has a long learning curve, they have not gained popularity among beginners in lapar...

Introduction: Craniosynostosis (CS) syndrome is an autosomal dominant condition (ADC) classically combining with CS and nonsyndromic CS (NSCS) including digital anomalies of the hands and feet. The majority of cases caused by a heterozygous mutation (HM) in the third immunoglobulin-like domain (IgIII) of fibroblast growth factor receptor (FGFR) 2...

Utility of Involvement of Custom-Designed Smartphone Application and other modes of Digital Technology in the Organization of National Conference of Pediatric Surgery

Puestow Procedure in Chronic Pancreatitis – An Institutional Experience

A search on PubMed and Web of Science revealed scarcity of the literature on anomalies of hepatic artery or portal vein and the presence of arterioportal fistula in biliary atresia; although, it has long-lasting implications for both the patient and the surgeon, including hepato-pancreato-biliary surgeons, pediatric surgeons (who perform Kasai's po...

Introduction: Caudal block analgesia is administered to lower the requirements of systemic and inhaled anesthetic drugs during hypospadias surgery. However, recent reports, all clustered in a short time-span have generated controversial and mutually opposing results while evaluating caudal block as an independent risk factor for urethroplasty-relat...

The treatment plan and the decision for surgery in a significant proportion of patients with pelvi-ureteric junction (PUJ) obstruction type of hydronephrosis are dependent on the findings of renal scintigraphy. We report a case of a 3.5-year-old girl with right-sided PUJ obstruction, wherein the tracer excretion into the cecum and ascending colon c...

Removal of sharp foreign bodies in the aero-digestive tract may inflict iatrogenic damage to the esophagus, trachea or other vital structures in case of impalement. We describe the ‘Kangaroo’ technique for safe and effective removal of sharp objects from the upper aero-digestive tracts. Index Case 1: 1-year old boy presented to us with an open (un)...

Aim: To assess the long-term urologic outcomes in follow-up of patients of sacrococcygeal teratoma (SCT) using urodynamic study (UDS) in addition to clinical and radiologic evaluation. Methods: A prospective study of clinical, radiological and urodynamic evaluation in patients with SCT who underwent resection between January 2002-June 2015 and w...

Congenital intestinal malrotation has a wide spectrum of presentation varying from incidental detection to recurrent episodes of benign abdominal pain to frank gastrointestinal obstruction, mid-gut volvulus, and bowel gangrene. Herein, we report the first case of congenital intestinal malrotation leading to gastric deserosalization. Intraoperative...

Chest-drain insertion is considered to be a benign procedure. A 6-year-old girl who is a known case of hyper-IgE/Job's syndrome presented to us following three episodes of fresh bleed following chest-drain insertion for the left lung abscess. The site of bleed was localized to be the ruptured pseudoaneurysm of the anterior segmental branch of the l...

Introduction: The authors present the rare yet enigmatic phenomenon of ‘pyelo-renal’ backflow. Case Presentation: An eight-month-old boy with multiple congenital anomalies underwent left Anderson-Hynes Pyeloplasty for pelvi-ureteric junction obstruction. Antegrade dye-study done through the nephrostomy revealed obstruction at the level of the pelvi...

Introduction Gastrointestinal tissue in the urinary tract results in numerous metabolic changes. This study investigates the effects of augmentation gastrocystoplasty on the height and bone mineralization in bladder exstrophy patients. Aim and Objective To analyze the long-term outcome following gastrocystoplasty in terms of height, bone mineral d...

OBJECTIVE: To provide updated information through E-counseling regarding pre-and post-conception use of oral folic acid with or without a multivitamin/micronutrient supplement. Through E-counseling prevention of neural tube defects (NTDs) and other congenital anomalies, Epilepsy and craniosynostosis (CS) will help physicians, midwives, nurses, and...

The presentation and management of two bizarre congenital cephalic curiosities at the two extremes of the clinical spectrum are discussed herewith. Case 1: presented to us as a neonate with a scalp swelling mirror-imaging her head and face. The journey from clinics to wards and to the operation theatre and to her home is introspected. Case 2: prese...

Aim: To analyze the impact of counseling on antenatal congenital surgical anomalies (ACSA). Methods: Cases presenting with ACSA for fetal counseling and those presenting in post-natal period following diagnosis of ACSA (PACSA) for surgical opinion were analyzed for spectrum, presentation and outcome. Results: 117 cases including ACSA(68);PACSA...

Background: Craniosynostosis (CS) syndrome is an autosomal dominant condition classically combining craniosynostosis and non-syndromic craniosynostosis with digital anomalies of the hands and feet. The majority of cases are caused by heterozygous mutations in the third immunoglobulin-like domain (IgIII) of FGFR2, whilst a larger number of cases ca...

Aim : To study the impact of Renin-Angiotensin system blockade in experimental acute pyelonephritis, induced by a novel surgical approach via dorsal lumbotomy incision. Materials and Methods : 45 Adult female WISTAR rats aged 8-12 weeks, underwent direct inoculation of 0.1 ml of E.coli suspension into the parenchyma of the surgically exposed kidney...