Bladder wall elasticity in neurogenic bladder: Insights from shear wave ultrasound elastography and its correlation with functional and structural parameters of upper and lower urinary tract.

Introduction: Children with neurogenic bladder (NB) exhibit increased bladder-wall stiffness, yet non-invasive tools to quantify this remain limited. In this study, we assessed whether shear-wave elastography (SWE) distinguishes NB from healthy bladder and explored its relationship with routine upper- and lower-tract investigations.

Methods: In this prospective single-centre study, children with NB and age-matched controls underwent bladder SWE.

Serum matrix metalloproteinase-7 (MMP-7) as a Biomarker for differentiating biliary atresia from neonatal hepatitis: evidence synthesis through systematic review and meta-analysis.

Purpose: Biliary atresia (BA) requires timely differentiation from neonatal hepatitis (NH) and early surgery for optimal outcomes. This systematic review and meta-analysis evaluated the diagnostic performance of serum Matrix metalloproteinase-7 (MMP-7) as a biomarker for differentiating BA from NH.

Methods: The PRISMA-DTA compliant synthesis was based upon primary data available till date, assessing the role of MMP-7 in diagnosing BA.

Easing Parental Worries: A Systematic Review and Network Meta-analysis on Preoperative Education Methods for Reducing Anxiety in Parents of Children Undergoing Surgery.

Parental anxiety during the time leading up to a child's surgery is a major concern. One approach that's gained attention for helping ease this stress is preoperative education, but there's still no clear agreement on which type of educational method works best. This review looked into a range of educational strategies to find out which ones are most effective at lowering anxiety in parents.

Novel CTNNB1 gene mutations reveal critical pathogenic mechanisms in pediatric hepatoblastoma.

Background: Hepatoblastoma (HB) is the most common primary malignant liver tumor in children, with alterations in the Wnt/β-catenin signaling pathway implicated in up to 90% of cases. The CTNNB1, which codes for β-catenin protein, plays a crucial role in this pathway, but its mutation landscape across diverse populations requires further investigation.

Objectives: To analyse and characterize the genetic variations in the CTNNB1 across three geographically diverse cohorts of hepatoblastoma patients and understand their potential pathogenic mechanisms.

Comparison of Microvessel Density and Growth Factor Levels Between Inner and Outer Prepuce in Distal Hypospadias.

Objective: Preputial flaps are frequently used in hypospadias repair, but the healing potential of preputial tissue remains a concern. This study aimed to evaluate the microvessel density (MVD) and growth factor receptor levels (VEGFR and TGF-!R) in the prepuce of patients with hypospadias compared to controls and to compare these parameters between the inner and outer preputial layers to determine their relative suitability for hypospadias repair. Methods: The study included children under 14 years of age undergoing primary distal hypospadias surgery as cases and individuals undergoing elective circumcision as controls.

Short-term Surgical Outcomes after Laparoscopic Excision of Choledochal Cyst and Roux-en-Y Hepaticojejunostomy in Children.

Background: Despite being a technically demanding procedure, the laparoscopic approach for choledochal cyst excision (LEC) has gained popularity in the last two decades. We conducted a study to evaluate the outcomes of the initial cohort of LEC and Roux-en-Y hepaticojejunostomy performed at our center.

Subjects And Methods: A retrospective observational study was conducted.

Type VI Choledochal Cyst and the Anomalous Pancreaticobiliary Junction: A Systematic Review.

Background: The type VI choledochal cyst of the cystic duct (CC-CD) is not only a taxonomical conundrum but also a matter of research in terms of its etiopathogenesis and optimal therapeutic options. The role of anomalous pancreaticobiliary junction (PBJ) and pancreatic juice regurgitation in the etiopathogenesis of CC-CD and its association with biliary malignancies has not been elucidated yet.

Objective: To evaluate the role of anomalous PBJ in the etiopathogenesis of CC-CD and generate a scientific opinion through a systematic review of the literature.

Chromosomal Microarray Analysis in Spina Bifida: Genetic Heterogeneity and Its Clinical Implications.

Background: The etiology of spina bifida is multifactorial; the phenotype is the end result of both genetic and environmental influences. While whole exome sequencing has identified several pathogenic variants in Indian cohorts, the role of chromosomal imbalances and long contiguous stretches of homozygosity (LCSHs) remains largely unexplored in this population. Chromosomal microarray analysis (CMA) is an important tool that provides insights into such genetic aberrations, making it significant for evaluating patients with spina bifida.

Harnessing Indocyanine Green Fluorescence for Checking Intraoperative Patency of Splenorenal Shunt for Extrahepatic Portal Venous Obstruction.

This case report discusses intraoperative indocyanine green (ICG) fluorescence angiography to confirm the patency of a proximal splenorenal shunt in an 11-year-old patient with extrahepatic portal venous obstruction. The patient, managed previously with endoscopic sclerotherapy and propranolol, experienced recurrent gastrointestinal bleeding, necessitating surgical intervention. A proximal splenorenal shunt was created following splenectomy, and portal pressures dropped significantly from 33 to 14 mmHg postshunt creation.

Unveiling the Unexpected: An Intriguing Case of Neonatal Nocardial Pneumonia.

Nocardial infections in neonates are exceptionally rare, posing significant diagnostic challenges due to their atypical presentations and the rarity of such cases. This case report delves into a unique instance of nocardial pneumonia in a neonate, initially misdiagnosed due to its unconventional clinical presentation and the absence of traditional risk factors for opportunistic infections. The neonate exhibited worsening respiratory distress, misleadingly suggestive of more common neonatal conditions or congenital anomalies such as an infected congenital pulmonary airway malformation, as per radiological imaging and initial clinical assessments.

Challenges in Managing Closed Gastroschisis: Addressing a Rare and Complex Variant of Abdominal Wall Defect.

Background: In closed gastroschisis, the initial herniation of the intestines through the abdominal wall defect subsequently leads to spontaneous closure of the defect during fetal development, even before the migration of the intestines back to the abdominal domain.

Materials And Methods: This study investigates the clinical presentation, diagnostic challenges, and management strategies of closed gastroschisis through a retrospective review of six cases presented at our clinic between 2009 and 2024. Data were prospectively collected and analyzed to gain insights into the varied presentations and outcomes of this rare condition.

Genetic Markers of Spina Bifida: Enrichment of Pathogenic Variants and Variants of Uncertain Significance.

Introduction: The genetic diversity of the population in India, shaped by its unique history of migrations and varied ethnic landscape, suggests the possibility of genetic profiles distinct from the western populations.

Objective: The objective is to investigate the genetic basis of spina bifida in the Indian cohort through whole-exome sequencing and pathway enrichment.

Methods: The variants of uncertain significance (VUS) of spina bifida were identified through whole-exome sequencing in the study cohort ( = 3).

Reference Standards for Stretched Penile Length in Indian Boys.

Introduction: Stretched penile length (SPL) is a vital anthropometric measurement for providing diagnostic, therapeutic, and prognostic information. SPL variations can indicate congenital anomalies or systemic disorders and are influenced by genetic, ethnic, and environmental factors. Despite its clinical importance, comprehensive age-stratified reference data for SPL in Indian children are lacking.

Comprehensive Analysis of Pediatric Mesenteric Cysts with Clinical Presentation, Diagnostic Challenges, Surgical Management, and Outcome.

Background: Mesenteric cysts are rare, benign abdominal tumors that pose diagnostic challenges due to their nonspecific symptoms. Their etiology is diverse, with congenital, lymphatic, and inflammatory origins proposed. Clinical presentation often includes abdominal pain, mass, or incidental findings.

Laparoscopic Management of Congenital Intrathoracic Stomach.

This case report describes a rare presentation of a congenital intrathoracic stomach (CIS) managed successfully through laparoscopic surgery in an 11-month-old girl. The condition was complicated by symptoms of vomiting and failure to thrive. Imaging confirmed significant intrathoracic displacement of the stomach, necessitating prompt surgical intervention.

Umbilical morphometry and centile curves in boys aged 1-14 years: Establishing reference values for umbilical reconstruction.

Unlabelled: Umbilicoplasty is essential for the reconstruction of congenital malformations such as bladder-exstrophy-epispadias complex and gastroschisis. Reference values for umbilical morphometry are critical for anatomically acceptable outcomes.

Objective: To measure vertical height and width of the umbilicus in male participants aged 1-14 years and generate age-specific centile curves for umbilical reconstruction.

Enhanced slope stability prediction using ensemble machine learning techniques.

The accurate prediction of slope stability is a challenging research endeavor, particularly in real-world environments. This study presents a machine learning (ML) model for evaluating slope stability that meets high precision and speed criteria in slope engineering. The goal of this study is to build an ensemble machine learning model that can accurately predict slope stability from both a classification and a regression point of view.

Mapping the serum testosterone landscape in boys aged 1-14 years: A population-based study.

Unlabelled: Testosterone plays a vital role in the development of boys. There is a lack of age-specific reference data for testosterone representing a gap in our abilities to differentiate physiological deviations from pathological conditions such as delayed or precocious puberty, anatomical aberrations such as hypospadias or epispadias, micro-penis or buried-penis and disorders of sex development.

Objective: To establish age-specific reference values for serum testosterone in boys aged 1-14 years and generate centile curves to predict testosterone levels by age.

Urethral duplication with five openings in anal canal: A novel case report.

Urethral duplication is a rare congenital anomaly characterized by more than one urethral channel, with varied course, location of the external opening, and presentation. Presentations can be varied, depending upon individual anatomical dispensation but mostly present as obstruction, recurrent urinary infection, or double urinary stream. Treatment depends on the type of duplication and associated anomalies.

KMT2C Polymorphism in Familial Hypospadias.

Hypospadias, a common congenital anomaly of male genitalia, shows significant heritability and familial recurrence, particularly in consanguineous families. This study explored the role of KMT2C polymorphisms in a Yemeni family with two affected siblings. Comprehensive analysis identified 475 unique SNPs in KMT2C, with 59 shared between parents, suggesting common ancestry.

Complicated foregut duplication cyst presenting as broncho-oesophageal fistula.

Oesophageal duplication cysts are a subtype of foregut cysts, associated with the presence of ectopic gastric mucosa. Gastric acid secreted by this mucosa can lead to complications. We report one such unusual case of complication leading to the formation of broncho-oesophageal fistula in a duplication cyst.

Evaluation of topical 1% posaconazole therapy in refractory fungal keratitis.

Purpose: The primary objective was to evaluate the clinical response of refractory cases of fungal keratitis to topical 1% posaconazole therapy.

Methods: Prospective longitudinal non-randomized open label dual-cohort study of 70 eyes of refractory fungal keratitis, 35 were recruited as posaconazole treatment (PCZ) group for topical 1% posaconazole therapy and compared to 35 eyes on conventional antifungal therapy. Study parameters included demographic and treatment details, visual acuity, comprehensive slit-lamp biomicroscopy, clinical photography, ASOCT at recruitment and weekly (week 1, 2, 3 and 4 after treatment initiation).

Measuring up: Ensuring Intra- and Interobserver Reliability in Stretched Penile Length with the SPLINT Technique.

Background: A discrepancy between the true and measured value of stretched penile length (SPL) may be a result of errors that can either be systematic or random. Hence, it becomes important to focus on the quality of measurements to prevent any iatrogenic harm to the patients.

Objective: The objective of this study was to assess the magnitude of intra- and interobserver variations in the measurement of SPL with the SPLINT technique.