Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

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: Databases were systematically searched using keywords ((mean platelet volume) OR mpv) AND (appendicitis). The inclusion criteria were all comparative studies of MPV in children aged less than 18 years and diagnosed with AA. Two authors independently assessed the methodological quality using the Downs and Black scale.Results: We included fourteen studies in the final meta-analysis; most were retrospective. Eight studies compared the MPV values between AA and non-AA; four studies compared the same between AA and healthy controls; two studies compared the MPV values among all three groups. The estimated heterogeneity among the studies for all outcomes was high and statistically significant. The pooling the data showed no statistically significant difference in MPV (weighted mean difference (WMD) = -0.42, 95% CI = (-1.04, 0.20), p = 0.19) between AA and healthy controls or AA and non-AA cases (WMD = 0.01, 95% CI = (-0.15, 0.17), p = 0.90).Conclusion: While MPV levels seem to have some utility in adult AA diagnosis, MPV levels should not dictate treatment options in pediatric AA.</p

Bibliometric analysis of pediatric glaucoma

Purpose: The research activity in pediatric glaucoma (PG) was qualitatively and quantitatively evaluated using a scientometric approach. Methods: The “Web of Science” database was accessed for primary bibliometric data regarding PG using search terms “pediatric glaucoma,” “paediatric glaucoma,” “congenital glaucoma,” and “childhood glaucoma.” The data was analyzed for total research productivity, citations, and scientific output in terms of journals, countries, institutions, and authors. The results were further characterized for coauthorship links and visualized by VOS viewer software. Also, the top 25 cited articles were reviewed with the above bibliometric characteristics. Results: One thousand two hundred and sixty-nine items were obtained from our search query from 1955 to 2022; these received 15,485 citations, originated from 78 countries. The top-3 contributing countries were the United States of America (n = 369), India (n = 134), and China (n = 127). LV Prasad Eye Institute (n = 58), Duke University (n = 44), and King Khalid Eye Specialist Hospital (n = 42) were the top-3 productive institutes. The top-3 prolific authors were Mandal AK (n = 53), Freedman, SF (n = 36), and Sarfarazi, M (n = 33). Journal wise, “Investigative Ophthalmology” (n = 187), “Journal of Glaucoma” (n = 92), and “Journal of AAPOS” (n = 68) were the journals in which the most articles were published. The top-25 cited documents received 3564 citations and were published between 1977 and 2016. The key areas of interest were basic sciences (genetics of childhood glaucoma) and surgical management. Conclusion: United States of America, LVPEI, Mandal AK, and “Investigative Ophthalmology” were the top rankers as far as the productivity and publications related to PG are concerned. Articles on molecular genetics in PG have received interest among the ophthalmology community

Transverse testicular ectopia with a blind ending vas deferens

Transverse testicular ectopia (TTE) is an uncommon anomaly of testicular descent. Herein, we describe a case of TTE with blindly ending vas and persistent Mόllerian duct syndrome in a 2-year-old child. Orchidopexy could be done through the normal orthotopic route after separating it from the Mόllerian structure and dividing the peritoneal fold just distal to the blindly ending vas. The report highlights that laparoscopy is useful for identifying subtle anomalies in addition to its therapeutic role

Use of pre and intra-operative bronchoscopy in management of bronchial injury following blunt chest trauma

Blunt chest trauma resulting in right bronchial tear in an 8-year-old girl is reported. Use of bronchoscopy in the management of such an injury is highlighted

Congenital diaphragmatic hernia with recurrent gastric volvulus and pulmonary sequestration: A "chance" combination

Congenital diaphragmatic hernia (CDH) is a known cause of secondary gastric volvulus. It is also known that bronchopulmonary sequestration (BPS) may be associated with CDH. An extremely rare case of BPS associated with gastric volvulus in a girl with left sided CDH is being reported

Comparison of anatomical landmarks and dimensions in a hypospadiac glans with those of a normal glans

Aim of the Study: The aim of this study is to establish ventral glans length (VGL), meatus (M) size, and their ratio VGL/M (R) in normal Indian boys and to compare these with the respective equivalent dimensions in boys with distal and mid-penile hypospadias using anatomic landmarks. Methods: Normal boys were designated as Group A (n = 108), and the boys with hypospadias were designated as Group B (n = 81). The anatomical landmarks marked on the glans were measured using a digital camera and appropriate software. Results: The mean age of the boys in Groups A and B was 4.26 ± 3.59 (range 0.5–12) and 3.82 ± 2.85 (0.7–11) years, respectively. The observed mean values in Group A for VGL-A, M-A, and R-A were 3.05 ± 1.27 (range 1.19–8.09), 4.3 ± 1.23 (range 1.61–7.04), and 0.8 ± 0.45 (range 0.27–2.1) mm, respectively. The observed mean values in Group B for VGL-B, M-B, and R-B were 3.77 ± 0.81 (range 12.41–5.2), 3.27 ± 0.71 (range 2.25–5.34), and 1.17 ± 0.26 (range 0.84–1.86) mm, respectively. Comparison of R-A and R-B showed a statistically significant difference (P < 0.0001). Conclusions: The dimensions and the studied ratio between a hypospadiac glans and a normal glans differed significantly. The ratio between VGL and M was 0.8 in normal boys. In comparison, the ratio between the equivalent VGL and M in the hypospadiac boys was 1.17. During glansplasty in surgery for hypospadias, this factor should be taken into consideration to avoid the creation of long and tight ventral glans closure

Whipple's pancreaticoduodenectomy in pediatric patients: An experience from a tertiary care center

Purpose: Whipple's pancreaticoduodenectomy (WPD) is rarely required in children. However, WPD is the only option with pathologies involving the head of the pancreas requiring surgical excision. The objective of our study was to review our experience with WPD performed on children. Materials and Methods: A retrospective analysis of case records was conducted on all patients <18 years of age, who underwent WPD at our center over the last 20 years. Data regarding demographics, signs, and symptoms at presentation, diagnostic imaging and procedures, pathologic reports, surgical and medical treatment, and follow-up were collected to study the indications and safety and outcomes of WPD in children. Results: Five patients had been planned for a WPD during the study (1995–2015); but in one patient, the procedure was abandoned, the rest four patients formed the study group. Male to female ratio was 3:1. Median age at the time of surgery was 9 years (11 months–12 years). The most common presentation was obstructive jaundice (50%, 2/4). Radiological imaging was able to accurately predict the surgical procedure required in all except one case. The mean operating time was 205 min (180–240 min). There were no intraoperative complications. The mean intraoperative blood loss was 85 mL (20–150 mL). The youngest patient requiring WPD was an 11-month-old child. Oral feeding was established by the 7th postoperative day (range 5–7 days) in all cases. There were no cases of anastomotic leak or pancreatic or jejunal fistulae. One patient developed features of subacute intestinal obstruction after discharge and required re-exploration. There was no intra- or post-operative mortality. Conclusion: WPD is safe and efficacious procedure in a selected group of children. The overall efficacy of surgical treatment combined with the relatively low severity of complications leads us to recommend WPD in children when indicated

Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

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: Databases were systematically searched using keywords ((mean platelet volume) OR mpv) AND (appendicitis). The inclusion criteria were all comparative studies of MPV in children aged less than 18 years and diagnosed with AA. Two authors independently assessed the methodological quality using the Downs and Black scale. Results: We included fourteen studies in the final meta-analysis; most were retrospective. Eight studies compared the MPV values between AA and non-AA; four studies compared the same between AA and healthy controls; two studies compared the MPV values among all three groups. The estimated heterogeneity among the studies for all outcomes was high and statistically significant. The pooling the data showed no statistically significant difference in MPV (weighted mean difference (WMD) = −0.42, 95% CI = (−1.04, 0.20), p = 0.19) between AA and healthy controls or AA and non-AA cases (WMD = 0.01, 95% CI = (−0.15, 0.17), p = 0.90). Conclusion: While MPV levels seem to have some utility in adult AA diagnosis, MPV levels should not dictate treatment options in pediatric AA

Giant renal Angiomyolipoma masquerading as a Wilms tumor

Renal Angiomyolipoma (AML) is not commonly seen in the pediatric age group other than patients of tuberous sclerosis where in they can have renal AMLs within the first decade with bilateral in involvement. Diagnosis of renal AML can generally be made by the current radiological modalities in the appropriate clinical setting, but it can be mistaken for other tumors when it is large and has low-fat content. Herein we report a case of giant renal AML that was initially misdiagnosed as a Wilms tumor in a 12-year-old girl