Single Stage Management of Anorectal Malformation in Male Neonates: Experience of a Tertiary Care Centre

Introduction: Anorectal malformation [ARM] can be treated either by staged procedures or by a single stage procedure. In the present study we have performed single stage surgery of ARM in male neonates. Materials and Methods: Retrospective review of cases of ARM operated over 4 years at Indira Gandhi Institute of Medical Sciences, Patna, and Bihar from January 2015 to December 2018 were undertaken. In this study we have compared the results of single stage repair of Anorectal malformation with that of staged procedures performed earlier. Fifty four patients of Anorectal malformation were operated by single stage procedure (category 1) this was compared with staged procedures (category 2). Forty three patients underwent primary PSARP (posterior sagittal anorectoplasty) and the remaining 11 primary APP (abdomino-perineal pull through) procedure. The result of these single stage procedures were compared with that of staged procedures (category 2) in which a total of 39 cases were operated from 2012 to 2014. Result: Mean post-operative hospital stay in category 1 was 11 days and 32 days in category 2. In category 1, 20 patients were analysed. In which PSARP procedure was done in 15 and in 5 patients APP procedure was performed. The Rest of the patients are in follow up. Kelly score was good to fair in 17 patients (85%) and poor in 3 (15%) patients. In category 2 it was good to fair in 28 (71.7%) cases and poor in 11 cases (28%). Conclusion: Single stage surgical repair of anorectal malformation in male neonates is reliable and can be safely performed. Early results are encouraging; however, a long term follow-up is required to get any definite conclusion

Malrotation with Distal Duodenal Necrosis in a Neonate

Malrotation with midgut volvulus often results in gangrene of midgut with relative sparing of duodenum. An extremely unusual case of Malrotation with isolated necrosis of distal duodenum is described with brief review of literature. Isolated duodenal necrosis in association with malrotation is very rare; it increases the complexity of surgery and prolongs hospital stay

Role of Nephrostomy in poorly functioning kidneys in patients with ureteropelvic junction obstruction (UPJO)

Introduction: Several studies have addressed the unique management challenges in poorly functioning kidneys of patients with ureteropelvic junction obstruction. Trial with percutaneous drainage of such kidneys as a guide to choose the type of surgical management would be a solution to this dilemma. We aimed to evaluate the role of percutaneous nephrostomy in treatment of poorly functioning kidneys in pediatric patients with UPJO.Materials and Methods: A prospective study was performed on patients with poorly functioning kidneys (split renal function<10% on renal dynamic scan) and unilateral ureteropelvic junction obstruction from August 2016 to January 2018. Ultrasound-guided nephrostomy was inserted for these patients. Data regarding the differential renal function and glomerular function rate (GFR) was collected before and after nephrostomy insertion. Decision regarding pyeloplasty or nephrectomy of the involved kidney was made based on changes seen in differential function and Glomerular filtration rate following the drainage.Results: Thirty three patients with unilateral UPJO with poorly functioning kidneys were treated during this period. Thirty patients had significant increase in differential function and glomerular filtration rate. These patients underwent pyeloplasty. In 2 patients, these parameters did not increase much and they underwent nephrectomy. One patient had an infected kidney which did not improve significantly on drainage and had to be removed. Of the 30 patients who had pyeloplasty, two developed obstruction after 3 months of removal of double-J stent and needed reoperation.Conclusion: Percutaneous nephrostomy in poorly functioning kidneys with ureteropelvic junction obstruction helps to identify potentially salvageable kidneys which merit pyeloplasty. Kidneys which do not improve with nephrostomy are unlikely to improve with pyeloplasty and therefore nephrectomy is done in such cases.

Bionomics and population dynamics of Bemisia tabaci on subabul (Leucaena leucocephala)

Leucaena leucocephala (subabul) has been recently reported as a host plant of the polyphagous whitefly Bemisia tabaci(Gennadius) from India. A study was carried out on the population dynamics of this whitefly on leucaena for two years and it revealed that its populations reached a peak (121.58 and 134.83 adults per two leaves) in September. The spatial distribution pattern revealed that it is always an aggregated dispersion (Taylor’s Power Law) in all the strata but more aggregation in the middle leaves (b = 3.123). Linear association between population and weather factors revealed that maximum and minimum temperature had a significant positive correlation (r = 0.60, 0.54). The sex ratio in the field varied from 1:1.9 to 1:4.9 (male: female).The present observations indicate that incidence of B. tabaci on L. leucocephala, is an adaptation to a suitable host so as to survive during the winter season when the lowest temperature is about 2-4°C

Chiral Metafilms and Surface Enhanced Raman Scattering For Enantiomeric Discrimination of Helicoid Nanoparticles

Chiral nanophotonic platforms provide a means of creating near fields with both enhanced asymmetric properties and intensities. They can be exploited for optical measurements that allow enantiomeric discrimination at detection levels greater than 6 orders of magnitude than is achieved with conventional chirally sensitive spectroscopic methods based on circularly polarized light. The optimal approach for exploiting nanophotonic platforms for chiral detection would be to use spectroscopic methods that provide a local probe of changes in the near field environment induced by the presence of chiral species. Here we show that surface enhanced Raman spectroscopy (SERS) is such a local probe of the near field environment. We have used it to achieve enantiomeric discrimination of chiral helicoid nanoparticles deposited on left and right-handed enantiomorphs of a chiral metafilm. Hotter electromagnetic hotspots are created for matched combinations of helicoid and metafilms (left-left and right-right), while mismatched combinations leads to significantly cooler electromagnetic hotspots. This large enantiomeric dependency on hotspot intensity is readily detected using SERS with the aid of an achiral Raman reporter molecule. In effect we have used SERS to distinguish between the different EM environments of the plasmonic diastereomers produced by mixing chiral nanoparticles and metafilms. The work demonstrates that by combining chiral nanophotonic platforms with established SERS strategies new avenues in ultrasensitive chiral detection can be opened

Ultrasensitive Raman detection of biomolecular conformation at the attomole scale using chiral nanophotonics

Understanding the function of a biomolecule hinges on its 3D conformation or secondary structure. Chirally sensitive, optically active techniques based on the differential absorption of UV–vis circularly polarized light excel at rapid characterisation of secondary structures. However, Raman spectroscopy, a powerful method for determining the structure of simple molecules, has limited capacity for structural analysis of biomolecules because of intrinsically weak optical activity, necessitating millimolar (mM) sample quantities. A breakthrough is presented for utilising Raman spectroscopy in ultrasensitive biomolecular conformation detection, surpassing conventional Raman optical activity by 15 orders of magnitude. This strategy combines chiral plasmonic metasurfaces with achiral molecular Raman reporters and enables the detection of different conformations (α-helix and random coil) of a model peptide (poly-L/D-lysine) at the ≤attomole level (monolayer). This exceptional sensitivity stems from the ability to detect local, molecular-scale changes in the electromagnetic (EM) environment of a chiral nanocavity induced by the presence of biomolecules using molecular Raman reporters. Further signal enhancement is achieved by incorporating achiral Au nanoparticles. The introduction of the nanoparticles creates highly localized regions of extreme optical chirality. This approach, which exploits Raman, a generic phenomenon, paves the way for next-generation technologies for the ultrasensitive detection of diverse biomolecular structures

Spatial control of 2D nanomaterial electronic properties using chiral light beams

Single-layer two-dimensional (2D) nanomaterials exhibit physical and chemical properties which can be dynamically modulated through out-of-plane deformations. Existing methods rely on intricate micromechanical manipulations (e.g., poking, bending, rumpling), hindering their widespread technological implementation. We address this challenge by proposing an all-optical approach that decouples strain engineering from micromechanical complexities. This method leverages the forces generated by chiral light beams carrying orbital angular momentum (OAM). The inherent sense of twist of these beams enables the exertion of controlled torques on 2D monolayer materials, inducing tailored strain. This approach offers a contactless and dynamically tunable alternative to existing methods. As a proof-of-concept, we demonstrate control over the conductivity of graphene transistors using chiral light beams, showcasing the potential of this approach for manipulating properties in future electronic devices. This optical control mechanism holds promise in enabling the reconfiguration of devices through optically patterned strain. It also allows broader utilization of strain engineering in 2D nanomaterials for advanced functionalities in next-generation optoelectronic devices and sensors

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Two new species of the genus Hishimonus (Hemiptera: Cicadellidae) with a new record from India

Meshram, Naresh M., Chaubey, Rahul (2016): Two new species of the genus Hishimonus (Hemiptera: Cicadellidae) with a new record from India. Zootaxa 4103 (3): 259-266, DOI: http://doi.org/10.11646/zootaxa.4103.3.

Appendicular Duplication – Variations in Anatomy and Associations: Appendicular Duplication

Background: Although Duplication anomalies are common in the Gastro-intestinal tract, appendicular anomalies are rare with variable anatomy. Objectives: To describe the series of appendicular duplication cases managed at a tertiary care center. Methods: Data regarding the clinical features, associated anomalies and management of cases of appendicular duplication at a tertiary care center from January, 2019 to December, 2020 were collected retrospectively and analyzed. Results: Four children with appendicular duplication were managed during this period; three neonates presented with high anorectal malformation and type two pouch colons with a large colovesical fistula. They had a single caecum with two separate appendices symmetrically on either side (type B1). They were managed by division of colo-vesical fistula, mobilization of colonic pouch after limited pouchoplasty and anoplasty as a single stage procedure. None of the appendix was removed. In one of these cases, bilateral ureters were dilated. The fourth case presented as a 3 year-old with pain abdomen and during surgery for suspected appendicitis, partial duplication of inflamed appendix was found (type A). Appendicectomy relieved this child of his symptoms. All patients are doing well on follow-up. Conclusion: The position, anatomy and associated anomalies of appendicular duplication can be variable complicating its presentation and management