Insensitivity of editors and indexers regarding the cultural variations of authors’ surnames.

Surnames, although widely used, are not obligatory in many parts of the world. This communication describes the hurdles and humiliations suffered by Oriental and South Indian authors who do not have a surname. A novel solution to the problem of author surnames is also proposed

Neonatal scrotal wall necrotizing fasciitis (Fournier gangrene): a case report

<p>Abstract</p> <p>Introduction</p> <p>Necrotizing fasciitis in neonates is rare and is associated with almost 50% mortality. Although more than 80 cases of neonates (under one month of age) with necrotizing fasciitis have been reported in the literature, only six of them are identified as originating in the scrotum.</p> <p>Case presentation</p> <p>We report the case of a four-week-old, full-term, otherwise-healthy Caucasian baby boy who presented with an ulcerating lesion of his scrotal wall. His scrotum was explored because of a provisional diagnosis of missed torsion of the testis. He was found to have necrotizing fasciitis of the scrotum. We were able to preserve the testis and excise the necrotic tissue, and with intravenous antibiotics there was a successful outcome.</p> <p>Conclusions</p> <p>Fournier gangrene is rarely considered as part of the differential diagnosis in the clinical management of the acute scrotum. However, all doctors who care for small babies must be aware of this serious condition and, if it is suspected, should not hesitate in referring the babies to a specialist pediatric surgical center immediately.</p

Empyema thoracis: Controversies and technical hints

This communication is the summary of Internet discussions held by members of the Indian Association of Pediatric Surgeons (IAPS) in June 2005. It reflects the opinion and practice of Indian pediatric surgeons on the treatment of childhood empyema thoracis (ET). Despite the availability of broad-spectrum antibiotics, a large number of ET in advanced stages is still seen in India. The management of ET appears to depend on the stage of pathology, the status of underlying lung and proper usage of antibiotic adjuncts. Intercostal tube drainage of pleural space is sufficient for stage 1 empyema. Thoracoscopic decortication reduces the treatment cost and morbidity of stage 2 disease. However, stage 3 lesions with very thick pleural peels require open decortication. Pros and cons of these three modalities of treatment are discussed. The members also describe the various innovative techniques, that they found useful in the surgical management of ET

ATHENA'S PAGES

Athena stands for abbreviation of Abstracting and Thoughtful Evaluation of Neonatal Articles; but it is also personified by the contributor. Like Athena of Greek mythology, she distills wisdom from published literature

Observations on the pattern of vomiting and morbidity in patients with acute sigmoid volvulus

Background: Vomiting is usually a late and an infrequent symptom of colonic obstructions. Contrary to this general rule, it occurs early and more frequently in some cases of sigmoid volvulus. Aim: To study the clinical significance of vomiting in patients with sigmoid volvulus. Setting: Teaching hospital in Western Orissa, India Study Design: Prospective observational study Material and Methods: Prospectively enrolled subjects with sigmoid volvulus diagnosed on the basis of clinical, radiological and laparotomy evidence were included in the study carried out in a tertiary care centre in India. Detailed history was obtained from them, especially to elicit information about the occurrence of various symptoms. Information regarding type of vomiting was also obtained. Efforts were made to exclude other causes of vomiting. Statistical tests such as Chi-Square test, Fisher&#x0027;s exact test or Student&#x0027;s t test were used. Results: Ninety-three consecutive subjects with sigmoid volvulus were enrolled. Five patients with possible other aetiologies for vomiting and seven patients with compound sigmoid volvulus were eliminated from further analysis. Two patterns of vomiting were noted in 81 evaluable patients with sigmoid volvulus. In 33 patients (Group A), vomiting preceded or coincided with the onset of other abdominal symptoms (Type 1 vomiting). In 48 patients (Group B) vomiting occurred after the onset of other abdominal symptoms (Type 2 vomiting). The period between the onset of these symptoms and that of vomiting varied from a few hours to several days. Group A patients sought medical help much earlier than those of Group B. Incidences of circulatory shock (24&#x0025; vs. 8&#x0025;), haemorrhagic ascites (21&#x0025; vs. 6&#x0025;) and colonic gangrene (64&#x0025; vs. 35&#x0025;) were significantly higher in Group A than in Group B. The mortality rate (15&#x0025; vs. 4&#x0025;) was higher in Group A as well. About 25&#x0025; (n = 7) of Group A patients in contrast to 4&#x0025; (n=2) of Group B required hospitalization exceeding 3 weeks. Vomitus was predominantly non-bilious (21 out of 33 patients) in Group A (64&#x0025;) and bilious (10 out of 11 patients) in Group B (91&#x0025;). Conclusion: Type 1 vomiting appears to be an indicator of more severe presentation and is associated with an increased morbidity and mortality. This study suggests that the pattern of vomiting could be a simple and useful predictor of prognosis in sigmoid volvulus

What do we discuss at IAPS meetings? An appraisal of free paper sessions at the 30th annual conference

Background : The traditional belief that attending medical conferences would further one′s knowledge needs to be examined critically. Although analytical reports on the effectiveness of conferences have been published from Western countries, such studies have never been conducted in India. Materials and Methods: The author prospectively analyzed 100 free papers presented at the 30th National Conference of the Indian Association of Pediatric Surgeons. Papers were categorized as original works, case reports, audit reports, innovations and theoretical papers. They were assessed for their scientific value, nature of conclusion, quality of discussion by authors and quality et quantity of audience interaction. Results: "Original works" and "innovations" frequently contributed additional information to the existing knowledge while most of the case reports, audit reports and theoretical papers were redundant. Nearly 40% of all papers had inappropriate conclusions. Only one author conferred all the five components of discussion while 32% of authors discussed nothing useful. Case reports, audit reports and theoretical papers topped the list of papers with inappropriate conclusion and poor discussion. About 24% of papers did not evoke any audience interaction. There was no significant difference in the enthusiasm of audience to interact with contributing versus redundant papers. Conclusion: Majority of case reports, audit reports and theoretical papers are found to be unsuitable for free paper session. To improve the quality of deliberations, the number of free papers should be reduced and the time allocation for each of them should be increased. Authors must be educated and reminded of the various components and importance of discussion. Whether audience at IAPS meetings react appropriately to free papers need to be evaluated further