Pediatric Surgery Workforce Around the World: A Need to Revise Residency Programs?

The study aimed to address the shortage of pediatric surgery specialists globally by investigating the discrepancies in training programs and population metrics across different countries and regions. An international survey of pediatric surgeons gathered data on training duration, examination procedures, certification, and population metrics like mortality rate and surgeon-to-population ratio. The study included 44 countries.

The outcome and complications of modern staged repair surgery in newborns with classic bladder exstrophy in different genders: A retrospective study.

Introduction: Classic bladder exstrophy (CBE) is a rare anterior midline birth defect that remains a challenge for pediatric surgeons. Despite multiple reconstructive methods, outcomes vary widely in various reports. This study aims to compare the success rate and complications of modern staged repair of exstrophy (MSRE) in each gender and compare together.

The effect of the caudal insertion angle of pedicle screws on postoperative thoracic kyphosis in adolescent idiopathic scoliosis: a pilot study.

The study was a prospective analysis of collected data to compare the effect of the insertion angle (parallel or oblique relative to the upper-end plates) of thoracic pedicle screws on postoperative thoracic kyphosis in patients with idiopathic thoracic scoliosis. This study was conducted on idiopathic adolescent scoliosis (AIS) patients. Two groups of patients were defined according to the insertion angle of thoracic pedicle screws in relation to the upper-end plate of the corresponding vertebra, the insertion angles being either oblique or parallel.

The effects of botulinum toxin injection on urodynamic changes in pediatric population with neurospastic bladder: First trial in Iran.

Background: Neurogenic bladder is one of the serious, disturbing problems referred to pediatric urologic clinics. The increase in bladder pressure may damage the upper urinary tract. Anticholinergic medications have been used as the first line of complementary treatment.

Early pyeloplasty versus conservative management of severe ureteropelvic junction obstruction in asymptomatic infants.

Background: Ureteric-pelvic junction obstruction (UPJO) is the most common cause of antenatal and neonatal hydronephrosis and its management remains controversial. While conservative management is advocated for all, this strategy puts a quarter of these patients at risk for possibly irreversible renal damage.

Aim: In this study, we compare functional and anatomic outcomes in newborns and infants less than 1 year of age with high-grade unilateral UPJO, following early surgical pyeloplasty (ESP) versus conservative management (CM).

Sporadic Insulinoma as a Rare Cause of Recurrent Hypoglycemia in Children.

Insulinoma is a rare pancreatic tumor in children and adolescents. As a result of insulin hypersecretion, signs and symptoms are more commonly consequences of the pathophysiologic responses to hypoglycemia. According to rarity of this tumor in children and nonspecificity of clinical presentations, diagnosis of insulinoma in this group of patients is usually delayed.

Impact of parental presence during induction of anesthesia on anxiety level among pediatric patients and their parents: a randomized clinical trial.

Introduction: Anesthesia induction is a stressful event for children and their parents, and may have potentially harmful consequences on the patient's physiological and mental situation. Stressful anesthesia induction has psychological adverse effects that recur with repeated anesthesia, can lead to increased pediatric discomfort during the recovery period, and may even induce reactionary postoperative behavior. A randomized controlled trial was performed to assess the impact of parental presence during induction of anesthesia (PPIA) on preoperative anxiety of pediatric patients and their parents at three different times, cooperation of child with anesthesiologist at induction of anesthesia, and parental satisfaction.

Evaluation of Onlay Island Flap Technique in Shallow Urethral Plate Hypospadiasis.

Background: Hypospadias is one of the most common congenital genital anomalies in males that necessitates to be operated early in infancy (when 6 to 9 months old). On the other hand, hypospadias is a challenging field of pediatric urology with multiple reconstruction techniques. A perfect hypospadias repair is supposed to return urethral continuity with sufficient caliber, eradicate phallus curvature, and supply an acceptable appearance with low complications.

Types and frequency of ovarian masses in children over a 10-year period.

Background: Ovarian masses represent a range of pathology from benign cyst to highly aggressive malignant tumors. It has been estimated that gynecologic malignancy account for approximately 2% of all types of cancer in children, 60-70% of these lesions arise in the ovary.

Methods: All ovarian masses which were resected or biopsied in Mofid Children's Hospital from 2002 to 2012 were reviewed retrospectively.

Outcomes of Second Look Exploration in Testicular Torsion of Children.

Background: Testicular torsion (TT), or twisting of the testicle resulting in a strangulation of the blood supply, occurs in men whose tissue surrounding the testicle is not well attached to the scrotum. It is important to emphasize that testicular torsion is a medical emergency.

Objectives: The aim of this study is to evaluate the second look exploration and outcomes in TT.

An unusual cause of protein losing enteropathy in a 2.5-year-old girl: meso-intestinal fibrosis.

Introduction Protein losing enteropathy is a symptom characterized by loss of protein in intestines resulting in low protein levels in serum and generalized edema. Several causes are reported for this condition. Hereby we report an as yet unreported cause of protein losing enteropathy that we named meso-intestinal fibrosis.

Pediatric Germ Cell Tumors; A 10-year Experience.

Objective: The aim of this study was to evaluate the outcome of germ cell tumors in patients admitted to our center during a ten year period.

Methods: In a retrospective descriptive study, patients with the pathological diagnosis of germ cell tumor (GCT) were included. All records were evaluated and patients followed by personal visit in clinic or phone call.

Protective temporary vesicostomy for upper urinary tract problems in children: a five-year experience.

Objective: Temporary vesicostomy is a urinary diversion procedure for patients with upper urinary tract (UUT) dilatation, secondary to bladder outlet obstruction or dysfunction. The aim of this study was to evaluate our experience in children undergoing such diversion, analyzing its efficacy to prevent urinary tract infection (UTI), improve or resolve hydronephrosis, stabilize or improve kidney function and restore the health of UUT.

Methods: In this retrospective study, patients who had vesicostomy by Blocksom technique due to bladder outlet obstruction or dysfunction were evaluated in Mofid Children's Hospital (in Tehran) from March 2007 to March 2012.

Postoperative intussusception in a neonate with congenital cutis laxa and huge hiatal hernia.

Congenital cutis laxa is a genetically heterogeneous condition presenting in the newborn with loose, redundant skin folds, decreased elasticity of the skin, and general connective tissue involvement. A 2-day-old full term neonate with congenital cutis laxa presented with respiratory distress. Investigations revealed huge hiatal hernia.

Ileocecal patch -low rectal anastomosis in total colectomy: New idea for the prevention of fecal incontinence.

Background: Total colectomy is used in children with total colonic aganglionosis, Ulcerative colitis (UC) and familial adenomatous polyposis (FAP). The purpose of this study was to maintain ileocecal valve and rectal-sparing surgery for the prevention of fecal incontinence in these children.

Methods: From1990 to 2011, 14 children with diagnosis of UC, FAP and Hirschsprung's disease were operated.

State's pull-through for total colonic aganglionosis and GI dismotility.

Background: Total colonic aganglionosis (TCA) is present in 4% - 5% of the patients with Hirschsprung's disease and has a high surgical mortality rate between 13% - 23%. Diagnosis and treatment of TCA is still a major challenge for pediatric surgeons. Many techniques with several advantages and disadvantages were established for its treatment.

Treatment of bilateral macrostomia (lateral lip cleft): case report.

Background: Macrostomia as a rare facial deformity is classified among facial clefts. It originates from failure in union of maxillary and mandibular prominences of first brachial arch during 7(th) embryonic week.

Case Presentation: We report a case of bilateral macrostomia (bilateral lip cleft) in a female newborn as a sole entity without other skeletal and facial deformities.

Acute mediastinitis in children: a nine-year experience.

Background: Acute mediastinitis is a serious medical condition with a mortality rate of 30 to 40% or even higher. Early diagnosis with prompt and aggressive treatment is essential to prevent its rapid progression. We evaluated acute mediastinitis cases and analyzed the outcomes.

Abdominal inflammatory myofibroblastic tumor: report on four cases and review of literature.

Background: The Abdominal Inflammatory Myofibroblastic Tumor (AIMT) is a rare tumor with unknown etiology which usually occurs in children and adolescents. It is composed of myofibroblastic spindle cells intermixed with inflammatory cells. We present four cases of AIMT.

Congenital rhabdomyosarcoma of shoulder.

A 16-day-old female was referred with congenital swelling on her right shoulder. On examination, there was a hard, round, ecchymotic, nontender, slightly movable, warm and shiny 10x15 cm mass on the right axillary pits which was extended to the right side of neck and chest wall. The mass separated the shoulder from the chest wall causing paralysis of right hand.

Survey on childhood solid malignant tumors in cases admitted to mofid pediatric hospital from 1996-2010: a single-center study.

Background: As children comprise a considerable proportion of our population, the importance of local epidemiologic research and geographic and racial differences can't be disputed on childhood malignancies.

Methods: In this descriptive retrospective study, we extensively reviewed the medical records of patients younger than 15 years of age, diagnosed with solid malignant tumors, from 1996 to 2010, using the last version of International Classification of Childhood Cancers.

Results: In our study the order of incidence of solid malignancies was relatively similar to the other national studies, with lymphomas and Central Nervous System (CNS) tumors as the most common, followed by Sympathetic Nervous System (SNS) tumors, soft tissue sarcomas and renal tumors.

Clinical evaluation of disc battery ingestion in children.

BACKGROUND The purpose of this study was to evaluate the characteristics, management, and outcomes of disc battery ingestion in children. METHODS We reviewed the medical records of children admitted to Mofid Children's Hospital due to disc battery ingestion from January 2006 to January 2010. Clear history, clinical symptoms and results of imaging studies revealed diagnosis of disc battery ingestion in suspected patients.

Complete colonic duplication in children.

Background: Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics.

Tracheoesophageal fistula following disc battery ingestion and foreign body impaction.

Background: Ingestion of foreign bodies may result in the formation of a tracheoesophageal fistula (TEF), which causes severe morbidity in children. We describe four cases of TEF, who underwent emergent surgery for repair.

Case Presentation: In this report, we present about four patients aged between 9 months to 2.