Objective:Only two devices [air-Q® intubating laryngeal airway (ILA) and AmbuAura-i] have been studied previously for blind endotracheal intubation (ETI) in paediatric patients. The aim of the study was to compare the success rate of blind ETI through BlockbusterTM laryngeal mask (LM) and air-Q® ILA in paediatric patients. Methods:Eighty patients with the American Society of Anesthesiologists' physical status I and II, aged between six months and 10 years, were enrolled in this randomised controlled trial. The patients were intubated through either of the supraglottic airway devices (SADs) by visualised, blind intubation. The primary outcome was the first- attempt success rate of ETI. Secondary outcomes were the overall success rate of ETI, the oropharyngeal leak pressure, the fiberoptic glottic view, the time to intubation, and the complication rate. Results:BlockbusterTM LM was having significantly higher first attempt success rate without any manipulation as compared to air-Q® ILA (55% vs. 32.5%; P value =0.042). Overall success rate was also significantly higher in BlockbusterTM LM (77.5% vs. 55%; P value =0.03). In subgroup analyses, BlockbusterTM LM demonstrated significantly higher first-attempt and overall intubation success rates in children aged 6 months to 5 years, while success rates were comparable between devices among children older than 5 years. Conclusion:BlockbusterTM LM, having more than 50% success rate of first-attempt blind intubation through SAD, can be a helpful device in crises during airway management of children and, thus, an ideal SAD for difficult airway carts.

Adrenocortical adenoma is a rare tumour in children and even rarer in infancy. Most of these tumours in the paediatric age group are hormonally active and predominantly present with virilisation. Cortisol hypersecretion, presenting as Cushing syndrome, is extremely rare and seen in older age groups. We are reporting two cases of adrenal adenoma with different clinical presentations. The first case was of a 9‑month‑old female who presented with isolated features of Cushing’s syndrome (CS). The second case was of a 3‑year‑old male who presented with features of CS, virilisation and dyselectrolytemia. The clinical, biochemical and histological features are discussed. These cases are being reported because of their rarity. Early diagnosis, proper peri‑operative management, complete excision of the tumour and close follow‑up are crucial to improve survival and quality of life. Keywords: Adenoma, adrenocortical tumour, Cushing’s syndrome, dyselectrolytemia, infant, paediatric, virilisation

BACKGROUND:Lower abdominal surgeries in the pediatric population are associated with significant post-operative pain. Regional anesthesia techniques including ilioinguinal nerve block, Transversus Abdominis Plane (TAP) block, and Quadratus Lumborum (QL) block have been explored for lower abdominal surgeries. This study compares the analgesic effect of three different approaches to quadratus lumborum block in pediatric patients undergoing lower abdominal surgeries. METHODS:This randomized controlled trial included 120 pediatric patients aged between 1 and 7 years, scheduled for lower abdominal surgery under general anesthesia. Patients were randomized into 3 groups. Patients of Group A received QL block via anterior approach, Group L received QL block via lateral approach, and Group P received QL block via posterior approach. A volume of 0.5 mL.kg-1 of 0.375% ropivacaine was injected unilaterally for QL block in all patients. The primary outcome was 24hr postoperative fentanyl consumption. Secondary outcomes included intraoperative fentanyl use, postoperative pain scores, time to rescue analgesia and parental satisfaction. RESULTS:Postoperative mean fentanyl consumption was significantly lower in Group A as compared to Group L (p < 0.001) and Group P (p < 0.011). Postoperative median FLACC scores were significantly lower (p < 0.05) in Group A in comparison to Group L and Group P in the early postoperative period. The parent satisfaction score was significantly higher (p < 0.05) in Group A. CONCLUSION:Anterior approach to QL block reduces postoperative analgesic consumption and provides longer duration analgesia with better parental satisfaction scores in comparison to lateral and posterior approaches in pediatric patients undergoing lower abdominal surgeries.

BACKGROUND:Many urinary biomarkers like MCP1, EGF, KIM1, CCL5/RANTES, CA19.9, NAG, TTF and micro albumin have been used as indicators of renal damage in HDN patients. Urine albumin-to-creatinine ratio (ACR) is widely used to detect renal damage in systemic diseases like diabetes and hypertension. While extensively studied in medical renal diseases, its role as an intraoperative prognostic biomarker for renal damage remains unexplored. ACR offers advantages such as low cost, easy availability, and spot testing. AIMS:To determine the correlation between urinary ACR from obstructed pelvis in the prognostication of renal function of children with unilateral pelviureteric junction obstruction. METHODS:This prospective observational pilot study included 30 patients with unilateral PUJO, aged over six months, undergoing Anderson-Hynes pyeloplasty. Patients underwent a standardized diagnostic protocol, including USG-KUB and technetium-99m DTPA renal scans. Preoperative urinary ACR from voided urine was measured. During surgery, urine from the obstructed pelvis was aspirated for ACR analysis. Data analysis compared preoperative and postoperative variables and intra-operative urinary ACR levels were correlated with change in differential renal function on DTPA. DISCUSSION:Postoperative outcomes currently rely on dynamic nuclear renal scans and USG performed 3 months after surgery. Intraoperative urinary ACR from the obstructed renal pelvis shows promise as an early biomarker for predicting renal function outcomes after pyeloplasty. It provides immediate results, alleviating parental anxiety by eliminating the usual delay in postoperative assessments. CONCLUSION:This study highlights the potential role of urinary ACR for peri-operative prognostication in children with PUJO, though larger studies are required to confirm these findings. LEVEL OF EVIDENCE:Level 2B - Prospective observational study.

The aim was to establish a specific and definite connection between non-syndromic orofacial cleft patients and associated congenital heart disease (CHD). Following PRISMA guidelines, selective databases were searched for data collection. Studies showing a definite association of CHD with orofacial cleft were included, and studies non-specific of the association of orofacial cleft with CHD were excluded. Data extraction criteria were study design, frequency of CHD in overall non-syndromic orofacial cleft and in specific cleft type, and most prevalent congenital cardiac anomaly. DerSimonian Laird random effects model was used to estimate the pooled proportion of CHD, along with corresponding 95% confidence intervals (CIs) for each measure. Publication bias was assessed using Fail-Safe N analysis and the Rosenthel approach. Of a total of 182 articles searched, only 30 studies were assessed. The overall pooled estimate of the proportion of CHD in total cleft lips/palates was 16% (95% CI: 13-19). The odds of developing CHD in cleft palates was 4.08 times more as compared to cleft lips with 95% CIs of 3.86-4.33, and 1.65 more as compared to cleft lips and palates both with 95% CI of 1.52-1.68. We affirm the upsurging prevalence of CHD in non-syndromic cleft children and vehemently propose that it is of utmost importance to inculcate it in practice and policy-making to screen all non-syndromic orofacial cleft children for congenital cardiac anomaly. This study was registered on PROSPERO (ID no. CRD42023391597) on February 24, 2023.

Background: Consent is never truly exercised in children as parents act as their proxy and often do not understand the advantages, disadvantages, risks, and benefits of the procedure. Their high anxiety state is mirrored in the child, leading to slower recovery. Hence, this study was designed to understand if an intervention can impact the effect of consent on parents’ anxiety, satisfaction, and knowledge. Methodology: A two-arm, parallel design, randomized controlled trial was conducted from March 2020 to March 2022 to analyze the effect of an educational video in comparison to an informational leaflet in parents giving proxy consents for various listed pediatric surgical procedures. Results: Parents in the video group had a higher mean knowledge score (6.97 vs. 6.77, P = 0.40), comparable satisfaction scores (27.45 vs. 27.58, P = 0.88), and statistically insignificant difference between anxiety scores. We noted highest score of satisfaction (28.5/40) in the parents educated up to High School level or less. Knowledge scores were lowest in pelvic-ureteric junction obstruction (5.1/10) patients. Conclusions: Our study done over a period of 2 years included a variety of diagnoses, and the videos and information leaflets were self-designed. It showed comparable anxiety, knowledge, or satisfaction in parents. Studies with more participants would be needed to take this research forward.

This research area focuses on analyses of gender differences in life course transitions and outcomes. The aim is to describe and explain recent changes in patterns of household and family formation and dissolution, increasing diversity in the pathways individuals take through the life course, and variations in the effects of differing pathways and transitions on women and men’s access to resources and wellbeing. Much of the research has focused on transitions relating to family and household formation (e.g. cohabitation, marriage, divorce and parenthood), but other life course transitions including education, employment, housing and retirement have also been examined. A key aspect of the research is to develop and explain patterns of gender inequality in paid and unpaid work over the life course and the ways in which men and women negotiate work and family life. This research group is led by Professor Janeen Baxter who holds an ARC Professorial Fellowship in School of Social Science and ISSR. Policy responses to emerging sustainability challenges are highlighted, along with the challenges of gaining stakeholder support for innovative approaches to sustainability based on new scientific research. The Program works closely with the new UQ Global Change Institute on a range of issues, including studies of the attitudes and knowledge of Australian decision-makers and the general public concerning climate change, and appropriate responses to climate change. The Program has also been with the Water Security Research on . Areas of research include: decision-making. The ReMASS team work closely with other researchers to collect and analyse quantitative data for informing policy development and planning. They use advanced statistical procedures for collecting and analysing social survey data – particularly those exhibiting multi-level, longitudinal and spatial structures. ISSR, through the ReMASS Program, is a partner in the network of nodes of the national electronic repository for social science data, The Australian Social Sciences Data Archive (ASSDA). The Program employs two archivists who archive social science research data and specialise in standards and methods for longitudinal survey data. The Australian Qualitative Archive (AQUA) was established through the ISSR node, its researchers are involved in a national consultation process to develop methods and technologies to allow the preservation and confidential reuse of the qualitative research data.

Anorectal malformations (ARMs) are common congenital anomalies in neonates. Colonic perforation is very rare in ARMs. Delay in diagnosis of neonate with ARM results in colonic perforations and life-threatening morbidity. Colonic perforation due to ARM may not be completely avoided; however, early diagnosis and management are essential in assuring better outcomes.

ABSTRACT:Genitourinary prolapse in newborn females as an introital mass is an uncommon entity. The usual causative mechanisms are poor pelvic innervation, damage or pressure on pelvic musculature and ligaments etc. Different methods of reduction as treatment were proposed in the past. Apart from uncommon occurrence of genitourinary prolapse in newborns, its association with anorectal malformation is not reported in English literature after searching on PubMed and Google Scholar. We report three cases of genitourinary prolapse with anorectal malformation in newborn females where decompressing colostomy was curative for the condition reflecting increased intra-abdominal pressure as causative mechanism.

Inflammatory myofibroblastic tumour in paediatric patients present with a diagnostic dilemma because of its clinical, radiological and histopathological features overlapping with other mesenchymal tumours common in this age. Because of its rarity, the exact features are still unclear. Here, we are reporting clinical, radiological and histopathological appearances of two such cases. In both cases, the exact diagnosis was confirmed only after immunohistochemistry. There is a need for further detailed study to exactly determine the natural course and prognosis of these tumours.

Congenital bilateral scrotal agenesis is very rare anomaly and characterized by the absence of scrotal rugae. It may be associated with other extra-genital anomalies as a part of a syndrome. Etiology is unknown but may be due to primary failure of labioscrotal folds development or secondary to localized 5-alpha-reductase type 2 deficiency. Various surgical techniques used for neoscrotum construction with different types of complications. In index case, we performed bilateral orchidopexy without creating neoscrotum.

Gastric teratomas are very rare tumours. They present with upper abdomen distension which can easily be confused with other common conditions with mass per abdomen in the paediatric age group. Surgical excision is curative for gastric teratomas. The diagnosis is confirmed by radiological evaluation followed by histopathological analysis of excised specimen. We are reporting two such cases of gastric teratomas who presented with complaints of upper abdomen distension. They were evaluated with radiological imaging and successfully managed by surgical excision.

Foreign body aspiration is a life threatening emergency in children. Different types of foreign bodies are aspirated and reported in literature but light emitting diode (LED) bulb is an unusual cause of foreign body aspiration. Rigid bronchoscopy is gold standard for treatment of foreign body aspiration. We wish to present a case of 9 years old male child with LED bulb aspiration which was retrieved with rigid bronchoscopy.

Introduction: Inguinal hernia is a common surgical condition in children. Conventionally, the open approach for inguinal hernia repair has been considered the gold standard. However, in the past two decades, laparoscopic inguinal hernia repair has gained popularity among paediatric surgeons as an alternative to the open approach. Apart from good cosmesis and shorter stay at hospital, laparoscopy offers clear-cut advantages of visualising contralateral site and simultaneous repair if it is patent. Many techniques for laparoscopic inguinal hernia repair have been proposed. In this retrospective observational study, we are comparing outcomes between proximal and distal disconnection of hernia sac. Materials and Methods: Ninety-five patients with inguinal hernia were studied in two groups. Group A included 50 patients in which hernia sac was disconnected from the peritoneal cuff proximal to deep inguinal ring (DIR). Group B included 45 patients in which hernia sac was disconnected distal to DIR. Various sociodemographic parameters and intraoperative findings were compared. Outcomes were analysed in terms of post-operative pain, duration of stay at the hospital and recurrences. Results: In group A, there were 46 males and four females with mean age of 4.01 years with standard deviation (SD) of 2.96. Group B included 37 males and eight females with mean age of 5.09 years with SD of 3.56. Excess post-operative pain was observed in 33 patients in Group A with proximal disconnection of hernia sac whereas it was seen in only three patients in Group B with distal disconnection of sac. The P was 0.001 which was highly significant. The duration of stay in the hospital was more in Group A (2.36 ± 1.22 days) as compared to Group B (1.8 ± 0.66 days) with a P of 0.0076 which was significant. Hernia recurrence was seen in four out of 50 patients in Group A (8%) as compared to no recurrence in Group B. However, the difference was not significant. Conclusion: The disconnection of hernia sac distal to DIR is associated with less post-operative pain and shorter duration of hospital stay. There is less recurrence seen in distal disconnection of hernia sac as compared to proximal disconnection; however, to achieve the level of significance, a large cohort study is required.

Background and Aims: Surgical procedure commonly performed in the advanced pediatric age group includes urogenital surgery, adenotonsillectomy, etc., Aim: The aim of this study is to determine the effect of single-dose gabapentin 15 mg/kg on acute pain in the immediate postoperative period in patients aged 8–14 years undergoing surgeries under general anesthesia. Material and Methods: After the approval from the institutional ethical committee, 60 American Society of Anesthesiologists (ASA) I and II patients aged 8–14 years undergoing urogenital surgeries (orchidopexy/urethroplasty) under general anesthesia were included in this study. The patients were assigned into one of the two treatment groups. Patients in group I received oral gabapentin 15 mg/kg dissolved in 5 mL of honey 2 h before surgery, while patients in group II received 5 mL honey orally 2 h before surgery. Results: A total of 60 patients participated. Patients in group I had lower consumption of fentanyl perioperatively (intraoperatively: 1.36 ± 0.70 mcg/kg; postoperatively: 2.36 ± 0.795 mcg/kg) than group II (intraoperatively: 1.8 ± 0.6 mcg/kg; postoperatively: 2.9 ± 0.47 mcg/kg). The differences in the two groups were significant. The time to first rescue analgesia was greater in group I (3.03 ± 0.60 h) than in group II (2.26 ± 0.57 h). There was an increase in sedation score in the treatment group. Conclusion: Our clinical study demonstrates that a 15 mg/kg single preemptive oral dose of gabapentin might reduce the requirement of analgesics perioperatively in pediatric urogenital surgery but might also be associated with undesirable effects such as increased sedation.