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INTRODUCTION: Animal-inflicted injuries continue to be a major health problem worldwide. In developing countries, the outcome of such injuries, especially in children may be poor. AIM: The study aimed to evaluate the diversity of spectrum and management of animal-inflicted injuries in the pediatric age group. MATERIALS AND METHODS: This was a prospective study on animal-inflicted injuries in children between 1 to 15 years of age over a period of 12 months. Data on various parameters such as age and sex, animal species involved, provoked/unprovoked, mechanism of injury, time of injury, prehospital care, injury-arrival interval, pattern and type of injury, trauma score, body region injured, treatment given and complications were collected and analyzed. RESULTS: Fifty-two children with animal-inflicted injuries were included, constituting <1% of all trauma cases seen during the study period (male:female = 2:1). The mean age of the cohort was 9.65 years. Domestic animals were responsible in 41 children (78.84%) and wild animals in 11 children (21.16%). Dog bite was the most common (57.69%). Penetrating injury was observed in 40 (76.9%) and blunt injury was observed in 12 (23.1%). The musculoskeletal system was the most common organ-system injured affecting 36 children (69.23%). Thirty-five children (67.3%) after minor treatment were discharged. Seventeen children (32.7%) required admission. Thirty-four children (65.38%) underwent surgical procedures. Wound debridement was the most common procedure performed. Wound infection was observed in 20 children (38.46%) and was significantly higher (P < 0.01) in delayed presenters. The length of hospital stay for the admitted children ranged from 3 to 28 days. CONCLUSION: Animal-inflicted injuries are rare in children and have a wide spectrum of presentation. Severe injuries require extensive resuscitation and expert surgical care. Mild injuries can be managed conservatively with the use of proper dressings, antibiotics, and analgesics.
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Background: Congenital hernia of the umbilical cord (CHUC) is the rarest type of anterior abdominal wall defect, in which an intact umbilical ring is always present and viscera pass through the base of normal-looking umbilicus. Objectives: This study was conducted to document the intraoperative findings and postoperative outcomes of patients with congenital hernia of the umbilical cord up to discharge from a tertiary care center. Methods: This study was a retrospective observational study conducted for two years (August 2020 to July 2022) in the Department of Pediatric Surgery, at the tertiary health care center of UP, India. Results: During this two-year duration, a total of 10 cases with CHUC were seen in our department and were surgically managed. In this study, out of these 10 patients (male 7 and female 3), eight had normal gastrointestinal tract, one had accessory liver tissue on thin pedicle, and one had features of gangrenous bowel. Of these 10 cases, three patients developed postsurgical complications in which two patients developed superficial wound infection while one developed wound dehiscence. No mortality was noted. Conclusions: Congenital hernia of the umbilical cord induces stress on parents and relatives. In this study, we conclude that the majority of cases had normal gastrointestinal tract and had no serious postoperative complications up to discharge.
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BACKGROUND: Firearm injuries (FAIs) continue to be a global public health problem possessing substantial emotional, physical and financial burdens on hospital resources. Although FAIs are rare in children, their incidence is gradually increasing. AIM: The aim of this study was to evaluate various aspects of FAI in children that were managed at a tertiary care centre located in the rural part of India. MATERIALS AND METHODS: This clinical observational study of children <18 years of age, all due to FAI, was conducted at a tertiary care centre located in the rural part of India. Data of all children admitted with FAI over 4 years from January 2016 to December 2019 were collected. Recorded data included age, sex, motive (intentional/unintentional) and circumstances leading to injury, type and license status of firearm used, time of injury, pre-hospital care, mode of transport to hospital, duration between injury and arrival to hospital, body parts and organs injured, trauma scores, management, complications, length of hospital stay and outcomes. The recorded data were entered into a worksheet and analysed. RESULTS: Out of 283 cases of FAI admitted, only 24 were children with age <18 years (8.48%). The mean age was 12.66 years (male:female = 2.4:1). Sixteen were intentional (66.67%) and eight were unintentional (33.33%). The family feud was the most common reason in case of intentional FAI (43.75%), and mishandling was the most common reason in case of unintentional FAI. Country made gun was the most common firearm used (62.5%). The chest and upper back were the most common sites of injury (54.16%). Intercostal drainage tube insertion was the most common surgical procedure performed (33.33%). There were three mortalities (12.5%). CONCLUSION: The present study found that intentional FAIs in children were more common than unintentional FAIs with family feuds and mishandling being the most common causes, respectively. The unlicensed country-made gun was the most common firearm causing injury in children.