Approach to concurrent inguinal hernias during laparoscopic appendectomy for early appendicitis.

PURPOSE: Concurrent inguinal hernia can be a challenge for a pediatric surgeon during a laparoscopic appendectomy in children. We aimed to present our approach to inguinal hernias seen during laparoscopic appendectomy. METHODS: In our pediatric surgery clinic between July 2019 and December 2022, the records of patients aged 0-18 who underwent laparoscopic appendectomy were retrospectively investigated. The clinical findings, surgical procedure, and results of intervened inguinal hernia cases during laparoscopic appendectomy were evaluated. RESULTS: Between the study dates, 293 laparoscopic appendectomies were performed in our clinic. Patent processus vaginalis was observed in 5 (1.7%) cases. Laparoscopic hernia repair was performed with the Burnia technique in 2 girls. In one case, the omentum was herniated and adhered to the hernia sac seen during laparoscopy. In another case, swelling in the groin occurred during the introduction of air into the abdomen at the beginning of the operation. Patent processus vaginalis seen in 3 asymptomatic cases was not intervened. There were no postoperative complications or recurrences in the two patients who underwent hernia repair. CONCLUSION: Hernia repair with the Burnia technique might be safely performed in symptomatic inguinal hernia cases seen during laparoscopic appendectomy for early appendicitis.

Is frenuloplasty a risk factor for post-circumcision meatal stenosis?

INTRODUCTION: Meatal stenosis (MS) is a common complication of circumcision. In this study, we aimed to examine the role of frenuloplasty in the development of MS in school-age boys undergoing circumcision. MATERIALS AND METHODS: Medical data of 502 patients who were circumcised surgically in the hospital setting aged ≥6 years between July 2019 and July 2020 were retrospectively analyzed. The patients were divided into two groups based on the appearance of the frenular region. The patients whose integrity of the frenular region was protected during circumcision were classified as Group 1 (n = 262), and the patients whose frenulum was absent for some reason were classified as Group 2 (n = 240). Both groups were evaluated based on the development of complications following frenuloplasty after circumcision. RESULTS: The median age was 11 (range: 6 to 17) years. The median circumcision age was seven (range: 6 to 12) years, and the median time since circumcision was four (range: 1 to 11) years. The main complaints of the patients were gastrointestinal (n = 254, 51%), respiratory (n = 148, 29%), and urinary system-related pathologies (n = 100, 20%). Meatal stenosis was the most common complication of circumcision with an overall incidence of 4%, which was significantly higher in Group 2 (7% vs. 2%, respectively; p = 0.006). CONCLUSION: Our results suggested that MS is a common complication of circumcision. Performing frenuloplasty during circumcision might increase the risk of developing MS in school-age boys.

The effect of COVID-19 in a newly established burn center.

OBJECTIVE: This study aims to investigate the effects of COVID-19 on epidemiological features, burn agent, burn percentage, and hospitalization time in a burn center. METHODS: This single-center, retrospective study included a total of 401 patients admitted to our study center between October 2019 and July 2020. The patients who were admitted before March 1, 2020, were considered the pre-March group, and those who were admitted after March 1, 2020, were considered the post-March group. According to their age, the patients were further divided into groups as those aged ≤ 18 years and those aged > 18 years. Demographic and clinical characteristics of patients, burn agent, burn surface area, COVID-19 status, and treatment and follow-up data were recorded. RESULTS: Our study results showed no significant difference in the number of patient admission, age, and sex of patients, burn agents and length of hospital stay before and after the COVID-19 outbreak. CONCLUSIONS: Burn centers can work safely in COVID-19 outbreak, paying special attention to precautions mandated by the national and global health authorities. However, the increase in pandemic burden may force the burn centers to be converted into alternate COVID-19 facilities. In such cases, the care of burn patients may pose a great problem.

In vitro antifungal effect of human milk.

A lower incidence of infection occurs among breast-fed babies because of the presence of antibacterial, antiviral, and antiparasitic effects, but little is known about the antifungal effects to fungi other than Candida albicans. This study was undertaken to assess the antifungal effect of human milk to the fungi in the environmental air, which also may be allergenic. Milk samples were obtained from lactating mothers of healthy term infants between the 3rd and 8th days of lactation. Ninety-six Sabouraud agar petri dishes were separated into three groups, closed, and incubated in the same location after 15 minutes uncovered. The first group (group 1, n=48 dishes) was used to detect the fungal flora of the environmental air. The second group (group 2, n=24 dishes) was rubbed with a thin layer of human milk by a sterile pipette. The last group (group 3, n=24 dishes) was rubbed with 0.9% NaCIlsolution. After 7 days of incubation, the colony-forming fungal growths of all dishes were evaluated by a microbiologist who did not know the groups of the dishes. The number offungal colonies grown in human milk-rubbed dishes in group 2 was less than both of the other groups (group 1 and 3; p < 0.001 and p < 0.001, respectively). These results indicated that human milk may have antifungal effects to fungi present in the environmental air as tested by Sabouraud agar petri dishes. To prevent infections and allergic diseases, human milk must be considered the ideal food for newborns.