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Background This study aims to describe our institutional experience in managing pediatric patients with PUJO associated with horseshoe kidney, focusing on clinical presentation, diagnostic evaluation, surgical management, and outcomes. By presenting these findings, we seek to contribute practical data that may guide diagnosis and treatment strategies for this rare but significant anomaly in children. Methods This retrospective study included 10 children (< 18 years) with PUJO in HSK managed at Sher-i-Kashmir Institute of Medical Sciences between January 2015 and December 2023. Diagnostic evaluation included ultrasonography, CT-IVP, VCUG, and renal scintigraphy (DMSA/MAG3). Surgical interventions included open transperitoneal or retroperitoneal pyeloplasty with or without vascular hitch procedures. Patients were followed for a minimum of six months postoperatively to assess symptom resolution and renal function. Results The cohort comprised 6 males and 4 females, with a mean age of 8.5 ± 4.2 years. Common symptoms were recurrent UTIs (40%) and flank pain (30%). Imaging confirmed HSK and varying grades of hydronephrosis. Aberrant or crossing vessels were found in 70% of cases and corrected intraoperatively. Open transperitoneal pyeloplasty was the most frequently employed approach (8/10). Postoperative recovery was uneventful in most patients, with mean hospital stay of 4.5 ± 1.3 days. Follow-up showed improved drainage and renal function in all patients. Complications included proteinuria and hypertension in one patient each. Renal scarring was observed in 2 patients preoperatively. Conclusion Open surgical management of PUJO in HSK is effective and safe in pediatric patients. Early diagnosis and appropriate surgical correction lead to favorable outcomes, including symptom relief and preservation of renal function. Larger prospective studies are warranted to guide long-term management strategies.

Aim:A variety of developmental abnormalities of the tracheobronchial tree and pulmonary parenchyma are found in the newborn. There is limited data available on their presentation and clinical course from third world countries.Materials and Methods:A retrospective review of the medical records of children with congenital lung malformations was conducted at our tertiary care hospital from June, 2014 to June, 2018.Results:This study included 30 patients with 12 males and 18 females. The mean age at diagnosis was 13 months (range 1 month to 4 years). Congenital pulmonary airway malformation was the most common malformation present in 18 (60%) patients, followed by congenital lobar emphysema in 4 (13.3%), bronchogenic cyst in 3 (10%), bronchopulmonary sequestration in 2 (6.7%), bronchial atresia in 2 (6.7%) and pleuropulmonary blastoma in 1 (3.3%) patient. The most common presentation was recurrent upper respiratory tract infection (53.3%). Lobectomy was the most common surgical procedure performed in 86.6% of the patients, followed by excision of cyst in 10% of the patients. The post-operative complication rate was 30% with an overall survival rate of 93.3%. The average follow-up duration was 9 months.Conclusion:The predominant lung malformation in this study was congenital pulmonary airway malformation. Recurrent respiratory tract infection with or without respiratory distress was the most common mode of presentation. Health education to raise awareness and emphasis on antenatal ultrasonography can avoid inordinate delays in diagnosis and treatment. Surgery is curative with good long-term outcomes.

Background Conventional hand suture techniques for intestinal anastomosis have been standard practice for decades, but the development of staplers has significantly impacted surgical procedures. Staplers, designed to simplify surgery, have been increasingly used in various gastrointestinal surgeries, including pediatric procedures. Colostomy takedown in infants is a commonly performed surgical procedure in pediatric surgery, yet the optimal technique remains debated. This study aims to compare the outcomes of linear stapler anastomosis and hand-sewn anastomosis for elective closure of loop colostomies in children. The hypothesis is that linear stapler anastomosis offers advantages over hand-sewn anastomosis in terms of operative time, recovery, and hospital stay. Aim To compare the outcomes of linear stapler and hand-sewn anastomosis in the elective closure of pediatric loop colostomies. Methods This prospective, randomized controlled study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, J&K, India, between 2021 and 2023. A total of 70 infants were enrolled, randomly assigned to two groups: Group A (35 infants) underwent SA (Stapled Anastomosis), and Group B (35 infants) underwent HS (Hand-Sewn Anastomosis). Both groups were matched for clinical characteristics. The primary outcomes included operative time and time to return of bowel movements. Secondary outcomes included anastomotic leaks, wound infections, and length of hospital stay. Data analysis was performed using appropriate statistical methods including t-tests and chi-square tests. Results The mean age of patients was 5.79 ± 3.23 months in Group A and 4.21 ± 3.13 months in Group B. The mean time to return of bowel movements was significantly shorter in Group A (24.82 ± 6.34 h) compared to Group B (47.56 ± 5.65 h, p = 0.05). Oral feeding was commenced earlier in Group A (2.18 ± 0.39 days) than in Group B (3.16 ± 0.37 days, p < 0.001). Both groups had a follow-up of 1.81 ± 0.98 years, with no cases of anastomotic leakage or small bowel obstruction in either group. Hospital stay was shorter in Group A (53.82 ± 6.34 h) compared to Group B (79.56 ± 15.65 h, p < 0.0003).

Objectives: To determine the prevalence of superior mesenteric artery (SMA) syndrome in patients presenting with abdominal pains, and to evaluate computed tomographic (CT) findings needed for its diagnosis. Methods: This retrospective record-based study was carried out at the radiology department, from January 2016 to January 2021. All young patients (aged under 25) who underwent CT scans for abdominal pains were reviewed. Post-surgery, tumor, and trauma cases were excluded. Imaging findings for SMA syndrome were recorded as 'suggestive' (reduced aortomesenteric angle and distance with proximal duodenal dilatation), 'possible' (reduced angle and distance without proximal duodenal dilatation) and 'probable' (reduction of either angle or distance). Two radiologists interpreted the findings and consensus reporting was made. Diagnoses were confirmed on clinical grounds (symptomatic improvement by specific treatment and exclusion of other diagnoses), or barium studies. Imaging findings were compared to final diagnoses. McNemar's Chi-square test was used to determine association. Results: Out of 141 patients (mean age=10.8, standard deviation=4), 7 (4.9%) patients mostly females were having SMA syndromes based on 'suggestive' imaging criteria (p=0.0005), and one patient underwent surgery. Conclusion: Superior mesenteric artery syndrome is not an uncommon condition and should be considered in differential diagnosis of acute abdomen in young patients after excluding other diagnoses. Keywords: SMA syndrome, computed tomography, aortomesenteric angle

Objectives:To determine the prevalence of superior mesenteric artery (SMA) syndrome in patients presenting with abdominal pains, and to evaluate computed tomographic (CT) findings needed for its diagnosis.Methods:This retrospective record-based study was carried out at the radiology department, from January 2016 to January 2021. All young patients (aged under 25) who underwent CT scans for abdominal pains were reviewed. Post-surgery, tumor, and trauma cases were excluded. Imaging findings for SMA syndrome were recorded as ‘suggestive’ (reduced aortomesenteric angle and distance with proximal duodenal dilatation), ‘possible’ (reduced angle and distance without proximal duodenal dilatation) and ‘probable’ (reduction of either angle or distance). Two radiologists interpreted the findings and consensus reporting was made. Diagnoses were confirmed on clinical grounds (symptomatic improvement by specific treatment and exclusion of other diagnoses), or barium studies. Imaging findings were compared to final diagnoses. McNemar’s Chi-square test was used to determine association.Results:Out of 141 patients (mean age=10.8, standard deviation=4), 7 (4.9%) patients mostly females were having SMA syndromes based on ‘suggestive’ imaging criteria (p=0.0005), and one patient underwent surgery.Conclusion:Superior mesenteric artery syndrome is not an uncommon condition and should be considered in differential diagnosis of acute abdomen in young patients after excluding other diagnoses.

Total hip arthroplasty (THA) is one of the most successful orthopaedic interventions globally, with over 450,000 procedures annually in the U.S. alone. However, issues like aseptic loosening, dislocation, infection and stress shielding persist, necessitating complex, costly revision surgeries. This highlights the need for continued biomaterials innovation to enhance primary implant integrity and longevity. Implant materials play a pivotal role in determining long-term outcomes, with titanium alloys being the prominent choice. However, emerging evidence indicates scope for optimized materials. The nickel-free β titanium alloy Ti-27Nb shows promise with excellent biocompatibility and mechanical properties. Using finite element analysis (FEA), this study investigated the biomechanical performance and safety factors of a hip bone implant made of nickel-free titanium alloy (Ti-27Nb) under actual loading during routine day life activities for different body weights. The FEA modelled physiological loads during walking, jogging, stair ascent/descent, knee bend, standing up, sitting down and cycling for 75 kg and 100 kg body weights. Comparative analyses were conducted between untreated versus 816-hour simulated body fluid (SBF) treated implant conditions to determine in vivo degradation effects. The FEA predicted elevated von Mises stresses in the implant neck for all activities, especially stair climbing, due to its smaller cross-section. Stresses increased substantially with a higher 100 kg body weight compared to 75 kg, implying risks for heavier patients. Safety factors were reduced by up to 58% between body weights, although remaining above the desired minimum value of 1. Negligible variations were observed between untreated and SBF-treated responses, attributed to Ti-27Nb’s excellent biocorrosion resistance. This comprehensive FEA provided clinically relevant insights into the biomechanical behaviour and integrity of the Ti-27Nb hip implant under complex loading scenarios. The results can guide shape and material optimization to improve robustness against repetitive stresses over long-term use. Identifying damage accumulation and failure risks is crucial for hip implants encountering real-world variable conditions. The negligible SBF effects validate Ti-27Nb’s resistance to physiological degradation. Overall, the study significantly advances understanding of Ti-27Nb’s suitability for reliable, durable hip arthroplasties with low revision rates.

An investigation was carried out to examine the combined and individual effects of cadmium (Cd) and arsenic (As) stress on osmolyte accumulation, antioxidant activities, and reactive oxygen species (ROS) production at different growth stages (45, 60, 75, 90 days after sowing (DAS)) of two maize cultivars viz., Dong Dan 80 and Run Nong 35. The Cd (100 μM) and As (200 μM) were applied separately as well as in combination (Cd + As) at 30 DAS. Results revealed pronounced variations in the behavior of antioxidants, osmolytes, and ROS in both maize cultivars under the influence of Cd and As stress. Activities of enzymatic (SOD, POD, CAT and APX, GPX, GR) and non-enzymatic (GSH and AsA) antioxidants, generation of ROS, and accumulation of osmolytes were enhanced with the passage of time; therefore, the maximum values for these attributes were observed at 90 DAS for both cultivars. Exposure of plants to Cd or As stress considerably enhanced the antioxidant activities, ROS, and osmolyte accumulation compared with control, while combined application of Cd + As was more devastating in reducing plant biomass of both maize cultivars. Among cultivars, Dong Dan 80 was better able to negate the heavy metal-induced oxidative damage, which was associated with higher antioxidant activities, greater osmolytes accumulation, and lower ROS production in this cultivar.

The livelihoods of poor people living in rural areas of Indus Basin Irrigation System (IBIS) of Pakistan depend largely on irrigated agriculture. Water duties in IBIS are mainly calculated based on crop-specific evapotranspiration. Recent studies show that ignoring the spatial variability of factors affecting the crop water requirements can affect the crop production. The objective of the current study is thus to identify the factors which can affect the water duties in IBIS, map these factors by GIS, and then develop the irrigation response units (IRUs), an area representing the unique combinations of factors affecting the gross irrigation requirements (GIR). The Lower Chenab Canal (LCC) irrigation scheme, the largest irrigation scheme of the IBIS, is selected as a case. Groundwater quality, groundwater levels, soil salinity, soil texture, and crop types are identified as the main factors for IRUs. GIS along with gamma design software GS + was used to delineate the IRUs in the large irrigation scheme. This resulted in a total of 84 IRUs in the large irrigation scheme based on similar biophysical factors. This study provided the empathy of suitable tactics to increase water management and productivity in LCC. It will be conceivable to investigate a whole irrigation canal command in parts (considering the field-level variations) and to give definite tactics for management.

The lab experiment was conducted in 2016-2017, to evaluate the influence of storage at room condition on sweetening and other chemical components of potato tubers in Swat District, Pakistan. Tubers of the three cultivars, Desiree Diamont and Kruda were stored at room condition in three replications for 90 days. Data was recorded at 0 day (fresh) and at 15 days interval on Reducing Sugars (RS), Total Sugars (TS), Dry Matter (DM), Total Starch (TS), and Vitamin C. The total sugars and reducing sugars increased in the first 15 days in Kruda and Diamont, whereas in Desiree, it decreased from the start-up to the end of storage. Starch content in Kruda cultivar decreased regularly and the lowest quantity was recorded after 45 days of storage while in Diamont and Desiree, it showed increase and reached its peak level after 30 and 45 days of storage. The Cultivar Means showed that the highest dry matter (21.605 %) was recorded in Diamont while the lowest was recorded in Desiree cultivar. Vitamin C decreased significantly in Diamont and Desiree cultivars in first 45 days of storage while minimum vitamin C was recorded in Kruda cultivar after 60 days of storage. The total decrease in Vitamin C remained about of 76 % throughout the 90 % storage. It is concluded that sweetening decreased in all cultivars during 90 days storage period at room condition. (Temperature 9-18 °C). In Desiree cultivar, starch content is little affected by change storage duration, in case of sweeting i.e reducing sugar and total sugar did not occur in Desiree up to 90 days of storage. Therefore, the Desiree has maintained edible quality up to three months storage.