Pediatric surgery and pediatrics as practiced in tropical countries is different from that practiced in developed countries. High population pressure, poverty and constraints of financial support for research limit basic science research in these areas. Most of the clinicians, rather because of large patient load, can only perform clinical research....This journal aims to provide space to independent surgeons, who work alone, without institutional support, research support and still are able to provide medical and surgical help to a large number of children in need.

Pediatric surgery has witnessed remarkable strides in recent years, bringing new hope and improved outcomes for young patients facing complex medical conditions. Surgeons, researchers, and innovators have continually pushed the boundaries of medical science, harnessing cutting-edge technologies and novel approaches to enhance surgical interventions in children. These transformative advances have not only revolutionized pediatric surgery, but they have also brought about profound positive change in the lives of countless young patients and their families.

The children in the low and middle income countries (LMIC) suffer the most. Political instability along-with regional armed conflicts for economic gains as well as natural environ-mental disasters and man-made climate related challenges lead to absolute poverty that deprived people of basic needs including safe drinking water, food, sanitation and many others. Interestingly high birth-rate, a reflec-tion of social needs without considering the responsibility at individual level with limited resources, adds to the perennial challenges in the LMICs. Though healthcare is given a prio-rity in all the policies but same is not visible on ground. The main reasons are the poor gover-nance, corruption and dysfunctional judiciary to name a few.

A brief introduction of the editors and editorial board members of the “Pediatric surgery in Tropics”

Urolithiasis in children is rare with a reported incidence of 1.8 per 1000 children. Cystine calculi are still rarer with a prevalence of 1:7000 and the typical age of onset is the second decade of life. We present a 3 years old girl with recurrent cystine stones in kidney.

Survival rate of gastroschisis has improved worldwide due to advancements in antenatal diagnosis, perinatal care and neonatal intensive care. This is in stark contrast with the persistently poor outcomes observed in low and middle-income countries. Aim of this study is to identify factors affecting survival in a resource constraint center, where intensive neonatal care and parenteral nutrition could not be provided.

Recent literature has focused on Enhanced Recovery After Surgery (ERAS) Programs or Fast Track Elements in peri-operative care of patients undergoing surgery. While fast-track surgery has been studied extensively in adult patients, studies in the pediatric age group are rather few. Existing few studies are disadvantaged by non-homogenicity of surgical procedures. For colonic surgeries, only early postoperative enteral feeding has been studied in detail. There are no randomized controlled trials that evaluate fast-track protocol in colonic surgery of children.

Tropical pyomyositis (TPM) is primarily an inflammatory disorder of skeletal muscles that is characterized by coagulative necrosis and superadded bacterial infection. It is common in tropical weather but not necessarily in a tropical country. Staphylococcus is the most common causative organism. TPM has 3 clinical stages. Local signs of inflammation such as redness and warmth are often deceptively missing. Streptococcal TPM is more aggressive disease. Mortality of stage-2 TPM is less than 2% while that of stage-3 approaches 20%. This article is a descriptive review of recent advances in this neglected tropical disease.

Long-term morbidity and functional bowel problems after surgical treatment of HD are significant. There is no consensus regarding the most appropriate scoring system for the assessment of functional outcomes. Also, there is a paucity of data from low- and middle-income countries (LMIC).

A newborn with pedunculated perianal lipoma and accessory scrotum is reported. By reviewing the 60 cases of accessory scrotum documented in the literature, we propose a standardized definition, diagnostic criteria and clinico-embryological classification of this rare malformation.

Biliary atresia is a common cause of neonatal jaundice. This article reviews the recent literature on biliary atresia. Recently near-infrared fluorescence cholangiography (NIR-FCG) using indocyanine green fluorescence (ICG) has been employed during Kasai portoenterostomy (KPE) to identify bile flow from hilar ductules. Intrahepatic cystic lesion (ICL) is a newly recognized complication of KPE. Patients with ICL developing after six months of KPE tend to have better outcomes. Usually, ICL are preceded by episodes of cholangitis. Higher GGT levels before KPE is now identified as a risk factor of post-operative cholangitis.