In recent decades, with an increasing number of women pursuing medical career, there is a striking contrast of women taking-up surgical specialties. Though, surgery is traditionally a macho field, the status of women surgeons has significantly improved in recent years. But, the basic challenges remain yet to be addressed.(1) Is surgery really appealing to women or is it appalling? Several issues drive them away from choosing a surgical carrier. These multifaceted factors include years of laborious, physically demanding, emotionally exhausting training which is compounded by male dominated work-environment, insufficient family time, poor quality of personal life, negligible prospects in career advancements and less financial perks. While most of the women doctors chose relatively cooler, family-friendly, less demanding or even ‘feminine specialties’, only a few (including me) take-up surgery with great passion.

A young lady postgraduate of the Department of Pulmonology at the Radha Gobinda Kar Medical College Hospital (Kolkata, India) had to sacrifice her life in the most gory and brutal way(1) to wake an entire nation and its rulers up to the fact that doctors working in India are extremely vulnerable to physical assault and are totally unprotected by the law as well as the institution where they work. In India, assaults on doctors have become a growing concern in the recent years. (2-6) For obvious reasons, big hospitals as well as small clinics tending to sick children are more vulnerable to such assaults. Physical attacks not only hamper the professional and emotional well-being of healthcare providers but also undermine the integrity of the medical system. Doctors, who are considered as healers and expected to save lives, often face physical and verbal abuse from patients and their families. Various factors contribute to this disturbing trend, and understanding them is essential to develop practical solutions.

Chemotherapy of Wilms tumor (WT) often induces neutropenia. This study explores whether enteral hyperalimentation can reduce the incidence of chemotherapy-induced neutropenia and the need for granulocyte colony-stimulating factors (GCSF) in these patients.

Myiasis (myasis) is a parasitic infestation of fly (diptera) larvae. Maggots are both a pest and a therapeutic agent. Ayurvedic surgeons of ancient India (2000-600 BCE) have described Krimi-Karna (aural myiasis) and Krimija-Siroroga (nasal myiasis). They also used maggot therapy (MT) to heal wounds (Krimi Upattikara Chikitsa). About 95% of pediatric myiasis is due to 80 species of flies belonging to 4 major categories: blowflies, flesh flies, botflies and house flies. Hence, myiasis is not one disease; but a group of diseases caused by various dipteran larvae. Cochliomyia, Chrysomya and Wohlfahrtia are the 3 important deadly maggots.

Sigmoid volvulus is a rare cause of colonic obstruction in children. In this age group it has higher morbidity and mortality than that of adults. There is a paucity of literature on pediatric sigmoid volvulus, and thus treatment strategies are largely based on adult data. Regardless of the patient age, prompt intervention is imperative in all cases. Emergent colectomy is typically reserved for cases complicated by gangrene, perforation and peritonitis; while non-operative emergency decompression followed by elective surgical resection is preferred in uncomplicated cases. In this report, we describe a 17-year-old female with sigmoid volvulus, who successfully underwent flexible sigmoidoscopic detorsion, followed by rectal tube decompression for 2 days and then elective laparoscopic sigmoid colectomy with primary anastomosis.

A15-year-old boy presented with recurrent episodes of non-bilious vomiting for the past 9 years. During these episodes he also had dehydration and oliguria. He required hospitalization during each episode that was marked by features of acute kidney injury. A plain radiograph showing ground glass opacity raised suspicion. Imaging studies confirmed intestinal malrotation with intermittent midgut volvulus. Following correction of malrotation by Ladd’s procedure, he became asymptomatic. Delayed presentation of malrotation beyond infancy is rare. Recurrent acute kidney injury is an unusual complication of late manifesting malrotation in adolescence

Pancreatic heterotopia (PH) is a rare congenital anomaly that is also known as ectopic pancreas or pancreatic choristoma. It is usually asymptomatic but rarely may cause abdominal pain, lower gastrointestinal bleeding or intussusception. This report describes two cases of PH: a 9-month-old boy presented with intussusception and a 6-year-old girl presented with a jejuno-colic inflammatory mass. Surgical excision of PH cured both of them.

Thyroid disorders represent a significant proportion of pediatric endocrine problems. Surgical intervention is often indicated in thyroid cancers, hyperthyroidism and solitary non-toxic nodules.

Conservative management of omphalocele is an accessible method in
resource-constrained settings. This review summarizes the literature on the usage of
escharotic agents in omphalocele.

Proper urodynamic evaluation of children is often limited by the cost, technical expertise and availability of the involved equipments. Bedside cystometry (BC) could be a useful alternative in the absence of facility for urodynamic study (UDS). In this study, the predictive value of BC is compared with that of the UDS in diagnosing functional abnormalities of the bladder in children.

Buried penis is a rare congenital anomaly due to dysplasia of the dartos fascia and lack of penile skin fixation to the Buck’s fascia. This report describes an experience with 8 boys with buried penis. In young children, the parental concerns were invisible penis, dribbling of urine and smelly urine. Unfurling of inner prepuce appears to be suitable for severe variety of buried penis, while Z- Plasty is suitable for mild or moderate varieties.

We report 2 cases of stray bullet injury to brain in children of age 3 months and 7 years respectively. One of them had an occipital penetrating wound (with no exit) and the other had trans-temporal wound (with both entry and exit points). The delay in doing a CT scan was 1 and 8 days respectively. The average duration of surgery was 80 min. The average time to complete control imaging was 18.5 days. Followup imaging showed cerebral swelling and re-bleeding in one patient while it was unremarkable in the other child. Pediatric head injuries due to firearms are very rare, but with high morbidity and mortality. Their management in limited resource settings is challenging.

‘Pediatric Thoracic Surgery’, edited by Mattioli, Petralia and Torre, is written by surgeons working at Giannia Gaslini Institute, Genoa. This book emphasizes that thoracic surgery in children ought to be performed by pediatric surgeons. Considering the limited experience many pediatric surgeons may have in thoracic surgery, authors describe in a simple and direct way, common congenital and acquired thoracic anomalies, and their management, emphasizing the physical, functional and psychological development of the pediatric patient.