| What does the term 'silk glove sign' refer to in relation to inguinal hernia? | Palpable silky thickening of cord | Danger signs should be explained to the parents at the time of making the diagnosis itself Surgical NICU managed by Pediatric Surgeon or NICU managed by neonatologist In inborn neonates who are diagnosed with inguinal hernia, surgery should preferably be performed prior to discharge FOLLOW-UP: WITH WHOM? • The first follow-up after discharge should be with the operating surgeon. • Subsequent follow-up may be with the primary health centre close to the residence of the patient subject to approval by the operative surgeon Complicated Irreducible with features of peritonitis Stabilize followed by urgent surgery Surgeon’s comfort SWELLING: Inguinal or inguinoscrotal (inguinolabial), reducible (with or without gurgling sound) or irreducible, cough impulse SILK GLOVE SIGN: Palpable silky thickening of cord CONTRALATERAL INGUINAL HERNIA: Upto 20% of patients may have synchronous contralateral inguinal hernia AGGRAVATING FACTORS: In males with bilateral inguinal hernia (especially if associated with umbilical hernia), lower urinary tract outflow obstruction must be ruled out; connective tissue disorders, etc CONTENT OF SWELLING: Usually only bowel and omentum, ovary (and/ or fallopian tube) in females and testis in boys with associated cryptorchidism; torsion of gonad to be ruled out | 778 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | • Subsequent follow-up may be with the primary health centre close to the residence of the patient subject to approval by the operative surgeon Complicated Irreducible with features of peritonitis Stabilize followed by urgent surgery Surgeon’s comfort SWELLING: Inguinal or inguinoscrotal (inguinolabial), reducible (with or without gurgling sound) or irreducible, cough impulse SILK GLOVE SIGN: Palpable silky thickening of cord CONTRALATERAL INGUINAL HERNIA: Upto 20% of patients may have synchronous contralateral inguinal hernia AGGRAVATING FACTORS: In males with bilateral inguinal hernia | 10 | page=10,block=2 | 0.700 | valid |
| What is the condition caused by the failure of the processus vaginalis to obliterate after testis descent? | protrusion of bowel, omentum or other intra-abdominal contents into the inguinal canal or beyond. | WHAT IS IT? Condition wherein the processus vaginalis fails to obliterate after descent of the respective testis resulting in protrusion of bowel, omentum or other intra-abdominal contents into the inguinal canal or beyond. | 126 | definition | 1.000 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | WHAT IS IT? Condition wherein the processus vaginalis fails to obliterate after descent of the respective testis resulting in protrusion of bowel, omentum or other intra-abdominal contents into the inguinal canal or beyond. | 10 | page=10,block=28 | 0.700 | valid |
| What could indicate a locomotor delay in children? | Previously unknown/undiagnosed weakness in legs, locomotor delay | • Constipation reported from birth or first few weeks of life • Failure to pass meconium/delay (more than 48 hours after birth in term baby) • All abnormal location or calibre of anal opening • 'Ribbon stools‘ (more likely in <1 year olds ) • Previously unknown/undiagnosed weakness in legs, locomotor delay, signs of hypothyroidism • Abdominal distension with vomiting Type 1 Type 2 Type 3 Type 4 Type 5 Type 6 Type 7 Separate hard lumps. Lumpy and sausage like A sausage shape with cracks in the surface Like a smooth, soft sausage or snake Soft blobs with clear-cut edges Mushy consistency with ragged edges Liquid consistency with no soild pieces Severe constipation Mild constipation Normal Normal Lacking Fibre Mild diarrhea Severe diarrhea | 243 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | • Constipation reported from birth or first few weeks of life • Failure to pass meconium/delay (more than 48 hours after birth in term baby) • All abnormal location or calibre of anal opening • 'Ribbon stools‘ (more likely in <1 year olds ) • Previously unknown/undiagnosed weakness in legs, locomotor delay, signs of hypothyroidism • Abdominal distension with vomiting Type 1 Type 2 Type 3 Type 4 Type 5 Type 6 Type 7 Separate hard lumps. |
| What is the intended outcome of empowering healthcare physicians and surgeons in India? | achieving the overall goal of Universal Health Coverage | Ministry of Health and Family Welfare, Government of India To empower the primary, secondary and tertiary health care physicians/surgeons towards achieving the overall goal of Universal Health Coverage with disease management protocols and pre-defined referral mechanisms by decoding complex guidelines. | 146 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | Ministry of Health and Family Welfare, Government of India To empower the primary, secondary and tertiary health care physicians/surgeons towards achieving the overall goal of Universal Health Coverage with disease management protocols and pre-defined referral mechanisms by decoding complex guidelines. | 6 | page=6,block=11 | 0.700 | valid |
| What is the reason for recommending early surgery for undescended testis with a large inguinal hernia? | due to the risk of obstructed hernia | DSD- needs complete evaluation and treatment planning based on genotype, phenotype and psychological counselling Undescended testis with torsion – needs immediate exploration and orchiopexy/orchidectomy Undescended testis with large inguinal hernia- needs early surgery before waiting for 6 months due to the risk of obstructed hernia | 298 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | DSD- needs complete evaluation and treatment planning based on genotype, phenotype and psychological counselling Undescended testis with torsion – needs immediate exploration and orchiopexy/orchidectomy Undescended testis with large inguinal hernia- needs early surgery before waiting for 6 months due to the risk of obstructed hernia | 12 | page=12,block=15 | 0.700 | valid |
| What is the role of diagnostic laparoscopy in managing impalpable undescended testis? | can be combined with therapeutic procedure | ESSENTIAL INVESTIGATIONS • No investigation is essential for diagnosis or localisation of testis. • Routine blood and urine investigations required for anaesthetic fitness OPTIONAL INVESTIGATIONS • Hormonal test (HCG stimulation test for bilateral undescended testis ) • MRI scan in cases suspected to be DSD • Diagnostic laparoscopy in impalpable UDT (can be combined with therapeutic procedure) SPECIAL SITUATIONS • DSD: hormonal assay, USG, genitogram, karyotyping • Syndromic child: genetic assessment, karyotyping, hormonal assays • Undescended testis with torsion: USG Doppler Guiding Principle: Diagnosis made at birth and reconfirmed at 3 and 6 months. Further management if descent has not occurred. | 353 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | • Routine blood and urine investigations required for anaesthetic fitness OPTIONAL INVESTIGATIONS • Hormonal test (HCG stimulation test for bilateral undescended testis ) • MRI scan in cases suspected to be DSD • Diagnostic laparoscopy in impalpable UDT (can be combined with therapeutic procedure) SPECIAL SITUATIONS • DSD: hormonal assay, USG, genitogram, karyotyping • Syndromic child: genetic assessment, karyotyping, hormonal assays • Undescended testis with torsion: USG Doppler Guiding Principle: Diagnosis made at birth and reconfirmed at 3 and 6 months. |
| What occurs when the processus vaginalis does not close properly after the testis descends? | protrusion of bowel, omentum or other intra-abdominal contents into the inguinal canal or beyond. | WHAT IS IT? Condition wherein the processus vaginalis fails to obliterate after descent of the respective testis resulting in protrusion of bowel, omentum or other intra-abdominal contents into the inguinal canal or beyond. | 126 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | WHAT IS IT? Condition wherein the processus vaginalis fails to obliterate after descent of the respective testis resulting in protrusion of bowel, omentum or other intra-abdominal contents into the inguinal canal or beyond. | 10 | page=10,block=28 | 0.700 | valid |
| What action is recommended if a chest X-ray shows significant effusion in a suspected empyema case? | Paediatric surgery consultation for ICD insertion or refer to higher center | Suspected empyema - X ray Chest - suggests significant effusion Paediatric surgery consultation for ICD insertion or refer to higher center No effusion - treat as pneumonia Effusion present Stage 1 phase Stage 2 or 3 complex effusion Chest USG for quantifying effusion ICD/ Aspiration/ Antiobiotcs CECT & VATS. If thick peel: thoracotomy | 64 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | Suspected empyema - X ray Chest - suggests significant effusion Paediatric surgery consultation for ICD insertion or refer to higher center No effusion - treat as pneumonia Effusion present Stage 1 phase Stage 2 or 3 complex effusion Chest USG for quantifying effusion ICD/ Aspiration/ Antiobiotcs CECT & VATS. | 11 | page=11,block=26 | 0.700 | valid |
| What is the goal of empowering healthcare physicians and surgeons in India? | achieving the overall goal of Universal Health Coverage | Ministry of Health and Family Welfare, Government of India To empower the primary, secondary and tertiary health care physicians/surgeons towards achieving the overall goal of Universal Health Coverage with disease management protocols and pre-defined referral mechanisms by decoding complex guidelines. | 146 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | Ministry of Health and Family Welfare, Government of India To empower the primary, secondary and tertiary health care physicians/surgeons towards achieving the overall goal of Universal Health Coverage with disease management protocols and pre-defined referral mechanisms by decoding complex guidelines. | 6 | page=6,block=11 | 0.700 | valid |
| What is the purpose of formulating treatment algorithms in India's healthcare system? | for common and serious medical & surgical conditions for both outdoor & indoor patient management | To formulate treatment algorithms for common and serious medical & surgical conditions for both outdoor & indoor patient management at primary, secondary and tertiary levels of India’s healthcare system that are scientific, robust and locally contextual. • Participation also from Public Health Specialists Search Strategists Graphic Designers • Review by Editorial Board • Approval by Advisory Committee • Prevalence studies • Global burden of diseases studies • HBP of AB-PMJAY Output ADVISORY COMMITTEE ICMR STW Team Speciality wise Expert Committees Editorial Board Book Web Portal Mobile Apps | 34 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569368_paediatric_surgery_all.pdf | To formulate treatment algorithms for common and serious medical & surgical conditions for both outdoor & indoor patient management at primary, secondary and tertiary levels of India’s healthcare system that are scientific, robust and locally contextual. | 6 | page=6,block=11 | 0.700 |