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Background: Pediatric laparoscopy (LS) is claimed to be superior to open surgery (OS). This review questions the scientific veracity of this assertion by systematic analysis of published evidences comparing LS versus OS in infants and children. Materials and Methods: Search of PubMed data base and the available literature on pediatric LS is analyzed. Results: One hundred and eight articles out of a total of 426 papers were studied in detail. Conclusions: High quality evidences indicate that LS is, at the best, as invasive as OS; and is at the worst, more invasive than conventional surgery. There are no high quality evidences to suggest that LS is minimally invasive, economically profitable and is associated with fewer complications than OS. Evidences are equally distributed for and against the benefits of LS regarding postoperative pain. Proof of cosmetic superiority of LS or otherwise is not available. The author concludes that pediatric laparoscopy, at the best, is simply comparable to laparotomy and its superiority over the latter could not be sustained on the basis of available scientific evidences. Benefits of laparoscopy appear to recede with younger age. Concerns are raised on the quick adoption, undue promotion and frequent misuse of laparoscopy in children.

This communication is the summary of Internet discussions held by members of the Indian Association of Pediatric Surgeons (IAPS) in June 2005. It reflects the opinion and practice of Indian pediatric surgeons on the treatment of childhood empyema thoracis (ET). Despite the availability of broad-spectrum antibiotics, a large number of ET in advanced stages is still seen in India. The management of ET appears to depend on the stage of pathology, the status of underlying lung and proper usage of antibiotic adjuncts. Intercostal tube drainage of pleural space is sufficient for stage 1 empyema. Thoracoscopic decortication reduces the treatment cost and morbidity of stage 2 disease. However, stage 3 lesions with very thick pleural peels require open decortication. Pros and cons of these three modalities of treatment are discussed. The members also describe the various innovative techniques, that they found useful in the surgical management of ET.

Background: The traditional belief that attending medical conferences would further one′s knowledge needs to be examined critically. Although analytical reports on the effectiveness of conferences have been published from Western countries, such studies have never been conducted in India. Materials and Methods: The author prospectively analyzed 100 free papers presented at the 30th National Conference of the Indian Association of Pediatric Surgeons. Papers were categorized as original works, case reports, audit reports, innovations and theoretical papers. They were assessed for their scientific value, nature of conclusion, quality of discussion by authors and quality et quantity of audience interaction. Results: "Original works" and "innovations" frequently contributed additional information to the existing knowledge while most of the case reports, audit reports and theoretical papers were redundant. Nearly 40% of all papers had inappropriate conclusions. Only one author conferred all the five components of discussion while 32% of authors discussed nothing useful. Case reports, audit reports and theoretical papers topped the list of papers with inappropriate conclusion and poor discussion. About 24% of papers did not evoke any audience interaction. There was no significant difference in the enthusiasm of audience to interact with contributing versus redundant papers. Conclusion: Majority of case reports, audit reports and theoretical papers are found to be unsuitable for free paper session. To improve the quality of deliberations, the number of free papers should be reduced and the time allocation for each of them should be increased. Authors must be educated and reminded of the various components and importance of discussion. Whether audience at IAPS meetings react appropriately to free papers need to be evaluated further.

Pre-conceptional supplementation of folic acid is well known to reduce the incidence of spina bifida. But Athena is frequently perplexed to see this anomaly occurring despite folate supplementation. In a largest Canadian study, De Wal et al [1] screened 1.9 million live births to study the effect of mass fortification. On comparing pre and post fortification periods they noted only 46% reduction in the incidence of neural tube defects (NTD). What happens to the remaining 54%? Why do they defy “folic acid” logics? Recently several publications have shed more light on this intriguing question.

Athena stands for abbreviation of Abstracting and Thoughtful Evaluation of Neonatal Articles; but it is also personified by the contributor. Like Athena of Greek mythology, she distills wisdom from published literature.

Dear editor, We read, with great dismay, the editorial on pediatric urology training.[sup] [1] We wish to share some concerns about subspecialization in pediatric urology. We regretfully observe that the [...]