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Awareness of Common Pediatric Surgical Entities among Practicing Indian Pediatricians
Santosh Kumar Mahalik1, Akash Bihari Pati1, Kanishka Das1
1Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Insights
Pediatricians show limited awareness in managing common pediatric surgical conditions, leading to delayed referrals and misdiagnoses. Improved collaboration between pediatricians and pediatric surgeons is crucial for better patient outcomes.
Area of Science:
- Pediatric Surgery
- Pediatrician Awareness
- Surgical Condition Management
Background:
- Delayed referrals to pediatric surgeons are common in India for pediatric surgical conditions.
- Assessing pediatrician awareness is vital for timely and appropriate management.
Purpose of the Study:
- To evaluate the knowledge of practicing pediatricians regarding the diagnosis and management of common pediatric surgical entities.
- To identify gaps in awareness that contribute to delayed surgical consultations.
Main Methods:
- An online multiple-choice questionnaire with 20 questions was distributed to Indian pediatricians.
- Questions covered diagnosis and management of common pediatric surgical issues encountered in routine practice.
- Responses were collected, analyzed, and scored for accuracy.
Main Results:
- Overall, 35% of responses were correct, with only 7% scoring above 75%.
- Significant knowledge gaps were observed, including unfamiliarity with preputial adhesions (65%) and inguinal hernias in preterm neonates (51%).
- Tendencies towards unnecessary investigations and overzealous medical management were noted, though consensus existed for conditions like hypospadias.
Conclusions:
- Only 35% of pediatricians demonstrated concurrence with pediatric surgeons on management principles for common pediatric surgical conditions.
- Misdiagnosis, unnecessary tests, and delayed referrals were prevalent in 65% of cases.
- Enhanced professional interaction between pediatricians and pediatric surgeons is recommended for coordinated patient care.
Aim:
Common pediatric surgical entities often get a delayed referral to the pediatric surgeon in the average Indian scenario. This study was conducted to assess the awareness about management of select common pediatric surgical entities among practicing pediatricians.
Materials And Methods:
An online multiple-choice questionnaire consisting of twenty questions related to the diagnosis and management of common pediatric surgical entities encountered by pediatricians in their routine office practice was prepared, and the electronic link was circulated among the practicing pediatricians of India. Each question had one correct response.
Results:
One hundred and seventy-five responses were obtained, collated, grouped, and analyzed. Overall, 35% of all responses were correct. Individually, 56% of respondents marked 51%-75% of answers correctly; only 7% scored above 75%. Some clinical observations were disparate: 65% were unfamiliar with preputial adhesions and 51% would discharge a preterm neonate with inguinal hernia without a surgical consult. There is a tendency toward unnecessary imaging (60% - localization of undescended testis, 91% - wet umbilicus, and 51% - postanal dimple) and overzealous medical management (propranolol for the involuting hemangioma). However, 82%-88% concurred on the standard conservative or surgical management in index conditions such as hypospadias and umbilical problems.
Conclusion:
There was a concurrence in the principles of management of common pediatric surgical entities between pediatricians and pediatric surgeons in 35%. Misdiagnosis, unwarranted investigations, overzealous medical management, and delayed surgical consults figured in 65%. A systematic professional interaction between the physicians and surgeons would facilitate a coordinated management. A larger study would yield more meaningful data.
