The collective efforts of editors, board members, reviewers, authors and of course readers have given a cause to celebrate the first birthday of this journal. Mighty oaks are born of tiny acorns, and we hope, in the coming years, this journal will become useful to pediatric surgeons across the world.

Editors and Board Members of the Pediatric Surgery in Tropics are pleased to welcome the new members of the Editorial Board.

This article narrates the history of pediatric surgery South Africa over 100 years. The first department was established in 1923 at Johannesburg. Professor Jannie Louw, who did pioneering work, is considered the Father of South African Pediatric Surgery. Subsequently, 9 universities started training programs in pediatric surgery. The South African Association of Pediatric Surgeons and the College of Pediatric Surgeons of South Africa were founded in 1976 and 2010 respectively. Gender disparity that prevailed in apartheid era is slowly rectified and now there are more women pediatric surgeons in South Africa than before. The year 2024 is the centenary year of South African Pediatric Surgery.

Tuberculosis (TB), despite being a preventable and treatable infection, still remains
a major cause of mortality worldwide. Delay in establishing the diagnosis significantly contributes to the mortality. Early diagnosis, especially in children, is faced
with several challenges. This article reviews the current knowledge and challenges
of TB diagnosis.
The philosophy of TB diagnosis is based on two principles: (1) demonstration of the
causative organism in the host, and (2) demonstration of the host-reaction to the
invading pathogen. Staining and culture demonstrate intact bacilli, while molecular
methods demonstrate cellular fragments of mycobacteria. Staining techniques use a
unique property of mycobacterial cell wall that resists decolourization with acidalcohol. Fluorescent stains (e.g. auramine-rhodamine) are better than the conventional Ziehl-Neelsen stain. When the bacterial load is too low to be detected in
stained smears, culturing is used to increase the bacterial density. The WHO recommends Bactec MGIT-960™ medium because of its better yield than the conventional
Lowenstein-Jensen medium.
Dead or multiplying bacilli shed their genetic materials (DNA and RNA) as well as
cell wall antigens into the host secretions or circulation. Techniques like polymerase
chain reaction amplify the miniscule amount of bacterial nucleic acids and facilitate
their detection. The specificity and sensitivity of these techniques are often greater
than 90%. Hence, the WHO recommends cartridge-based nucleic acid amplification
test (CB-NAAT) as the preferred investigation of childhood TB. Lipoarabinomannan, a cell wall glycolipid specific to mycobacteria, is a useful urinary biomarker of
TB, especially in HIV patients.

Laparoscopy has increasingly become popular in the treatment of acute appendicitis. Despite its many advantages, it is not yet a routine practice in low-income countries like Senegal. Scarcity of research papers from Africa on the comparative benefits of laparoscopy has prompted the present study.

Optimal management of 46,XY disorders of sex development (DSD) has numerous challenges. The aim of this study was to evaluate the epidemiological, diagnostic, therapeutic and prognostic aspects of 46,XY DSD in Senegal.

The traditional classification and etiopathogenic theory of choledochal cyst (CDC)
has recently been challenged. A 16-month-old baby girl presented with jaundice,
abdominal distention and clay colored stools for 2 weeks. Investigations revealed a
Type IVA CDC. At laparotomy, a hugely distended biliary apparatus with an
apparent blind distal end was noted. Excision of the CDC and Roux-en-Y hepaticojejunostomy was performed. Her recovery is marked by a transient ascites for just 2
weeks. Histopathology of the excised distal bile duct showed hypertrophied nerve
bundles similar to Hirschsprungs disease. Ultrasonography after 4 mo of surgery
revealed complete regression of intra-hepatic duct dilation. From these, it appears
that Todani Type I and Type IVa CDC may be just variations of the same disease.

A full-term low birth-weight female newborn presented with clinical features of esophageal atresia. Investigations revealed Kluth type-13, an extremely rare varient of
esophageal atresia without fistula, in which the upper pouch is long and ends
blindly just above the diaphragm near the gastro-esophageal junction. She was
managed with esophagostomy and feeding gastrostomy in the neonatal period,
followed by gastric tube esophagoplasty at 2 years of age. At 18 months of follow-up
she is thriving well and asymptomatic.

Pediatric gastroparesis is characterized by delayed gastric empyting in the absence
of any mechanical obstruction. This case report describes the successful use of
domperidone and erythromycin in managing refractory gastroparesis in a 7-yearold girl. Owing to its rarity and shared symptomatology with other common gastrointestinal conditions, the diagnosis of gastroparesis is often delayed. In resourcelimited centers without scintigraphy, the diagnosis may be made based on the
clinical features and contrast radiography

One-lung ventilation (OLV) in pediatric patients, especially those under 8 years of
age, poses significant challenges due to anatomical constraints. However, the need
for lung isolation is increasing with advancements in surgical techniques such as
thracoscopy. The availability of newer bronchial blockers and innovative methods
of their placement have made OLV more feasible. This article briefly reviews the
recent developments in pediatric OLV. Technique such as double lumen tube,
bronchial blockers and endobronchial intubation of single lumen tube are
discussed. Technical tips of using Bronchial blockers such as Fogarty catheters,
Arndt blocker, uniblocker and univent tube are described.

Distal colonic aganglionosis is increasingly been treated with transanal pull-through that avoids a laparotomy. This study is intended to evaluate the results of this approach in a resource-limited setting.

Childhood burns are common injuries that carry significant morbidity. In this article, the outcome of pediatric burns in Senegal is audited.