Evidence map›Paper›PMID 38685347›Full record

ArticleWorld neurosurgery2024

The Importance of Neurosurgical Intervention and Surgical Timing for Management of Pediatric Patients with Myelomeningoceles in Bangladesh.

Sudipta Kumer Mukherjee, Joanna E Papadakis, D M Arman, Joynul Islam, Mubinul Azim, Asifur Rahman, Sheikh Muhammad Ekramullah, Hafiza Sultana Suchanda, Afifah Farooque, Benjamin C Warf and 1 more

Abstract read
In one paragraph

Article in World neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sudipta Kumer MukherjeeDepartment of Paediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS), Dhaka, Bangladesh.
Joanna E PapadakisDepartment of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
D M ArmanDepartment of Paediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS), Dhaka, Bangladesh.
Joynul IslamDepartment of Paediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS), Dhaka, Bangladesh.
Mubinul AzimDhaka Shishu Hospital, Dhaka, Bangladesh.
Asifur RahmanDepartment of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Sheikh Muhammad EkramullahDepartment of Paediatric Neurosurgery, National Institute of Neurosciences & Hospital (NINS), Dhaka, Bangladesh.
Hafiza Sultana SuchandaPaediatric Neurosurgery Research Committee, National Institute of Neurosciences & Hospital (NINS), Dhaka, Bangladesh.
Afifah FarooqueDepartment of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Benjamin C WarfDepartment of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Maitreyi MazumdarDepartment of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: Maitreyi.Mazumdar@childrens.harvard.edu.

Funding

Translational Research Support CoreP30ES000002 · NIEHS · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI JAIME ELIZABETH HART · 1985 to 2026
$44.6M
Interdisciplinary approaches for understanding how arsenic and micronutrients affect the epigenome to influence spina bifida riskR01ES034713 · NIEHS · BOSTON CHILDREN'S HOSPITAL · PI MAZUMDAR, MAITREYI · 2023 to 2025
$2.3M
Does arsenic increase risk of neural tube defects in a highly-exposed population?R01ES026317 · NIEHS · BOSTON CHILDREN'S HOSPITAL · PI MAZUMDAR, MAITREYI · 2016 to 2020
$2.2M
Examining tissue-specific DNA methylation after prenatal exposure to arsenic among infants with spina bifidaR21ES030784 · NIEHS · BOSTON CHILDREN'S HOSPITAL · PI MAZUMDAR, MAITREYI · 2020 to 2021
$497k
NIEHS NIH HHS P30 ES000002NIEHS NIH HHS R01 ES026317NIEHS NIH HHS R01 ES034713NIEHS NIH HHS R21 ES030784
6 · The paper itself

Abstract

objectiveReports on the management and survival of children with myelomeningocele defects in Bangladesh are limited. This study describes the characteristics and outcomes of these children, focusing on the timing of surgical repair and factors affecting survival.

methodsWe enrolled patients with myelomeningoceles in a case-control study on arsenic exposure and spina bifida in Bangladesh. Cases were subsequently followed at regular intervals to assess survival. Demographic, clinical, and surgical characteristics were reviewed. Univariate tests identified factors affecting survival.

resultsBetween 2016 and 2022, we enrolled 272 patients with myelomeningocele. Postnatal surgical repair was performed in 63% of cases. However, surgery within 5 days after birth was infrequent (<10%) due to delayed presentation, and there was a high rate (29%) of preoperative deaths. Surgical repair significantly improved patient survival (P < 0.0001). Older age at time of surgery was also associated with improved survival rates, which most likely represents that those who survived to older ages prior to surgery accommodated better with their lesions. Patients who presented with ruptured lesions had lower survival rates.

conclusionsTimely neurosurgical repair of myelomeningoceles in Bangladesh is hindered by late patient presentation, resulting in a high preoperative patient death rate. Neurosurgical intervention remains a significant predictor of survival. Increased access to neurosurgical care and education of families and non-neurosurgical providers on the need for timely surgical intervention are important for improving the survival of infants with myelomeningoceles.

Indexed as

MeningomyeloceleNeurosurgical ProceduresBangladeshCase-Control StudiesChildChild, PreschoolFemaleHumansInfantInfant, NewbornMaleSurvival RateTime-to-TreatmentTreatment OutcomeArsenicFolic acidLMICMyelomeningocelePediatricsSpina bifida

Identifiers

PMID38685347
PMCPMC11227413

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.