bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Pre_Operation Desogestrel Estradiol in Endometrial Preparation at Hysteroscopic Polypectomy
Authors: Mardanian Farahnaz , Mehrabian Ferdous , Rouholamin Safura , Izadpanahi Somayeh , Hashemi Maryam
Published: July 2024

Background:

Hysteroscopic surgery is a common gynecologic process in many conditions. Endometrial thinning is the main successful key for this process associated with many preoperative preparations. This study aimed to evaluate DE (Desogestrel-estradiol) to reduce endometrial thickness in comparison with the control group.

Materials and Methods:

This Randomized clinical trial was done on the patients candidate for polypectomy that were randomly divided into two groups of intervention and control; the first group received DE OCP (oral contraceptive pill with 30 microgram Ethinyl estradiol + 150 micro gram Desogestrel) once daily from the 1st to 5th day of the menstrual cycle for 21 days and then in the first day of next menstruation cycle, the drug was used up to one day before hysteroscopy done in the 5th to 8th day of the cycle. The second group received no drugs. Hysteroscopy was done in the early follicular phase in both groups and all the subjects received one dosage of Misoprostol a night before surgery.

Results:

There were no significant differences between the parity, polyp size, and BMI (Body Mass Index) in the two groups. The mean duration of surgery, mean endometrial thickness before hysteroscopy, the quality of endometrial tissue, and surgeon satisfaction were significantly difference between the two groups. However, the quality of the surgeon’s vision in the intervention group was better than the control group but there was no significant difference between the two groups.

Conclusion:

Pre-operation endometrial thinning by oral contraceptives such as DE could be an effective method and reduce the duration of surgery.
Compliance and Lifestyle of Children with Celiac Disease in the Iranian Children
Authors: Rafeey Mandana , Ghergherehchi Robabeh , Nikniaz Zeinab , Shoaran Maryam , Hosseinalizadeh Amaneh
Published: July 2024

Background:

Celiac disease is popular and needs a proper and constant gluten-free diet. However, data on the experience of the disease by children are insufficient. A few children have difficulty adjusting their lifestyles, and gluten-free foods are difficult for them. The present study aimed to find influential factors in the growth disorders and nonresponse to the treatment diet in celiac patients.

Materials and Methods:

We gave a list of all children with celiac disease to the project manager and according to the criteria extracted additional information from their files. Duodenal biopsies on 382 patients with suspected celiac disease and 93 patients with positive pathology were included in the study, regardless of antibody and genetic titer, then analyzed their information using appropriate statistical tests.

Results:

The mean age of individuals was 9.48 ± 3.88, and 35 were male and 58 female. At the age of <5, there was more growth disorder than other age groups. The recovery percentage in short stature was significantly better in children with higher marches, and they responded better to the treatment regimen. Individuals with comorbidities had higher anti-tTG and lower Hb levels, higher incidence of growth disorder, did not respond to the treatment regimen. Those with a first-degree relative with celiac disease had a lower growth disorder than others.

Conclusion:

Identifying and correcting nutritional disorders in patients with celiac disease need to evaluate persistent symptoms and identify their causes to plan appropriate treatment and follow-up of patients with celiac disease step by step and continuously.
Comparison of Endometrial Polyp Characteristics in Transvaginal Sonography and Hysteroscopy in Predicting Endometrial Malignancies in Premenopausal and Postmenopausal Women
Authors: Rouholamin Safoura , Irannezhad Parisa , Hashemi Maryam
Published: July 2024

Background:

Hysteroscopy is known as the gold standard for endometrial polyps diagnosis and its findings on vascularity, size, and number of polyps can indicate malignancy, but it is a relatively expensive method with some complications. Ultrasound is a common part of the gynecological examination, and with technological advances, its ability to predict pathological outcomes has increased. This study aimed to determine the accuracy of ultrasound in diagnosing the characteristics of endometrial polyps.

Materials and Methods:

This diagnostic value study was performed on 300 premenopausal and postmenopausal women over 40 years of age with endometrial polyps referred to Alzahra and Beheshti hospitals in Isfahan. The characteristics of endometrial polyps were evaluated by transvaginal ultrasonography and hysteroscopy and biopsy specimens were sent for pathological evaluations.

Results:

In this study, 103 premenopausal women and 197 postmenopausal women were evaluated. Malignancy was confirmed by pathology in 4 premenopausal women (2%) and 2 postmenopausal women (2%). In both hysteroscopy and ultrasound methods, the frequency of vascularity was significantly different in postmenopausal and premenopausal women, but the other features of the polyp were not significantly different in them. Ultrasonic sensitivity in detecting the presence of vascularity, polyps larger than 1.5 mm, more than 1 polyp, and the presence of pedicle were 39.04, 57.38%, 91.93 and 94.95%, respectively, its specificity were 98.94, 36.47, 99.57 and 98.89% respectively.

Conclusion:

A comparison of the characteristics of polyps in both ultrasound and hysteroscopy methods shows that hysteroscopy has been more effective in diagnosing malignancy and ultrasound has not have acceptable sensitivity in diagnosing size and vascularity.
Overexpression of Long Non-coding RNAs MCM3AP-AS1 and LINC00092 Predict Poor Prognosis in Patients with Gastric Adenocarcinoma
Authors: Bagheri Mahdi , Aghaabdollahian Safieh , Asghardoust Rezaei Milad , Gholian Kholerdi Ali Mehdi , Raei Mehdi , Keyvanloo Shahrestanaki Mohammad
Published: July 2024

Background:

LINC00092 and MCM3AP-AS1 long non-coding RNAs (LncRNAs) play significant roles in the development and pathogenesis of many cancers. However, their expression levels and prognostic values were not evaluated in human gastric adenocarcinoma (GAC). Therefore, the present study aimed to investigate the clinico-pathological correlations of LINC00092 and MCM3AP-AS1, LncRNAs expression in GAC, and evaluate their prognostic values.

Materials and Methods:

The expression of LINC00092 and MCM3AP-AS1 was detected in 89 GAC tissues by quantitative real-time reverse-transcription PCR (qRT-PCR).

Results:

Our results showed that LINC00092 and MCM3AP-AS1 are overexpressed in GAC patients and positively correlated with GAC invasion and vascular, peritoneal, and lymph node metastasis (P < 0.05). Furthermore, the results indicated that MCM3AP-AS1 (P = 0.0225) and LINC00092 (P < 0.001) have positive correlations with GAC patients’ overall survival.

Conclusion:

Altogether, the present results indicated that LINC00092 and MCM3AP-AS1 overexpression is associated with clinico-pathological characteristic of GAC patients. In addition, both of these LncRNAs may have prognostic value for estimation of patients’ overall survival.
A Longitudinal Examination of Blood Sugar Dynamics in Diabetes and Non-Diabetes Using Growth Curve Model: The Sabzevar Persian Cohort Study
Authors: Tabarraei Yaser , Keshtkar Abbas Ali , Yekaninejad Mir Saeed , Rahimi Najme , Dowlatabadi Yousef , Azam Kamal
Published: July 2024

Background:

Diabetes mellitus is a chronic metabolic disorder with substantial implications for public health. Understanding the factors influencing blood sugar fluctuations is crucial for effective diabetes management and prevention. This study aimed to evaluate factors associated with blood sugar changes in diabetic patients and healthy individuals attending the Sabzevar Persian Cohort Center, employing the growth curve model.

Materials and Methods:

Data related to 589 diabetic patients and 589 non-diabetic patients participating in the Persian cohort study of Sabzevar were used. Due to the repetition of blood sugar measurements for each individual over time, we use the conditional latent growth curve model to examine intra-individual changes and variables that affect these changes over time.

Results:

The linear latent growth curve model, fitted with independent variables, exhibited a superior fit. The slope of the line for the diabetic group was measured at 1.78, while for the non-diabetic group, it was estimated to be -0.29. Within the diabetic group, the influence of age, the presence of fatty liver, and history of congenital heart disease (CHD) had a significant impact on the baseline (the intercept), and the effect of body mass index (BMI) on the changing trend of the response variable (slope) was also significant. In the non-diabetic group, significant effects were observed for age variables, BMI, family history of diabetes, and history of stroke in the family.

Conclusion:

Overall, the linear latent growth curve model showed good performance in the evaluation of the factors related to blood sugar changes in diabetic patients and healthy people.
Compare the GCS and the Rotterdam CT Score in Predicting the Mortality and Disability of Patients with Traumatic Brain Injury
Authors: Mahmoodkhani Mehdi , Behfarnia Parham , Aminmansour Bahram
Published: July 2024

Background:

Given the dearth of extensive research comparing the Glasgow Coma Scale with the Rotterdam scoring system for predicting mortality in trauma patients, this study was conducted to determine which scale provides a more realistic prediction of mortality in trauma patients after three months.

Materials and Methods:

This observational study was performed at Kashani Hospital in Isfahan, Iran. Patients with TBI who were admitted between February 2022 and February 2023 were included in the study. Approval from the Ethical Committee of Isfahan University of Medical Sciences was obtained prior to conducting this study.

Results:

We included 152 adult patients who completed the GOS-E and the QOLIBRI-OS three-month post-injury. The median age was 35 years (IQR = 17–70). Most patients 139 (91.4%) were classified as having a severe TBI.

Conclusion:

The results of the present study showed that both the use of GCS and Rotterdam CT scores can be effective in predicting the three-month mortality and QOLIBRI-OS scores of patients, with the difference that the predictive power of the three-month Rotterdam CT score is greater than that of the GCS.
Smoking and the Risk of Type 2 Diabetes: A Cross-sectional Analytical Study
Authors: Debnath Dhrubajyoti J. , Ray Jayanti , Jah Syed Mustafa , Marimuthu Yamini
Published: July 2024

Background:

India is undergoing epidemiological transitions with the increase in noncommunicable disease (NCD) burden. Targeting the modifiable risk factors through lifestyle changes in the early years of life remains the most effective strategy for decreasing the prevalence of type 2 diabetes mellitus (T2DM). To determine the association between cigarette smoking and T2DM.

Materials and Methods:

An analytical cross-sectional study was conducted among the patients attending the outpatient department of a tertiary care teaching hospital in Kolkata, West Bengal, India. Patients aged more than 35 years were enrolled, and details regarding sociodemography, clinical status, and NCD risk factors were collected using pretested semistructured questionnaires after obtaining IEC approval. Data collected were entered in MS Excel and analyzed using SPSS software. Simple logistic regression and multivariable logistic regression analysis were used to calculate the crude and adjusted odds ratio with 95% confidence interval.

Results:

Out of 434 participants, 37.3% had diabetes mellitus, 51.6% were males, and 28.6% had alcohol consumption. Univariate logistic regression analysis revealed age, BMI, systolic BP, diastolic BP, and cigarette smoking were significantly associated with increased risk of T2DM. Multivariable logistic regression analysis revealed cigarette smoking, systolic BP, age, and female gender were significant risk factors for T2DM.

Conclusions:

Our study reported cigarette smoking and systolic BP are modifiable risk factors associated with T2DM. Early identification of smoking through screening and appropriate control of hypertension in T2DM patients will decrease the morbidities and mortalities in T2DM cases.
Trend, Pattern, and Prevalence of Adverse Pregnancy Outcomes among Women of Reproductive Age in India, 1992–2021
Authors: Swain Prafulla K. , Jena Anmol
Published: July 2024

Background:

Adverse pregnancy outcomes (APOs) are the most important vital statistics used to assess maternal health and child health statistics. They are an indicator of the quality of maternal and child health care services, i.e., antenatal care, intrapartum care, and medical services.

Material and Methods:

The objective of the study is to analyze the trend, pattern, and prevalence of APOs among women of reproductive age group at the national level over successive NFHS rounds. The current study uses data from the National Family Health Survey (NFHS), conducted during 1992–2021. The study uses geo-spatial mapping techniques through QGIS software and report analysis to arrive at definitive conclusions.

Results:

The study finds that the incidence of APOs among women of reproductive age (15–49 years) has increased over the years. Twenty states and union territories have APOs that are below the national average. On the other hand, States like Madhya Pradesh, Meghalaya, Sikkim, Goa, Maharashtra, Andhra Pradesh, Karnataka, and Kerala have witnessed their APOs worsening as per NFHS-5 vis-à-vis NFHS-4. The study also finds that apart from the Himalayan belt and the east coast of India, APOs are more prominent in the contiguous regions adjoining these areas.

Conclusions:

The findings of the study have thrown on very interesting facts. Despite rapid economic development during the intervening period between NFHS-4 and NFHS-5, rising APOs are a testament to the fact that the policymakers in the country need to be more target-oriented and get their acts together.
Qualitative Study to Identify Strengths, Weakness, Opportunities, and Challenges of Family Adoption Programs among Students
Authors: Reshmi Panchasheela S , Lunagariya Ruchita , Patel Hiren , Patel Nikhil , Chauhan Dixit , Patel Ravi
Published: July 2024

Background:

National Medical Commission (NMC) in their recent notification included Family Adoption Program (FAP) in the undergraduate curriculum to provide a learning opportunity towards community-based health care to Indian medical graduates. This study is carried out to explore and know strengths, weaknesses, opportunities, and challenges of FAP.

Materials and Methods:

FAP were used to gather data using Focus Group Discussion (FGD) and in-depth interviews of the stakeholders of the program. FGD of students was conducted. In-depth interviews of families, Sarpanch, Panchayat members, ASHA workers of the village, faculties, and Head of the Department of Community Medicine were conducted. Data analysis was done by using deductive–inductive content analysis method using computer software NVivo.

Results:

Four main categories or themes were formed: strengths, weaknesses, opportunities, and challenges. Strengths include increased understanding about Community Medicine subject, beneficence to students, and community. Weakness includes difficulties in field with respect to time and availability and implementation of programs. Opportunities include early field exposure and FAP as a platform for primary healthcare. Challenges include competencies not aligned with phasewise curriculum and difficulties in adopting five families per student.

Conclusions:

The family adoption program needs to be adopted and implemented as a part of curriculum for MBBS students as there are many strengths and opportunities, while weaknesses and challenges need to be addressed.
Assessing the surgical competency of novice surgeons by using a three-dimensional heads-up display microscope
Authors: Varman Aadithreya , Varman N V Arulmozhi , Balakumar Dinesh
Published: July 2024

Purpose:

To evaluate the surgical performance of novice surgeons operating on a three-dimensional (3D) heads-up display system compared to those using a traditional microscope (TM).

Methods:

Prospective study design in a private practice setting. Twenty novice surgeons with similar experiences in cataract surgery were selected. Each surgeon performed 20 phacoemulsification cataract surgeries: 10 surgeries on the 3D heads-up display microscope, and 10 surgeries using a TM system. Data were collected from a total of 400 patients operated on by 20 surgeons. Outcome measures were recorded and graded according to the International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric-Phacoemulsification system. The main outcome measure was mean surgical competency scores.

Results:

Overall, 400 data points were equally distributed between TM (200) and 3D (200) surgeries. The mean surgical competency scores were 60.19 (11.41) for TM surgeries and 62.99 (11.11) for 3D surgeries. 3D surgeries had significantly higher surgical competency scores than TM surgeries (P= 0.013). The mean surgical duration for TM and 3D surgeries was 35.98 (6.02) min and 34.31 (7.12) min, respectively. 3D surgeries took significantly less time than TM surgeries (P= 0.012). The overall mean best corrected visual acuity in the logarithm of the minimum angle of resolution units was 0.27 (0.42); in TM and 3D surgeries, it was 0.28 (0.43) units and 0.26 (0.41) units, respectively.

Conclusion:

The 3D heads-up display system enhances stereopsis in cataract surgery, making it a valuable training tool for novice surgeons in phacoemulsification procedures.
Association of fracture type with enophthalmos and intraorbital volume correction in orbital fractures: A computed tomographic study
Authors: Parameswaran Anantanarayanan , Panneerselvam Elavenil , Mukherjee Bipasha
Published: July 2024

Purpose:

To determine the influence of different types of orbital fractures on the radiographic post-treatment outcomes.

Methods:

The investigation was a retrospective cohort study involving CT data of all patients who underwent delayed primary or secondary surgery for orbital/zygomatico-orbital trauma between 2019 and 2021. The sample was divided into three groups 1, 2, and 3: isolated floor, floor and medial wall, and combined orbit and zygomatic complex fractures. The type of orbital fracture was the exposure, while the outcome measures were reduction in enophthalmos and intraorbital volume and linear relationship between the two variables. Data were analyzed for variance between groups and association. Statistical significance was set at < 0.05.

Results:

Forty-four patients (3 females and 41 males) with a mean age of 28.6 years were included in the study. Reductions in enophthalmos (P < 0.001) and intraorbital volume (P = 0.003) demonstrated significant variance between the groups. For every cubic centimeter of reduction in volume, the reduction in enophthalmos was 0.78 mm (P < 0.001) in isolated floor fractures, 0.60 mm (P = 0.013) in combined fractures involving the floor and medial walls, and 0.24 mm (P = 0.456) in combined fractures of the orbit and zygoma.

Conclusion:

Correction of enophthalmos strongly depends on the type of orbital fracture. There exists a significant linear relationship between enophthalmos and intraorbital volume in fractures involving the internal orbit.
Gonioscopy-assisted transluminal trabeculotomy (GATT) with scleral or iris fixation for subluxated intraocular lenses and glaucoma
Authors: Sharon Tal , Ben-Haim Liron Naftali , Dar Nimrod , Assia Ehud I , Belkin Avner
Published: July 2024

Introduction:

This retrospective chart review aims to report a combined surgical approach of intraocular lens (IOL) fixation and gonioscopy-assisted transluminal trabeculotomy (GATT) for the treatment of subluxated IOLs and glaucoma or ocular hypertension.

Methods:

Charts of patients who underwent IOL fixation combined with GATT between November 2019 and July 2023 were reviewed. The main outcome measure was surgical success, defined as a well-centered IOL and an IOP of 18 mmHg or lower and either a 30% IOP reduction or a reduction in medications as compared to baseline. Complications and the need for reoperation were recorded.

Results:

Eleven patients who underwent GATT with IOL fixation were included. The mean age was 80.45 years (range: 73–90). IOL subluxation was associated with pseudoexfoliation in all cases. Seven patients underwent scleral fixation, and four underwent iris fixation. The mean follow-up was 15.36 (range: 2.7–26.6) months. The success rate was 72.73%. The mean baseline IOP was 20.63 ± 6.56 mmHg on 2.81 ± 1.53 medications. Four patients were on oral carbonic-anhydrase inhibitor (CAI) before surgery. The mean IOP at the end of the follow-up was 13.86 ± 3.5 mmHg on 1.36 ± 1.57 medications, and none were on oral CAIs. No intraoperative complications occurred, and transient hyphema and vitreous hemorrhage were the most common postoperative complications. All patients had a well-centered IOL. No patients needed additional surgery for IOL position or IOP control. The mean corrected distance visual acuity was 0.634 ± 0.62 logMAR at baseline and 0.36 ± 0.38 at the end of follow-up.

Conclusions:

GATT can be combined with IOL fixation to the sclera or iris to effectively reduce IOP and medication usage.
Effective low-cost pediatric vision screening by naive nonophthalmic examiners using the ‘Arclight’ device
Authors: Gore Rujuta , Wang Jenny N , Yang Christopher D , An Miranda , Hunter Stephen C , Shahraki Kourosh , Blaikie Andrew , Suh Donny W
Published: July 2024

Purpose:

To explore whether a low-cost ophthalmoscope (Arclight) can be used by naive nonophthalmic examiners to effectively screen for pediatric eye disease.

Methods:

Fifty-four children (108 eyes) were examined by five medical students using an Arclight. Gold standard examination was performed by an ophthalmologist using a slit lamp and indirect ophthalmoscope. Examinations performed included ophthalmoscopy of the optic disc, estimation of the cup-to-disc ratio (CDR), corneal light reflex test (CRT), Bruckner’s reflex test (BRT), and evaluation of refractive error. We determined the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the nonophthalmologist’s Arclight exam compared to the gold standard findings of comprehensive evaluation by pediatric ophthalmologists.

Results:

Using the Arclight, the optic nerve exam was successfully completed in 65% of patients. CDRs above and below 0.5 could be determined with 66.7% sensitivity and 84.4% specificity. Arclight CRT measurements were significant (P < .00001) predictors of strabismus, with 80% sensitivity, 95.1%, specificity, 80% PPV, and 95.1% NPV. BRT was not a significant predictor of amblyopia, with a 34.6% sensitivity, 85.7% specificity, 69.2% PPV, and 58.5% NPV. Refractive error was estimated with a success rate of 81% for emmetropia, 38% for myopia, and 21% for hyperopia. The Arclight ease-of-use was rated on average as 4.4 (SD = 0.9) on a scale of 1 to 5, with 1 being the hardest and 5 being the easiest.

Conclusions:

Our study shows the Arclight as an affordable and effective alternative to the traditional ophthalmoscope for assessing eye disease in children. This device can improve eye health services in under-resourced regions.
The buccal plug: A technique for management of focal cicatricial entropion and trichiasis
Authors: Saffari Persiana S , Roelofs Kelsey A , Rootman Daniel B
Published: July 2024

Cicatricial entropion can be challenging to manage, and surgery may lead to anterior lamellar and focal lash loss or tarsal scarring. We describe a surgical technique to address focal cicatricial entropion that avoids conjunctival incisions and minimizes changes to the aesthetic contour of the eyelid. Four patients underwent surgery with a square portion of the posterior row of eyelash follicles being excised anterior to the tarsus. A buccal mucous membrane graft was then harvested and inserted between the lamella. The plug served to recreate a mucosal membrane at the posterior reflection of the eyelid and separate the anterior and posterior lamella mechanically. With a mean follow-up of 5.16 months, no patients experienced regrowth of lashes at the graft site, and corneal irritation from aberrant eyelashes was abated. The buccal plug technique provides an aesthetically minded, less invasive approach to surgical management of localized entropion with trichiasis.
Microkeratome versus manually dissected donor tissue for Descemet stripping endothelial keratoplasty: A randomized prospective study
Authors: Mali Ritu , Priyadarshini Smruti R. , Sahu Srikant K. , Mohanty Amrita , Das Sujata
Published: July 2024

Purpose:

To compare the visual outcomes, postoperative complications, and graft asymmetry between precut and manually dissected donor tissues for Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet stripping endothelial keratoplasty (DSEK) procedures, respectively.

Methods:

Seventy eyes of 70 patients undergoing DSEK/DSAEK at a tertiary eyecare center in eastern India were included in this prospective randomized control study. The 70 eyes were divided equally into two groups. Group A (n = 35) and Group B (n = 35) underwent DSEK and DSAEK procedures, respectively. the operating surgeons prepared the manually dissected corneal grafts using lamellar dissectors. the eye bank technicians prepared the precut corneal grafts using a microkeratome. The patients were investigated postoperatively after 1 day, 1 week, 1 month, 3 months, and 6 months. The data were compared for visual outcomes [uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical and cylindrical refraction, and spherical equivalent], incidence of postoperative complications, and pachymetry.

Results:

The mean age was 56.5 (±17.8) years, and the male-to-female ratio was 1.3:1. The most common indications were pseudophakic bullous keratopathy (45.71%, 32/70), failed graft (32.86%, 23/70), and Fuchs’ endothelial corneal dystrophy (10%, 7/70). The indications for surgery (P = 0.732) and donor (P = 0.258) and host pachymetry (P = 0.986) were comparable between both groups. There was no significant difference in change of UCVA, BCVA, and postoperative refraction (mean spherical refraction, P = 0.849; mean cylindrical refraction, P = 0.516; spherical equivalent, P = 0.518) between the two groups. Postoperative complications like graft detachment (P = 0.179), graft failure (P = 0.513), graft infiltrate (P = 0.428), and endophthalmitis (P = 0.493) were higher in the DSAEK group; however, the difference between the groups was insignificant. The graft asymmetry index was higher in DSAEK than in DSEK; the difference was significant till the 1-month follow-up (P = 0.005).

Conclusion:

The outcome was similar in both groups. Therefore, manual donor dissection can be an alternative for microkeratome-assisted dissection in low-resource centers and countries to achieve good results.
Clinical profile and outcomes of rejection after deep anterior lamellar keratoplasty in keratoconus
Authors: Sudaboina Priyanka , Chaurasia Sunita , Murthy Somasheila
Published: July 2024

Purpose:

To report the clinical features and management outcomes of rejection after deep anterior lamellar keratoplasty (DALK).

Methods:

The clinical features, indications, predisposing risk factors, management, and outcome of six eyes of six patients with rejection after DALK were analyzed retrospectively.

Results:

The median time of rejection from the day of surgery was 12 (range 3–36) months. Median duration of symptoms was 4 (range 2–28) days. The indication for DALK was keratoconus in all eyes. The clinical features at presentation included graft haze, vascularization, and melt at the graft–host junction. The risk factors noted were noncompliance to steroids in all eyes, vernal conjunctivitis (four eyes), and eccentric graft (one eye). The rejection episode reversed with topical steroids in all eyes and intravenous methylprednisolone in one eye. One eye developed secondary fungal keratitis after initial recovery and one eye had a second episode of rejection 3 months later, which resulted in progressive vessels and lipid keratopathy in the visual axis. The median best corrected visual acuity was 20/40 (range 20/30–20/200).

Conclusion:

Severe stromal rejection can present with graft melt. Repeat episodes of rejection can occur on sudden cessation of topical steroids. Prompt recognition of clinical signs and symptoms with timely management helps in quick reversal of the rejection episode. Reversal of graft rejection results in good visual outcomes.
Therapeutic Potential of Adipose-Derived Stem Cells and Their Secretome in Reversible Alopecias: A Systematic Review
Authors: Ortega-Cuartiella Alexis
Published: July 2024

Androgenic alopecia (AGA) and alopecia areata (AA) are two highly prevalent conditions, affecting both men and women of a wide range of ages, which strongly impact their quality of life and self-esteem. Both pathologies are deemed to be reversible, although conventional therapies have shown limited scope and efficacy. New therapeutic approaches, focusing on the degenerative changes that take place in the hair follicle, are needed to achieve better outcomes. For instance, adipose-derived stem cells (ADSC), abundant and easy to obtain, hold great potential in follicular regeneration. ADSCs can be isolated as stromal vascular fraction (SVF) by the enzymatic digestion of the lipoaspirate or as nanofat by the mechanical breakdown of adipocytes. In addition, commercial preparations of the conditioned medium of the ADSCs secretome (ADSC-conditionate medium [CM]) have entered the market as an appealing alternative because of their comparatively lower cost and accessibility. A search was conducted, crossing relevant terms, on PubMed Central and Google Scholar. Criteria for inclusion were studies in the past 10 years on humans with AGA or AA, where either SVF, nanofat, or ADSC-CM was tested as the main treatment. Eleven publications qualified: two studied nanofat, three, ADSC-CM, and six, SVF, either individually or in combination with other therapies. Only one randomized controlled trial (RCT) was found and classified as evidence 2b according to the Sackett scale. The rest were case–control studies or case series with small samples and no control, graded as evidence 3b and 4. A meta-analysis could not be conducted due to the heterogenicity of the study designs. Given the evidence obtained, Level D NICE recommendation was established. However, we consider that the positive findings are sufficiently consistent to support the elaboration of further RCTs that share criteria and methods.
Comparative Study Between Latarjet Procedure Versus Free Iliac Graft in the Management of Recurrent Shoulder Dislocation
Authors: Elwan Mohamed Mohamed Moussa , Shawky Mohamed Salah Eldin , Bayomy El Sayed
Published: July 2024

Background:

The most common form of shoulder dislocation is the recurrent anterior traumatic type. Latarjet and Eden Hybinette are the two competing techniques in reconstructing significant bone loss accompanying this type.

Aim of the Work:

The aim is to evaluate the functional results in the management of recurrent shoulder dislocation with bone loss by comparing Latarjet and Eden Hybinette techniques.

Patients and Methods:

A prospective, randomized controlled trial was performed on forty adult patients suffering from recurrent shoulder dislocations. Two groups (a total of forty patients; twenty iliac graft cases and twenty Latarjet controls) were performed in a randomized method. We compared the two groups; clinical evaluation was completed before surgery and at least 1 year postoperatively, by using the modified Rowe score which consists of pain level, stability, motion loss, and limitation of function. Satisfactory results included excellent and good results, while unsatisfactory results included fair and poor results. Adverse events were prospectively recorded. CT studies were performed to assess the radiographic result preoperatively, immediately-postoperatively, and at final follow-up visits.

Results:

Both groups did not differ significantly in either the clinical or the radiological aspects (P > 0.05) except for more limited range of motion (ROM) (external and internal rotation) in the Latarjet group at the final follow-up (P < 0.05). One case in the Latarjet group had recurrent dislocation due to tramadol fits. Two cases in each group had anterior apprehension only. Donor-site sensory disturbances were reported in 10% of the iliac group patients. Computed tomography revealed a larger graft size in the iliac group.

Conclusion:

Both Latarjet and Eden Hybinette can be used as reconstructive surgeries in restoring critical bone loss accompanying shoulder dislocations; they did not show significant differences except for the more limited external and internal rotation motions in the Latarjet group.
Is Arthroscopic Management of Synovial Chondromatosis of the Hip Enough?
Authors: Bakr Hany Mohammed Abdelfattah , Abdelkader Salah Mahmoud , Metwally Osam
Published: July 2024

Study Design:

The design of the study was a retrospective case series.

Objective:

This study evaluated the clinical and radiological manifestations of synovial chondromatosis (SC) of the hip, along with the role of hip arthroscopy in the diagnosis and treatment of this pathologic condition and its postoperative curative effect.

Patients and Methods:

With a minimum 1-year follow-up, 13 hips with SC received arthroscopic surgery. Preoperatively and postoperatively, patients were assessed for hip pain using the modified Harris Hip Score and Nonarthritic Hip Score.

Results:

Considerable reduction in postoperative hip pain was observed in all cases, along with sufficient improvement in hip range of motion.

Conclusion:

Hip arthroscopy is a trusted and adequate treatment option for hip SC.
Correlation between Component Size and Functional Knee Score in Patients Undergoing Bilateral Simultaneous Total Knee Arthroplasty: A Cross-Sectional Study
Authors: Abouelyazid Saeid , Hafez Mahmoud A. , Toreih Ahmed , Kotb Mohamed Soliman , Tamer Ahmed
Published: July 2024

Background:

Simultaneous bilateral total knee arthroplasty (simBTKA) has been a favored surgical solution to reduce costs and patient suffering. We aimed to evaluate the rate of asymmetry of component size in patients undergoing simBTKA and its impact on knee function as we believe that implant asymmetry may affect the functional outcomes in those patients.

Methods:

A cross-sectional study design was done on on 60 patients (120 knees) with simBTKA using patient-specific templating (PST). Patients were included if they had Kellgren–Lawrence Grade III-IV osteoarthritis. Revision surgeries, staged BTKA, or patients with bone defects, valgus deformity, severe varus deformity (defined as above 20°), and extra-articular deformities were excluded from the study. The outcome measures were interlimb component asymmetry, Knee Society Score (KSS), and range of motion (ROM). The comparison between pre- and postoperative findings was done using a dependent t-test.

Results:

A total of 29 (48.34%) patients had symmetrical femoral and tibial components, whereas the rest had asymmetry, of them, 11.7% had both femoral and tibial component size asymmetry. There were no statistically significant differences between the changes in KSS and ROM in the smaller implant and larger implant groups (P = 0.5 and P = 0.4, respectively). The total number of complications was eight and as follows: superficial infection, aseptic loosening, rupture of the patellar tendon after a bathroom fall, anemia requiring blood transfusion, residual varus deformity, deep venous thrombosis, periprosthetic fracture, and malalignment.

Conclusion:

There is no correlation between the interlimb component asymmetry and the knee function. However, there was statistically significant improvement from preoperative to postoperative KSS and ROM in small and large implants.
Functional and Radiological Outcomes of a Newly Introduced Modified Manual Cementation Technique Versus Second-Generation Technique in Primary Cemented Hip Arthroplasty
Authors: Youssef Abdoulrahman Elsayed , Mehanna Mohamed Taha , Mustafa Mohamed Saleh , Henawy Ayman Tawfik
Published: July 2024

Background:

Hip arthroplasty is one of the most common reconstructive procedures done in adults.[1] The main purpose of this surgery is to eliminate pain, regain full extent of joint motion, maintaining hip stability, and improve the quality of life for patients.

Objectives:

This work aims to compare the clinical and radiological outcomes of two techniques; the second-generation cementation technique and a newly introduced modification of the manual technique in primary cemented hip arthroplasty.

Patients and Methods:

This prospective, randomized clinical trial included 44 patients. Patients were allocated into two equal groups: the case Group A; who had primary hip arthroplasty operation with the modified manual cementation technique and the control Group B; who had arthroplasty using the second generation cementation technique. The average follow-up period was about 12 months after the operation. Operation time, intraoperative parameters, postoperative clinical and radiological outcomes, and complications were compared between the two groups.

Results:

The operation duration was significantly longer in Group B (123.4 ± 9.0 vs. 107.5 ± 15.2, P = 0.001). No intraoperative complications were found among 77% while 13.6% showed allergic reaction to cementation 72% of them are in Group B, 6.8% needed blood transfusion, and 2.3% had pulmonary embolism on cementation. No significant difference between the two studied groups regarding postoperative Visual Analog Scale (VAS) score,[2] barrack grading,[3] complications and Harris hip score[4] at 3 months, 9 months, and 12 months was noted.

Conclusion:

In conclusion, this study concluded that Group A the newly introduced modified manual cementation technique might provide a cheaper and effective alternative to Group B the second-generation technique, with relatively less intraoperative complications and almost no difference in postoperative VAS, Harris hip score, and radiological outcomes over a period of 1-year follow-up.
Comparison of Conventional and Ultrasound-assisted Femoral Nerve Motor Conduction Study in Healthy Controls
Authors: Gattu Abhinay Kumar , Reddy Y. Muralidhar , Murthy J.M.K. , Kiran ESS , Pidaparthi Lalitha , Jaiswal Shyam Krishnakumar , Pennuru Anusha , Nulaka Ravi , Kumar Sudhir
Published: July 2024

Background:

Ultrasound (US) can identify morphologic abnormalities and aid in the accurate localization of peripheral nerves. It can identify the femoral nerve and improve the stimulator placement in the femoral nerve motor conduction study. We aimed to compare the conventional and US-assisted femoral motor conduction techniques in a healthy population.

Methods:

One hundred and sixty-eight healthy controls (336 nerves) aged 18 years or more and both sexes were enrolled. Height, weight, body mass index (BMI), waist circumference (WC), and waist–hip ratio (WHR) were recorded. Stimulation of the femoral nerve was first done blindly (conventional) at the inguinal ligament and later at the site of the nerve identified using the US. Recording was done from the rectus femoris muscle. The mean and fifth percentiles of the compound muscle action potential (CMAP) obtained by both techniques were compared.

Results:

Mean (standard deviation) age of the cohort was 45.5 ± 14.01 years. US-assisted technique recorded larger CMAP than conventional in all age groups, gender, World Health Organization and Asia-Pacific BMI categories, WC, and WHR categories (P < 0.01). The fifth percentile of the CMAP amplitude was also higher in the US-assisted technique.

Conclusion:

Our results indicate that a US-assisted setup could improve conventional femoral nerve conduction studies.
Low-grade dermatofibrosarcoma protuberance - A rare case report
Authors: Yogesh T. L. , Jha Anjani Kumar , Jayaraman Sindhumati , Jayaraman Vidhya
Published: July 2024

Dermatofibrosarcoma protuberans (DFSP) is a slow-growing, soft-tissue tumour of early or mid-adult life, affecting both the genders equally. The most common sites are soft tissue of the trunk (50 to 60%), followed by proximal extremities (20 to 30%) and the head and neck region (10 to 15%). Its metastatic potential is low though the local recurrence rate is high. Here, we report a case of a female patient with a large soft tissue growth located at the right cheek, chin and neck region. Local excision was done under the impression of a benign tumour such as lipoma or sebaceous cyst. Histological evaluation showed bland spindle cells arranged in a storiform pattern questioning the provisional diagnosis of the lesion. Further evaluation with the immunohistochemistry (IHC) panel confirmed the diagnosis of DFSP. Since it is a rare tumour of the head and neck region with non-alarming initial presentation and the potential for erroneous diagnosis as another lesion, we present a case of DFSP.
Parasitic colloid cyst: A diagnostic dilemma
Authors: Lewis Amitha J. , Rammohankumar K , Kini Hema , Boaz Karen
Published: July 2024

The pathologies of the neck are varied and at times may cause a diagnostic dilemma for the pathologist. In this report, we present a case of a 32-year-old man with a slow-growing nodular swelling in the right neck region, which was diagnosed as a simple colloid cyst arising in a parasitic thyroid nodule. Simple colloid cysts are cysts that develop due to impaired accumulation of thyroglobulin in inactive follicles. Most thyroid-related pathologies occur as midline swellings. However, the present case was unique due to its location with no connection to the thyroid gland. This case report describes the diagnostic process and adds insight into the pathology of a colloid cyst.
Role of C-reactive protein, IL-6, and D-dimers in prediction of severity of coronavirus disease 2019: A pilot study
Authors: Jahagirdar Pramod , Vaishnav Kalpesh , Sarathy Niharika Abhay , Singh Harneet , Kumia Komal , Banerjee Abhishek
Published: July 2024

Background:

The global outbreak of coronavirus disease 2019 (COVID-19) presents numerous obstacles for healthcare professionals. The present study aimed to evaluate and compare the role of serum biomarkers like- C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimers in the severity of COVID-19 infection.

Methodology:

A cross-sectional, observational retrospective pilot study was conducted in Udaipur, Rajasthan, wherein data was collected from 250 subjects, out of which, data of 100 subjects were included as per the inclusion criteria. The data was recorded retrospectively among the health professionals via Google Forms in Udaipur, Rajasthan.

Results:

There were 1 (1%), 3 (3%), 31 (31%) and 65 (65%) participants with minor elevation (0.3-1.0), moderate elevation (1-10), marked elevation (10-50) and severe elevation (>50) of CRP respectively. The difference between the groups was statistically highly significant with a significantly higher number of study participants with a severe elevation of CRP levels (χ2 = 107.84, P < 0.001). The results showed that there was a significant difference between the groups with IL6 in 0-7 range while 96 (96%) study participants had >7 IL6, and the difference was statistically highly significant (2 = 84.640, P 0.001).

Conclusion:

In conclusion, the existing body of research indicates a discernible correlation between COVID-19 infection and the fluctuation of biomarker levels. This supplement has the potential to be utilised in clinical practice as a means of informing treatment decisions and determining the necessity of admission to the intensive care unit (ICU).
Expression of caveolin 1 in oral squamous cell carcinoma
Authors: Mishra Shefali , Kanetkar Sujata R. , Datkhile Kailas D.
Published: July 2024

Context:

Caveolin-1 is a surface protein that is a major structural component of caveolae, which are vesicles of the plasma membrane integral to a variety of signal transduction molecules and transport functions. Caveolin-1 is a biomarker undergoing research & studies have shown an increased expression of Cav-1 in the stepwise carcinogenesis from the normal oral mucosa, hyperplastic mucosa, dysplastic mucosa, precancerous lesions to Oral Squamous Cell Carcinoma. In the present study Correlation between Caveolin-1 expression and grade of tumor was established statistically.

Aims:

To study immunohistochemical expression of Caveolin-1 in Oral Squamous Cell Carcinoma.

Settings and Design:

Cross sectional study carried out in a tertiary care hospital.

Materials and Methods:

A total of 90 cases of histopathologically diagnosed oral squamous cell carcinoma was evaluated. Grading of the cases into well, moderate and poorly differentiated carcinomas was done as per WHO guidelines . Margin and lymph node status were evaluated. Anti- Caveolin-1 antibody (E249)- Caveolae marker ab32577 was used in the dilution of 1:100. Results were expressed taking reference of the methodology used by Hung et al 2003.

Statistical Analysis Used:

Statistical Package for the Social Sciences (SPSS 25.0).

Results:

Correlation of tumor grade and lymph node metastasis was statistically significant p=0.0006. There was a significant statistical correlation between tumor grade and immunohistochemical expression of Caveolin-1, p- value=0.00. Correlation between Lymph node metastasis and Caveolin-1 was statistically significant, p-value=0.008.

Conclusions:

Caveolin-1 expression correlates with aggressive tumor behavior and poor prognostic outcome.
Mucous extravasation phenomenon: A clinicopathologic evaluation of 68 cases
Authors: Kalaimani Gnanambigai , Sivapathasundharam B. , Priyadarshini Lekha , Rajeswari MRC , Karthick B Prem
Published: July 2024

Background:

A mucocele is a benign, mucus-containing cystic lesion of the minor salivary gland also called a sialocele and ptyalocele. Two types are recognized as mucus extravasation cyst and the other is retention type.

Objective:

To evaluate the clinicopathologic features of oral mucocele cases.

Materials and Methods:

The archival blocks which were signed out as mucocele were taken for the study. The following parameters such as age, gender, history of trauma, site, histological features, and clinical presentations were taken into consideration.

Results:

68 cases of mucous extravasation cysts were analysed, among which 58% were males and 42% were females. Age of the patients ranged from 4 to 70 years with an average of 20 years. The most common locations were the lower lip (87%), tongue (5%) and buccal mucosa (8%). Almost 53% of cases are seen on the left side of the oral cavity. Most of the cases presented a history of trauma. Histopathologically 23% of cases presented with muciphages in the lumen and connective tissue.

Conclusion:

The commonly encountered benign salivary lesion of the oral cavity is the mucus extravasation phenomenon of the mucocele. Various histopathological features were discussed in this study to avoid misdiagnosis of this common lesion in dental practice.