bluuebunny/crossref_metadata_2025 huggingface dataset:
A Data-Driven Methodology to Comprehensively Assess Bone Drilling Using Radar Plots
Authors: Nigam Aman , Kellam James F. , Ambrose Catherine G. , Tai Bruce L.
Published: January 2024

Background:

The study aims to develop a data-driven methodology to assess bone drilling in preparation for future clinical trials in residency training. The existing assessment methods are either subjective or do not consider the interdependence among individual skill factors, such as time and accuracy. This study uses quantitative data and radar plots to visualize the balance of the selected skill factors.

Methods:

In the experiment, straight vertical drilling was assessed across 3 skill levels: expert surgeons (N = 10), intermediate residents (postgraduate year-2-5, N = 5), and novice residents (postgraduate year-1, N = 10). Motion and force were measured for each drilling trial, and data from multiple trials were then converted into 5 performance indicators, including overshoot, drilling time, overshoot consistency, time consistency, and force fluctuation. Each indicator was then scored between 0 and 10, with 10 being the best, and plotted into a radar plot.

Results:

Statistical difference (p < 0.05) was confirmed among 3 skill levels in force, time, and overshoot data. The radar plots revealed that the novice group exhibited the most distorted pentagons compared with the well-formed pentagons observed in the case of expert participants. The intermediate group showed slight distortion that was between the expert and novice groups.

Conclusion/Clinical Relevance:

This research shows the utility of radar plots in drilling assessment in a comprehensive manner and lays the groundwork for a data-driven training scheme to prepare novice residents for clinical practice.
Treatment and Outcomes of 4,973 Unicameral Bone Cysts
Authors: Ruiz-Arellanos Kim , Larios Felipe , Inchaustegui Maria L. , Gonzalez Marcos R. , Pretell-Mazzini Juan
Published: January 2024

» Unicameral bone cysts (UBCs) can increase the risk of pathologic fractures of both long and short bones. Although multiple treatments exist, data are conflicting regarding optimal management.

» We sought to analyze treatment strategies for UBCs and their rates of successful treatment.

» Success rates were analyzed according to treatment modality, with emphasis on filling techniques and/or decompression associated with curettage, and injection compounds.

» Curettage with bone substitute and cyst decompression was identified as a highly successful technique for UBC treatment.

» Decompressing the cyst wall after injection, regardless of the specific compound used, had a greater potential to enhance healing rates.

» The management decision should be individually guided within the patient's context.

Level of Evidence:

Level III. See Instructions for Authors for a complete description of levels of evidence.
Cognitive and Behavioral Aspects in Children with Nephrotic Syndrome; Does it Need Special Attention
Authors:   Assistant Professor, Department of Pediatric Nephrology,Dhaka Shishu (Children) Hospital, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh., Khondaker Tarannum , Rafika Quaderi Humaira ,   Assistant Professor, Department of Pediatric Neurology, Dhaka Shishu (Children) Hospital, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh.
Published: January 2024

Purpose: This study was done to see and assess the cognitive and behavioral impairment in children with nephrotic syndrome and to find out any relationship with disease-specific or treatment specific characteristics. Methods: This one-year case-control study was conducted from October 2018 to November 2019 among the diagnosed case of nephrotic syndrome, age range 3-16 year without an active stage of nephrosis or infection. Control groups were selected from age and sex-matched patients admitted in the same hospital after controlled active disease and without any chronic illness. The Wechsler Intelligence Scale for children (WISC) for assessment of Cognitive function was performed in both groups. Moreover, to assess behavioral impairment, the Strengths and Difficulties Questionnaire (SDQ) were performed in both groups. Results: Among the case group steroid dependency was noted with 58.1% and about 27% received for prolong period (> 3months). A total cumulative dose before hospital admission was 384.16±206.94 mg/kg. All the domains of cognitive parameter and behavioral parameters affected significantly in nephrotic syndrome children than the control group(p<0.05). Mostly affected cognition domains were verbal 72% and processing speed 74%. Considering behavioral parameters, conduct 44.2% and hyperactive 14.2% disorders were affected severely among these children. Both the cognitive and behavioral impairment were significantly affected by prolonged corticosteroid therapy(p<0.0001). Conclusion: Severe psychosocial and emotional impairment are commonly seen among those children who are getting steroid for a prolonged period, which argues in favor of a low threshold for switching to sparing drugs.
Telomere Length and Structured Deep Touch Pressure Therapy in Autism Spectrum Disorder-A Project Synopsis
Authors:   Professor and Head, Department of Neonatology, Jawaharlal Nehru Medical College, Wardha, Sawangi, Wardha, Maharashtra 442005, India., Lakhkar Bhavana
Published: January 2024

Autism spectrum disorder is characterised by inability of the child to socially interact with people , poor eye to eye contact, absent or perverted speech, abnormally received sensory stimuli (more or less than optimum response to sensory stimulus),self stimulating, self injurious behaviour ,with associated intellectual disability of varying severity, liking for sameness, abnormal stereotactic movements. Hyperactivity and sleep disorders are usually associated ,making it difficult for parents to look after the child. Mostly this abnormal behaviour is noticed at the age of 11/2 to 3 years. This is a progressive condition worsening with age.1 The incidence has been noticed to increase over the years in most parts of world.2 The incidence in western world is said to be around 1 in 59 children.3 In India the incidence has been estimated to increase but real prevalence is not known. Many of these children remain undiagnosed and untreated due to difficulty in diagnosis by health care personnel and poor understanding by parents. Two scales developed for Indian children4,5 have now made the work easy. Juneja et al found prevalence around 0.9/1000.6 This study will test the utility of deep touch pressure therapy on telomere length and development of the child. Keywords: Deep touch pressure therapy; Autism Spectrum Disorder; Synopsis.
A Case of Salmonella Enteritidis Meningitis in a Two Month Old Immuno Competent Infant
Authors:   Additional Professor,Department of Pediatrics, Government Medical college, thrissur, Kerala-685695, Indian., Kesavan TM Anand , Bakry Said ,   Junior Resident, Department of Pediatrics, Government Medical college, thrissur, Kerala-685695, Indian., sankar K Leksmi ,   Lecturere, Department of Microbiology, Government Medical college, thrissur, Kerala-685695, Indian.
Published: January 2024

Meningitis due to Salmonella Enteritidis is very rare in children. Only a very few case reports of Salmonella Enteritidis meningitis reported in immunocompetent infants. Usually the infection will be severe and may lead to longterm morbidity and mortality. So early diagnosis and treatment is important.
Blood Investigations as Predictive Tool for Predicting Bleeding Manifestations and Death with Dengue like Illnesses
Authors:   Assistant Professor, Department of Paediatric, Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra 442001, India., Uke Punam , Bang Akash ,   Additional Professor Department of Paediatric, AIIMS Nagpur, Maharashtra 440003, India., Lakhkar Bhavana ,   Professor and Head, Department of Neonatology, Jawaharlal Nehru Medical College, Sawangi, Wardha, Maharashtra 442001, India.
Published: January 2024

Background: Dengue has a broad range spectrum of clinical presentations and many times unpredictable clinical evolution and outcome. Though the disease is complex in its manifestations, management is relatively simple hence it is very important to be able to predict which patients are more likely to land up in complications like bleeding manifestation and death. There is a paucity of literature on this. Objective: To study blood investigation parameters as predictive tool for predicting bleeding manifestations and death in children with dengue like illnesses. Methods: We enrolled all the consecutive admissions to pediatric ward of a tertiary care teaching hospital satisfying the inclusion criteria from February 2014 to May 2015. Blood investigations were sent and patients were assessed for appearance of bleeding manifestations and death. Results: 200 children were enrolled of age group 3 month to 12 years. Investigation parameters are predictors of outcome of bleeding in mortality group Vs survivals (TLC - 4.81±2.69 Vs 5.97±4.84; p=0.031, Platelet-65.50±32.89 Vs 79.66±39.46; p=0.010, Highest haematocrit-40.67±3.89 Vs 38.77±4.45; p=0.003). Patients having bleeding have more dengue positivity (p=0.0001) with maximum positivity for NS1 69%. Hb% on admission and lowest Hb% were significantly lower in mortality group than in survival group. Conclusion: 3 patients died and bleeding manifestations were present in 74 patients out of 200 patients. Investigation parameters are predictors of outcome of bleeding in mortality group Vs survivals. Dengue positivity was not a significant factor for prediction of death.
Neurocysticercosis (NCC) in Children: A Review
Authors:   Assistant Professor, Department of Pediatrics, College of Medicine and Health Sciences, National University of Science and Technology (formerly Oman Medical College), Sultanate of Oman. And ExAssistant Professor, Department of Pediatrics, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai 400012, India.,, Akshay Divecha Chhaya , S. Tullu Milind ,   Additional Professor, Department of Pediatrics, Seth G.S. Medical College & KEM Hospital, Mumbai 400012, Maharashtra, India.
Published: January 2024

Neurocysticercosis (NCC) is the commonest parasitic infestation of the brain caused by Taenia solium larvae and a preventable cause of epilepsy worldwide. NCC may be parenchymal or extraparenchymal, and its clinical presentation may vary based on the location, number, and host immuneresponse to the cysts. Seizures are more frequently seen in children, and single colloidal parenchymal cyst is the common radiologic finding in pediatric NCC. The diagnosis is generally by neuroimaging, a scolex within the cyst being pathognomic; however, serology may help when the neuroimaging is inconclusive. Initial treatment generally focuses on symptomatic management by antiepileptics and corticosteroids. Albendazole is the cysticidal drug of choice in most cases; praziquental is added for multiple lesions. The outcome depends on the type, location, number of lesions, seizure recurrences and radiologic resolution of the lesions. Single lesions have a better prognosis. In endemic areas, NCC should be a differential in any child presenting with recentonset seizures, headache, vomiting, or focal motor deficits, in the absence of another known neurological condition. Due to the potentially eradicable nature of cysticercosis, preventive measures need to be encouraged.
Anesthetic and Airway Management of Post Burn Microstomia: A Case Report
Authors:   Resident,Department of Anesthesiolog & Critical Care, All India Institutes of Medical Sciences, Bhopal 462020, Madhya Pradesh, India., Sinha Divas , Waindeskar Vaishali ,   Professor, Department of Anesthesiolog & Critical Care, All India Institutes of Medical Sciences, Bhopal 462020, Madhya Pradesh, India., Francis Thomas ,   Resident, Department of Anesthesiolog & Critical Care, All India Institutes of Medical Sciences, Bhopal 462020, Madhya Pradesh, India., Kumar Harish ,   Assistant Professor, Department of Anesthesiolog & Critical Care, All India Institutes of Medical Sciences, Bhopal 462020, Madhya Pradesh, India., Singh Pooja ,   Associate Professor, Department of Anesthesiolog & Critical Care, All India Institutes of Medical Sciences, Bhopal 462020, Madhya Pradesh, India., T Kama Sunaina ,   Associate Professor, Department of Anesthesiolog & Critical Care, All India Institutes of Medical Sciences, Bhopal 462020, Madhya Pradesh, India.
Published: January 2024

Anesthetic and airway management of microstomia patients is challenging for anesthesiologists and requires special care and preparation during intubation and extubation. Back up plan with other airway management equipment’s should be available at hand before dealing with these patients, Decision of extubation is crucial and senior anesthetist should be available in the operating room. In case of prolonged surgery elective ventilation should be done in these cases. Keywords: Anesthetic; Difficult; airway; Post burn; One contract.
Vaccine Safety in Pregnancy
Authors:   B.Sc Nursing 3rd year Student, Department of Community Health Nursing, Galgotias School of Nursing, Galgotias University, Greater Noida 201306, Uttar Pradesh, India., Gaur Vishal , Pal Abhishek ,   B.Sc Nursing 3rd year Student, Department of Community Health Nursing, Galgotias School of Nursing, Galgotias University, Greater Noida 201306, Uttar Pradesh, India., Thakur Priyanka ,   Assistant Professor, Department of Community Health Nursing, Galgotias School of Nursing, Galgotias University, Greater Noida 201306, Uttar Pradesh, India.
Published: January 2024

Immunize dubious infectious disease are accountable for significant maternal, neonatal and young infant despair and loss of life. While there is emerging confirmation as well as theoretical thought indicating that certain. Vaccine Sarerisk free for pregnant women and fetuses, policy– formulation is difficult because of behold potential danger to the fetus. The immature adaptive immune system of neonate impulsive infant build them particularly vulnerable despair and loss of life due to infection. Vaccinated pregnant women can defend the fetus. It can also directly defend the fetus via specific transplant from the mother in time of pregnancy. Keywords :Theoretical; Policy-formulation; Vulnerable; Transplant.
Role of Sromal Vascular Fraction in Wound Bed Preparation in Post Traumatic Wound
Authors:   Senior Resident, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Susendran Premnath , kumar Chittoria Ravi ,   Professor & Registrar, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Kumar Singh Barath ,   Senior Resident, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

Degloving Injury are major debilitating conditions and its treatment is also challenging. The treatment of post traumatic degloving injury requires a multimodal approach. Adjuvant platelet rich fibrin matrix can be tried for post traumatic wounds as a modality for wound bed preparation. In this study we share our experience regarding the use of stromal vascular fraction as an adjunct in the management of post-traumatic degloving wounds of the lower extremity.
Total Parenteral Nutrition
Authors:   Senior Resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Kumar Singh Barath , Kumar Chittoria Ravi ,   Professor & Registrar, Department of Plastic Surgery & Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

Total parenteral nutrition is a medication used to manage and treat malnourishment. It is in the nutrition class of drugs. Parenteral nutrition (TPN) is when the intravenous administered nutrition can serve as the main source of nutrition and also as a supplementary nutrition if the patient is not having adequate nutrition. This article highlights the composition, initiation, indications, contraindications, complications of total parenteral nutrition as a valuable agent in managing malnourishment.
Duplication Cysts and Autoimmune Hemolytic Anemia: An Association or a Coincidence?
Authors:   Senior Resident, epartment of Pediatrics, Seth G.S. Medical College & K.E.M. Hospital, Mumbai 400012, Maharashtra, India., Sanju Sidaraddi , S. Tullu Milind ,   Additional Professor, Department of Pediatrics, Seth G.S. Medical College & K.E.M. Hospital, Mumbai 400012, Maharashtra, India., Tonge Rucha ,   Junior Resident-II, Department of Pediatrics, Seth G.S. Medical College & K.E.M. Hospital, Mumbai 400012, Maharashtra, India., Agrawal Mukesh ,   Ex-Professor & Head, Department of Pediatrics, Seth G.S. Medical College & K.E.M. Hospital, Mumbai 400012, Maharashtra, India.
Published: January 2024

Duplication cysts are rare congenital anomalies of the gastrointestinal tract and the occurrence of multiple such cysts is an extremely rare occurrence. Autoimmune hemolytic anemia is an extremely unusual manifestation of these duplication cysts. Herein, we report a case with two duplication cysts (one cyst in the thorax; another in the abdomen) complicated with autoimmune hemolytic anemia. This patient was a five year-old-male child who presented with congestive cardiac failure due to severe anemia (which, on evaluation, was diagnosed as autoimmune hemolytic anemia). Imaging studies (chest radiograph and computed tomography) revealed duplication cysts in the chest and abdomen. Anemia flare-up was noted in the patient despite two months of prednisolone therapy (2 mg/kg/day) and two high dose intravenous methylprednisolone pulse therapy courses (30 mg/kg/day for 5 days each). The steroid refractory autoimmune hemolytic anemia responded to rituximab (375 mg/ m2 body surface area/week for 4 weeks). Four months after tapering off the steroid therapy, the patient did not experience flare-up of the anemia. To the best of our knowledge, this is the youngest and first pediatric age group patient to be reported, with a possible association between gastrointestinal duplication cysts with autoimmune hemolytic anemia.
Evaluation of Burns Patient in a Tertiary Care Hospital
Authors:   MBBS Intern, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India, Kumar Avel Hemavathi , Kumar Chittoria Ravi ,   Professor & Registrar (Academic) Head of IT Wing and Telemedicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.Department of Plastic Surgery & Telemedicine,, Kumar Singh P Barath ,   Senior Resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India
Published: January 2024

This article describes the evaluation and management of a child with severe burns in a tertiary care center with a dedicated tertiary-level burns unit. An 8-year-old child with 25% Second-degree scald burns was evaluated and treated with ATLS, WHO Guidelines, and assessed with Abbreviated Burn Severity Index (ABSI) score. We have used routine blood investigations, and microbiological investigations. The child was treated with intravenous fluids and antibiotics. In addition, regenerative treatment modalities were used to improve wound healing.
Anti-Glomerular Basement Membrane Disease in a Six-year-old Child: A Rare Presentation
Authors:   Senior Resident, Department of Pediatrics, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India., J. Bhanushali Darshna , S. Tullu Milind ,   Professor Additional,  Department of Pediatrics, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India., Kori Niharika ,   Junior Resident, Department of Pediatrics, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India., Agrawal Mukesh ,   Ex-Professor and Head, Department of Pediatrics, Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Parel, Mumbai 400012, Maharashtra, India.
Published: January 2024

Antiglomerular basement membrane (anti-GBM) disease is a rare small vessel vasculitis caused by auto-antibodies targeting auto-antigen expressed in basement membranes of capillary beds in lungs and kidneys. A six-year-old male presented with fever, cough, and generalized weakness for three days with respiratory distress for one day. The child had three prior admissions with similar complaints and was treated as a case of lower respiratory tract infection with severe iron deficiency anemia in the past. Multiple packed red cell transfusions were required in these past admissions. In this current admission, he had tachycardia, tachypnea, severe pallor, right-sided lung crepitations & bronchial breath sounds. The hemogram showed severe anemia and leukocytosis. Urine examination showed mild proteinuria and microscopic hematuria. Chest X-ray (current admission) showed right middle and lower zone consolidation. HRCT of the chest revealed an interstitial pattern. A lung biopsy showed pulmonary hemorrhage and positive Prussian blue staining. Raised anti-GBM titers confirmed diagnosis of anti-GBM disease. Renal biopsy revealed normal glomerular morphology on histopathology; with immune fluorescence showing linear positivity for IgG (3+), Kappa (3+), and Lambda (3+). Electron microscopy reported mild effacement of visceral epithelial foot processes and subepithelial/intramembranous electron-dense deposits. He was treated with intravenous methylprednisone for 5 days followed by oral prednisolone for one month, which was thereafter tapered to a lower maintenance dose for 18 months. The child received six cycles of intravenous cyclophosphamide along with a daily low dose of steroids. Currently, the child is asymptomatic after one year of follow-up with seroconversion (antiGBM titers decreased) and normalization of the chest radiograph.
Evaluation of Importance of S Bilirubin Level in Cases of Simple and Complicated Acute Appendicitis
Authors:   Assistant professor, General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Mandya, Karnataka, 571448, India., Basavaraju Sachin Murukanahalli , Srinivasa Akshatha Hebbale ,   Assistant professor, General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Mandya, Karnataka, 571448, India., Vaggara Hanumantha Basappa ,   Postgraduate, General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Mandya, Karnataka, 571448, India., Kempegowda Sachin ,   Assistant professor, General Surgery, Adichunchanagiri Institute of Medical Sciences, B G Nagara, Mandya, Karnataka, 571448, India.
Published: January 2024

Introduction: Acute Appendicitis is the most common general surgical emergency and early surgical intervention improves outcomes. Despite the increased use of ultrasonography, computed tomography scanning and laparoscopy, the rate of misdiagnosis of appendicitis has remained constant (15.3%) and the rate of appendicular perforation. In an age, accustomed to early and accurate preoperative diagnosis, acute appendicitis remains an enigmatic challenge and a reminder of the art of surgical diagnosis. This study was done to conclude whether the Serum Bilirubin can be considered as a new laboratory marker to aid in the diagnosis of acute appendicitis. Aims: To evaluate whether elevated Bilirubin level is important in predicting the diagnosis of acute appendicitis (simple and complicated appendicitis). Material and Methods: This retrospective study was conducted in the department of general surgery, Adichunchanagiri institute of medical sciences, B. G. Nagara, Mandya (D), from August 2018 to February 2020. A total of 100 patients with clinical diagnosis of acute appendicitis or appendicular perforation were studied. Results: In this study, males (68%) outnumbered females (32%) and overall mean age was 27±9.58 years. Of the 100 patients, 71% were confirmed as acute appendicitis while 29% were diagnosed with appendicular perforation. Of 71 patients with acute appendicitis, 12.7% had raised bilirubin levels, while 87.3% had normal levels. Conclusion: This scoring system is practical and reliable diagnostic modality for the accuracy in diagnosis of acute appendicitis and to avoid negative appendicectomies.
Study of Clinically Nonpalpable Testis
Authors:   Senior resident, Department of General Surgery, Shri M P Shah Government Medical College, Jamnagar, Gujarat 361008, India., Trivedi Bhargav Dharmendrabhai , Vadaliya Akshat Keshubhai ,   Second Year Resident, Department of General Surgery, Shri M P Shah Government Medical College, Jamnagar, Gujarat 361008, India.
Published: January 2024

Undescended testis or cryptorchidism is a common genital problem in boys. Non palpable testis represents 25% of all undescended testis. Non palpable testis presents a unique diagnostic and therapeutic problem. Non palpable testis should be treated to enhance future chances of fertility and to place the testis at a site where it can be easily palpated because such a testis has an increased susceptibility to malignant degeneration. Aims: • Toestablishdiagnosticefficacyandaccuracy in identifying clinically non-palpable testis. • To establish therapeutic role of Open and laparoscopic management of non-palpable testis. Methods and Material: Between 2015 and 2019, 25 boys with 28 clinically non-palpable testis, aged 16 months to 65 years, underwent operative intervention in a single surgical unit at our institute. Out of the 25 patients, 22 had unilateral (11 leftsided, 11 right-sided) and three had bilateral non palpable testis. The testis was considered non palpable after thorough clinical examination, ultrasonography and examination under anaesthesia failed to detect it. Keywords: Nonpalpable Testis
A Clinical Study on Axillary Lymphadenopathy in Breast Disorders
Authors:   Assistant professor, Department of General Surgery, Vydehi Institute of Medical Science and Research Centre, Whitefield, Bengaluru, Karnataka 560066, India., D Chandrashekar , HG Vinay ,   Associate Professor, Department of General Surgery, Vydehi Institute of Medical Science and Research Centre, Whitefield, Bengaluru, Karnataka 560066, India.
Published: January 2024

Aims: The aim of this study is the axillary lymphadenopathy in breast disorders. This study categorizes the various disorders of the breast which involve axillary lymph nodes and their incidences. Materials and Methods: A three years retrospective study was performed at the General Surgery department at Vydehi Institute of Medical Science and Research Centre, Bengaluru. A total of 225 cases were included in this study. Demography, Preoperative and postoperative data were recorded, including post-operative complication. Results: Breast carcinoma is the leading disorder which constitutes about 34.3% of the cases. Out of 225 cases, 72 cases belonged to carcinoma breast. The next disorders are breast abscess and fibroadenomas which involve axillary lymph nodes, about 25%. The breast abscess cases are 39 and fibroadenosis are 36 cases out of 225 cases. Paget’s disease accounts for 1.3% (3 cases out of 225). The remaining benign disorders constitute 40%. Conclusion: In our study, the carcinoma breast (About 1/3rd of the cases-34.3%) is the major disorder that involves the axillary lymph nodes among other various disorders of the breast. Next are breast abscess and fibroadenosis, which constitutes 1/3rd of the total breast disorders (Breast abscess 17.3% and fibroadenosis 16%).
A Clinical Study and Management of Appendicular Mass
Authors:   Junior resident, Department of General Surgery, Basaveshwara Teaching and General Hospital, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka 585105, India., Awati Adityakumar M , Tanga Sharad M ,   Professor, Department of General Surgery, Basaveshwara Teaching and General Hospital, Mahadevappa Rampure Medical College, Kalaburagi, Karnataka 585105, India.
Published: January 2024

Background: Appendicular mass, a common surgical clinical entity is noticed in about 2–6% of patients and present with features of acute appendicitis. Treatment of appendicular mass is often cited as being controversial. Earlier, these patients were managed conservatively which was then followed by an interval appendicectomy carried out 4–6 weeks later. The need for interval appendicectomy has also been questioned. Early surgery on the other hand has an advantage of being curative in the index admission and ensures early return to work and higher compliance. A true controversy exists as to which is the best approach towards this problem and the opinion is divided about the management of an appendicular mass. The present study is designed to evaluate feasibility and safety of immediate appendicectomy in appendicular mass in our hospital by comparing the results of an equal number of patients treated conservatively. Title: Management of appendicular mass: comparative study between different modalities. Aim: To study the effective management of appendicular mass. Materials and Methods: This study is prospective interventional study and included patients aged between 15 to 70 years diagnosed with appendicular mass. Data collected included history, clinical presentation, investigation, diagnosis, surgery, complications and length of hospital stay. Results: A total of 30 patients were admitted with diagnosis of appendicular mass, 15 pts were treated with ochsnersherren regimen out of which 6 were treated with interval appendectomy and other 15 patients were treated with open appendectomy. Conculsion: Patients with appendicular mass who were treated with open appendectomy had longer duration of hospital stay associated with wound infection when compared to that of patients treated with ochsnersherren regimen and interval appendectomy. Therefore this study favors ochsnersherren regimen as preferred approach for the treatment of appendicular mass.
Is The Laparoscopic Approach a Better Alternative in Comparison to The Open Technique for The Management of Primary Ventral Hernias? A Comparative Analysis
Authors:   Assistant Professor, Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka 560066 India., Kumar Om Pramod , Ghosh Shaurav ,   Assistant Professor, Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka 560066 India., Sharma Pranav ,   Assistant Professor, Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka 560066 India.
Published: January 2024

Introduction: Since its introduction in the early 1990s, laparoscopic ventral hernia repair has gained popularity Over 400,000 ventral hernia repairs (VHRs) are performed each year world-wide. Purpose of this study to evaluate open repair versus laparoscopic approach to offer best possible and effective hernia management.4,11,12,15,24 Methods: Between January 2018 and December 2020, 30 patients with primary ventral hernia were randomized to receive either open retro-rectus mesh repair (OHR, Group 1) or laparoscopic mesh repair (LVHR, Group 2). These patients were followed up at 2,4 and 6 months intervals thereafter annually for both groups. Results: Primary ventral hernia are common in age range 41–50 years. In the group 1, majority of patient opting OHR were females (53.3%) while in group 2, males opted for LVHR (66.7%). Swelling was a common presentation in group 2, where as pain was common in group 1. Duration of complaints were similar in both groups. Precipitating factor in group 1 was multiparity (46.7%),whereas in group 2 it was obesity (46.7%). The majority of defect sizes was less than 2x4cm2 in the open (group 1) and 3x1 to 3x3 cm2 in laparoscopic group (group 2). In group 1, 60% infra-umbilical location,whereas in group 273.3% had supra-umbilical location of hernia. 66.7% showed reducibility in group 1, whilst 73.3% showed reducibility in group 2. Cough impulse was positive in both groups. Both groups had a diagnosis of para-umbilical hernia. Hypertension (13.3%) was mostly associated with group 1, where as Diabetes mellitus (13.3%) was mostly associated with group 2. Both groups underwent their respective surgeries as planned. Seroma collection and wound-related infectious complications were common in group 1 and post-operative respiratory distress was common in group 2. Patient compliance and follow-up was more in group 2 when compared to group 1.There were no cases of recurrence until the time frame of follow-up. Conclusions: Laparoscopic repair of Primary ventral hernias is superior to open mesh repair in terms of fewer complications, recurrence, and patient compliance outcome.
A Clinical Study on Left Sided Indirect Inguinal Hernia Containing Sigmoid Colon
Authors:   Assistant Professor, Vydehi Institute of Medical Science and Research Centre, White field Bengaluru 560 066, India., D Chandrashekar , G. Ramesh Reddy. ,   Professor and Head, Vydehi Institute of Medical Science and Research Centre, White field Bengaluru 560 066, India.
Published: January 2024

Aim: The aim of this article is “A clinical study on left-sided indirect inguinal hernia containing sigmoid colon”. In this study, we have projected the incidence and management of sliding inguinal hernia containing a Sigmoid colon. Materials and Methods: A three years retrospective clinical study, was done at the “General Surgery department” at Vydehi Institute of Medical Science and Research Centre, White field Bengaluru-560 066. This Institute is a tertiary hospital attached to a medical college. Results: This analysis contained a total of 189 cases. Sliding sigmoid colon occurrence is very rare and only one case, which is less than one percent, was found in this study (0.52 percent). Conclusion: The sigmoid sliding hernia is a peroperative diagnosis among left-sided indirect inguinal hernia. The surgical management/repair is meticulous and needs gentle dissection after identification of the sigmoid colon. Care must be taken to identify the contents of the hernia to avoid inadvertent injury to the structures. The Lichtenstein repair could be considered to lower recurrence and reoperation rates. Surgeons should function according to these standards and it is of utmost significance to be accompanied by a wide variety of prosthetic materials. Key words: Sliding hernia; Amyand’s hernia; Littre’s hernia; Meckel’s diverticulum; Spermatic cord; Round ligament of uterus; Inguinal (Poupart) ligament; Ilioinguinal nerve; Genital branch of the genito-femoral nerve; Midpoint of the inguinal ligament; EOM External oblique muscle IOM Internal oblique muscle PT-Pubic Tubercle; PS Pubic Symphysis; Hesselbach’s triangle; ASIS=Anterior superior iliac spine.
An Unusual Case of Trauma: Pseudo Aneurysm of Superior Mesenteric Artery after Parachute Jumping
Authors:   Vascular Surgeon, Department of Surgury Leeds General Infirmary, Stoke on trent, United Kingdom., .. Uzmasadia , Vijayasimha Srikanth ,   Vascular Surgeon, Department of Surgury Leeds General Infirmary, Stoke on trent, United Kingdom.
Published: January 2024

Pseudo aneurysms of visceral arteries which occur due to blunt abdominal trauma are rare. There are different modalities of blunt abdominal trauma which are seen in seat belt injuries secondary to motor vehicle accidents. We present the case of a 39 year old woman with history of abdominal pain and vomiting following a parachute jump. She was diagnosed with a pseudo aneurysm of superior mesenteric artery. She underwent open exploration and a vein interposition graft was used for the repair of the pseudo aneurysm. The pseudo aneurysm of superior mesenteric artery after a parachute jump has never been reported earlier. This case report highlights the possibility of pseudo aneurysm of superior mesenteric artery even in car seat belt injuries as the mechanism of injury is comparable in both.
Role of Elevated Liver Enzymes in the Diagnosis of Liver Injury in Bluntabdominal Trauma
Authors:   Associate Professor of Surgery, Department of general surgery, New fort road, Bangalore 560018, India., Manjunath B D , Swamy D Manjunatha ,   IIIrd Year Post Graduate in General Surgery, Department of general surgery, New fort road, Bangalore 560018, India.
Published: January 2024

The liver is the second most commonly injured organ following blunt abdominal trauma. The stable patient with minimal physical findings with a history of blunt abdominal trauma presents a challenge for diagnosis of liver injury. This study was conducted to determine the usefulness of hepatic transaminases in predicting the presence of liver injury and its severity following blunt abdominal trauma. In this study we included all patients who had sustained blunt abdominal injury and were treated in hospitals attached to bmcri between November 2018 to October 2020. The grading of the liver injury was verified using CT scans or surgical findings. All patiens with blunt abdominal trauma underwent the required blood tests and were included in the study. In patients with blunt abdominal trauma, abnormal hepatic transaminase levels are associated with liver injuries. Patients with ALT >57 U/l and AST >113 U/l are strongly associated with liver injury and require further imaging studies and close management. Key words: Liver injury; Blunt trauma; Transaminase; Computed tomography; Retrospective study.
Diagnostic Accuracy of Mammography and FNAC in Comparison to Gold Standard Histopathological Examination in Carcinoma Breast
Authors:   Assistant Professor, MS in Department of general surgery, JLN medical college and attached hospitals, Ajmer, Rajasthan 305001, India., Yadav Dinesh Kumar , Yadav Rashmi ,   Senior Resident, MS in Department of otorhinolaryngology, JLN medical college and attached hospitals, Ajmer, Rajasthan 305001, India.
Published: January 2024

Context: Screening and diagnostic efforts for breast cancer are critical because the disease has a high rate of successful outcomes with early identification and treatment. The mammography (MG) and fine needle aspiration cytology (FNAC) are individually effective diagnostic modalities for detection of breast pathologies. Aim: To compare the efficacy of mammography and FNAC in Cancer Breast. Setting & Design: The prospective study conducted on patients admitted for surgery for Breast lump or symptoms of breast malignancy in surgical wards of JLN Medical College, Ajmer and undergoing surgery for same with an aim to evaluate breast lesions using mammography and FNAC independently and in correlation with gold standard histopathology. Results: A total number of 100 cases of breast lump studied. The mammography, FNAC and histopathology results were collected and analysed. In present study, Mammography shows Sensitivity – 93.846, Specificity – 82.857, Positive Predictive value – 91.045, Negative Predictive Value – 87.87and Accuracy – 90. FNAC shows Sensitivity – 93.8, Specificity – 97.14, Positive Predictive value – 98.38, Negative Predictive Value – 89.474 and Accuracy - 95 Conclusion: This study confirms that the Mammography and FNAC have significantly higher sensitivity and NPV in detecting the both benign and malignant lesions of the breast. In the present study, FNAC has more accuracy in predicting breast cancer than mammogram. Association between FNAC and Mammography result was calculated to be.717 Key words: Breast lesions; fine needle aspiration cytology; mammography; histopathological examination. Key message: for successful treatment outcome of carcinoma breast early diagnosis is must.
Prospective Comparative Analysis of Intra-operative Factors Influencing Outcome in Abdominal Surgeries
Authors:   Professor, Department of Surgical Oncology, Government Royapettah hospital, Chennai, Tamilnadu 600014, India., Shanmugam Subbiah , Susikar Sujay ,   Associate professor, Department of Surgical Oncology, Government Royapettah hospital, Chennai, Tamilnadu 600014, India., Ayyanar Rajeswaran ,   Resident, Department of Surgical Oncology, Government Royapettah hospital, Chennai, Tamilnadu 600014, India.
Published: January 2024

Introduction: All abdominal (either laparoscopic or open) surgeries need intra operative monitoring of Oxygen saturation(SpO2), mean blood pressure, End tidal carbon dioxide (ETCO2) and blood loss. This monitoring is vital to prevent intra operative adverse events. Blood loss must be monitored and has to be replaced whenever essential. The objectives of the study is 1. To find the difference in intra operative factors like SpO2, mean blood pressure, ETCO2 , and blood loss between open and laparoscopic surgeries Materials and methods: This was a prospective observational study was performed over a period of 12 months from October’ 2018 to October 2019. All abdominal surgeries (either laparoscopic or open surgeries) performed at department of surgical oncology, Government Royapettah Hospital, Tamilnadu, Chennai were included in the study. All patients were given anesthesia by ETGA and monitored values recorded intra operatively. ETCO2, Blood Pressure, SPO2 and blood loss were recorded. These factors were compared between open and laparoscopic surgeries. Results were analyzed using standard statistical methods. Results: There were no statistically significant differences noted in SPO2, Mean BP and ETCO2, between all abdominal surgeries. Mean blood loss noted was 160.5ml, 192.7ml; 300.5ml in laparoscopic, lap assisted and open abdominal surgeries respectively.Hypotension was found more among open surgeries (51%) compared to laparoscopic (18%) or lap assisted (18%) abdominal surgeries (p=0.004). ETCO2 values >35 were recorded in 68%, 41%, 38% in laparoscopic, lap assisted and open abdominal surgeries respectively. Conclusions: We concluded that there was no statistical difference noted in intra-operative factors SPO2, Mean BP, ETCO2, between all abdominal surgeries. Mean blood loss, hypotension and blood transfusions were noted more among open than laparoscopic abdominal surgeries. Hypotension was significantly associated with open surgeries compared with laparoscopic abdominal surgeries. Key words: Intraoperative factors; ETCO2; laparoscopy Vs open surgeries.
Rare Case of Sacro Coccygeal Teratomatous Cyst in Adult with Infertility
Authors:   Resident, Department of SurguryIPGMER, SSKM, Hospital, West Bengal 700020, Kolkata, India., Patturu Sivakumar , Edupuganti Rajya Lakshmi ,   Consultant, Department of Neurosurgeon, IPGMER, SSKM, Hospital, West Bengal 700020, Kolkata, India., Das Rinki ,   Associate professor, Department of Neurosurgeon, IPGMER, SSKM, Hospital, West Bengal 700020, Kolkata, India., Sarkar P.K. ,   Cheif and Professor, Department of Surgury, IPGMER, SSKM, Hospital, West Bengal 700020, Kolkata, India.
Published: January 2024

Pseudo aneurysms of visceral arteries which occur due to blunt abdominal trauma are rare. There are different modalities of blunt abdominal trauma which are seen in seat belt injuries secondary to motor vehicle accidents. We present the case of a 39 year old woman with history of abdominal pain and vomiting following a parachute jump. She was diagnosed with a pseudo aneurysm of superior mesenteric artery. She underwent open exploration and a vein interposition graft was used for the repair of the pseudo aneurysm. The pseudo aneurysm of superior mesenteric artery after a parachute jump has never been reported earlier. This case report highlights the possibility of pseudo aneurysm of superior mesenteric artery even in car seat belt injuries as the mechanism of injury is comparable in both Key words: aneurysm.
In-Situ Anterolateral Thigh Flap for Lower Abdominal Reconstruction: Versatile Way for Recontruction
Authors:   Professor, Department of Surgery, Travancore Medicity, Kollam, Kerala 691589, India., Venugopal P R
Published: January 2024

A case of Osteomyelitic sinuses of the ilium with lower abdominal defect following a run over accident is treated with primary excision of sinuses with bone and reconstruction using pedicled anterolateral thigh flap. The Anterolateral thigh flap is a versatile pedicled flap1,2 for the reconstruction of the abdominal wall more effective and efficient than the fascia lata flap or other rotation flaps. Here is a case report describing the procedure and outcome in a complicated case.
Complications and Outcome of Percutaneous Nephrolithotomy (PCNL) procedures in our Institution: An Observational Study
Authors:   Assistant Professor, Department of Urology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu 636001, India., Marudhamuthu Rajasekar , Periyasamy Pugazhenthi ,   Assistant Professor, Department of Urology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu 636001, India., Palanisamy Jayakumar ,   Assistant professor, department of pediatric surgery, government mohar kumarangalam medical college hospital, Salem, Tamilnadu-636001,India.
Published: January 2024

Aim and Background: Percutaneous Nephrolithotomy (PCNL) is the primary treatment in renal stones more than 2 cms, staghorn calculi and diffult stone to fragment with ESWL. Outcome of stone disease with PCNL was studied here. Materials and Methods: A prospective observational study was done in our institution to find the PCNL outcome/complications in relation to Guy’s Stone Score (GSS). Statistical analysis was done by using Fisher's Exact Test, and ANOVA accordingly. P Value of <0.05 was considered significant. Results: Total 50 PCNL were done. There were 25 males and 25 females. The mean age was 42.48 years. The mean stone burden average was 2.882 cm with a minimum of 2.5 cm and a maximum of 4 cm. Total complications noted was 25 (50%), but most were managed conservatively. As the GSS score increases the residual stones, complications, operation time and length of hospital stay also increases (P Value <0.05). Conclusion: Increase in GSS associated with increase in residual, complications, operation time and length of hospital stay.