bluuebunny/crossref_metadata_2025 huggingface dataset:
Methylene Blue-mediated Photodynamic Therapy for the Treatment of Oral Leukoplakia
Authors: Bhandari Akanksha , Budakoti Akansha , Chaudhary Manjari
Published: May 2024

Objective:

To evaluate the efficacy of methylene blue-mediated photodynamic therapy (MB-PDT) for the treatment of oral leukoplakia (OL) and compare it to systemic Vitamin A therapy.

Materials and Methods:

Forty clinically and histopathologically confirmed cases of OL were included. They were divided into two groups: 20 were given systemic Vitamin A therapy and on the other group MB-PDT for 30 days. Pre- and posttreatment assessment of size of lesion and clinical appearance were done and followed up for 1 year to check for recurrence and delayed side effects.

Results:

The reduction in size of lesion pre- and posttreatment was statistically nonsignificant in the Vitamin A Group, but statistically highly significant in the PDT group according to unpaired t-test with no immediate or delayed side effects seen in both the groups.

Conclusion:

Both the treatment methods showed response in terms of reduction of size of lesion, but MB-PDT was a better treatment option for OL.

Clinical Relevance:

Oral cancer is often preceded by various premalignancies, OL being the most common among them. Early diagnosis and intervention will prevent malignant transformation thereby reducing the cost, side effect and mortality associated with oral cancer. Considering the prevalence, symptomless nature of OL, an effective, well-accepted mode of treatment with minimal side effects is of utmost need.
Outcome of Treatment for Hepatitis C Infection in Hemodialysis Patients with Direct-Acting Second-Generation anti-HCV Drugs at Azzawiyah Kidney Hospital, Libya
Authors: Shaibani Badreddin , Ayad Khairi , Melodi Marwa , Albarasi Sabah , Annajar Badereddin , Jibani Mahdi
Published: May 2024

Background:

Hepatitis C virus infection is the most common viral infection in patients on hemodialysis and is a leading cause of chronic liver disease in end-stage renal disease patients. The main aim of this study was to review the outcome of the treatment of HCV in hemodialysis patients with second-generation anti-HCV drugs at Azzawiyah Kidney Hospital.

Patients and Methods:

Thirty-two hemodialysis patients with proven HCV infection (HCV-polymerase chain reaction-positive) received antiviral treatment for 12 weeks and followed up for 12 months, with liver function tests and repeated HCV-RNA. The primary outcome was the proportion of patients who achieved sustained virological response at 12 weeks posttreatment (SVR-12).

Results:

32 patients (32/280, 11.4%) out of the total number of (280) regular hemodialysis patients were proven to have HCV infection, during the period from December 2016 to December 2019. The median age of the study population was 53.5 ± 12 years, and 55% were females. The median duration of dialysis was 9.6 years (range 3–25 years). The causes of chronic kidney disease were diabetes mellitus at 43.7%, hypertension at 25.5%, adult polycystic kidney disease at 12.5%, and chronic glomerulonephritis at 9.3%. Twenty nine (29/32) patients received antiviral treatment with sofosbuvir/daclatasvir (SOF/DLC) and (3/32) patients with elbasvir and grazoprevir (ERB/GZR). 96.9% of SOF/DLC achieved SVR 12 and 100% of EBR/GSR by the end of the treatment, only one patient (3.1 %) failed to achieve it. No significant side effects were reported for the treatment drugs.

Conclusion:

This study confirmed that the treatment of hemodialysis patients with chronic hepatitis C infection with second-generation anti-HCV drugs is safe and has elicited a sustained negative virological response.
Ocular Complications Resulting from the Use of Traditional Herbal Medicine in Central Saudi Arabia
Authors: Al-Ghadeer Huda , Al-Amry Mohammed
Published: May 2024

The present paper reviewed the ocular complications resulting from the use of traditional eye medicine in Central Saudi Arabia. We performed a literature search of the PubMed database using the keywords “traditional medicine,” “herbal medicine,” “ocular injuries,” and “visual impairments,” covering all years available for peer-reviewed full-text articles, letters, and review chapters of books. An additional search was performed in Google Scholar. All published materials were in English. Several ocular symptoms and disorders, including conjunctival cicatrization, symblepharon formation, obliteration of the fornices and the canaliculi, keratinization of the cornea, dryness, central corneal thinning, and corneal epithelial defect, have been associated with the use of traditional herbal medicine. In addition, the use of traditional eye medicine may result in corneal edema, opacity, ulceration, and perforation. Early recognition of ocular injuries could avoid or at least delay long-term sequelae. Ophthalmologists should be aware of the side effects of traditional remedies. Furthermore, public education, early detection of symptoms, and timely intervention may prevent permanent damage to the eyes.
Bromfenac 0.09% for the Treatment of Macular Edema Secondary to Noninfectious Uveitis
Authors: Saade Joanna S. , Istambouli Rachid , AbdulAal Marwan , Antonios Rafic , Hamam Rola N.
Published: May 2024

PURPOSE:

The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment of UME.

METHODS:

The charts of 10 patients with macular edema due to noninfectious uveitis treated with bromfenac 0.09% were reviewed retrospectively. The main outcomes studied were the best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) compared 4 months before bromfenac initiation, at the time of its initiation, and 4 months later.

RESULTS:

Twelve eyes of 10 patients were included. BCVA and CRT were unchanged 4 months befoew bromfenac compared to the time of bromfenac initiation (P = 1.0 and P = 0.2, respectively). There were a significant improvement in BCVA after 4 months of bromfenac treatment (P = 0.043) and a significant decrease in CRT (P = 0.002). Subretinal fluid resolved completely in 8/9 eyes, and 4/9 eyes had a complete resolution of cystoid macular edema at 4 months.

CONCLUSION:

Bromfenac may be a useful addition to the treatment of UME.
Successful Pars Plana Vitrectomy with Zonulo-hyaloidectomy Performed 4 Years after the Onset of Chronic Low-Grade Aqueous Misdirection
Authors: Alsarhani Waleed K. , Almater Abdullah I. , Abouammoh Marwan A. , Almobarak Faisal A.
Published: May 2024

In aqueous misdirection, the interval between diagnosis and surgical intervention is inversely proportional to the success of the surgery. Here, we report a successful outcome of pars plana vitrectomy (PPV) with irido-zonulo-hyaloidectomy 4 years after the onset of the disease. A 34-year-old female, known to have primary angle closure glaucoma, underwent trabeculectomy with mitomycin C in the right eye for uncontrolled intraocular pressure (IOP). Six weeks after the surgery, the patient presented with a shallow anterior chamber centrally and peripheral iridocorneal touch along with a patent peripheral iridectomy. Ultrasound biomicroscopy showed a shallow AC centrally with peripheral iridocorneal touch, and the ciliary body was rotated forward confirming the diagnosis of aqueous misdirection. The patient refused surgical management and was managed medically, which was unsuccessful. Four years after the diagnosis, the patient underwent PPV with irido-zonulo-hyaloidectomy because of progressive shallowing of the AC and corneal edema. One month postoperatively, visual acuity improved from 20/200 to 20/60, and the AC maintained appropriate depth. In conclusion, PPV with irido-zonulo-hyaloidectomy may result in a complete resolution of a chronic low-grade form of aqueous misdirection.
Validation of Artificial Intelligence Algorithm in the Detection and Staging of Diabetic Retinopathy through Fundus Photography
Authors: Pawar Bhargavi , Lobo Suneetha N. , Joseph Mary , Jegannathan Sangeetha , Jayraj Hariprasad
Published: May 2024

PURPOSE:

Diabetic retinopathy (DR) is one of the leading causes of vision loss globally, and early detection plays a significant role in the prognosis. Several studies have been done on the single field fundus photography and artificial intelligence (AI) in DR screening using standardized data sets in urban outpatient settings. This study was carried out to validate AI algorithm in the detection of DR severity using fundus photography in real-time rural setting.

METHODS:

This cross-sectional study was carried out among 138 patients who underwent routine ophthalmic examination, irrespective of their diabetic status. The participants were subjected to a single field color fundus photography using nonmydriatic fundus camera. The images acquired were processed by AI algorithm for image quality, presence and refer ability of DR. The results were graded by four ophthalmologists. Interobserver variability between the four observers was also calculated.

RESULTS:

Of the 138 patients, 26 patients (18.84%) had some stage of DR, represented by 47 images (17.03%) positive for signs of DR. All 26 patients were immoderate or severe stage. About 6.5% of the images were considered as not gradable due to poor optical quality. The average agreement between pairs of the four graders was 95.16% for referable DR (RDR). The AI showed 100% sensitivity in detecting DR while the specificity for RDR was 91.47%.

CONCLUSION:

AI has shown excellent sensitivity and specificity in RDR detection, at par with the performance of individual ophthalmologists and is an invaluable tool for DR screening.
Multi-purpose Disinfecting Solutions only Partially Inhibit the Development of Ocular Microbes Biofilms in Contact Lens Storage Cases
Authors: de Araújo Fabiano B.M. , Morais Vinicius C. , de Oliveira Bianca T.M. , de Lima Kaíque Y.G. , Gomes Victor T. , do Amaral Ian P.G. , Vasconcelos Ulrich
Published: May 2024

PURPOSE:

Certain ocular resident or pathogenic microbes may remain viable in the presence of multi-purpose disinfectant solutions (MPDSs), subsequently developing biofilms inside contact lens storage cases (CLSCs) which pose a risk of infection to wearers. This study evaluated the formation of ocular microbiota biofilms exposed to three top selling MPDS.

METHODS:

Crystal violet assay was carried out for the verification of biofilm formation. The in vitro assays evaluated Pseudomonas aeruginosa UFPEDA 416 and Staphylococcus aureus UFPEDA 02 exposure of 48 h to MPDS, as well as the use of 40 KHz ultrasound at the beginning and with 24 h immersion in the MPDS. Subsequently, in vivo assays evaluated the formation of microbial biofilms on the CLSC walls containing silicone-hydrogel contact lenses immersed in MPDS from 15 healthy volunteer patients, who had been wearing the lenses for 7 days.

RESULTS:

Biofilms were inhibited by 26%–98% in the in vitro assays, with a statistically significant difference only for P. aeruginosa UFPEDA 416 exposed to diluted MPDS. Most inhibitions occurred moderately and weakly. In addition, adherent cells were detected in more than 90% of the tests. Biofilm was not inhibited in more than one third of the results, nor was it disturbed, especially with the ultrasound treatments. The average of obtained optical densities at 590 nm was between 0.6 and 0.8 in the in vivo assays. The results were similar between the CLSC right and left wells. There was a correlation between microbial biofilm formation and the type of MPDS tested, with statistical difference between the three treatments.

CONCLUSION:

MPDS promoted a partial inhibition of microbial biofilm formation but only one MPDS proved to be more effective in vitro and in vivo. This study, however, could not distinguish the effect of possible errors in the good hygiene practices of the users.
A Prospective Evaluation of the Effect of Mitomycin-C on Corneal Endothelium after Photorefractive Keratectomy for Myopia Correction
Authors: Mohan Sashwanthi , Gogri Pratik , Murthy Somasheila I. , Chaurasia Sunita , Mohamed Ashik , Dongre Pankaj
Published: May 2024

PURPOSE:

The aim of the study was to assess the effect of mitomycin-C (MMC) 0.02% application on corneal endothelium in patients undergoing photorefractive keratectomy (PRK) for the correction of myopia and compound myopic astigmatism.

METHODS:

A prospective observational study including patients with myopia who underwent PRK plus intraoperative application of MMC 0.02%. All patients underwent noncontact specular microscopy preoperatively and 6 months postoperatively. The following parameters were analyzed: mean cell area (MCA), central corneal endothelial cell density (ECD), and coefficient of variation (CV) in cell size.

RESULTS:

One hundred and thirty-nine eyes of 73 patients with a mean age of 24.95 ± 3.23 years were included in the study. Mean baseline preoperative pachymetry was 519.54 ± 28.62 μm. The mean preoperative spherical equivalent was −4.6 ± 2.3D (range from −1D to −10D) which decreased to mean postoperative spherical equivalent of −0.125 ± 0.32D. Mean baseline ECD was 2829.3 ± 188.8 cells/mm2, MCA was 354.6 ± 24.9 μm2/cell, CV was 0.35 ± 0.06, and hexagonality was 50.1 ± 6.64. The mean ECD decreased by 43 ± 1.6 cells/mm2 which was not statistically significant (P = 0.07). The MCA increased by 5 ± 1.3 μm2/cell, but this was not statistically significant (P = 0.07). However, both the CV and percentage of hexagonal cells showed statistically significant differences in the median values as compared to preoperatively (P < 0.001).

CONCLUSION:

In our study, MMC had no significant effect on corneal endothelial cell counts or MCA. While there were statistically reduced CV and percentage of hexagonal cells, these did not appear to be clinically significant. MMC is safe to use routinely to prevent haze formation in PRK.
Burden and Presentation of Age-Related Macular Degeneration among Nigerians
Authors: Okonkwo Ogugua N. , Ibanga Affiong , Adenuga Olukorede , Nkanga Dennis , Ovienra Wilson , Agweye Chineze T. , Akanbi Toyin , Oyekunle Idris , Udoh Martha-Mary
Published: May 2024

PURPOSE:

Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide, and its prevalence may also be on the increase in Nigeria. The purpose of this study is to ascertain the burden and pattern of presentation of AMD in a developing country.

METHODS:

We conducted a multicenter, prospective study from January to December 2018. Biodata and history of systemic disease were obtained from consecutive patients presenting at four collaborating retina clinics and diagnosed with a retina disease after dilated fundus examination and ocular investigations such as fundus photography, fluorescein angiography, and optical coherence tomography. All eyes diagnosed to have wet and dry AMD were used for the study analysis.

RESULTS:

Out of 8614 patients, 156 eyes of 78 patients were diagnosed with AMD. The hospital-based prevalence for AMD was 0.91%. The mean age at presentation was 67.9 ± 9.2 years, ranging from 44 to 95 years. A majority (75.6%) of patients were between 60 and 79 years, 53.8% were females. Thirty-two eyes (20.5%) had wet AMD, while 124 eyes (79.5%) had dry AMD. Sixty-one eyes (39.1%) had moderate visual impairment (<6/18-6/60); 58 eyes (37.2%) had normal vision (6/18 and better); while 27 eyes (17.3%) were blind, and ten eyes (6.4%) had severe visual impairment.

CONCLUSION:

AMD contributes to the burden of visual impairment and blindness in the elderly Nigerian. In Nigeria, AMD occurs more in females and most common between the ages of 60 and 79. Dry AMD is four times more common than wet AMD. About 24% of eyes have severe visual impairment or blindness, while about a third each have a moderate visual impairment and normal vision. Increasing awareness of AMD among the at-risk population will be beneficial in achieving early diagnosis and treatment.
An Algorithm for the Reconstruction of Nonfingertip Upper Extremity Soft Tissue Defects
Authors: Bas Soysal , Sizmaz Mert , Aydin Alican , Sirvan Selami Serhat , Karsidag Semra
Published: May 2024

Aims:

The aim of this study was to evaluate the advantages and disadvantages of reconstructive methods used in the upper extremity soft tissue defects other than the fingertips, according to location.

Materials and Methods:

This retrospective study included 212 patients operated between January 2012 and January 2019 due to upper extremity soft tissue defects excluding the fingertip. Patients were evaluated in terms of age, gender, etiology, reconstruction area, method, and complications.

Statistical Analysis Used:

The relationship between the reconstructive method or location and the complication was evaluated by one-way analysis of variance test. The relationship between categorical variables was tested by Kruskal–Wallis test. The significance of multiple comparisons was adjusted using Bonferroni correction.

Results:

The average age of patients was 35.4 ± 19.12 years; 168 were male and 44 were female. 158 patients were operated for trauma, 34 for malignant tumor, 12 for infection, and 8 for extravasation. Complications were observed in 19 of the 220 reconstructive procedures (8.6%): two of the local flaps, three distant flaps, two regional flaps, five perforator flaps, and seven free flaps. 26% of these complications were seen in fingers, 15% in hands, 42% in wrists, 5.2% in forearms, 5.2% in elbows, and 5.5% in arms.

Conclusions:

There are many procedures for upper extremity reconstruction that can be selected according to defect location and character. It should be kept in mind that complex reconstructions that are preferred especially in complicated injuries may end up with challenging complications. In these types of complicated injuries, it would be better to prefer a reconstructive ladder instead of a reconstructive elevator.
Soft-Tissue Sarcomas
Authors: Kapukaya Rana
Published: May 2024

Advances in multimodal therapy and limb-salvage surgery (LSS) have led to improvements in the quality of life of sarcoma patients. Despite all the advances, controversy continues in the diagnosis and treatment of soft-tissue sarcomas (STSs). Significant structural and functional losses occur in the extremity due to both wide resections and radiotherapy combined with surgery. This situation necessitates the restructuring of extremity functions. The opinion of plastic surgery must be obtained, when planning LSS, before excision of high-volume tumors, to decide postresectional reconstruction and to manage the postsurgical complications. The need for plastic surgery in the multidisciplinary approach to STSs is increasing. The information presented in this article has been compiled from the articles obtained by searching the titles of “soft tissue sarcomas, reconstruction, diagnosis, current treatment” in Google Scholar and PubMed databases, international books written in the field, and the experiences of the authors.
Intraosseous Epidermoid Cysts in Distal Phalanx
Authors: Toplu Gaye , Altinel Dincer , Leblebici Cem , Serin Merdan
Published: May 2024

Intraosseous epidermoid cyst is a rare nonneoplastic lesion. It's usually caused by a trauma which places the epidermal fragments inside the bone. 31-year-old female patient was presented with a mass in the distal phalanx of the 3rd digit of the right hand. The histological examination following the excision of the cyst revealed intraosseous epidermoid cyst. Histopathological features, patient demographics, history, treatment, and prognosis of this rare case are presented.
The Anterolateral Thigh Perforator Flap is a Versatile Resource for Reconstructive Surgery
Authors: Sliesarenko Sergii V. , Badiul Pavlo Olexii , Rudenko Oleh I.
Published: May 2024

The Aim of Work:

The aim of this study was to increase the efficiency of reconstruction of extensive soft-tissue defects of various localizations by differentiated use of the anterolateral thigh (ALT) perforator flap.

Methods:

We have retrospectively reviewed 39 patients, who had undergone soft-tissue reconstruction using pedicled and free transposition of ALT flaps.

Results:

In this series, all cases ended with a complete recovery of patients with adequate restoration of integumentary tissues. In the postoperative course, we encountered complications during free flap transplantation in nine cases (23%), two of which were associated with arterial insufficiency (5.1%) and seven – with venous thrombosis (17.9%). Most of these complications were not critical, and the problem was resolved by conservative treatment; in two cases, partial tissue death required a secondary suture. In three cases (7.7%), the complications were critical and led to the loss of the flap.

Conclusions:

The unprecedented versatility and the minimal trauma of the donor area make the ALT perforator flap one of the most demanded skin flaps. Despite the variable vascular anatomy, the ALT flap is the most adaptable plastic resource for extensive soft-tissue coverage of abdominal, perineal, and hip joints as a transposition flap on the vascular leg and for closing distant defects in any area of the body using it as a free microsurgical transplant. Other advantages include its variability in size and the ability to harvest multiple tissue components in different combinations depending on the desired outcome.
Comorbidity Analysis of Turkish Patients Operated for Dupuytren's Contracture in a University Hospital
Authors: Kose Aydan Ayse , Demirkan Bahadir , Sevencan Adnan , Tokmak Büsra , Ekinci Can
Published: May 2024

Background:

Dupuytren's contracture (DC) is characterized by progressive fibroplasia of the palmar fascia resulting in significant impairment of hand function. Genetic factors and environmental factors are suspected in the etiology. Although the disease has a benign character, its formation and course follow a tumoral pattern. Several studies show that cancer-related mortality is higher in people with DC. Besides, various risk factors such as diabetes, smoking, and heavy handwork as triggers for DC led us to analyze the epidemiologic characteristics of our patients and search for the concomitance of chronic diseases and cancer.

Methods:

Seventy patients were operated for DC between 2009 and 2019. Information on occupation, dominant hand, diseased hand, family history, additional comorbidities, cancer, smoking, and drinking habits was sought.

Results:

A significant number of the patients were manual laborers. Most of the patients were active smokers at the time of the surgery. Dominant hand was predominantly right hand and the disease was mostly observed in the right hand but it was not significant (P > 0.05). Diabetes and cardiovascular disease (CVD) were the most common accompanying diseases. After surgery for DC, seven patients were diagnosed with cancer.

Conclusions:

This is the first Turkish study to show the relationship between DC and several comorbidities. Male gender and medium-heavy handwork were associated with DC. Although it was not statistically significant, the dominant hand was more affected by DC. Diabetes, CVD, smoking, and alcohol were significant comorbidities in our patients. The association between DC and cancer was remarkable.
Is Iatrogenic Sciatic Nerve Neuropathy following Thigh Lift Surgery Uncommon and Preventable?
Authors: Çiçek Çağla
Published: May 2024

Obesity is a serious public health problem, and bariatric surgery that is applied for obesity-related morbidities has led to a decrease in obesity-related morbidities and can also improve the quality of life of patients. Plastic, reconstructive, and esthetic surgery plays a major role in the management of skin laxity after bariatric surgery and is therefore generally considered a necessity. However, body contouring surgery can also be associated with some devastating complications. We present a case who developed sciatic nerve neuropathy after medial thigh lift surgery. Complete functional loss of the sciatic nerve was found by clinical and electroneurographic examination on the right side, and full nerve conductance recovery was obtained after 7 months in the patient. It is important to raise awareness about the fact that this significant complication, although rare, can occur even with such a benign and easy procedure and that it is readily reversible with prompt diagnosis and early treatment.
Demographics and Prediction Accuracy of Upper Extremity Tumors
Authors: Üstün Galip Gencay , Kara Murat , Menku Ozdemir Fethiye Damla , Uzun Hakan , Gököz Özay , Aksu Ali Emre
Published: May 2024

Background:

Upper extremity tumors (UETs) and their treatment may impair hand functions. Successful prediction of the histopathological examination before surgery will speed up the treatment process. The aim of this study is to determine the frequency and prediction accuracy of tumors encountered in the upper extremity.

Patients and Methods:

Records of patients operated for UETs between January 2010 and December 2019 were reviewed. Patient gender, initial complaint, the anatomic region of the tumor, comorbidities predisposing to malignancy, method of biopsy, preliminary diagnosis and predicted malignancy status after initial examination, definitive histopathological diagnosis, and malignancy status were extracted retrospectively. Prediction accuracy rates were calculated for each tumor group. Chi-square analysis was used for comparative analysis of prediction accuracy rates between cutaneous pigmented versus soft-tissue lesions and patients with/without a predisposition to malignancy.

Results:

The study included 416 pathological specimens from 290 patients. The most common tumors of the upper extremity were lipoma (20%), ganglion cyst (10.1%), and epidermoid cyst (5.8%). After pathological evaluation, 23 specimens were diagnosed as malignant (5.5%) and 32 specimens as premalignant (7.7%). The prediction of malignancy status was accurate in 390 specimens (93.7%). Soft-tissue sarcomas (67.7%) and vascular lesions (58.1%) have the lowest accuracy rates among all tumors.

Conclusion:

Definitive diagnosis and malignity status can be predicted after the initial examination in the majority of the cases. However, imaging studies or incisional biopsies are needed for soft-tissue sarcomas, vascular tumors, or tumors of patients with a predisposing condition to malignancy.
Experience on Subfascial Mammary Augmentation and Influence of Incisions on Technique
Authors: Gökkaya Ali , Görgü Metin
Published: May 2024

Introduction:

Mammary augmentation is among the most popular types of cosmetic procedures and mammary prosthesis the most commonly accepted technique. A mammary prosthesis can be placed on transaxillary, periareolar, submammary incisions in subglandular, subpectoral, subfascial planes or in a combination of planes. Given the potential interaction between the prosthesis and the surrounding tissues, the plane in which the prosthesis is implanted has an important role among the factors affecting this interaction. The plastic surgeon decides on the incision and plane to be used by assessing the advantages and disadvantages.

Materials and Methods:

Prostheses were implanted in the subfascial plane in 47 patients who underwent augmentation mammaplasty. Round Moderate Plus or High Profile Cohesive II™ Gel implants were used. Device volumes ranged from 275 to 600 cc. Of the 47 procedures, 23 were performed over an axillary incision, 20 over an inframammary incision, and 4 over a periareolar incision. Endoscopic-assisted dissection was performed in all of the 23 cases in which transaxillary incision was used.

Results:

All 47 patients who underwent subfascial prosthesis implantation were followed up for a mean of 5 years (range: 2–7 years). Long-term results were satisfactory with few complications. The overall patient satisfaction rate was 89.3%, and none of the patients required an implant removal or change. None of the patients complained of severe pain, regardless of the type of incision, and resumed their daily activities on postoperative day 2.

Conclusion:

The subfascial augmentation technique provides good and long-term results. It requires longer operating times and is a more difficult technique compared to other planes. As the choice of incision does not largely affect the overall result, the position of the scar depends on the patient's preference, the properties of the implant, and the experience of the surgeon. The endoscopic assistance should be preferred when using the transaxillary approach.
Giant Dermatofibrosarcoma Protuberans in the Forearm
Authors: Kargalioglu Ferhat , Üstün Galip Gencay , Gürsoy Koray , Kocer Ugur
Published: May 2024

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing, locally aggressive malignant fibroblastic mesenchymal skin tumor, which is considered as the most common skin sarcoma. As a treatment modality, local excision with 4–5 cm border is commonly replaced by Mohs micrographic surgery. A 24-year-old woman with a giant DFSP in the forearm is presented. The patient was admitted to clinic with a large protuberant mass on the left forearm. The preliminary diagnosis was soft-tissue sarcoma due to a history of rapid growth and absence of any skin lesion. DFSP originates from the dermis and commonly infiltrates underlying muscles, tendons, fascia, and bones. In this case, there was no skin infiltration. Mohs micrographic surgery was not used in the treatment since the tumor was confined to subcutaneous tissue and did not infiltrate to the skin. Although the Mohs micrographic surgery was not used, the tumor did not recur postoperative 6 months' follow-up. A long-term follow-up is strongly recommended in DFSP cases.
Endovascular Management of Auricular Arteriovenous Malformations
Authors: Ahmad Saima
Published: May 2024

This is a retrospective review of eight patients with extracranial arteriovenous malformations (AVMs) of the auricular region. All cases presented with significant hemorrhages or cosmetic defects. Highflow AVMs of the auricular are quite rare in contrast to low flow vascular lesions of the head and neck, making early diagnosis and treatment critical as incidences of recurrence are high if not managed properly. The purpose of this study is to present our experience of experimental endovascular treatment in a series of eight patients with auricular AVMs. From January 2015 to December 2017, eight patients with auricular AVM were put through transcatheter arterial embolization and percutaneous direct puncture embolization with polyvinyl alcohol (PVA) and bleomycin in five patients, glue embolization in one patient and coiling along with PVA in two patients to occlude high-flow fistula. Clinical outcomes were obtained through physical examination, and symptoms and a degree of devascularization on follow-up angiography. We performed 10 therapeutic embolization procedures. Of these, 3 resulted in absolute devascularization while 5 resulted in 75% obstruction. In 5 patient's embolization was performed as a palliative procedure. The other 3 were embolized as a sole mean of treatment for occluding the AVM. Only two patients developed postembolization necrosis and infection, and there has been no reexpansion of lesions to date. While thus far only having been used as percutaneous local sclerotherapy, this study found that bleomycin and PVA mixture, if used intraarterially can be more effective in the management of auricular AVM's.
Fat Graft and Platelet-Rich Plasma Treatment for Localized Facial Scleroderma
Authors: Gökkaya Ali , Demirez Dilek , Görgü Metin , Karanfil Ertugrul , Kizilkan Jehat , Dogan Ali
Published: May 2024

Scleroderma is an autoimmune disorder characterized by hardening of the skin on the hands, arms, and face. Immunosuppressors, vasodilators, and physiotherapy are among the treatments for scleroderma. Although these treatments can improve quality of life, the treatment response in locally affected areas may be poor. At present, there is no specific treatment for localized fibrotic skin lesions in scleroderma, although stem cell treatment shows promise for local symptoms. We describe the case of a patient with facial skin symptoms of scleroderma treated with platelet-rich plasma combined with fat grafts rich in stem cells.
The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: A systematic review and meta-analysis
Authors: Borkar Nitinkumar , Tiwari Charu , Mohanty Debajyoti , Singh Sunita , Dhua Anjan
Published: May 2024

Background:

Hypospadias is among the common congenital anomalies in boys. Snodgrass urethroplasty is one of the most popular techniques for correcting distal and mid hypospadias. Although there is consensus among pediatric surgeons on using absorbable sutures for urethroplasty, there are no established guidelines about the suturing techniques (interrupted suturing [IS] or continuous suturing [CS]) for neourethra creation in Snodgrass urethroplasty. This analysis aims to compare the reported outcomes of both the urethroplasty suturing techniques.

Materials and Methods:

This systematic review and meta-analysis was conducted as per the preferred reporting items for systematic review and meta-analyses guidelines. A systematic, detailed search was carried out by the authors in the electronic databases – MEDLINE, PubMed Central, Scopus, Google Scholar, and Clinical Trial Registry. Studies were selected and compared based on primary outcomes – development of urethrocutaneous fistula (UCF), meatal stenosis, and secondary outcomes – wound infection, urethral stricture, and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio, and I
2 heterogeneity.

Results:

Five randomized studies with a total of 521 patients met our inclusion criteria. Pooled analysis for total complications, UCF, meatal stenosis, and wound infection showed no significant difference between the CS and IS groups. Subgroup analysis of patients with the use of polyglactin sutures showed a decrease in total complications and UCF in the IS group.

Conclusion:

There is no difference in total complication rates among the CS and the IS group with the use of absorbable sutures in Snodgrass urethroplasty; however, there is a decrease in the incidence of total complications and UCF in the IS group when polyglactin was preferred over polydioxanone suture for urethroplasty.
Cutaneous metastasis of castration-resistant prostate cancer: A rare case report and review of literature
Authors: Sarangi Shakti Swarup , Singh Vikram , Bhirud Deepak Prakash
Published: May 2024

Carcinoma prostate is the second most common malignancy in males. It starts with a relatively indolent course and maybe asymptomatic during the initial stages. However, metastasis is highly common in Carcinoma prostate. The sites of metastases include bone, lung, liver, pleura and adrenals with cutaneous metastasis being one of the rarest sites being less than 1%. In our case report we present one such rare finding of Carcinoma prostate with cutaneous metastasis.
Chronic pelvic pain syndrome symptoms significantly affect medical students’ well-being
Authors: AlKhayal Abdullah , Alasmari Faisal Ali , Alomeyr Bander Khaled , Abumelha Saad , Alrabeeah Khalid
Published: May 2024

Aims:

This study aims to determine the prevalence of chronic pelvic pain syndrome (CPPS) symptoms among male-medical students in Riyadh, Saudi Arabia.

Settings and Design:

It is a cross-sectional study at King Saudi Bin Abdulaziz University for Health Sciences, College of Medicine at Riyadh, Saudi Arabia.

Subjects and Methods:

A total of 300 male medical students were given a hardcopy questionnaire to be filled anonymously that includes demographic characteristics, several questions regarding the health status, habits of the participants, and the National Institutes of Health Chronic Prostatitis Symptom Index for evaluating CPPS symptoms.

Statistical Analysis Used:

SPSS (v21) was used for the analysis. Qualitative data presented by frequencies and percentages and quantitative data presented by median and interquartile range (Q1 to Q3). The Chi-square test and binary logistic regression were used to assess the relationship between the outcome variables with demographical data.

Results:

In total 300 male medical students were surveyed, 245 medical students returned the questionnaire giving a response rate of 81.6%. The prevalence of CPPS symptoms among all participants was 57.9%. Majority of the participants does not have any associated medical/psychological conditions 152 (62%). Students with irritable bowel syndrome (IBS) or/and anxiety have statistically significant association with CPPS symptoms (P < 0.05). A total of 23% of students with CPPS reported being impaired with their quality of life (QOL), while 77% are satisfied.

Conclusions:

The prevalence of CPPS symptoms among male medical students is high. Anxiety, IBS, and lack of activity might be associated with CPPS symptoms, which have a significant negative impact on the QOL. For the future direction, a large-scale global study should be conducted to link the effects of CPPS symptoms on male medical students well-being.
Adult renal angiomyolipomas: A retrospective analysis of the histological subtypes and their clinicoradiological correlates
Authors: Chacko Arman Z. , M. Prashanthy T. Annie , Gopinathan Vikramraj , George Arun J. P. , Kumar Santosh , Chacko Geeta
Published: May 2024

Background:

Renal angiomyolipomas (AMLs) are rare, benign mesenchymal tumors of the kidney. Asian data on the prevalence of the subtypes of AMLs and their association with tuberous sclerosis are sparse prompting us to evaluate the clinicopathological characteristics of these tumors.

Materials and Methods:

We included cases diagnosed from 2001 to 2021 extracting demographic details, clinical presentation, syndromic association with tuberous sclerosis, and preoperative clinicoradiological features from the electronic medical records.

Results:

Ninety-five cases of adult renal AML were diagnosed among 2402 renal tumors, a prevalence of 3.95%. Forty tumors (42%) were detected incidentally; two patients had life-threatening retroperitoneal hemorrhage. Tuberous sclerosis complex (TSC) was associated with ten cases (10.5%). These patients were a decade younger than those in the non-TSC group (P = 0.008) and had bilateral, multiple, and larger tumors (P = 0.0009, 0.001, and 0.047, respectively). Microscopically, classic and epithelioid subtypes were seen in 87 (91.6%) and 8 cases (8.4%), respectively. Hemorrhage was more common in the epithelioid subtype (P = 0.13). HMB-45, melan-A, and smooth muscle actin immunohistochemistry were useful in cases which lacked the prototypical classic histology and for confirming a diagnosis of epithelioid AML.

Conclusions:

The prevalence of renal AML in our series was four times higher, and the mean age at diagnosis was a decade earlier than that reported in Western literature but similar to data from two Asian countries. Similar studies from other countries will help ascertain if these differences in prevalence can be attributed to ethnic differences.
Evaluation of lower urinary tract symptoms among male COVID-19 patients during the second wave: An observational study
Authors: Bani-Hani Morad , Alnifise Mohammad , Al-Zubi Mohammad , Albazee Ebraheem , Al-Balawi Mohammed , Majeed Hashem , Alhouri Abdullah
Published: May 2024

Background:

Coronavirus disease-19 (COVID-19) pandemic has affected almost all age groups globally, and lower urinary tract symptoms (LUTS) may be one of the early manifestations of COVID-19, especially in elderly patients. This study aimed at evaluating LUTS in male COVID-19 patients during the COVID-19 s wave.

Methodology:

A prospective observational study was conducted between March 15, 2021, and March 25, 2021, at the Prince Hamza Hospital in Amman, Jordan. Newly admitted COVID-19 confirmed male patients who were able to fill the LUTS (validated) questionnaire were included. Vitally unstable patients requiring intensive care unit admissions or medical or surgical intervention (except catheterization) for their presenting symptoms were excluded.

Results:

Two-hundred and four patients (mean age: 51.1 ± 17.3 years) were included; among COVID-19 symptoms, augmented urinary frequency (3.4%) was the commonest urological symptom, followed by dysuria (1.0%), and acute urinary retention (1.0%). Twenty-four patients (10.8%) had benign prostatic hyperplasia, two patients had bladder cancer, and one hadprostate cancer. Most patients exhibited mild symptoms on international prostate symptom score (IPSS) before (n = 149, 67.1%) and during (n = 157, 70.7%) COVID-19, and this difference between IPSS scores was statistically significant (P = 0.025). Both IPSS sub-scores of storage (IPSS/S) and voiding (IPSS/V) had a positive correlation with pre- and post-COVID-19 scores (IPSS/S: P < 0.001, r = 0.63; IPSS/V: P < 0.001, r = 0.76).

Conclusion:

This study demonstrated a strong correlation between COVID-19 and LUTS; therefore, COVID-19 infection should be investigated and excluded in any patient presenting with LUTS during the current pandemic. Further research is needed to elucidate the exact pathophysiology of this correlation.
Detection of renal anomalies using antenatal and postnatal ultrasound
Authors: Alsaywid Basim , Mohammed Afrah , Al Ghamdi Layal , Banjar Lama
Published: May 2024

Introduction:

Antenatal ultrasound (US) is considered the gold standard tool to detect fetal anomalies during the antenatal period. However, its highly operator dependent and maybe affected with other variables. The aim of this study to compare discrepancy between antenatal and postnatal US diagnosis of congenital anomalies of the kidney and urinary tract (CAKUT) and to evaluate the incidence of parent’s consanguinity among those patients at King Abdulaziz Medical City – Western Region (KAMC-WR), as it may help changing the current practiced guidelines and applied protocols.

Methods:

This is an observational, retrospective, cross-sectional study, conducted at the Maternal Fetal Medicine Unit at KAMC-WR, reviewing antenatally detected CAKUT between the years 2009 and 2014. Utilizing the congenital anomalies database and using multiple databases collected the data. A data sheet was completed and divided into four sections, which consist of maternal data, antenatal data, delivery, and postnatal data. The analysis was performed using Statistical Package for Social Sciences program (Armonk, NY: IBM Corp).

Results:

We included 137 fetuses with renal anomalies in our study, with 17% perinatal mortality rate, and 13% loss of follow-up. Abnormal amniotic fluid was detected in 32%, and bilateral anomalies presented in 41% and it was most commonly seen in male fetuses. Added to that, 41% of the fetuses were product of consanguineous marriage and 11% had a history of other child with renal anomalies. However, the rate of discrepancy between antenatal and postnatal renal US findings was 24%. Finally, the most common anomaly found antenatally and confirmed postnatally was hydronephrosis disease spectrum (60.6%).

Conclusion:

There is a significant association between children with CAKUT and parents’ consanguinity. Furthermore, the discrepancy rate for the detection of CAKUT between antenatal and postnatal US in our study was comparable to other international studies. Further prospective studies are recommended in this field for further understanding.
A case report of large testicular mass: An Eastern Province report from KSA
Authors: Alaskari Mohammed Mansour , Hassan Islam A. Bary , Aldakhil Talib Abdulaziz , Al Khatem Raihanah Saeed
Published: May 2024

Large testicular tumor is not a commonly seen entity in the modern era. While treatment of large testicular tumors is via inguinal radical orchiectomy, large testicular tumors carry the dilemma of delivering these large masses via the inguinal or scrotal approach. Here, we present a case of a 53-year-old male patient with a testicular tumor weighing 2.170 kg, measuring 22 cm × 16 cm × 12 cm, who was treated via inguinal orchiectomy with the extension of the surgical wound to the neck of the scrotum, with pathological report showing seminoma with no spermatic cord invasion. We review some case reports of such large tumors to illustrate this treatment dilemma.
Simple method for correcting imperfectly placed fiducial markers for image-guided radiotherapy technologies of the prostate cancer
Authors: Gawlik-Jakubczak Teresa
Published: May 2024

One of the main method of treating prostate cancer is radiotherapy . Contemporary techniques as IGRT concentrate on proper delivery and exact delineation of the target. We present the simple method of correction the visualisation of gold markers implanted before radiotherapy . In the case when one or two seeds were located imperfectly or were lost with stool or urine we implant additional seeds which create the spatial figure recognised in CT and MRI . Implantation of additional seeds is safe and very simple method which can “rescue” sense of image guided procedure in the case of unfavourable primary fiducial seeds location.
Management of rectal injury and rectourinary fistula from radical prostatectomy
Authors: Luchaichana Nuttaphon , Ramart Patkawat
Published: May 2024

Objective:

This study aimed to demonstrate our management of rectal injury (RI) and rectourinary fistula (RUF) from radical prostatectomy (RP) and identify a possible factor that increased the chance of developing RUF.

Materials and Methods:

Between January 2011 and December 2019, a total of 14 cases of RI were retrospectively reviewed and analyzed, including preoperative, perioperative, and postoperative information.

Results:

In all 14 cases of RI, the average age at RP was 66.3 years (54–77). During the study period, 8 of 14 cases of RI occurred in our hospital, and the incidence of RI was 0.42%. RI was intraoperative recognition in 8 cases and delayed diagnosis in 6 cases. For immediate recognition, 4 of 8 cases were primarily repaired without developing RUF and did not require diverting colostomy and suprapubic cystostomy. RUF occurred in 10 cases including 4 cases of intraoperative recognition and all cases of delayed diagnosis. In a subgroup analysis of RI that occurred in our hospital, the timing for diagnosis was clinically and statistically significant difference (P = 0.029). Instantly detected RI during RP and intraoperative rectal repair resulted in no postoperative complication. Among all 10 cases of RUF, 5 cases were successfully repaired by modified York–Mason procedure with dartos tissue flap interposition. No major complications were reported.

Conclusions:

Incidence of RI was 0.42% and intraoperative recognition of RI was a key to prevent the development of RUF. Modified York–Mason procedure with dartos tissue flap interposition was an effective treatment for RUF.