bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ambulatory laparoscopic inguinal hernioplasty
Authors: Sanchez Natalia J. , Cetolini Fernando , Scaravonati Rodolfo , Roche Sebastian , Brandi Claudio , Bertone Santiago 
Published: May 2024

BACKGROUND:
In recent years, laparoscopic inguinal hernia repair has become one of the elective techniques, attributing the advantages of minimally invasive procedures to it. However, the high costs related to the need for hospitalization and materials make them a limitation at the time of its indication.

OBJECTIVE:
Evaluate the feasibility of performing this procedure in an outpatient surgery center and the cost analysis of an outpatient procedure regarding the same in the setting of hospitalization. Retrospective cohort study of feasibility and minimization cost.

METHODS:
A retrospective analysis was carried out on a prospective database in which all patients were included in those who underwent laparoscopic inguinal hernioplasty on an outpatient basis between August 2015 and June 2018. Feasibility is expressed as the percentage of patients who were referred from the outpatient surgery unit. A cost minimization study was conducted taking the average cost of performing an ambulatory procedure versus the same procedure requiring a day of hospitalization. This work has been reported in line with the CHEERS criteria.

RESULTS:
116 patients were operated as outpatients, of which 109 were men (93.96%). The median age was 56.5 years (RIQ 19). 102 patients (87.93%) were operated on due to bilateral inguinal hernia, and 14 of them (12.07%) due to recurrent unilateral hernia, adding a total of 218 inguinal hernioplasties. The mean operative time in bilateral interventions was 112 minutes (DS 24) and in the unilateral recurrences it was 79 minutes (DS 13). 114 patients were discharged from the outpatient unit with 98.3% feasibility. The average postoperative stay was 2.53 h (DS 1). The average cost of ambulatory inguinal hernioplasty was $17725.1 vs $27297.3 in hospitalization. The same implies a cost reduction of 35%.

CONCLUSIONS:
Laparoscopic inguinal hernioplasty is a feasible and safe technique to perform on an outpatient basis. It provides a significant reduction in the costs of the procedure.
Surgical treatment for inguinoscrotal hernia with loss of dominion with preoperative progressive pneumoperitoneum and botulinum toxin
Authors: Cubero José Ángel Ortiz , Soto-Bigot Marco , Chaves-Sandí Marcelo , Méndez-Villalobos Armando , Martínez-Hoed Jesús 
Published: May 2024

PURPOSE:
The aim of this article is to establish which is the best peri- and intraoperative approach for patients with giant inguinoscrotal hernia.

METHODS:
A systematic review of the literature was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria through a search in PubMed, Scielo, and other resources, from January 2011 to April 2020. Prospective, retrospective, case reports, and clinical series were included. Patients who underwent emergency procedures and studies involving children or pregnant women were excluded.

RESULTS:
A total of 24 publications related to giant inguinal hernia were identified, which together group a total of 81 patients. The average age of the patients was 62 years. Of the 81 patients, in 10 cases (12%), loss of domain was objectively established. In patients with loss of domain, preoperative pneumoperitoneum (PPP) + botulinum toxin type A (TBA) was used in 80% of the cases. In 10% only NPP was used and in the remaining 10% only TBA was used. Regarding the repair technique, 70% used the anterior route. The most frequent surgery was Lichtenstein's procedure (38%), followed by Stoppa's procedure (9%) and transabdominal preperitoneal procedure (9%). The most frequent complication was the development of seromas. The median postoperative follow-up was 15 months.

CONCLUSIONS:
Inguinoscrotal hernias with loss of domain are rare, and therefore their management is far from being clearly defined. In those cases, where the loss of domain is confirmed, both botulinum toxin and preoperative pneumoperitoneum have been used, without documenting major complications. To repair the defect, the most widely used technique is Lichtenstein's procedure; however, the possibility of long-term recurrence should be assessed. The retrorectal repair could reduce the risk of recurrence as it is associated with greater mesh overlap.
Successful closure of the open abdomen utilizing novel technique of dynamic closure system with biologic xenograft
Authors: Puckett Yana , Caballero Beatrice , McReynolds Shirley , Richmond Robyn E. , Ronaghan Catherine A. 
Published: May 2024

PURPOSE:
The objective of this study was to demonstrate an alternative option for definitive fascial closure and accelerated wound healing of catastrophic open abdominal wounds utilizing a novel technique combining a mechanical closure system with biologic xenograft.

MATERIALS AND METHODS:
All patients who underwent abdominal closure with a dynamic wound closure system with biologic xenograft were analyzed between 2016 and 2017. ABRA® dynamic wound closure system was placed and adjusted daily until fascial closure was achieved. ACeLL® urinary porcine bladder matrix was placed in midline of wound once fascial closure was achieved. Information was abstracted on patient demographics and extent of open abdomen (OA) and postoperative outcomes.

RESULTS:
Fifty patients underwent novel closure of the OA with mean age of 48.3 years with males comprising 72%. The average body mass index was 35.0. Majority (62%) of OAs were secondary to abdominal sepsis. The average myofascial gap prior to closure of abdomen was 19.0 cm, incision length 28.9 cm, and visceral extrusion 7.7 cm. Prior to installation, the abdomen on average had 3.6 laparotomies and was open for 8.6 days. Primary myofascial closure was achieved in 49/50 (98%) patients; 3/50 (8.3%) developed a hernia. Surgical site infection (SSI) occurred in 4/50 (8%).

CONCLUSION:
We present a novel technique to achieve primary myofascial closure rate in critically ill patients with OA associated with low hernia rate and SSI.
A case report of a combined laparoscopic-open approach to a bladder inguinal hernia and mesh herniorrhaphy
Authors: Pillay Yagan , Naidoo Vimal 
Published: May 2024

Abstract
An inguinoscrotal hernia of the urinary bladder is a rare surgical entity with an incidence of 0.5%–4%, in the literature. Its surgical management may vary given the paucity of information in the published literature. Most herniorrhaphy attempts have been open with some sporadic attempts at a laparoscopic preperitoneal repair. We present a unique combined approach involving a laparoscopic and open-mesh herniorrhaphy. The surgical outcomes are generally good, even in the presence of bladder complications such as necrosis or perforation. One of the advantages of the combined approach is the ability to confirm the pelvic bladder position posthernial reduction without the need for a voiding cystourethrogram. It also allows the surgeon to exclude any bladder injury which may have occurred during bladder reduction.
Chemical abdominal wall release using botulinum toxin A
Authors: Hoffmann Henry , Nowakowski Debora , Kirchhoff Philipp 
Published: May 2024

Introduction:
Botulinum Toxin A (BTA) has gained increasing interest in hernia surgery, especially when dealing with complex ventral hernias. The goal of using BTA is the preoperative reduction of the transverse hernia diameter achieving a higher primary fascial closure rate, avoiding a potential additional component separation. However, high evidence data are sparse and the treatment protocols of BTA and patient selection are heterogenic. In this article, we review the most recent literature; discuss indications for BTA, the ideal patient selection, and available BTA protocols. Also, we provide our own data and discuss the potential future role of BTA in treating complex ventral hernias.

Materials and Methods:
We reviewed the available literature and analyzed our own data from patients with complex ventral hernias undergoing preoperative BTA application retrospectively. We present our BTA protocol and measured abdominal wall muscle and hernia parameters before BTA application and before surgery using CT scans.

Results:
In total 22 patients with a median diameter of the incisional hernias of 11.75 cm (IQR 10.9–13.4) were included in our study. BTA administration was performed 4 weeks prior to surgery. In CT scans a significant reduction of the thickness and an elongation of the lateral abdominal wall muscle compartment were seen in all patients. Also, the transverse hernia diameter decreased in all cases from median 11.8 cm (IQR 10.9–13.4) pre-BTA to 9.1 cm (IQR 7.6–10.2) presurgery. Primary fascial closure was achieved in all cases with additional component separation in three cases.

Conclusion:
BTA administration in the lateral abdominal wall muscle compartment is a helpful tool to simplify surgery of complex ventral hernias. It has a visible effect on the muscle parameters in the CT scans and subsequently may increase the rate of primary fascial closure. Further multicenter studies are necessary to gain data with higher evidence.
Assessment of glaucoma severity and deterioration by using Spaeth/Richman contrast sensitivity (SPARCS) and its correlation with retinal nerve fiber layer thickness and perimetry
Authors: Jinna Shihail , Bhatnagar Kavita R , Jaisingh Kirti , Shakrawal Jyoti , Meena Seema , Agarwal Nikhil 
Published: May 2024

Purpose:
To assess the severity of glaucoma and its worsening using Spaeth/Richman contrast sensitivity (SPARCS). To evaluate its correlation with retinal nerve fiber layer thickness (RNFL) and perimetry.

Methods:
In this prospective observational study, 90 eyes of primary open-angle glaucoma were categorized into mild, moderate, and severe glaucoma (30 each). All eyes were subjected to contrast sensitivity measurements by using the Pelli-Robson (PR) chart and SPARCS, Humphrey automated perimetry, and optical coherence tomography (OCT) RNFL, along with routine ophthalmological evaluation at baseline. Contrast sensitivity was repeated at 1, 3, and 6 months. Other investigations were repeated at 6 months. The correlation between contrast sensitivity and other parameters was analyzed at baseline and 6 months.

Results:
Total SPARCS showed a significant positive correlation with visual field index, pattern standard deviation, mean deviation, OCT RNFL, and a negative correlation with best corrected visual acuity. Central SPARCS and PR scores exhibited strong positive correlations. Both total and quadrantic SPARCS significantly reduced from mild to moderate to severe glaucoma. The quadrant-wise SPARCS also correlated well with opposite-side RNFL thickness. At 6 months, SPARCS showed a significant reduction along with RNFL measurements preceding any significant changes in visual field parameters.

Conclusion:
This study establishes SPARCS as a reliable and reproducible tool in assessing the deterioration of visual function in glaucoma patients even before significant perimetric changes. The specific relationship of quadrantic SPARCS with opposite-side RNFL is a novel yet expected finding. The findings advocate integrating SPARCS into routine glaucoma assessment for timely detection of any worsening and prompt intervention, improving the visual outcomes in these patients.
A compressive assessment of patient satisfaction with ophthalmology with ophthalmology clinic services: A study at a tertiary care academic institution amidst and after the COVID-19 pandemic
Authors: Asodariya Ronak , Bhatnagar Kavita R , Tandon Manjari , Jaisingh Kirti , Shakrawal Jyoti , Meena Seema , Pandey Latika 
Published: May 2024

Purpose:
The study aims to systematically assess patient satisfaction concerning eye care services provided during and after the coronavirus disease 2019 (COVID-19) pandemic at a tertiary care academic institution. This work seeks to analyze the various dimensions influencing the holistic measure of overall patient contentment.

Methods:
A cohort of 2485 patients seeking physical consultation for ocular conditions at a tertiary care academic institution between April 2020 and December 2022 were recruited in a cross-sectional study. They were divided into two groups, viz. during the COVID period and post-COVID period. The primary focus was on evaluating overall satisfaction, measured through a validated patient satisfaction questionnaire (PSQ-18).

Results:
The study encompassed a total of 2485 participants, with 1242 individuals in the cohort during the COVID period and 1243 in the post-COVID phase. Within the COVID period subgroup, the mean age of male and female patients was 39.46 ± 19.31 and 39.58 ± 19.07 years, respectively. In the post-COVID subgroup, the mean age of male and female patients was 45.26 ± 19.38 and 45.36 ± 19.22 years, respectively. Examining the COVID subgroup, the highest satisfaction scores were observed in the domain of time spent with the doctor (3.3453 ± 0.59), followed by financial aspects (3.0816 ± 0.47), interpersonal manner (3.0589 ± 0.37), and accessibility and convenience (3.0585 ± 0.37). Notably, technical quality received the lowest satisfaction score (2.4763 ± 0.42). A statistically significant difference (P < 0.0001) was noted in the PSQ-18 scores between the two groups. In the post-COVID subgroup, patients expressed higher satisfaction with the technical quality of treatment, irrespective of the mode of management. However, financial satisfaction was better in the COVID group.

Conclusion:
Our study using the PSQ-18 questionnaire highlights significant variations in patient satisfaction with ophthalmology clinic services during and after the COVID era. Notably, time spent with the doctor scored the highest, emphasizing its positive impact. However, addressing concerns related to technical quality is crucial for overall improvement.
Effect of anterior segment structure on vault and position after implantable collamer lens implantation
Authors: Wang Qin , Chen Xiao , Li Li , Zhou Lin , Gao Yang , Shen Li , Peng Shaomin , Zhou Qizhi 
Published: May 2024

Purpose:To evaluate the effect of anterior-segment structure on vault and position after implantable collamer lens (ICL) implantation using ultrasound biomicroscopy.Methods:The retrospective case-control study included insufficient vault eyes (<250 µm), ideal vault eyes (250–750 µm), and excessive vault eyes (>750 µm). The preoperative biometric parameters of the anterior-segment structure and basic data between the three groups were analyzed using one-way analysis of variance.Results:There were significant differences (P< 0.05) between the three groups in maximum ciliary body thickness (CBTmax), iris-zonule distance (IZD), and trabecular-ciliary angle (TCA). The vault gradually decreased as CBTmaxdecreased and TCA increased. In the pairwise comparison, the CBTmaxcomparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P= 0.024, 95% CI: −0.17–0.017 µm); the TCA comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P= 0.005, 95% CI: 1.78°–12.15°); The IZD comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant (P= 0.037, 95% CI: 0.0027–0.1119 µm). The analysis of 284 ICL haptics locations showed that there were 16.67%, 32.69%, and 70.83% haptics located in the ciliary sulcus in three groups, respectively.Conclusion:The vault and ICL haptics position are related to anterior-segment structure. A thinner and posteriorly positioned ciliary body would increase the risk of low vault and fewer ICL haptics located in the ciliary sulcus after ICL implantation. This provides guidance for the selection of the ICL size and placement position before surgery.
Histopathological findings of anterior lens capsule in pediatric cataract
Authors: Özer Ferhad , İnanç İrem , Kızıltunç Pınar B , Atilla Hüban , Can Belgin 
Published: May 2024

Purpose:
To investigate the histopathological findings of the anterior lens capsule in pediatric patients who had surgery for cataracts.

Methods:
This study is a prospective interventional study. Anterior capsule tissue samples that were obtained by the anterior capsulotomy method during phacoemulsification surgery were fixed and examined under a transmission electron microscope.

Results:
Twenty-two eyes of 19 patients who were diagnosed with congenital and juvenile cataracts were included in this study. Five patients had associated systemic diseases, including hydrocephalus, cerebral palsy, prematurity, juvenile myelomonocytic leukemia, and Down’s syndrome. Electron microscopic evaluation demonstrated single-layered epithelium under the capsule, degenerated organelles with round-oval and prismatic-oval nuclei, and degenerated mitochondria and heterochromatin-rich nuclei. In the case with cerebral palsy, collagen fibrils of the connective tissue and fibroblast-like cells were observed replacing the epithelium that should be underneath the capsule in both eyes, and there was a disorganized distribution of collagen fibrils and vacuole structures in the cytoplasm of fibroblast-like cells.

Conclusion:
Similar histopathological findings were found in pediatric cataracts with or without systemic disease except in one cerebral palsy case. The absence of lens epithelium may have been a result of degeneration in this patient, and this can be attributed to the presence of systemic inflammation and gliosis in cerebral palsy. The absence of lens epithelium can play a role in the development of dense subcapsular fibrosis and cataract formation.
Ultrasound-Guided Hydrodistention with Corticosteroid Instillation in Glenohumeral Joint for Relief in Frozen Shoulder: A Case Series
Authors: Gulati Smita , Singh Aparna , Sharma Kush 
Published: May 2024

Abstract
The frozen shoulder (FS) also known as adhesive capsulitis is one of the most common causes of shoulder pain and disability. It is marked by pain and limitation of movement resulting in progressive deterioration of quality of life. Although a few patients with an FS recover without any intervention, the majority of patients have persistent pain with or without movement restriction. Ultrasound (USG)-guided hydrodistension of the shoulder joint is an upcoming mode of treatment for FS which can theoretically lead to pain relief, functional improvement, and a better quality of life, especially if combined with the anti-inflammatory effects of intra-articular corticosteroids. Here, we are presenting our experience with USG-guided hydrodistention of the shoulder joint along with intra-articular corticosteroid in cases of FS both in terms of objective indices of shoulder functionality and subjective outcomes of pain. Eight patients who presented to the outpatient department of pain medicine in our hospital having FS (stage 2/3) were selected. Outcome measures included pain score, Shoulder Pain and Disability Index (SPADI) and Shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Visual Analogue Scale, and range of movement. Data were collected at baseline, as well as at 6 weeks, 12 weeks, and 6 months. We performed hydrodistension with 30 ml of volume constituted by adding lignocaine and triamcinolone acetate to normal saline immediately, followed by physiotherapy of the shoulder joint and cryotherapy. We found promising results with all our patients both in the short term as well as long term with both SPADI and QuickDASH scores as well as the range of motion of the shoulder joint improving significantly in all eight patients at 6 weeks and 12 weeks. This improvement notably persisted in all the patients when reassessed at 6 months indicating a long-term benefit of the intervention.
Research on clinical aspects of bipolar disorder: A review of Indian studies
Authors: Narula Sharon , Pal Arghya , Reddy MS , Mahajan Sudhir L. 
Published: May 2024

Background:
Bipolar disorder is one of the severe mental disorders that are associated with significant morbidity of the patients. Despite advancements in our understanding about the disorder, it remains a challenging proposition to treat bipolar disorder, largely since the prophylactic treatment of the disorder requires assessment of complex clinical algorithms. The revisions of the classificatory systems have also changed the conceptualization of the disorder. In this background, we conducted a review of the Indian studies conducted on the clinical aspects of bipolar disorder.

Methods:
A narrative review was conducted with focus on the literature published from India. The databases searched included PubMed, Scopus, and Google Scholar, and articles published over the last 15 years by Indian authors were included for this review.

Results:
In our review, we could access a substantial volume of research published from India. We could identify studies that catered to most of the relevant themes in bipolar disorder including epidemiology, etiology, comorbidities, stigma, disability, clinical course, cognitive profile, pathways to care, and recovery.

Conclusion:
The research trajectory was in line with the research conducted elsewhere in the world. However, certain dissimilarities in terms of focus could also be observed. The possible reason behind this deviation could be the difference in clinical need and unique challenges faced in the management and rehabilitation of patients in bipolar disorder in Indian scenario.
How severe are ocular surface abnormalities 3 months following cataract surgery? An observational study
Authors: Undrakonda Vivekanand , Koyi Amulya , Kamireddy Krishnapriya , Lobo Sarita 
Published: May 2024

Aim:
The aim of this study was to detect the pattern of ocular surface changes seen 3 months after undergoing phacoemulsification or manual small-incision cataract surgery (SICS) and match them with age-matched normal individuals.

Materials and Methods:
A prospective observational study was conducted in the ophthalmology outpatient department (OPD) in a tertiary care center. Consecutive patients coming to OPD were grouped into three study groups – Group 1 included 25 patients who had undergone manual SICS, Group 2 included patients who had undergone clear corneal phacoemulsification surgery, and Group 3 included age-matched controls. Patients with ocular and systemic diseases were excluded. All the patients underwent Schirmer’s test, tear film breakup time, ocular surface staining, and ocular surface disease index score. One-way analysis of variance test was used for the comparison of data, and P = 0.05 or less was considered to indicate a significant difference.

Results:
Significant dry eye changes after 3 months of cataract surgery were present in SICS and Phacoemulsification groups as compared to age-matched normals (p-value < 0.05), but there was no significant difference between SICS and PHACOEMULSIFICATION surgery groups in the incidence of dry eye incidence.

Conclusion:
Dry eye symptoms are significant following cataract surgery irrespective of the type of surgery either SICS or phacoemulsification.