bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case report and a contemporary review of incarcerated and strangulated obturator hernia repair
Authors: de Figueiredo Sergio Mazzola Poli , Tastaldi Luciano , Mao Rui-Min Diana , Lu Richard , Tyler Douglas , Perez Alexander 
Published: May 2024

BACKGROUND:
Obturator hernia (OH) usually presents as a surgical emergency, with open primary repair most commonly performed. Given the morbidity and high recurrence of this approach, we present a case and review the literature to evaluate the influence of the operative approach on OH repair.

METHODS:
A literature search via PubMed was performed. Inclusion criteria were studies that: (1) were written in English and published within 10 years; (2) included as keywords “obturator hernia” and/or “incarcerated” and/or “strangulated”; (3) reported the operative approach; and (4) reported postoperative outcomes.

RESULTS:
Overall, 225 studies were identified, and 53 met the inclusion criteria. Data from 425 patients were pooled. Open repair without mesh was performed in 239 (56.2%) patients, 121 (28.5%) had open repair with mesh, 44 (10.4%) had laparoscopic repair with mesh, and 21 (4.9%) had laparoscopic repair without mesh. Open repair had a mean hospital length of stay (LOS) of 13.4 days, 40.3% postoperative complications, and 9.7% 30-day mortality rate whereas laparoscopic repair had a mean LOS of 7.9 days, 3.1% postoperative complications, and no deaths. Small bowel resection (SBR) was performed in 44.7% of open and 15.4% of laparoscopic repairs. Patients with SBR demonstrated higher morbidity and mortality compared with patients without SBR. In patients without SBR, laparoscopy had advantages over open surgery in LOS, complications, and mortality rate. The overall recurrence rate was 7.7%, with a mean follow-up of 20.4 months. One (0.7%) recurrence was reported in mesh repair, whereas 28 (12.1%) recurrences were reported with tissue repair.

CONCLUSION:
OHs are the most common open repair without mesh. Our literature review showed that laparoscopic OH repair is associated with enhanced postoperative recovery and the use of mesh was associated with less recurrence. Further studies are still necessary to determine the optimal approach for OH repair, but laparoscopic repair with mesh should be performed when possible.
Evaluation of the satisfaction and effectiveness of the learning in abdominal wall surgery in residents of the digestive system surgery at a tertiary public hospital in Brazil
Authors: Roll Sergio , Pivetta Luca Giovanni Antonio , Konichi Renata Yumi Lima , Fujikawa Victor Kenzo , Antunes Pedro de Souza Lucarelli , de Carvalho João Paulo Venancio , Macret Jessica Zilberman , Dia Eduardo Rullo Maranhão , Francis Maurice Youssef , Ribeiro Hamilton Brasil , de Freitas Amaral Pedro Henrique , Silva Rodrigo Altenfelder 
Published: May 2024

AIM:
To report the outcomes of questionnaire assessment about the teaching of the abdominal wall surgery and the incorporation of the techniques taught during the general surgery and digestive tract surgery residency into the individual practice.

METHODS:
The graduated surgeons and resident doctors from 2014 to 2019 were invited to answer a standardized questionnaire about the abdominal wall surgery teaching program, mastery of specific techniques, and medical practice of each. We performed a chi-square test to evaluate whether the degree of satisfaction correlates to the degree of personal confidence and whether it correlates to performing the procedure in this practice.

RESULTS:
When assessing the degree of self-confidence to perform specific procedures, all students were confident in performing the Lichtenstein procedure; 22% were confident in transabdominal pre-peritoneal hernioplasty (TAPP); 77% were confident in Rives-Stoppa and anterior separation technique; and 18% were confident in Transversus Abdominis Muscle Release (TAR) technique. The statistical analysis showed a correlation between teaching program satisfaction and the degree of self-confidence only for the TAR procedure (P = 0,06). The analysis also showed a correlation between the degree of self-confidence to perform a specific procedure and its usage on daily practice only for the Rives-Stoppa procedure (P = 0,00).

CONCLUSION:
These results show the importance of a structured Abdominal Wall Surgery Program, as well as the continuing education evaluation and quality improvement, as the instrument exposed, which to our knowledge, is the first questionnaire to assess the teaching of the abdominal wall and it may be considered a helpful tool.
Critical body mass index associated with increased ventral hernia recurrence rate
Authors: Rihan Maged , Mostafa Mostafa Mahmoud Salama 
Published: May 2024

Abstract

BACKGROUND:
Body mass index (BMI) is a settled risk factor for ventral hernia repair complications. There is no agreement for a specific perfect BMI maximum value for elective hernia surgical repair. The goal of this study is to determine a BMI threshold that represents a risk for ventral hernia recurrence after repair.

MATERIALS AND METHODS:
This is a retrospective single-center study of electronic medical records for patients with repair of ventral hernia from June 2017 to May 2023. The primary outcome of the study is to measure the hernia recurrence. The decision regression trees method was utilized to set the BMI threshold that is associated with a significant increase in the hernia recurrence risk. Bivariate and multivariate analysis was applied to prove the BMI threshold and to assess other factors related to recurrence.

RESULTS:
In total, 110 patients were included, 8.2% of them suffered from ventral hernia recurrence. The analysis defined BMI 38.7 kg/m2 as the critical value for the recurrence of hernia. Patients with liver disease were more likely to have hernia recurrence (11.1% vs. 0%, P = 0.006), irreducible hernias (66.7% vs. 32.6%, P = 0.002), emergency surgery (66.6% vs. 21.7%, P < 0.001), and BMI >38.7 kg/m2 (77.8% vs. 26.7%, P < 0.001).

CONCLUSION:
We found that a BMI of more than 38.7 kg/m2 had a significant increase in the risk of recurrence in ventral hernia patients. This shows the importance of defining a BMI threshold in ventral hernia patients for repair.
Twenty-year retrospective audit of inguinal herniorrhaphy at the Victoria Hospital in Prince Albert, Northern Saskatchewan
Authors: Vetter Cheyenne , Pillay Yagan , Fast Hope 
Published: May 2024

AIM:
To perform a retrospective clinical audit of the long-term effects of inguinal herniorrhaphy at the Victoria hospital in Prince Albert, Saskatchewan. Our hope is that this will form a template for a possible hernia registry in Saskatchewan, Canada.

PATIENTS AND METHODS:
A telephonic audit was carried out for all hernia surgeries performed in the year 2000 at the hospital. Demographics such as age and sex as well as the type of surgery and the mesh used were recorded. Chronic complications were also recorded. The surgical questionnaire was adapted from an established short quality-of-life questionnaire (Qol), the EuroQol questionnaire. We then performed a chart audit to identify basic information including the surgical approach and any intraoperative complications.

RESULTS:
Overall, 119 herniorrhaphies were performed at the Victoria hospital in 2000; 18% of patients (21/119) responded to the telephonic survey. There was a 24% complication rate. All cases of hernial recurrence arose from an original open herniorrhaphy technique. Overall, 22% of patients (27/119) had demised since the surgery; five patients remained incarcerated; and six had dementia and could not respond to the survey. The chronic inguinodynia in four patients was managed with analgesia and non-steroidal anti-inflammatories (NSAIDs). There was no need for chemical or surgical nerve ablation procedures.

CONCLUSION:
Long-term clinical audits in surgery remain sparse. There remains a paucity of data for studies that are more than a decade long. This 20-year audit of inguinal herniorrhaphy is the first of its kind in Saskatchewan, Canada. We propose its use to establish a hernia database that will record chronic complications as well as surgical outcomes. This will hopefully facilitate an improved surgical technique and a universally established method of defining and documenting complications such as chronic inguinodynia and hernia recurrence. Hernia databases help to remove patient subjectivity as well as observer bias and to provide an objective scientific overview of outcomes.
An observational study of short- and long-term complications including pain after onlay mesh umbilical hernia repair
Authors: McCombie Andrew Mark , Osborn Debbie , Roberts Ross 
Published: May 2024

BACKGROUND:
Information about outcomes for patients who undergo onlay mesh placement for umbilical hernia repair is scarce and the factors that influence adverse outcomes, such as long-term pain, are not well understood. A study of patients undergoing open umbilical hernia repair was undertaken.

MATERIALS AND METHODS:
Patients who underwent open umbilical hernia repair through a private surgical practice over a 13-year period using either an onlay mesh or suture alone repair were given a questionnaire following surgery to document the incidence of long-term pain or other complications. Data were then analyzed to understand any potential contributors to a poor outcome.

RESULTS:
The information on 346 patients was available for study. Mesh was used for repair in 327 (94.5%) patients, whereas 19 (5.5%) had suture alone repair. Early (≤30 days) complications were experienced by 73 patients (21.1%). The most common complications were seroma formation (27 patients), wound infection (13 patients), and hematoma (11 patients). Four patients developed a combination of hematoma, infection, and seroma formation. Late (>30 days) complications (other than persistent pain) were recorded for nine patients and were all wound-related problems. Long-term pain was significantly more common in those patients reporting wound complications (odds ratio: 7.01, 95% confidence interval 1.82–26.99). Recurrent umbilical herniation developed in three patients (0.9%).

CONCLUSION:
Onlay mesh repair for umbilical hernia repair can be performed with low rates of chronic pain and low recurrence rates; however, surgical site occurrences remain common albeit easily treatable.
Rapid survey for assessing effective cataract surgical coverage (eCSC) and effective refractive error coverage (eREC)—Novel indicators of universal eye health
Authors: Vashist Praveen , Grover Sumit , Manna Souvik , Senjam Suraj S , Gupta Vivek , Gupta Noopur , Bhardwaj Amit 
Published: May 2024

Purpose:
As per the recent World Health Organization estimates, approximately 2.2 billion people have near and distance vision impairment (VI) globally, and out of this almost 50% is avoidable.

Methods:
The Rapid Assessment of Avoidable Visual Impairment survey was a cross-sectional study conducted in September 2021, using cluster random sampling in 42 clusters with a cluster size of 140, giving a total of 6000 participants. Two teams comprising of trained optometrists and social workers conducted the ocular examination which included unaided, pinhole, and aided visual acuity assessments followed by examination of the anterior segment and lens. Distance visual acuity was measured using simplified tumbling “E” charts of different sizes for VA of 6/12, 6/18, and 6/60. The lens assessment was done in an un-dilated pupil with torch light by the optometrist.

Results:
Overall, 6520 individuals aged 6 years and above were enumerated, of whom 5440 (83.4%) were examined. The response rate for examination was better among females (93.1%) than males (73.9%), and it decreased from 93.8% in the age group 6–15 years to 77.1% in the 45+ age group. The prevalence of blindness and VI were 0.18% (95% CI: 0.06–0.29) and 4.19% (95%CI: 3.65–4.72), respectively. The major causes of VI in all age groups were uncorrected refractive error (65.4%), cataract (23.7%), cataract surgical complications (2.6%), corneal opacity (0.4%), and other posterior segment diseases (7.5%). The effective cataract surgical coverage (eCSC) was 61.8%, effective refractive error coverage (eREC) for distance vision was 59.8%, and eREC for near vision was 47.0%.

Conclusion:
The RAAVI methodology is suitable to measure effective coverage in the general population, both for baseline measurement and periodic monitoring. The 2030 targets for the surveyed district are 90% eCSC and 100% eREC. Such exercises need to be conducted in each district of the country to determine the baseline and target values of effective coverage.
Clinical characteristics and treatment outcomes of patients with IgG4-positive ocular adnexal marginal zone B-cell lymphoma
Authors: Yang Yu , Jin Xuelian , Xu Manhua , He Weimin 
Published: May 2024

Abstract

Purpose:
To explore the clinicopathological characteristics of immunoglobulin G4 (IgG4)-positive ocular adnexal marginal zone B-cell lymphoma (OAML) and associated patient treatment outcomes.

Methods:
Medical records from patients diagnosed with IgG4-positive OAML treated at the West China Hospital between January 2016 and August 2023 were retrospectively analyzed.

Results:
This study included data from 22 patients (11 males, 11 females), aged between 36 and 83 years, with disease durations from 1 month to 30 years. Sixteen cases exhibited unilateral ocular involvement (ten left eyes, six right eyes), while six exhibited bilateral involvement. Common clinical symptoms included ocular masses, eyelid swelling, and proptosis, with the orbit and lacrimal gland being the most commonly impacted sites. Among the 22 patients, 13 who were clinically suspected of having IgG4-related ophthalmic disease (IgG4-ROD) underwent serum IgG4 testing pre-operatively, revealing elevated IgG4 levels in 11 of these patients. The use of computed tomography and magnetic resonance imaging facilitated the evaluation of the location and size of lesions. All 22 patients received surgical treatment. Subsequently, 14 of these patients underwent local radiotherapy, five received post-operative chemotherapy, and three were closely observed. The follow-up period of patients in this study was 3–77 months, with an average follow-up time of 36 months. Except for one patient who died of disease progression, all others showed favorable prognoses with significant improvements.

Conclusions:
These results support the classification of IgG4-positive OAML as a distinct OAML sub-type with clinical features that partially overlap with IgG4-ROD. Therefore, accurate differentiation between OAML and IgG4-ROD is imperative, necessitating timely surgical intervention and precise pathological diagnosis to prevent diagnostic errors and inappropriate treatment. Currently, no standardized treatments for IgG4-positive OAML exist, but our results suggest that standard OAML therapies are generally efficacious.
Transzonular moxifloxacin and dexamethasone delivery in phacoemulsification: A novel dropless regimen
Authors: Gounder M Srinivasan , Rizvi Syed W A , Asharaf Humayoun , Khan Adeeb A , Ashraf Sameer , Akhtar Afeefa 
Published: May 2024

Purpose:
To assess the safety and efficacy of transzonular moxifloxacin and dexamethasone versus standard postoperative topical drug regimen in phacoemulsification.

Design:
Nonrandomized prospective study.

Methods:
The study included 100 eyes of 100 age and gender-matched individuals with senile cataract undergoing routine phacoemulsification. The patients were consecutively divided into transzonular (TZ = 50) and topical (TP = 50) groups. Both the groups were followed up for 4 weeks and assessed for intraocular inflammation, visual acuity, changes in intraocular pressure (IOP), and any adverse events.

Results:
The grades of inflammation were significantly lower in TZ as compared to the TP group (P < 0.001). The IOP remained normal and comparable in both the groups. Most of the patients in the two groups attained a visual acuity of 0.2 or better at the end of the follow-up. No adverse effects and increased rate of endophthalmitis were noted in TZ group.

Conclusion:
A one-time peroperative TZ moxifloxacin and dexamethasone combination is a safe and effective method to control postoperative inflammation after cataract surgery. A word of caution though, due precautions to be exercised to prevent the risk of inflammation and endophthalmitis.
Assessment of choroidal perfusion indices in thyroid eye disease by using optical coherence tomography
Authors: Goel Ruchi , Shah Shalin , Yadav Uddeshya 
Published: May 2024

Purpose:
To study choroidal vascularity changes in active and inactive TED orbits by using high-definition optical coherence tomography (HD-OCT) and correlate the changes with the duration and severity of TED and Barrets’ index.

Methods:
A cross-sectional study wherein 37 TED orbits and 30 healthy control (HC) orbits were enrolled. Choroid was imaged using HD-OCT scans centered at the fovea, and subfoveal choroidal thickness (SFCT) was measured. The OCT images were analyzed using ImageJ software to calculate choroidal vascularity index (CVI) and associated choroidal perfusion indices.

Results:
The study included eight active, 13 non-inflammatory active (NIA), and 16 inactive TED orbits. The mean age was 39.73 ± 12.91 years, and the male: female ratio was 1.18:1. Intraocular pressure and CVI were higher, while SFCT was similar in TED on comparison to healthy orbits. CVI and SFCT were raised in active as compared to inactive TED. CVI and SFCT correlated positively with Barrets’ index and negatively with the duration of thyroid disease. The area under curve of CVI (95% CI: 0.651–0.864, P < 0.001) helped in differentiating TED orbits from HC, while CVI (95% CI: 0.780–0.983, P < 0.001) had the maximum discriminatory power in predicting the activity of disease.

Conclusions:
CVI has greater sensitivity than SFCT in differentiating healthy from TED orbits. The blood flow stagnation in active orbits, which improves during the course of TED and tends to worsen with increase in Barret’s index, can lead to choroidal vascularity changes. CVI and SFCT can act as adjunct to existing modalities for monitoring the disease activity.
Combined topography-guided photorefractive keratectomy and corneal collagen crosslinking
Authors: Kumar K Kiran , Nataraj Spurti , Maganty Vandana , Porwal Kinjal H , Gangasagara Suresh B 
Published: May 2024

Purpose:
This study aimed to report the long-term results of combined topography-guided photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) for keratoconus using the Zeiss refractive coordinated system.

Methods:
A prospective interventional study was conducted in a tertiary eye care hospital in South India. Patients with mild-to-moderate progressive keratoconus and corneal pachymetry greater than 450 µm were included. They underwent customized topography-guided PRK followed by CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and keratometry readings and complications were evaluated at 1, 3, 6, 12, and 24 months postoperatively.

Results:
Thirty patients (30 eyes) were included in the study. All study parameters showed a statistically significant improvement postoperatively over baseline values. At 24 months, the mean UDVA improved from 0.8 ± 0.180 logarithm of the minimum angle of resolution (logMAR) to 0.38 ± 0.118 logMAR (P-value <0.001) and CDVA improved from 0.467 ± 0.142 logMAR to 0.227 ± 0.078 logMAR (P-value <0.001). The mean flat, steep, and maximum keratometry values were significantly reduced by 2.133, 3, and 4.54 diopters, respectively, at the last follow-up examination (P-value <0.001).

Conclusion:
The combined topography-guided PRK and accelerated CXL procedure seem to be a promising treatment alternative for early keratoconus. This is the first such study on the Zeiss refractive coordinated system. However, further studies with a larger study population and longer follow-up periods are required to draw final conclusions about the benefits of this procedure in keratoconus.
Development and validation of home-based psychosocial self-management interventions in schizophrenia and related disorders in low-resource settings: A mixed methods approach
Authors: Chadda Rakesh K. , Sood Mamta , Chawla Nishtha , Mahapatra Ananya , Patel Rekha , Mohan MohaPradeep , Iyer Srividya N. , Ramachandran Padmavati , Rangaswamy Thara , Shah Jai , Madan Jason , Birchwood Max , Meyer Caroline , Lilford Richard , Furtado Vivek , Graeme Currie , Singh Swaran P. 
Published: May 2024

Background:
Psychosocial interventions, crucial for recovery in patients with schizophrenia, have often been developed and tested in high income countries. We aimed at developing and validating home-based a booklet based psycho-social intervention with inputs from stakeholders: patients, families, and mental health professionals (MHP) for patients with schizophrenia and related disorders in low resource settings.

Methods:
We developed a preliminary version of psychosocial intervention booklets based on six themes derived from focus group discussions conducted with patients, families, and MHP. Initially, quantitative assessment of content validity was done by MHP on overall and Content Validity Index of individual items of the specific booklets, followed by in-depth interviews about their views. The booklets were modified based on their inputs. Further, pilot testing of manuals was done on the users - nine pairs of patients and caregivers followed by development of a final version of psycho-social intervention.

Results:
The percentage content validity of individual modules and overall booklets was ≥78.5% indicating good validity. Most MHP reported that the manuals were relevant and easy to use but were text-heavy, and lengthy. On pilot testing of modified manuals with patients and their family caregivers, majority (77.8%) of them found booklets useful and suggested that there should be separate booklets for both patients and caregivers for providing information and entering separate response for the activities, integrating helpful tips. Language should be simple. Finally, two sets of booklets (“info book” and “workbook”) named ‘Saksham’ (meaning empowered) were created with specific modules (viz., ‘Medicine adherence’, ‘Daily routine’, ‘Eating right’, ‘Physical activity’, ‘Physical health monitoring’, ‘Self-reliance’, and ‘Psychoeducation’) for patients and caregivers each, in two languages (Hindi and English).

Conclusion:
Booklets with modules for psychosocial interventions for patients with schizophrenia and their caregivers were developed after establishing content validity and pilot testing.
Associations between neurological soft signs, executive functions, and brain-derived neurotrophic factor in boys with attention-deficit hyperactivity disorder
Authors: Tunagur Mustafa Tolga , Aksu Hatice , Kurt Tunagur Elif Merve , Yilmaz Mustafa 
Published: May 2024

Background:
To determine the association between neurological soft signs, executive functions, and serum brain-derived neurotrophic factor (BDNF) levels in children with attention-deficit hyperactivity disorder (ADHD).

Methods:
Serum BDNF levels were measured in 87 drug-naive boys with ADHD, aged 7–12 years. The Revised Physical and Neurological Examination for Subtle Signs for neurological soft signs, Stroop Color-Word Test for attention functions, and Judgment of Line Orientation Test (JLOT) for visuospatial abilities were performed.

Results:
Age correlated negatively with dysrhythmia, total time, and total overflow in timed movements, Stroop Color-Word Time (SCWT), and serum BDNF levels. The JLOT significantly negatively correlated with Total Gaits and Stations (P1) and Total Time in Timed Movements (adjusted R
2
= 0.247). In addition, SCWT maintained a significant correlation with Total Overflow in Timed Movements (adjusted R
2
= 0.206). There was no correlation between serum BDNF levels and NSS.

Conclusion:
The association between NSS, visuospatial abilities, and selective attention may express a maturational delay in ADHD pathophysiology. Moreover, BDNF may play a role in this maturational delay. Future studies should investigate the contribution of BDNF to neuronal maturation in ADHD.