bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior cruciate ligament avulsion associated with an epiphyseal fracture of the proximal fibula: a case report of a 13-year-old child
Authors: Toumia Mohamed L. , Zairi Mohamed , Msakni Ahmed , Mohsni Ahmed A. , Saied Walid , Bouchoucha Sami , Boussetta Rim , Nessib Mohamed N. 
Published: March 2023

Introduction and importance:
Posterior cruciate ligament (PCL) avulsion fractures are rare among the pediatric population. Reported PCL injury incidence varies from 1 to 40% depending on the study population. PCL lesions can be isolated or associated with other ligamentous lesions, which makes their management challenging. Knee ligament reconstruction is essential to restore knee stability and, thus, prevent future menisci and cartilage degeneration. However, surgical management of these injuries can lead to subsequent iatrogenic growth disturbances.

Case presentation:
The authors describe the case of a 13-year-old child involved in a sports accident causing a PCL avulsion fracture associated with an epiphyseal fracture of the proximal fibula resulting from an incomplete peel-off injury of the lateral collateral ligament. The patient was scheduled for open reduction and internal fixation on the same day of the presentation. A long-leg cast was then applied for 6 weeks. By 3 months postoperatively, the patient regained full range of motion, and return to sport was possible 6 months after the surgery.

Conclusion:
In children and adolescents, PCL avulsion fractures are often associated with other occult lesions. Although good functional and clinical outcomes using operative management for these lesions are reported, specific treatment recommendations are lacking in skeletally immature patients.
Control of diabetes, hypertension, and dyslipidemia in Jordan: a cross-sectional study
Authors: Hyassat Dana , Abu Noor Nancy , AlAjlouni Qais , Jarrar Yazan , Qarajeh Raed , Mahasneh Awn , Elzoubi Zaid , Khader Yousef , Farahid Oraib , El-Khateeb Mohammed , Ajlouni Kamel 
Published: March 2023

Aims:
To determine the level of glycemic, blood pressure (BP), and lipids control among patients with type 2 diabetes mellitus (DM) attending the National Center for Diabetes, Endocrinology and Genetics and to determine factors associated with poor control.

Methods:
A cross-sectional study of 1200 Jordanian type 2 DM patients was included in this study during the period of December 2017–December 2018. We reviewed the charts of these patients until January 2020. Data obtained from medical records included information about sociodemographic variables, anthropometric measurements, glycated hemoglobin (HbA1c), BP, low-density lipoprotein (LDL), the presence of DM complications, and treatment.

Results:
The percentage of subjects who had HbA1c values of less than 7% was 41.7%. BP targets (<140/90 and 130/80 mmHg) were achieved in 61.9 and 22% of our patients, respectively. LDL targets less than 100 and 70 mg/dl or less were achieved in 52.2 and 15.9% of our studied population. Only 15.4% of our patients could have simultaneous control of HbA1c less than 7%, BP less than 140/90 mmHg, and LDL less than 100 mg/dl. Factors associated with poor glycemic control were obesity [odds ratio (OR)=1.9], DM duration between 5 and 10 years or more than 10 years (OR=1.8 and 2.5, respectively), and the use of a combination of oral hypoglycemic agent plus insulin or insulin alone (OR=2.4 and 6.2, respectively). Moreover, factors associated with uncontrolled BP (≥140/90) were male gender (OR=1.4), age 50–59 years or at least 60 years (OR=3.3 and 6.6, respectively), overweight and obesity (OR=1.6 and 1.4, respectively), insulin use (OR=1.6), and LDL at least 100 mg/dl (OR=1.4).

Conclusion:
The overall prevalence of poor glycemic control was high and alarming. Future research should focus on capturing all variables that may impact glycemic, BP, and dyslipidemia control, with special emphasis on a healthy lifestyle that would be of great benefit in this control.
Giant hydronephrosis masquerading as ovarian tumor: a case report
Authors: Kurniadi Andi , Kurniaputra Muhamad P. , Yulianti Herry , Kireina Jessica 
Published: March 2023

Introduction and importance:
Giant hydronephrosis is defined as the accumulation of more than 1 l of fluid in the kidney’s collecting system. Its presentation can mimic other conditions including ovarian tumor. Herein, the authors report a case of giant hydronephrosis caused by urolithiasis that mimics the presentation of an ovarian tumor. The authors also highlight the challenges in diagnosing this rare entity and the management options available.

Case presentation:
The authors present a case of a 65-year-old P5A0 woman with an abdominal tumor of 1-year duration that progressively increased in size. She also complained of mild left flank pain since a year ago. Ultrasonography revealed a large cystic mass in the lower to middle abdomen. Ovarian tumor was suspected and laparotomy was performed. Surgical exploration revealed a left giant hydronephrosis with normal gynecological organs. The postoperative course was uneventful, and she was discharged in satisfactory condition.

Clinical discussion:
Giant hydronephrosis should always be considered as a differential diagnosis when presented with a large abdominal cystic lesion.

Conclusion:
Routine screening for bilateral kidneys during gynecological ultrasonography will help detect giant hydronephrosis and prevent unplanned surgical interventions.
A rare presentation of urolithiasis in a child with urine retention from a nonendemic area: a case report and literature review
Authors: Muhumuza Joshua , Musinguzi Brian , Bukyana Sedrick , Kajoba Dickson , Kithinji Stephen M. , Molen Selamo F. 
Published: March 2023

Introduction and Importance:
Even though urolithiasis in general is not uncommon, urethral stones have an incidence of less than 0.3% and are 20 times less common in children. Though cases of urethral stones have been reported in children from endemic areas, they are even rarer in countries like Uganda that are not endemic for urolithiasis.

Case Presentation:
The authors present a 7-year-old male who presented with acute urine retention. Though the diagnosis of retention was made in a lower-level health facility, the cause of the retention was not determined till the patient arrived at a general hospital. Diagnosis of an obstructing stone in the penile urethra was made clinically. Meatotomy and stone extraction were done, and a urethral catheter was passed.

Clinical Discussion and Conclusion:
When attending to children with acute urine retention, urolithiasis should be kept among the differential diagnoses, even in areas that are not endemic for urinary tract stones. A thorough clinical evaluation may be all that is needed to make a diagnosis.
A mesenteric cystic lymphangioma with no cysts’ radiological findings on X-ray in a 16-month-old boy
Authors: Shbani Abdulrahman , Toufan Ebrahim , Martini Nafiza , Yousif Mayas A. 
Published: March 2023

Background:
Mesenteric cystic lymphangiomas (MCLs) are uncommon benign tumors that arise from the lymphatic vessels. These tumors represent 5–6% of all pediatric benign tumors.

Presentation:
Herein, we present a case of MCL in a 16-month-old child with an unusual report of symptoms. We used abdominal X-rays, ultrasonography, laboratory tests, and histopathological examination. Exploratory laparotomy confirmed the diagnosis of the MCL along with histopathological examination.

Conclusion:
The main message of this report is not to ignore the cases of intestinal obstruction, even if they were transient, and the operation choice should always be in mind, even in the absence of any surgical precedents. In addition, the X-ray may not tell us the whole story about MCL’s existence. These cases must be carefully dealt with and studied, which gives a remarkable level of uniqueness in this case.
Coronary ostial stenosis after coronary artery bypass graft and combined aortic valve replacement: case report
Authors: Nadeem Abdullah , Bilal Wajeeha 
Published: March 2023

Introduction and Importance:
A 65-year-old patient with the left anterior descending artery (LAD) ostial stenosis proved by coronary angiography is presented. LAD ostial stenosis is an uncommon condition whose etiology is unknown. The patient also had a coronary artery bypass graft combined with aortic valve replacement 13 years ago. The clinical and angiographic profiles of the patient are discussed here, supported by the literature.

Case Presentation:
A 65-year-old female patient with a medical history of hypertension and dyslipidemia came to the outpatient department with a complaint of chest pain and shortness of breath. Coronary angiography was carried out in 2008, which revealed triple vessel coronary artery disease, valvular heart disease, and ostial stenosis. In 2009, the patient underwent coronary artery bypass graft surgery combined with aortic valve replacement and remained asymptomatic thereafter. In 2022, transthoracic echocardiography and a Doppler study were conducted, which revealed normal size left ventricle, an ejection fraction of 55%, and diastolic dysfunction grade I. A graft study was done, which revealed left main and right coronary artery were normal, and the left circumflex artery with mild stenosis and obtuse marginal with subtotal stenosis and severe ostial stenosis of the LAD was observed.

Clinical Discussion:
Recognizing this complication early can prevent life-threatening complications and is then of the utmost importance. Coronary ostial stenosis is an uncommon but potentially dangerous consequence of aortic valve replacement whose etiology is not well understood in the literature. Rapid clinical identification is therefore essential. Coronary angiography needs to be done right away if coronary ostial stenosis is suspected. The mainstay of treatment for ostial stenosis is coronary artery bypass surgery or percutaneous coronary angioplasty. Since the patient has already undergone a coronary artery bypass graft (CABG) surgery, there is a significant risk of redoing CABG, as it is associated with considerable morbidity, which has a negative effect on long-term quality of life.

Conclusion:
Despite the fact that CABG is the most common form of therapy, percutaneous coronary intervention has demonstrated good short-term outcomes. To assess the effectiveness of CABG with drug-eluting stents for the treatment of coronary ostial stenosis, further information on long-term outcomes is required.
Intra-abdominal ectopic breast tissue in male patient presenting as a fibroadenoma: a case report
Authors: Baset Zekrullah , Arafat Yaser , Amini Jawad , Rezaie Fatema , Mohammady Nooria , Mousavi Sayed H. 
Published: March 2023

Introduction:
Fibroadenoma (FA) in ectopic male breast tissue is extremely rare. The ectopic breast tissue (EBT) is mostly appearing along the milk line; however, uncommon locations are also seen, such as the present case.

Case Presentation:
The authors report a 19-year-old male presenting with intestinal obstruction. The patient underwent laparoscopic surgery, and an excisional biopsy of the lesion was done. The histopathologic result confirms FA arising from EBT. This case is reported for its rarity. It indicates that FA should always be considered when there is an intra-abdominal suspicious mass.

Discussion:
EBT presenting as FA is also reported in the face, posterior neck, chest, middle back, buttocks, vulvar, and thighs. In this case, the authors present a EBT presented as a FA in the intra-abdomen of a young male patient, causing intestinal obstruction. FA in the male breast is rare; however, benign breast parenchyma showing FA in the intra-abdomen of a male patient is extremely rare.

Conclusion:
When a tumor is palpated in the milk line, the existence of FA should be taken into consideration. FA of the male EBT in the intra-abdomen is extremely rare. However, a close follow-up of the patient is strongly recommended, as the carcinoma arising from FA has a very poor prognosis.
The outcome of concomitant cholecystectomy with bariatric surgery: a retrospective cohort study
Authors: Yildirim Kadir , Karabicak Ilhan , Gursel Mahmut F. , Karabicak Can , Malazgirt Zafer 
Published: March 2023

Background:
Gallstones are more common in obese individuals than in healthy individuals. They are diagnosed during the preoperative evaluation for bariatric surgery (BS). However, simultaneous cholecystectomy with BS is still controversial in patients with asymptomatic gallstones in the same session. In this study, the authors aimed to present an analysis of these operations performed with BS in the hospital.

Materials and Methods:
The records of 396 patients who underwent BS at Samsun VM Medicalpark Hospital between September 2017 and October 2021 were retrospectively reviewed. The length of hospital stay, operation time, complications, and safety of patients who underwent simultaneous cholecystectomy and BS only were examined.

Results:
Of 396 patients, 262 (66.1%) underwent laparoscopic sleeve gastrectomy and 134 (33.8%) underwent laparoscopic gastric bypass surgery. Gallstones were detected during the preoperative examination in 72 (18.1%) of the 396 patients who underwent BS. It was observed that 11 of them had symptoms. No major complications occurred during or after surgery in patients who underwent simultaneous cholecystectomy and only in those who underwent BS.

Conclusion:
Simultaneous cholecystectomy with BS does not burden the patient, and complication rates are very low. The procedure is also cost-effective, as patients do not require a second surgery.
Combined personalized therapy for the treatment of multiple giant keloids: a case report and literature review
Authors: Niraula Himalaya , Timilsina Sujan , Joshi Surya P. , Lamichhane Rajan , Yadav Rupesh K. , Sharma Samit , Shrestha Jayan M. , Lohani Ishwar 
Published: March 2023

Introduction:
Keloids are the result of an abnormal wound-healing process and are associated with various risk factors. The majority of diagnoses are clinical. Successful treatment of keloid is challenging due to its nonregressing and recurring nature.

Case presentation:
We discuss the case of a 30-year-old mongoloid male who had multiple swellings over his body for the past 10 years. More striking are the giant keloids that are present over his bilateral scapulae. Diagnosis of keloid was made clinically. Smaller sessile lesions over his shoulder and upper limbs were subjected to intralesional 5-fluorouracil and triamcinolone injections, whereas the giant bilateral scapular keloids underwent excision and split skin grafting.

Clinical discussion:
Keloids usually present with firm and rubbery masses that extend beyond the site of the previous wound/injury. Keloids are diagnosed and evaluated clinically. Its differentiation from the hypertrophic scar is done based on the presence of multiple lesions beyond the site of the previous wound/injury.

Conclusion:
Treatment of keloids is difficult due to their nonregressing and recurring nature. Hence, the main goal of treatment is to tailor the therapy to the patient’s needs such that the benefits outweigh the risks.
Gastrointestinal bleeding due to jejunal metastasis of pleomorphic lung carcinoma: a case report
Authors: Beji Hazem , Laamiri Ghazi , Chtourou Mohamed F. , Zribi Slim , Sbaihi Siwar , Nechi Salwa , Bouassida Mahdi , Touinsi Hassen 
Published: March 2023

Introduction and importance:
Gastrointestinal metastasis of pleomorphic lung cancer presents with nonspecific manifestations, leading to delayed diagnosis. Herein, the authors report the case of a 56-year-old patient who presented with gastrointestinal bleeding due to pleomorphic lung carcinoma.

Case presentation:
A 56-year-old patient presented to the emergency department with melena. On examination, he was hemodynamically stable. He had a sensitive and mobile mass in the periumbilical region. A thoracoabdominal computed tomography scan showed a mass of the right apical superior lobe measuring 4 cm and a lobulated jejunal mass measuring 10 cm. A percutaneous biopsy of the lung tumor revealed primary pleomorphic lung carcinoma. The authors performed a midline laparotomy and made a bowel resection with an end-to-end anastomosis. The postoperative course was marked by severe nosocomial pneumonia, leading to septic shock and death. The histopathologic examination concluded with a metastatic lesion of pleomorphic lung carcinoma.

Clinical discussion:
The authors reported a rare case of jejunal metastasis of pleomorphic lung cancer. Pleomorphic carcinoma of the lung is a rare pathology that accounts for 0.1–0.4% of nonsmall-cell lung cancer. The prognosis is poor. In the presence of gastrointestinal bleeding caused by small bowel metastases of pleomorphic lung cancer, surgery is the treatment of choice.

Conclusions:
Small bowel metastasis of pleomorphic lung cancer is rare. Surgical treatment is the treatment of choice. The authors highlight the importance of suspecting gastrointestinal metastases in patients with pleomorphic lung cancer in the presence of nonspecific digestive symptoms.
Mitral valvar anomalies causing subaortic stenosis: two rare case reports
Authors: Faraj Raid , Dib Hassan , Belhoussine Houda , Sarsari Mohamed , Lahjouji Reda , Bargach Inesse , Zarzur Jamila , Cherti Mohamed 
Published: March 2023

Introduction and importance:
Subaortic stenosis (SubAS) is a common cause of left ventricular outflow tract obstruction. It may be focal or diffuse, leading to the development of a subaortic tunnel. Considered for a long time as a congenital anomaly, SubAS has been established lately as an acquired anomaly and secondary to a pre-existing anatomic alteration in the interventricular septum and mitral valve apparatus. It is a progressive disease that is often confused with obstructive hypertrophic cardiomyopathy, which can lead to several complications.

Case presentation:
In this paper, the authors report two cases of SubAS secondary to different mitral valvar anomalies. The analysis of echocardiographic data was a milestone in raising this diagnosis and identifying its mechanisms.

Conclusion:
This work highlights a rare situation, often underdiagnosed, in which the evolution can be marked by an important risk of recurrence even after surgical cure.
Anti-photoaging Effect of Micronized Fat in Ultraviolet B-Induced Human Dermal Fibroblasts
Authors: He Anqi , Zheng Shaoluan , Luan Wenjie , Wang Lu , Qian Leqi , Qi Fazhi , Feng Zihao 
Published: March 2023

Background:
Adipose-derived stromal vascular fraction and mesenchymal stem cells have been proven to reduce the effects of skin photoaging. However, there is no standardized protocol for their preparation. This study aimed to investigate the skin rejuvenation potential of micronized fat, obtained using a novel device attached with a trifoliate blade, in the ultraviolet B-induced human dermal fibroblasts model.

Materials and Methods:
Micronized fat was prepared to obtain adipose-derived stromal vascular fraction and the adipose-derived mesenchymal stem cells to stromal vascular fraction ratio was determined by flow cytometry. The ultraviolet B-induced human dermal fibroblasts model was constructed to identify the characteristic of the human dermal fibroblasts using Vamiten and S-100 immunostaining, observe their morphology, and measure the levels of photoaging related factors. After the previous steps were completed, different cell groups were co-cultured with ultraviolet B-induced human dermal fibroblasts and the extent of improvement of photoaging was evaluated.

Results:
Micronized fat had a higher adipose-derived mesenchymal stem cells to stromal vascular fraction ratio than the control fat preparations. The ultraviolet B-induced human dermal fibroblasts model showed lowered levels of type I collagen and transforming growth factor-βand increased expression of matrix metalloproteinases, which are the characteristics of photoaging in normal human dermal fibroblasts. Compared to different cell groups co-cultured with ultraviolet B-induced human dermal fibroblasts, micronized fat could lower the expression of matrix metalloproteinases and increase the level of type I collagen but lower the level of transforming growth factor-β

Conclusions:
Obtaining micronized fat is more effortless and clinically safer. Micronized fat has an anti-photoaging effect by inhibiting the expression of MMPs via MAPK signaling pathway.
Autologous Fat Grafting is not Superior to Placebo as Treatment of Postherpetic Neuralgia A Double-Blinded Randomized Clinical Trial.
Authors: Sollie Martin , Thomsen Jørn B. , Sørensen Jens A. 
Published: March 2023

Background:Postherpetic neuralgia (PHN) is a chronic pain syndrome occurring after a herpes zoster (HZ) outbreak, also known as shingles. Treatment is complex, and no effective treatment exists today. Autologous fat grafting (AFG) has previously shown promise in treating PHN, but no randomised controlled trial has been performed.This RCT aimed to investigate the effect of autologous fat grafting on postherpetic neuralgia compared to a sham treatment.Methods:We included forty-six participants suffering from PHN in our double-blinded, two-armed RCT. Participants were randomly assigned either the intervention group or control group. All participants had liposuction performed under general anaesthesia. The intervention group received AFG to the area of pain, and the control group received a sham treatment of saline injection. The primary outcomes were the average and maximum degree of pain measured on an 11-point numerical rating scale (NRS). Secondary outcomes were quality and degree of neuropathic pain (NPSI) and Quality of Life (SF-36).Results:Forty-two participants completed follow-up. In the maximal degree of pain, we observed a reduction of -1.1(0.6) and -1.0(0.5) Δ mean(SE) on the NRS in the intervention and control groups, respectively. In the average degree of pain, the reduction was -1.2(0.5) and -1.3(0.4) in the intervention and control groups. We observed stationary or minor improvements in neuropathic pain, with similar changes in both groups. We observed small reductions in QoL in all parameters and in both groups. The exceptions were pain and social functioning, where the control group reported minor improvements. For all the measured outcomes, the differences between the groups were not statistically significant.Conclusions:We did not find autologous fat grafting superior to a placebo when treating postherpetic neuralgia of the skin. Based on our results, we cannot recommend the routine use of this method to treat these pains.
Anatomical proposal for botulinum neurotoxin injection for horizontal forehead lines
Authors: Yi Kyu-Ho , Lee Ji-Hyun , Seo Kyle K. , Kim Hee-Jin 
Published: March 2023

The frontalis muscle is situated across the forehead and is a representative target muscle for botulinum neurotoxin injections aimed at treating horizontal wrinkles in this region. However, a lack of anatomical information regarding the shape and thickness of the frontalis may lead to unexpected adverse effects, such as ptosis and samurai eyebrows, due to the lack of detail on anatomical variation. Achieving the maximum effect using the minimal amount of botulinum neurotoxin requires a precise injection into the frontalis muscle. The anatomical factors associated with botulinum neurotoxin injection into the frontalis muscle have been reviewed in the current study. Up-to-date understanding of the localization of the botulinum neurotoxin injection point according to an updated understanding of the anatomy leads to more accurate localization of the injection point into the frontalis muscle. Optimal injection sites have been provided for the frontalis muscle, and the injection method has been recommended. We suggest optimal injection sites according to the external anatomical landmarks of the forehead. Furthermore, these proposals could aid in a more precise procedure that avoids the deleterious effects of botulinum neurotoxin.
Key Contribution: The research proposes a guide for effective botulinum neurotoxin injection for frontalis muscle.