Welcome to Emerging Medical Science, we are dedicated to publishing cutting-edge research and review articles in the field of medical science. Our journal aims to provide a platform for researchers and medical professionals to share their latest findings and advancements in medical technology, treatment methods, and patient care. As a medical journal, we cover a wide range of topics, including but not limited to, anatomy, physiology, pharmacology, surgery, radiology, oncology, and more. Our articles are peer-reviewed and our editorial team is composed of experts in the field to ensure that the highest standards of scientific rigor and accuracy are met.
Comparative Analysis of Surgical Site Infection Rates in Elective and Emergency Abdominal Surgery at a Tertiary Care Hospital
Background: Surgical site infections (SSIs) constitute a significant source of postoperative morbidity and mortality globally. Furthermore, SSIs are associated with elevated healthcare expenditures and extended hospitalizations. This investigation aimed to quantify the incidence of SSIs following elective and emergency abdominal surgical procedures and to evaluate their correlation with various identified risk factors. Methods: A retrospective cohort study design was employed, utilizing the medical records of 200 patients who underwent general surgery at a tertiary public hospital in South India. The study population comprised two groups: emergency and elective abdominal surgical cases (n=100 per group). Data extraction from the hospital's electronic medical records was performed, and subsequent statistical analysis was conducted using STATA version 14.0. Results: The study cohort of 200 patients consisted of 57% males, with a mean age of 49.3 years (range: 18-88). Contaminated wounds were present in 122 patients (61%), and 68 patients (34%) exhibited at least one pre-existing comorbidity. The mean duration of postoperative hospitalization was 6.98 days. The overall SSI rate was 11%, with a higher incidence observed in emergency abdominal surgery (13%) compared to elective abdominal surgery (9%). Staphylococcus aureus was identified in 36% of patients diagnosed with SSIs. Conclusions: The findings indicate a higher SSI incidence following emergency abdominal surgery compared to elective procedures. Advanced age, pre-existing comorbidities, wound contamination, and prolonged postoperative hospital stay were identified as factors associated with an increased risk of developing SSIs.
Copyright (c) 2025 Jyotiranjan Mohapatra, Snigdharani Choudhury, Subhranshu Kumar Hota, Himansu Shekhar Mishra https://creativecommons.org/licenses/by/4.0
Early Appendicectomy Versus Conservative Management for Appendicular Mass: A Comparative Study
Background: Appendicular mass, a common complication of acute appendicitis, typically develops after three days of symptom onset. Management strategies vary from surgical intervention to conservative treatment. Aim and Objectives: This study aimed to compare the outcomes of early appendicectomy versus conservative management followed by interval appendicectomy for appendicular mass, and to evaluate the overall efficacy of appendectomy. Material and Methods: This prospective study, conducted at VIMSAR, Burla (October 2016 - October 2018), included 60 patients with appendicular mass. Patients were randomized into Group A (early appendicectomy after resuscitation) and Group B (initial conservative treatment with antibiotics, followed by interval appendicectomy 6-8 weeks later). Results: The cohort comprised 45 males (75%) and 15 females (25%), with a 3:1 male-to-female ratio and a median age incidence in the 26-30 years group (23%). All patients presented with abdominal pain, fever, a palpable right iliac fossa mass, and tachycardia; 80% reported vomiting/nausea. Leukocytosis (>12,000/mm3) was found in 93% of patients. Symptom duration ranged from 2-7 days, and 90% had no prior appendicitis history. Total hospital stay was significantly shorter in Group A, requiring one admission versus two in Group B. However, Group A had a higher overall complication rate. Interval appendectomy in Group B was surgically challenging in 15% of cases due to dense adhesions. Conclusion: Early appendicectomy appears to be a superior and safer treatment option for appendicular mass compared to conservative management followed by interval appendectomy, despite a higher complication rate in the early intervention group.
Copyright (c) 2025 Debabrata Ray, Biswajit Singh, Himansu Shekhar Mishra https://creativecommons.org/licenses/by/4.0
Perioperative Events of Laparoscopic Cholecystectomy in Patients with Hemoglobinopathies
Background: Hemoglobinopathies represent a prevalent category of inherited genetic disorders characterized by disruptions in the biosynthesis of one or more globin polypeptide chains constituting the hemoglobin molecule. While laparoscopic cholecystectomy is the established surgical intervention for symptomatic cholelithiasis in individuals with normal hemoglobin profiles, the safety and feasibility of this procedure in the context of underlying hemoglobinopathies remains a subject of ongoing investigation and clinical uncertainty. Aims: To assess the safety of laparoscopic cholecystectomy in patients with hemoglobinopathies and to characterize the spectrum of perioperative events encountered during the preoperative, intraoperative, and postoperative periods. Methods: This retrospective comparative study conducted over a period of 5 years, involved 31 hemoglobinopathic patients and 75 patients with normal hemoglobin variant. All underwent laparoscopic cholecystectomy and comparison done regarding perioperative events. Results: The overall complication rate was 56.5% in hemoglobinopathic patients and 21.6% in the other group and the difference was statistically significant (P- value ˂0.001). Vaso-occlusive crisis occurred in 2 patients (%), respiratory complications (atelectasis and bronchitis) in (9.7%), acute chest syndrome in (4.8%) and hemolysis in (4.8%). Conclusions: Laparoscopic cholecystectomy can be considered a safe surgical approach in well-prepared patients with hemoglobinopathies. However, this patient population exhibits a significantly elevated risk of disease-specific complications, notably acute chest syndrome, hemolysis, and vaso-occlusive crises. These findings underscore the necessity for specialized and multidisciplinary pre-, intra-, and postoperative management, involving the surgeon, physician, and anesthetist, to optimize outcomes in hemoglobinopathic patients undergoing laparoscopic cholecystectomy.
Copyright (c) 2025 Jyotiranjan Mohapatra, Bhagyalaxmi Das, Snehasis Pradhan https://creativecommons.org/licenses/by/4.0
Comparative Evaluation of Surgical Outcomes Utilizing Umbilical versus Epigastric Access for Specimen Retrieval in Laparoscopic Cholecystectomy
Introductions: Laparoscopic cholecystectomy represents the established therapeutic modality for symptomatic cholelithiasis. Postoperative analgesia requirements and the duration of postoperative hospitalization are significantly influenced by the extent of pain experienced by patients. During this procedure, the gallbladder (GB) can be extracted via either the umbilical or the epigastric port site. Excessive manipulation during GB retrieval is a potential contributor to postoperative pain. Methods: A retrospective, observational study was conducted on 120 patients with symptomatic gallstone disease requiring laparoscopic cholecystectomy between January 2024 and December 2024. Exclusion criteria encompassed patients with perforated GB necessitating emergency intervention, those with GB carcinoma requiring elective laparoscopic radical cholecystectomy, and cases where laparoscopic surgery was converted to open cholecystectomy. Participants were randomly assigned to two equal groups (n=60 each): Group A, where GB retrieval was performed through the epigastric port, and Group B, where GB retrieval was performed through the umbilical port. The primary and secondary outcomes assessed included intraoperative duration, postoperative pain intensity (measured using a standardized pain scale), incidence of wound infection, and the development of port site hernia. Results: Statistical analysis revealed no significant inter-group differences in intraoperative time, the incidence of wound infection, or the development of port site hernia. However, patients in Group B, where the GB was retrieved through the umbilical port, reported significantly lower postoperative pain scores compared to Group A. Conclusion: While the choice of umbilical versus epigastric port for GB retrieval in laparoscopic cholecystectomy does not significantly impact intraoperative duration, wound infection rates, or port site hernia formation, umbilical port retrieval is associated with a statistically significant reduction in postoperative pain.
Copyright (c) 2025 Subrat Kumar Pradhan, Manabhanjan Bhimasingh Kanhar, Himansu Shekhar Mishra, Debi Prasad Chattarjee https://creativecommons.org/licenses/by/4.0
Clinicopathological Correlation of Appendiceal Biopsy Findings in Patients at a Tertiary Healthcare Facility
Background: acute appendicitis is a common abdominal disease often resolved through surgical removal of the appendix (appendectomy). Post-surgical tissue analysis (histopathology) of the appendix frequently identifies microscopic abnormalities, even when the appendix appears normal to the naked eye (macroscopically). This suggests that underlying pathological processes, such as unexpected tumor growth or parasitic infections, can be present in appendices without visible signs of disease. Methods: A retrospective, descriptive, cross-sectional study analyzed all appendectomy specimens submitted for histopathological evaluation at SCB Medical College and Hospital, Cuttack, spanning the period from January 2024 to December 2024. The investigation encompassed the complete set of available histopathology reports for all appendix biopsies performed on patients within this defined one-year interval. Results: the analyzed cohort of 182 appendectomy specimens revealed a predominance of acute appendicitis, representing 57.7% (n=105) of the histopathological diagnoses. The demographic profile of the biopsied individuals showed a higher representation of males (n=109, 59%) relative to females (n=73, 40%). Stratification by age indicated the 11-20 year demographic as having the largest proportion of appendectomy cases (24%). Furthermore, while acute pathologies constituted the numerical majority, proportional analysis across age strata demonstrated a relative increase in chronic appendicitis diagnoses within the 21-30 year age group compared to younger cohorts. Conclusions: Post-appendectomy, detailed microscopic analysis of the removed appendix is crucial to confirm its identity, precisely diagnose any existing disease (like inflammation or infection), and importantly, to exclude the presence of hidden cancerous growths. This thorough histopathological examination is a fundamental step for accurate diagnosis and the detection of any unexpected malignancies.
Copyright (c) 2025 Himansu Shekhar Mishra, Manabhanjan Bhimasingh Kanhar, Subrat Kumar Pradhan, Debi Prasad Chattarjee https://creativecommons.org/licenses/by/4.0
Prognosis of Prehospital Hypotensive Patients in the Emergency Department: A Retrospective Cohort Study
Objective: To evaluate the emergency department (ED) and in-hospital outcomes of patients presenting with prehospital hypotension and to identify prognostic factors associated with mortality. Design: Retrospective cohort study. Subjects/Patients: Adult patients (≥18 years) with prehospital systolic blood pressure <90 mm Hg, admitted directly to the ED between January 2023 and December 2024. Methods: Medical records from Esenyurt Necmi Kadıoğlu State Hospital were reviewed. Primary outcome was in-hospital mortality. Secondary outcomes included ICU admission, vasopressor use, hospital length of stay, and 30-day mortality. Multivariable logistic regression was performed to identify predictors of mortality. Results: Of 10,000 patients screened, 8,682 met the inclusion criteria. The mean age was 53.6 years, and 50% were male. In-hospital mortality was 25.96%, and 30-day mortality was 19.90%. ICU admission was required in 35.1% of cases, and 39% required vasopressors. Elevated lactate levels, older age, low initial systolic blood pressure, ICU admission, and vasopressor use were independently associated with higher mortality. Lactate level was the strongest predictor, with a 1.5-fold increase in mortality per 1 mmol/L rise. Conclusions: Prehospital hypotension is associated with high mortality. Early identification of risk factors, especially elevated lactate levels, can aid in improving outcomes for these critically ill patients.
Copyright (c) 2025 Erkan Boğa, MD https://creativecommons.org/licenses/by/4.0
Histopathological Diagnoses of Lymphadenopathy from Excisional Biopsies: A Retrospective Study at a Tertiary Care Center
Background: Lymph nodes, distributed throughout the human body, are critical components of the immune system and are routinely evaluated for pathological changes. These nodes are susceptible to infection and neoplastic transformation. Lymphadenopathy, characterized by abnormal lymph node size and/or number, is a common clinical finding. Reactive lymphadenitis and granulomatous lymphadenitis represent frequent etiologies of lymphadenopathy. Excisional biopsy followed by histopathological examination remains the definitive diagnostic modality for lymph node disorders. Methods: A retrospective, descriptive, cross-sectional study was conducted, encompassing all patients who underwent lymph node biopsies at SCB Medical College and Hospital, Cuttack between January 2023 and December 2024. Histopathology reports of all lymph node biopsies performed at this period were included in the analysis. Results: Tuberculous lymphadenitis was the predominant diagnosis, constituting 53.2% (n=251) of the 120 analyzed cases. A higher prevalence of tuberculous lymphadenitis was observed in female patients (52%) compared to male patients (48%), although the difference was not statistical significant. Malignant diagnoses represented the second most frequent category, accounting for 17% of cases. Conclusions: The evaluation of lymphadenopathy necessitates appropriate diagnostic procedures, including fine needle aspiration cytology (FNAC), core needle biopsy, and/or excisional biopsy, to establish an accurate diagnosis. The histopathological spectrum of lymph node biopsies encompasses a range of conditions from benign reactive hyperplasia to tuberculosis and malignancy.
Copyright (c) 2025 Girija Sankar Naik, Bismaya Kumar Rout, Himansu Shekhar Mishra https://creativecommons.org/licenses/by/4.0
Incidence of Intraoperative and Postoperative Complications Among Patients Undergoing Laparoscopic Cholecystectomy: A Retrospective Analysis from a Tertiary Care Hospital
Background: Laparoscopic cholecystectomy is a prevalent surgical intervention for gallbladder pathologies. However, its adoption introduced a novel profile of intraoperative and postoperative complications in conditions like symptomatic cholelithiasis and cholecystitis. This study aimed to evaluate the spectrum and incidence of these complications in patients undergoing laparoscopic cholecystectomy. Methods: A retrospective analysis was conducted on 100 patients who underwent laparoscopic cholecystectomy at the Department of Surgery, SCB Medical College and Hospital, Cuttack, between December 2022 and December 2023. Intraoperative and postoperative complications were extracted from patient records following informed consent. Results: The majority of patients (30%) were aged 40-60 years (mean age 50.6 ± 8.1 years), with a predominance of females (59%). The mean body mass index was 23.33 ± 2.26 kg/m². Pre-existing comorbidities included smoking (21%), diabetes mellitus (19%), and hypertension (11%). The mean operative time was 50.25 ± 4.75 minutes. Symptomatic gallstones were the primary indication for surgery (56%). The most frequent intraoperative complication was trocar site bleeding (8%), while surgical site infection was the most common postoperative complication (5%). Conclusions: Despite the occurrence of some intraoperative and postoperative complications, laparoscopic cholecystectomy demonstrates low mortality and morbidity rates, establishing it as a safe procedure with favorable outcomes for the management of gallbladder diseases.
Intraoperative and postoperative complications
Copyright (c) 2025 Himansu Shekhar Mishra, Girija Sankar Naik, Bismaya Kumar Rout https://creativecommons.org/licenses/by/4.0
A Retrospective Analysis of the Clinical Utility and Cost-Effectiveness of Routine Preoperative Blood Grouping and Saving Protocols in Patients Undergoing Laparoscopic Surgical Procedures
Introduction: In patients undergoing elective laparoscopic cholecystectomy or appendicectomy, standard preoperative practice often includes blood grouping and saving (G&S). Notwithstanding the infrequent requirement for blood transfusion during these procedures, the procurement and laboratory analysis of G&S specimens impose a cost of £31 (approximately $40) per sample. This investigation seeks to evaluate blood transfusion utilization in these surgical cohorts to ascertain the clinical justification for routine G&S sampling versus its potential as a dispensable expenditure. Methods: A retrospective review of patient records was performed for individuals who underwent laparoscopic cholecystectomy or laparoscopic appendicectomy between January 2023 and June 2024. The data extracted comprised the timing of (G&S) procedures, preoperative and postoperative haemoglobin concentrations, the timing of any blood transfusions administered, and the total number of blood units transfused. Results: A total of 310 patients participated in this investigation. Within the laparoscopic cholecystectomy cohort (n=164), 129 individuals (78.65%) underwent preoperative grouping and screening (G&S) for blood compatibility. In the laparoscopic appendicectomy group (n=146), 95 patients (65.06%) received preoperative G&S. It is noteworthy that no patient within the entire cohort of 310 required a blood transfusion within the 30-day postoperative period. Conclusions: The results indicate that routine Group and Save (G&S) blood sampling does not represent a clinically necessary expenditure for patients undergoing elective laparoscopic appendectomy or cholecystectomy. To optimize resource allocation and minimize non-essential costs, it is advised that G&S sampling be selectively employed in patient populations identified as being at elevated risk for perioperative complications requiring blood transfusion.
Copyright (c) 2025 Satyajit Behera, Subrat Kumar Pradhan, Himansu Shekhar Mishra https://creativecommons.org/licenses/by/4.0
Inguinal Hernia Repair Outcomes Across Various Surgical Techniques: A Hospital Based Retrospective Study from a Tertiary Care Center
Background/Aim: Inguinal hernia repair is a common surgical procedure. This study aims to compare the effectiveness of different surgical techniques used for inguinal hernia repair at a tertiary care teaching hospital over a three-year period. Methods: This study will retrospectively analyze data from patients who underwent elective surgical repair of uncomplicated inguinal hernias between 2020 and 2022 at a single institution in Cuttack, Odisha. Patients were treated using various surgical techniques and followed prospectively for a defined post-operative period to assess outcomes. Results: Analysis of 260 inguinal hernia repairs demonstrated a procedural distribution where Lichtenstein hernioplasty was the most frequently employed technique, accounting for 80.8% of cases (n=210). Preperitoneal meshplasty was utilized in 10.4% of repairs (n=27), while transabdominal preperitoneal (TEP) repair was performed in 8.8% of cases (n=23). Conclusion: Comparative analysis demonstrates that Lichtenstein tension-free repair exhibits equivalent clinical efficacy to endoscopic/laparoscopic techniques in the management of hernias. However, the Lichtenstein procedure remains the prevailing standard of care, largely attributable to its well-established cost-effectiveness.
Copyright (c) 2025 Himansu Shekhar Mishra, Subrat Kumar Pradhan, Satyajit Behera https://creativecommons.org/licenses/by/4.0
Deciphering the Non-invasive Tests in NAFLD: A Systematic Review and Meta-analyses
Background: Non-alcoholic fatty liver disease (NAFLD) is a significant health issue worldwide now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), varying from mild fat accumulation in the liver to non-alcoholic steatohepatitis (NASH). Aim and objective: The primary aim of this study was to answer the question:” How does the combination of non-invasive tests help in enhancing the accuracy for advancing fibrosis in NAFLD patients and how this could assist in clinical practice and management?”. Methods: The systematic review and meta-analyses included studies published from 2016 to 2024 assessing non-invasive tests (NITs) in the diagnosis of advanced fibrosis in NAFLD patients across Scopus, PubMed and Embase. Fifteen studies were finally selected with seven studies included in the meta-analyses. Results: The pooled estimates for mean AUC, sensitivity and specificity for various NITs were 0.82, 0.53 and 0.83 respectively. Magnetic resonance elastography (MRE) and enhanced liver fibrosis (ELF) tests showed high accuracy in the diagnosis of advanced fibrosis. Conclusion: A combination of non-invasive tests will aid in enhancing the accuracy of fibrosis detection and progression in NAFLD improving patient outcomes. Emerging methods like the use of AI and ML, microRNA signatures, optical coherence tomography, and future directions including liquid biopsy and molecular imaging techniques show promising results in the diagnostic performance and accuracy of NAFLD.
Copyright (c) 2025 Sanul Shahi Salim, DNB, Shamim Hyder, DNB, Jamila Hameed, MD https://creativecommons.org/licenses/by/4.0
A Dual Perspective on Chromic Urticaria: Insights from a Retrospective Study and Systematic Review and Meta-Analytical Evaluation
Background: Chronic urticaria (CU) is a common skin condition that causes hives and swelling, lasting for six weeks or longer. This condition can really take a toll on people's lives, causing physical discomfort, mental stress, and social difficulties. Aim and Objective: The primary aim of the study was to answer the question: "How do the prevalence rates and related comorbidities of chronic urticaria vary among different populations, and what do these variations imply for clinical management?". Methods: A systematic review and meta analyses was conducted by selecting studies from the period 2015 to 2024 on the prevalence of spontaneous urticaria and the associated risk factors from PubMed, Embase and Scopus. In addition to this, a retrospective study was conducted alongside including 664 patients with 332 patients each in the control (diagnosed with chronic urticaria) and case group. Results: The review looked at 12 studies and found some noticeable differences in prevalence rates across different regions, with an overall pooled estimate of 0.12. The retrospective study pointed out that chronic urticaria is more common in women and also noted that conditions like obesity, thyroid issues, and diabetes are often linked to it. Conclusion: The findings highlight the importance of thorough clinical evaluations and personalized management plans for patients dealing with chronic urticaria. More research is needed to look into the long-term impacts of related health issues and to better grasp how this condition affects different populations.
Copyright (c) 2025 Prathyusha Prabhakar, MD, Darsan S, MD, Jamila Hameed, MD https://creativecommons.org/licenses/by/4.0
Mapping The Diagnostic Spectrum: Systematic Review and Meta-Analysis on CESM VS MRI for Breast Lesions
Background: Breast cancer represents a major public health challenge and requires novel diagnostic approaches. Contrast-enhanced mammography (CEM) combined with magnetic resonance imaging (MRI) is one of the major imaging approaches in the assessment of breast lesions. Aim and objective: The study aimed to answer the question:” Why is it essential to comprehend the differences in sensitivity, specificity and accuracy for contrast-enhanced mammography and MRI in the diagnosis of breast lesions and how these parameters will assist in clinical scenarios and patient outcomes?”. Methods: This was a systematic review and meta-analyses including 1272 subjects done to find out studies published between 2015 to 2024 on the comparison between contrast-enhanced spectral mammography (CESM) and MRI for the detection of breast lesions. Electronic database search was done in PubMed, Scopus, and Embase, and 12 articles were finally selected. Results: MRI was more sensitive (91% to 100%) and specific (23% to 100%) compared with CEM, which demonstrated sensitivity (65% to 100%) and specificity (28% to 100%). The estimated overall accuracy for MRI was 85.4%, and for CEM, it was 80.7%, with MRI being especially good at detecting invasive viruses of the breast. Conclusion: The key findings of our study were that although both CEM and MRI could diagnose breast cancer, there was a significant difference between the two tests in sensitivity and specificity, with MRI scoring better on both counts. MRI was the gold standard for breast imaging, particularly in higher-risk patient populations.
Copyright (c) 2025 Shamim Hyder, DNB, Sanul Shahi Salim, DNB, Jamila Hameed https://creativecommons.org/licenses/by/4.0
Preoperative Nutritional Status and Its Effect on Surgical Outcomes and Public Health in General Surgery: An Evaluation of Postoperative Impact
Background: Malnutrition is linked to more postoperative problems, a longer recovery period, and a higher death rate; preoperative nutritional condition is a critical factor in surgical outcomes. Objective: This study aimed to evaluate the impact of preoperative nutritional status on surgical outcomes in general surgery patients and explore its broader public health implications. Methodology: A two-year observational research with 250 adult patients undergoing general surgery was carried out between January 2022 and December 2023. Based on preoperative nutritional tests, such as Nutritional Risk Screening (NRS-2002), Body Mass Index (BMI), and blood albumin levels, participants were divided into two groups: nutritionally sufficient and nutritionally compromised. Postoperative problems, such as infections, wound healing, duration of hospital stay, readmissions, and 30-day mortality, were examined in the data. Results: Nutritionally compromised patients exhibited significantly worse outcomes, including higher rates of postoperative infections (74 out of 125, 59.4% vs. 28 out of 125, 22.4%), delayed wound healing (29 outof 125, 23.3% vs. 11 out of 125, 8.8%), increased readmission rates (22 out of 125, 17.6% vs.6 out of 125, 4.8%), and higher 30-day mortality (14 out of 125, 11.2% vs. 3 out of 125, 2.4%) compared to the nutritionally adequate group. Long-term follow-up showed persistent differences in infection rates and wound healing, supporting the prolonged impact of poor nutritional status. Conclusion: Preoperative malnutrition significantly affects surgical outcomes, emphasizing the importance of nutritional optimization in preoperative care to enhance recovery and minimize complications.
Copyright (c) 2025 Dr Himansu Shekhar Mishra, Debabrata Ray, Swopna Sagar Das, Manabhanjan Bhimasingh Kanhar, Sashibhushan Dash https://creativecommons.org/licenses/by/4.0
Clinicopathological Profile of Anal Fissures in a Tertiary Care Setting: A Retrospective Analysis
Background: The epidemiology and contemporary treatment of anal fissures (AF) are underreported in the literature. To address this deficiency, this investigation examined the incidence, comorbidity profiles, and treatment patterns of anal fissures within a hospital-based population. Methods: This retrospective analysis examined all adult patients (≥20 years) diagnosed with anal fissures (AF) at a tertiary care teaching hospital from 2022 to 2024. Case ascertainment was performed using hospital utilization records, encompassing outpatient visits, inpatient admissions, and surgical interventions. Comorbidity profiles were evaluated by comparing cases to age- and gender-matched controls. Results: This retrospective analysis of 350 anal fissure (AF) cases indicated a female predominance (60%, n=210) over males (40%, n=140). The age-specific incidence of AF varied significantly by sex, with peak incidence occurring in females aged 31-50 years and males aged 51-70 years. Furthermore, the study identified statistically significant associations between AF and several comorbidities, including chronic constipation, hypothyroidism, obesity, and solid tumors without metastasis, with elevated prevalence rates observed in the AF cohort. Conclusions: Anal fissure is a clinically significant condition with a heterogeneous incidence across age and sex groups. Common comorbid conditions include constipation, obesity, and hypothyroidism. Initial management typically involves topical medications, though prescription adherence is often poor. Surgical interventions, encompassing botulinum toxin injection and lateral internal sphincterotomy, are employed less frequently.
Copyright (c) 2025 Debabrata Ray, Dr Himansu Shekhar Mishra, Swopna Sagar Das, Manabhanjan Bhimasingh Kanhar, Sashibhushan Dash https://creativecommons.org/licenses/by/4.0
Liver Function Indicators Before and After Detection of Hepatic Metastases in Patients with Breast Cancer: A Retrospective Analysis Over Time
Background: Hepatic metastases represent a significant clinical challenge in breast cancer management, underscoring the importance of identifying predictive factors to optimize patient care. As the longitudinal patterns of liver function protein levels surrounding hepatic metastasis development remain poorly characterized, this study prospectively analyzed protein level trajectories over an 18-month period, spanning six months prior to and twelve months following metastasis diagnosis. Methods: This retrospective cohort study examined 104 patients with breast cancer-derived hepatic metastases, who received treatment at A.H. Post-Graduate Institute of Cancer, Cuttack, between 2022 and 2024. Data were retrospectively extracted from patient medical records. Results: Six months preceding the diagnosis of hepatic metastases, statistically significant deviations from established reference intervals were observed in hepatic function biomarkers. Specifically, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) exhibited elevations (p<0.001), while albumin levels demonstrated a concomitant decrease (p<0.001). At the time of metastatic diagnosis, further statistically significant increases in AST, GGT, and LDH were noted relative to the six-month pre-diagnosis levels (p<0.001). These hepatic function indicator changes were independent of patient or tumor-specific parameters. Notably, increased AST and decreased albumin at the time of diagnosis were associated with reduced overall survival. Conclusion: Evaluation of hepatic function protein levels is warranted to determine their clinical utility as biomarkers for the early identification of liver metastasis in breast cancer patients. Implementation of such screening protocols, in conjunction with advanced therapeutic interventions, may positively impact patient survival.
Copyright (c) 2025 Biswajit Pradhan, Snigdharani Choudhury, Satyajit Behera, Jyotiranjan Mohapatra, Diptish Kumar Sahoo, Sashibhushan Dash https://creativecommons.org/licenses/by/4.0
A Study on Trends of Chest X-Ray Radiological Patterns in Community Acquired Pneumonia, In Association with Bacterial and Fungal Etiologic Agents
Introduction: Pneumonia is one of the leading cause of infectious disease worldwide. Chest radiography plays a crucial role in clinical diagnosis of Community Acquired Pneumonia (CAP). This study is conducted to identify the common infiltrative patterns in CAP and their association with specific microbial pathogens. Materials & Methods: Chest radiography infiltrative patterns for about 150 cases of CAP are studied and the specific etiologic pathogens were identified by microbiological investigations, according to Standard Operating Procedures. Results: The most common type of radiologic finding is lobar type of consolidation (55.33%) followed by bronchopneumonia type of consolidation (17.33%). Culture positivity rate was 69.33%. Monomicrobial infection was identified in 90 cases (86.54%), while polymicrobial infection was found in 14 cases (13.46%). Bacterial pathogens predominate over fungal pathogens. 85.18% of K. pneumoniae isolates presented with lobar type of consolidation.66.66% of Staphylococcus aureus isolates with bronchopneumonia type of consolidation.50-100% of poly microbial infections presented with lobar type of consolidation.27.77 % each of fungal isolates presented with cavitary consolidation and nodular type of consolidation. Conclusion: As newer pathogens are emerging with specific pattern of chest infiltrates, primary knowledge about the specific chest X ray patterns by various pathogens are important to obtain preliminary idea about the possible pathogen and thereby to choose an ideal empiric antibiotic therapy, which is the main line of treatment in CAP.
Copyright (c) 2025 Dr. A. V. Sowmya, Dr. David Agatha, Dr. G. Jayalakshmi https://creativecommons.org/licenses/by/4.0
Eating Habits and Lifestyle Changes During COVID-19 Pandemic Among Healthcare Professionals in Dubai Health
Background: The COVID 19 impacted global lifestyles, causing major issues for healthcare workers because of their position in the front line. The present research aimed to understand the effects of COVID-19 on the dietary preferences and lifestyle alterations of healthcare staff working in Dubai Health (DH), a population that should possess better health literacy but is likely to face significant stress and workload variations during the pandemic. Objective: To assess changes in dietary behavior, physical activity levels, sleep, smoking, and stress levels during the COVID-19 pandemic among Dubai Health; Healthcare Professionals, and to determine demographic and lifestyle predictors of these behaviors. Methods: A cross-sectional study was conducted using online questionnaires administered to 413 DH Healthcare Professionals. The questionnaire was validated and distributed to participants in both English and Arabic. It includes questions on sociodemographic data, lifestyle changes in eating habits, physical activity, smoking, and sleep patterns in the context of the COVID 19 pandemic. Data were analyzed using descriptive statistics and cross-tabulation. Ethical clearance was obtained from the Dubai Scientific Research Ethics Committee. Results: This study examined healthcare professionals' lifestyle behaviors and perceptions during COVID-19. The majority were female (82%), aged 35-44 (41%), and predominantly Asian (60%). Most resided in Dubai (75%) and were nurses (39%). Chronic diseases affected 81% of participants. Unhealthy lifestyle behaviors were prevalent, with 90% exhibiting three or more. Minimal changes were noted in physical activity (33%), food intake (54%), and sleep (72%). Stress increased for 61%, with prayer (36%) and entertainment (32%) as common coping strategies. Dietary shifts favored home-cooked meals (78%), and 70% believed vitamins strengthened immunity. Vitamin C (60%) and D (38%) were widely used. Women showed greater declines in physical activity and smoking, while married individuals reduced smoking more than singles. These findings highlight behavioral shifts influenced by demographic factors during the pandemic. Conclusion: This study highlights significant lifestyle and behavioral changes among healthcare professionals during COVID-19. High stress levels, poor diet, and inactivity were common, with prayer and entertainment as key coping mechanisms. Women saw greater declines in physical activity and smoking, while married individuals reduced smoking more than singles. Despite widespread belief in vitamins for immunity, unhealthy habits persisted. These findings underscore the need for targeted interventions to support mental health, nutrition, and physical activity in healthcare workers during crises. Implications: These insights into lifestyle changes therefore have the utility of designing health promotion intervention programs for HCWs in the future. Proactively, the following practice propositions are critical for developing hardiness within this vital employee population, especially during health crises.
Copyright (c) 2025 Areen Al Zorba, Maryam Essa, Ayesha Al Qemzi, Hessa Al Shaibi https://creativecommons.org/licenses/by/4.0
Effect of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet (LCCD) on Deep Superficial Adipose Tissue in Obese Adults: A Randomized, Controlled Trial
Introduction: This study aims to compare the effects of a 2-month very low-calorie ketogenic diet (VLCKD) with a standard low-calorie diet (LCCD) on deep superficial adipose tissue (dSAT) in obese adults. The primary goal was to evaluate changes in dSAT and other anthropometric measurements, while the secondary objectives included assessing weight loss, fat mass (FM), and fat-free mass (FFM). Methodology: In this randomized controlled trial, 70 obese adults (35 in each group) were assigned to follow either the VLCKD or the LCCD for 2 months. dSAT was measured using ultrasound, and additional parameters, including body weight, waist and hip circumference, body fat percentage, and FFM, were recorded at the beginning and end of the study. Results: After 2 months, the VLCKD group showed a significantly greater reduction in dSAT (-3.86 mm) compared to the LCCD group (-2.88 mm) (p < 0.05). The VLCKD group also experienced a 12% decrease in body fat percentage, while the LCCD group showed a 9% reduction (p < 0.01). Both groups maintained similar levels of FFM, with no significant differences. Discussion: The VLCKD group demonstrated more substantial reductions in dSAT and body fat percentage compared to the LCCD group, suggesting that VLCKD may be more effective in reducing visceral fat. These findings indicate potential metabolic health benefits of VLCKD for obese individuals. Further research with longer follow-up periods is necessary to determine the sustainability and underlying mechanisms of these effects.
Copyright (c) 2025 Amro Ashmawy, Ligia Stella Guerrero Orjuela https://creativecommons.org/licenses/by/4.0
Study on Covid-19 Associated Mucormycosis in Patients Attending a Tertiary Care Hospital During Pandemic in India
Background: The Corona virus (Covid-19) infection is one of the cause for immunosuppressed state and increased risk for secondary infections. The Delta variant (B.1.617.2) was the most common variant circulating at that time. We have evaluated clinical features, predisposing factors, diagnosis and outcomes for mucormycosis among patients with Covid-19 infection. Mucormycosis is an opportunistic and angioinvasive fungal infection caused by the Mucorales family with Rhizopus and Mucor. It has the high morbidity and Mortality that requires prompt recognition and immediate intervention. The most important risk factors are uncontrolled blood sugar, the use of corticosteroids, and immune dysfunction due to Covid-19 infection. Poor glycaemic control is the single most cause for worse outcomes despite aggressive medical and surgical interventions. Aim & Objectives: To study the association between covid-19 and Mucormycosis in patients attending at Tertiary care centre during pandemic attack. Materials & Methods: This prospective observational study was conducted from May 2021 to October 2021.A total of 77 Covid-19positive patients with signs and symptoms suggestive of Mucormycosis were included in this study attending at Department of Microbiology in association with Department of Oto Rhino laryngology (ENT), Government Tiruvannamalai Medical College and Research Institute, Tiruvannamalai. As per the Standard aseptic precautions, Biopsy tissue samples were collected during FESS (Functional Endoscopic Sinus Surgery) from clinically and radiologically suspected cases of mucormycosis with Covid-19 infection after getting informed consent. All the samples were processed for Mycology culture isolation. The isolates examined under 10% KOH for detection of fungal elements and inoculated into Sabouraud’s Dextrose Agar (SDA) and kept in Biological Oxygen Demand (BOD) for 2-4 weeks. The results were analysed in correlation with the clinical details and cultural growth identification. The cultural isolates were then subjected to LPCB (Lacto Phenol Cotton Blue) for Mucorales confirmation. Results: A total of 35 (45.4%) were positive for presence of fungal elements in either KOH mount or fungal growth on SDA. Gram positive budding yeast cells (ie) Candida species were most commonly isolated in culture, followed by Rhizopus spp, Aspergillus spp and Mucor spp. Mucormycosis was predominantly seen in males, 8 (10.38%), then in females 2 (2.6%). The commonest risk factors associated with mucormycosis were Covid-19 positivity and Diabetes mellitus (poor Glycaemic control). Conclusion: Mucormycosis can occur among Covid-19 patients, especially with poor glycaemic control, widespread and injudicious use of corticosteroids and broad-spectrum antibiotics, and invasive ventilation, owing to the high mortality. High index of suspicion is required to ensure timely diagnosis and appropriate treatment in high- risk populations to avoid mortality and reduce the complications of Mucormycosis.
Copyright (c) 2025 Dr. S. Viji, Dr. C. Nithya, Dr. K. Shanmugam, Dr. P. Suganthi https://creativecommons.org/licenses/by/4.0
Inter-Relation between Type 2 Diabetes Mellitus and Hypertension in Asia
Type 2 Diabetes Mellitus(T2DM) and hypertension (HTN) are most commonly inter-related. Diabetic patients are at a high risk of developing uncontrolled blood pressure leading to other complications like cardio vascular disease (CVD) and chronic kidney disease (CKD). The risk factors are ageing, obesity, dyslipidaemia, sedentary lifestyle, urbanization, and smoking. A keen comprehension of these interconnected factors will assist in prevention and management. The primary objective of the study is to evaluate the prevalence of HTN in diabetic patients in Asia to establish the inter-relationship to make the general public aware of the condition. The question that we aimed to answer was:” What is the relationship between T2DM and HTN and other variables causing morbidity?”. A total of 27103 studies were retrieved from PubMed, Google Scholar and Embase in the period 2014 to 2024 out of which finally 12 studies were considered. HTN prevalence was found to be the highest among T2DM patients in Kuwait and China (87.16% each). Saudi (23%) reported the lowest prevalence followed by Iran (36.1%). The majority of studies reported higher prevalence in females in comparison to males. Factors such as obesity, dyslipidaemia, and low physical activity proved to be the key drivers in the development and progression of diabetes along with urbanization. HTN is a global burden and there has been a strong correlation between T2DM and HTN. Awareness, timely diagnosis and lifestyle modification can prove to be extremely beneficial in appropriate management of the condition and avert mortality.
Copyright (c) 2025 Sarathlal S, DNB, Aleena Thomas Cheeran, DNB , Jayakrishnan K S, MD, Hariharan A, DFM, Jamila Hameed *, MD https://creativecommons.org/licenses/by/4.0
A Virtual Solution to Social Isolation in the Asian American Geriatric Community Post Covid-19 Pandemic
The COVID-19 pandemic highlighted and deepened key aspects of social gerontology, including mental health, mobility issues, and social isolation among elderly Asian Americans. This study examines the compounded effects of loneliness stemming from mobility limitations, health concerns, and heightened xenophobia during the pandemic, which have increased susceptibility to mental health issues such as depression, anxiety, and overall health decline. Existing solutions, including senior centers and generic applications, fail to adequately address the cultural and linguistic needs of Asian American seniors. To address these gaps, this study introduces “Bloom,” an application targeted at geriatric Asian Americans. The Bloom interface comprises a mood tracker, recreational and cultural classes, games, chat rooms, and a location tracker to enhance socialization, well-being, and safety. Activities such as tai chi, knitting, mahjong, and karaoke are incorporated to align with cultural preferences, and the app’s bilingual functionality mitigates language barriers. A pre-designed survey consisting of 37 Chinese-speaking seniors from Los Angeles was surveyed prior to designing the app to understand their preferences and barriers to social activities. Following this, a pilot study with ten beta testers demonstrated the app's efficiency. Results demonstrated enhanced levels of social interaction, cognitive stimulation, and favorable user feedback, indicating the app's potential as a multipurpose solution to social exclusion. This study supports the need to incorporate culturally sensitive technology interventions in combating social isolation among the elderly. Bloom aims not only to build caring interpersonal relationships but also to promote mental well-being and physical health. This work provides a roadmap for how digital innovation can support rights and appropriate care for marginalized senior groups. Future versions of the app should be designed to address the needs of other cultural groups, fulfilling its potential to meet the diverse needs of the aging population.
Copyright (c) 2024 Kimberly Chang https://creativecommons.org/licenses/by/4.0
Prevalence of Aspirin Resistance in Indian Patients with Coronary Artery Disease: A Study of 1,000 Cases
Background: Aspirin is safe in secondary prevention of coronary artery disease mainly because of its antiplatelet actions, decreasing the chance of unfavorable cardiological outcomes. Nevertheless, the issue of aspirin resistance, defined as lower efficacies of antiplatelet effects, seems a crucial clinical problem. Though, researches across the globe have studied this problem, however literature available concerning the Indian population is scarce. Objective: The present work also seeks to establish the proportion of Indian patients diagnosed with CAD who are resistant to aspirin and identify correlation between aspirin resistance and demographic, clinical and therapeutic characteristics. Methods: This was a cross-sectional survey with 1000 Indian CAD patients from several tertiary care centers. Diagnosis of aspirin resistance was made based on plate function tests and application of a cut-off value defining sensitivity and specificity. Patients’ demographic details and clinical records were obtained, and information regarding the treatment that they received was also obtained. Descriptive statistics were computed to demonstrate prevalence rates of aspirin resistance, and inferential statistics for prediction. Results: The authors identified that the overall prevalence of AR among the study sample was X% (Cl: X%-X%). Secondary analysis by different subgroups showed the following: Resistance level had significant correlation with age, gender, comorbidities including diabetes and hypertension as well as aspirin dosage. Just as expected, the observed aspirin resistance was found to be responsible for more cardiovascular relapses than the normal platelet response patients.
Copyright (c) 2024 Dr Jitender Sharma https://creativecommons.org/licenses/by/4.0
Traumatic Isolated Interhemispheric Fissure Subdural Hematoma Under Anticoagulant Therapy in an Elderly Patient: A Case Report
Acute subdural hematomas are often encountered over the convexity of the cerebral hemisphere, but the localization of the interhemispheric fissure is rare. Interhemispheric fissure subdural hematoma (IHSDH) is usually accompanied by subdural hematoma, intracerebral hemorrhages, while its isolated form is extremely rare. They are usually benign due to the fact that they are usually treated conservatively and are not directly correlated with an increase in intracranial pressure. In cases which develop under the use of antiplatelets or anticoagulants, it is recommended to discontinue the drug for a while so that the hematoma does not grow in size. There is no clear answer in which patients the drug will be discontinued and how long the use will be interrupted.
Acute interhemispheric fissure subdural hematoma
Copyright (c) 2024 Enes Tarık İnci, Tahir Kurtuluş Yoldaş https://creativecommons.org/licenses/by/4.0
The Pattern of Serum Copper and Magnesium in Pregnant Women Covered by Urmia Urban Health Centers and Its Clinical and Nutritional Determinants in the Third Trimester of Pregnancy, 2018
Background: Copper and Magnesium are essential for development of the fetus and maternal health. The aim of this study was to determine the pattern of serum copper in pregnant women in Urmia and its association with some clinical and nutritional factors in the third trimester of pregnancy. Materials and method: In this analytic cross-sectional study, 400 pregnant women in the third trimester were randomly selected from the women who referred to 6 selected health centers for their routine care. It was investigated demographic, nutritional and clinical factors and fasting blood samples were obtained. The data were analyzed using Chi-square, Independent T-test and logistic Regression tests using SPSS 21 software. Results: The serum analysis showed that Magnesium and copper deficiency among studied population were not prevalent but high serum levels of magnesium and copper were seen in 24% and 13% of them respectively. Based on binary logistic regression model outputs, the development of excessive serum magnesium levels was directly correlated with dietary magnesium intake, magnesium supplementation and dietary fiber intake (OR: 1.109; 95% CI: 1.008-1.219) and inversely correlated with total dietary intake of calcium. The high concentration of serum copper was directly associated with dietary intake of copper and negatively associated with total intake of dietary magnesium, iron deficiency anemia (OR: 0.369; 95% CI: 0.166-0.819) and pre-pregnancy BMI. Conclusion: Pregnant women in Urmia probably have high concentrations of serum magnesium in comparison to other parts of the country. It is likely related to consumption of the Mg supplementation.
Copyright (c) 2024 Masoomeh Gholizadeh, M. Sc, Saeid Ghavamzadeh, PhD, Hamid Reza Khalkhali, PhD https://creativecommons.org/licenses/by/4.0
Factors Affecting Peripartum Blood Transfusion in Women Undergoing Cesarean Section
Background: Postpartum hemorrhage is the most common cause of maternal death in developing countries. Since no known risk factors are observed in a number of women who experience postpartum hemorrhage and blood transfusion, this study was conducted with the aim of determining risk factors of blood transfusion in women who underwent cesarean. Methods: This cross-sectional study was conducted in 2022 and 2023 in two hospitals in Tehran. Demographic characteristics of mother and newborn, and information about pregnancy and cesarean of 54 women who underwent cesarean and received blood during the peripartum period and 108 women who did not receive blood were recorded and compared to determine risk factors of needing blood transfusion in the peripartum period in women who underwent cesarean. Results: The results showed that the two groups in terms of mother's age (P<0.001), gestational age (P=0.001), number of previous births (p=0.015), mother's body mass index (P=0.019), sufficient number of visits during pregnancy (P<0.0001), weight of the newborn (P=0.045), frequency of cesareans that lasted more than 60 minutes, the cesareans that were completed during the night shift (P < 0.001) were significantly different. Also, these groups had significantly difference in terms of emergency cesarean (P= 0.005), cesarean in the active phase (P=0.007), uterine atony (P<0.001), preoperative hemoglobin and hematocrit level and women with hemoglobin less than 9 g/dL (P<0.001). Conclusion: The results of this study showed that some factors increase the probability of peripartum hemorrhage and some of these factors can be corrected. Probably, paying attention to these risk factors will reduce the amount and better management of peripartum hemorrhage in women who undergo cesarean.
Copyright (c) 2024 Nafiseh Faghih; Minoo Yaghmaei, Mojgan Mokhtari, Hamid Reza Kouhpayeh https://creativecommons.org/licenses/by/4.0
Occupational Exposure to Aluminum Particles and Alzheimer's Disease-Like Damage
Cohort studies have indicated that prolonged occupational exposure to aluminum causes cognitive impairment and neurotoxicity. Al is a widespread neurotoxin that can induce Aβ deposition and abnormal tau protein phosphorylation, leading to Alzheimer’s disease-like damage, such as reduced learning and memory and neuronal damage. For many years, Al has been implicated in the etiology of AD according to the so-called "Al in AD hypothesis", and researchers have described how it plays a role in the onset, progression, and aggressive nature of AD. The toxicity of Al is related to its prooxidant activity, which occurs through the formation of Al superoxide radical cations. However, although the role of Al in AD has become clearer, the dominant toxic mechanism involved is still not understood. In this mini-review, we investigated the effect of exposure to aluminum particles on phosphorylated tau levels and cognitive impairment.
Copyright (c) 2024 Mojtaba Ehsanifar, Akram Gholami, Maryam Saberi https://creativecommons.org/licenses/by/4.0
Echocardiography as an Initial Diagnostic Tool for Rare Extra Cardiac Diagnosis- Idiopathic Achalasia
Transthoracic echocardiography (TTE) is a noninvasive initial imaging modality in evaluating the anatomic structure and function of the heart. Although the diagnostic coincidence rate of TTE is slightly lower than that of computer tomography (CT) and magnetic resonance tomography (MRT), TTE has certain diagnostic value for extra-cardiac lesions. We report about a very rare and interesting finding observed using TTE study. Our case shows the role of TTE in identifying extra cardiac structure leading to the new important diagnosis and deferent treatment strategy. 61-year-old male patient was admitted to the hospital with main complaints: chest pain, dyspnea, cough, also he had dysphagia and weight loss. First of all, cardiologic examination has been done, TTE revealed left atrial (LA) compression by an inhomogeneous mass and accelerated flow in LA. TTE provided useful information of the location, size, echogenicity of the extra cardiac structure and its relationship with the heart. Esophageal pathology was suspected, the patient had been subjected to X-ray examination with barium and then an endoscopy. The result of which was confirmed diagnosis of idiopathic achalasia. Our case shows the role of routine TTE in identifying extra cardiac structure - esophageal achalasia, leading to important extra cardiac diagnosis and indication for further surgical intervention. Incidental echocardiographic extra cardiac findings in the clinical case presented by us led to a new diagnosis, referral of patients to surgeons and, accordingly, changed the treatment strategy. Thus, it is very important to train, improve knowledge, focus on extra cardiac manifestations on echocardiography and establish appropriate guidelines for conducting a comprehensive study.
Copyright (c) 2024 Ketevan Lartsuliani, MD, PhD, Lali Patsia, MD, PhD, Nodar Sulashvili, MD, PhD https://creativecommons.org/licenses/by/4.0
Polymeric Antibiotic Beads for Canine Osteomyelitis: Advancing Localized Antibiotic Treatment with Enhanced Efficacy and Minimized Side Effects
Antibiotic beads represent a compelling treatment method for the treatment and prevention of canine osteomyelitis, as they provide localized antibiotic concentrations at the infection site with minimal systemic toxicity. The therapeutic efficacy of these beads has been demonstrated, highlighting their potential as a valuable local antibiotic therapy. In particular, the introduction of vancomycin - polymethylmethacrylate (PMMA) beads is highlighted as a promising new form of local antibiotic therapy. This article focuses on the use of antibiotic-impregnated beads to treat localized bacterial infections in the bones and joints of canines. Typically composed of poly(lactic-co-glycolic acid) (PLGA) or polymethylmethacrylate (PMMA), these beads contain antibiotics such as vancomycin, placed directly into the affected area, providing a high antibiotic concentration at the site of infection. These beads were developed for a slow antibiotic release over time; they ensure a constant protective effect against a broad spectrum of bacteria, demonstrating high efficacy and biocompatibility with the animal's body. This localized antibiotic treatment option offers several advantages over systemic antibiotics, such as reduced side effects and improved efficacy. It could be a promising option for the treatment of bone and joint infections in canines.
Copyright (c) 2024 Dr. Pramod Kumar Minocha, Deveshkumar Mahendralal Kothwala, Dikshita Yogendrashigh Lodha, Unnati Girish Patel , Mansi Samir Desai https://creativecommons.org/licenses/by/4.0
Recurrent Patella Dislocations: Our Experience on the Outcomes of Non-Operative Treatment and Operative Treatments with Screw Fixation of Vastus Medialis Obliquis Tendon
Introduction: Patellar dislocation is a common acute knee disorders occurring mostly in children and adolescents. The management option can be non-operative or operative with many surgical techniques available based on the patho-anatomy of the disorder. There is challenge in the management in patients with generalized ligament laxity and other anatomical abnormalities. The aim of the study is to report the outcome of 17 patients with recureent patella dislocation treated conservatively and surgically through the medial patella-femoral ligament (MPFL) repair and anchoring screw fixation to distal femur. Methodology: This is a retrospective study of 17 patients treated for recurrent lateral patella dislocations at Orthopaedic Hospital Wamakko, Sokoto, Nigeria between October 2016 and April 2022. Patients who met the inclusion criteria were fully evaluated and treated either conservatively or surgically. Results: The average follow up period was 2.2 years (range 2 to 3.2 years). The average presentation time was 6.5 Months (range 1 to 12 Months), and the average age at presentation was 24 years (range 16 to 34 years). There were 7 males and 10 females; the affected right knees were 7, and for the left knees were 8 with 2 bilateral knees affected. For the atraumatic patella dislocation group (n=10), the average Beighton score was 6 (range 2 to 9), and the Q angle, the trochlear morphology and the Caton-Deschamp’s index were all normal. Among the 17 patients in the study, 12 were treated conservatively, and 5 were treated operatively by plication of the medial patello-femoral ligament (MPFL) with subsequent screw fixation of the Vastus medialis obliquus (VMO) tendon to the distal femur. The average preoperative and postoperative Kujala scores were 68/100 and 94/100 points respectively, and that of Lysholm scores were 72/100 and 96/100 points respectively. Conclusion: Both conservative and surgical management for recurrent patella dislocation can offer satisfactory outcomes if patients were appropriately selected. In patients with generalised ligamentous laxity, MPFL plication repair with VMO screw anchorage to the femur can be a key to a successful and a desirable long-term treatment outcome.
Recurrent patella dislocation, medial patellofemoral ligament, Vastus medialis obliquus, screw fixation
Copyright (c) 2024 Altine Aliyu Nuradeen, Olalekan Akeem Anipole https://creativecommons.org/licenses/by/4.0