Articles

The role and limitations of minimally invasive pectus excavatum repair: A single center 20-year experience

Research Article   Open Access
Pectus Excavatum (PE) is the most common congenital deformity of the chest wall. Patients with severe deformities suffer from devastating physical, cardiac and psychological problems. Due to its heterogeneity, repair is generally not easy to perform, even with minimally invasive repair.

The future of minimally invasive aortiv valve replacement

Short Commentary   Open Access
Aortic valve disease represents the most prevalent valvular pathology in developed countries, with its incidence expected to rise substantially as populations age [1]. While conventional Aortic Valve Replacement (AVR) through full sternotomy has achieved remarkable outcomes, with contemporary perioperative mortality rates below 2% in low-risk patients [2].

Prophylactic ilioinguinal neurectomy in open inguinal hernia surgery

Short Commentary   Open Access
Chronic Postoperative Inguinal Pain (CPIP) represents one of the most debilitating complications following inguinal hernia repair, with a reported incidence in the literature ranging from 10% to 30%. While the introduction of prosthetic meshes has significantly reduced recurrence rates, neuropathic pain due to nerve entrapment or postsurgical fibrosis remains a persistent clinical challenge.

Robotic-assisted varicocelectomy: A comprehensive literature review of outcomes, challenges, and future directions

Review Article   Open Access
Varicocele is the dilatation of spermatic veins within the spermatic cord and is a common condition that arises during puberty. Varicoceles can lead to venous incompetence or absent valves, potentially causing further testicular enlargement. It is a common condition that can impact male infertility.

Preoperative prediction of lymph node metastasis in ovarian cancer: Development and validation of a nomogram incorporating CT imaging features and clinical risk factors

Research Article   Open Access
To develop and validate a preoperative nomogram that integrates CT imaging features and clinical indicators for predicting Lymph Node Metastasis (LNM) in ovarian cancer, thereby facilitating individualized risk assessment.

Compartment syndrome: A clinical review

Review Article   Open Access
Acute Compartment syndrome is a rare but potentially devastating condition that demands immediate intervention. Failure to diagnose and manage compartment syndrome promptly is associated with long term disability and litigation.

Giant pituitary metastasis from a duodenopancreatic neuroendocrine tumor: A case report and literature review

Case Report   Open Access
Pituitary metastases are rare and often mimic benign adenomas, leading to diagnostic delays. Even more uncommon are metastases from gastrointestinal or pancreatic Neuroendocrine Tumors (NETs), especially when presenting as a giant sellar mass, and present significant diagnostic challenges.

Analysis of the mechanism of tolvaptan in the treatment of autosomal dominant polycystic kidney disease based on network pharmacology

Research Article   Open Access
Basic information and targets of tolvaptan were retrieved from ChemicalBook and SwissTargetPrediction. ADPKD-related targets were screened via GeneCards and Comparative Toxicogenomics Database (CTD), with all databases updated through April 2024. Common targets were subjected to Gene Ontology

Clinical experience on laparoscopic resection with primary anastomosis without stoma in Hinchey III and IV acute left colon diverticulitis (ALCD)

Research Article   Open Access
Diverticular disease is the fifth most important gastrointestinal disease and is a major cause of hospitalizations. In urgency: Hartmann’s procedure or primary anastomosis? Report of a retrospective analysis of 129 cases.

Schroth’s progress in correcting adolescent

Review Article   Open Access
Scoliosis is a complex spinal disease characterized by an abnormal curvature. Adolescent Idiopathic Scoliosis (AIS) is a lateral C or S curvature that begins at the peak of adolescent growth [1]. The global prevalence of scoliosis is 0.47%-5.2%.

A novel approach for management of recurrent recto vaginal fistula – Bilateral internal pudendal artery perforator flap

Case Report   Open Access
Rectovaginal fistula is a rare problem predominantly caused by obstretic trauma. Rectovaginal fistulas are rare abnormal epithelial-lined connections between the rectum and vagina. It is reported to represent approximately 5% of all anorectal fistulas.

Effect of Admission Hyperglycemia on Short-Term Functional Outcome in Patients with Primary Brainstem Hemorrhage

Research Article   Open Access
We aimed to investigate the association between hyperglycemia on admission and short-term functional outcome in patients with primary brainstem hemorrhage. We conducted a retrospective analysis of 75 patients diagnosed with acute PBSH from January 2018 to December 2020 at our institution.

Surgical Approach to Bilateral Brachymetatarsia: A Clinical Case

Case Report   Open Access
Brachymetatarsia is a congenital anomaly characterized by the shortening of one or more metatarsal bones, which impacts both the functionality and appearance of the foot. This study describes a case of bilateral brachymetatarsia treated through an oblique osteotomy with an autologous calcaneal graft.

Causes and Preventive Strategies of Anal Stenosis after PPH

Review Article   Open Access
Hemorrhoids, including internal hemorrhoids, external hemorrhoids and mixed hemorrhoids, are one of the common perianal diseases in our country, and the formation mechanisms of internal and external hemorrhoids are different. As one of the surgical procedures for the treatment of internal hemorrhoidal prolapse.

What you need to know about Spontaneous Clostridium Septicum Gangrene

Short Commentary   Open Access
Clostridial myonecrosis is a rapidly progressing infection affecting subcutaneous and muscle tissues. While usually secondary to traumatic inoculation (accidental or surgical), these infections can, in rare cases, be spontaneous. Unlike Clostridium perfringens, responsible for 80% of traumatic gangrene cases.

Spray on Skin Therapy used for Bilateral Traumatic above Knee Amputations: A Case Report Demonstrating Efficacy in Traumatic Wounds

Case Report   Open Access
Traumatic amputations following subway accidents are a frequent occurrence in New York and impose a significant burden on both patients and society. Proximal and bilateral amputations often limit the availability of tissue for Split-Thickness Skin Grafts (STSG).

A Comprehensive Investigation on Partial Shunt Excision of Brachial Arteriovenous Fistula for Treating Steal Syndrome

Research Article   Open Access
A skilled surgeon and enough maturation time are needed to create long-lasting functional Arteriovenous Fistulas (AVFs), which are associated with the steal, among other serious complications in hemodialysis patients.

Risk Factors Associated with Post-Cholecystectomy Syndrome and Insights into Post-Surgical Follow-Up: Retrospective Cohort Study

Research Article   Open Access
Post Cholecystectomy Syndrome (PCS) refers to a persistence of heterogenous symptoms in patients who have undergone cholecystectomy. Although the term PCS remains in contention, we define it as a complex of ≥1 varied symptoms which include right upper quadrant pain, nausea/vomiting, diarrhea, or dyspepsia.

A Case of Duodenal-Type Follicular Lymphoma

Clinical Image   Open Access
A 47-year-old female patient underwent esophagogastroduodenoscopy because of intermittent abdominal pain for more than 10 years. The patient has a history of hepatitis B. No obvious abnormality was found in physical examination and laboratory examination.

Intravenous and Subcutaneous Administration of Neostigmine for Acute Colonic Pseudo-Obstruction: A Short Review

Review Article   Open Access
Acute Colonic Pseudo-Obstruction (ACPO), also known as Ogilvie's Syndrome, is a rare postsurgical complication characterized by acute dilation of the colon without anatomical obstruction. Neostigmine is increasingly used to manage ACPO when conservative measures fail.

Perceptions and Experiences of Commercial Virtual Reality Games in Early Postoperative Rehabilitation among Cardiac Surgical Patients: A Qualitative Study

Research Article   Open Access
Although numerous studies in China and abroad have focused on the outcomes of virtual reality games for early postoperative rehabilitation in cardiac surgical patients, research on these patients' perceptions and experiences with virtual reality games has been limited.

A Rare Case of Celiomesenteric Trunk and Concomitant Giant Type-2 Thoracoabdominal Aortic Aneurysm

Clinical Image   Open Access
An 73-year-old man was referred to our Emergency Vascular Surgery Department from another tertiary hospital without vascular service, due to acute abdominal pain and a known history of a type-2 thoracoabdominal aortic aneurysm diagnosed 3 years ago. He was hemodynamically stable at presentation.

An Analysis of Variations in the Arterial Vascular Pattern of the Right Middle Lobe using Three-Dimensional CT Angiography

Research Article   Open Access
With the early detection of lung malignant tumors in thoracic surgery, segmentectomy has become a new surgical method in thoracic surgery, which requires thoracic surgeons to have a clear understanding of the structure of the lung segment and blood supply to ensure the smooth operation of the operation.

Rare Case of Adenocarcinoma of the Bladder in Multiple Myeloma Patients

Short Report   Open Access
Adenocarcinoma of the bladder is a rare subtype of bladder cancer, accounting for approximately 2% of all bladder malignancies. This short report describes a unique presentation of bladder adenocarcinoma in a 72-year-old Multiple Myeloma male patient.

A Rare Presentation of Primary Thymic Small Cell Carcinoma Found after Trauma: A Case Report

Case Report   Open Access
Thymic small cell carcinoma is an exceedingly rare diagnosis with undefined treatment options and, typically, poor prognosis. A 69-year-old female presented to the Emergency Department with chest pain and was found on Computed Tomography (CT) to have a multilobulated cystic mass in the anterior mediastinum.

A Curious Case of Needle Embolism to the Heart in a Former Addict: Cardiac Tamponade Ten Years after the Last Use of Injective Drugs

Case Report   Open Access
Migration of a foreign body to the heart is a rare cause of chest pain in adult patients. Various clinical manifestations have been described in the literature, such as pericarditis and pleuritis, empyema and pneumothorax.

Dual Mobility Cup Fixation Augmented by Pegs and Screws for Total Hip Arthroplasty in a Geriatric Population with Osteoporosis: Short- and Medium-Term Results of a Retrospective Series of 45 Patients

Research Article   Open Access
Total Hip Arthroplasty (THA) requires stable primary fixation of the acetabular implant. The main objective of this study was to evaluate, in a geriatric population, the radiological results and the medium-term survival of a Dual Mobility Cup (DMC) with hydroxyapatite coating and tripod fixation augmented by 2 pegs and a screw.

Fournier`S Gangrene: The Importance of an Early Diagnosis

Research Article   Open Access
Fournier's Gangrene (FG) is a necrotizing fasciitis that affects the external genitalia, perineum and perianal region, with occasional extension to the abdomen, lower limbs and even to the chest. The objective is to perform a descriptive analysis of the etiology.

Advancements in the Treatment of Recurrent Metastatic Colorectal Cancer

Review Article   Open Access
Radical resection is the main approach for achieving a cure in patients with recurrent liver metastasis of colorectal cancer. However, due to the limited liver volume and the tolerance of late-stage tumor patients, it is not possible to perform repeated resections infinitely.

Early Gastric Cancer Widespread Invading the Duodenum: A Case Report

Case Report   Open Access
Gastric cancer has been observed to infrequently infiltrate the duodenum, with a prevalence of duodenal involvement ranging from 11.9%-23.8% [1] among patients with cancer in the gastric antrum. However, it is importantto note that the majority of these instances. ....

Peritoneal Mesothelioma: A Case Report and Review

Case Report   Open Access
Despite its low incidence, peritoneal mesothelioma manifests with nonspecific symptoms, often leading to delayed diagnosis. Diagnosis relies on imaging techniques, histopathological evaluation, and immunohistochemistry. ....

Relationship Between Farnesoid X Receptor and Macrophage Polarization Status in Colorectal Cancer

Research Article   Open Access
Most colorectal cancer patients are insensitive to immunotherapy, which is associated with the polarization state of macrophages in the immune microenvironment. Research indicates that the farnesoid X receptor can modulate the immune microenvironment of colorectal cancer. ....

Pancreas Transplantation for the Treatment of Pancreatic Exocrine Disorders

Review Article   Open Access
Pancreas transplantation is mostly performed to cure diabetes mellitus. However, patients with chronic pancreatitis, cystic fibrosis, benign pancreatic tumors or patients with other exocrine disorders of the pancreas can also be candidates. ....

Liraglutide (Saxenda) Combined with Lifestyle Coaching for Weight Loss in a Bariatric Center

Research Article   Open Access
Overweight and obesity should be viewed as chronic diseases, for which liraglutide (Saxenda) might be a treatment option. The aim of the current study is to describe a real-world experience with the use of liraglutide combined with lifestyle coaching in a bariatric center....

Relationship between Somatic Mutations and Clinic Pathological of Follicular Variant Papillary Thyroid Carcinoma: A Meta-Analysis

Research Article   Open Access
The incidence of somatic mutations and clinicopathological features in Follicular Variant Papillary Thyroid Carcinoma (FVPTC) demonstrate inconsistent findings. A total of 104 publications from PubMed/MEDLINE, Embase and The Cancer Genome Atlas (TCGA) were included in this meta-analysis. ...

Breast-Conserving Therapy and Irradiation in Women with Prior Breast Augmentation

Research Article   Open Access
The incidence of breast-augmented women developing breast cancer is increasing and there is some disagreement regarding the optimal cancer treatment, in the setting of prior breast augmentation. ...

Transcanal Endoscopic Management of Attic Cholesteatoma: Surgical Steps from a Case Report

Case Report   Open Access
This case report describes the case of a patient affected by an attic cholesteatoma treated by a totally transcanal endoscopic approach. Each surgical step of this minimally invasive technique is explained. The functional and anatomical results during follow-up are described. ...

Bacterial Meningitis Caused by Streptococcus Suis, Complicated by Secondary Ventriculoperitoneal Shunt-Associated Peritonitis: A Rare Clinical Case Presentation

Case Report   Open Access
The main method of treating hydrocephalus is through liquor shunt surgery, with preference given to Ventriculoperitoneal Shunts (VPS). However, as the number of implanted bypass systems in the abdominal cavity increases, so does the number of complications, both intraventricular and abdominal. ...

The Clinical Significance of Flat Epithelial Atypia on Core Biopsy: A Single Institution Experience

Short Commentary   Open Access
The clinical significance and management (surgical excision vs. follow-up) of the patients with the diagnosis of Flat Epithelial Atypia (FEA) on Core Needle Biopsy (CNB) varies between institutions, largely due to uncertainty of its biologic potential and its association with more advanced lesions. ...

Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis After Endoscopic Removal of Common Bile Duct Stones: An Update in Chinese Patients with Choledocholithiasis

Research Article   Open Access
Endoscopic Retrograde Cholangiopancreatography (ERCP) has been widely used in endoscopic surgery for many biliary and pancreatic diseases. Post-ERCP Pancreatitis (PEP) is the most common complication that occurs, even with expert surgeons. However, few reports have addressed the risk of PEP by focusing on the removal of Common Bile Duct Stones (CBDS). ...

Bibliometric Analysis of the Relationship Between Breast Cancer and Exercise Based on Citespace

Research Article   Open Access
This study aims to conduct a bibliometric analysis of the literature on the relationship between breast cancer and exercise using Citespace software, in order to explore the research hotspots, trends, and deficiencies in this field. Relevant literature including keywords such as "breast cancer" and "exercise" was retrieved from the Web of Science database and analyzed using Citespace software for data processing and visualization. ....

Qualitative Systematic Review on the Bio-Psycho-Socioeconomic Impact of Hidradenitis Suppurativa/Acne Inversa

Research Article   Open Access
Hidradenitis Suppurativa or Acne Inversa (HS) is a chronic, inflammatory, recurrent integumentary disease, with periods of exacerbation, related to metabolic comorbidities, affecting the well-being, quality of life and mental health of patients, in addition to negatively influencing oral health and women's health levels as well. ....

Pilot Study: Prophylatic Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Colorectal Cancers at High Risk of Developing Peritoneal Metastases in a Tertiary Asian Centre

Research Article   Open Access
The second most common site of Colorectal Cancer (CRC) recurrence is the peritoneum. The primary aim of this study was to assess feasibility of prophylactic Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Asian patients, and to determine the associated morbidity and time to start of adjuvant chemotherapy. ....

Intermediate-Term Follow-Up of Biopro® Modular Thumb Implant for Carpometacarpal Arthritis

Research Article   Open Access
Basilar thumb arthritis is a common condition that can be associated with significant disability. While surgical management has historically consisted of trapeziectomy-type procedures, hemiarthroplasty has become an increasingly common alternative. While outcomes have been promising, they vary according to the implant used. We sought to evaluate the performance of the BioPro® Modular Thumb implant. ....

Hemodynamic Changes in Elective Cesarean Section, Under Spinal Anesthesia: A Prospective Randomized Controlled Double-Blind Comparison Study with Preoperative Ondansetron Administration

Short Commentary   Open Access
The most widely used anesthesia technique for cesarean delivery is the spinal anesthesia (SA). In Bnai-Zion Medical Center over than 90% of the elective cesarean sections performed under SA. However, this type of anesthesia frequently associated with side effects that primarily affect the parturient and the fetal health [1]. ....

Impact of Protective Mask Position on Inspired Gas Concentration During Oxygen Supplementation: A Study in Healthy Volunteers

Research Article   Open Access
Patients with respiratory diseases are often required to wear protective masks to minimize the risk of spreading infections. However, when these patients necessitate oxygen enrichment, the impact of wearing both a protective mask and an oxygen mask on the concentration of inhaled oxygen and carbon dioxide remains unclear. ....

Impact of Peri-Operative Blood Transfusion on Post-Operative Complications in Colorectal Surgery

Research Article   Open Access
Colorectal cancer (CRC) is commonly associated with anaemia often requiring perioperative blood transfusions (BT). There is significant evidence to show poor long term outcomes following BT in CRC surgery due to the immunomodulatory effects of BT. This study aims to analyse the impact of BT on post-operative surgical complications in CRC surgery. ....

Flexor Pollicis Longus Rupture After Scaphoid Fracture Repair: A Case Report

Case Report   Open Access
Flexor Pollicis Longus (FPL) tendon attritional rupture is a rare diagnosis. Reported causes include distal radius plates, SNAC wrist, steroid injection and CMC1 arthrodesis hardware. We describe an FPL rupture 1 year after scaphoid waist fracture fixation. ....

Custodiol Histidine-Tryptophan-ketoglutarate Versus Blood Cardioplegia in Totally Thoracoscopic Cardiac Surgery

Research Article   Open Access
The present study aimed to evaluate and compare the myocardial protection performance between Custodial histidine-tryptophan-ketoglutarate cardioplegic solution and blood cardioplegic solution in the context of totally thoracoscopic cardiac surgery. ....

Case Report and Review of the Literature: Human Amniotic Membrane in the Management of Burn Wounds

Case Report   Open Access
High-voltage electrical burns often have a deeper extent and cause more damage to surrounding soft tissue than injuries caused by fire burns or scalds. For the treatment of burn injuries there are dressings, dermal analogues, temporary skin substitutes; which favor the re-epithelialization of the wound bed, accelerating the healing process and some of them having specific properties. ....

Cost-Minimization Analysis of Robotic Versus Laparoscopic-Assisted Liver Cancer Resection

Short Commentary   Open Access
In the treatment of patients with liver cancer, laparoscopic liver cancer resection is the earliest and most widely used minimally invasive surgery. Robotic surgery technology helps surgeons overcome the shortcomings of traditional laparoscopic surgery by providing surgeons with high-resolution 3D images, wrist instruments that provide degrees of freedom, and tremor filtering technology. ....

Amyand's Hernia in an Infant: A Case Report and Review of Literature

Case Report   Open Access
Inguinal hernia is a common surgical disease among a pediatric population with patent processus vaginalis being the major risk factor. Omentum and small intestine loops are the often-encountered hernia sac contents, however in a rare instance (1% of cases), a vermiform appendix is found in the sac, and it is referred as Amyand's hernia (AH). The appendix can be normal, inflamed, strangulated, or perforated. ....

Peripheral Monocyte Count as an Independent Prognostic Factor for Patients with Locally Advanced Esophageal Squamous Cell Carcinoma

Research Article   Open Access
There is no accurate clinicopathological risk model for localized advanced esophageal squamous cell carcinoma (LA-ESCC) that can be used to guide treatment by predicting prognosis. This study aimed to investigate the use of the novel biomarker peripheral absolute monocyte count (AMC) as independent prognostic factor for LA-ESCC with esophagectomy. ....

Laparoscopic Hartmann Reversal: A Single Center Five-Years' Experience

Research Article   Open Access
Since 1921, when the french surgeon Henry Albert Hartmann described the technique of recto-sigmoidal resection with end left colostomy and closure of the rectal stump, such operation begun to be used to treat or palliate patients with rectosigmoid pathologies such as rectosigmoid cancer, perforated diverticulitis and more. ....

Heart Transplantation in a Patient with Propionic Acidemia

Case Report   Open Access
Propionic acidemia is a rare autosomal recessive error of metabolism that may be associated with dilated cardiomyopathy and heart failure. We present the case of an 18-year-old male patient with severe heart failure secondary to dilated cardiomyopathy related to propionic acidemia, who underwent a successful heart transplant and 5 months after the procedure progressed satisfactorily, without evidence of rejection, in functional class I and with adequate medical control of propionic acidemia. ....

Laparoscopic Approach in the Surgical Management of McKittrick–Wheelock Syndrome

Case Report   Open Access
Mckittrick-Wheelock syndrome is a pathological entity that is represented by the presence of a large rectal tumour with histopathological findings of tubular-villous adenoma that associates important secretion of electrolyte-rich mucin. ....

Primary Extra Gastrointestinal Stromal Tumors of Vagina: A Rare Case Report without Gastroenterology Manifestations

Case Report   Open Access
Primary extragastrointestinal stromal tumors (EGISTs) of vagina without invading gastrointestinal tracts are rare. Here, we reported the case of a 72-year-old female who presented with vaginal bleeding for 2 weeks and a vaginal mass. MRI showed a 3.05 x 2.87 x 3.86 cm mass on the posterior wall of the vagina. ....

Subarachnoid Hemorrhage Following Drainage of Chronic Subdural Hematoma: A Case Report

Case Report   Open Access
Acute subarachnoid hemorrhage (SAH) is a rare but severe complication after burr hole surgery for Subarachnoid hemorrhage (CSDH). An 86-year-old male was found fainted. Computed tomography (CT) scans showed a right fronto-temporo-parietal CSDH with a shift in the midline structures. Under local anesthetic with medical sedation a closed-system drainage of the hematoma was performed via one burr hole. ....

Ultrasound-Guided Vacuum-Assisted Breast Complete Duct Excision: A Novel Minimally Invasive Surgical Technique for Pathological Nipple Discharge

Research Article   Open Access
Pathological nipple discharge (PND) is a common challenge in breast surgery, requiring surgical management. However, the noticeable scars after traditional surgical approaches become a nightmare for patients. Ultrasound-guided vacuum-assisted breast minimally invasive complete duct excision is a novel exploration attempt. ....

Nasopharyngeal Occupation as a Symptom of Fungal Otitis Media: A Case Report

Case Report   Open Access
The symptoms of fungal otitis media are ear discharge,pain, itching, blocking and decreased hearing. There have been no reported cases of nasopharyngeal occupation as a symptom of fungal otitis media. A 87 year-old male presented with progressive left head ache without blood in the snot, blurred vision, nausea, vomiting, neck mass, limb numbness, and movement disorders. ....

Postoperative Nutritional Strategies for Lung Cancer Patients: Enhancing Recovery and Well-Being

Review Article   Open Access
Lung cancer is a common and serious malignancy, and dietary management plays a pivotal role in the postoperative recovery process for lung cancer patients. This study explores the nutritional requirements, dietary challenges, and dietary strategies for postoperative lung cancer patients. ....

Application of a New Urine Collection Device and Stirring System in the Collection of 24h Urine Specimens from Patients

Research Article   Open Access
To use a new type of urine collection device and stirring system to retain 24h urine specimens from patients, and to explore the effect of its application in the process of clinical 24h urine specimen retention. ....

Sclerosing Angiomatoid Nodular Transformation Disguised as Splenic Metastasis: A Case Report

Case Report   Open Access
SANT (Sclerosing Angiomatoid Nodular Transformation) is a relatively rare, benign vascular lesion of the spleen, usually found incidentally during un-intended medical procedure. Most of patients with SANT have no clinical symptoms and difficult to make differential diagnosis with any imaging modalities. Definite diagnosis needs to be confirmed pathologically, post-operatively. ....

Giant Aneurysmal Bone Cyst of the Femoral Head: A Case Report and Literature Review

Case Report   Open Access
Aneurysmal bone cyst (ABC) is often regarded as a benign tumor of bone with local destruction of the bone. Its cause is unknown, but the large aneurysmal bone and cyst of the femoral head are rarely seen, thus being one of the most effective methods to treat this aneurysmal cyst. ....

Intraoperative Protection by Position Limiting Device in General and Orthopedic Surgery Application

Short Communication   Open Access
Intraoperative protection using a surgical position limiting device is becoming increasingly significant in both general and orthopedic surgeries. The utility model provides a surgical position limiting device comprising a restraint belt, wherein the restraint belt is connected with an elbow pocket....

Shoulder Coccidioidomycosis Masquerading as Synovial Chondromatosis

Case Report   Open Access
Coccidioidomycosis is an endemic fungal infection in arid areas of Southwestern US and Northern Mexico. It is difficult to diagnose and treat, may take years to make the correct diagnosis, may leave sequelae and could even be fatal. It may mimic other infectious or neoplastic pathology and can be frequently misdiagnosed. The patient in our case report was misdiagnosed and treated for 17 years as synovial chondromatosis. Coccidioidomycosis requires a high index of suspicion to make the correct diagnosis and addition of cultures of biopsy specimens in case of unusual pathology may help make the correct diagnosis. ...

The Utility of Diffusion Weighted MRI Imaging in the Diagnosis of Infectious Sacroiliitis

Case Report   Open Access
MRI imaging plays an important role in musculoskeletal infections to allow prompt diagnosis and early treatment. Diffusion Weighted Imaging (DWI) is an additional pulse sequence that can be obtained in cases where infection is suspected to enhance the diagnostic ability of an MRI. DWI sequences are not routinely obtained during standard imaging and there is a paucity of literature discussing their role in Musculoskeletal infection. We present a case report which illustrates the benefit of DWI imaging in diagnosing a challenging case of de novoseptic sacroiliitis. ...

Heart Rupture Associated with Vertebral Fractures: An Unusual Blunt Trauma Presentation

Case Report   Open Access
Blunt trauma of the chest consequent to car accidents can rapidly cause lethal multiple organ injuries. The rupture of a cardiac chamber, most likely an atrium, following blunt chest trauma leads to immediate death in 80-90% of the patients [1]. 3.2% of the blunt chest traumas present one or more vertebral fractures [2]. ...

Excellent Outcome Following Very Severe Traumatic Brain Injury with Bilateral Acute Traumatic Intracranial Hematomas: A Case Report

Case Report   Open Access
Traumatic Brain Injury (TBI) is a significant global burden in terms of mortality and disability. The Glasgow Coma Scale (GCS) is used to determine the severity of TBI, categorizing cases as mild (GCS 13-15), moderate (GCS 8-12), or severe (GCS 3-7). Good recovery from very severe TBI (GCS 3-5) is exceedingly rare. Here, we present a case exhibiting an excellent outcome following a very severe TBI. ...

Experience of Diagnosis and Treatment of 16 Cases of Placenta Accreta Spectrum at Different Degrees: A Case Report

Case Series   Open Access
In oder to explore the risk factors, diagnosis, management, outcome of placenta accreta spectrum disorders at varying degrees. 16 cases of placenta accreta admitted to Suzhou Ninth People's Hospital affiliated to Soochow University from January 2021 to June 2022 were retrospectively analyzed, and the general information, pathogenesis and treatment process of the patients were summarized. ...

Efficacy of Electro acupuncture for Intestinal Paralysis after Laparoscopic Cholecystectomy: A Case Report and Literature Review

Case Report   Open Access
Postoperative Intestinal Palsy (POI) is a common complication after surgery and is a major cause of high morbidity, prolonged hospital stay, increased resource utilization, and high economic burden. We report a case of a 60-year-old male patient with a 10-year history of gallbladder stones who underwent laparoscopic cholecystectomy and presented with postoperative incisional pain, abdominal distention, and failure to defecate. ...

Combining SIRI and AFR to Predict Early Serious Complications and Recurrent or Metastases after Respectable Gastric Cancer

Research Article   Open Access
The aim of this study was to assess the clinical importance and prognostic significance of Systemic Inflammatory Response Index (SIRI) and the Albumin Fibrinogen Ratio (AFR) on early postoperative outcomes in patients undergoing radical gastric cancer surgery. ...

Prognostic Significance of SPATS2L Methylation and mRNA Expression in Lung Adenocarcinoma

Research Article   Open Access
Spermatogenesis-associated serine-rich 2-like gene (SPATS2L) is ubiquitously expressed in multiple tissues and involved in many diseases, while its role in Lung Adenocarcinoma (LUAD) remains elusive. The current study aimed to excavate the prognostic significance of SPATS2L methylation and mRNA expression for patients with LUAD. ...

The Effect of Selective Dorsal Rhizotomy on Gait Outcomes for Children with Cerebral Palsy

Case Series   Open Access
Management of spasticity is often challenging in children with Cerebral Palsy (CP), however Selective Dorsal Rhizotomy (SDR) shows promising results in reducing spasticity. There is no consensus regarding patient selection for SDR and there are few studies investigating gait outcomes. ...

Constrictive Pericarditis induced by Human Herpes Virus Infection: A Case Report

Case Report   Open Access
Constrictive pericarditis represents a severe diastolic heart failure secondary to an inelastic and poorly compliant pericardium mediated by inflammation and fibrosis. It shows relative regional and temporal differences with respect to the etiologies. Regardless, a significant proportion of patients remain idiopathic on account of the limitation of testing and imaging in practice. ...

Predicting Lymph Node Metastasis of Ovarian Cancer by MSCT Radiomics

Research Article   Open Access
Purpose: To explore the value of radiomics preoperative enhanced Multislice Computed Tomography (MSCT) imaging in predicting Lymph Node Metastasis (LNM) of epithelial Ovarian Cancer (OC). Patients with epithelial OC confirmed by operation and pathology were retrospectively analyzed. Each patient underwent MSCT enhanced scan 2 weeks before operation, and the Region Of Interest (ROI) was obtained by manually segmenting CT enhanced scan venous phase images on Huiyihuiying scientific research platform. ...

Pretibial Haematoma in the Elderly: A Review of Management and Mortality

Review Article   Open Access
Background: Pretibial injuries are common, with an estimated 0.4-0.7 per 1000 of the population affected per year, more commonly affecting elderly women. Pretibial haematomas complicate 42% of pretibial injuries admitted for hospital treatment. In District General Hospitals (DGH), they may ...

Cauda Equina Syndrome due to Spinal Dural Arteriovenous Fistula

Case Report   Open Access
A 80 year old man with a prior history of benign prostatic hyperplasia was referred to neuromuscular clinic for evaluation of 6 months of progressive sensory neuropathy. He developed numbness in his left leg which one week later progressed to involve his right leg and subsequently ascended over a month to the level of his groin. ...

Eye Injuries Requiring Surgery in the Bahamas

Research Article   Open Access
Objective: The purpose of this study is to describe the age and sex profile of the study participants, the identification of the clinical procedures concerning eye injuries that presented to the emergency department, and to identify those injuries that resulted in surgical management at the Princess Margaret Hospital (PMH) Ophthalmology Unit in The Bahamas. Furthermore, to describe the range of surgical procedures performed for ocular injuries among the study participants. ...

Changes in the Epidemiological Profile of Patients with Cervical Cancer in a Reference Hospital between 2010 and 2019

Research Article   Open Access
Introduction: Cervical cancer is one of the most frequent tumors in the female population, with an estimate that it is the fourth most prevalent type worldwide. The study of cervical cancer is of great importance, as it is a very prevalent cancer, with an efficient screening strategy and a high rate of cure and response to treatment, if detected in the early stages. ...

General Anesthesia for Cesarean Section: Indications and Materno-Fetal Outcomes

Research Article   Open Access
Introduction: General Anesthesia (GA) during Cesarean Sections (CS) is uncommon. The objective of the study is to evaluate the maternal-fetal outcome aiming to improve the care of the mother and the newborn. ...

Necrotizing Fasciitis of Breast: A Rare but Fatal Entity

Case Report   Open Access
Necrotising fasciitis is a rapidly developing, fatal bacterial infection of deep subcutaneous tissues. It may occur at any site in the body; breast being a rare site. We describe a case of necrotizing fasciitis in the breast that was diagnosed on the basis of ultrasound and CT scan findings....

The Safety and Efficacy of Endoscopic Lacrimal Duct Probing in Neonates with Acute Dacryocystitis

Research Article   Open Access
Objective: To observe the safety and efficacy of endoscopic-assisted lacrimal duct probing in neonates with acute dacryocystitis. Methods: The prospective treatment of 148 eyes of 103 cases of neonatal acute dacryocystitis was studied. In the observation group, 58 cases (76 eyes) underwent endoscopic exploration of lacrimal passage under topical anesthesia ...

Amyand's Hernia with Perforated Appendicitis Presenting as Strangulated Hernia: A Rare Case Report

Case Report   Open Access
An inguinal hernia is one of the most common surgical conditions accounting for both elective and emergency cases. Amyand's hernia is a rare entity and is often an incidental intraoperative finding but may present as strangulation or appendicitis in the hernia sac ...

Complete Rupture of the Insertional Tendon of Biceps Brachii: What we Know

Review Article   Open Access
Purpose and objective: Ruptures of the distal biceps tendon present surgeons with a complex set of potential management options, and significant variation in practice exists. This review aims to succinctly collate the current evidence with regards to epidemiology, diagnosis, and management, in order to allow clinicians to inform themselves as to how best to deal with this increasingly frequently encountered phenomenon. ...

UCP2 45bp Ins/Del Gene Polymorphism in Association with Overweight and Obesity: A Meta-Analysis

Research Article   Open Access
Uncoupling Protein (UCP) is a mitochondrial inner-membrane protein that is involved in energy homeostasis. In human tissues, UCP2 is widely expressed, acts as an uncoupling agent for oxidative phosphorylation, and is involved in the regulation of metabolism and ATP production. ...

Influence of Shoulder Hemiarthroplasty Protocol on the Nature of the Glenoid Tissues at the Hemi-Implant Interface: A Three Cases Study

Case Series   Open Access
The interactions between a hemi-implant head and the native glenoid cavity are determinant in the efficiency and longevity of the medical strategy. The glenoid tissues harvested from three clinical cases who underwent different types of shoulder hemi-arthroplasty were investigated. ...

Operating Room Assessment in Endoscopic Skull Base Surgery

Short Commentary   Open Access
Since the introduction of endoscopic endonasal surgery for skull base pathologies in the 1990s [1], increasing experience with this technique has led to many progressive changes in patient positioning, technique, and assessment in the operating room. In addition, new surgical instruments have been developed for endoscopic endonasal skull base surgery. We present our experience and assessment of the operating room. ...

Neonatal Abdominal Surgical Emergencies: Therapeutic and Evolutionary Aspects in the Pediatric Surgery Department of the Hospital in Mali

Research Article   Open Access
Neonatal abdominal surgical emergencies include acquired or congenital conditions of the digestive tract of the newborn, which manifest themselves from birth to the end of the first month of life (0 to 28 days). We carried out a retro-prospective and descriptive study over three (3) years, from June 1, 2018 to May 31, 2021, the main purpose of which is to study the therapeutic and evolutionary aspects of neonatal abdominal surgical emergencies in the pediatric surgery department of the Mali Hospital. ...

Abdominal Trauma in Children in the Pediatric Surgery Department of the Hospital in Mali

Research Article   Open Access
Abdominal trauma is a shock of any type exerted on the stomach. Traumatic lesions of the abdomen are very frequent and very varied. It can be closed or open. According to the world report on the prevention of injuries in children established in 2004, the sex ratio is between 3/1 and 5/1 in favor of boys. ...

Brain Metastasis in HER2-Positive Breast Cancer: Case Report and Review of Literature

Case Report   Open Access
Introduction: Breast cancer (BC) is one of the most common cancers in women in developed countries. Approximately 15 to 20% of patients with BC have tumors with elevated levels of Human Epidermal Growth Factor Receptor 2 (HER2), which are associated with an aggressive clinical phenotype and poor prognosis. ...

Anatomical Classification of Caterpillar Hump of RHA and its Surgical Importance (Nagpur Classification)

Research Article   Open Access
Background: Ligation of cystic artery is important surgical step involving gallbladder and hepatobiliary surgery. Right hepatic artery may come very close to gallbladder & cystic duct and CHD in the form of "Caterpillar hump or Moynihan hump''. Such hump has variations in position and depending on hump type, cystic artery anatomy is defined. ...

Where No Surgeon Has Gone Before

Short Commentary   Open Access
Long-duration manned space missions beyond Low Earth Orbit, such as the new programs for the International Space Station around the Moon and the future Mars exploration missions, present a unique set of challenges to the health and well-being of crew members. Due to the inherent risks and the remote nature of these missions, we appreciate it is crucial to have at least one dedicated medical professional, specifically a surgeon astronaut, as part of the crew. ...

High Expression of ZNF692 Impairs Overall Survival in Patients with Colorectal Cancer

Research Article   Open Access
Background: Zinc Finger Protein 692 (ZNF692) promotes tumor progression as a potential oncogene, but its role in Colorectal Cancer (CRC) is not fully understood. We therefore carried out the present study to explore the correlation between ZNF692 expression and the progression of CRC. ...

Bioprospective Role of Ocimum Sanctum & Solanum Xanthocarpum against Emerging Pathogen: Mycobacterium Avium Subspecies Paratuberculosis

Review Article   Open Access
Mycobacterium avium subspecies Paratuberculosis (MAP) chronic, contagious and typically life-threatening enteric disease of ruminants caused by a bacterium of the genus Mycobacterium but can also affect non-ruminant animals. MAP transmission occurs through the fecal-oral pathway in neonates and young animals. ...

Giant Bladder Calcium Lithiasis: A Rare Clinical Presentation

Case Series   Open Access
The incidence of uro lithiasis is increasing with higher proportion of calcium lithiasis. While the large majority of lithiasis are formed in the kidney before migrating in the urinary tract, certain lithiasis are formed in the bladder owing to local factors. We report 2 cases of giant bladder lithiasis in patients presenting lower urinary track obstruction. A review of the literature was performed to discuss these clinical presentations. ...

Impact of Pathological Excision Margin Status on Survival of Sri Lankan Patients with Oral Squamous Cell Carcinoma

Research Article   Open Access
Introduction: In Sri Lanka, chewing betel quid significantly contributes to the aetiology of oral squamous cell carcinoma (OSCC). Due to quid induced changes in the stroma, the behaviour of OSCC is unique. We analyzed the impact of pathological excision margins (PEM) on survival of these patients. ...

Enhanced Cardiac Reverse Remodeling after Pulmonary Artery Denervation Combined with Mitral and Maze Surgery

Research Article   Open Access
Increased pressure in the pulmonary circulation in patients with damage to the valvular apparatus of the heart reduces the effectiveness of surgical intervention, reduces the topic of postoperative reverse remodeling of the cardiac cavities, and also increases the risk of recurrence of AF after radiofrequency atrial ablation according to the Maze IV scheme ...

Exploring the Mechanism of "Fangyifang" in the Prevention of COVID-19 based on Network Pharmacology and Molecular Docking

Research Article   Open Access
The novel coronavirus pneumonia (COVID-19) outbreak at the end of 2019 has continuously raged all around the world. Existing research has suggested that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) comprises single stranded positive strand RNA 1, which is easy to invade the respiratory and digestive systems of the body, thus causing several disease symptoms.

A Rare Adenocarcinoma of Ectopic Pancreatic from Duodenum: A Case Report

Case Report   Open Access
Ectopic pancreas is a rare disease in which pancreatic tissue appears outside the pancreas. Malignant transformation of ectopic pancreatic tissue is uncommon. We present a case of ectopic pancreatic malignant transformation from the first part of the duodenum. A 68-year-old male was referred to our hospital with recurrent upper abdominal pain for 3 months.

Clinical and Radiographic Results of a Dual-Component Intramedullary Implant for Hammer Toe Deformity in Patients with Rheumatoid Arthritis

Research Article   Open Access
Clinical and radiographic results of proximal interphalangeal (PIP) joint arthrodesis using a dual-component intramedullary implant for rheumatoid arthritis (RA) forefoot deformities have not been reported. Thus, the outcomes of this implant were investigated

Technical Features of the Experimental Target Device for Denervation of the Pulmonary Arteries

Research Article   Open Access
Creation of a device that allows additionally performing a procedure to correct high pulmonary hypertension during heart valve replacement surgery. In laboratory conditions, a number of parameters of the pulmonary vessels were measured - the wall thickness in various areas, the diameter of the pulmonary trunk in the initial state (without squeezing it) and the transverse size of the pulmonary trunk when squeezing until its inner walls were completely closed.

Analysis of Reasons for Medical Malpractice Litigation due to Epidural Steroid Injection

Research Article   Open Access
Administration of Epidural Steroid Injection (ESI) increased approximately 99% from 2000 to 2014. Analysis of reasons for malpractice claims due to ESI may provide insight into methods to improve patient care. This study analyzed malpractice claims due to ESI using two well-established legal databases. We queried Westlaw and VerdictSearch databases between 2000 and 2021. Utilizing the terms "epidural injection" and "spine," our queries yielded 4,567 results on WestLaw and 2,926 results on VerdictSearch.

Delayed Wound Healing in Aged Mice is Associated with Traumatic Stress, not with EGFR Block

Research Article   Open Access
Studies evidenced no wound healing risks related with EGFR blockade but it is unknown whether anti-epidermal growth factor receptor therapy poses an additional risk for the wound healing process in aged patients. The objective was to evaluate the effect of EGF block in the wound healing of aged mice. Studies evidenced no wound healing risks related with EGFR blockade but it is unknown whether anti-epidermal growth factor receptor therapy poses an additional risk for the wound healing process in aged patients. The objective was to evaluate the effect of EGF block in the wound healing of aged mice.

Hemorrhagic Stroke: Why can a Low-Intensity Stroke Lead to Extensive Cerebral Hemorrhage?

Short Commentary   Open Access
Currently, there is no definitive opinion on the advantage of surgical treatment of hemorrhages over their medical treatment. However, there is an experimental and theoretical justification for early surgical intervention. The question is discussed: why low-intensity hemorrhagic stroke (micro stroke) can lead to extensive cerebral hemorrhage. The data obtained by the authors of the article are presented that blood serum albumin under conditions of excess glutamate (Glu) and activation of Nitric Oxide (NO) synthesis can lead to further death of nerve cells by the mechanism of necrosis.

Surgical Management of Spontaneous Hepatic Rupture Associated with HELLP Syndrome: Case Presentation and Literature Review

Case Report   Open Access
HELLP syndrome is a serious complication in pregnancy characterized by hemolysis, elevated liver enzymes and low platelet count occurring in 0.2 to 0.6% of all pregnancies and in 10–20% of cases with severe preeclampsia. Spontaneous hepatic capsular rupture is a rare (0,015% of all pregnancies), but a life-threatening complication of HELLP syndrome with a mortality rate of up 50% for both mother and infant. We present the case of a 34-year-old nulliparous woman with a second trimester gestational hepatic rupture associated with HELLP syndrome.

Perception of People towards Cleft Lip and Palate: A Cross-Sectional Study

Research Article   Open Access
In this study, we assess the knowledge, awareness, and practices of the general population regarding Cleft lip and palate. In this descriptive cross-sectional survey-based study, we recruited 505 individuals from August 2020 to August 2021 visiting Fatima Memorial Hospital, Pakistan. A pre-validated questionnaire was used containing 36 questions to assess knowledge, awareness, and practices regarding cleft lip and palate, along with demographic data.

Five-Year Survival of the Delta One TT and Revision TT Systems after Primary Complex and Acetabular Revision Surgery

Research Article   Open Access
Use of Trabecular Titanium™ cups in total hip arthroplasty is expected to reduce the incidence of loosening of the acetabular component of the prosthesis. We reviewed clinical outcomes of the Delta One TT and Delta Revision TT acetabular systems during five-year follow-up after primary complex or acetabular revision surgery. Retrospective cohort study included 72 consecutive patients that received a Delta one TT implant in acetabular (revision) surgery between April 2011 and December 2014.

Influence of Patella Height on Knee Joint Function after Total Knee Arthroplasty: A Retrospective Study

Research Article   Open Access
The aim of this study was to explore the correlation between the change of patella height and postoperative functional outcomes, range of motion, and patellar crepitus after total knee arthroplasty. Analysis of an observational, retrospective case series was conducted on 116 patients suffering total knee arthroplasty in the Department of Orthopedics from August 2020 to September 2022.

The Obesity Paradox in Emergency Abdominal Surgery: A Pilot Study

Research Article   Open Access
Emergency surgery is associated with high mortality and morbidity and identifying the patients at highest risk of death represents a major challenge for intensivists. Obesity is a common comorbidity with increasing prevalence in the last 20 years. While conflicting results were reported on the association between obesity and mortality in elective surgery, very few data are available on this relationship in emergency surgery.

Drug Overdose Mortality and Morbidity - A Spatial Analysis

Research Article   Open Access
Drug overdose (OD), defined as "when someone collapses, has blue skin, has convulsions, has difficulty breathing, loses consciousness, cannot be woken up, has a heart attach or dies while using drugs" (Bohnert, Tracy, & Galea, 2012), is being considered as an important public health issue. According the statistics from the CDC [2] more than 70,000 people died of drug OD in the US between 1999 and 2017.

Vaginal Hysterectomies: 5 Years of Experience in the Department of Gynecology-Obstetrics II, HASSAN II University Hospital of Fez

Research Article   Open Access
We made this study to describe through our experience the epidemiological profil, of patients who underwent vaginal hysterectomy and to describe the indications and the complication of such surgery in our department. This is a retrospective study of 60 cases of vaginal hysterectomies collected in the gynecology-obstetrics II department of the Hassan II University Hospital in Fez, during the period from 01/01/16 to 31/12/21.

Epidemiological Evaluation of Running: Clinical Parameters and Main Pathologies of the Lower Limbs in Amateur Runners

Research Article   Open Access
To analyze the epidemiological profile of lower limb pathologies in road runners assessed in a Brazilian private orthopedics and physical therapy service. Retrospective analysis of 197 medical records of runners undergoing a running assessment in an Orthopedics and Physical Therapy clinic in Campinas, state of São Paulo, Brazil, in 2017 and 2018. Of the total number of runners evaluated, 59.9% were male, mean age 38.1 years and the majority (88.3%) ran weekly between 1 and 35 km

Development and Evaluation of Virtual Teaching of Surgical Skills: A Feasibility Study

Research Article   Open Access
The COVID-19 pandemic has created unprecedented challenges to health service delivery around the world, with an adverse impact on doctors-in-training. However, creating an opportunity to utilise and apply digital tools to replace most, if not all, face-to-face teaching. The aim of this study was to ascertain the feasibility and effectiveness of virtual training of basic surgical skills using the Kirkpatrick model of curriculum evaluation.

Direct Anterior Approach Total Hip Arthroplasty for Managing Complicated DDH: Not Just Minimally Invasive in Nature

Review Article   Open Access
The aim of this article is to evaluate the article by Zai-yang Liu et al. titled "Direct Anterior Approach in Crowe Type III-IV Developmental Dysplasia of the Hip: Surgical Technique and 2 years Follow-up from Southwest China", published in the Orthopaedic Surgery in April 2020 and titled "Surgical technique and case series of total hip arthroplasty with the Heuter anterior approach for Crowe type IV dysplasia", published in The Journal of Bone and Joint Surgery in November 2020 , by Viamont-Guerra et al.

Modular Dual Mobility Cup: A Matched Short-Term Study

Research Article   Open Access
Instability remains one of the main problems after primary complex and revision hip surgery. The introduction of modular Dual Modular Cup (modular DMC) has helped to overcome some of the limitations of standard DMC. The aim of this study was to review the clinical, radiological outcomes and rate of complications with the use of these kind of constructs.This is a retrospective series of patients who received different types of modular DMC in a single institution. We analyzed clinically and radiologically 101 patients at one, three and six months for the first year then every year from the date of surgery.

One Year Experience with the use of a New Expendable Cage and Large Endplates for Thoracolumbar Vertebral Body Replacement

Research Article   Open Access
Subsidence is the most common complication following thoracolumbar vertebral body replacement (VBR) with expandable cages. Implants with large endplates are now being used in order to reduce the rate of subsidence. However, these require more elaborate preparations of the vertebral endplates, which may lead to higher surgical morbidity. Herein we present the 30-Day morbidity results following VBR with these devices.

The Impact of Preoperative Hemoglobin Concentration and Erythropoietin Administration on Renal Tumors Patients with Inferior Vena Cava Tumor Thrombus Underwent Robot-Assisted Laparoscopic Inferior Vena Cava Thrombectomy

Research Article   Open Access
The impact of preoperative hemoglobin (Hb) concentration and recombinant human erythropoietin (rh-EPO) treatment on renal tumors (RTs) patients with inferior vena cava (IVC) tumor thrombus who underwent robot-assisted laparoscopic inferior vena cava thrombectomy (RAL-IVCTE) were not well studied. We retrospectively analyzed the demographic and clinical data of 61 patients with RTs who underwent RAL-IVCTE.

New Strategy in Fournier's Gangrene Treatment: 10-Year Experience of a Tertiary Hospital

Research Article   Open Access
To analyze the diagnosis and treatment of Fournier's Gangrene (FG) for the first diagnosis and referral at a tertiary hospital retrospectively. This retrospective study included all patients diagnosed with FG at the authors' tertiary medical institution. Patient characteristics, treatment features, and clinical results were extracted from the medical charts. The average age of patient was 56.7 (range, 23-81) years. In addition to the systemic application of antibiotics, extensive debridement and open drainage were performed in all patients.

Modulation of Occipital Alpha Rhythm in Expert and Novice Surgeons Performing Suture

Research Article   Open Access
Surgeons learn to perform highly repetitive suture movements. Simple movements elicit synchronization of the alpha frequency band (8–12 Hz) in occipital area, attributed to inhibition of task irrelevant areas. Yet, there is limited evidence on alpha amplitude in complex motor performance. In this study, we evaluated the impact of movement performance, expertise and task demand in the alpha power in occipital areas during suturing. We obtained the EEG alpha power spectra and the number of sutures in expert surgeons and medical students.

Appendectomy Impact and Associated Disease: Systematic Review of Literature. Call for Awareness to All Physicians

Research Article   Open Access
Appendectomy is one of the most common emergency surgical procedures, but the long-term consequences have not been fully explored and the physiological function of the human appendix has not been completely understood. Several hypothesis have been made. It could act as a "priming station" with an immune-modulatory function or as "safe house" for saprophytic gut bacteria, thus leading to certain diseases when removed. A systematic review was performed according to PRISMA guidelines. Articles with appendectomy and post operative implication were screened and those with pertinent information were evaluated.

The Significance of Thromboelastometry in Cardiac Surgery

Research Article   Open Access
Bleeding during and after cardiopulmonary by-pass is multifactorial. Namely, the prolonged contact of platelets with the plastic hoses of the extracorporeal blood flow system disrupts their function, leads to the activation of platelets and the coagulation cascade, which ultimately results in thrombocytopenia by more than 30%, as well as consumptive coagulopathy. Due to all of the above, one of the most difficult tasks in cardiac surgery is the establishment of timely, physiological hemostasis.

A Retrospective Study on the Complications of Ilizarov Technique in the Treatment of Neurogenic Talipes Equinovarus

Research Article   Open Access
In order to discuss the postoperative complications of Ilizarov technique in the treatment of neurogenic talipes equinovarus, we conducted a retrospective study on the postoperative complications of neurogenic talipes equinovarus patients treated with Ilizarov technique from January 2013 to December 2020. 182 patients (228 feet), 134 males (171 feet) and 48 females (57 feet). The age ranged from 4 to 70 ( 23.6 ± 13.9) years old.

Application of Modern Neurosurgical Technologies in Low and Middle-Income Countries

Research Article   Open Access
In the last 10 years neurosurgical practice has seen exponential growth that has shattered all the imaginary borders of its predecessors. From tremendous advancements in neuroendovascular care to treat stroke patients that have sustained symptoms more than 24 hours ago, to minimally invasive robotic spine surgery that discharges patients' homes on the same day. All these advancements have drastically improved patient outcomes in the developed world.

Orbital Rhabdomyosarcoma; Case Report and Review of Literature

Case Report   Open Access
The wide varieties of rare intraocular and orbital neoplasms differ in presentation in the pediatric population when compared to these same lesions in adults. While most pediatric ophthalmic tumors are benign, they may have a significant impact on vision and may result in significant morbidity and mortality. 8-year-old girl presented with diffuse swelling of the right eye for one month followed by sudden dystopia, pain and proptosis in the same eye two days prior to ED visit.

Bone Marrow Derived Cells Mediated Regulation of Schwann Cells Proliferation and Migration in Vitro

Research Article   Open Access
Schwann cells (SCs) are the unique glial cells in the peripheral nerve. After peripheral nerve injury, SCs change their morphology, function, and play a new role as repair cells, through this process, factors that enhance SCs proliferation and promote SCs migration will benefit nerve regeneration and functional recovery. Bone marrow-derived cells (BMDCs), which has been proved to offer several regenerative benefits for tissue and organ injuries.

Effect of Surgery Combined with Gemcitabine and Oxaliplatin Chemotherapy on Primary Signet Ring Cell Carcinoma of Bladder: A Case Report

Case Report   Open Access
Primary signet ring cell carcinoma of the bladder is an extremely rare and highly invasive variant of primary bladder cancer. When tumors are found, they usually show high-level and high-stage lesions and diffuse invasion of the bladder wall, and most tumors do not grow in the cavity. Most patients have no specific symptoms at the beginning, which leads to delayed diagnosis and treatment and poor prognosis.

Percutaneous Nerve Block Catheter; A Novel Minimal Invasive Treatment for Patients with Abdominal Cutaneous Nerve Entrapment Syndrome (ACNES)

Case Report   Open Access
Anterior cutaneous nerve entrapment syndrome (ACNES) is a commonly overlooked and ill understood cause of abdominal pain resulting in unnecessary, costly and potentially harmful diagnostic procedures. The pain is often severe and can have a debilitating effect on the patient's quality of life. A good response to trigger point infiltration using local lidocaine injection has both a diagnostic and therapeutic purpose and can be performed freehand.

Glial Heterotopia Nasal Septum in an Adult: A Case Report

Case Report   Open Access
We report a case of Heterotopia of nasal neuroglia from the right nasal septum in a middle-aged man. This Heterotopia is a very rare Heterotopia in the nasal cavity. It presents as a mass of extracranial brain tissue that is not connected to the brain. It often occurs in neonates and children, and is extremely rare in adults.

Three-Dimensional Interactive Quantitative Surgical Planning with Complete Thoracoscopic Lateral Basal Segmentectomy

Research Article   Open Access
Thoracoscopic segmentectomy for the lateral basal segment (S9) is one of the most technically challenging anatomical segmentectomy. This study aimed to describe thoracoscopic segmentectomy of S9 or S9b using three-dimensional (3D) interactive quantitative surgical planning through inferior pulmonary ligament approach. This retrospective study included 17 patients who underwent thoracoscopic S9 segmentectomy or S9b subsegmentectomy between February 2018 and December 2020.

The Case of the Broken Linx® System in a Sleeve Gastrectomy Patient

Case Report   Open Access
De novo breaking of the LINX® system inside the patient's body has not been reported. The LINX® system was introduced in 2012 after FDA approval as a device to control reflux symptoms in the general population. Its use was expanded into the bariatric population in 2015. Until now the only complication known to occur due to the device itself is erosion into the esophagus. Our case report is the first to show the possibility of such break to occur in the connecting wire between the magnetic beads in a patient after sleeve gastrectomy without MRI exposure.

A Novel Application of Anterior Chamber Cells and Aqueous Humor Cytokines Analysis in Uveitis-Glaucoma-Hyphema (UGH) Syndrome: A Case Report

Case Report   Open Access
Uveitis-glaucoma-hyphema (UGH) syndrome could be identified by clinical history and detailed ophthalmologic examination. In order to better understand the pathological processes of UGH syndrome, we introduced findings of enhanced red blood cells (RBCs) and inflammatory factors expression in a case of an UGH syndrome. A 51-year-old male was presented to the eye clinic due to right reduced visual acuity, eye redness and pain. There was a history of implantation of intraocular lens (IOL) 8 years ago in the right eye. Ophthalmic examination revealed the best corrected visual acuity of 60/100 (0.25/-1.25×7).

IHC-Based Gene Expression Analysis Predicts Response to Neoadjuvant Chemotherapy for Bladder Cancer

Research Article   Open Access
To explore the related genes and clinical characteristics of neoadjuvant chemotherapy (NAC) in bladder cancer, and to establish the prediction model of NAC response. We downloaded the clinical information and gene expression detected by IHC of 149 patients from the attachment of published paper. Patients were divided into three groups according to different pathological reactions of NAC. Then, Chi-square test and independent T test were used to compare the clinical features.

The Impact of Timing of Surgery on Patients with Hip Fractures

Research Article   Open Access
A hip fracture is a severe injury with complications that can be life-threatening. Studies show that the risk of hip fracture increases with age. As a result, hip fracture is common among the elderly. This paper aims to assess the impact of the timing of surgery in patients with hip fractures. Exploring the duration that patients with hip fracture have to wait before getting surgery will help promote rehabilitation services as well as provides a reference to how clinical postoperative complications can be prevented.

Peripheral Ameloblastoma of the Mandible: A Rare Case Report

Case Report   Open Access
The purpose of this study is to present the authors experience in the management of a rare clinical condition. A 31-year-old female was referred to Maxillo-facial Surgery Department, reporting the presence of a growing mandibular lesion. The radiological examination confirmed the presence of osteolytic unicystic lesion that was excised and after a clinical pathological exam, diagnosis of ameloblastoma was established.

Severe Ankyloglossia and its Surgical Management: Case Report

Case Series   Open Access
Tongue frenulum is a band of mucosal tissue attaching the lingual bottom to the mouth's floor and mandibular arch. Most frenum abnormalities occur in the lingual site. The Ankyloglossia is one of these frenulum anomalies showing different classifications. Ankyloglossia can be silent or may have several symptoms. This condition may disturb skeletal development, affect oro facial functions and also may induce difficulties in oral hygiene.

Irreversible Sequels of Poly Acrylamide Gel (Paag) in Breast Augmentation

Case Report   Open Access
Breast augmentation is increasingly popular and office based procedures are interesting for clients who do not like general anesthesia for surgeries. PAAG as old labeled filler was used among nations mostly in eastern countries. Gradual complicated presentations of injected breasts caused some limitations in its use. A 41 years old woman who had PAAG injection 15 years before, admitted for breasts` lumps and irregularities.

Equianalgesic Conversion from Intrathecal Morphine to Another Regimen is Still Uncertain

Short Report   Open Access
There is lack of experience regarding the conversion from Intrathecal (IT) morphine to another regimen and we have never faced a surgical patient that needed this kind of conversion. For these two reasons, we think it is necessary to explain our approach. A 69-year-old female was scheduled for a L4 pedicle subtraction osteotomy for severe sagittal imbalance correction. She had a 50-meter walking distance claudication and was unable to stand upright.

Compound Odontoma: Current Clinical Problem

Case Report   Open Access
Odontomas are among the most common odontogenic tumors found in the oral cavity, corresponding to between 21% and 67% of such lesions. Majority of authors divide them into complex and compound odontomas. Their etiology is not fully understood. Most authors point to traumatic or infectious etiology or genetic disorders. Most odontomas appear in the first two decades of life.

Time to Focus on the Scalp Incision Design for Chronic Subdural Hematoma: Technical Note and Experience

Research Article   Open Access
The scalp incision design in surgery for Chronic Subdural Hematoma (CSDH) is important but is given little attention or is neglected by most neurosurgeons currently. Faulty scalp incision design will affect the ease of surgery, wound healing, and patients' satisfaction. This study introduces the technique and experience used in our center regarding scalp incision with an adjustable question mark-shaped for CSDH procedures.

Sedative and Antinociceptive Effects of Xylazine Combined with Tramadol or Pentazocine in Goats

Research Article   Open Access
The aim of the study was to evaluate the quality of sedation and analgesia produced by xylazine alone and in combination with tramadol or pentazocine in goats. Four male adult West African goats weighing 8.5 ± 0.2 kg (Means ± Standard Deviation) were sedated with each of three treatments in a randomized cross over design at one week interval between treatments. Treatments were Xylazine (0.1 mg/kg) with normal saline (XYL-SAL); with tramadol (3 mg/kg, XYL-TRA) and with pentazocine (2 mg/kg, XYL-PEN).

Surgical Efficacy Concerning Pylorus Preserving Gastrectomy Versus Distal Gastrectomy in Early Gastric Cancer (EGC): Meta-Analysis

Research Article   Open Access
The purpose of this study is to evaluate and compare the surgical efficacy following pylorus-preserving gastrectomy and distal gastrectomy in patient with early gastric cancer. Electronic database such as PubMed, google scholar and Medline were search for original studies from the year 1998 to 2019. Postoperative outcomes, complications and nutritional status were the main outcome of the studies. Selected studies were analyzed by the Review manager 5.3 software.

Peripheral Giant Cell Granuloma, Diode Laser Surgical Treatment: A Case Report

Case Report   Open Access
Peripheral giant cell granuloma is a tumour-like lesion arising on the mucosa of the adherent vestibular or lingual gingiva, or edentulous alveolar ridge mucosa. This lesion is often misdiagnosed because it is clinically mistaken for a pyogenic granuloma. This work aims to present a case of peripheral giant cell granuloma and its surgical laser excision.

Effect of Individualized Cardiac Rehabilitation on Functional Capacity, Quality of Life, Hope and Blood Lipid among Patients after CABG

Research Article   Open Access
To investigate the effect of individualized cardiac rehabilitation (CR) on functional capacity, quality of life (QoL), hope and blood lipid in post-CABG patients. Two different CR strategy: Basic rehabilitation and Individualized rehabilitation was designed. The patients were screened and randomized into the two groups: Basic rehabilitation group (BRG) and Individualized rehabilitation group (IRG).

The Effects of Structured Online Preparation for Medical Students Assisting at Surgery

Research Article   Open Access
The feeling of unpreparedness by medical students hinders learning in the operating room. The effects of an online structured video-based platform (Incision Academy) were analyzed during surgical clerkship. In a prospective longitudinal study, medical students in their surgical clerkship were approached for participation.

Nerve Injuries Following Third Molar Surgery at an Australian University: A 4-Year Review

Research Article   Open Access
Nerve injury during the removal of third molars in oral surgery is a rare complication; however, it could lead to severe and long-term complications. For this study, data regarding third molar extractions were collected to identify predictive risk factors for inferior alveolar nerve and lingual nerve injuries.

Job Satisfaction among Medical Specialists in Sudan

Research Article   Open Access
Maintaining a high Job satisfaction is crucial for ensuring optimal performance of employees. As stressful and sensitive the job of doctors could be, it is necessary to prove all the help and support to keep doctors running with the best they could. It is well established that dissatisfaction of doctors is associated with more adverse incidents, more job turnover and more migration of health care workers.

An Unusual Case of Cholestasis and Gastrointestinal Bleeding: Hepatic Cysts

Clinical Image   Open Access
An 84-year-old man presented to our hospital with abnormal liver function tests. He had a medical history of hepatic cysts which increased progressively in volume over time. Physical examination revealed the distended abdomen with a palpable tender mass in the right upper quadrant. Liver function tests were in keeping with a cholestasis, with a gamma-glutamyl transpeptidase of 684 IU/L (normal range, 10-60 IU/L), and alkaline phosphatase of 224 IU/L (normal range, 45-125 IU/L).

Repair of a Lumbar Hernia of the Triangle of Petit with Prolene Mesh Hernia System (PHS): Case Report and Review of the Literature

Case Report   Open Access
Many varieties of lumbar hernia repair have been described. Repairing a lumbar hernia is not as straightforward as other abdominal wall hernias. This is because there is a lack of a strong aponeurosis to place anchoring sutures and a risk of injury to nearby major vessels and nerves. With traditional methods that employ suture closure, recurrence rates are high. Although open and laparoscopic mesh repair is frequently conducted, a consensus to the ideal operation is not apparent.

A Vascular Arc Mimicking Asthma in an Infant

Case Report   Open Access
The Arteria lusoria or retroesophageal right subclavian artery is the most common malformation of the aortic arch, it can be associated with other congenital anomalies of the heart and large vessels, including the bicarotid trunk which constitutes a common trunk giving rise to the two internal primitive carotid arteries. We report a rare observation of an aortic arc mimicking asthma in a 2-month-old infant discovered by an angioscan performed after poor evolution under bronchodilator treatment.

Epilepsy Surgery in Tuberous Sclerosis: An Overview of Neurosurgical Concerns in a Low-Income Country

Research Article   Open Access
Oftentimes, patients with early-onset seizures fail to respond well to initial medication. Mental retardation and early onset seizures are linked. There is growing evidence that early seizure control may adversely affect the development of cognitive skills and social behaviour in children with Tuberous sclerosis complex. According to recent studies, despite the challenges associated with epilepsy surgery planning for TSC patients, a substantial number of patients (>60%) can be seizure-free if the right clinical candidates are selected and evaluated.

Transient Global Amnesia after Cardiac Surgery: The Presenting but Mostly Unrecognized Sign of Heparin-Induced Thrombocytopenia

Case Series   Open Access
Benign heparin-induced thrombocytopenia (HIT) is common after cardiac surgery. HIT can be complicated with thromboembolic events. One of these rare and possibly underreported symptoms is transient global amnesia (TGA) which could cause higher morbidity in the short and midterm follow up.

Patient Safety in the Surgical Process: The Circulating Nurse's Role

Short Commentary   Open Access
Patient safety is of primary concern in all healthcare fields. Unintentional injury or "Never Events" occur in surgeries. During a surgical procedure it requires teamwork to ensure that all steps are taken to maintain patient safety. A major emphasis should be teamwork and leadership. While there are multiple sub-teams in the operating room, there must be a person to coordinate these sub-teams into a cohesive team where all members know the same information at the same time. This coordinator is the circulating nurse.

Differences in Tissue Damage-Related Markers Between Large-Stitch Versus Small-Stitch Surgical Closure Techniques

Research Article   Open Access
A hundred of patients (50% female, 62.0 ± 15.1 years, body mass index = 27.6 ± 5.1 kg/m2) were randomised into large stitches (n=50) or small stitches (n=50) surgical closure groups. Large stitches closure is considered the standard suture while Small stitches closure can be defined as a smaller suture. Surgeries performed included exploratory laparotomy, intestinal and colon resections, and hepatobiliary, pancreatic, gastric and oesophagi interventions.

Entrapment of the Suprascapular Nerve Due a Complex Scapular Fracture: A Case Report

Case Report   Open Access
Suprascapular nerve (SSN) entrapment is rare. Direct contusion or traction of the SSN may occur due to fracture fragments within the narrow scapular notch. Decompression of contused or entrapped SSN may release weakness of supraspinatus/infraspinatus muscles when recognized in time. A young male patient with a complex fracture of the right scapula suffered from an additional lack of muscle activity (M0/5 = complete paralysis of the supraspinatus/infraspinatus muscles) innervated by the SSN.

Progress in Annulus Fibrosus Regeneration: Connecting Recent Research with Clinical Operation

Review Article   Open Access
As a leading course of global disability, the intervertebral disc disorder has brought great burden to the society. Compared to the great input on nucleus pulposus condition, which is the core part of IVD, less attention has been paid on the outer structure, Annulus Fibrosus (AF). However, the failure of AF plays a key role on degenerative disc disease and has shown great influence of the IVD function.

Management of Acute Angle-Closure Glaucoma in Nanophthalmos: A Case Report

Case Report   Open Access
Nanophthalmos is often associated with varying degrees of acute angle-closure glaucoma. The treatment has a high complication rate and a large number of reoperations occur. We report a case of combined surgeries for bilateral nanophthalmos and the address for severe complications. The patient was successfully treated with primary posterior capsulectomy combined with IZHV or anterior vitrectomy, along with phacoemulsification and implantation of a posterior chamber IOL.

Treatment of Iatrogenic Femoral Pseudoaneurysm: Case Report and Review of the Literature

Case Series   Open Access
Iatrogenic femoral artery pseudoaneurysm is usually caused by poor compression of the femoral artery after puncture during endovascular surgery, or by guide wire puncture of the femoral artery branch, and a few are caused by migration of small trochanteric fragments during internal fixation of hip fracture or trauma of the femoral artery by steel nails. Timely detection and treatment of femoral artery pseudoaneurysm will not only accelerate the patient's recovery, but also reduce the occurrence of serious complications.

A Descriptive Study of Trauma During the COVID-19 Pandemic in a Major Trauma Centre in the United Kingdom

Research Article   Open Access
The coronavirus disease 2019 pandemic has caused a major health crisis. A significant reconfiguration of services occurred to help deal with this pandemic. This study aims to describe the change in trauma and orthopaedics services during this period of major lockdown rules. A retrospective data analysis was performed using the trauma and orthopaedics electronic trauma database, between the 23rd of March to the 23rd of April 2020. A 30 day period was used to identify outcomes.

Acute Abdomen and its Outcomes in Children with Acute Leukemia: A Single Center Experience

Research Article   Open Access
Acute abdominal conditions such as tiflitis, acute appendicitis and intussusception can be found in the follow-up of children with leukemia. In this study, we examined our patients with leukemia diagnosed with acute surgical abdomen in terms of clinical findings, prognosis and treatments, and we aimed to show that the results were satisfactory with good management in these patients.

Granular Cell Tumor of the Chest Wall

Case Report   Open Access
Granular Cell Tumors (GrCTs) often present as slowly growing painless nodules, and can arise in essentially any anatomical location, but occur most commonly in the head and neck. GrCTs are unique and so named because of the classic histomorphology of the tumor cells having abundant granular eosinophilic cytoplasm. The presence of these tumors in the chest wall has unique implications. The purpose of our case report is to review the diagnosis and management of a patient with a granular cell tumor of the chest wall.

Trapeziectomy and Acute Carpal Tunnel Syndrome. MRI Anatomical Study of the Relationship between Trapezium and Median Nerve

Research Article   Open Access
Thumb Carpometacarpal joint (CMCJ) osteoarthritis is a common problem. It has an increased incidence in females over fifty years old. The usual clinical presentation includes activity-related discomfort at the base of the thumb. The standard first line treatment would include modification of activities, analgesia, splintage, and corticosteroid injection. Trapeziectomy or excision arthroplasty is an appropriate option when all non-operative measurements have failed.

Excimer Laser Assisted Therapy and Combined with Drug Coated Balloon in the Treatment of Femoropopliteal In-Stent Restenosis: A Systematic Review and Meta-Analysis

Research Article   Open Access
The purpose of this article was to assess the efficiency of Excimer laser assisted therapy and combined with drug coated balloon in the treatment of stent stenosis femoropopliteal in-stent restenosis. Pubmed, OVID, Scopus, Embase, and Cochrane were searched systematically. The endpoints were patency at 12 months, target lesion revascularization at 12 months, TLR of femoropopliteal In-Stent restenosis and Tosaka class III at 12 months, reocclusion of femoropopliteal In-Stent restenosis and Tosaka class III at 12 months, bail-out stenting, and ankle brachial index at 6 months.

How Intraspinal Tumors Cause Hydrocephalus: A Systematic Review in the Light of Novel CSF Circulation Model

Review Article   Open Access
This review aims to assess and sum up the proposed pathomechanisms underlying the Coexistence of Hydrocephalus (HC) with spinal cord tumors. The PubMed database search identified 119 publications, of which 23 were eligible for this study. Hydrocephalus was mostly described in the presence of spinal ependymomas and astrocytomas. Tumor cells can compromise the CSF flow (obstructing ventricular outlets and Subarachnoid Space (SAS) of cerebral convexity – impairing function of arachnoid granulations and villi, Virchow-Robin spaces, perineural lymphatics).

An Audit of Wound Healing Complications Including Surgical Site Infection Following Laparoscopic Surgery

Research Article   Open Access
Surgical site infections (SSIs) are one of the most common healthcare-associated infections. Wound concerns not due to SSI, such as redness, swelling, comfort, odour and exudate are often reported. Although these symptoms may not be due to SSI per se, they can nevertheless negatively affect patient experience. The aim of this audit was to evaluate the incidence of surgical site infection and patient reported wound healing concerns following laparoscopic surgery.

Role of Prolotherapy in Leg Defect

Case Report   Open Access
Non healing wounds are the major problem all over the world. Many therapies have been introduced for the management of chronic non healing ulcers. It is always challenging to manage these ulcers. There is no well-established method that accelerates the wound healing rate. Prolotherapy is a method that involves injecting some irritant locally in the wound that is claimed to hasten the healing. This article discusses about the role of prolotherapy in leg defects.

Role of Autologous Platelet Rich Plasma in Scar Management

Case Report   Open Access
Autologous platelet rich plasma (APRP) has gained its importance in medical field since its first use in sports medicine and open-heart surgeries. It is widely used in plastic surgery and in cosmetic medicine because of its wound healing properties. Scar management is the most important part of cosmesis and is an important factor in improving the post traumatic quality of life of the patient.

Pelviureteric Junction Obstruction in an Ectopic Right Kidney-Mimicking Vesicoureteric Junction Obstruction: Radiological Diagnostic Dilemma

Case Report   Open Access
Anomalous kidneys are mostly asymptomatic and are often found incidentally during physical or radiological investigations for urological or other medical complaints. 1-month old male presented with difficulty in micturition and crying during micturation. On examination, an ill-defined lump was found in the right iliac fossa. Ultrasound abdomen was suggestive of gross right sided hydronephrosis with paper thinning of cortex with hydroureter. Micturating cystourethrogram was normal.

Does Human Height Have a Correlation with the Risk of Knee Osteoarthritis: A Cross-Sectional Study?

Research Article   Open Access
Knee Osteoarthritis (KOA) is more prevalent in Asian population as compared to American and Europeans, and Obesity, measured by Body Mass Index (BMI) is said to be an important risk factor. Body weight alone has been, since ages, highlighted for changes in Body Mass Index (BMI) although BMI has two components: height and weight of the subjects. This study was, therefore, designed to identify the association of height and weight individually with the risk of KOA development.

Homologous Recombination Deficiency and ERBB2 Alterations as Differential Diagnosis and Personalized Treatment Options in Primary Pulmonary Enteric Adenocarcinoma

Research Article   Open Access
Primary Pulmonary Enteric Adenocarcinoma (PEAC) is a special and rare subtype of lung adenocarcinoma. There is very little data on differential diagnosis from Metastasis Colonrectal Cancer (MCC) and potentially treatable molecular alterations in PEAC. We retrospectively evaluated immunostaining profile and the classic driven genes signatures in 6 PEACs and 16 MCCs, using immunohistochemistry and real-time PCR.

Tensor Fascia Latae Assisted Keystone Flap

Case Report   Open Access
Keystone flap is a local fasciocutaneous advancement perforator flap based on the underlying perforators. No perforator mapping is necessary. Tensor Fasciae Latae (TFL) is used as an autologous tissue substitute, which provides useful in reconstructive surgery is well known. In this case report, the author present the experience of using TFL as autologous tissue substitute while doing a keystone flap.

A Technique for Prosthetically Aligning Multiple Non-Parallel Implants

Short Commentary   Open Access
A device was designed to be used together with a dental surveyor to determine the proper abutment angle combination in cases with multiple non-parallel implants. Anatomical and technical difficulties may lead to unfavorable implant positioning and/or alignment. Angled abutments can be used to properly align non-parallel implants. Determining the required abutment angulation can be challenging especially with multiple implants.

Contamination Assessment in Surgery Support Rooms in a Real-Time Routine of the Hospital Environment

Research Article   Open Access
One of the most severe problems in patients care is hospital-acquired infections and adversely effect on the mortality and morbidity despite available antimicrobial therapy and advances in supportive care. The researchers were willing to determine the contamination of inanimate hospital environments by bacterial agents and their susceptibility to various antimicrobial agents....

Reporting Guidelines in Orthopaedic Journals: Can We Do More to Promote Adoption? A Systematic Review

Research Article   Open Access
Reporting guidelines have been developed as tools to improve research practices and minimise bias in reporting. Past studies have shown the adoption of reporting guidelines by journals in different fields to be variable, but generally poor. The aim of this study was to evaluate the policies of orthopaedic journals regarding reporting guidelines and checklists, and requirements for publication...

Isolated Adrenal Metastasis of Breast Invasive Ductal Carcinoma: Case Report of an Uncommon Finding and Review of Literature

Case Report   Open Access
Adrenal glands are a common site for metastasis. It is uncommon for Breast Invasive Ductal Carcinoma (BIDC) to spread to the adrenal glands. There are few cases describing this clinical entity in recent literature, and as a result, there is a lack of information about management and outcome of the patients affected...

Menopause, Effects and Care for Women at this Age

Research Article   Open Access
The average life expectancy of women is about 80 years, with most of them living 40% of menopausal life. More than 10% of women switch to natural menopause by the age of 45. Menopause is divided into two phases: early and late. Numerous studies confirm the increased risk of cardiovascular disease...

Successful ERCP for Hydatic Angiocholitis with Kystobiliary Fistula

Clinical Image   Open Access
A 32 years old woman lastly operated for hepatic hydatic cyst and cholecystectomy, presented for jaundice, fever and right hypochondrium pain. Abdominal examination was showed tenderness of the right hypochondrium. Biological tests showed cholestasis with total bilirubin 123 and conjugated at 80 with elevated CRP (205) and cytolisis. Prothrombin time was normal. Abdominal ultrasound (Figure 1) and CT scan showed dilated...

Optical Coherence Tomography capabilities for early stent Thrombosis after Primary Percutaneous Coronary Interventions

Short Communication   Open Access
Early stent thrombosis is a life-threatening complication of primary percutaneous coronary intervention, which manifests itself in the clinical picture of recurrence of myocardial infarction. The frequency of early stent thrombosis after the primary PCI is significantly higher than in the intervention for stable coronary heart disease, and in large registers reaches 3.5%, the lethality, according to various reports, is 20-40%. Angiography is limited in the ability to determine the causes of early stent thrombosis....

The Impact of Self-Expanding Metallic Stent Insertion on Survival and Oncological Outcomes in Oesophageal Cancer

Research Article   Open Access
Oesophageal cancer (OC) is an aggressive malignancy which can be temporarily managed with self-expanding metal stents (SEMS) to improve patient's dysphagia and "bridge the gap" preceding surgical resection. This study aimed to determine whether SEMS has an adverse effect on patient's oncological outcome and mean survival time through a retrospective data analysis....

Care of the Burn Patient in the Burner Center: 1 Year Invoice-Cost Evaluation

Letter to Editor   Open Access
The fact that severe burns are exposed to expensive and long-term treatments, and they have to return to their jobs late, constitute an important problem for countries such as our country where all treatment costs are covered by social security insurance. In this study, we aimed to perform a cost analysis by dividing invoice expenses into subgroups of burn patients who were treated in the Tersier Hospital Burn Center for 1 year....

Appendicitis in the Setting of an Active Crohn's Disease Flare

Case Report   Open Access
Appendicitis is a common disease that affects 7-8% of the population. Crohn's Disease (CD) is characterized by inflammatory flares in the gastrointestinal tract. Treatment of appendicitis in the setting of a CD flare poses a significant challenge. Herein we describe the treatment and outcomes for an 86-year-old patient with refractory CD who presented with perforated appendicitis concurrent with a Crohn's flare...

Rare Case of Reactive Nodular Fibrous Pseudotumor Causing Small Bowel Volvulus and Obstruction

Research Article   Open Access
This is a rare case of a reactive fibrosing pseudotumor that caused small bowel volvulus in a 55-year-old gentleman that resulted in small bowel resection. This case report will focus on the diagnosis of this rare cause of small bowel obstruction and compare the histological and radiological findings with that of the other commonly mistaken differential...

Obstructive Sleep Apnea: How to Select the Proper Surgical Treatment

Review   Open Access
Obstructive Sleep Apnea (OSA) need to be treated to avoid its serious complication such as hypertension, pulmonary hypertension, stroke or sudden death [1]. Moreover, OSA may affect growth of children [2]. Choice of the proper surgical treatment is the way for satisfactory outcome...

Coincidentally Detected Button Battery Ingestion in Patient Presenting with Intestinal Obstruction

Clinical Image   Open Access
Foreign body ingestions still can lead to life-threatening clinical charts and challenging symptoms [1]. Button battery ingestion is one of the foreign bodies carried higher morbidity and mortality for children [2]. Button battery ingestion may result in serious complications due to three type injury (chemical caustic injury, electrical current effect, and pressure on tissue) in gastrointestinal tract [3]...

Revascularisation of Marginally Viable Limbs; A Long-Term Follow-Up Study

Research Article   Open Access
Reperfusion of the limb is usually not attempted if more than 2 of 4 compartments are non-viable due to Acute Limb Ischemia (ALI) because of the risk of reperfusion effects. This study reports long term follow up of such patients who underwent revascularisation at the Teaching Hospital Anuradhapura (THA)...

Impact of Price Transparency on Patient Relationships in an Outpatient Surgical Center

Research Article   Open Access
Healthcare price transparency initiatives are becoming a larger force in healthcare reform. These initiatives promise to bring actionable pricing information to consumers/potential patients in a sector of the US economy that has historically struggled to be transparent. Physicians and some outpatient/ambulatory surgery centers are slowly adopting the idea of price transparency in various ways....

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