Evaluation of suburethral transobturator sling procedure on urinary incontinence and quality-of-life

Background: Urinary incontinence has an estimated incidence of 25-50% in the adult female population. It has a profound physical and psychosocial impact, compromising women抯 quality-of-life (QoL). The suburethral sling is currently considered the surgical treatment of choice for stress urinary incontinence (SUI). The present study aimed to evaluate the impact of urinary incontinence on women抯 QoL before and after transobturator suburethral sling surgery, as well as the effectiveness of surgical treatment.Methods: A prospective longitudinal, observational and analytical study was performed between June and December 2021. The study population included 64 women with urinary incontinence, to whom the King's Health Questionnaire (KHQ) was applied, before and after surgery.Results: Of the 64 women included in the study, 59.4% (n=38) had SUI and 40.6% (n=26) had mixed urinary incontinence (MUI). There was an improvement in the global KHQ score in 96.9% (n=62) of subjects, with a statistically and clinically significant impact on QoL (p<0.001). Patients with MUI had higher preoperative KHQ global scores, reflecting a more substantial impact on their QoL. Surprisingly, postoperative improvement in QoL was equally significant, both clinically and statistically (p<0.001), with no differences when comparing to isolated sui patients (p>0.05).Conclusions: QoL assessment questionnaires help to quantify individual impact of urinary incontinence and identify which patients benefited most from treatment. This study not only enhances our understanding of the true impact of urinary incontinence on QoL, but also emphasizes the effectiveness and importance of this minimally invasive surgery in improving the QoL of patients with SUI as well as MUI.

Dietary habits and nutritional status of upper primary school children covered under Mid-Day Meal scheme in rural Punjab

Background: The objective of this study was to evaluate the dietary habits and nutritional status of upper primary school children covered under mid-day meal scheme (MDMS) in rural Punjab. Methods: This cross-sectional research was conducted among 336 adolescent (10-15 years) students of 6th to 8th standard randomly selected from 11 government/ municipality schools selected randomly from the total 112 schools rural Punjab in 2018. After taking informed written assent/ consent, pretested, semi structured questionnaire was administered. Anthropometric measurements were taken to establish malnutrition, underweight, stunting, wasting and overweight. Results: Majority (90%) liked the MDMS which was being served to them. There was 96% regularity in attending the school daily with a slightly less emphasis on the cleanliness maintenance (73%) of the children by the schoolteachers. Malnutrition and underweight were 59% and 50% prevalent, respectively. The prevalence of stunting was higher in girls (30%). In boys (154) both the stunting and wasting was 23%, with 5% and 6% prevalence of overweight and at risk of overweight respectively. Whereas in case of girls (182), the prevalence of stunting (30%) was more than wasting (25%) with less girls (3% each) being overweight and at risk of overweight. Conclusions: Regularity and attendance were up to mark due to increased likeliness of the food by majority of the students, though cleanliness should be improved further. Higher prevalence of malnutrition, wasting and stunting was observed which was even higher among girls. Overweight and risk of overweight was higher among boys. Hence, nutritional status was unsatisfactory.

Assessment of quality of mid-day meal in Khamanon, Fatehgarh Sahib, Punjab

Background: Mid-day meal (MDM) is a scheme implemented by Government of India to combat the problem of malnourishment. Periodic assessment of the food and nutritional quality of mid-day meals being served to the school children for nutrient consumption is imperative. This study was designed to evaluate the quality of food served under MDM. Methods: A cross-sectional study was conducted in randomly selected 11 government schools of Fatehgarh Sahib, Punjab (May-July, 2018). The cooked food samples were evaluated for assessing the food quality of MDM in different schools with respect to colour, consistency and taste by a panel of 5-6 judges. The amount of food grains, pulses, vegetables, etc. provided to all the upper primary school children were recorded and then evaluated for the nutritive content (calories, protein, fat) of MDM and its contribution per day. Results: In the present study, energy as well as protein requirement was fulfilled by mid-day meal but was low for fat (2.4 gm). The quantity of mid-day meal provided was adequate except for the vegetables (leafy also). Usage of green leafy vegetables was low (42 gm), served once in a week. There was 76% adequacy of nutrient intake in the present study. Conclusions: The present study shows that improvement in the quality and quantity of the Mid-day meal is essential to fill the nutrient gap. There is a need to improve fat content of the meal, as it was low. More leafy vegetables should be included in the meal or their substitutes should be encouraged.

A study of short cervix in mid trimester of pregnancy

Background: Preterm birth is truly a global problem. Cervical length is one of the major determinants of preterm births. Diagnosis of cervical insufficiency can be made by history of previous mid trimester loss, on clinical evaluation or sonographically by measuring cervical length or seeing funnelling of OS. The mainstay treatment of cervical insufficiency is the cervical cerclage.Methods: Present study includes 55 cases of cervical length less than or equal to 2.5 cm on TVS examination between 18 to 22 weeks of gestation of singleton pregnancy was conducted at department of obstetrics and gynaecology at SMT NHL medical municipal hospital, Ahmedabad from July 2022 to December 2023 and shows comparison of rate of full term and preterm deliveries.Results: Out of 55 patients with cervical incompetence, 22 (40%) patients were diagnosed on examination. Out of 55 patients with cervical incompetence 33 (60%) patients had preterm births and only 19 (35%) patients delivered full term, 3 (5%) had abortions. Present study shows there were 35% full term deliveries, 60% preterm deliveries and 5% had abortion among patients having cervical length less than or equal to 2.5 cm.Conclusions: Internal OS status of every patient should always be examined by ultrasound between 18 to 22 weeks. Thus, cervical length is very useful in prognostication and prediction of preterm birth. There are highest chances of late preterm in cervical incompetent patients. Our study showed better outcome with OS tightening group compared to conservative group.

Programa SONQO-CALCHAQUÍ 2022: Evaluación de variables cardiovasculares en una población Calchaquí de media y alta montaña de Tucumán / 2022 SONQO-CALCHAQUÍ Program: Evaluation of Cardiovascular Variables in a Mid- and High Mountain Calchaquí Population of Tucumán

RESUMEN Introducción: La comunidad de Quilmes (Tucumán) consta de 2400 habitantes de media y alta montaña (1800 a 4000 metros sobre el nivel del mar). En el año 2018 se realizó un estudio sobre su estado de salud cardiovascular (Programa SONQO-CALCHAQUÍ 2018). Objetivo: Actualizar y amplificar el relevamiento realizado en el año 2018, para obtener un panorama más completo de la salud cardiovascular de la comunidad. Material y métodos: Se efectuó un estudio descriptivo transversal en la comunidad Quilmes, en personas que asistieron voluntariamente a consultorios especialmente establecidos, en el mes de septiembre de 2022. Se realizaron cuestionarios, dosajes de laboratorio, ECG, ecocardiograma, determinaciones antropométricas, y pruebas de resistencia y fuerza muscular. Resultados: Concurrieron 186 pobladores (119 mujeres y 67 varones) con edad 45,0±1,3 años. La prevalencia referida de factores de riesgo cardiovascular (hipertensión 17,8%, tabaquismo 14,1%, diabetes 4,9%, dislipidemia 30,6%) fue aceptable, pero con alta proporción sin exámenes en el último año. La alimentación estaba constituida principalmente por derivados de harinas, con escasa fruta y verdura fresca. La prevalencia de sobrepeso (34,3%) y obesidad (35,4%) fue elevada. El 40% de los encuestados tenía educación secundaria o superior. Se refirió buena calidad de vida (69,5±1,1% del valor máximo posible de satisfacción en la escala de autopercepción). El Minimental Test arrojó un valor promedio de 15,7±0,2 puntos. La fuerza prensil en el 55,8% de los casos estuvo por debajo del rango normal. Conclusiones: la población Quilmes presenta un estado físico aceptable, pero con alto índice de sobrepeso y obesidad, debido al régimen alimentario. Esta situación debería ser contemplada en los programas de salud futuros.

ABSTRACT Background: The community of Quilmes (Tucumán) encompasses 2400 mid- and high mountain inhabitants (1800 to 4000 meters above sea level). In 2018, a study was carried out on their cardiovascular health status (2018 SONQO-CALCHAQUÍ Program). Objective: The aim of this study is to update and expand the survey carried out in 2018, to obtain a broader panorama of the cardiovascular health of this community. Methods: A descriptive cross-sectional study was carried out in the Quilmes community, in people who voluntarily attended specially established clinics in September 2022. Questionnaires, laboratory tests, ECG, echocardiogram, anthropometric measurements, muscular resistance and strength tests were carried out. Results: A total of 186 patients (119 women and 67 men) aged 45.0±1.3 years attended the study. The prevalence of cardiovascular risk factors (hypertension 17.8%, smoking 14.1%, diabetes 4.9% and dyslipidemia 30.6%) was acceptable, but a high proportion of cases had not been examined in the last year. The diet consisted mainly of flour products, with little fresh fruit and vegetables. The prevalence of overweight (34.3%) and obesity (35.4%) was high. Forty percent of respondents had secondary or higher education. Good quality of life (69.5±1.1% of the maximum possible value of satisfaction on the self-perception scale) was reported. The Minimental Test average was 15.7±0.2 points. Prehensile strength in 55.8% of cases was below the normal range. Conclusions: The Quilmes population presents an acceptable physical condition, but with a high rate of overweight and obesity, due to the diet, a condition that should be considered in future health programs.

Value of combination of first-trimester and mid-trimester ultrasound in screening fetal pentalogy of Cantrell / 中华超声影像学杂志

Objective:To explore the diagnostic value of first-trimester and mid-trimester ultrasound in screening fetal pentalogy of Cantrell, and to analyze missed and misdiagnosed cases.Methods:The fetal ultrasound image characteristics of pentalogy of Cantrell diagnosed in the Affiliated Suzhou Hospital of Nanjing Medical University from March 2018 to November 2022 were retrospectively analyzed. The necessary sections and key features of ultrasound images for diagnosing the disease in first-trimester and mid-trimester were summarized. The diagnostic value of ultrasound screenings in first-trimester and mid-trimester was analyzed, and the progression of the disease during pregnancy was understood, the missed diagnosis rate and misdiagnosis rate were calculated, and the reasons for missing diagnosis were analyzed. All fetuses were followed up to birth or induction of labor.Pentalogy of Cantrell was divided into types Ⅰ, Ⅱ, and Ⅲ according to Toyama′s research.Results:Among the 120 190 fetuses, 13 cases of pentalogy of Cantrell were diagnosed by ultrasound in first-trimester and mid-trimester. Ultrasound predominantly showed the fetal heart being malpositioned outside the chest and the fetal abdominal contents bulging outside the abdominal cavity, and the sternumal echo was partially or completely missed in some cases. All 13 cases were confirmed by follow-up, including 1 case of type Ⅱ, and 12 cases of type Ⅲ. In addition, 1 missed case of type Ⅱ pentalogy of Cantrell was followed up after birth. The correct diagnostic rates of fetal pentalogy of Cantrell using standard ultrasound sections during the first-trimester and mid-trimester were 99.9% and 100%, the sensitivity were 88.9% and 100%, the specificity were both 100%, the positive predictive values were both 100%, and the negative predictive values were 99.9% and 100%, respectively.Conclusions:First-trimester and mid-trimester ultrasound screenings have high diagnostic accuracy for pentalogy of Cantrell, and early detection and early diagnosis are of great clinical significance for the guidance of pregnancy outcomes.

Association of elevated plasma ferritin and triglyceride concentrations in early pregnancy and the risk of gestational diabetes mellitus / 公共卫生与预防医学

Objective To investigate the relationship between combined plasma ferritin and triglyceride (TG) concentrations in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods A total of 1 000 pregnant women who had antenatal care at the Sixth Hospital of Wuhan from January 2021 to January 2023 were selected as the research subjects. The cut-offs of ferritin and TG were analyzed by using unrestricted cube splines. All participants were divided into 4 groups according to the cut‐off values of ferritin and TG. Associations between combined ferritin and TG concentrations and GDM risk were estimated using multivariable logistic regression models. Results A total of 158 (15.8%) participants were diagnosed with GDM. The ferritin and TG levels in early pregnancy of pregnant women in the GDM group were significantly higher than those in the non-GDM group (P<0.05). After adjusting for potential confounders, the OR for the risk of developing GDM after combining ferritin with TG was 2.35 (1.65, 3.35). Couclusion The increase in plasma ferritin and TG concentrations in early pregnancy is positively correlated with the increased risk of GDM. Pregnant women with high plasma ferritin (˃65.7 ng/mL) and high TG (˃1.9mmoL/L) have the greatest risk of GDM.

Maternal mid-upper arm circumference as a predictor of low birth weight outcome among newborn deliveries of adolescents in a Tertiary Level Hospital

Background@#Maternal malnutrition is a major cause of low birth weight (LBW) newborn outcome especially among adolescent mothers. It is one of the key drivers of child stunting and initiates the vicious cycle of intergenerational malnutrition. The body mass index prior to pregnancy or at the initial trimester is currently being used to establish the desired weight gain throughout pregnancy. However, Filipino adolescents often delay their first antenatal visit at a later stage of pregnancy. Without a baseline weight, the establishment of appropriate weight gain and nutritional status is often challenging. Mid-upper arm circumference (MUAC) was proven to be a good proxy measure of acute malnutrition, however, there was no global consensus on what MUAC cut-off point to use to identify pregnant adolescents at risk for delivering LBW babies. Finding the optimal cut-off could facilitate early identification and intervention of pregnant adolescents who are nutritionally at risk and could eventually break the cycle of intergenerational malnutrition.@*Objectives@#The study aims to determine the association of maternal MUAC and the birth weight outcomes among newborn deliveries of adolescents in a tertiary hospital for a period of six months and to identify the optimal maternal MUAC cut-off point that can be used to predict low birth weight outcome among newborn deliveries of adolescents in a tertiary hospital. Methods. A cross-sectional study was conducted among adolescents ages 10 to 19 years who delivered babies in a tertiary hospital in the Philippines for a period of six months. Maternal MUAC and LBW outcome were documented, and their association was determined using a logistic regression analysis. To measure diagnostic accuracy, the sensitivity, specificity, and the area under the curve were taken for each MUAC point. A receiver operating characteristic (ROC) curve was used to aid the MUAC cut-off determination.@*Results@#Out of 237 newborn deliveries, 35% were noted with low birth weight while 65% had normal birth weight. Most of the mothers were in their late adolescence at 78%. The crude association for the MUAC cut-offs ≤23.00 cm, ≤23.50 cm, and ≤24.00 cm and LBW showed a significant value of 2.19, 2.25, and 2.39 at 95% CI, respectively. However, it is only the cut-off ≤24.00 cm that showed significant results for adjusted association by the logistic regression analysis. The MUAC cut-off ≤24.00 cm also showed a better trade-off value between the sensitivity and specificity. Furthermore, the optimal maternal MUAC measurement that predicts LBW newborn outcome points to ≤24.00 cm cut-off based on the ROC curve.@*Conclusion@#This study shows that the maternal MUAC is predictive of LBW outcome among adolescent deliveries.A MUAC cut-off of ≤24.00 cm was superior to lower cut-offs studied. The pregnant adolescents might need a higher MUAC cut-off than adults to allow timely intervention and prevention of poor neonatal outcomes. By doing this simple screening test, suspected pregnant adolescents can be easily identified and referred for further confirmatory testing.

Dosimetric study of two-arc and dual-arc techniques in VMAT program for lower mid-thoracic esophageal cancer / 医疗卫生装备

Objective To compare the effects of two arc(TA)and dual arc(DA)techniques on the dose distribution to the planning target volume(PTV)and organs at risk(OAR)in volumetric modulated arc therapy(VMAT)for lower mid-thoracic esophageal cancer.Methods Ten patients with lower mid-thoracic esophageal cancer who received radiation therapy at some hospital from July 2020 to June 2022 were selected retrospectively.A TA radiation therapy plan and a DA radiation therapy plan were developed for each patient using the Ray Arc module of RayStation 4.7.5.4 planning system,and the two kinds of radiation plans were compared in terms of dosimetric parameters including D2,D5,D50,D95,D98,homogeneity index(HI),conformity index(CI),beam-on time and total monitor unit for PTV and lung V5,V10,V20,V30 and Dmean and heartV30,V40 and Dmean and spine cord Dmax for OAR.SPSS 22.0 was used for statistical analysis.Results TA and DA radiation therapy plans had no significant differences in PTV CI,HI,D2,D5,D50,D95 and beam-on time(P＞0.05),and DA plan had D98 and total monitor unit higher obviously than those of TA plan(P＜0.05).In terms of OARs protection,DA plan had heart V30,V40 and Dmean slightly lower than those of TA plan with non-significantly differences(P＞0.05),while lung V5,V30 and Dmean and spine cordDmax significantly lower(P＜0.05).Conclusion DA technique gains advantages over TA technique in PTV dose distribution and dose to OAR,and the involvement of DA technique in preparing the VMAT plan for esophageal cancer contributes to enhancing the treatment efficacy.[Chinese Medical Equipment Journal,2024,45(1):62-66]

Urethro-cutaneous fistula: a rare complication in anti-incontinence surgery with trans-obturator tapes sling

This case report presents a rare complication of tension-free mid-urethral tape surgery by the obturator approach (TOT) in the form of a urethro-cutaneous fistula. The patient underwent successful surgical repair, highlighting the importance of intraoperative cystoscopy to minimize surgical risks and complications. Tension-free mid-urethral tape surgery is a commonly performed procedure for the treatment of stress urinary incontinence (SUI). However, complications can occur, albeit rarely. In this case, a 52-year-old female patient developed a urethro-cutaneous fistula following TOT surgery. The fistula was identified by the presence of urine leakage at the right inguinal level, leading to significant distress and discomfort for the patient. Prompt diagnosis and appropriate management are crucial in such cases. The patient underwent surgical repair, which involved excision of the fistulous tract. The procedure was successful, resulting in complete resolution of the fistula and restoration of normal urinary function. In conclusion, this case report highlights the occurrence of a rare complication, namely a urethro-cutaneous fistula, following TOT surgery. The successful surgical repair emphasizes the importance of prompt diagnosis and appropriate management. Furthermore, the authors propose that an intraoperative cystoscopic evaluation be considered, even after a TOT procedure. Especially in cases that present risk factors or in hospital-school institutions. By implementing this practice, surgeons can enhance patient safety and improve surgical outcomes in anti-incontinence procedures.

Study of Ecological Diversity of Predatory Asopinae Bugs in the Agro-ecosystem of the Mid-Western Plains

The aim of the present study was to investigate the seasonal abundance of Asopinae predatory stink bugs within an agro-ecosystem. This research was carried out by utilizing sweep nets to collect these insects during the period spanning from May to August in the year 2022. The survey yielded two prominent species of predaceous bugs, specifically Andrallus spinidens and Eocanthecona furcellata. Interestingly, E. furcellata emerged as the dominant species within the field conditions. A noteworthy phenomenon occurred in June when a sudden surge in the population of both species was observed. This population increase was attributed to the presence of lepidopteran larvae in the field, which likely served as a rich food source for these predatory stink bugs. The ecological analysis revealed some important findings regarding the diversity and distribution of these insects in the agro-ecosystem. Specifically, the Shannon Diversity Index was notably low, registering at less than 1.99, indicating a limited variety of species within the sampled population. Similarly, the Simpson Index indicated a low degree of diversity or heterogeneity, falling within the range of 0.01 to 0.04, which further supports the notion of a relatively homogeneous population. Additionally, the Margalef Richness Index signalled a level of disturbance, measuring less than 2.05. This disturbance could be linked to various factors affecting the ecosystem, including changes in agricultural practices or environmental conditions. Lastly, the Dominance Index was relatively high, ranging between 0.5 and 1.0, signifying that a few dominant species, particularly E. furcellata, exerted a significant influence within the ecosystem. In summary, the ecological indices suggested limited diversity, low heterogeneity, disturbance, and dominance within the stink bug population, shedding light on the dynamics of these beneficial insects in the agro-ecosystem.

Contribution of mid-day meal scheme to students nutrition in Bengaluru, India: time to re-look

Background: The mid-day meal scheme (MDMS) in India is the world’s largest free school lunch program. In 2021, the scheme was renamed as PM-POSHAN (Pradhan Mantri Poshan Shakthi Nirman). We conducted a study to quantify the routine daily dietary intake of school children with reference to calorie and protein intake and assess the proportion of calorie and protein intake from mid-day meals compared to routine daily intake. Methods: This was a cross-sectional study conducted in select five government schools of urban area of Bengaluru. From each school, a sample of 69 students (23 from each class i.e., 5th, 6th, and 7th standard) were selected using a computer-generated random number table amounting to a total sample size of 345. All the data were collected in a structured proforma and electronically entered using Microsoft Excel and analyzed using Epidata analysis software, version 3.1. Results: Our study findings revealed that nearly 1 in 3.6 children have protein deficiency routinely in their diet and 1 in 7.5 children have both protein plus calorie deficiency. Conclusions: Our study has the following programmatic implications: first, the protein deficiency among the school children in the age group 9 to 14 is considerably high. Second, it is imperative to evaluate the quality of food distributed to the schools and children at regular point of time. It is also necessary that the food served to the children should be customized to their taste and it should be locally accepted.

Prevalence of severe acute malnutrition among 6-59 months children from community-based SAM management program in Dungarpur district of southern Rajasthan: diving deeper through study of block-wise prevalence

Background: Acute malnutrition (severe and moderate) is a major public health problem in India and especially Rajasthan. National family health surveys now provide prevalence of SAM children till district level but there’s an undenying need for data at even more granular, like block level, to assess the field reality in more depth. The present study tries to demystify the same at block level by studying data collected from a community-based SAM management program i.e., AMMA (acute malnutrition management action) program in Dungarpur.Methods: As part of AMMA program, block wise data from 20 districts of Rajasthan was collected monthly during implementation and its dedicated MIS was used as the source of this data. The data includes information of all children screened in the age-group of 6-59 months in Dungarpur district which was subsequently analyzed and studied till block level. The SAM prevalence is assessed, using Mid Upper Arm Circumference (MUAC) of 6-59 months children. <12.5 cm of MUAC was considered as acute malnutrition while <11.5 cm of MUAC was considered as SAM as per WHO standards.Results: A total of 1,13,547 children were screened (84.91%) in the study period. A total of 4829 children (4.25%) were found with Acute Malnutrition, out of which 4622 were identified with moderately acute malnutrition (MAM) and 207 are identified with SAM. Out of total 207 children with SAM, 118 were girls (57%) while 89 (43%) were boys. The prevalence of SAM children in the district came out as 0.18% whereas state prevalence is 0.9%. Among blocks the SAM prevalence varied from as low as 0.02% in Dowda and Chikhali to as high as 0.63% in Jothari block.Conclusions: Prevalence of SAM in Dungarpur district is low at 0.18% but block-wise analysis helped in further disaggregating the burden. To identify all children with acute malnutrition in the district there’s an urgent need to do screening based on WFH Z-score instead of complete reliance on MUAC tape.

Mid-term effectiveness of arthroscopic Bankart repair in treatment of recurrent anterior shoulder dislocation / 中国修复重建外科杂志

OBJECTIVE@#To investigate the mid-term effectiveness of arthroscopic Bankart repair for recurrent anterior shoulder dislocation.@*METHODS@#The clinical data of 107 patients with recurrent anterior shoulder dislocation who met the inclusion criteria between January 2017 and June 2021 was retrospectively analyzed, and all patients underwent arthroscopic Bankart repair. There were 88 males and 19 females. The age of the primary dislocation ranged from 13 to 48 years (mean, 23.3 years). The number of preoperative dislocations was 2-160 times (median, 7 times). The duration of preoperative instability was 0.2-240.0 months (median, 36.0 months). The mean age at operation was 28.2 years (range, 16-61 years). There were 43 cases of left shoulder and 64 cases of right shoulder. The proportion of glenoid defects in 63 patients was 1.7%-16.1% (mean, 8.1%). MRI showed that none of the patients had rotator cuff tears or shoulder stiffness. The CT three-dimensional reconstruction was performed at 1 day after operation to evaluate the distribution of implanted anchors and the occurrence of glenoid split fracture and whether there were nails pullout at the implant site. The postoperative complications were observed, and the pain and function of the shoulder were evaluated by visual analogue scale (VAS) score, Rowe score, Constant-Murley score, and American Shoulder and Elbow Surgeons (ASES) score. The recurrence of instability, the results of apprehension test, the number of patients who returned to preoperative sports level, and the satisfaction rate of patients were recorded.@*RESULTS@#All patients were successfully operated and were followed up 20-73 months (mean, 41.5 months). All incisions healed by first intention. The CT three-dimensional reconstruction at 1 day after operation showed that the anchors were located at the 2 : 00-5 : 30 positions of the glenoid, and there was no glenoid split fracture or nails pullout at the implant site. At last follow-up, VAS score was significantly lower than that before operation, and Rowe score, Constant-Murley score, and ASES score were significantly higher than those before operation ( P<0.05). Seven patients (6.5%) had recurrence of anterior shoulder dislocation at 23-55 months (mean, 39.9 months) after operation, including 6 cases of dislocation and 1 case of subluxation. At last follow-up, 51 patients (47.7%) returned to preoperative sports level, and 11 patients (10.3%) had a positive apprehension test. The patients' satisfaction rate was 90.7% (97/107). Among the 10 patients who were not satisfied with the surgical effectiveness, 7 patients had postoperative recurrence of instability, and 3 patients felt that they did not return to preoperative sports level.@*CONCLUSION@#Arthroscopic Bankart repair has good mid-term effectiveness in patients with recurrent anterior shoulder dislocations, minimal or no glenohumeral bone defects and low sports need.

Short- and mid-term effectiveness of unicompartmental knee arthroplasty for post-traumatic arthritis of knee / 中国修复重建外科杂志

OBJECTIVE@#To investigate the short- and mid-term effectiveness of unicompartmental knee arthroplasty (UKA) for post-traumatic arthritis (PTA) of knee.@*METHODS@#The clinical data of 30 patients with PTA of unilateral knee between March 2014 and September 2021 was retrospectively analyzed. There were 14 males and 16 females with an average of 64.5 years (range, 33-81 years). The average body mass index was 26.7 kg/m 2 (range, 19.8-35.6 kg/m 2). The types of injuries that caused PTA included intra-articular fracture in 16 cases, extra-articular fracture in 8 cases, and soft tissue injury in 6 cases. The initial injuries were treated by conservative therapy in 12 cases and by surgical therapy in 18 cases. Ten cases were medial compartment osteoarthritis and 20 cases were lateral compartment osteoarthritis. According to Kellgren-Lawrence staging, there were 19 cases of grade Ⅲ and 11 cases of grade Ⅳ. The operative time, the length of hospital stay, complications, and subjective satisfaction were recorded. The Oxford Knee Function Score (OKS), Hospital for Special Surgery (HSS) score, and knee range of motion (ROM) were used to evaluate knee function. Weight-bearing X-ray films were taken to measure the femoro-tibial angle (FTA) and to assess alignment correction of the lower limb.@*RESULTS@#The operative time ranged from 50 to 95 minutes (mean, 63.7 minutes), the length of hospital stay ranged from 3 to 8 days (mean, 6.9 days). Superficial infection occurred in 2 patients, while the remaining incisions healed by first intention. There was no deep vein thrombosis or neurovascular injury. All patients were followed up 17-109 months (median, 70 months). At last follow-up, OKS score, HSS score, and ROM in 30 cases significantly improved when compared with those before operation (P<0.05). Lower limb alignment was significantly corrected and there was significant difference in FTA of the varus and valgus knees between pre- and post-operation ( P<0.05). The patient satisfaction rate was 86.7% (26/30). Two cases developed contralateral osteoarthritis progression during follow-up. No bearing dislocation, prosthesis loosening or sinking occurred and none required further revision.@*CONCLUSION@#For patients with PTA of knee, UKA can obtain definite short- and mid-term effectiveness with high patient satisfaction.

Mid-term effectiveness of arthroscopic "mini incision" transtendon repair for partial articular-sided supraspinatus tendon avulsion lesion / 中国修复重建外科杂志

OBJECTIVE@#To explore the mid-term effectiveness of arthroscopic "mini incision" transtendon repair for partial articular-sided supraspinatus tendon avulsion (PASTA) lesion.@*METHODS@#A clinical data of 39 patients with PASTA lesions, who underwent the arthroscopic "mini incision" transtendon repair and met the selected criteria between May 2017 and April 2021, was retrospectively analyzed. There were 13 males and 26 females, with an average age of 63.7 years (range, 43-76 years). Nine patients underwent trauma history, and no obvious inducement was found in the other 30 patients. The main clinical symptom was shoulder pain with positive hug resistance test. The interval from symptom onset to operation was 3-21 months (mean, 8.3 months). The visual analogue scale (VAS) score, University of California Los Angeles (UCLA) shoulder score, American Association of Shoulder and Elbow Surgeons (ASES) score and shoulder range of motion (ROM) of forward flexion, abduction, and external rotation were used to evaluate shoulder function. MRI was performed to assess the structural integrity and tension of reattached tendon. Patient satisfactions were calculated at last follow-up.@*RESULTS@#All incisions healed by first intention with no complications such as incision infection or nerve injury. All patients were followed up 24-71 months (mean, 46.9 months). The VAS, UCLA, and ASES scores significantly improved at 24 months after operation when compared with preoperative ones ( P<0.05). The ROMs of forward flexion and external rotation of the shoulder joint significantly increased at 3 and 24 months, and further increased at 24 months compared to 3 months, with significant differences ( P<0.05). However, the ROM of abduction of the shoulder joint at 3 months did not significantly improve compared with that before operation ( P>0.05), and it was significantly greater at 24 months than before operation and at 3 months after operation ( P<0.05). At last follow-up, the patients were very satisfied with the effectiveness in 30 cases (76.9%), satisfied in 5 cases (12.8%), and dissatisfied in 4 cases (10.3%). At 6 months after operation, 31 patients underwent reviews of MRI scans, of which 28 patients possessed intact structural integrity, good tendon tension and tendon healing, and 3 patients underwent tendon re-tear.@*CONCLUSION@#Arthroscopic "mini incision" transtendon repair in treatment of PASTA lesion could obtain satisfying mid-term effectiveness with low risk of tendon re-tear.

Concomitant repair of moderate or less tricuspid regurgitation during mitral valve surgery improves early and mid-term prognosis of tricuspid valve and right heart function / 中国胸心血管外科临床杂志

@#Objective    To investigate the effect of concomitant tricuspid valve repair during mitral valve surgery on the early and mid-term prognosis of the tricuspid valve and right heart function in the patients with moderate or less tricuspid regurgitation. Methods    A retrospective study of 461 patients with mitral valve disease requiring cardiac surgery combined with moderate or less tricuspid regurgitation in our hospital from 2011 to 2014 was done. They were 309 males and 152 females with a median age of 53.00 (44.00, 60.00) years. According to whether they received tricuspid valve repair (Kay’s annuloplasty, DeVega’s annuloplasty or annular ring implantation), the patients were divided into a mitral valve surgery only group (a nTAP group, n=289) and a concomitant tricuspid valve repair group (a TAP group, n=172). At the same time, 43 patients whose tricuspid valve annulus diameter was less than 40 mm in the TAP group were analyzed in subgroups. Results    The median follow-up duration was 3.00 years (range from 0.10 to 9.30 years). There was no perioperative death. Three months after surgery, the anteroposterior diameter of the right ventricle in the TAP group was significantly improved compared with that in the nTAP group [–1.00 (–3.00, 1.00) mm vs. 0.00 (–0.20, 2.00) mm, P=0.048]. Three years after surgery, the improvement of right ventricular anteroposterior diameter in the TAP group was still significant compared with the nTAP group [–1.00 (–2.75, 2.00) mm vs. 2.00 (–0.75, 4.00) mm, P=0.014], and the patients in the TAP group were less likely to develop moderate or more tricuspid regurgitation (3.64% vs. 35.64%, P<0.001). Annuloplasty ring implantation was more effective in preventing regurgitation progression (P=0.044). For patients with a tricuspid annulus diameter less than 40 mm, concomitant tricuspid valve repair was still effective in improving the anteroposterior diameter of the right ventricle in the early follow-up (P=0.036). Conclusion     Concomitant tricuspid valve repair for patients with moderate or less tricuspid regurgitation during mitral valve surgery can effectively improve the tricuspid valve and right heart function in the early and mid-term after surgery. Annuloplasty ring implantation is more effective in preventing regurgitation progression. Patients whose tricuspid annulus diameter is less than 40 mm can also benefit from concomitant tricuspid repair.

Study of the effect of mid-ventricular obstruction on left ventricular systolic function in patients with hypertrophic cardiomyopathy by four-dimensional automatic left ventricular quantitation technology / 中华超声影像学杂志

Objective:To investigate the effect of mid-ventricular obstruction (MVO) on left ventricular systolic function in patients with hypertrophic cardiomyopathy(HCM) by four-dimensional automatic left ventricular quantitation technology(4D Auto LVQ).Methods:Fifty-seven hypertrophic obstructive cardiomyopathy patients were selected from December 2020 to October 2022 in the First Affiliated Hospital of Zhengzhou University. According to the presence of MVO, HCM patients were divided into two groups: HCM 1 group, HCM without MVO ( n=34); HCM 2 group, HCM with MVO ( n=23). In addition, 25 healthy subjects in the same period were selected as the control group. Conventional ultrasound parameters were collected, and 4D Auto LVQ technology was used to obtain the mechanical parameters of left ventricular myocardium, including left ventricular longitudinal strain (GLS), circumferential strain (GCS), area strain (GAS), radial strain (GRS), segmental longitudinal strain (SLS) and area strain (SAS). The differences of these parameters among the three groups were compared. Results:①Compared with the control group, the thickness of the maximum basal segment of interventricular septum, the thickness of the middle segment of the maximum interventricular septum, the thickness of the apical segment of the interventricular septum, the thickness of the left ventricular posterior wall and left atrium diameter were significantly increased. Six-minute walk distance and the left ventricular end-diastolic diameter was decreased in the two groups of HCM(all P<0.05). Left ventricular outflow tract gradients in HCM 1 group was higher than HCM 2 group( P<0.05), but there was no significant difference in left ventricular ejection fraction among the three groups( P>0.05). There was significant difference in the incidence of left ventricular apical aneurysm among the three groups( P<0.05). ②Compared with the control group, the GLS in both HCM groups was lower, and it was lower in the HCM 2 group than in the HCM 1 group(all P<0.05) the GRS and GAS in both HCM groups were lower than in the control group ( P<0.05), and there was no significant difference between the two groups of HCM, and there was no significant difference in GCS among the three groups(all P>0.05). ③Compared with the control group, the SLS of basal segment, middle segment, apical cap, posterior septum, inferior wall and lateral wall in HCM group were significantly lower than those in control group. The SLS of apical segment of posterior septum, anterior septum, anterior wall, posterior wall, inferior wall and apical segment of posterior septum, lateral wall and inferior wall in HCM 2 group were significantly lower than HCM 1 group(all P<0.05), but there was no significant difference in SLS of posterior septum, anterior septum, anterior wall, lateral wall and inferior wall between the two groups(all P>0.05). ④Compared with the control group, the SAS of posterior septal basal segment, middle segment, anterior septal middle segment, anterior wall basal segment, middle segment, apical segment, lateral wall basal segment, middle segment, apical segment, posterior wall basal segment, middle segment, inferior wall basal segment, middle segment and apical cap in HCM groups were significantly lower than the control group(all P<0.05), but there was no significant difference in SAS between the two groups of HCM( P>0.05). Conclusions:4D Auto LVQ can quantitatively evaluate the damage of MVO on the left ventricular systolic function in patients with HCM, especially for the evaluation of local myocardial function damage in the medial segment and apical segment.

Short-, mid-, and long-term outcomes of suburethral slings with concomitant pelvic organ prolapse surgeries / Philippine Journal of Obstetrics and Gynecology

Background@#This retrospective cohort study assessed the outcomes of combined surgeries for pelvic organ prolapse (POP) and stress urinary incontinence (SUI) in 31 patients with a follow-up of 7 years.@*Objectives@#The study aimed to determine the success and recurrence rates of POP and SUI while comparing the outcomes, analyzing the predictors for recurrence, and reporting on complications.@*Materials and Methods@#Demographic and clinical profiles were analyzed descriptively using frequency and percentages. Objective SUI cure rate was assessed via office cystometry with a cough stress test, while POP was evaluated using the POP-Q system. Subjective cure rates for both conditions were determined using a symptom severity checklist based on the King's Health Questionnaire. Chi-square tests assessed associations between objective outcome parameters and time elapsed since surgery, and other outcome predictors, with significance set at p < 0.05.@*Results@#The results showed a high objective cure rate of 96% for SUI and subjective cure rates of 96% for both SUI and POP. Long-term symptoms included urine frequency and retention, while mesh erosion occurred in one patient. The objective cure rate for POP was 67.7%, with recurrence in the anterior compartment at the midterm and in various compartments at long term. Vault fixation suggests efficacy in reducing apical prolapse recurrence. The preoperative age was identified as a significant risk factor for POP recurrence. @*Conclusion@#This study supports the durability and efficacy of combined surgeries for SUI and POP, with high patient satisfaction.

Could mid-upper arm circumference be a valid proxy to the body mass index for elderly persons?

Introduction: In elderly persons, due to physiological, anatomical, and functional changes, body mass index (BMI) may not be suitable for the assessment of nutritional status. Mid-upper arm circumference (MUAC) can be a proxy indicator to identify underweight and overweight/obesity among elderly persons. This study aimed to estimate the correlation between MUAC and BMI, and the cutoffs for MUAC using receiver operating characteristic (ROC) analysis. Material and Methods: This survey was carried out in a resettlement colony of Delhi. The participants were residents of the area who were aged 60 years or older, and selected by a simple random sampling technique. The arm span, weight, and MUAC of the participants were measured. The correlation between MUAC and BMI for gender and age group was calculated. The ROC curve was also constructed. Results: A total of 946 eligible participants were enrolled. The correlation between MUAC and BMI was 0.67 (P < 0.001) and 0.76 (P < 0.001) among men and women, respectively. The MUAC cutoff for underweight was <25 cm with a sensitivity of 68.8% and specificity of 84.9%. The area under the curve (AUC) was 0.84 (0.80–0.88). The MUAC cutoff for overweight/obesity was ?27 cm with a sensitivity of 83.9% and specificity of 64.9%, and AUC was 0.78 (0.75–0.82). Conclusion: The MUAC of the participants increased as the BMI of the participants increased. MUAC cutoff was determined using the ROC curve for underweight and overweight/obesity among elderly persons.