Follicular unit grafting in chronic ulcers: a valuable technique for integrated management

Abstract Chronic ulcers significantly affect the quality of life of patients and impose a high cost on the healthcare system. The therapeutic management should be comprehensive, taking into consideration the etiological diagnosis of the wound and the characteristics of the wound bed when deciding on a therapeutic proposal appropriate to the healing phase, correcting factors that delay healing. During the epithelialization phase, repair techniques with grafts are recommended to shorten re-epithelialization time, improve the quality of scar tissue, and achieve adequate pain management. Currently, due to the reported benefits of skin appendages, the technique of follicular unit auto-grafting obtained with a scalp punch is among the chosen strategies for wound repair. This is a minimally invasive, outpatient practice, whose technique has advantages over the donor site, patients recovery and well-being.

Clinical efficacy of PDCA cycle management model cycle management combined with pulsed tooth punch applied in maintenance period of patients with moderate to severe periodontitis / 吉林大学学报(医学版)

Objective:To observe the clinical efficacy of plan-do-check-Act(PDCA)cycle management model combined with pulsed tooth punch applied in maintenance period of the patients with moderate to severe periodontitis,and to provide the theoretical basis for application of the PDCA cycle management model in the periodontitis patients.Methods:A total of 50 patients with moderate to severe periodontitis were selected based on predefined inclusion,exclusion,and elimination criteria.The patients were randomly divided into experiment group(n=25)and control group(n=25).The patients in experiment group underwent maintenance care with pulsed tooth punch in combination with the BASS brushing technique,while the patients in control group maintained oral hygiene with the BASS brushing technique alone.The patients in both two groups were managed with the PDCA cycle management model.The patients were asked to return for follow-up visits at 2,4,8,and 12 weeks of self-care,and the personalized corrections and guidance were provided based on the plaque accumulation.The clinical periodontal parameters,including plaque index(PLI),probing depth(PD),and bleeding index(BI),at 4 and 12 weeks of self-care,as well as the levels of tumor necrosis factor-α(TNF-α)and interleukin-17(IL-17)in the gingival crevicular fluid of the patients in two groups were observed and recorded.Results:After 4 and 12 weeks of self-care,compared with control group,the PLI,PD,and BI of the patients in experiment group were significantly decreased(P<0.01);compared with baseline,the PLI,PD,and BI of the patients in both two groups at 4 and 12 weeks of self-care were increased(P<0.05 or P<0.01);Compared with 4 weeks of self-care,the PLI,PD,and BI of the patients at 12 weeks of self-care were increased(P<0.01).After 4 and 12 weeks of self-care,compared with control group,the levels of TNF-α and IL-17 in gingival crevicular fluid of the patients in experiment group were significantly decreased(P<0.01);compared with baseline,the levels of TNF-α and IL-17 in gingival crevicular fluid of the patients in two groups at 4 and 12 weeks of self-care were increased(P<0.01).Conclusion:The use of pulsed tooth punch under the PDCA cycle management model can significantly decrease the PLI,PD,BI,and the levels of inflammatory factors in gingival crevicular fluid of the patients with moderate to severe periodontitis,and inhibit the plaque formation and control the gingival inflammation,benefite the maintenance of efficacy of the patients with moderate to severe periodontitis.

Double-column Die-punch fractures of distal radius treated with butterfly plate fixation via Henry approach / 中国骨伤

OBJECTIVE@#To explore clinical effect of open reduction and internal fixation with Henry's approach butterfly plate in treating double-column Die-punch fractures of distal radius.@*METHODS@#From January 2018 to June 2021, 26 patients with double-column Die-column distal radius were treated with open reduction and internal fixation through Henry's surgical approach and using distal radius volar column plate(butterfly plate), including 14 males and 12 females, aged from 20 to 75 years old with an average age of (44.2±3.4) years old. Postopertaive complications were observed, Gartland-Werley score at 12 months after opertaion was used to evaluate wrist joint function.@*RESULTS@#All 26 patients were followed up from 10 to 18 months with an average of(13.4±0.8) months. All fractures were obtained fracture union, the time ranged from 8.5 to 15.8 weeks with an average of (11.4±0.5) weeks. All incisions healed at stageⅠwithout infection, nerve injury and internal fixation failure occurred. Postoperative Gartland-Werley score at 12 months was (3.65±0.36), and 16 patients got excellent result, 8 good and 2 moderate.@*CONCLUSION@#Open reduction and internal fixation with butterfly plate for the treatment of double-column Die-punch fractures of the distal radius through volar Henry approach could obtain satisfactory clinical outcomes.

Prevalence of premalignant cervical lesions among women in community-based screening program using visual inspection with acetic acid in Metro Manila / Philippine Journal of Obstetrics and Gynecology

Background@#Cervical cancer remains a health-care burden in our country. Majority of women afflicted with this cancer are diagnosed in advanced stage. Several groups like the Philippine Society for Cervical Pathology and Colposcopy (PSCPC) have put forth efforts to decrease and eventually eliminate cervical cancer through improvement in level of awareness on the disease and community-based cervical cancer screening programs using visual inspection using acetic acid (VIA). Data on the prevalence of premalignant lesions using this screening method are limited in our country. Thus, the initiative of the society (PSCPC) to embark on this study. @*Objective@#The objective of this study was to determine the prevalence of premalignant cervical lesions among women screened in community-based screening program using VIA in Metro Manila.@*Methodology@#A retrospective cross-sectional study with collection of data from medical records of cervical screening programs done by the PSCPC from March 2017 to December 2019 was done. VIA was done for screening. All VIA-positive women underwent colposcopy and those with abnormal findings had colposcopically guided cervical punch biopsy.@*Results@#A total of 1072 women were screened with a positivity rate of 14.6%. One hundred and fifty-six women were VIA positive and 79 of these women underwent colposcopically guided biopsy. Premalignant cervical lesions were seen in 21 women. The prevalence rate of premalignant cervical lesions in VIA-positive women was 13.5%. The prevalence of premalignant cervical lesions among all women screened was 2%. Risk factors associated with premalignant lesions were early coitarche and smoking.@*Conclusion@#The prevalence of premalignant cervical lesions among women who underwent community-based cervical cancer screening using VIA is lower compared to other studies at 2%.

Clinical analysis of triamcinolone acetonide in the treatment of keloids / 中国药师

Objective To investigate the clinical efficacy of triamcinolone acetonide combined with punch excision in the treatment of keloids.Methods Patients with keloids diagnosed and treated in The First Affiliated Hospital,Zhejiang University School of Medicine from January 2021 to January 2022 were retrospectively collected.Patients with keloids were divided into conservative(triamcinolone acetonide and fluorouracil)and non-conservative(punch excision combined with treamcinolone acetonide and fluorouracil)according to their treatment regimens.The scores of the Patient and Observer Scar Assessment Scale(POSAS),the Vancouver Scar Scale(VSS)and the Visual Analogue Rating Scale(VAS)were compared before and after treatment,the total effective rate was calculated to evaluate,the clinical efficacy,and the occurrence of adverse events was observed to evaluate the safety.Results A total of 99 patients with keloids were included in the study,including 53 in the conservative treatment group and 46 in the non-conservative treatment group.Before treatment,there was no significant difference in POSAS score,VSS score and VAS score between the two groups(P>0.05).Compared with the conservative treatment group,the POSAS score,VSS score and VAS score of the non-conservative treatment group decreased significantly after treatment(P<0.05).The total effective rate of treatment in the non-conservative treatment group was significantly higher than that in the conservative treatment group(P<0.05).In terms of adverse reactions,the risk of bleeding increased,the incidence of skin pigmentation decreased,and the telangiecasia and skin atrophy didn't occur in the non-conservative treatment group.Conclusion Triamcinolone acetonide combined with punch excision has a significant effect on keloids,which can reduce the incidence of skin atrophy but increase the risk of bleeding.

Research progress on"one-two punch"strategy in the therapy of glioma / 中国肿瘤临床

Glioblastoma(GBM)originates from glial cells,and complete surgical resection followed by radiotherapy and chemotherapy is the current standard treatment.However,gliomas are subjected to not only accelerated cell death after radiotherapy and chemotherapy but also cellular senescence.Senescent cells produce a senescence-associated secretory phenotype(SASP),which has a dual effect on the tumor microenvironment.The"one-two punch"strategy of specifically eliminating senescent cells and inhibiting SASP-derived secretions provides a new direction for tumor therapy.In this article,we review the mechanisms that mediate tumor cellular senescence and SASP,the elimina-tion of senescent cells by senolytics for SASP inhibition,and the current situation of the"one-two punch"strategy for the treatment of glioma.

Analysis of postoperative adverse reactions in 27 cases of acne scars treated with punch elevation / 中华皮肤科杂志

Objective:To analyze postoperative adverse reactions in patients with acne scars treated with punch elevation.Methods:Totally, 27 patients with moderate or severe acne scars, who were treated with punch elevation, were collected from the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2020 to March 2021. The patients received local infiltration anesthesia during the operation, and were cared for with tensile adhesive plaster bandaging, cold compresses, and waterproofing after the operation; telephone and face-to-face follow-up visits were conducted immediately, 3, 7, 14, 21, 30, and 60 days after the operation, and numerical rating scale (NRS) of intraoperative pain, postoperative swelling duration, postoperative erythema duration, and the incidence of post-inflammatory hyperpigmentation were recorded.Results:Among the 27 patients, the severity score of acne scars was 77.76 ± 43.76 points. The intraoperative pain NRS score was 3.75 ± 2.95 points after local infiltration anesthesia, the postoperative swelling lasted 3.42 ± 2.43 days, postoperative erythema lasted 4.74 ± 3.25 weeks, and the duration of postoperative erythema was not significantly correlated with the severity score of acne scars ( r = -0.13, P = 0.449). After the operation, post-inflammatory hyperpigmentation occurred in 2 patients, and no local infections or fulminant acne was observed. The patient satisfaction rate was 100% (27/27) . Conclusion:The main adverse reactions to punch elevation for acne scars were postoperative swelling and erythema, which subsided spontaneously about 1 month after the operation.

Bone-Anchored Hearing Implants: Surgical and Audiological Comparison of Different Surgical Techniques

Abstract Introduction The bone-anchored hearing implant system (BAHS) is an effective amplification system that transmits the sounds received by an external operating system to the inner ear by bypassing the middle ear placed in the temporal bone. Objective This study compares the results of patients who underwent bone-anchored hearing implant system (BAHS) surgery using two different surgical methods in terms of preoperative and postoperative complications, surgical time, audiological findings, and patient satisfaction. Methods The results of 22 patients who underwent BAHS were evaluated retrospectively from video records and audiological results, The Turkish Version of the Glasgow Benefit Inventory (GBI) questionnaire were evaluated. Two different surgical approaches were used for implantation: the linear incision technique (n = 9) and the punch technique (n = 13). Results Mean surgical durations were 9.67 ± 2.85 and 47.65 ± 6.13 minutes for Groups A and B, respectively, and these were significantly different (p < 0.001). There were no significant differences between the groups' speech recognition scores for a signal-to-noise ratio (SNR) of +5 (p = 0.173), SNR of 0 (p = 0.315), or SNR of -5 (p = 0.360) and results of the GBI scores. Conclusion The punch technique has a significant advantage due to a shorter surgery duration without increased surgical complications. Additionally, the punch technique showed no significant difference in hearing performance or satisfaction compared with linear incision.

Comparison of three techniques of harvesting full-thickness retinal tissue for large or persistent macular holes

Purpose: To evaluate the success rate of autologous retinal graft (ARG) for the closure of full?thickness macular holes (MHs) and compare the outcomes of three different techniques of harvesting the graft. Methods: Clinic files of all patients who had undergone ARG for MH using intraocular scissors, membrane loop, or retinal punch to harvest retinal tissue were retrospectively reviewed. All patients were evaluated for MH closure, retinal reattachment, and visual improvement. Results: Twenty?two eyes of 22 patients were included. ARG was done for 16 eyes (72.7%) with failed, large persistent MH, and six eyes (27.3%) also underwent simultaneous repair of retinal detachment. The basal diameter of MH was 1103.67 ± 310.09 (range 650–1529) ?m. Intraocular scissors were used in 10 eyes (45.5%), a membrane loop in five eyes (22.7%), and a retinal punch in seven eyes (31.8%). Silicone oil tamponade was used in seven (31.8%) eyes and gas in 15 (68.1%) eyes. The follow?up ranged from 6 to 18 months. The hole closure rate was 72.7% (16/22). Visual improvement was noted in 18 eyes (81.8%). Retinal reattachment was seen in all eyes. Good graft integration with the surrounding area was seen in 17 eyes (77.3%). Graft retraction was seen in four eyes (18.18%) and graft loss in one eye (4.55%). No significant differences were noted among the three groups. Conclusion: ARG is successful in closing large, failed MH with and without retinal detachment. A membrane loop and retinal punch are equally useful in harvesting the graft, but scissors are preferable in case the retina is detached. With all three techniques, integration of the graft with the surrounding tissue can be achieved

Mejora del rendimiento post-activación con banco plano o landmine en la fuerza del golpe recto / Melhoria do desempenho de pós-ativação com banco plano ou landmine na força do golpe reto / Post-activation performance enhancement with bench press or landmine on straight punch strength

RESUMEN La presente investigación centró sus esfuerzos en descubrir alternativas metodológicas que beneficien la posibilidad de aplicar altos niveles de fuerza en el golpe recto, favoreciendo con ello la probabilidad de una victoria por la vía del knock out. La hipótesis de trabajo planteó que, si se emplean ejercicios con un efecto de mejora del rendimiento postactivación, se puede incrementar la fuerza aplicada al golpe recto. Este cuasi-experimento tuvo como objetivo determinar los efectos agudos de la mejora del rendimiento postactivación en la fuerza aplicada en el golpe recto, utilizando el banco plano o el Landmine como actividad condicionante. Se trabajó con 20 boxeadores (ocho profesionales y 12 amateur), y dividió la población en dos grupos, emparejados según el peso corporal. Se evaluó la fuerza máxima de impactocon una celda de carga modelo WLCC01, luego se determinó la fuerza máxima dinámica para cada ejercicio, y a partir de estos datos, se colocó una carga a movilizar del 60 % de la fuerza máxima dinámica, ejecutando repeticiones hasta que la velocidad del movimiento disminuyó más del 10 %. Seguidamente, se volvió a evaluar la fuerza máxima de impacto. Se tomaron registros inmediatamente después, al minuto uno, dos, tres, cuatro y cinco. Los resultados expresaron un aumento del 9.3 % en el grupo de banco plano y del 12,46 % en el grupo de Landmine. Se concluyó que ambos ejercicios, al ser utilizados como actividad condicionante, generan un incremento significativo (p 0.05) de la fuerza máxima de impacto en el golpe recto.

RESUMO A presente investigação centrou os seus esforços na descoberta de alternativas metodológicas que beneficiem a possibilidade de aplicar níveis elevados de força no golpe reto, favorecendo assim a probabilidade de uma vitória por knock-out. A hipótese de trabalho propôs que, se forem utilizados exercícios com um efeito de melhoria do desempenho pós-ativação, a força aplicada ao golpe reto pode ser aumentada. Esta quase-experimentação visava determinar os efeitos agudos do melhoramento do desempenho pós-ativação sobre a força aplicada ao golpe reto, utilizando como atividade condicionadora a bancada plana ou Landmine. Trabalhámos com 20 pugilistas (oito profissionais e 12 amadores). A força máxima de impacto foi avaliada com uma célula de carga modelo WLCC01, depois a força dinâmica máxima foi determinada para cada exercício, e a partir destes dados, foi colocada uma carga para mobilizar 60 % da força dinâmica máxima, executando repetições até a velocidade do movimento diminuir mais de 10 %. Depois, a força máxima de impacto foi reavaliada. Os registos foram tirados imediatamente após, aos um, dois, três, quatro e cinco minutos. Os resultados mostraram um aumento de 9,3 % no grupo dos bancos planos e de 12,46 % no grupo das minas terrestres. Concluiu-se que ambos os exercícios, quando utilizados como atividade condicionante, geram um aumento significativo (p 0,05) da força máxima de impacto no soco reto.

ABSTRACT The present research focused its efforts on discovering methodological alternatives that benefit the possibility of applying high levels of strength in the straight punch, thus favoring the probability of a victory by knockout. The working hypothesis proposed that, if exercises with a post-activation performance enhancement effect are used, the strength applied to the straight punch can be increased. This quasi-experiment aimed to determine the acute effects of post activation performance enhancement on the strength applied to the straight punch, using the bench press or the Landmine as the conditioning activity. It was worked with 20 boxers (eight professional and 12 amateur), and the population was divided into two groups, matched according to body weight. The maximum impact strength was evaluated with a load cell model WLCC01, then the maximum dynamic strength was determined for each exercise, and from this data, a load was placed to mobilize 60 % of the maximum dynamic strength, performing repetitions until the speed of the movement decreased by more than 10 %. Then, the maximum impact strength was re-evaluated. Records were taken immediately after, at one, two, three, four and five minutes. The results showed an increase of 9.3 % in the bench press group and 12.46 % in the Landmine group. It was concluded that both exercises, when used as conditioning activity, generate a significant increase (p 0.05) of the maximum impact strength in the straight punch.

Impacto del puñetazo y de la patada en los deportes de combate: una revisión sistemática / Punch and kick impact in combat sports: a systematic review

Resumen Marques-Junior, N.K. (2020). Impacto del puñetazo y de la patada en los deportes de combate: una revisión sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 18(2), 1-27. El objetivo de la revisión sistemática fue presentar el impacto del puñetazo y de la patada en algunos deportes de combate. Los artículos fueron recuperados de internet entre septiembre de 2018 y agosto de 2019. La recopilación de los artículos se realizó por medio de Google Scholar, Research Gate y PubMed. La revisión sistemática contó con 19 artículos científicos. El golpe con el puño de mayor impacto, en los luchadores masculinos, fue el golpe recto del boxeo con 4800 ± 601 newtons (N); mientras que, en las mujeres, fue el jab del boxeo con 1170.7 ± 165.3 N. El impacto de la patada del taekwondo femenino (TKD) tuvo un mayor resultado realizando el tchagui con 2490.3 ± 846.2 N y en el sexo masculino tuvo un mayor resultado del impacto realizando la bandal tchagui del TKD con 6400 ± 898 N. En conclusión, el impacto del puñetazo y de la patada de los deportes de combate es un contenido importante para que el atleta conozca el ataque más efectivo.

Resumo Marques-Junior, N.K. (2020). Impacto do soco e do chute dos esportes de combate: uma revisão sistemática. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 18(2), 1-27. O objetivo da revisão sistemática foi apresentar o impacto do soco e do chute de alguns esportes de combate. Os artigos foram identificados na internet durante setembro de 2018 a agosto de 2019. A coleta de artigos foi praticada no Google Scholar, no Research Gate e no PubMed. A revisão sistemática teve 19 artigos científicos. O maior impacto de soco do lutador masculino foi o direto do boxe com 4800 ± 601 newtons (N). A lutadora do sexo feminino o maior impacto foi o jab d-o boxe com 1170.7 ± 165.3 N. O impacto do chute no taekwondo feminino (TKD) teve um resultado maior do que tui tchagui com 2490.3 ± 846.2 N e no masculino teve um resultado de maior impacto do bandal tchagui do TKD de 6400 ± 898 N. Em conclusão, o impacto do soco e do chute dos esportes de combate é um conteúdo importante para o atleta conhecer o ataque mais eficaz.

Abstract Marques-Junior, N.K. (2020). Punch and kick impact in combat sports: a systematic review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 18(2), 1-27. The objective of the systematic review was to present the punch and kick impact of some combat sports. The studies were identified in electronic databases from September 2018 to August 2019. Literature searches were conducted in Google Scholar, Research Gate, and PubMed. The systematic review had 19 scientific articles. The greater punch impact of the male fighter was of the boxing straight with 4800 ± 601 newtons (N). Female fighter the greater punch impact was of the boxing jab with 1170.7 ± 165.3 N. The kick impact of the female taekwondo (TKD) had a greater result of the tui tchagui with 2490.3 ± 846.2 N and in the male had a greater result of the TKD bandal tchagui impact of 6400 ± 898 N. In conclusion, the punch and kick impact of combat sports is an important content for the athlete to know the most effective attack.

The role of skin punch grafting with plasma-rich plasma injection on stable segmental vitiligo

@#Vitiligo is a non-communicable, chronic skin condition that has psychosocial effects for the patient. The case of an otherwise healthy skin phototype IV Filipino male with a two-year history of stable vitiligo is presented here. Three sessions of skin punch grafting and platelet-rich plasma injection under local anesthetic were done on the patient three months apart, resulting in excellent cosmetic results and patient satisfaction.

The role of skin punch grafting with platelet-rich plasma injection on stable segmental vitiligo

@#Vitiligo is a non-communicable, chronic skin condition that has psychosocial effects for the patient. The case of an otherwise healthy skin phototype IV Filipino male with a two-year history of stable vitiligo is presented here. Three sessions of skin punch grafting and platelet-rich plasma injection under local anesthetic were done on the patient three months apart, resulting in excellent cosmetic results and patient satisfaction.

Impacto do soco e do chute dos esportes de combate: uma revisão sistemática / Punch and kick impact in combat sports: a systematic review

Resumo O objetivo da revisão sistemática foi apresentar o impacto do soco e do chute de alguns esportes de combate. Os artigos foram identificados na internet durante setembro de 2018 a agosto de 2019. A coleta de artigos foi praticada no Google Scholar, no Research Gate e no PubMed. A revisão sistemática teve 19 artigos científicos. O maior impacto de soco do lutador masculino foi o direto do boxe com 4800 ± 601 newtons (N). A lutadora do sexo feminino o maior impacto foi o jab d-o boxe com 1170.7 ± 165.3 N. O impacto do chute no taekwondo feminino (TKD) teve um resultado maior do que tui tchagui com 2490.3 ± 846.2 N e no masculino teve um resultado de maior impacto do bandal tchagui do TKD de 6400 ± 898 N. Em conclusão, o impacto do soco e do chute dos esportes de combate é um conteúdo importante para o atleta conhecer o ataque mais eficaz.

Resumen El objetivo de la revisión sistemática fue presentar el impacto del puñetazo y de la patada en algunos deportes de combate. Los artículos fueron recuperados de internet entre septiembre de 2018 y agosto de 2019. La recopilación de los artículos se realizó por medio de Google Scholar, Research Gate y PubMed. La revisión sistemática contó con 19 artículos científicos. El golpe con el puño de mayor impacto, en los luchadores masculinos, fue el golpe recto del boxeo con 4800 ± 601 newtons (N); mientras que, en las mujeres, fue el jab del boxeo con 1170.7 ± 165.3 N. El impacto de la patada del taekwondo femenino (TKD) tuvo un mayor resultado realizando el tchagui con 2490.3 ± 846.2 N y en el sexo masculino tuvo un mayor resultado del impacto realizando la bandal tchagui del TKD con 6400 ± 898 N. En conclusión, el impacto del puñetazo y de la patada de los deportes de combate es un contenido importante para que el atleta conozca el ataque más efectivo.

Abstract The objective of the systematic review was to present punch and kick impact in some combat sports. The articles were retrieved from Google Scholar, Research Gate, and PubMed between September 2018 and August 2019. The systematic review included 19 scientific articles. The punch with the greatest impact was the boxing straight punch with 4800 ± 601 Newtons (N) in male fighters and the boxing jab with 1170.7 ± 165.3 N in female fighters. The kick with the greatest impact in taekwondo (TKD) was tui tchagui with 2490.3 ± 846.2 N in females and TKD bandal tchagui with 6400 ± 898 N in males. In conclusion, punch and kick impact in combat sports is an important content for athletes to know the most effective attack.

Histomorphological analysis and clinical correlation of neoplastic and non neoplastic skin lesions: a study in a tertiary care centre of Western Uttar Pradesh, India

Background: Clinical examination may suffice in making diagnosis of most dermatologic disorders but histopathological examination is often required to confirm the diagnosis and further categorize the lesions. Authors carried out this study to analyse the demographic and histomorphological characteristics of skin lesions, to determine the frequency of various dermatological disorders in the region and to evaluate the agreement between clinical and histopathological diagnosis.Methods: Punch biopsies of skin lesions received in histopathology section, were included in the study. Cases over a period of six months were analysed. Clinical details were recorded and histopathological analysis done. Special stains were applied wherever required.Results: Of the 120 cases studied, maximum cases fell in the category of 31-40 years, with male predominance.  Authors observed wide variety of non-neoplastic and neoplastic lesions. Infectious diseases were the most common of all pathologies. Leprosy was the most common histopathological diagnosis. Complete clinicopathologic correlation was seen in 51.67% of cases while partial correlation was noted in 23.33% making a total of 75%. 25% histopathological diagnosis were inconsistent with the clinical diagnosis.Conclusions: Histopathology is a gold standard investigation and plays a very important role in confirmation of clinical diagnosis of various skin lesions. Punch biopsy is a relatively easy outpatient procedure to perform.

Clinical Study on Surgical Outcomes of Endoscopic Dacryocystorhinostomy (DCR) between Powered and Non-Powered Techniques.

Dacryocystorhinostomy (DCR) is a bypass operation for tear drainage system which involves removal of bone adjacent to lacrimal sac and incorporating lacrimal sac with nasal mucosae. The operative approaches to lacrimal apparatus are external and endoscopic. In recent times advances in surgical technique and better standing of anatomy have made several changes in endoscopic DCR all aiming to improve results, reduce complications, and reduce operative time. Both costly powered and cost affective non-powered instruments are commonly used to make bone windows in endoscopic DCR. The aim of this study is to compare merits and demerits of powered instrument (Drill) and non-powered (Kerrison’s punch) DCR. METHODSA randomized comparative study of 60 patients in the age group of 21-70 yrs. who attended our outpatient department regularly and underwent endoscopic DCR procedure at our institution from June 2017 until Aug. 2019 was conducted. Patients were categorised into two groups of 30 patients each, one group which had patients who were operated conventionally by Kerrison’s punch and the group with patients who were operated by powered drill. Operative technique, surgical outcome and complications were compared between the two groups. RESULTSA total of 60 endoscopic endonasal DCRs were performed during the period. Male: female ratio; 1:5. 36 (60%) patients presented with watering of eye. Procedure success rate among Kerrison’s punch group was 93.33 % vs. 90% in powered drill group (p= 0.476). The complications rate in Kerrison’s punch group was 10% compared 20% in powered drill group (p= 0.032). The mean operating time among Kerrison punch group was 33.3 min which was significantly lower than that of powered drill group which was 78.3 min. CONCLUSIONSEndoscopic DCR is keyhole minimal invasive magic surgery. In a comparative study, Kerrison’s punch was found to be better tool for making bony window in terms of cost, operating time and complications when compared to powered drill. In terms of success rate of surgery and other factors, there was no significant difference between the two groups.

Comparison Of Cervical Biopsy Using Punch Biopsy Forceps Versus Loop Electrode

Context: The biopsy of cervix can be obtained by various methods with availability of newer modalities like loop elec-trode. Objectives: To compare the histo-pathological parameters and clinical outcome of cervical biopsy obtained using punch biopsy forceps versus loop electrode. Methods: Women attending OPD were screened for cervical pa-thology, and colposcopy was done for those who screened positive. Patients who required cervical biopsy after col-poscopy were allocated into 2 group; one undergoing LEEP biopsy and other half biopsied with Punch forceps. During procedure patients were evaluated for the intra–op pain and bleeding and their severity. The histo-pathological di-agnosis was carried out and the sample was studied for its size, adequacy, and presence of any thermal or crush ar-tefacts. Result: The two methods of biopsy were comparable in intra-op parameters, except for the increased re-quirement for additional haemostasis in LEEP biopsy. There was no case of bleeding from biopsy site at the follow-up visit. LEEP biopsy was associated with continued vaginal discharge more often than punch biopsy. An adequate sam-ple for histopathological diagnosis was obtained in 91.25% of all cases. The comparative findings were reflective of comparable efficacy of both methods in providing an acceptable tissue sample for diagnosis. Conclusion: After ana-lysing and comparing the aforementioned parameters, we opined that neither method can be deemed clearly supe-rior to the other as a cervical biopsy procedure.

Treatment of posterior pilon fractures according to classification of die-punch fragments by CT scanning / 中华创伤骨科杂志

Objective To propose a CT classification of die-punch fragments in posterior pilon fracture and to explore its significance in helping the surgery.Methods ACT scan classification of die-punch fragments in posterior pilon fracture into 5 types was proposed according to their size and location.A retrospective study was conducted of the 48 posterior pilon fractures which had been treated at Department of Orthopaedics,Huashan Hospital from January 2013 to December 2015.They involved 16 men and 32 women,aged from 20 to 87 years (average,46.5 years).According to the preoperative CT scan classification of die-punch fragments,16 cases (33.3％) belonged to type Ⅰ,2 (4.2％) to type Ⅱ,18 (37.5％) to type Ⅲ,10 (20.8％) to type Ⅳ and 2 (4.2％) to type Ⅴ.Choice of operative approach,reduction and internal fixation and removal of the fragments were guided by the CT classification of die-punch fragments.Their postoperative ankle functions were evaluated with American Orthopaedic Foot and Ankle Society (AOFAS) and visual analog scale (VAS) scoring systems.Results All the 48 cases were followed up for 11 to 21 months (average,13.7 months).Their AOFAS scores for ankle-hindfoot at the final follow-up ranged from 77 to 92 points,averaging 84.3 points;their VAS scores ranged from 0 to 1 point,averaging 0.2 point.There were no significant differences in their postoperative AOFAS scores for ankle-hindfoot or in their postoperative VAS scores between the types of die-punch fragments (P ＞ 0.05).No complications were recorded except superficial infection at the posteromedial wound of the ankle in 2 cases,tarsal tunnel syndrome in 2 cases,and sural nerve irritation in 2 cases.Conclusion It is feasible and effective to classify the die-punch fragments in posterior pilon fracture according to their size and location on the CT scan,because the classification can help choose an appropriate operative approach and manage the die-punch fragment,leading to fine clinical outcomes.

Surgical treatment of old die-punch fractures of distal radius / 中华创伤骨科杂志

Objective To report the effects of surgical treatment of old die-punch fractures of the distal radius.Methods A retrospective study of case series was made of the 21 old die-punch fractures of the distal radius which had been surgically treated from January 2012 to January 2017 at Department of Orthopaedics,Shandong Provincial Hospital.There were 13 males and 8 females,aged from 34 to 63 years (average,46.9 years).According to the preoperative definite diagnoses by the X-ray and CT images,there were 14 metacarpal compression fractures and 7 dorsal compression fractures.The palmar approach was used in 13 cases,the dorsal approach in 7 and the combined approach in one.Autogenous iliac bone grafting was performed for all the cases.Their preoperative and postoperative Cooney scoring and visual analogue scale (VAS) of the wrist,and postoperative complications as well,were observed and recorded.Results This cohort was followed up for 8 to 14 months (average,9.2 months).All their postoperative wounds healed by the first intention.Their Cooney functional scores of the wrist were,respectively,58.5 ± 4.2 and 84.0 ± 3.1 points preoperatively and at the final follow-up,and their corresponding VAS scores 7.6 ± 0.9 and 3.4 ± 1.3 points,showing significant differences between preoperation and the final follow-up (P ＜ 0.05).Carpal arthritis was observed in one case.Conclusion For old die-punch fractures of the distal radius,surgical treatment can obviously reduce pain,improve function of the wrist and enhance the quality of life of the patients.

A Case of Cutaneous Lymphatic Rupture on Calf Secondary to Punch Biopsy / 대한피부과학회지

No abstract available.