IJSS Journal of Surgery https://surgeryijss.com/index.php/IJSS <p style="text-align: justify;"><strong>IJSS Journal of Surgery</strong>&nbsp;is a peer-reviewed journal publishing articles of surgeons those who perform abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. IJSS Journal of surgery has the goal of providing its readership the highest quality rapid retrieval of information relevant to surgeons. It provides an in-depth, international forum for the most recent, authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Journal content includes Leading Articles, Reviews, Original Research Articles, Randomized Clinical Trials, Your Views and Book Reviews. All papers published in the IJSS are subject to rigorous peer review.</p> International Research Organization for Life & Health Sciences (IROLHS) en-US IJSS Journal of Surgery 2395-1893 Application of Platelet-rich Plasma in Androgenic Alopecia and in Female Pattern Hair loss https://surgeryijss.com/index.php/IJSS/article/view/414 <p>Aim: The aim of the study was to evaluate the efficacy of platelet-rich plasma (PRP) injections in Androgenic Alopecia (AGA)<br>and female pattern hair loss.<br>Settings and Design: A prospective clinical trial consisting of ten patients with AGA was undertaken in the institutional settings,<br>where each patient was treated with intradermal injections of PRP, after the approval from the institutional ethical committee.<br>Materials and Methods: Patients suffering from hair loss were assessed preoperatively using hair-pull test and dermascopic<br>examination to evaluate the number of hair follicles and anagen-telogen ratio. Digital pictures of the scalp were recorded before<br>the treatment. PRP was isolated from blood and approximately 2–3 ml was injected in deficient regions in the patients, using<br>nappage technique. A patient satisfactory questionnaire was recorded at the end of the treatment. Results at the end of 6 months<br>were evaluated and statistical analysis was done.<br>Results: Decrease in the hair-pull test before and after the treatment was statistically significant (mean = −6.40; P = 0.000). The<br>increase in the total dermascopic hair count and anagen-telogen ratio of all the regions of the scalp, when assessed before and<br>after the treatment was statistically significant (mean = 87.50 and 6.27, respectively; P = 0.001 and 0.000, respectively). The<br>patient satisfaction score was 8.1 out of 10.<br>Conclusions: PRP is a cost-effective, easy and reliable therapy, with negligible side effects and very high patient satisfaction. It<br>has proved to be a valuable treatment option in patients suffering from AGA.<br>Key Messages: The injections of PRP in androgen affected regions of scalp in men and deficient regions in female, gives excellent<br>results of increased hair density with reduced hair fall, in all the regions of the scalp with specifically significant difference seen<br>in vertex region of scalp in our study</p> Deval Mehta Sonal Madan Setu P Shah Drashti Trived Copyright (c) 2021 IJSS Journal of Surgery 2021-08-05 2021-08-05 7 4 1 7 Study of Variations in the Blood Supply of Thyroid Gland in Uttar Pradesh Population (Cadaveric Study) https://surgeryijss.com/index.php/IJSS/article/view/415 <p>Background: As the thyroid gland is a largest endocrine gland and highly vascular organ hence it has blood supply from different<br>sources of blood vessels whenever enlarged pathologically/physiologically surgical innervations are essential. Hence, knowledge<br>of variations of blood supply is essential for surgeons.<br>Materials and Methods: Thirty adult cadavers (18 males and 12 females) were studied. Length external carotid artery (ECA)<br>from its point of emergence from common carotid artery (point A) its point of emergency of superior thyroid arteries (STA)<br>(point B) was measured. The length of STA from emergence from ECA to its branching (point C) was measured. Length thyroid<br>cervical trunk (TCT) from its point (point AB) the length of inferior thyroid arteries from its point of emergence to its point of<br>branching at the lower pole of the thyroid gland was measure (point BC). The number of branches of TCT was noted. The<br>presence of any additional artery supplying the thyroid gland was also noted. The measurement was taken from digital caliper.<br>Results: Variations of length in every branch of the right and left side, and both sexes are observed.<br>Conclusion: These anatomical variations in blood supply for the thyroid gland will be a tool for surgeon to protect the arteries<br>during thyroid surgery, the upper part of the larynx, parathyroid surgeries, and avoid alarming situations during surgery.</p> Mohammad Asif Khan, Mohd Arshad Israr Ahmad Khan Kamil Khan Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 8 11 Comparison of Outcome of Locking Plate Fixation and Closed Intermedullary Interlocking Nail in the Management of Extra-articular Distal Tibial fractures https://surgeryijss.com/index.php/IJSS/article/view/416 <p>Background: Distal tibia fractures are the second highest incidence in tibia fractures. Management of distal tibia fracture is most<br>challenging due its superficial nature and propinquity to the ankle joint. Hence, two different techniques were used to treat such<br>fractures.<br>Methods: Out of 26 patients, 13 were operated with interlocking nail (ILN) and 13 with locking plate fixation, patients were regularly<br>followed up to 1 year postoperatively, assessed clinically and radio-logically to rule out any complication and treated the same.<br>Results: Duration of surgery 40–60 min in 9 (69.2%) ILN, 5 (38.4%) plating 61–80 min in 4 (30.7%) ILN, and 5 (38.4%) in plating<br>&gt;80 min observed in 3 (23%) only plating patients. Duration of total weight bearing 8–10 weeks in 9 (69.2%) IUN, 2 (15.3%) in<br>plating, 11–12 weeks in 4 (30.7%) ILN, 4 (30.7%) in plating, 13–14 weeks, and &gt;14 weeks observed only in 2 (15.31%) plating<br>patients. Duration fracture union 16.9 (SD ± 1.48) in ILN, 20.7 (SD ± 1.84) in plating t-value 5.9 P &lt; 0.001, post-surgical complications<br>– pain in anterior knee, 3 (23%) in ILN. superficial skin infection 1 (7.59%) in plating deep infection, 2 (15.3%) in plating valgus<br>&gt;50 (angulations), 3 (23%) in IUL, and 2 (15.3%) in plating. Stiffing of knee 2 (15.3%) in ILN stiffness of ankle 1 (7.6%) in ILN,<br>3 (23%) in plating. Non-union 1 (7.6%) in ILN, implant irritation 3 (23%) in plating, and implant failure 1 (7.6%) in ILN.<br>Conclusion: Closed intermedullary nailing is preferable than planting technique because of early weight bearing, early union<br>and decreased implant related problems.<br><br></p> Medisetty Vinod Kumar Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 12 17 Comparative Study of Non-operative versus Operative Management of Appendicular Lump in Maharashtra Population https://surgeryijss.com/index.php/IJSS/article/view/417 <p>Background: Acute appendicitis is one of the most common acute surgical conditions of the abdomen and appendicular lump is<br>formed, if the treatment is delayed. There is no clear standardized approach with abscess or phlegmon. Hence, different therapy<br>would be useful and cost effective.<br>Materials and Methods: 60 patients aged between 20 and 40 years were studied. The patients classified into Group-I – emergency<br>surgery group 19 (31.6%) and Group-II had conservative treatment – 41 (68.3%) (a) surgery after certain time (II A), (b) ambulatory<br>follow-up (II B), and (c) underwent appendectomy (II C).<br>Results: The clinical manifestations were compared – Duration of symptoms 6.58 in Group-I, 9.48 in Group-II, body temperature<br>(c) 39% in Group-I, 37.7 group to heart rate (pulse/min) 87.4 in Group-I, and 85.7 in Group-II in Group-II. Size of abscess 3.42<br>in Group-I, 4.98 in Group-II, in the comparison of surgical outcome between emergency and delayed operation groups. 13<br>appendectomy in Group-II, 24 in Group-II, Ileostomy was 5 in Group-I, 2 in Group-I right hemicoloctomy 1 in Group-I, 2 in Group-<br>II. Duration of operation 107.66 in Group-I, 89.18 in Group-II, post-operative complication 2 in Group-I, 6 in Group-II, and postoperative<br>stay 9.31 in Group-I, 9.46 in Group-II.<br>Conclusion: Early surgical exploration confirms the diagnosis and cures the problem; reduce the cost of management with<br>satisfactory outcome.<br><br></p> Jahangir Gulab Sayyed Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 18 24 Comparative Study between Collagen Dressings and Conventional Dressings in Chronic Leg Ulcers https://surgeryijss.com/index.php/IJSS/article/view/418 <p>Background: Chronic leg ulcer is defined as a non-healing or slow disintegration of epidermal and dermal tissue on the legs that last longer than 6 weeks. The majority of these ulcers are associated with venous disease, peripheral vascular disease, peripheral arterial occlusive disease, diabetes, nutritional factors, or metabolic factors like uremia. Collagen sheet is a material that is suitable for use as an allograft in wound healing. It is employed in sheets, membranes, and sponge forms; later, in preserved preparations, the material aids in the healing process by promoting regenerative healing while lowering scar formation through several properties such as physical, biochemical, and molecular biological pathways.<br>Materials and Methods: Study Design: A prospective follow-up study. Study Duration: One year from March 2, 2019, to March 1, 2020, at the time of Institutional Ethics Committee approval. Source of Data: Cases admitted in general surgery wards in S.V.R.R.G.G. Hospital, Tirupati. Sample Size: 100 patients.<br>Results: The mean rate of the percentage of reduction ulcer size was higher in the study group than in the control group. The Chi-square test results were analyzed, which showed a highly significant difference in the percentage of ulcer size (P &lt; 0.0001). The total number of days in the hospital for the patient to stay is compared. The mean number of days of hospital stay in the control group was 18 days and that in the study group was 14 days. The results were analyzed by the Chi-square test, which showed a significant difference in the number of days of hospital stay. The total number of dressings required for complete wound healing with collagen dressing was 5.88 compared to conventional which was 11; t-test shows the significance. The rate of ulcer healing with the collagen group was 3.58 compared to the conventional group which was 4.66, t-test shows high significance.<br>Conclusion: Collagen dressing increases the rate of wound healing as compared to conventional dressings. Collagen dressings could be used to treat chronic non-healing leg ulcers.<br><br></p> K Rojaramani1, G V Prakash G V Ramanaiah R Likhith Kumar Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 22 28 Comparative Study of Laparoscopic-Assisted Appendectomy and Open Appendectomy https://surgeryijss.com/index.php/IJSS/article/view/419 <p>Background: Acute appendicitis is a common indication for abdominal surgery which is the most common surgical procedure. To evaluate the comparison of laparoscopy-assisted extra corporeal appendectomy (laparoscopic appendectomy [LA]) versus conventional open appendectomy (OA) in terms of post-operative complications were studied.<br>Method: Fifty patients aged between 19 and 45 years operated. Twenty-five patients with LA and 25 patients with OA techniques were used for acute appendectomy. Ultrasonography and routine blood examination were done. The operation was done under general anesthesia. The post-surgical manifestations of both groups were noted.<br>Results: Prevalence of Pain 5 (20%) in LA and 13 (52%) in OA, vomiting 7 (28%) in LA and 11 (44%) in OA, fever 5 (20%) in LA and 12 (48%) in OA, constipation 4 (16%) in LA and 8 (32%) in OA, paralytic ileus 5 (20%) in LA and 9 (36%) in OA. Infection of wound 8 (32%) observed only in OA, return of bowel sound 42–43 h in LA, and 50–52 in OA. Duration of hospital stay is 3–4 days in LA and 7–9 days in OA.<br>Conclusion: LA surgery is more preferable for acute appendicitis than OA because lesser post-operative complications, post-operative stay at hospital even though duration of LA is more than OA.<br><br></p> Rajesh Jasti CH B L Prasad Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 29 31 Comparative Study of Olecranon Osteotomy versus Paratricipital Approach for Intra-Articular Fracture of Distal Humerus in Maharashtra Population: A Retrospective Study https://surgeryijss.com/index.php/IJSS/article/view/420 <p>Background: Management of distal humerus fractures continues to be a challenge for orthopedic surgeons. The unique and complex anatomy of the distal humerus, involving ulna-humeral and radiocapitellar joints, makes anatomic reduction difficult and hardware placement challenging.<br>Materials and Methods: Out of 28 cases, 14 had olecranon osteotomy (OO) and 14 had paratricipital (PT) approach. The surgery was carried out under general anesthesia. Mid-line posterior incision was used with slight lateral bent on olecranon tip to avoid the weight-bearing zone ulnar nerve was identified first, then release of the ligament of struthers and medical intermuscular septum was done to transpose the ulnar nerve. All fractures were fixed as per AO principles using bicolumnar plating. Range of motion was measured by goniometer. Functional assessment was done by Mayo Elbow Performance Score (MEPS).<br>Results: Parameters of OO and PT were compared, mean values were more or less similar values but MEPS shows variations in C3 type fractures in PT studies, as compared to OO.<br>Conclusion: The PT approach and the OO approach can be used alternatively for AO-13 C1 and C2 fractures with similar outcomes. However, in type C3, the PT approach yields poor outcome in comparison with OO approach.<br><br></p> Pravin Prakash Patil Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 32 37 Study of Hypertensive Disorders in Pregnancy and Its Outcome in Neonates https://surgeryijss.com/index.php/IJSS/article/view/421 <p>Background: A hypertensive (HTN) disorder of pregnancy is a multi-factorial disorder and seriously endangers the safety of fetus during pregnancy.<br>Methods: 150 HTN pregnant women were selected for study and followed them till delivery and 6–8 weeks post-delivery, routine Blood examination, complete blood count, CT, BT, and serum electrolyte ultrasound (USG) was done. Fetal monitoring included DFMC, FHR, NST umbilical, and cerebral Doppler, USG to assess the fetal serial growth, AFI, BPP, placental location, and maturity.<br>Results: Types of delivery – 97 (64.6%) lower segment cesarean section, 39 (26%) normal vaginal delivery, 5 (3.3%) forceps, 9 (6%) consanguinity, 30 (20%) had &lt;140 systolic, 90 diastolic blood pressure (BP), 80 (53.3%) had 140–159 systolic, 90–190 diastolic BP, 40 (26.6%) had &gt;160 systolic, and &gt;110 diastolic BP. The gestational ages of neonates were – 21 (14%) were &lt;32 weeks, 40 (26.6%) were 32–36 weeks, and 89 (59.3%) were 37–42 weeks. Birth weight of neonates 70 (46.6%) had low birth weight (LBW), 17 (11.3%) had very LBW, 33 (22%) had normal weight, 30 (20%) had intrauterine growth restriction, 118 (78.6%) were alive, and 32 (21.3%) neonatal deaths were noted.<br>Conclusion: Eclampsia is still common and serious complications of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high risk patients would reduce of the maternal and perinatal morbidity and mortality.<br><br></p> Vasavi Korupolu A Amrin Copyright (c) 2021 IJSS Journal of Surgery 2021-08-10 2021-08-10 7 4 38 41