A Structured Pre- and Post-Operative Voice Therapy Program for Benign Vocal Fold Lesions

Benign vocal fold lesions (BVFLs) are acquired structural anomalies of the vocal folds, and these are primarily a result of vocal abuse or phonotrauma. Phonotraumatic lesions are not generally regarded as recurrent, provided that appropriate behavioral changes are made after resolution or surgical removal. Voice therapy plays a crucial role in this aspect. The aim of this article is to propose a structured pre- and post-operative voice therapy program for patients undergoing surgical intervention for BVFLs. Voice therapy post-surgery has been proven to reduce the rate of recurrence in BVFLs. Having a standard treatment protocol is a useful tool for the therapist, particularly one without extensive voice training.

Las lesiones benignas de los pliegues vocales (LBPV) son anomalías estructurales adquiridas de los pliegues vocales, y son principalmente el resultado de un abuso vocal o fonotrauma. Las lesiones fonotraumáticas generalmente no se consideran recurrentes, siempre que se realicen cambios apropiados en el comportamiento después de la resolución o la excisión quirúrgica. La terapia vocal juega un papel crucial en este aspecto. El objetivo de este artículo es proponer un programa estructurado de terapia de voz pre y postoperatorio para pacientes que son expuestos a una intervención quirúrgica para LBPV. Se ha demostrado que la terapia de voz después de la cirugía reduce la tasa de recurrencia en LBPV. Tener un protocolo de tratamiento estándar es una herramienta útil para el terapeuta, particularmente uno sin un entrenamiento extenso en patología de la voz.

Miositis aguda asociada a infección por virus influenza. Serie de casos en un hospital pediátrico

La miositis aguda benigna asociada a influenza es una complicación esporádica. En Argentina, en el año 2022, hubo un aumento temprano de la circulación de influenza y del número total de las notificaciones, con la aparición de miositis secundarias. Serie clínica retrospectiva de nueve pacientes pediátricos que consultaron por dolor e impotencia funcional de extremidades inferiores, y enzimas musculares elevadas, en el hospital Pedro de Elizalde de la Ciudad Autónoma de Buenos Aires, entre agosto y octubre del 2022. En todos se detectó infección por virus influenza y se recuperaron sin secuelas. La miositis aguda benigna es una entidad infrecuente en la infancia, cuyo diagnóstico es predominantemente clínico y de recuperación ad integrum. Debe ser sospechada en pacientes con clínica compatible en contexto de alta circulación viral. La vigilancia epidemiológica aporta herramientas para identificar los virus circulantes y sus posibles complicaciones.

Benign acute myositis associated with influenza is a sporadic complication. In Argentina, in 2022, there was an early increase in influenza circulation and the total number of notifications, with the appearance of secondary myositis. Retrospective clinical series of nine pediatric patients who consulted for pain and functional impotence of the lower extremities, and elevated muscle enzymes, at the Pedro de Elizalde hospital in the Autonomous City of Buenos Aires, between August and October 2022. In all of them, infection by influenza virus and recovered without sequelae. Benign acute myositis is a rare entity in childhood, whose diagnosis is predominantly clinical and recovery ad integrum. It should be suspected in patients with compatible symptoms in a context of high viral circulation. Epidemiological surveillance provides tools to identify circulating viruses and their possible complications.

Hemangioma cavernoso / Cavernous Hemangioma

Introducción: El hemangioma cavernoso es una de las neoplasias benignas más frecuentes en la infancia. Objetivo: Describir el caso de un hemangioma cavernoso en edad pediátrica. Caso clínico: Lactante femenina de 6 meses de edad, de procedencia urbana, cuyo nacimiento tuvo lugar en el Hospital Materno Fe del Valle Ramos, del municipio Manzanillo. Al nacer se observa una lesión en forma placa eritematosa violácea infiltrada de ± 10 cm, de borde definido, de superficie liza, con aumento de temperatura al tacto, que se extendía desde la parte medial anterior y posterior hasta la superior de la pierna del miembro inferior izquierdo. Se decidió interconsultar con el Servicio de Angiología, el cual diagnostica la lesión como hemangioma cavernoso. Conclusiones: Se corroboró que el hemangioma cavernoso es una entidad frecuente en la infancia, su diagnóstico y tratamiento oportunos son altamente beneficiosos para la mejoría y la cura, por lo que se impone la realización de un correcto y exhaustivo examen físico, de lo que se deriva también la prevención de complicaciones a corto, mediano y largo plazo(AU)

Introduction: Cavernous hemangioma is one of the most frequent benign neoplasms in childhood. Objective: To describe the case of a cavernous hemangioma at pediatric age. Clinical case: A 6-month-old female infant of urban origin was born at Hospital Materno Fe del Valle Ramos, Manzanillo Municipality, Granma Province. At birth, a violaceous erythematous plaque-like infiltrated lesion was observed, of approximately 10 cm, with a defined border, smooth surface, increased temperature at hand contact, extending from the anterior and posterior medial part to the upper leg of the left lower limb. It was decided to do an interconsultation with the angiology service, which diagnosed the lesion as a cavernous hemangioma. Conclusions: Cavernous hemangioma was corroborated to be a frequent entity in childhood, whose timely diagnosis and treatment are highly beneficial for improvement and cure, so it extremely necessary to carry out a correct and exhaustive physical examination, also deriving the prevention of complications in the short, medium and long terms(AU)

Calcinosis escrotal: ¿una entidad idiopática? / Scrotal Calcinosis: an Idiopathic Entity?

La calcinosis escrotal es una enfermedad benigna e infrecuente que se presenta en adultos de mediana edad, con múltiples nódulos asintomáticos a nivel de la piel del escroto. Algunos autores vinculan la aparición de estas lesiones a la calcificación secundaria de quistes epidérmicos o ecrinos. Cuando no se encuentra relacionada con dichas entidades ni con alteraciones del metabolismo fosfocálcico, el cuadro se considera idiopático. El tratamiento de elección es quirúrgico, en caso de impacto en la calidad de vida o relevancia estética para el paciente. (AU)

Scrotal calcinosis is a rare, benign disease that presents in middle-aged adults with multiple asymptomatic nodules on the skin of the scrotum. Some authors link the appearance of these lesions to the secondary calcification of epidermal or eccrine cysts. When it is not related to these entities or to alterations in phosphocalcic metabolism, the condition is considered idiopathic. The treatment of choice is surgical, in case of impact on the quality of life or aesthetic relevance for the patient. (AU)

Resección hepática laparoscópica versus hepatectomía abierta para lesiones benignas: estudio comparativo con propensity score matching / Laparoscopic liver resection versus open liver resection for benign lesions: a comparative study with propensity score matching

RESUMEN Antecedentes : las ventajas de la hepatectomía videolaparoscópica (HVL) hicieron que gane cada vez más campo para el tratamiento de los tumores hepáticos benignos (THB). Objetivo : comparar los resultados perioperatorios de pacientes sometidos a HVL con los de los operados con hepatectomía abierta (HA) por THB, emparejados con propensity score matching (PSM). Material y métodos : estudio descriptivo, retrospectivo y comparativo de HA y HVL por THB entre agosto de 2010 y junio de 2021. Se analizaron variables demográficas, preoperatorias, intraoperatorias y posoperatorias. Para evitar sesgos de las distintas covariables entre los grupos se realizó un PSM 1:1. Resultados : de 403 hepatectomías, se analizaron 82 por THB. De ellas 36 (44%) fueron HA y 46 (56%) HVL. Edad media 45 ±14 años, 65% mujeres. Tras realizar el PSM, quedaron dos grupos de 28 pacientes cada uno. En HA, 5 (18%) pacientes requirieron transfusiones y ninguno en HVL (p = 0,01). Las complicaciones mayores se presentaron en 4 (14%) pacientes en HA, y ninguna en HVL (p = 0,03). Se reoperaron 4 (14%) pacientes con HA y ningún paciente con HVL (p = 0,03). La estadía hospitalaria total fue significativamente mayor en las HA (p = 0,04). No se registraron muertes a los 90 días en ninguno de los dos grupos. Conclusión : la HVL por THB es una técnica segura y eficaz, ya que los pacientes presentaron menor requerimiento transfusional, número de reoperaciones, de complicaciones mayores y de estadía hospitalaria que con HA. Por las ventajas encontradas, la HVL podría ser considerada la técnica de elección en cirugía por THB.

ABSTRACT Background : The advantages of laparoscopic liver resection (LLR) have increased its use for the treatment of benign liver tumors (BLTs). Objective : The aim of this study was to compare the perioperative outcomes of patients undergoing LLR with those operated on with open liver resection (OLR) for BLTs using propensity score matching (PSM). Material and methods : We conducted a descriptive and retrospective study comparing OLRs with LLRs performed between August 2010 and June 2021. The demographic, perioperative, intraoperative and postoperative variables were analyzed. We used PSM with 1:1 matching to avoid biases of the different covariates between the groups. Results : Of 303 liver resections, 82 corresponded to BLTs and were included in the analysis; 36 (44%) were OLRs and 46 (56%) were LLRs. Mean age was 45 ±14 years and 65% were women. After PSM, two groups of 28 patients each were constituted. Five patients (18%) in the OLR group and none in the LLR required transfusions (p = 0.01). Major complications, occurred in 4 (14%) patients in the OLR group and in no cases in the LLR group (p = 0.03). Four (14%) undergoing OLR required reoperation versus no patients with LLR (p = 0.03). Total length of hospital stay was significantly longer in OLR (p = 0.04). There were no deaths in any of the groups within 90 days. Conclusion : LLR for BLTs is a safe and effective technique, with lower requirement for transfusions, fewer reoperations and major complications and shorter length of hospital stay than OLR, Therefore, LLR could be considered the surgical technique of choice for BLTs.

Angioleiomioma oral mimetizando um granuloma piogênico: relato de caso raro / Oral Angioleiomyoma mimetizing a pyogenic granuloma: A rare case report

Angioleiomioma (AL) é um tumor benigno de origem perivascular que raramente é observado na cavidade oral, principalmente em localizações como a gengiva. Devido sua apresentação clínica inespecífica, os ALs podem mimetizar outras lesões orais, como tumores benignos de glândulas salivares e lesões reacionais, como o granuloma piogênico. O presente artigo objetiva relatar um caso raro de AL localizado em gengiva, em uma paciente de 19 anos. Clinicamente, a lesão apresentava-se como um tumor assintomático, oval, pedunculado, bem definido, com superfície lisa, consistência fibrosa e cor eritematosa, semelhante a um granuloma piogênico, Uma biópsia excisional foi realizada e o fragmento foi encaminhado para análise histopatológica, que revelou uma proliferação vascular de diversos calibres, contendo paredes musculares espessas e proliferação muscular adjacente, além de infiltrado inflamatório, predominantemente crônico, hemácias extravasadas e área de ulceração, consistente com o diagnóstico de AL inflamado. A histopatologia desempenha um papel importante no diagnóstico final de lesões raras e com características clínicas inespecíficas. A excisão cirúrgica da lesão é o tratamento de escolha mais eficaz para os ALs orais. (AU)

Angioleiomyoma (AL) is a benign tumor of smooth muscle of perivascular origin that is rarely seen in the oral cavity, mainly in locations like the gingiva. Due to their nonspecific clinical presentation, ALs can mimic other oral lesions, such as benign salivary gland tumors and reactional lesions, as a pyogenic granuloma. We reported a case of an AL located in the gingiva in a 19-year-old female patient. In clinical terms, the lesion was presented as an asymptomatic, oval, pedunculated, well-defined nodule with a smooth surface, fibrous consistency and erythematous color, similar to a pyogenic granuloma. An excisional biopsy was performed and the fragment was sent for histopathological analysis that revealed a vascular proliferation of different calibers, containing thick muscle walls and adjacent muscle proliferation, in addition to an inflammatory infiltrate, predominantly chronic, extravasated red blood cells and an area of ulceration, consistent with the diagnosis of inflamed AL. The histopathology plays an important role in the final diagnosis of rare lesions and with nonspecific clinical characteristics. The surgical excision of the lesion is the most effective treatment of choice for oral ALs. (AU)

Angina bolhosa hemorrágica: características clínicas, histopatológicas, diagnóstico e estratégias terapêuticas

Introdução: A angina bolhosa hemorrágica (ABH) é uma condição rara, benigna e geralmente assintomática, caracterizada pelo surgimento súbito de bolhas preenchidas com sangue nas superfícies mucosas da cavidade oral e orofaringe. Objetivo: Este trabalho tem como propósito fornecer uma análise abrangente das características clínicas, etiológicas e histopatológicas da angina bolhosa hemorrágica, além de abordar métodos de diagnóstico e opções de tratamento. Materiais e métodos: Foi realizada uma busca por artigos científicos publicados de 2010 a 2023, nas bases de dados Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) e ScienceDirect. Foram coletados artigos em inglês e português utilizando as palavras-chave "angina bolhosa hemorrágica", "estomatite bolhosa hemorrágica benigna", "hemorrhagic bullous angina" e "benign hemorrhagic bullous stomatitis". Conclusão: A ABH é escassamente documentada na literatura, com muitos dados ausentes ou subnotificados. Embora seja uma condição benigna com rápida evolução espontânea, o procedimento diagnóstico deve ser rigoroso para descartar outras possíveis lesões.

Introduction: Hemorrhagic bullous angina (ABH) is a rare, benign and generally asymptomatic condition, characterized by the sudden appearance of blisters filled with blood on the mucous surfaces of the oral cavity and oropharynx. Objective: This work aims to provide a comprehensive analysis of the clinical, etiological and histopathological characteristics of hemorrhagic bullous angina, in addition to addressing diagnostic methods and treatment options. Materials and methods: A search was carried out for scientific articles published from 2010 to 2023, in the Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed) and ScienceDirect databases. Articles were collected in English and Portuguese using the keywords "hemorrhagic bullous angina", "benign hemorrhagic bullous stomatitis", "hemorrhagic bullous angina" and "benign hemorrhagic bullous stomatitis". Conclusion: ABH is scarcely documented in the literature, with many data missing or underreported. Although it is a benign condition with rapid spontaneous evolution, the diagnostic procedure must be rigorous to rule out other possible lesions.

Hepatotoxicidad por tamsulosina / dutasterida: reporte de un caso probable

La tamsulosina y dutasterida son medicamentos ampliamente usados como tratamiento de la hipertrofia benigna de próstata. teniendo un buen perfil de seguridad. Existen escasos reportes de injuria hepática asociado al uso de tamsulosina; sin embargo, no hay reportes de toxicidad hepática por el uso de dutasterida y del uso combinado de tamsulosina/dutasterida. Se presenta el caso de un varón de 64 años quien desarrolla injuria hepática tras el uso combinado de tamsulosina/dutasterida, desarrollando un patrón de daño hepatocelular y clínica de hepatitis aguda. Se realizo descarte de patología hepática viral, autoinmune y enfermedades metabólicas de depósito, así como de patología biliar mediante ecografía abdominal y colangioresonancia. En la evaluación de causalidad, presentó CIOMS-RUCAM: 6 puntos (probable) y Naranjo: 4 puntos (posible). El paciente presentó respuesta clínica y laboratorial luego de suspender el medicamento.

Tamsulosin and dutasteride are drugs widely used to treat benign prostatic hypertrophy. having a good safety profile. There are few reports of liver injury associated with the use of tamsulosin; however, there are no reports of hepatic toxicity from the use of dutasteride and the combined use of tamsulosin/dutasteride. We present the case of a 64-year-old man who developed liver injury after the combined use of tamsulosin/dutasteride, developing a pattern of hepatocellular damage and acute hepatitis symptoms. Viral, autoimmune, and metabolic storage diseases of the liver were ruled out, as well as biliary pathology by means of abdominal ultrasound and resonance cholangiography. In the causality evaluation, CIOMS-RUCAM presented: 6 points (probable) and Naranjo: 4 points (possible). The patient presented a clinical and laboratory response after discontinuing the drug.

Pólipo fibroepitelial vulvar: una serie de casos

Los pólipos fibroepiteliales son tumores cutáneos benignos frecuentes en la población general. Sin embargo, la afectación del tracto genital es inhabitual. Su etiología no es clara, pero se han descrito asociaciones con trastornos metabólicos y fluctuaciones hormonales, lo cual explica su mayor prevalencia en mujeres. Debido a la variedad de diagnósticos diferenciales, es necesaria la evaluación histopatológica. Su manejo es habitualmente conservador; sin embargo, pueden requerir intervención quirúrgica en algunos casos. Exponemos cuatro casos de tumores fibroepiteliales vulvares de diferentes tamaños, uno de ellos clasificado como gigante, así como la aproximación de manejo. Con esta presentación, esperamos mejorar el conocimiento, la precisión del diagnóstico y contribuir al tratamiento eficaz de las pacientes con esta patología vulvar tan poco frecuente.

Fibroepithelial polyps are common benign skin tumors in the general population. However, genital tract involvement is unusual. Their etiology is unclear, but associations with metabolic disorders and hormonal fluctuations have been described, which explains their higher prevalence in women. Due to the variety of differential diagnoses, histopathological evaluation is necessary. Their management is usually conservative. However, they may require surgical intervention in some cases. We present four cases of vulvar fibroepithelial tumors of different sizes, one of them classified as giant, as well as the management approach. With this presentation, we hope to improve knowledge, diagnostic accuracy and contribute to the effective treatment of patients with this rare vulvar pathology.

Intraoral healing type of pyogenic granuloma (A benign vascular tumor): A case report

Pyogenic granulomas represent tumor-like lesions affecting the skin and the oral cavity. This classic definition can be somewhat misleading because such lesion is not associated with infection and lacks any clinical evidence of pus or histological evidence of actual granulation tissue. This case report describes a surgical excision of the growth to exclude angiomatous proliferation. The patient reported a chief complaint of localized gingival overgrowth since 4 months. Intraoral examination revealed an irregular, sessile exuberant growth in respect to labial aspect and interdental gingiva of 31, 32, and 33, measuring about 1.6 × 1.1 cm. Based on the clinical findings, the case was provisionally diagnosed as “pyogenic granuloma“. A treatment was planned for the patient. A surgical excision was done irt 31, 32, 33, and the tissue was sent for histopathological examination, which was suggestive of a healing type of pyogenic granuloma.

A retroperitoneal myopericytoma: The first case located at the retroperitoneal area and not originate from the kidneys

A 25-year-old woman had a mass of approximately 65 cm × 33 cm × 102 cm, located in the left paraaortic area on CT scan. It was diagnosed as retroperitoneal malignant neoplasm on imaging. Afterward, open retroperitoneal tumor excision was performed. At laparotomy, the mass was carefully dissected from the ureter, renal artery, and aorta and excised as en-bloc. The pathological result was “myopericytoma.” Histologically, the pathological findings characterized a pericytic neoplasm characterized by a perivascular growth of myoid tumor cells. In addition, there were uniform, oval-shaped cells with eosinophilic cytoplasm arranged in short fascicles around blood vessels. The cytologic atypia and mitoses were absent. There are many different tumors in the retroperitoneal area. Most of these lesions are malign nature. Nevertheless, for each benign and malign neoplasm, the preoperative imaging method is generally similar. This present case showed the significant findings of myopericytoma, a benign pathology located in the retroperitoneal area.

Analysis of Various Histopathological Patterns in Pleomorphic Adenoma - An Institutional Case Study

Introduction: Pleomorphic adenoma, the most common benign mixed salivary gland tumor which accounts for 70-80%, is a biphasic tumor with dual origin from epithelial and myoepithelial elements. It shows a malignant transformation rate of 6%. Microscopically, pleomorphic adenoma characteristically displays vast morphologic diversity. This present study is done to analyze prevalence rates and histomorphological variations to better elucidate the pattern of occurrence, diagnosis and treat- ment plan of pleomorphic adenoma. Materials and Methods: This are a retrospective study which was conducted in a private institution, Chennai. Based on the proportion of parenchymal and stromal tumor components, the cases were classified into four subtypes as proposed by Foote and Frazell. Morphological patterns, cellular patterns, capsular alterations and Stromal components were analyzed and statisti- cally evaluated. Results: Our analysis showed an overall 0.87% of pleomorphic adenoma cases being reported were associated with minor salivary glands followed buccal mucosa and palate. All the reported cases showed Type II pattern with histological cellular pat- tern of spindle cells and ductal morphological pattern. Conclusion: We observed the great diversity of morphological aspects of the stroma in pleomorphic adenoma, in which many cases showed variation in morphology and cellularity associated with tumor location.

Multiple Osteomas of Mandible in a Patient with Gardner’s Syndrome - Report of a Case

Introduction: Osteomas are benign tumors of the bone usually seen in craniofacial bones which arise from either the cortex or medulla. They are usually asymptomatic with slow painless growth. Multiple osteomas are often associated with Gardners syndrome. Solitary osteomas are typically non syndromic. Case Presentation: The patient presented with remarkable facial asymmetry following the growth in the mandible. Multiple os- teomas were noted which invoked suspicion of a syndrome. On endoscopic evaluation the patient was found to have multiple intestinal polyps, pathgnomonic for Gardners syndrome. Management and prognosis: The lesion was surgically removed under local anaesthesia. as an excisional biopsy and the asymmetry was rectified. Histopathologic examination revealed it to be ivory osteoma with dense compact bone and less mar- row spaces. The jaw lesions would precede the development of colonic polyps and therefore may contribute to early diagnosis of Gardner’s syndrome. There is also a chance of malignant evolution associated with the polyps Conclusion: People with the condition have a higher risk of developing other family adenomatous polyp (FAP)related cancers including pancreatic cancer and liver cancer. The patient should be in close follow up

Evaluation of prostate-specific antigen and total serum acid phosphatase in prostatic carcinoma

Background: The importance of prostatic carcinoma and its detection has increased manifold over the last few decades. Total serum acid phosphatase (ACP) was the world’s first emerged clinically useful tumor marker in the 1940s and 1950s in patients with prostatic diseases. With the introduction of the prostatic specific antigen (PSA) test in the 1980s, which performed significantly better in screening and treatment programs bringing disfavor to the advent of ACP. Aims and Objectives: To determine serum PSA and total serum ACP in patients with prostatic cancer and benign prostatic diseases, followed by evaluation of these tumor markers. Materials and Methods: This study was conducted on 30 patients with histologically proven cases of prostatic carcinoma and compared against 30 patients as control with benign prostatic pathology, residing in Punjab who were admitted and treated with symptoms complex of prostatism or retention urine or other urinary complaints as the primary symptoms. PSA and ACP in serum were determined using ELISA test kit and King and Kind method, respectively. Results: The mean level of serum PSA was 81.19 ± 49.02 for cancer prostate and 4.975 for benign prostatic diseases, while the mean level of serum ACP was 5.22 ± 1.70 and 2.52 ± 2.27, respectively, for the cancer prostate and benign prostatic diseases showing statistically difference between study and control groups was highly significant as P < 0.0001. Conclusion: Statistical analysis and results of the present study indicated that although serum ACP has better specificity to PSA, yet later is a very sensitive tumor marker in prostate diseases for screening, diagnosis, and post-treatment follow-up.

Schwannoma in the nasal cavity: A benign nerve sheath tumor at an odd location

Schwannomas are neurogenic tumors arising from the Schwann cells present in the neural sheath of the myelinated nerves. These are benign tumors that can arise anywhere in the body. Schwannomas are rarely seen in the nose and paranasal sinuses representing <4% of all head-and-neck schwannomas. Surgical excision is the treatment of choice in these cases. Nasal polyps are common nasal cavity lesions which are usually inflammatory polyps. Schwannoma of the nasal cavity usually presented with headache, unilateral nasal obstruction due to mass obliterating the nasal cavity, and epistaxis. Here, we report the case of a 47-year-old female who presented with a mass in the left nasal cavity causing the nasal blockage.

SEBACEOMA : A RARE CASE REPORT CLINICALLY DIAGNOSED AS PLEOMORPHIC ADENOMA.

Sebaceoma is a benign tumour of epidermal appendages with sebaceous differentiation also known as sebaceous epithelioma .We report a case of a 31 year old male presented with an exophytic mass on the posterior side of right ear lobule. Histopathology revealed rippled pattern sebeceoma comprising of cells arranged in sheets, cohesive nests and islands mostly comprising of basaloid cells (>50%)with mature sebocytes interspersed in between. The sebocytes appeared as clear cells , some cells multivacuolated with central indented nuclei. The rippled pattern sebeceoma is a histological variant and is seen predominantly in males in the head, neck and face region.The immunohistochemistry markers Epithelial Membrane Antigen (EMA) was focally positive along with Pan-Cytokeratin being strongly positive and diffuse which were con?rmatory for the disgnosis.

Evaluation of Laparoscopic Management of Adnexal Mass- An Observational Study in a Tertiary Care Hospital

Background: Adnexal masses are of increasing distress among women because of high fatality related to ovarian malignancy. Finding masses at the primary stage is of crucial significance and in these cases, adnexal masses could be dangerous. Laparoscopy has seemed as one of the most feasible surgical procedures and is now recommended as the “gold standard” method for the management of a wide range of gynecological complaints. The study aimed to determine the evaluation of laparoscopic management of adnexal mass. Material & Methods: A prospective observational study was carried out in the Department of Gynecology & Obstetrics, Ibn Sina Medical College and Hospital, Kallyanpur, Dhaka from 1st January 2020 to July 2022. A total of 146 patients (N=146) were enrolled in this study. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: Among the study population (N=146), the majority of the patients (70,48.0%) belonged to 21-30 years old. Most of the patients (124, 85.0%) were of the reproductive age group & only five patients (5, 3.4%) were of postmenstrual age. Most of the patients (38,26.0%) had ectopic mass, and around one-fourth of the patients (35,24.0%) had a simple cyst. around two-fifths of the patients (63,43.1%) underwent ovarian cystectomy, one-fourth of the patients (37,25.3%) underwent salpingectomy, twenty patients (20,13.7%) underwent excision of chocolate cyst, fourteen patients (14,9.6%) underwent salpingo-oophorectomy and two patients (2,1.4%) underwent conversion to laparotomy. Postoperative fever was seen in only three patients (3,2.0%), and minor port-site infection was seen in three patients (3,2.0%). Conclusion: The diagnosis of adnexal masses is indispensable which may upset all age groups of women. The laparoscopic method is an operative and innocuous procedure for managing patients with adnexal masses. An adequate selection of cases, a laparoscopic surgery-based hospital, and a proficient laparoscopic surgical team are vigorous for good patient consequences.

Mastalgia and associated breast diseases in a tertiary care center, Tamil Nadu: A cross-sectional study

Background: Mastalgia is the common breast condition among women. Mastalgia has highly variable prevalence which ranges 41–79%. It is more common in age group between 30 and 50 years. Mastalgia is approached according to its classification into three major categories, that is, cyclical pain, non-cyclical pain, and extra mammary pain. Breast pain ranges from mild to severe influencing the lifestyle of women affecting sexual relations, sleep pattern, and decreasing their daily life activities. Aim and Objectives: The aim of the study was to determine the incidence of benign and malignant breast disease in mastalgia. Materials and Methods: This cross-sectional study was conducted in Government Medical College, Sivagangai. Patients complaining of breast pain were examined. The data were compiled in an Excel worksheet, Epiinfo version 7.0 was used to analyze the data. Results: In our study, 100 patients complaining of breast pain were examined ranging from age 18 to 68 years. The mean age of the study population was 37.54 years and standard deviation of 9.077. Among 100 patients with mastalgia only 1 (1.64%) had malignancy which is insignificant and among rest 99 patients with mastalgia, 60.61% had benign breast diseases and 39.39% had no any breast lesions. Benign breast diseases are more commonly found in patients with mastalgia. Conclusion: Women having mastalgia can be reassured and some lifestyle modifications may aid the women. Hence, early detection of any breast disease in women having mastalgia and treating accordingly has considerable importance. Lifestyle modifications are needed in patients with mastalgia and they should come to facility to check and identify the issues and solve soon.

Mucocele apendicular benigno / Benign Appendiceal Mucocele

Introducción: El mucocele apendicular se considera una lesión rara del apéndice que se caracteriza por la dilatación de la luz del órgano con acumulación de moco. Este puede ser benigno o maligno. Objetivo: Caracterizar un caso de mucocele apendicular de comportamiento benigno en un paciente adulto masculino. Presentación del caso: Se asiste a un paciente, en estudio de tumor de vías digestivas, que se interviene quirúrgicamente con cuadro peritoneal agudo hallando masa de localización apendicular. Se realiza apendicectomía convencional y se estudia la pieza por anatomía patológica como mucocele apendicular benigno. La evolución del paciente fue satisfactoria. Conclusiones: Se presenta clínicamente de forma inespecífica, lo que posibilita que su diagnóstico sea intraoperatorio con mayor frecuencia. La estrategia quirúrgica depende de los hallazgos intraoperatorios donde la apendicectomía y la hemicolectomía derecha son las técnicas más utilizadas. El pseudomixoma peritoneal es una complicación temida(AU)

Introduction: Appendiceal mucocele is considered a rare lesion of the appendix characterized by dilatation of the organ lumen with mucus accumulation. It can be benign or malignant. Objective: To characterize a case of appendiceal mucocele with benign behavior in an adult male patient. Case presentation: A patient under study of digestive tract tumor is attended. The patient underwent surgery for having acute peritoneal symptoms; a mass of appendicular location was found. Conventional appendicectomy was performed and the piece was studied by pathological anatomy, being a benign appendicular mucocele. The patient's evolution was satisfactory. Conclusions: This condition is presented clinically in a nonspecific manner, which makes for its diagnosis to be more frequently intraoperative. The surgical strategy depends on the intraoperative findings, in which appendectomy and right hemicolectomy are the most used techniques. Pseudomyxoma peritonei is a feared complication(AU)

Assessment of Saudi Physicians and Physical Therapists' Adherence to the Updated Clinical Practice Guideline for Benign Paroxysmal Positional Vertigo: A Cross-Sectional Study

Abstract Introduction Variations in clinical practice regarding the management of benign paroxysmal positional vertigo (BPPV) among clinicians have been noted in previous studies. Such variations might be related to the different adherence to clinical practice guidelines. Objective To evaluate clinicians' adherence to BPPV guidelines and investigate the variations in the adherence between different specialties and qualifications. Methods This is a cross-sectional study with a vignettes-based survey conducted between June and August, 2020. We included clinicians engaged in managing BPPV that had at least one year of clinical experience. We excluded students, and clinicians who were not involved in the management of individuals with BPPV. Participants were asked to make their management choices based on four hypothetical patient vignettes. The sample ranged from 77 participants for the first vignette to 45 participants for the last vignette. Results We included 77 clinicians in the study, with the majority being Otolaryngologists (31.2%). The respondents' mean adherence to the guideline was of 63.3%. Result showed that Otolaryngologists' adherence was higher than that of clinicians from different specialties (p = 0.006, d = 0.72). Furthermore, clinicians with a postgraduate degree were more likely to adhere than those with a bachelor's degree only (p = 0.014, d = 0.58) and participants who were aware of the guideline were more likely to adhere to it (p < 0.001, d = 1.05). Lastly, regression analysis exhibited that adherence was affected by postgraduate degree and guideline awareness. Conclusion Otolaryngologists were more likely to adhere to the guideline than other specialties. Among all specialties, higher adherence was associated with guideline awareness and postgraduate degrees.