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Background: Primary graft dysfunction (PGD) is the leading cause of short- and long-term mortality associated with lung transplantation. The impact of pretransplantation blood transfusions for recipients is not fully elucidated. Methods: This is a retrospective review of 206 consecutive lung transplantations performed at a single academic center (Northwestern University Feinberg School of Medicine, Chicago, IL) from January 2018 to July 2022. Data on patient characteristics, pretransplantation laboratory values, transfusion requirements, and intraoperative and postoperative outcomes were collected. Results: PGD grade 3 (PGD 3) occurred in 13.2% of the cohort (n = 28). A total of 33 patients received a blood transfusion within 4 weeks, whereas 21 patients received a blood transfusion a week before their lung transplant. Pretransplantation transfusions were strongly associated with a higher incidence of PGD 3 (48.5% vs 6.9%; P < .001). There was no significant difference in 1-year survival between the pretransplantation transfused group and the nontransfused group (77.7% vs 88.0%; P = .478). The 1year survival was reduced in recipients with PGD 3 compared with recipients without PGD 3 (63.5% vs 89.9%; P = .0012). In univariate analysis, pretransplant and intratransplant predictors of PGD 3 included younger age (P < .01), pretransplant extracorporeal membrane oxygenation (ECMO) use (P < .001), higher lung allocation score (P < .001), coronavirus disease 2019 (COVID-19)–related acute respiratory distress syndrome (P < .01), blood transfusion within 4 weeks (P < .001), longer operative time (P < .001), intratransplant blood transfusion (P < .001), and intratransplant venoarterial ECMO use (P < .001). Conclusions: Pretransplantation blood transfusions could be associated with a higher rate of PGD. The findings indicated the potential risks of pretransplantation blood transfusions in lung transplant recipients.

Salivary gland neoplasms account for 3% of all head and neck tumours. Pleomorphic adenoma (PA) is the most common salivary gland tumour that mainly occurs in the parotid gland, followed by minor salivary glands of the oral cavity, however, the occurrence of PA inside the jaw bones is exceedingly rare and very few cases have been reported in the literature. Inside jaw bones these lesions tend to imitate large osteolytic lesions encompass a diagnostic challenge. An exhaustive review of the literature revealed only 10 cases of central pleomorphic adenoma. We present a rare case of primary PA that occurred inside the mandible and was provisionally diagnosed as ameloblastoma.

Abstract Background Salmonella spp. cause infectious aortitis through the hematogenous spread of an intestinal Salmonella infection. Salmonella aortitis can result in extensive tissue damage in the aorta leading to complications including dissection, abscess formation, pseudoaneurysms, and rupture, which require early diagnosis and treatment with both surgery and antibiotic therapy. Case presentation We report a case of Salmonella aortitis complicated by Stanford type A aortic dissection. A 62-year-old man with a history of heroin use presented with chest pain, epigastric pain and vomiting. The computed tomography scan showed Stanford type A aortic dissection without malperfusion. At the time of surgery, an aortic dissection with purulent fluid and contained rupture was noted in the ascending aorta. Fluid culture was consistent with Salmonella. A composite valve-graft conduit aortic root replacement with ascending aorta and hemiarch replacement was performed. The patient recovered well and was discharged on long-term antibiotics. Conclusions This rare case of a Stanford type A aortic dissection with contained rupture due to Salmonella aortitis was successfully treated with emergent surgery and antibiotic therapy.

Objective: In the evolving era of minimal access surgery, low rectal cancers still pose a challenge to laparoscopic or robotic surgeons. Hence, at our institute we intended to demonstrate the oncological efficacy of intersphincteric resection and coloanal anastomosis in the treatment of distal rectal cancers, performing the abdominal part of the procedure which includes rectal mobilization, laparoscopically. Methods: From February 2017 to March 2021, 125 patients who had undergone intersphincteric resection and coloanal anastomosis via the perineal approach at Galaxy Care Laparoscopic Institute, Pune, were included in this study. Transabdominal mobilization of the rectum was performed laparoscopically. All patients had a diversion ileostomy and a pelvic drain. Patients were followed-up for a period of 18 months post-surgery. Data on clinical and oncological outcomes were collected and analysed. The pre-operative and post-operative Wexner incontinence scores were compared. Results: The mean time taken for surgery was 181.57 ± 30.00 min. The mean blood loss was 119.76 ± 42.53 mL. Most patients (103, 82.4%) had their tumour at a distance of 1–2 cm from the anal verge. A loco-regional recurrence rate of 12.8% (16/125) was noted in our study. For the post-surgery Wexner score, 74.4% of patients (93/125) had a score of 5 or less, depicting that three-quarters of the study population had satisfactory continence. Overall, 81.6% of patients were satisfied with the functional results of surgery. Conclusion: Intersphincteric resection and coloanal anastomosis, with a 12.8% recurrence rate, can now be considered an oncological and technically feasible procedure with sphincter salvage and good continence.

Introduction: Dental professionals play an important role in an individual's appearance which can affect the perception of others that can vary greatly depending on their educational and socioeconomic background. Aim and Objective: The purpose of this study was to determine an insight of recognizing ability of dental professionals and laypersons toward facial aesthetics with different types of orthodontic malocclusion. Materials and Methods: A questionnaire-based study was conducted on 90 dental professionals and 90 laypersons. The perceptions differences between groups were assessed using visual analogue scale on 11 photographs. Kolmolgorov-Smirnov was used for normality test. Results: The perceptions of facial aesthetics showing various malocclusions were significantly different between dental professionals and laypersons. Conclusion: The dental professionals and layperson perceptions regarding the facial particularly in central Indian population are significantly different for most of the malocclusion types.

Introduction: Lower limb veins are most prone to having venous disorders and varicose veins are the biggest issue. Varicose veins can be grouped into Primary or Secondary Varicose veins. Secondary Varicose veins are associated with acquired factors causing stasis and hypercoagulable state. This study addresses the various associated risk factors for secondary varicose veins such as age, sex, Body Mass Index (BMI), pregnancy, prolonged standing, tobacco use, and deep vein thrombosis history and family history of secondary varicose veins. Methods: A prospective non-randomized study of fifty patients was carried out between August 2015 and July 2016. Demographic details of all patients were recorded. Detail history and examination of both lower limbs were performed. Descriptive statistics were calculated by measuring means, standard deviation (SD), and proportions with 95% confidence interval. Results: Tobacco chewing in any form was the most common associated risk factor of secondary varicose vein in our study of 50 patients and it was observed in 46% of patients. We found that varicose veins were more common in males and it was especially predominant in the over fifty years of age. Amongst them, twenty patients were obese with body mass index of more than 25 kg/m2. Past history of varicose veins and treatment for same was not associated significantly with varicose veins prevalence. More than two numbers of pregnancies were found in 26% females with varicose veins. Conclusion: We found that prolong standing, smoking (> 10 cigarettes/day), more than two pregnancies, and family history of deep venous thrombosis were some of the major associated risk factors for varicose veins. We couldnt establish any strong association between previous history of deep venous thrombosis and varicose vein surgery with respect to recurrence of it. Among modifiable risk factors, tobacco chewing and smoking should be abandoned to decrease the incidence of varicose veins. [Arch Clin Exp Surg 2018; 7(3.000): 104-107]

Introduction: Breast cancer is the most common cancer in females worldwide. The presentations of breast cancer patients are varied, and available treatment options are many. Management of breast cancer has changed over the period of years from radical surgeries to more of conservative approaches. The present study was undertaken to evaluate the role of neoadjuvant chemotherapy therapy in downstaging large operable breast cancer (LOBC) in the Indian population and usefulness of less radical, breast conservative surgery (BCS) in these patients. Materials and Methods: A prospective nonrandomized study of 32 patients with LOBC was carried out between September 2014 and August 2015. Patients with stage IIIA disease of 18–70 years of age were included. Clinical tumor response was graded according to the World Health Organization Criteria for clinical tumor response. Locoregional management consisted of either BCS (wide local excision, complete axillary dissection, postoperative radiotherapy) or modified radical mastectomy (MRM), depending on feasibility for BCS and patients' choice about the type of surgery to undergo. Data collected was documented and analyzed. Results: The mean age of patients was 43.73 years. Most of the patients were premenopausal. About 75% of patients achieved maximal response after 4 cycles neoadjuvant chemotherapy. Statistically significant response was achieved in downstaging the breast cancer. Complete clinical response was seen in 12.5%, and partial clinical response (cPR) was seen in 75% patients after neoadjuvant systematic chemotherapy. Postneoadjuvant chemotherapy, 68.75% patients became feasible for BCS. There was no statistically significant association between age, initial tumor size, and menstrual status with tumor response to chemotherapy and feasibility for BCS. Conclusions: To conclude, Neoadjuvant Systemic Therapy is effective in the management of LOBC. BCS is feasible in the majority of LOBC after downstaging by Neoadjuvant Systemic Therapy, which otherwise would require MRM.