Dr. Sevgul Donmez
Faculty of Health Sciences, Gaziantep University, Turkey.


ISBN 978-93-5547-038-6 (Print)
ISBN 978-93-91882-71-6 (eBook)
DOI: 10.9734/bpi/nfmmr/v16


This book covers key areas of medicine and medical research. The contributions by the authors include nasopalatine, non-odontogenic, asymptomatic, epithelial cyst, colorectal adenocarcinoma, screening, colonoscopy, epidemiological shifts, increased incidence, perspectives, challenges, CRC: colorectal carcinoma, myometrium, placenta accrete, placental polyp, Kyphosis correction, short-segment posterior fixation, thoracolumbar burst fracture, cold avian Infections, opportunistic infections in children living with HIV/AIDS, closed-eruption surgical technique, discontinued traction, impacted, periodontal status, upper central incisor, auricular prosthesis, maxillofacial, microtia, mirror image wax pattern, silicone prosthesis, carcinoma cervix, chemotherapy, histopathology, radiotherapy, squamous cell carcinoma, stress response, laryngoscopy and intubation, Ca2+ sparks, mitochondria, mitochondrial membrane potential, mitochondrial ROS flashes, ophthalmology practice, COVID-19, immunohistochemistry, leiomyosarcoma, post-menopause, burning mouth syndrome, stomatodynia, oral dysesthesia, etiology, diagnosis, infertility, human Immunodeficiency Virus, tuberculosis, neovascular glaucoma, proliferative diabetic retinopathy, rubeosis iridis, open angle stage, angle closure stage, shoulder recurrent dislocation, boytchev treatment. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical research.

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Study on Nasopalatine Duct Cyst: A Common Lesion with Uncommon Presentation in a Young Girl

Shivani Sharad Desai, Sanika Kulkarni, Jaydeep N. Pol, Dipti Patil

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 1-7

Nasopalatine cysts are developing cysts that are not odontogenic. These are the most common asymptomatic cysts in the oral cavity, and they appear as a bulge in the front maxillary region. Nasopalatine duct cyst is more common in men in their fourth to sixth decades of life. The objective of this study is to review the prevalence, epidemiology and clinical presentation, to describe the radiographic and pathological findings, and to explain surgical management of this entity in a 11-year-old female patient.

This paper is a current review of work done on colorectal adenocarcinoma in Uganda highlighting the perspectives associated with the increased rate of cases observed in our hospitals. Differences in tumor location compared to the Western world and the challenges encountered in obtaining an early diagnosis of CRC in Ugandan patients are also highlighted in this work. A steady increase of CRC in other Sub-Saharan African countries is also currently being documented however this is associated with a higher CRC-associated morbidity and mortality. Reasons behind this increase may be the nutrition transition in Sub-Saharan Africa characterized by decreased consumption of dietary fibre, starch and plant proteins to a Western diet associated with consumption of fatty foods and red meat. The emergence of noncommunicable diseases such as diabetes and obesity coupled with increased alcohol consumption and smoking confers a higher risk to CRC. A shift in the demographics is observed in Uganda compared to high income countries with 22.8% of our CRC cases being diagnosed at <40years of age compared to 3-7% in high income countries. A challenge experienced with this early age onset is that it is associated with an aggressive biological behavior with a poor prognosis. The high proportion of left sided colon and rectal adenocarcinoma in Uganda makes our population more amenable to screening. However challenges experienced in Uganda and other Sub-Saharan African countries include the availability of endoscopic training and equipment, costs, availability of pathologic services and patient acceptance. The increased diagnosis of CRC cases that will result from screening will eventually require a parallel increase in surgical and oncological infrastructure to manage CRC patients. An improvement in diagnosing, screening and treating CRC by increasing surgical and endoscopic capacity with the aid of international medical and surgical societies should be a public health priority in Uganda given the observed epidemiological shifts. Future implementation of National screening programmes to detect CRC at an early stage is also necessary to reduce the mortality in the Ugandan population.

Placenta Accreta Presenting as a Placental Polyp: A Rare Case Report

Rama Garg, Parneet Kaur, Namita Chopra

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 16-21

A placental polyp is a polypoidal or pedunculated mass of placental tissue that remains in the uterus after delivery or abortion for an indefinite period. For its rarity, there are few references in the literature, and there are many different approaches to diagnosis and management. A rare case of placenta accreta appearing as a uterine polyp is presented. This is the sole case that has been diagnosed and treated conservatively at our hospital. A proper preoperative diagnosis with accurate interpretation of imaging findings and satisfactory curettage or biopsy can prevent unnecessary hysterectomy as was in our case.

Clinical Outcomes of Short Same-segment Fixation in Thoracolumbar Junction Fractures

Shubham Jain, Piyush Mittal, Amit Kumar

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 22-29

Background: The number of vertebral levels involved in fixing a spine fracture is reduced with short same-segment posterior fixation (SSPF). Short same-segment posterior fixation with pedicle fixation at the fracture level provides biomechanical advantages for kyphosis correction maintenance, lowering failure rates, and increasing spinal motion and early rehabilitation [1-4].

Materials and Methods: Between 2014 and 2016, all patients with thoracolumbar junction fractures in our study were analysed using biomechanical criteria and clinical outcomes. The immediate postoperative radiographs were compared to follow-up radiographs to assess any loss of correction by measuring the kyphotic angle using Cobb's technique. Clinical result was also assessed using the Oswestry disability score at each follow-up. The reliability of the intraobserver and interobserver was investigated.

Results: In our study, 35 patients with unstable thoracolumbar fractures were operated on with a posterior spinal fixation system and pedicle screw insertion at the level of the fractured vertebrae during 2014 to 2016. The average time between visits was 18 months. In all of the cases, the average preoperative kyphotic angle was 17.2°, which improved to 5.9° immediately postoperatively, resulting in a mean of 65 percent correction. The average postoperative Cobb's angle was 7.7° at final follow-up, retaining a 55 percent correction. Disability improved from 78% mean preoperatively to 47.27% mean postoperatively at final follow-up.

Conclusion: When compared to traditional SSPF, short same-segment posterior fixation has a lower implantation failure rate and improved biomechanical stability; nevertheless, long-term kyphosis correction was not maintained to the same level, which was statistically insignificant. Despite the lack of kyphosis correction, long-term clinical pain and disability improved. This study indicated that SSPF decreases implantation failure rate and reoperation rate and offers greater biomechanical advantages.

Determination of Climatic Impact of Temperature in Presence of Avian Respiratory Infections in Villa Clara Province, Cuba

Rigoberto Fimia Duarte, Ricardo Osés Rodríguez, David del Valle Laveaga, María Patricia Zambrano Gavilanes, Pedro Yoelvys de la Fé Rodríguez, Yanira Zaita Ferrer, Fran M. Wilford González, Ismabel Domínguez Hurtado

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 30-42

The objective of the research was to determine the climatic impact of temperature on avian respiratory infections in Villa Clara province, Cuba. In this work retrospective data were used to obtain the epizootiological statistical information of susceptible and dead birds regarding avian respiratory infections, in specialized poultry farms of Villa Clara province, during the period 2005-2007. These data were correlated with the temperatures stockings average corresponding to this period in this county. The total of deaths was correlated with the total of susceptible; these last ones correlated in turn with the provincial temperatures stockings. For the information processing, the model Autoregressive Integrated Moving Averages (ARIMA) was used of Box-Jenkins Methodology through the statistical package SPSS Version 13. Techniques of multivariate regression for modeling the total of poultry deaths were also applied. The final ARIMA model expressed that an increase of 1 degree of temperature, which meant an increase of 53.37 deaths. It was also used a 95% of probability value. This work allows corroborating and quantifying the impact of mean temperature in the susceptible and in the poultry deaths in the study area of Villa Clara province, Cuba. It was obtained that with 1ºC of monthly half temperature, it can be expected an increase of 8 894 susceptible cases and as the susceptible ones’ increase in 1000 the deaths, are increased in 6 birds, for what the susceptible ones for 0.06 will be the same approximately to the total of deaths.

Investigating the Effects of Standardised Treatment Protocols for Opportunistic Infection in Children Living with HIV/AIDS on Their Clinical Profile

Shilpa Yashwant Pawar, Sadhana Jagannath Raut, Smita Mundada, Amol Suryawanshi, P. S. Patil

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 43-49

Introduction: AIDS has become prevalent all across the world. As in adults, pediatric HIV/AIDS is on rise all over the world. Since 1981, about 25 million individuals have died around the world as a result of HIV. The risk of mother to child transmission of HIV infection varies from country to country and also within a country depending on the facilities available.  

Aims and Objectives: To investigate a standardised treatment protocol for opportunistic infections in HIV/AIDS children.

Methodology: A cross-sectional study was conducted on children living with HIV/AIDS at the A.R.T. Centre, government medical college and hospital in Aurangabad from July to December, 2007. One of the primary goals of this project was to develop a standard treatment protocol for the management of opportunistic infections in HIV/AIDS-infected children. Necessary permission from NACO, MSACS and Parents or Care takers Consent was taken. A total of 280 paediatric patients were enrolled, with 50 of them receiving antiretroviral therapy.

Result: The most frequent OI in the study group was tuberculosis, which was followed by diarrhoea and acute respiratory infection. After initiating the Standard Treatment Protocol in Children with HIV/AIDS, there was an overall rise in height, weight, and CD4 count.

Conclusion: After starting the Standard Treatment Protocol in Children with HIV/AIDS, there was a positive response in the form of increased height, weight, and overall increase in CD4 Count, indicating that these standard protocols should be strictly followed for a better prognosis for opportunistic infections in children with HIV/AIDS.

Aim: For the treatment of upper impacted central incisors (ICIs), two main surgical approaches are typically described: open and closed. The closed-eruption surgical method (CEST) is currently the most popular because it provides the best esthetic and periodontal benefits. The purpose of this study was to see how traction discontinuation affected maxillary central incisor sulcal depth and alveolar bone ridge levels when compared to contralateral incisors when CEST was used.

Materials and Methods: CEST was used to treat 28 unilaterally impacted maxillary central incisors. At the time of crown emergence, thirteen teeth were subjected to a month of traction interruption, whereas 15 teeth were subjected to continuous traction. The ICIs and contralateral central incisors (CCIs) were subjected to periapical digital X-rays, anterosuperior cone beam computed tomography (CBCT) scanning, and periodontal probing one year following treatment. The CCI measurements were utilized as a reference, and the Student's t-test was employed to see if there was a statistically significant difference between continuous and interrupted tractions.

Results: Only the following measurements showed a statistically significant difference between the two techniques: Mesial probing (p-value 0.039352), labial bone level (p-value 2.58E-08), and palatal bone level (p-value 2.56E-06).

Limitations: To draw more robust conclusions, a larger sample size and longer term follow-up are required.

Conclusion: On ICIs, a temporary discontinuation during tooth traction appears to improve treatment outcome. Technical modifications and the use of a temporary interruption during tooth traction can result in better treatment outcomes.

Clinical significance:

  • The CEST leads to the best periodontal status for ICIs.
  • The discontinuation of traction at the emergence of the tooth allows the supracrestal fibers to insert into the cement in a proper way.

Application of an Innovative Technique for Fabrication of Silicone Auricular Prosthesis

Pramod K. Chahar, Abir Sarkar, E. Mahesh Gowda, Poonam Prakash

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 62-68

Aim: To make a silicone auricular prosthesis, that perfectly mimics the healthy contralateral ear for a unilateral auricular defect.

Background: Any loss of facial structure, whether congenital or acquired, has a significant detrimental influence on an individual's life. Replicating the complicated anatomy of an auricle while imitating the contralateral ear is a difficult issue in prosthetic rehabilitation of a patient with unilateral auricular impairment.

Case description: This case report discusses an innovative, accurate, and simple technique for fabricating the wax pattern of the auricular prosthesis without the use of any expensive or complicated equipment that is yet to be described in the literature. The only disadvantage seen in this technique is the loss of some anatomic details while merging the margins of wax slices with a hot spatula, which require finer adjustment by minor carving and finishing of the wax pattern.

Conclusion: This case report describes a technique for replicating the anatomy of the auricle in ordinary clinical practice without the need of expensive equipment.

A Retrospective Clinicopathological Study of Cervical Cancer

Gopalakrishna Nandini, Jessica C. Fernandes, Punuru Sindhu

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 69-76

Introduction: In developing countries, cervical cancer is still the most frequent gynaecological cancer among women.

Objective: The goal of this study was to look at the clinical presentation and histological pattern of carcinoma cervix over a three-year period.

Design: This was a retrospective analysis.

Results:  The majority of the patients were between the ages of 40 and 50.The majority of the patients were in stage III of the disease. The most common histological pattern was squamous cell carcinoma. The treatment modality was radiotherapy with concurrent chemotherapy.

Conclusion: The result clearly demonstrates the inadequacy of the screening programme for detecting preinvasive stages of cervix carcinoma. Early diagnosis of the preinvasive stage by screening and appropriate treatment should be instituted at the preinvasive stage.

Introduction: Esmolol and Labetalol, at low doses, were evaluated for attenuation of sympathomimetic reaction to laryngoscopy and intubation in this prospective, randomised, double-blind, comparative clinical study.

Materials and Methods: This study involved 50 ASA 1 patients of either sex who were undergoing elective surgery under general anaesthesia. Prior to induction, patients were randomly assigned to one of two groups: group E got intravenous Esmolol (0.5 mg/kg) or group L received intravenous Labetalol (0.25 mg/kg), and hemodynamic parameters were monitored as per the procedure to determine stress response to laryngoscopy and intubation.

Results: The demographic profiles of both research groups were similar. For statistical calculations, Instat version 3.10 was utilised. The data from the study was evaluated using statistical approaches such as mean and standard deviation. During laryngoscopy and intubation, esmolol (0.5 mg/kg) and Labetalol (0.25 mg/kg) significantly reduced the increase in heart rate, systolic blood pressure, and RPP. However, the difference was not statistically significant among the values for DBP and MAP.

Conclusion: In lower doses, intravenous Labetalol (0.25 mg/kg) is a better agent than intravenous Esmolol (0.5 mg/kg) in attenuating the sympathomimetic reaction to laryngoscopy and intubation, according to our clinical trial. The typical dose of esmolol used to obtund intubation response is 2-4 mg/kg, whereas labetalol has been tested in all doses ranging from 0.25, 0.5, 0.75, and 1 mg/kg [1].

ROS Flashes in Mitochondria Occur Concomitantly with Inner Mitochondrial Membrane Depolarization and Mitochondrial Calcium Sparks

Andrey V. Kuznetsov, Judith Hagenbuchner, Michael J. Ausserlechner

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 83-104

Objectives:  Study of complex ROS dynamics and ROS mito-flashes in various living cells using fluorescent confocal imaging. Simultaneous analysis of the mitochondrial and extra-mitochondrial ROS dynamics. Analysis of the mitochondrial membrane potential and depolarization. Simultaneous analysis of mitochondrial calcium and ROS kinetics.

It is well documented that mitochondria can produce a major amount of reactive oxygen species (ROS) which are involved in many physiological and pathological processes. The complex interrelationships, however, between ROS, mitochondrial inner membrane potential (\(\Delta\Psi\)m) and mitochondrial Ca2+ were not entirely investigated. In this work, we further underline biphasic ROS dynamics, demonstrating initial and continuing ROS expansion, followed by mitochondrial ROS flashes. Additionally, a huge heterogeneity in the rates of mitochondrial ROS production and ROS flashes start times has been shown. Comparing mitochondrial and extra mitochondrial fluorescence signals, we demonstrated that the mechanisms of ROS flashes may be a triggering of flashes by certain amounts of external ROS. These mechanisms involve mitochondrial permeability transition pore opening (collapse of mitochondrial membrane potential, \(\Delta\Psi\)m) and mitochondrial calcium sparks. Furthermore, mitochondria to mitochondria interactions can be seen as a wave propagation of mitochondrial ROS flashes and \(\Delta\Psi\)m collapses similar to the phenomenon of ROS-induced ROS release first demonstrated for cardiomyocytes. Our data show that mechanisms of mitochondrial ROS flashes activation and simultaneous depolarization can entail involvement of extra mitochondrial ROS produced either by individual mitochondrion or by adjacent mitochondria. This could represent common processes in ROS-ROS and mitochondria-mitochondria signaling, playing thus an important role in the cellular and mitochondrial physiology.

The Study of Financial Impact of COVID-19 on Ophthalmic Practices

Nishant Renu

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 105-110

The unprecedented threat of Covid-19 has forced transition from the normal way of life. The new norm now includes social distancing, the use of face masks, and reduced contact to only necessary cases. In ophthalmology, practice procedures are currently only limited to emergency procedures such as trauma and endophthalmitis. The state of affairs, as described in this review, is greatly reduced the number of patients seeking ophthalmology services. There are fewer patients making visits as a result of extreme caution on both their parts and the medics. Expectedly, many private practitioners are feeling the financial pinch, with as many as 90% of private practices seeking federal loans, among other initiatives to cushion their practices. Despite these efforts, the outlook is grim, with an estimated 6% of private practices expected to close, while those that pull through are predicted to be smaller in size and poor financial positions.

Determination of Technological Advancement in the Era of COVID-19

Nishant Renu

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 111-117

Regional and local governments worldwide are working tirelessly towards effective ways of addressing the COVID-19 crisis. During this time, the government has had to ensure that they provide full usage of technological means to confront the pandemic and discourse a wide range of COVID-19 related problems. Herein, the objective of this paper is to discuss the application of technical means and the advancement of technology in different sectors as a consequence of the COVID-19 crisis. As will be discussed, how government and health organizations have introduced new policies intending to try to curb the spread of the coronavirus. These new policies, such as lockdowns and social distancing measures, have resulted in technological advancement and new means of interaction with government, businesses, and citizens. Such changes include increased online shopping, as well as robotic delivery systems, the introduction of digital as well as contactless payment systems, remote working, the role of technology in distance learning, Telehealth, 3D Printing, and online entertainment. These technological advancements have been embraced all the way during this pandemic by a few countries around the world, with its limitation in some underdeveloped and developing countries.  

A Rare Uterine Cancer: Epithelioid Leiomyosarcoma

Upadhya Rekha, Vidyashree G. Poojari, Muralidhar V. Pai, Jayaraman Nambiar

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 118-124

A uterine epithelioid leiomyosarcoma is a type of uterine mesenchymal tumour that arises from the smooth muscle lining the walls of the uterus. The specific cause of leiomyosarcoma is uncertain, with uterine leiomyosarcoma accounting for 5 to 10% of cases. The most prevalent subtype of uterine sarcoma, leiomyosarcoma, accounts for 1-2 percent of all uterine malignancies. Recent application of molecular techniques has identified numerous lesions with distinctive genetic abnormalities and clinicopathological characteristics. Menopausal women who are not on hormonal replacement medication and have tumour development should be suspected of malignancy. A 64-year-old woman had reached menopause 16 years prior and had been experiencing postmenopausal haemorrhage for the past two months, with a palpable mass measuring 16 weeks in size. The whorled mass lesions, endometrium, and myometrium could not be seen separately on ultrasonography. Uterus with both ovaries removed. Intraoperative investigations revealed a 16-week-old uterine mass with a diameter of 15x15 cm and a weight of 1kg, as well as an intramural fibroid. On cut section, necrotic and haemorrhagic regions with degenerative alterations suggest cancer. Epithelioid leiomyosarcoma was discovered using histopathology and immunohistochemistry.

A Review and Update on Clinical Management on Burning Mouth Syndrome

Juliana Cassol Spanemberg, Eugenia Rodríguez de Rivera Campillo, Enric Jané Salas, Albert Estrugo Devesa, José López López

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 125-143

Burning Mouth Syndrome (BMS) is a persistent condition that primarily affects postmenopausal middle-aged women. The absence of clinical indications and burning feelings of the oral mucosa identify this illness.BMS has a complicated aetiology that incorporates a number of factors.BMS can be caused by a variety of local, systemic, and psychological conditions, including stress, anxiety, and depression. BMS Type I, II, or III are possible classifications. Although there are no obvious organic changes and no health hazards associated with this illness, it can drastically affect the patient's quality of life. The objective is to review the available literature related to BMS, and makes special reference to its therapeutic management. The sections that follow will also go through important diagnostic criteria, etiological factors, and clinical aspects. The main objective of management is that of providing support to the patient and working towards symptom reduction, rather than total elimination of such symptoms. Tricyclic antidepressants, benzodiazepines, and antipsychotic medicines are the most frequently accepted therapy alternatives with variable results; nevertheless, there are other therapies that will be presented that can also be used.  The management of this group of patients should be done by professionals who talk and reaffirm to them the nature of the disease and discuss the benefits of intended therapies or possibility of pain relief. Patients should be educated about the need for a multidisciplinary team approach and the probability of needing multiple changes in therapies until effective treatment is achieved. Professionals in the field of dentistry should develop standardised symptoms and diagnostic criteria so that multidisciplinary research can more easily discover the most successful and reliable BMS treatment techniques.

A Descriptive Cross-sectional Study on Diet and Women Fertility

Hayder G. Oufi, Ruaa E. Alabd

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 144-153

Aims: The goal of this study was to determine the impact of diet and dietary habits on women's fertility.

Materials and Methods: Between January and September 2014, this study was conducted in seven different institutes and hospitals in Baghdad. The participants were 400 adult women, ranging in age from 17 to 47 years, who were separated into two groups. There were 300 fertile women in group I and 100 infertile women in group II.A specific questionnaire had been designed and used for data collection.

Results: A significant difference in weight and body mass index (BMI) was discovered between the infertile and control groups. The mean weights for the infertile and control groups were 73.07 kg vs 69.06 kg, respectively, while the mean BMI was 28.83 vs 26.70 for the infertile and control groups. In addition, the infertile women consumed more carbonated beverages, tea, chicken, and fish than the control group, while consuming less milk and red meat. Furthermore, the infertile group consumed less corn oil and olive oil than the control group (5 and 0% vs 21 and 2%, respectively), but ingested more solid fat and mixed fat (2 and 6% vs 0 and 2.7%, respectively).

Conclusion: Although there are treatment options for infertility, their high cost and high frequency of side effects have prompted researchers to look into dietary aspects that may contribute to infertility. This study confirmed the association between weight, BMI, and infertility. Diet was identified as one of the modifiable risk factors that may affect fertility in the selected groups in the current study; therefore, it is critical to focus more on the role of diet in women's fertility and raise women's awareness of it, as well as suggesting more educational programmes at the primary health care level.

Introduction: The Human Immunodeficiency Virus (HIV) is the most potent risk factor for Tuberculosis progression (TB). Surveillance of HIV among & TB patients has been recognized to be important as the HIV epidemic continues to fuel TB epidemic. In those who are infected with both HIV and TB, the interaction is bidirectional and synergistic. The purpose of this study was to determine the seroprevalence of HIV infection among patients with tuberculosis in a tertiary care hospital.

Method: A one-year study of 4500 confirmed tuberculosis patients was conducted, and HIV antibodies were tested in accordance with National AIDS Control Organisation (NACO) guidelines. The results showed that 244 (5.42 percent) of the 4500 patients screened were HIV positive. The male to female ratio was 2.34 (171/73), and the prevalence of co-infection was highest among those aged 35 to 50 years.

Conclusion: The current study found 5.42 percent HIV seroprevalence in tuberculosis patients. Early diagnosis of HIV infection in tuberculosis patients will allow for quicker access to care and treatment, including antiretroviral therapy (ART).  This will reduce the number of deaths and illnesses among HIV-TB co-infected patients.

Neovascular Glaucoma: Etiology and Staging

Totli Kuruba Mayuri

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 159-168

Purpose: To identify the most common cause and the most common stage of presentation of the patient in neovascular glaucoma.

Methods: The current study is an observational prospective study. The study comprised 136 eyes from 109 patients with neovascular glaucoma in one or both eyes.  Visual acuity, slit lamp biomicroscopy, intraocular pressure (IOP) measurement by Goldmann applanation tonometry, gonioscopy with Posner 4 mirror indirect gonioscope, and dilated fundus examination were all performed on all patients. Neovascularization of iris (NVI) was identified as tuft of new vessels on iris mostly at the pupillary margin in an undilated state, presence of any ectropion uveae, hyphema, anterior chamber reaction, pseudoexfoliative material, keratic precipitates and other signs of uveitis were noted. The number of neovascularized quadrants in the angle was counted.

Results: The average age was58.18±13 years, with 80.73 percent of men and 19.26 percent of women. The average IOP was 27.14 ± 11.3 mm Hg.  The rubeosis iridis stage was represented by 74 (54.4%), the angle closure stage by 38 (27.9%), and the open angle stage by 24 (17.6%). 89 (65.4%) of the participants had diabetic retinopathy of varying severity, whereas 16 (11.7%) had uveitis and 14 (10.2%) had retinal vein occlusion. The average IOP angle closure stage was 36.53±16.259 mm Hg, much greater than the other two stages (P = 0.000).

Conclusion: The most common cause of NVG is proliferative diabetic retinopathy, and rubeosis iridis is the most common stage of presentation, according to the findings of this study.

Study on Recurrent Anterior Shoulder Dislocation: An Approach to Boytchev Treatment

Otman Benabdallah, Ahmed Khamlichi

New Frontiers in Medicine and Medical Research Vol. 16, 30 August 2021, Page 169-180

Background: The Boytchev method, which has been used since 1951 to treat anterior glenohumeral instability, is an open anterior repair that entails rerouting the muscles that join the coracoid process deep to the subscapularis muscle between this and the capsule. In the anatomical position, the tip of the coracoid is reattached to its base by its muscles.

Methods: We conducted a prospective study of twenty patients with recurrent shoulder dislocations who were treated by the Boytchev procedure. All are men, with an average age of 29.2 years (age range from 17 to 42 years). 14 patients were affected on the right shoulder, 6 on the left. All had a clinical history of recurrent dislocation. We also performed a search of all published articles in the literature (16),17 studies including our series, with the aim of estimating, via a statistical analysis, to shed light on the post-operative results of recurrent anterior dislocations of the shoulder, for determining the reliability of this technique and possible specific risk factors that might lead to recurrence.

Results: Evaluated using the Rowe score in our series, 19 patients had excellent and good results; one patient, who suffered a recurrence, had a poor result in terms of stability. Another patient developed osteoarthrosis. For the 17 studies, the number of patients is 477 with 485 dislocated shoulders. The rate of recurrence is 7.33% .In 12 studies, the rate is 2%, versus 21.05% in 5 studies with a significant difference (1-p=99.89%). Concerning the gradation of results, we have 441 excellent and good results and 44 fair and poor (91% versus 9% with p=>99.9% which is also very significant).

Conclusion: The Boytchev procedure exhibits low recurrence rates in compiled studies and so can be considered a reliable surgical technique.