Do we have sufficient evidence of timing to return-to-sports after anterior cruciate ligament reconstruction?

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The causes of gallstone formation include rapid gain or loss of weight. Not all gallstones become symptomatic. Concurrent cholecystectomy in sleeve gastrectomy remains controversial. This study aimed to investigate whether concurrent cholecystectomy should be performed after sleeve gastrectomy (SG). A total of 268 patients with normal preoperative gallbladder ultrasonography findings, who underwent laparoscopic SG in Ankara Numune Training and Research Hospital between 2011 and 2018, were retrospectively examined. The data collected from 40 patients with symptomatic cholelithiasis during the postoperative follow-up were analyzed. Forty patients [32(80%) female and 8 (20%) male] developed symptomatic cholelithiasis after an average of 10.65 ± 5.98 months of SG and underwent surgery. The mean age of the patients was 38 ± 11 years. The mean body mass index before SG was 48.15 ± 5.61. The mean percentage of excess weight loss was 69.85 ± 17.4 at the time the patients underwent cholecystectomy. As the percentage of excess weight loss increased, the time to the development of postoperative symptomatic cholelithiasis decreased, and this relationship was statistically significant (R = 0.435, P = 0.005). Prophylactic cholecystectomy need not be performed concurrently with SG in patients without preoperative symptomatic gallstones. The reason is that laparoscopic cholecystectomy can be safely performed in the postbariatric surgery period, and the risk of symptomatic gallstone formation depends on individual risk factors.

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The outpatient department (OPD) is the first point of contact of a hospital with patients and serves as the shop window of the hospital. The care in the OPD indicates the quality of services provided by the hospital and is reflected by patient satisfaction. Overcrowding contributes significantly to patient dissatisfaction because of the long waiting and less consultation time. Data on the services of AYUSH systems in India are scarce, although AYUSH systems are now a part of the national health-care delivery structure. Therefore, this study aimed to investigate the services rendered by the AYUSH hospitals to understand the lacunae, help improve the system, and increase the accessibility among the masses. A time–motion study (TMS), including 100 patients from the state-level AYUSH Hospital, New Delhi, was conducted to assess the average waiting time of patients and the level of satisfaction of patients in terms of services provided by the hospital. The duration of this study was 15 working days. The data were gathered by TMS and direct patient interviews. The findings revealed that, on average, a patient spent nearly 2 h in the OPD from its arrival to exit. The major reason for this prolonged waiting time was the time for consultation, which was 1 h 10 min, and almost 16 min at the pharmacy. Moreover, the average time a patient spent with the doctor for consultation was 3 min. In conclusion, the patients were least satisfied by the OPD waiting time, consultation time, and pharmacy services.

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Chronic rhinosinusitis (CRS) is one of the most frequent otorhinolaryngologic diseases encountered in daily practice with an estimated prevalence of 14% of the global population. This study aimed to explore the efficacy of Viola odorata flower decoction against CRS. In this prospective randomized controlled trial, 30 patients with CRS were randomly assigned to receive either test drug (10 g of V. odorata flower in the form of decoction administered orally empty stomach in the morning daily) or active control drug (single nasal spray of fluticasone propionate 50 µg/spray in each nostril daily) for 30 days. The primary outcome measure was an improvement in sinonasal symptoms assessed using a 22-item sinonasal outcome questionnaire (SNOT-22). Reduction in absolute eosinophil count (AEC) and improvement in x-ray paranasal sinus were secondary outcome measures. The significance level was kept as 5%. After completing the therapy, the SNOT-22 score was significantly low in the test group compared with the control group and a significant difference was found in AEC between the groups. Also, the SNOT-22 score remained significantly low after completion of the treatment on the 45th and 60th days compared with the control drug. Changes in x-ray paranasal sinuses were not significant between the groups. These results suggested that V. odorata flower was effective in reducing the symptoms of CRS. Trial Registration No. Clinical Trial Registry of India CTRI/2017/09/009788 (01/09/2016)

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This study aimed to evaluate traumatic cardiac arrest (TCA) cases in Turkey. This study was performed on 241 of the 10974 arrest cases (2.2%) intervened by Ankara Provincial Ambulance Service teams in 2017–2018, who developed after traumatic events. The cases recorded as R09 and I46 according to the ICD-10 classification were included in the study. The significance tests of the data were performed using SPSS for Windows version 13.0. For the statistical significance level, the P value was accepted as >0.05. The arrival at scene time was 09: 48 (min: s) in 2017 and 14: 23 (min: s) in 2018. The intervention at the scene time was 18: 04 (min: s) in 2017 (P = 0.043) and 28: 48 (min: s) in 2018. The emergency department wait time was 21: 10 (min: s) in 2017 and 17: 29 (min: s) in 2018 (P = 0.000). The driving distance to the scene was 6.4 km in 2017 and 8.0 km in 2018. The business time of a unit for a case was 1: 31: 49 (h: min: s) in 2017 and 01: 10: 03 (h: min: s) in 2018. The average wage for a case was 738 YTL in 2017 and 622 YTL in 2018. In 2018, 24.5% of the cases (n = 25) were dead on arrival, while the number was 18% (n = 25) in 2017. In 2017, a demand arose for secondary transport of 29 patients after primary transport to a hospital, and 6 (20.7%) of them were secondarily transported to another hospital for specialist consultation. In 2018, 12 (54.5%) out of a total of 51 patients transported primarily to a hospital were secondarily transported to another hospital for specialist consultation. In Turkey, as in other countries, patients with TCA constituted the group of patients with the lowest survival rate. It was determined that trauma teams should be formed to intervene the cases transported to the hospital.

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Alveolar soft-part sarcoma (ASPS) is a rare soft tissue malignant tumor. This study aimed to evaluate the epidemiological data of ASPS. Data on ASPS were obtained from Surveillance, Epidemiology, and End Results (SEER) database. Patients diagnosed with ASPS between 1975 and 2016 were scanned retrospectively. Age, sex, ethnicity, disease prognosis, tumor location, tumor grade, follow-up time, and follow-up results of all patients were evaluated. A total of 312 patients with ASPS [171 female (54.8%), mean age 27.4 (1–84 years)] were included. The most common tumor location was soft tissues (84.2%). The mean follow-up duration was 86.8 months (range 1–484 months). The most common tumor grade was grade 4, with 30 patients in this category (43.4%). At the time of diagnosis, 104 (48.5%) patients had distant metastasis. ASPS is a rare soft tissue sarcoma, and approximately half of the patients are metastatic at the time of diagnosis with metastasis to the lungs, most commonly. Despite the high metastasis rate, ASPS has a satisfactory 5-year survival rate

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