Asian Journal of Research in Surgery https://journalajrs.com/index.php/AJRS <p style="text-align: justify;"><strong>Asian Journal of Research in Surgery</strong>&nbsp;aims to publish&nbsp;high-quality&nbsp;papers (<a href="/index.php/AJRS/general-guideline-for-authors">Click here for Types of paper</a>) in all aspects of&nbsp;‘Surgery’. By not excluding papers based on novelty, this journal facilitates the research and wishes to publish papers as long as they are technically correct and scientifically motivated. The journal also encourages the submission of useful reports of negative results. This is a quality controlled, OPEN peer-reviewed, open-access INTERNATIONAL journal.</p> Asian Journal of Research in Surgery en-US Asian Journal of Research in Surgery Shaheed Procedure: An Innovative Technique in the Management of Chronic Pancreatitis Calculous https://journalajrs.com/index.php/AJRS/article/view/184 <p><strong>Aim: </strong>To describe a new technique (Shaheed Procedure, single anastomosis-based side-to-side lateral pancreatojejunostomy) instead of two anastomoses of Roux-en-Y pancreatic jejunostomy for chronic pancreatitis calculous.</p> <p><strong>Methods:</strong> The Prospective longitudinal study was carried out in three tertiary-level hospitals in Bangladesh from 2010 to 2018. All the cases were diagnosed as chronic calculous pancreatitis with a dilated central pancreatic duct. The duct diameter is 6mm and above. The commonest investigation was ultra-sonography, and ERCP was carried out in all cases. The patients were subjected to surgery only when their pain was intractable and not responding to analgesics. A single anastomosis-based Pancreatic-Jejunostomy was made for all cases instead of the two-step anastomoses of Roux-en-Y pancreatic-jejunostomy. Postoperative assessment of their clinical and biochemical features was done every three months.</p> <p><strong>Description of Technique:</strong> The transverse colon with mesocolon is lifted upwards after incision. A longitudinal incision was made and exposed the whole length of the Pancreas. The anastomosis was made at the antero-inferior surface of the Pancreas, the most dependent part. The jejunal loop selected for anastomosis is 56 cm away from the DJ flexure, held by two Babcock forceps. No Rouxen Y anastomosis.</p> <p><strong>Results:</strong> A total of 146 cases were evaluated in this study, including 76 male and 70 female patients. Age ranges from 15 years to 54 years. Complications like abdominal bleeding and anastomotic leakage did not happen in the postoperative period. Long-time follow-up was six years, and short-time follow-up was only one month. The total operating time is 90 to 120 minutes, with minimal blood loss. No recurrence and postoperative complications were observed in the follow-up time. The pain was relieved in 96% of cases postoperatively. Single anastomosis, shorter operating time, less morbidity with zero mortality rate.</p> <p><strong>Conclusion:</strong> The new technique is a new option with better outcomes in pancreatic calculi management's drainage and decompression procedure.</p> Md. Shahidur Rahman Syeed Mehbub Ul Kadir Md. Saifur Rahman Amena Sharmeen Zefrin Akter Copyright (c) 2024 Rahman et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-03 2024-01-03 7 1 1 7 Safety and Efficacy of an Affordable Glaucoma Drainage Device Implantation (AADI) in Refractory Glaucoma https://journalajrs.com/index.php/AJRS/article/view/185 <p><strong>Aims: </strong>This study aimed to assess the safety and efficacy of implanting an affordable glaucoma drainage device in patients with refractory glaucoma.</p> <p><strong>Methodology:</strong> A prospective longitudinal study was conducted involving 30 patients diagnosed with refractory glaucoma who underwent implantation of the Aurolab Aqueous Drainage Implant (AADI) at Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh between November 2021 and April 2022. All surgeries were performed by a single surgeon using a consistent technique. Patients were followed up for three months postoperatively. Outcome measures included postoperative intraocular pressure (IOP), best-corrected visual acuity (BCVA), the number of anti-glaucoma medications, and post-surgery complications. Complete success was defined as an IOP between ≥5 and ≤21 mm Hg, without the need for additional glaucoma medications.</p> <p><strong>Results:</strong> The majority of the patients were male (56.7%), while females comprised 43.3%. The mean age was 24.97 (±16.5). A significant decrease in the mean preoperative IOP from 31.67 (±9.8) mmHg to 12.7 (±4.0) mmHg was observed at the three-month follow-up, with a mean percentage reduction of 59.9% (P value &lt;0.001). The mean number of preoperative topical anti-glaucoma medications (AGM) decreased from 3.17 (±0.59) to 0.17 (±0.53) at the three-month follow-up. Visual acuity remained stable in 10 (33.3%) eyes, improved in 9 (30%) eyes, and deteriorated in 11 (36.7%) eyes. Complications occurred in 4 patients (13.3%), including hyphema in 1 (3.3%) patient, choroidal detachment (CD) in 1 (3.3%) patient, and choroidal detachment with retinal detachment in 2 (6.6%) patients. The overall success rate was 96.6%.</p> <p><strong>Conclusion:</strong> The non-valved affordable glaucoma drainage device (AADI) demonstrated safety and efficacy in patients with refractory glaucoma, exhibiting good intraocular pressure control. Further follow-up is recommended to assess sustainability over time.</p> Habiba Sultana Bipul Kumer De Sarker Khairul Islam Md. Sajidul Huq Copyright (c) 2024 Sultana et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-03 2024-01-03 7 1 8 15 An Audit of Antibiotic Prophylaxis for Laparoscopic Cholecystectomy https://journalajrs.com/index.php/AJRS/article/view/186 <p><strong>Background: </strong>Laparoscopic cholecystectomy is a commonly performed surgical procedure for the treatment of symptomatic gallstones. Antibiotic prophylaxis is recommended to prevent surgical site infection (SSI) and other related complications and has been known to lower the incidence of postoperative infection in surgeries. The American Society of Health-System Pharmacists (ASHP) guideline summarizes current data on the appropriate use of antibiotic for surgical prophylaxis.</p> <p><strong>Objective: </strong>The objective of this study is to assess and audit the use of antibiotics for laparoscopic cholecystectomy surgeries in a tertiary care centre according to the recommendation of ASHP guidelines.</p> <p><strong>Methods: </strong>A retrospective audit was conducted and medical records of patients who underwent laparoscopic cholecystectomy between August 2022 to February 2023 in the surgical wards of a private hospital in Mira road, were studied. Antibiotic indication and choice, dose, dosing interval, route of administration, and timing of first administration and duration of prophylaxis were compared with the ASHP guideline recommendations.</p> <p><strong>Results: </strong>A total of 100 patients with the age of &gt;18 years were retrospectively studied. About 87 % of procedures had full compliance with all guideline recommendations. The variables with least compliance were “Appropriate Dose” (87% compliance rate) and “Appropriate initiation time of prophylaxis” (97% compliance rate). The variables with most compliance were Appropriate Agent used (100%), Appropriate Duration of Prophylaxis (100%), Appropriate administration route (100%), and Appropriate decision regarding use and non-use of antibiotic prophylaxis (100%).</p> <p><strong>Conclusion: </strong>This audit highlights the need for improved adherence to guidelines regarding antibiotic prophylaxis in laparoscopic cholecystectomy. The study revealed that most of the prescribed antibiotics for surgical prophylaxis in the hospital are in accordance with standard treatment guideline. The density of antimicrobial use in the hospital for preoperative antimicrobial prophylaxis is as indicated/optimal.</p> Arbaab Khan Imran Shaikh Vasim Shaikh Copyright (c) 2024 Khan et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-03 2024-01-03 7 1 16 19 Cross Testicular Ectopia: Two Case Report and Review of Literature https://journalajrs.com/index.php/AJRS/article/view/189 <p>Cross testicular ectopia is an exceptionally rare congenital urogenital anomaly where both gonads migrate towards the same hemiscrotum. This condition is typically accompanied by other abnormalities like persistent Mullerian duct syndrome, inguinal hernia, true hermaphroditism, hypospadias, and scrotal anomalies. While most reported cases involve children, there have been a few instances in adults. The incidence of cross testicular ectopia is extremely low, occurring in 1 in 4 million male children. In cross testicular ectopia, both testes migrate to the same hemiscrotum and descend through a single inguinal canal, often associated with inguinal hernia and an empty contralateral hemiscrotum. One or both testes may be ectopic in the abdomen, inguinal region, or descend to the hemiscrotum with the contralateral hemiscrotum remaining empty.</p> <p>&nbsp;We present two cases of cross testicular ectopia in a 9-year-old and a 5-year-old boy, both presenting with right inguinal hernia and a non-palpable left testis. Ultrasound examination revealed both testes located in the right scrotum, with the hernia sac in the right inguinal area. A trans-septal orchidopexy was performed along with hernioplasty to address these cases. Top of Form</p> S. N. Jatal Sudhir Jatal Supriya Jatal Ganesh Swami Copyright (c) 2024 Jatal et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-20 2024-01-20 7 1 33 38 Perineal Ectopic Testis: A Rare Case of Congenital Anomaly https://journalajrs.com/index.php/AJRS/article/view/191 <p>Perineal ectopic testis is an uncommon congenital anomaly observed in less than 1% of undescended testis cases. Typically, it arises from either an overdeveloped lengthening of a segment of the gubernaculum or an obstruction at the entrance to the scrotum. Diagnosis is usually straightforward through a physical examination of the ectopic regions and an empty scrotum on the same side. While imaging techniques such as ultrasonography and tomography may rarely be necessary, it is predominantly identified during childhood, with its occurrence being even rarer in adults and young boys. The recommended and widely accepted treatment for perineal ectopic testis is open orchiopexy.</p> <p>We present a 5 years boy with empty left scrotum and there was a palpable left testicle in the left perineum, which confirmed by ultrasonography. Left dartos pouch orchidopexy done though inguinal incision.</p> S. N. Jatal Sudhir Jatal Supriya Jatal Shubhangi Jatal Copyright (c) 2024 Jatal et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-02-03 2024-02-03 7 1 46 49 Indications for Laparoscopic Cholecystectomy Conversions at the University Hospital Center Ibn Rochd: A Prospective Study Over 3 Years https://journalajrs.com/index.php/AJRS/article/view/192 <p>Laparoscopic cholecystectomy is the gold standard in gallbladder surgery whatever the clinical context. Contraindications to laparoscopic cholecystectomy are exceptional, however, there is a significant proportion of patients in whom it cannot be performed successfully and conversion to open surgery will be necessary due to technical difficulties or intraoperative complications.&nbsp; Conversion should not be considered as a failure but rather as a security for the patient.&nbsp; Conversion is often related to surgeon, patient and possibly equipment factors. The aim of our study is to identify the indications and the rate of conversion to open surgery in 10 patients among 482 patients who underwent laparoscopic cholecystectomy in the general surgery department of the CHU Ibn Rochd of Casablanca over a period of 3 years from January 1/ 2014 to December 31/ 2016 and to compare them with the data in the literature.</p> Amal Hajri El Kinani Siham El Hayal Anas Rachid Boufettal Driss Erguibi Saad Rifki El Jai Farid Chehab Copyright (c) 2024 Hajri et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-02-06 2024-02-06 7 1 50 53 Are Breast Implants Associated with an Increased Risk of Cancer Development in the Breast? https://journalajrs.com/index.php/AJRS/article/view/187 <p>Cancer is a global concern that has sparked ongoing research to understand its risk factors and causes. A recent question has emerged regarding the relationship between breast implants and cancer risk, particularly in the context of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). This literature review aims to provide insight into this complex issue, examining existing scientific evidence and exploring potential associations. A thorough search in Pubmed, Google Scholar, ISI Web of Science, EMBASE, CINAHL and Scopus databases regarding study keywords including breast implant, cancer, BIA-ALCL was made. Three key articles were reviewed, revealing a significant link between breast implants, especially textured ones, and BIA-ALCL. The incidence of BIA-ALCL ranges from 1 in 2,969 women with breast implants to 1 in 355 women with textured implants after breast reconstruction. As this risk grows, the use of textured implants may decline in favour of round and smooth implants, albeit with aesthetic trade-offs. Surgeons must inform patients thoroughly, considering both risks and advantages when choosing implant types. This review underscores the importance of discussing BIA-ALCL risks during informed consent for breast implant surgery and highlights the need for global registries and further research to elucidate predisposing factors and genetic susceptibility. Despite the relatively low risk, it is crucial for all women, with or without breast implants, to continue regular cancer screenings and self-examinations, ensuring informed decision-making about their health.</p> Arbaab Khan Mutarba Altaf Khan Jaanam Altaf Khan Copyright (c) 2024 Khan et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-18 2024-01-18 7 1 20 25 Is there an Increased Risk of Breast Cancer in Night Shift Workers? https://journalajrs.com/index.php/AJRS/article/view/188 <p>In the modern 24/7 global society, the prevalence of night shift work has risen significantly, offering flexibility but also raising concerns among medical professionals and researchers about a potential link to increased breast cancer risk. This article delves into the intricate relationship between night shift work and breast cancer, examining scientific evidence, underlying mechanisms, and the imperative need for awareness and prevention. The objective of this research article is to systematically investigate and analyse existing epidemiological evidence concerning the association between night shift work and an elevated risk of breast cancer in female workers.<br>By examining five key articles, this literature review presents compelling results. It demonstrates an increased risk of breast cancer in women with high-intensity and long-duration night shift work. <br>Circadian rhythm plays a critical role in breast cancer development, involving hormone regulation, DNA repair, cell division, immune function, metabolism, light exposure, and timing of medications. Night shift work disrupts this internal clock, potentially leading to an increased breast cancer risk. Additionally, a randomized controlled trial found that melatonin supplementation significantly reduced the risk of breast cancer among night shift workers. Understanding this association is of paramount importance for public health, as it has the potential to enhance occupational guidelines, support strategies for night shift workers, and ultimately reduce breast cancer incidence among vulnerable populations.</p> Arbaab Khan Jaanam Altaf Khan Mutarba Altaf Khan Copyright (c) 2024 Khan et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-19 2024-01-19 7 1 26 32 A Review of the Conservative Management of Adhesive Intestinal Obstruction in Low Resource Centres https://journalajrs.com/index.php/AJRS/article/view/190 <p>Adhesions are common following abdominal surgeries usually after about a few years from the previous Surgical procedures. This review aims to summarize the latest evidence and clarify previous uncertainties, specifically regarding the duration of conservative treatment, and the reliability of conservative management in low-resource countries like Nigeria. Previous pieces of literature were searched online and current reported management options were explored. The management options for adhesive intestinal obstruction AIO could be non-operative (conservative management) or operative treatment. A trial of non-operative management is recommended in all patients except those with signs of peritonitis, strangulation, or bowel ischemia which would have been diagnosed during physical examination and imaging. However, in poor resource countries where prompt access to imaging is not feasible, a surgical option often results from failed conservative treatment. Whereas such patients were candidates for surgical treatment ab into where resources were available. Relapse and recurrence are universal in patients with AIO; once an adhesion, always an adhesion. As the number of (re)admissions increases, recurrence risk increases and the disease‐free interval between recurrences decreases.<sup>&nbsp;</sup>This is one of the banes of AIO; more is needed to be done to reduce the incidence and re-occurrence, especially in low-resource countries.</p> Samson Ojedokun Nicholas Aderinto Gbolahan Olatunji Emmanuel Sanni Fewajesuyan Aponinuola Ayodeji Ilelaboye Copyright (c) 2024 Ojedokun et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-01-20 2024-01-20 7 1 39 45 Lower Eyelid Reconstruction Using the Tenzel Technique in a Case of Eyelid Basal Cell Carcinoma https://journalajrs.com/index.php/AJRS/article/view/193 <p><strong>Summary:</strong> The reconstruction of transfixing eyelid defects is subject to surgical requirements determined by the anatomical and functional particularities of the eyelids. In order to meet these requirements, numerous reconstruction processes are available, presenting their own objectives and particular constraints.</p> <p>Among them, we sought to determine the place and reliability of the use of the TENZEL technique.</p> <p><strong>Observation: </strong>This is a patient operated on in our training for left lower eyelid basal cell carcinoma and in whom a reconstruction was carried out using the Tenzel technique. A very good progress was noted in our patient without any notable complications. The functional and aesthetic results were satisfactory.</p> <p><strong>Conclusion:</strong> The blepharopoiesis process using the TENZEL technique has many advantages. It is a simple, versatile technique, allowing extensive and complex eyelid reconstructions, in a single operating stage. This process is characterized by great reliability and allows good results to be obtained, both functional and aesthetic. The Tenzel technique represents a major tool in eyelid repair surgery.</p> Hafssa EL Hadri Zahira Benzenzoum Saad Fawzi Nadia Mansouri Hattab Copyright (c) 2024 Hadri et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 2024-02-12 2024-02-12 7 1 54 59