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Background The medial sural artery perforator (MSAP) flap is reliable in resurfacing defects of the popliteal fossa. There is possibility of resurfacing the popliteal fossa defects after postburn contracture release with scarred MSAP flaps with good overall long-term outcomes. Materials and Methods A study was conducted from June 2017 to July 2023 to evaluate the functional and surgical scar aesthetic outcome in patients with soft-tissue defects in the popliteal fossa after postburn contracture release that were reconstructed using scarred and unscarred MSAP flap with 10 patients in each group. Results The clinical outcome was assessed in terms of the perioperative and late postoperative complications, range of motion of the knee joint along with surgical scar outcome using the Patient and Observer Scar Assessment Scale (POSAS). The functional results in the scar tissue flap group were comparable with those in the normal tissue flap group, but the aesthetic outcome of surgical scar was found to be better in the normal tissue flap group. Conclusion The MSAP flap provides ideal tissue for soft-tissue reconstruction with minimal donor site morbidity for popliteal fossa defects after postburn contracture release in both the scarred and unscarred flap groups. [ABSTRACT FROM AUTHOR]

Extraskeletal Ewing sarcoma (EES) is a rare entity, accounting for only 3% of lesions encountered in upper extremity. We present two paediatric patients, who were initially diagnosed with a vascular malformation based on clinical assessment and imaging. Final histopathology revealed Ewing sarcoma of soft tissue origin, confirmed by immunohistochemical analysis. Hand surgeons, who are routinely approached for a myriad of hand pathologies, should be wary and consider EES as a differential when treating such lesions. A multidisciplinary approach with an appropriate treatment algorithm can help in a speedy diagnosis, improving the long-term prognosis of the disease. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Ectodermal dysplasia-syndactyly syndrome 1 (EDSS1) is an exceedingly rare condition associated with mutations in the PVL4 gene. It is characterised by sparse, brittle hair, eyebrows and eyelashes, abnormal dentition and nails, along with bilateral cutaneous syndactyly involving the fingers and toes. We report a 2-year-old girl who presented to us with bilateral complete simple syndactyly of the third and fourth web spaces of the hands, along with bilateral syndactyly of both feet involving the second to fourth toes. Upon examination, sparse hair and eyebrows, along with abnormal dentition, were noted. Thorough clinical examination and genetic analysis were conducted on the affected child and her father, who exhibited similar clinical features. Genetic analysis revealed a homozygous nonsense mutation in the PVL4 gene in both individuals. According to the literature, EDSS1 has been reported in only 10 families worldwide, and there are no reported cases from India. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Background The keystone design perforator island flap (KDPIF) is unique among local flaps because of its high potential for adaptation. We describe our experience with the use of the keystone flap for the reconstruction of a variety of defects in different regions of the body concerning its versatility, surgical outcomes, complications, postoperative pain, operative time, and esthetic outcomes. Methods A prospective observational study was conducted at our institute from June 2021 to June 2023 where the use of KDPIFs in resurfacing soft tissue defects of different etiopathogenesis was evaluated and the data were analyzed. Results Forty-four patients were included in the study with soft tissue defects of various etiologies and at different locations. The largest flap raised was 18 × 10 cm and the smallest was 4 × 2 cm. The average intraoperative time for completion of the procedure was 74.86 minutes (range: 45–120 minutes). The success rate of flap survivability was 95.45% with two patients having total flap loss necessitating another reconstructive option. Partial flap dehiscence which healed secondarily was observed in two patients. Postoperative pain showed a significant fall of 83.7% from baseline and 82.9% of cases were extremely satisfied with the esthetic outcome. Conclusion The keystone flap is a valuable reconstructive tool in the armamentarium of a plastic surgeon. It is technically reproducible, suitable to be done in resource-limited settings, and provides contiguous tissue with good vascularity and fewer complications. [ABSTRACT FROM AUTHOR]

Introduction: Literature on implementation leadership program in undergraduate (UG) medical education is lacking in the Asian continent. We aim to describe our experience in sensitizing the 1st year undergraduate medical students (UGMS) toward the principles of leadership in a medical institution. Materials and Methods: Each year, one hundred 1st year UGMS were sensitized towards leadership principles and core domains through interactive sessions, focus group discussions, and short lectures. The students were asked to reflect on the sessions’ activities as well as their follow-up usefulness in their day-to-day activities through a structured questionnaire shared through Google forms. Results: A high proportion (75%) of students reported an improved perception or knowledge toward leadership principles and practices. Leadership attributes such as team building, decision making, confidence building, motivation, and managing crisis were reported to be very useful by 77.8%, 74.1%, 69.1%, 64.2%, and 61.7% of students, respectively. On follow-up, students described this sensitization exercise to be useful in their academic (16/52, 30.76%), organizational (10/52, 19.2%), sports (6/52, 11.53%), short-term research (4/52, 7.7%) activities, and editorial responsibilities (3/52, 5.7%). Conclusion: The leadership sensitization workshop helps students adjust to the medical school’s environment; and this may be incorporated in the UG curriculum to strengthen students’ leadership potential. [ABSTRACT FROM AUTHOR]

A woman in her 40s presented with a swelling over her left distal forearm and hand since 7 months, progressively increasing in size. She had history of difficulty in moving her wrist and fingers with no associated pain. She had no immune or chronic conditions except for hypothyroidism for which she was on regular medication. On examination, there was an 8×7 cm swelling on the radial side of the volar surface of her left distal forearm extending till the thenar eminence. MRI of the left upper limb was suggestive of a soft tissue swelling arising from the flexor tendon. The patient was planned for surgical excision of the swelling. Intraoperatively, there was a mass arising from the flexor tendons of flexor digitorum superficialis, flexor digitorum profundus (FDP) and flexor pollicis longus (FPL), extending distally up to the mid palm region. On incising the flexor tendon sheath, it was observed that multiple yellowish rice like granules extended across the tendons. The lesion was excised completely and sent for histopathology examination. The lax FDP of little and ring fingers were plicated following proper tension adjustment and defect in FPL was primarily repaired. Postoperatively, the patient recovered well with no local wound complications. The biopsy report was suggestive of tuberculosis. The patient completed a course of antituberculosis treatment in 6 months. [ABSTRACT FROM AUTHOR]

Background: Literature on implementation leadership programme in undergraduate medical education is lacking in Asian continent. We aim to describe our experience in sensitizing the first-year undergraduate medical students (UGMS) towards the principles of leadership in a medical institution. Materials and methods: Each year, one hundred first year UGMS were sensitized towards leadership principles and core domains through interactive sessions, focus group discussion, and short lectures. The students were asked to refiect upon the sessions' activities as well as its follow up usefulness in their day-to-day activities through a structured questionnaire shared via Google forms. Results: A high proportion (75%) of students reported an improved perception or knowledge towards leadership principles and practices. Leadership attributes such as team building, decision making, confidence building, motivation, and managing crisis were reported to be very useful by 77.8%, 74.1%, 69.1%, 64.2%, 61.7% of students. On follow up, students described this sensitization exercise to be useful in their academic (16/52, 30.76%), organizational (10/52, 19.2%), sports (6/52, 11.53%), short term research (4/52, 7.7%) activities, and editorial responsibilities (3/52, 5.7%), etc. Conclusion: Leadership sensitization workshop helps students adjust to the to the medical school's environment; and this may be incorporated in UG curriculum to strengthen students' leadership potential. [ABSTRACT FROM AUTHOR]

Background: Liposuction is the most accepted technique for treatment of gynecomastia at present with or without residual gland tissue excision. Conventional liposuction uses incisions for introduction of cannula, made usually at the inframammary crease or axilla resulting in consequent scars. Cross-chest liposuction technique was introduced to avoid these additional scars and improve the aesthetic outcome. This study aimed to evaluate the difference between aesthetic outcome of conventional liposuction and cross-chest liposuction in treatment of gynecomastia. Method: A prospective comparative study between 2 groups with 15 patients in each was conducted, one with conventional and the other cross-chest liposuction. Excision of residual gland tissue was performed through circum-areolar incision in both the groups. Aesthetic outcome was evaluated in both the groups using Likert scale and compared. Result: The mean age of the patients was 22.6 years and the mean duration of presentation was 8.13 years. Satisfaction rate with conventional and cross-chest liposuction was 80% and 86%, respectively, as assessed by the patients. The rate was 80% and 77%, respectively, in both the groups as assessed by independent observer. The complication rate was 13.3% in conventional and 20% in cross-chest group. The difference in outcome was not statistically significant between two groups. Difference between the mean Likert scores of pre-operative and post-operative satisfaction was statistically significant for both the techniques. Conclusion: The conventional and the cross-chest liposuction, both yield comparable results when used for treatment of gynecomastia in terms of aesthetic outcome. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 [ABSTRACT FROM AUTHOR]

The article focuses on a study to identify the significant factor affecting the compression behavior of machine-made carpets manufactured by M-Tuft high technology machine from Modra Technology. The research includes an exploration of the Taguchi robust design philosophy for quality and productivity characteristics optimization. The study aims to develop a quantitative analysis framework to evaluate optimal parametric combination.