Cosmetic Effect Research Articles

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

Background. In patients with skull bone tumors, it was demonstrated that not only the oncological but also the cosmetic result has a significant influence on the long-term outcome. The traditional approach to the surgical treatment of tumor lesions of the skull bones is removal of the tumor and intraoperative modeling an artificial bone flap without a template. Recently, the technology of simultaneous resection and computer-aided design/computer-aided manufacturing (CAD/CAM) cranioplasty has received more and more attention.Aim. To compare the results of surgical treatment of patients with tumors of the cranial bones using the traditional approach (intraoperative formation of a plate to close the defect) and simultaneous resection followed by plastic surgery of the defect with a personalized implant made using preoperative virtual modeling.Materials and methods. The study included 24 patients with tumors of the skull or meningiomas with extracranial growth. Depending on the surgical procedure, patients were divided into 2 groups: group 1 (n = 13) – the technology of simultaneous resection and CAD/CAM cranioplasty; group 2 (n = 11) – where surgery was performed using a traditional approach based on intraoperative modeling an artificial bone flap without a template.Results. There were no statistically significant differences between groups in gender, age, time of surgery, blood loss, or time in hospital. The use of simultaneous resection and CAD/CAM cranioplasty did not demonstrate a statistically significant better result in terms of maintaining skull symmetry compared to the traditional approach. All patients had a good cosmetic result and there were no complications.Conclusion. The technology of simultaneous resection and CAD/CAM cranioplasty is an effective method of treating patients with neoplasmas of the skull bones. Despite the absence of statistically significant differences in the results of treatment of cranial bone tumors between this method and the traditional approach based on intraoperative modeling an artificial bone flap without a template this method seems to be a more precise providing the best cosmetic effect in patients with lesion in fronto-orbital region.

Evaluation of Cosmetic Effect of Radio Frequency Ablation of Primary Varicose Veins

Evaluation of Cosmetic Effect of Radio Frequency Ablation of Primary Varicose Veins

Characterization of the mechanical properties of the cortex region of human hair fibers by multiparametric atomic force microscopy mapping

We show the benefit of the use of atomic force microscopy (AFM) in spectroscopy force mode (FV: force volume) for evaluation of the cosmetic active effectiveness in improving the mechanical properties of human hair fibers cortex region. For this, we characterized human hair fibers without and with chemical damage caused by bleaching process. Fiber and resin (embedding material) data were obtained simultaneously in the mapping in order to have the resin data as a reference to ensure a coherent comparison between data from the different fiber groups. Our AFM results, which were evaluated using statistical tests, demonstrated the degradation of fibers after bleaching, corroborating the findings of transmission electron microscopy analysis and the effectiveness of a cosmetic active ingredient in improving the Young's modulus (elastic modulus) (E) of the damaged fibers. We also found a radial decrease in the natural logarithm of Young's modulus ln(E) along the cross-section of the active group fiber, which is compatible with confocal Raman spectroscopy analysis by other authors, demonstrating variation of the active permeation with depth. We note that Young's modulus was also determined by a tensile tester (macro-scale technique), in which it was not possible to obtain statistically significant differences between the groups, evidencing the advantage of the FV-AFM analysis. We also found an increase in ln(E) accompanied by a decrease in maximum adhesion force between tip and sample (negative Pearson correlation coefficient). This result can be explained by the fact that structures composed of hydrophobic components have a higher Young's modulus than structures composed of hydrophilic components.•Bleaching damage and cosmetic hair treatment assessed by AFM, TEM, and tensile tester.•Young's modulus by AFM nanoindentation of hair fibers monitored by sample standard.•Young's modulus changes radially along the cross-section due to the cosmetic active.•AFM data show statistically significant differences among sample groups.•Tensile tester was not able to show statistically significant differences.

Modified Internal Pudendal Artery Perforator Flap Interposition for Rectovaginal Fistula.

Rectovaginal fistula (RVF) is a challenging condition associated with recurrences and significant functional impairment. The internal pudendal artery perforator (IPAP) flap has become a viable option for reconstructing the vagina and perineal regions. This study aims to introduce a modified technique of IPAP flap interposition and evaluate its postoperative outcomes in the treatment of low RVF. Sixteen patients with RVF who underwent modified IPAP flap interposition between 2016 and 2021 were retrospectively enrolled. Recurrence rate, the satisfaction of vulvar appearance (Visual Analog Scale), and quality of sexual life (Female Sexual Function Index score) were followed up and analyzed. All patients presented with low fistula with a mean diameter of 8.3 mm. The mean width and length of the IPAP flaps were 3.8 and 6.2 cm, respectively. The mean follow-up period was 14.1 months. All patients achieved successful healing without recurrence. High satisfaction was reported for the cosmetic effect of the vulva with a mean Visual Analog Scale score of 8.4. The proportion of female sexual disorder exhibited a statistically significant reduction, decreasing from 100% preoperatively to 38% after surgery ( P < 0.05). The modified IPAP flap interposition is a reliable and safe option for repairing low RVF, with high success rates and minimal donor site morbidity. Moreover, this procedure provides a suitable volume flap and preserves the vaginal physiological environment, which benefits postoperative sexual function.

A REVIEW: THERAPEUTIC, MEDICINAL AND FOOD USES OF ALOE VERA

The history for the use of Aloe vera for medicinal purposes starts from about 3000 years. Medicinally, this plant may be able to treat skin cancer as well as sunburns, burns, and small wounds. More than 104 compounds from various parts of this plant, including minerals, vitamins, amino acids, enzymes, sterols, anthraquinone, flavonoids, terpenoids, coumarins, polysaccharides, sugars, and polyphenols, have been isolated thus far, according to scientific reports on phytochemical analysis of this plant. The biological activities of these compounds are diverse and include anthelmintic, hepatoprotective, antidiabetic, diuretic, antibacterial, antiviral, antioxidant, antiseptic, anti-inflammatory, anticancer, and cosmetic effects for medical therapy. This article mainly emphasizes therapeutic, medicinal and food uses of A. vera. Peer Review History: Received: 26 October 2023; Revised: 9 November; Accepted: 25 December, Available online: 15 January 2024 Academic Editor: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, ahmad.najib@umi.ac.id Prof. Ali Gamal Ahmed Al-kaf, Sana'a university, Yemen, alialkaf21@gmail.com

Robotic surgery in endometrial cancer: first Polish experience.

In Poland, robotic surgery is nowadays perceived as a new method of surgical treatment in endometrial cancer patients. We aim to present the first Polish group of endometrial cancer patients treated using robotic surgery. The analysis was based on 79 patients with mean age of 59.72 ± 11.709 (range 27-83) years and endometrial cancer scheduled for surgical treatment. Mean BMI was 31.38 ± 8.78 (range 19.03-65.97)kg/m2. The data were collected based on a questionnaire consisting of 19 questions concerning the patient's perception of robotic surgery before the procedure. Patients with a family history of neoplastic diseases indicate precision of movements as the most important reason for choosing robotic surgery (p = 0.0035). Patients after surgery procedures in the past named shorter hospitalization as a major benefit (p = 0.0037). Patients who chose robotic surgery for financial reasons stressed the cosmetic effect as a priority (p = 0.0319). Shorter length of hospital stay, less blood loss, enlarged view, and good visualization were statistically significant reasons for choosing robotic surgery (p < 0.05). Women who consider work, good material status, and well-being as the most important aspects of their lives cited the cosmetic effect as a benefit of robotic surgery (p = 0.0029 vs. p = 0.0074 vs. p = 0.01745, respectively). In the follow-up after operations, no patients regretted choosing robotic surgery. Good visualization, precise movements, less blood loss, and cosmetic effects are the most frequent reasons for choosing robotic surgery. Even patients after other types of surgery in the past decided on robot-assisted radical hysterectomy because of the clear benefits of this approach.

The Medial Canthus Fibrous Band's Impact on Epicanthal Fold Severity and Classification in Asians: Implications for Epicanthoplasty.

The epicanthal fold (EF) is a semilunar skin fold located in the medial canthus in most Asians. The medial canthus fibrous band (MCFB) reportedly plays a critical role in EF formation. Variations in MCFB shape and size affect the severity and type of EF. We aimed to analyze MCFB variations in different types and severities of EF and explore the effect of the MCFB resection epicanthoplasty technique (MCFB epicanthoplasty). Surgical videos of 40 patients undergoing MCFB epicanthoplasty in our department were reviewed. The MCFB (area), transverse dimension, vertical dimension, upper eyelid direction length (UEDL), and lower eyelid direction length (LEDL) were measured. For aesthetic assessment, 37 patients were followed up for 6 months; intercanthal distance (ICD) and horizontal lid fissure length (HLFL) were measured. Preoperative and postoperative ICD/HLFL ratios were compared. Postoperative scar recovery was evaluated with the Patient and Observer Scar Assessment Scale. Statistical significance was set at P < .05. The MCFB diameter and area were larger for severe EF than for moderate EF (P < .01). Patients with severe EF had larger LEDL than UEDL (P < .01). The tarsalis type had a larger LEDL than the palpebralis type with the same severity (P < .01). MCFB epicanthoplasty yielded favorable postoperative cosmetic effects and scar recovery. Postoperative ICD decreased, while HLFL increased compared to preoperative values (P < .001). The ICD/HLFL ratio was significantly lower postoperatively than preoperatively (P < .001). Postoperative ICD/HLFL ratio was 1.2:1. The MCFB affects the severity and type of EF. MCFB epicanthoplasty effectively corrected moderate to severe EF.

Knowledge, perceptions, and consumption behaviour of cosmetics among undergraduates of Sri Lanka: a descriptive cross-sectional study.

Despite the increasing usage of personal care products among young adolescents in Sri Lanka, limited studies have been conducted to understand the behaviour of cosmetic users and associated health complications. Therefore, the current study was conducted to evaluate the cosmetic consumption related behaviour of the undergraduate community in Sri Lanka and to identify the driving factors behind the incidences of cosmetic related adverse health effects. An analytical cross-sectional study was conducted by recruiting 421 undergraduates from five state universities in Sri Lanka through stratified random sampling, as the study population. Information on socio-demographic factors and cosmetic consumption behaviour of the participants were acquired through a self-administrated structured questionnaire, along with Knowledge, Attitudes and Practices (KAP) relevant for cosmetic usage. The Binary Logistic Regression model was used to determine the significant socio-demographic driving factors on cosmetic usage among the undergraduate community in Sri Lanka at a confidence level of 95%. Around 96.4% of the study population used one or more cosmetic products (77%) out of which, 75.3% experienced cosmetic related adverse health effects. Skin dryness (24%), acne (21%), allergies (20.5%) and rashes (19.8%), were identified as the most dominant adverse health effects, related to cosmetic usage. Perfumes (65.6%), face cream (63.2%) and body lotion/hand cream (60.6%), were the mostly used cosmetic products. Even though half of the study population exhibited higher levels of good practices during purchase (54.9%) and application (52%) of cosmetics, around 47.5% were characterized with a low level of knowledge on cosmetics. Gender, academic year, knowledge on cosmetics, monthly expenditure on cosmetics, source of recommendation for cosmetics, practices related to purchase and consumption of cosmetics and preference to receive medical care in case of cosmetic related emergency were recognized as significant risk factors (p < 0.05) associated with the incidence of cosmetic related adverse health effects among undergraduate students. Given the high prevalence of cosmetic related adverse health effects, the health authorities of Sri Lanka should pay more attention towards the wellbeing and responsible cosmetic usage among undergraduates. Designing of effective tools and regulations to monitor the cosmetic market and improving the knowledge on cosmetics are recommended to ensure safe cosmetic usage within the country in general and of adolescent users in particular.

The oncological safety and long-term cosmetic effect of free dermal fat graft with epidermis removal for breast defect repair in breast conserving surgery

BackgroundFree dermal fat grafts (FDFG) are used for immediate breast defect repair in breast-conserving surgery (BCS), and have achieved satisfactory immediate postoperative cosmetic effects (Sawai et al., 2004) [1]. However, the oncologic safety and long-term cosmetic outcomes of these surgical procedures remain unknown. Therefore, t，in this study, we aim to investigate the oncological safety and long-term cosmetic outcomes of FDFG in patients with breast cancer. MethodsThis matched retrospective case-control study included patients with non-special types of breast cancer who underwent FDFG for breast defect repair after BCS or BCS alone at two breast cancer research centers in Guangxi Province, China, from January 2016 to December 2019. The patients were divided into either the FDFG or BCS group. Control cases were screened using propensity score matching, and survival analysis and cosmetic evaluations were performed. ResultsA total of 442 patients with breast cancer were included in the study. After 1:4 propensity score matching, 53 and 212 patients were included in the FDFG and BCS groups, respectively. The median follow-up time was 49.9 (9.0–76.0) months. The rate of local recurrence in the FDFG group (9.4 %) was significantly higher than that in the BCS group (1.9 %; p < 0.05). The total cosmetic evaluation score was significantly higher in the BCS group 18 months after surgery than in the FDFG group (p < 0.05). ConclusionsIn this retrospective study, FDFG was significantly associated with an increased risk of local recurrence. Further prospective studies are required to confirm these results. No significant difference in long-term cosmetic effects were observed for FDFG than for BCS alone for immediate breast defect repair.

Effect of trapezoidal excision combined with modified embedded vertical mattress suture technique on postoperative scar formation after cesarean section.

To study the impact of modified embedded vertical mattress suture technique in conjunction with trapezoidal resection on the formation of scars after cesarean section. This retrospective study involved 339 pregnant women who had cesarean sections at the Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xiamen University from September 2020 to August 2023. Among them, 150 patients who received traditional subcutaneous fat layer discontinuous suture during September 2020 and June 2022 were assigned to the control group, and 152 patients who received improved buried vertical mattress suture technique and trapezoidal resection between July 2022 and August 2023 were assigned to the observation group. The therapeutic effect, surgical parameters and cosmetic effects in the two groups were compared. The suture time of the observation group was longer than that of the control group (t=27.858, P<0.001). The grade A healing rate (96.05%) and cosmetic satisfaction rate (94.08%) in the observation group were significantly higher than those (76.00% and 74.00%) in the control group (all P<0.001); while the incidences of suture reaction (12.05%), complication (1.96%), and hypertrophic scar (5.26%) were significantly lower than those in the control group (38.00%, 22.00%, and 27.33%, respectively) (all P<0.001). The visual analogue scale (VAS) score in the observation group was lower than that of the control group (intergroup effect: F=1434.000, P<0.001; time effect: F=91.091, P<0.001; interaction effect: F=2.409, P=0.091). The postoperative VSS score and scar width in the observation group were lower than those in the control group (all P<0.001). Multivariate analysis showed that complications (P=0.006) and suture method (P=0.016) were independent influencing factors for the occurrence of hypertrophic scars in pregnant women. Trapezoidal resection combined with improved buried vertical mattress suture technique can promote incision healing, reduce suture reaction, incision pain, adverse complications and the incidence of hyperplastic scar, and improve the cosmetic effect of surgery.

A comparative study of fractional CO2 laser with topical triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of alopecia areata.

Alopecia areata (AA) is a non-scarring alopecia of chronic autoimmune etiology with heterogenous severity against the anagen hair follicle over the scalp, beard, or any part of the body and is associated with a significant psychological morbidity in the mental status of the patients leading the patients to seek treatment for cosmetic reasons. The management of AA is very unpredictable and is associated with various cosmetic adverse effects. This study aimed at comparing the efficacy and safety of a novel procedure of laser-assisted drug delivery system of steroids with the first-line procedure of intralesional steroids (ILS) for the treatment of patchy AA. To assess and compare the efficacy and safety of fractional CO2 laser in combination with topical triamcinolone acetonide aqueous solution and intralesional triamcinolone acetonide as a monotherapy and in the treatment of AA. A total of 60 patchy AA patients were included in this study. Patients were randomized into two equal groups: Group A and Group B with 30 patients in each group using a computer-generated block randomization. Patients in Group A received fractional CO2 laser with topical triamcinolone acetonide aqueous solution and Group B received ILS. Both groups received treatment for five settings with each setting a gap of 3 weeks. The efficacy and safety of treatment modalities in both groups were assessed using global photograph assessment (GPA)-scale, lesional area density score percentage of improvement (LAD score improvement %), visual discomfort scale (VDS), visual analogue scale, and documentation of adverse effects in each setting. Efficacy of treatment modality-assessed using means score of GPA-scale and LAD score improvement % suggests quicker results to patients in Group B in initial settings but drastic improvement happens to patients in Group A in subsequent settings. At the end of 5th setting, GPA-scale and LAD score improvement % suggest maximum efficacy in patients in Group A and they are statistically significant (P-value < 0.001). The mean VDS in both groups suggests maximum discomfort in Group A, yet the patient satisfaction at the end of 5th setting was maximum with patients in Group A and they are statistically significant (P-value < 0.001). Cosmetic notable adverse effect of atrophy of skin was documented in 30% of patients in Group B. This study showed that fractional CO2 laser with topical triamcinolone acetonide is a better treatment modality than the intralesional triamcinolone acetonide for the treatment of AA with respect to efficacy, safety, and adverse events.

Adverse effects of Cosmetics on the Women Health

The Cosmetics used for beautification or enhancement of appearance are in high demand especially among the women but these products have deep dark side. Many additive chemicals in cosmetics like parabens, phthalates, polyethylene glycol, hydroquinone, resorcinol, 1,4 dioxane, trace heavy metals etc. are hazardous and pose a variety of health risks ranging from neurotoxicity, nephrotoxicity, carcinogenicity, endocrine disruption, reproductive disorders etc. Hence the safety of the cosmetics is an issue of prime concern. It is necessary to make people aware of cosmetic chemicals and their deleterious effects. The present study analyses the current scenario of cosmetic use in India, the behaviour of women consumers in Indian Cosmetic market in terms of age group using cosmetics, reasons for using cosmetics and expenditure on beauty products etc. The harmful chemical ingredients in cosmetics are discussed along with their adverse effects on health. The study is carried out with objective of making women aware of large number of toxic chemicals used in cosmetics and their negative health impacts. It will also draw attention of researchers and clinicians to investigate the likely causes of their negative consequences. A relatively new concept of green cosmetics is also mentioned, which are associated with less toxicity to human health and is suggested to be promoted and adopted by women.

Assessment of the Cosmetic Effect of Eye Bag Surgery on Facial Morphology Changes

Assessment of the Cosmetic Effect of Eye Bag Surgery on Facial Morphology Changes

Mitral valve surgery via minimally invasive and conventional access

To compare the immediate results of mini-thoracotomy and sternotomy in patients with mitral valve disease. The study included 52 patients who underwent mitral valve surgery (25 cases - mini-thoracotomy, 27 cases - sternotomy). Aortic cross-clamping time was significantly longer in sternotomy compared to mini-thoracotomy group - 110 vs 94 min (p=0.03). Ventilation time was also significantly longer in the sternotomy group (12 vs. 8 hours, p=0.01). Postoperative morbidity was similar (postoperative wound infection, neurological complications, coronavirus disease, overall in-hospital mortality). In addition to cosmetic effect, minimally invasive approach in mitral valve surgery has some other advantages including less duration of aortic cross-clamping and mechanical ventilation, availability of reconstructive interventions due to better exposition of the mitral valve and subvalvular structures.

Comparing clinical course and patients out comes in patients undergoing Open surgical Versus Thoracoscopic closure of the atrial and ventricular septal defects in children

The current study is aimed at evaluation of the impact of different surgical approaches while correcting congenital heart diseases (CHD). Clinical outcomes like; operative time, complications, hospital stay were evaluated in children undergoing surgical repair of atrial septal defect (ASD) and ventricular septal defect (VSD).&#x0D; Patients and methods: Between 2015 and 2019, a total of 111 patients surgically managed for CHD with male: female ratio of…. and mean age 10.42±3.24 years. Two surgical approaches: open either right anterolateral thoracotomy or sternotomy and thoracoscopic were used. The study conducted to determine the operative time, ICU stay, complications, recovery period and long term follow up of the patients in both the groups.&#x0D; Results: 67 patients with ASD and 44 patients with VSD underwent cardiac surgery. Mean operation time was significantly longer in TS patients in comparison with TT and ST groups. However, mean intensive care unit (ICU) stay and hospital stay were significantly shorter in TS group in comparison with TT and ST patients.&#x0D; Conclusion: TS approach in repair of congenital heart defects not only resulted of good cosmetic effect, but also reduces time in ICU and hospital stay in comparison with “classical” operational techniques. In this article we tried to show the whole results of research.&#x0D; Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 115-120

The use of snail slime collected by sustainable methods in cosmetic creams

There are many snail slime (secretion) creams in the cosmetic industry. Many of them are formulated with herbal or synthetic allantoin when the cream ingredients are read. However, natural snail secretion also contains many bioactive components (glycoproteins, fatty acids, polyphenols, vitamins, etc.) other than allantoin. For this reason, cosmetic effectiveness decreases in products that do not contain natural snail secretion. It is not easy to reach the natural snail slime cream due to the limited collection of secretions from the appropriate snail species and limited sustainable methods. While the secretions are collected from snails by traditional methods (exposure to stresses such as salt and electricity application), animals are usually harmed or killed. If the method used for secretion collection is not suitable, animals are exposed to stress and release skin irritants. In addition, the secretion of each snail species does not have the suitable ingredients in the production of cosmetics. In this study, various essential oils and ozone were sprayed with cold steam into the porous chamber containing the snails in a specially designed device. Secretion was collected, from live snails (Helix aspersa) suitable for use in cosmetics, without being exposed to stress. Then the cream was formulated with this secretion. Microbiological and physicochemical analyzes were made in the cream produced. As the results; secretion containing important bioactive components was obtained from the appropriate snail species with sustainable methods, and the analysis results showed that the cream formulated with the addition of the secretion was qualified and suitable for use.

Comparison of the quality of life of children with congenital megacolon (Hirschsprung’s disease) post transanal endorectal pull-through with other children's surgical cases in the 5-7-years age group at Moewardi Hospital Surakarta

Background: Congenital megacolon (Hirschsprung's disease) is caused by intestinal innervation abnormalities, due to failure of neuroblast migration from the proximal to the distal intestine so there is no nerve innervation in the distal intestine and causes functional ileus and hypertrophy and excessive intestinal distension. The classic triad of clinical features in neonates is late meconium expulsion, namely more than the first 24 hours, green vomiting, and an enlarged stomach. Management of congenital megacolon is divided into two, namely non-surgical treatment to overcome complications that may occur and to improve the general condition until definitive surgery and surgical treatment namely transabdominal approach (TAB), consisting of Swenson, Duhamel, Rehbein, and Soave, and transanal endorectal pull-through (TEPT). The advantages of TEPT include better cosmetic effects and shorter hospital stays. Quality of life (QoL) is a subjective perception of a person's well-being regarding levels in his life, which includes physical, social, and psychological conditions. Methods: This research is observational analytical research with a cross-sectional approach conducted at RSUD Dr. Moewardi Surakarta during August - September 2022. Results: Patients with congenital megacolon (Hirschsprung disease) after TEPT have a worse QoL than patients without congenital megacolon (p value &lt;0.05). All components of the pediatrics quality of life questionnaire (PedsQLTM) are influenced by the patient's condition (p value &lt;0.05). Conclusions: The poor quality of life should increase awareness of the importance of immediate treatment. Difficulty defecating, diarrhea, and abdominal pain can reduce the patient's QoL after TEPT. Family dynamics and support must be prioritized to improve the QoL.

Perioperative outcomes of transvaginal natural orifice transluminal endoscopic surgery and transumbilical laparoendoscopic single-site surgery in hysterectomy: A comparative study.

This study aimed to compare the perioperative outcomes of patients who underwent hysterectomy for benign gynecologic diseases using transvaginal natural orifice transluminal endoscopic surgery (vNOTES) or transumbilical laparoendoscopic single-site surgery (TU-LESS). A total of 314 patients who underwent hysterectomy for benign uterine disease at West China Second University Hospital between October 2018 and December 2021 were enrolled in this retrospective study. vNOTES (n = 157) and TU-LESS (n = 157) recipients were matched 1:1 in terms of uterine volume. The operation time, blood loss, postoperative decrease in hemoglobin, uterus weight, postoperative hospital stay, postoperative pain score at 12 h, postoperative indwelling catheter time, and other clinical indicators were compared between the two groups. All 314 patients successfully completed the surgery, and the two groups had similar baseline characteristics, with no statistical difference. Regarding intraoperative outcomes, the operation time was shorter in the vNOTES group than in the TU-LESS group (80 vs 100 min, P = 0.04), and there were no significant differences in intraoperative blood loss, intraoperative blood transfusion rate, postoperative decrease in hemoglobin, or uterine weight. Concerning postoperative outcomes, vNOTES hysterectomy was significantly superior to TU-LESS hysterectomy in terms of the length of hospital stay (3 vs 4 days, P < 0.001), visual analog scale score for pain at 12 h after surgery (P = 0.04), postoperative indwelling catheter time (39.5 vs 64.0 h, P < 0.001), and postoperative exhaust time (24.0 vs 42.0 h, P < 0.001). There were no significant differences in postoperative complications between the two groups. vNOTES and TU-LESS seem safe and feasible for hysterectomy, but vNOTES hysterectomy was more conducive to the postoperative rehabilitation of patients, with less trauma, less pain, and better cosmetic effects than TU-LESS hysterectomy. As an emerging surgical approach, more studies, including large-sample, multicenter, randomized controlled trials, are needed to validate our findings.

Whole-Course Intraperitoneal Robot-Assisted Choledochal Cyst Excision with a Hidden Incision in Children Under 1 Year Old.

Background: Whole-course intraperitoneal robot-assisted choledochal cyst resection in children under 1 year of age is controversial due to its technical challenges. Current Pfannenstiel incision is widely used in adults for its cosmetic effects but is rarely used in children. Materials and Methods: We conducted a prospective, single-center study to assess the feasibility, safety, and cosmesis of whole-course intraperitoneal robot-assisted choledochal cyst resection with Pfannenstiel incision in children under 1 year of age. Results: Ten patients were treated with our surgical protocol, and there was no conversion to laparotomy. The average total operation time was 223 minutes. The average duration of anesthesia was 260.2 minutes. The average docking time between the robot arm and Trocar was 17.5 minutes. The average intraoperative blood loss was 16 mL. No postoperative complications occurred in the 10 patients. The mean time to start drinking water after surgery was 2.4 days. The mean postoperative drainage tube removal time was 2.6 days. The average length of stay was 8.5 days. The scar assessment scale total scores of the 2 observers were (6.8 ± 1.23) and (7.4 ± 1.84), respectively. For every patient, there are only four abdominal surgery scars of which 75% of scars were hidden by underpants and 25% of scars were not covered. Conclusion: It is feasible and safe to perform whole-courses intraperitoneal robot-assisted choledochal cyst resection with Pfannenstiel incision in children under 1 year old. It also has a hidden incision effect and is worthy of promotion.

Encapsulation of Leptadenia pyrotechnica (Khip) Extract in Carbomer Based Emulgel for Its Enhanced Antioxidant Effects and Its In Vitro Evaluation.

The use of natural products in skin care has been valued for their tremendous therapeutic benefits since ancient times. The current study was aimed at exploring the Leptadenia pyrotechnica plant extract and development of a stable emulgel loaded with the same extract to assess its cosmeceutical potentials. A stable emulgel loaded with methanolic plant extract along with its control gel was prepared by homogenization. The antioxidant potential of extracts prepared in different solvents (methanol MLP, ethanol ELP, n-hexane nLP, ethyl acetate EALP, and petroleum ether PLP) was determined by DPPH scavenging activity. The presence of phytochemicals was confirmed by total phenolic and flavonoid content analysis (TPC/TFC). HPLC was used for quantification of bioactive components. FTIR analysis was performed for confirmation of functional groups. SPF was calculated via spectroscopic analysis for extract, control gel, and extract loaded emulgel. Stability studies included physical evaluation, pH, conductivity, spreadability, and rheological testing of both control and test emulgels at different temperatures, i.e., 8 °C ± 1, 25 °C ± 1, 40 °C ± 1, 40 °C ± 1 with RH of 75% for a period of 90 days. DPPH radical scavenging activity showed the highest antioxidant activity of 85.5% ± 2.78 for MLP. TPC and TFC were also found to be highest for the methanolic fraction, i.e., 190.98 ± 0.40 mgGAE/g and 128.28 ± 2.64 mgQE/g, respectively. The SPF of methanolic extract, placebo gel, and LPEG was 13.43 ± 0.46, 2.37 ± 0.33, and 7.28 ± 0.56, respectively. HPLC assay confirmed the presence of catechin, vanillic acid, caffeic acid, and sinapinic acid. Rheological analysis showed that formulation has pseudo-plastic flow behavior. Other stability tests also revealed that prepared emulgel is a stable one. A stable emulgel loaded with Leptadenia pyrotechnica plant extract was successfully prepared and characterized for its cosmetic effects.