New Indian Journal of Surgery

Context: Testicular torsion is a urological emergency requiring prompt diagnosis and intervention. The TWIST (Testicular Workup for Ischemia and Suspected Torsion) score is a clinical tool designed to aid in the rapid diagnosis of this condition

Aims: To evaluate the diagnostic accuracy of the TWIST score in patients presenting with acute scrotum.

Settings and Design: prospective observational study

Methods and Material: A prospective observational study was conducted with 70 patients presenting with acute scrotal pain. TWIST scores were assigned, followed by ultrasound and Doppler scans. Intraoperative findings were compared with preoperative TWIST scores.

Statistical analysis used: Sensitivity, Specificity, NPV, PPV.

Results: For TWIST scores ≤ 2, the sensitivity was 93.75%, specificity was 4.60%, PPV was 32.60%, and NPV was 95.83%. For scores > 2, sensitivity was 93.75%, specificity was 94.44%, PPV was 83.33%, and NPV was 98.07%. A TWIST score > 2 indicated a higher likelihood of torsion

Conclusions: The TWIST score is effective in ruling out testicular torsion in low- risk cases and in identifying patients at high risk, guiding the need for surgical intervention. It should be used alongside clinical judgment and imaging to ensure accurate diagnosis.

Autologous platelet-based concentrates, such as platelet-rich plasma (PRP), are increasingly popular in medical, surgical, and aesthetic treatments due to their high concentration of growth factors that promote tissue repair.

PRP can improve atrophic acne scars when combined with ablative fractional CO2 laser, reducing side effects like oedema and erythema. It enhances wound healing and early scar quality. It also improves texture, color, and contour in traumatic scars when used with fat grafting and non-ablative fractional laser.

This article presents a case study on the efficacy of Low-Level Laser Therapy (LLLT) as an adjunctive treatment for thermal burns. Thermal burns, injuries to the skin and underlying tissues from heat sources, are typically managed with immediate cooling, pain control, wound care, and infection prevention; severe cases may require surgical intervention like skin grafting. While various local wound therapies exist, the role of LLLT in tissue healing has shown mixed results in clinical studies.

Wilkie’s syndrome also known as Superior mesenteric artery syndrome is a rare condition in which the patient presents with a clinical picture of proximal small intestinal obstruction. It’s cause is the reduction of the aorto-mesenteric angle (angle between aorta and superior mesenteric artery) to less than 25 degrees. This increase in the acuity of the said angle leads to compression of the third part of duodenum, which normally passes through the angle; due to a ‘sandwiching’ effect between the 2 major blood vessels. Herein, the authors present the case of a 22 years old female patient who was diagnosed by them to have Wilkie’s syndrome. She was initially put on a trial of conservative management, failing which she underwent definitive laparoscopic surgical therapy.

Introduction: Lipomas are common benign mesenchymal neoplasms composed of mature adipocytes, but their occurrence in the oral cavity is rare, accounting for only 1–4.4% of benign intraoral tumors. Among these, lipomas arising in the floor of the mouth are particularly uncommon (4–11%). Due to the complex anatomy of the sublingual region, diagnosis and management require careful clinical, radiological, and histopathological correlation.

Case report: A 52-year-old male presented with a painless, progressively enlarging sublingual swelling for two months, associated with difficulty in speech. Clinical examination revealed a soft, non-tender, 4×5 cm swelling on the floor of the mouth with negative transillumation.

MRI showed a well-circumscribed lesion with classic imaging characteristics of lipoma T1/T2 hyperintensity and fat-suppression hypointensity measuring 52×32×39 mm, displacing adjacent tongue musculature. Complete surgical excision was performed under general anesthesia via a midline approach. The excised mass measured 4.8×4×3.8 cm.

Conclusion: Sublingual lipomas are rare lesions that may mimic other developmental or neoplastic masses of the floor of the mouth. MRI serves as a valuable modality for assessing lesion extent, while definitive diagnosis requires histopathological confirmation. Surgical excision remains the treatment of choice, with excellent prognosis and low recurrence rates when completely removed.