The levels of evidence of articles published by Indian authors in Indian journal of plastic surgery

Level of Evidence Analysis in Journal of Maxillofacial Oral Surgery: A Twelve-Year Bibliometric Analysis of 1300 Publications (2009-2020)

Aim

Analysing Level of Evidence (LOE) provides an insight to evidence-based medicine (EBM). The aim of our study was to evaluate and analyse trends in Levels of Evidence (LOE) in Journal of Maxillofacial and Oral Surgery (MAOS) since inception, i.e. December 2009 along with categorization into subtopics.

Methodology

LOE for each article was determined according to modified American Society of Plastic Surgeons (ASPS) scale and National Health and Medical Research Council (NHMRC) Evidence Hierarchy.

Results

A total of 1264 articles were included in the final analysis, out of which high-quality evidence (Level A) accounted for 7% of the journal. The percentage of Level I/II (Level A) has increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, representing a promising trend toward higher-quality research in just 10 years. Case reports and narrative reviews with Level of Evidence value "D" account the highest number (36%) of all the published articles. The majority of articles fell under Class 2 (Maxillofacial pathology) classification (35%) highlighting myriad of articles covering pathologies and various reconstruction methods, followed by trauma (16%).

Conclusion

The status of LOE and categorizing of published articles are the first step to audit and quantify the nature of literature published by JMOS and may further help in refining the quality of research jointly by the researchers and the editorial board.

Giant intramuscular thigh lipoma: A case report and review of literature

INTRODUCTION

Lipomas are the most common soft tissue tumor. Giant lipomas are defined by measuring at least 10 cm in diameter in one dimension or by a minimum of 1000 g. They often are asymptomatic; however, they can cause compression syndromes due to nerve damage and difficulties in walking.

PRESENTATION OF CASE

We described the case of a 25-year-old female with no significant medical history who began her condition two years before her consultation. The patient referred to the appearance of a non-painful mass on her right thigh with progressive growth that hinders daily activities. A simple CT scan reported a 10.3 × 8.1 × 19.6 cm adipose mass with infiltration towards the semitendinosus muscle and the biceps femoris muscle. A free margin resection of the tumor was performed, and the involved muscles were preserved. The patient had a satisfactory postoperative outcome.

DISCUSSION

Lipomas are common benign soft tissue tumors that arise from fatty tissue and may challenge surgical management due to their extension and dimensions; they often require delicate surgical intervention due to their potential risk of malignant transformation. We believe surgical pathologists and radiologists must draw attention to muscle involvement and the infiltrative pattern.

CONCLUSION

Giant lipomas should always raise awareness of malignant transformation. Radiological guidance should provide enough evidence to decide whether to do a biopsy or not; hence, saving the patient an extra invasive procedure. We recommend taking at least 1 cm of border margin while removing these tumors to avoid local recurrence.