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 In this instance, the patient's thoracic injury was successfully stabilized and use of the negative pressure therapy device allowed the incisions to be closed with a much more cosmetically pleasing result. Copyright © 2020, Taylor et al.Central nervous system infections with nontuberculous mycobacteria (NTM) are rare but have been increasing in frequency. A small fraction of these infections are related to surgical hardware, with approximately 20 cases reported. Patients typically present with an indolent course but can rapidly deteriorate. We report two novel cases of NTM infection in ventriculoperitoneal shunts, and review the literature on treatment options, challenges and outcomes in these patients. Clinicians should consider NTM when dealing with unusual hardware infections as it is an emerging infectious disease with high potential for morbidity and mortality. Copyright © 2020, Padmanaban et al.A Spigelian hernia is a very rare hernia, making up approximately 0.1% of all abdominal wall hernias. This hernia goes through a defect in the Spigelian fascia which is the part of the transversus abdominis aponeurosis lateral to the rectus muscle, often at the level of the arcuate line, where the fascia is widest and weakest. We present the case of a 77-year-old female with no past surgical history who presented to our teaching hospital with high-grade small bowel obstruction secondary to an incarcerated Spigelian hernia. She was taken to the operating room for a laparotomy and a portion of the small bowel mesentery was found to be strangulated. The hernia was reduced, and the defect was repaired primarily. The diagnosis of a Spigelian hernia can often be difficult to diagnose on history and physical examination alone, but computed tomography (CT) imaging can be a valuable adjunct in diagnosis. Prompt surgical treatment should ensue when the diagnosis of high-grade bowel obstruction is made in a patient with imaging findings consistent with a Spigelian hernia. Copyright © 2020, Lavin et al.Purpose Music therapy is an effective non-pharmacologic intervention that is cost-effective, easy to implement, and customize. It has been shown to significantly alleviate anxiety and improve patient satisfaction. In this study, we aimed to compare music therapy to a control (no music) group with respect to sedation requirements, anxiety levels, and patient satisfaction for patients undergoing total knee arthroplasty under spinal anesthesia. Methods In this randomized controlled study, we compared the effect of music therapy in patients ≥ 18 years old. Patients undergoing total knee arthroplasty were screened for the study to rule out any contraindications for spinal anesthesia. Patients were randomized in a 11 ratio for either the "music" or "control" group. Both groups were compared for sedation requirements, preoperative and postoperative anxiety levels, and patient satisfaction. Results Subjects in the music group had a statistically significant lower than average State-Trait Anxiety Inventory (STAI)-Staty. The type and mode of delivery of music also need to be studied to better understand the impact of music therapy. Clinical trial registry Clinicaltrials.gov # NCT03569397. Copyright © 2020, Kukreja et al.A major complication after total hip arthroplasty (THA) is infection, which can have devastating clinical and financial results. Silver-impregnated dry dressings, such as Aquacel dressings, and incisional negative pressure dressings (Prevena) have been developed to reduce the rates of surgical site infections (SSIs) after surgery. We retrospectively reviewed the medical records of 235 patients who underwent primary posterior approach THA at our institution during a three-year period. Patients were grouped based on surgical dressing. Rates of SSI were recorded, as well as the effects of factors including age, sex, body mass index, and medical comorbidities. In the high-risk subgroup, defined as BMI > 30 and ASA > 3, the infection rate was 2.97% in the Aquacel group, compared to 1.20% in the Prevena group. This difference did not reach statistical significance. There was a statistically significant impact on readmissions rate (p = 0.028) and reoperation (p = 0.001). The findings of this study suggest that negative pressure dressings in carefully selected patients may help to reduce reoperations and readmissions in this subgroup. Copyright © 2020, Tyagi et al.Objectives To estimate the normal dimensions of lacrimal glands (LGs) in the Pakistani population using computed tomography (CT) scan and to determine the associations of LG dimensions with age, sex, and laterality. Methods The study population included subjects aged ≥16 years without orbital pathology who underwent CT evaluation of both the right and left LGs at Dr. Ziauddin University Hospital from June 2018 to November 2019. The mean axial length (AL), axial width (AW), coronal length (CL), and coronal width (CW) of each LG were measured separately. Results The 108 subjects enrolled in this study included 75 (69.4%) men and 33 (30.6%) women, with a mean age of 49±20 years. Right and left LG dimensions were similar, including mean AL (13.53±1.80 mm vs. 13.35±1.72 mm), mean AW (4.20±0.81 mm vs. Tegatrabetan 4.05±0.93 mm), mean CL (15.46±1.97 mm vs. 15.26±1.87 mm), and mean CW (3.99±0.80 mm vs. 3.86±0.81 mm). The AL of both LGs and the CL and CW of right but not left LGs were significantly lower in women than in men. Age showed significant correlations with the AL and CL of both LGs. Conclusion These findings establish the normal range of LG dimensions in adult Pakistani populations. Some LG dimensions are smaller in women than in men, as well as correlating with age. Copyright © 2020, Nawaz et al.Hypophosphatemia is a rarely reported side-effect of cannabis use. The potential mechanisms of hypophosphatemia include enteric malabsorption/loss, excessive urinary excretion, or rapid trans-cellular shifts. Severe hypophosphatemia from daily marijuana use is a rare side-effect. A trans-cellular shift is the most likely proposed mechanism. Although it tends to self-correct fairly rapidly, close observation for the dreaded consequences related to hypophosphatemia is required. Both the users and providers must be aware of this rare association of hypophosphatemia with daily marijuana use. Copyright © 2020, Ahmed et al.