The document discusses using Z-plasty techniques to treat post-burn scar contractures and pilonidal sinus. Z-plasty involves reorienting scar tissue to lengthen it and correct deformities. The author describes using Z-plasty on 10 cases of scar contractures and 5 cases of pilonidal sinus. It resulted in scar lengthening and zero recurrence of pilonidal sinus with less hospital stay compared to other techniques. The document concludes that Z-plasty is a versatile technique for general surgeons to manage linear scar contractures and pilonidal disease.
different type of lower limb amputation with indication, peri-operative care, surgical steps, post op care complication and different type of prosthesis
The presentation is for the use of Physiotherapy students. It covers a brief introduction, classification, clinical features and general principles of management.
different type of lower limb amputation with indication, peri-operative care, surgical steps, post op care complication and different type of prosthesis
The presentation is for the use of Physiotherapy students. It covers a brief introduction, classification, clinical features and general principles of management.
A breif discussion on some of the available options in the reconstruction of pilonidal sinus defect. Post excision of pilonidal sinus. A plastic surgery view of the problem.
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The Aging Face and Facial RejuvenationDrScottSmith
What is Facial Beauty? What makes someone more attractive is eye of the beholder and phi of the beholder. A look at how aging effects our beauty and what can be done to improve our facial beauty.
Pterygium Excision with Free Conjunctival Limbal Autograftiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Use of Three Different Suturing Techniques for Wound Closure of Mucoperio...Ziad Hazim Delemi
The Use of Three Different Suturing Techniques for Wound Closure of Mucoperiosteal Flaps After Surgical Removal of Impacted Lower Wisdom Teeth (Comparative Study)
Jc sclerotherapy in pyogenic granuloma and mucoceleSunbultabrez
Its a journal club on the topic of pyogenic granuloma and mucocele which can be treated with sclerotherapy. Even though the gold standard still remains as a biopsy, sclerotherapy is a non invasive procedure for needle phobic patients. It also has other article as references to support sclerotherapy.
Made by:
Dr. Sunbul Tabrez
Mahendra Azad et al. GAINT ODONTOGENIC KERATOCYST OF MANDIBLE OPERATED UNDER LOCAL ANESTHESIA- A CASE REPORT. JOURNAL OF DENTAL HEALTH & RESEARCH (VOL. 1, ISSUE 2, JUL - DEC 2020): 24-2
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Conventional technique
1. Post Burn Scars- are managed by release /
excision of scar followed by SSG, and post
operatively patient requires splinting in
corrected position for almost 6-12 months
to prevent recurrence of deformity. But
compliance of patients for prolonged
splinting is very poor, hence come back
with recurrence.
DPU
3. Conventional technique
Pilonidal sinus : Several surgical techniques
are available for repair of the defect created
after excision of pilonidal sinus including
excision and direct closure, marsupalisation,
skin grafting or local flaps but each
technique has some advantages/ limitations.
Recurrence is almost 40% percent after
excision and direct closure.
DPU
4. Z- PLASTY-is it the answer?
1. Scars- Z-plasty serves to reorient and lengthen
a scar
2. In Pilonidal disease- Z-plasty eliminates the
deep natal cleft by bringing healthy, lateral skin
and subcutaneous tissue into the midline
3. This report is based on our experience in
managing 10 cases of Post burn contractures and
05 cases of Pilonidal sinus utilising Z-plasty
technique.
DPU
5. What is Z-plasty?
Z-Plasty is a surgical technique that is
extensively used in plastic surgery to
lengthen the linear scars and thus correct the
deformity and improve the function.
This technique redirects the forces acting
on the scar to improve the appearance.
DPU
6. Z- plasty in Scar contracture
A total of 10 patients of scar contractures
were operated.(linear scars)
There were 5 males and 5 females, in the
age group of 3 – 30 years.
DPU
12. Z-plasty in Scar contractures(cont)
Result
Complications Number of patients Percentage
Flap necrosis 0 0%
Wound infection 2 20%
Hematoma formation 0 0%
Dehiscence 0 0%
Trap door effect 0 0%
total 2 20%
Scar lengthening was achieved in all the cases and
02 cases had superficial wound infection, which
resolved by dressings
DPU
13. Z- plasty in Pilonidal sinus
A total of five patients of Pilonidal sinus
were operated
All were males, majority in the age group of
15 – 30
The operating time ranged between 30-45
minutes (mean 35 + 2).
DPU
16. Z-plasty in Pilonidal sinus (cont.)
Result
Complications Number of patients Percentage
Flap necrosis 0 0%
Wound infection 1 20%
Hematoma formation 0 0%
Dehiscence 0 0%
Trap door effect 0 0%
total 1 20%
DPU
17. Z-plasty in Pilonidal sinus (cont.)
Mean postoperative stay was 3.5 days ( 2-5
days) and return to work was between 7 –
18 days (Mean 12.5 days).
There was no recurrence
DPU
24. Discussion
Multiple reconstructive methods have been used
for the treatment of postburn scar contractures
including skin grafting, local flaps and free flaps.
Similarly, multiple Techniques such as drainage,
excision, and marsupilization yield mixed results
in the treatment of pilonidal sinuses. Patients are
often dissatisfied, because of long post op period
and recurrence.
DPU
25. Discussion (cont.)
Severe contracture lines crossing flexion folds can
be released effectively by using Z- plasty
technique.
In pilonidal disease, the Z- plasty eliminates the
deep natal cleft by bringing healthy, lateral skin
and subcutaneous tissue into the midline.
Excision and Z- plasty together can lead to a low
recurrence rate with rapid healing
DPU
26. Conclusion
In linear scar contracture Z plasty technique
helped to increase the length of scars with
release of contractures
In pilonidal sinus management with Z
plasty showed zero recurrence and less
hospital stay
DPU
27. Conclusion
Z- plasty is a versatile technique, easy to perform
and can be an armamentarium of general surgeon
to manage linear scar contractures where scar
lengthening is necessary.
Once the concept of dual transposition of the
triangular flaps is understood, any general surgeon
should be able to use to achieve optimal results
DPU
28. References
1. Wiliams NS, Christopher JK. Bulstrode P,Ronan O Connell. Pilonidal
sinus. In: Bailey and Love’s Short practice of
Surgery.25thed.London: Hodder Arnold 2008:1247-8.
2. I. Iesalnieks, A. Furst, M. Rentsch and K.W. Jauch. Primary midline
closure after excision of a pilonidal sinus is associated with a high
recurrence rate.Chirurg, 74 (2003), pp. 461–468
3. The basic Z-plasty. Am Fam Physician. 2003 Jun 1 ;67(11):2329-32
4. Bernstein L. Z-plasty in head and neck surgery. Arch Otolaryn
89:574-84, 1969 Apr
5. Rohrich RJ, Zbar RI. A simplified algorithm for the use of Z-plasty.
Plast Reconstr Surg 1999;103:1513-7.
DPU
Editor's Notes
Conventionally pbc were managed by release or excision of scars wit ssg