Dermal nipple-areola complex flap method in female to male gender affirming surgery

Subcutaneous mastectomy plays a major role in female to male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola complex (NAC) flap, with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularisation. This case report describes how the novel approach may potentially be applied as an alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The technique is simple, provides an aesthetically appealing outcome and presumably poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or resizing of the NAC where required.

To the Websïor-Baldy-Franke technique for retro-fleхio uïeri

We can confidently say at the present time that one of the diseases of the female genital area requiring surgical treatment is not replete with such a richness and variety of the proposed methods of surgical intervention as the dislocation of the uterus in the form of retroflexio. Only a year and a half ago, at a meeting of the obstetric-gynecological society in Hamburg (1/30/30), where the issue of choosing an operative method for the treatment of retroflexio uteri was debated, Grube, while demonstrating his tables in separate phases of operations, simultaneously emphasized that despite the presence of about 250 methods of surgery, yet the results of treatment are still not entirely encouraging.

Mastering the learning curve significantly reduces operative time for laparoscopic treatment of complicated appendicitis

Laparoscopic appendectomy is the preferred operative method for acute appendicitistreatment. In terms of complicated appendicitis it can be effective in hands of an experiencedlaparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospectivestudy examines whether the operative time for laparoscopic appendectomy for complicatedappendicitis is shortened after mastering the learning curve. Material and methods: A totalnumber of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77were diagnosed with complicated appendicitis. They were subsequently divided in two groups(laparoscopic and open). Operative time in both groups was measured and the conversionand postoperative complications were noted. Results: Conversion rate was 2.3%. Operativetime was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033).Overall postoperative morbidity was 25.97% with wound infection present only in the opengroup (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopicgroup (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052).

Operative method of treatment of tuberculous spondylitis

After in the 90s of the XVIII century. the pathology of bone tuberculosis became known, it was found that the rest of the diseased joint is an essential factor in the fight against tuberculosis.

TINGKAT PENGETAHUAN PASANGAN USIA SUBUR BERHUBUNGAN DENGAN PENGGUNAAN ALAT KONTRASEPSI SENGGAMA TERPUTUS

LEVEL OF KNOWLEDGE OF RELATED FERTILE AGE COUPLES WITH THE USE OF DISCONNECTED CONTRACEPTION TOOLS Background: This increase in population growth rate is due to the high birt rate. The government's efforts to reduce the high birth rate are through the National Family Planning Program. One of the factors affecting the increase in birth rates is the lack of use of contraceptive methods. Tembalang Subdistrict has 12 Kelurahan with a total of 29,756 Fertile Age Couples (PUS), and the number of Fertile Age Couples (PUS) who are not Family Planning (KB) participants as many as 7,905 people. The subdistric that do not use family planning (KB) the most are located in Kelurahan Meteseh with 1669 PUS from the number of fertile age couples (PUS), which are 4299 people (38.8%). Of the 4299 people who used the Intra Uterine Device (IUD), 272 were, the Operative Method for Men (MOP) was 14, the Female Operative Method (MOW) was 230, the Implant was 167 people, the injection was 1312, the Pill was 439, and the Condom was 196 people.Purpose: To determine the relationship between the level of knowledge of couples of childbearing age and the use of intercourse contraceptives.Methods: descriptive study with cross sectional research design. By using a total sample of 39 couples of childbearing age in the village of Meteseh.Results: Majority of respondents had less knowledge 53.8% (21 PUS) and good knowledge 46.2% (18 PUS) while the use of contraceptive devices at PUS found that the majority of respondents were irregular in the use of interrupted intercourse 53.8% and the frequency 46.2% of regular intercourse use.Conclusion: There is a relationship between the level of knowledge and the use of the intercourse contraceptive method.Suggestion For the community, especially fertile age couples, should increase knowledge about contraception, interrupted intercourse by seeking information through health workers or through the media. Keywords: Knowledge, Fertile Age Couple, Contraception ABSTRAK Latar Belakang: Kenaikan laju pertumbuhan penduduk disebabkan karena angka kelahiran yang masih tinggi. Upaya pemerintah untuk menurunkan angka kelahiran yang masih tinggi tersebut melalui Program Keluarga Berencana Nasional. Salah satu faktor yang mempengaruhi meningkatnya angka kelahiran yaitu masih kurangnya penggunaan metode kontrasepsi. Di Kecamatan Tembalang mempunyai 12 Kelurahan dengan jumlah 29.756 Pasangan Usia Subur (PUS), dan jumlah Pasangan Usia Subur (PUS) bukan peserta Keluarga Berencana (KB) sebanyak 7.905 jiwa. Kelurahan yang paling banyak tidak menggunakan Keluarga Berencana (KB) yaitu terletak di Kelurahan Meteseh sebesar 1669 PUS dari jumlah Pasangan Usia Subur (PUS) yang ada 4299 jiwa (38,8%). Dari 4299 jiwa yang mengunakan Intra Uterine Device (IUD) sebesar 272 jiwa, Metode Operatif Pria (MOP) 14 jiwa, Metode Operatif Wanita (MOW) 230 jiwa, Implant 167 jiwa, Suntikan 1312 jiwa, Pil 439 jiwa, dan Kondom 196 jiwa.Tujuan: Untuk mengetahui hubungan tingkat pengetahuan pasangan usia subur dengan penggunaan alat kontrasepsi senggama terputus.Metode: Penelitian diskiptif dengan rancangan Penelitian cross sectional. Dengan menggunakan total sampel yaitu 39 pasangan usia subur di kelurahan Meteseh.Hasil: Mayorita responden memiliki pengetahuan kurang 53,8% (21 PUS) dan yang berpengetahuan baik 46,2% (18 PUS) seangkan penggunaan alat kontasapesi pada PUS didapatkan bahwa mayoritas responden tidak teratur dalam penggunaan senggama terputus 53,8% dan frekuensi yang teratur dalam emnggunakan senggama terputus 46,2%. Simpulan: Ada hubungan antara tingkat pengetahuan dengan penggunaan metode kontrasepsi senggama terputusSaran bagi masyarakat khususnya pasangan usia subur hendaknya meningkatkan pengetahuan tentang kontrasepsi senggama terputus dengan mencari informasi melalui tenaga kesehatan atau melalui media Kata Kunci : Pengetahuan, Pasangan Usia Subur, Kontrasepsi

FAKTOR-FAKTOR YANG MEMPENGARUHI PENGGUNAAN KONTRASEPSI METODE OPERASI PRIA (MOP)

FACTORS AFFECTING THE USED OF MAN CONTRACEPTION OPERATION METHOD Background: The use of operation method of man contraception was still very little used, especially among husbands. Though the male operative method is very effective in terminating pregnancy. Operation method of man contraception was a method with a very high level of effectiveness. So the hoped that method of man contraception choice for couples if they intend to terminate the pregnancy. However, currently the use of method of man contraception is still very small, so it needs hard work to increase the use of method of man contraception. Purpose:The purpose of this study was to determine the dominant factors associated with the use of MOP in Bebetin Village. Methods:This type of research is quantitative research with the independent variables of education, knowledge, attitudes, family support and support from health workers. While the dependent variable is the use of the male operative method. The minimum sample size used was 68 respondents with the sampling technique used simple random sampling. This study used a questionnaire instrument in data collection. Then used enumerators assisted by posyandu and puskesmas in data collection. Analysis using chi-square then multivariate analysis used logistic regression. Result:The results of the study found that there was a relationship between family support and the use of male operation method (AOR: 7.4 95% CI 1.6-33.6) and support from health professionals (AOR: 4.5 95% CI 1.0-20.1). Meanwhile education, attitudes and knowledge are not related to the use of male operation method in Bebetin Village. Conclusion: The conclusion is that family support and health worker support are the dominant factors that husbands want to use male operation methodSuggestion: It is hoped that in the future support for family support and support for health workers will be increased while at the same time increasing the use of male operation method. Keywords : male operative method; contraception; behavior ABSTRAK Latar Belakang: Penggunaan kontrasepsi mantap masih sangat sedikit digunakan khususnya pada kaum suami. Padahal metode operatif pria (MOP) sangat efektif untuk menghentikan kehamilan. Penggunaan MOP merupakan metode dengan tingkat efektifitas yang sangat tinggi. Sehingga harapannya kontrasepsi mantap menjadi pilihan pasangan jika berniat untuk menghentikan kehamilan. Namun saat ini penggunaan MOP masih sangat kecil dilakukan sehingga perlu kerja keras dalam meningkatkan penggunaan MOP.Tujuan: Tujuan dari penelitian ini adalah mengetahui faktor dominan yang berhubungan dengan penggunaan MOP di Desa Bebetin.Metode: Jenis penelitian yang dilakukan adalah penelitian kuantitatif dengan variabel independent pendidikan, pengetahuan, sikap, dukungan keluarga dan dukungan tenaga kesehatan. Sedangkan variabel dependen adalah penggunaan metode operatif pria. Besar sampel minimal yang digunakan adalah 68 responden dengan Teknik pengambilan sampel secara simple random sampling. Penelitian ini menggunakan instrument kuesioner dalam pengumpulan datanya. Kemudian menggunakan enumeroator dibantu posyandu dan puskesmas dalam pengumpulan data. Analisis menggunakan chisquare kemudian analisis multivariat menggunakan regresi logistik.Hasil: Hasil penelitian menemukan bahwa terdapat hubungan dukungan keluarga dengan penggunaan MOP (AOR :7,4 95% CI 1,6-33,6) dan dukungan tenaga kesehatan (AOR :4,5 95% CI 1,0-20,1). Sedangkan pendidikan, sikap dan pengetahuan tidak berhubungan dengan penggunaan MOP di Desa Bebetin.Kesimpulan: Kesimpulannya bahwa dukungan keluarga dan dukungan tenaga kesehatan menjadi factor yang dominan suami mau menggunakan MOP.Saran: Diharapkan kedepannya dukungan keluarga dan dukungan tenaga Kesehatan semakin ditingkatkan sekaligus meningkatkan penggunaan MOP Kata kunci : metode operatif pria; kontrasepsi; perilaku

FAKTOR-FAKTOR YANG MEMPENGARUHI KELULUSAN UJI PRAKTIK ANTENATAL CARE PADA MAHASISWA TINGKAT I SEMESTER II AKADEMI KEBIDANAN

FACTORS AFFECTING THE GRADUATION OF ANTHENATAL CARE PRACTICE TEST IN LEVEL I SEMESTER II STUDENTS OF MIDWIFERY ACADEMY Background. The success of students in higher education is influenced by several factors, both internal and external. Internal factors are factors that come from students themselves, such as learning motivation, learning attitudes and habits, learning skills, physical condition. External factors are factors that come from outside the students themselves, such as the family, school and community environment. The preliminary survey which was conducted by interviewing 10 students on August 1, 2019, as many as 8 students said that the practice of Antenatal Care is one of the tests that is rather difficult to understand because it was the first experience facing the exam so that the experience of the practical exams that had been carried out had not been described. Students also said that they rarely study independently in the laboratory because the steps to practice antenatal care are difficult to learnPurpose knowing the factors that influence the graduation of antenatal care (ANC) practice in midwifery students semester II at the Midwifery Academy of the Gatot Soebroto Army Hospital in 2019.Method. The research design used was quantitative by using a cross sectional approach, the research location was carried out at the MidwiferFACTORS AFFECTING THE USED OF MAN CONTRACEPTION OPERATION METHOD Background: The use of operation method of man contraception was still very little used, especially among husbands. Though the male operative method is very effective in terminating pregnancy. Operation method of man contraception was a method with a very high level of effectiveness. So the hoped that method of man contraception choice for couples if they intend to terminate the pregnancy. However, currently the use of method of man contraception is still very small, so it needs hard work to increase the use of method of man contraception. Purpose:The purpose of this study was to determine the dominant factors associated with the use of MOP in Bebetin Village. Methods:This type of research is quantitative research with the independent variables of education, knowledge, attitudes, family support and support from health workers. While the dependent variable is the use of the male operative method. The minimum sample size used was 68 respondents with the sampling technique used simple random sampling. This study used a questionnaire instrument in data collection. Then used enumerators assisted by posyandu and puskesmas in data collection. Analysis using chi-square then multivariate analysis used logistic regression. Result:The results of the study found that there was a relationship between family support and the use of male operation method (AOR: 7.4 95% CI 1.6-33.6) and support from health professionals (AOR: 4.5 95% CI 1.0-20.1). Meanwhile education, attitudes and knowledge are not related to the use of male operation method in Bebetin Village. Conclusion: The conclusion is that family support and health worker support are the dominant factors that husbands want to use male operation methodSuggestion: It is hoped that in the future support for family support and support for health workers will be increased while at the same time increasing the use of male operation method. Keywords : male operative method; contraception; behavior ABSTRAK Latar Belakang: Penggunaan kontrasepsi mantap masih sangat sedikit digunakan khususnya pada kaum suami. Padahal metode operatif pria (MOP) sangat efektif untuk menghentikan kehamilan. Penggunaan MOP merupakan metode dengan tingkat efektifitas yang sangat tinggi. Sehingga harapannya kontrasepsi mantap menjadi pilihan pasangan jika berniat untuk menghentikan kehamilan. Namun saat ini penggunaan MOP masih sangat kecil dilakukan sehingga perlu kerja keras dalam meningkatkan penggunaan MOP.Tujuan: Tujuan dari penelitian ini adalah mengetahui faktor dominan yang berhubungan dengan penggunaan MOP di Desa Bebetin.Metode: Jenis penelitian yang dilakukan adalah penelitian kuantitatif dengan variabel independent pendidikan, pengetahuan, sikap, dukungan keluarga dan dukungan tenaga kesehatan. Sedangkan variabel dependen adalah penggunaan metode operatif pria. Besar sampel minimal yang digunakan adalah 68 responden dengan Teknik pengambilan sampel secara simple random sampling. Penelitian ini menggunakan instrument kuesioner dalam pengumpulan datanya. Kemudian menggunakan enumeroator dibantu posyandu dan puskesmas dalam pengumpulan data. Analisis menggunakan chisquare kemudian analisis multivariat menggunakan regresi logistik.Hasil: Hasil penelitian menemukan bahwa terdapat hubungan dukungan keluarga dengan penggunaan MOP (AOR :7,4 95% CI 1,6-33,6) dan dukungan tenaga kesehatan (AOR :4,5 95% CI 1,0-20,1). Sedangkan pendidikan, sikap dan pengetahuan tidak berhubungan dengan penggunaan MOP di Desa Bebetin.Kesimpulan: Kesimpulannya bahwa dukungan keluarga dan dukungan tenaga kesehatan menjadi factor yang dominan suami mau menggunakan MOP.Saran: Diharapkan kedepannya dukungan keluarga dan dukungan tenaga Kesehatan semakin ditingkatkan sekaligus meningkatkan penggunaan MOP Kata kunci : metode operatif pria; kontrasepsi; perilaku y Academy of RSPAD Gatot Soebroto, with a total sample of 49 female students. Research time from March to August 2019.Univariate and bivariate data analysis using ChiSquare.Result. Evaluation of the ANC practice exam in students is very good with the results of the psychological test still being suggested by 16 respondents 84.2%. The results of most ANC practice exam evaluations are good with health tests fulfilling the requirements as many as 15 respondents 60.0%. The results of the most evaluations of ANC practice exams are good results with 21 respondents 70.0% of the origin majoring in science. Most ANC practice exam evaluation results are with good results with guidance intensity> 3 times as many as 29 respondents 96.7%.Conclusion. ANC practice exam evaluation on students is very good with the results of the psychological test can still be suggested, there is a significant relationship between the ANC practice score and the psychological test. There is no significant relationship between ANC practice scores with health tests, high school majors and intensity of guidance.Suggestions based on the results of the research show that the results of the psychological test have a very significant effect on academic achievement, therefore focusing on increasing the psychological factors of students is the most appropriate effort to improve and or maintain academic achievement. It is suggested to students to further increase their motivation to learn through various ways, including liking each subject presented, having a desire to acquire knowledge and others. Key words: antenatal care, psychology test, students

Pattern of Abdominal Stab Injury in a Tertiary Hospital in Nigeria

Background: Abdominal stab injury is a type of penetrating abdominal injury. The management may be operative or non-operative. Objectives: To determine the pattern, treatment options and outcome in abdominal stab injuries. Methods: This was a retrospective study carried out over 4 years between January 2014 and December 2017, at the University of Benin Teaching Hospital, Benin City, Nigeria. Patients aged 18 years and above formed the study population. The case files of the patients were retrieved from the medical record. The information obtained included age, gender, injury to arrival time (IAT), type of weapon, the abdominal injury sustained, clinical symptoms and signs, surgical intervention time (SIT), type of surgery carried out, operative findings and complications. Results: Overall, there were 34 patients made up of 30 (88.2%) males and 4 (11.8%) females with a male to female ratio of 7.5:1. The mean age of the patients was 30±8.9 years with the age range of 17-50 years. The mean injury to arrival time (IAT) was 2.0±1.6 hours; surgery intervention time (SIT) was 5.9±5.6 hours. Twenty (58.8%) patients had laparotomy while 14 (41.2%) were successfully managed non-operatively. Post-operative complications included surgical site infection (SSI), entrance wound infection, intra-peritoneal abscess and intestinal obstruction. There was no mortality. Conclusion: Abdominal stab injury was predominant among males and can be managed by the operative method or non-operative method in the absence of significant visceral injury. Selective non-operative management was effective in avoiding unnecessary laparotomy in more than one-third of the cases.

The Dermal Nipple-Areola-Complex Flap Method in Female-to-Male Gender Affirming Surgery

Background:Subcutaneous mastectomy (SCM) plays a major role in female-to-male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola-complex (NAC) flap with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularization.Methods:Through a horizontal incision, a superior thoracic full skin flap was elevated at the dissection plane for mastectomy. The mastectomy was continued inferiorly, creating an inferior flap including the NAC. The surface of the inferior flap was deepithelialized, secluding the NAC, which allowed the inferior dermal flap to be inserted posterior to the superior flap. A circular defect was created in the superior flap, into which the NAC was sutured.Results:The surgery delivered satisfactory results with an aesthetically pleasing masculine appearance and a high level of patient satisfaction. We were able to place the horizontal scars inferiorly along the pectoral muscles, which enabled some camouflage. Additionally, the inferior flap provided a uniform filling effect to the chest, further contributing to the male aesthetic. There were no NAC complications.Conclusion:The dermal NAC flap method could be applied as an excellent alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The method is simple, provides an aesthetically appealing outcome, and poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or reduction of the NAC where required.