A Study of Prominent Ears Among Undergraduates in Delta State University at Abraka in Nigeria

The goal of this inquiry is to establish the pervasiveness of prominent ears among undergraduates of Delta State University, Abraka in Nigeria.The outcome can act as a guide during correctional surgical measures in congenital or acquired ear defects. This enquiry adopted an observational cross-sectional study plan. The study sample comprised of both male and female undergraduates of Delta State University, Abraka aged between 16-30 years. Exactly 384 individuals (184 males and 200 females) were sampled and the cluster sampling procedure was practiced. Data was collected with the aid of a sliding vernier caliper, pencil, and a data collection sheet. Every subject’s head was kept in Frankfort’s horizontal plane and dimensions were taken with a sliding caliper. Ear projection greater than 21mm was defined as ear prominence. Totality of 36 (9.38%) had small right ear while 28 (7.29%) had small left ear. Prominent ear was more prevalent on the right region (n=44, 11.45%) than on the left (n=19, 4.95%). Entirety of 63 (16.4%) had prominent ears with more males affected compared to the females. The gender disparity in the occurrence of prominent ears is not remarkable (p>0.05). The relationship between age and the occurrence of prominent ears was remarkable (p=.000). Indubitably prominent ear is not widespread among the considered undergraduates.

Etiology and treatment modalities in epistaxis

<p><strong>Background:</strong> Epistaxis or 'hemorrhage from the nose' is a frequent presentation in the otorhinolaryngologic emergency and both conservative and surgical modalities have been used in the treatment. The present study was undertaken to estimate the proportion of patients with epistaxis who are effectively managed with conservative modalities.</p><p class="abstract"><strong>Methods:</strong> A total of 60 patients (39 males and 21 females) between 18 and 70 years, with epistaxis were studied in the department of otorhinolaryngology and emergency units of Dr. Somervell Memorial C.S.I Medical College Hospital, Karakonam, Thiruvananthapuram, between November 2018 and April 2020. The data, that is the proportion of patients who are effectively managed with conservative modalities, was entered into Microsoft - Excel sheet and analysis was done using statistical package for social sciences (SPSS) software trial version.</p><p class="abstract"><strong>Results: </strong>Out of 60 cases of epistaxis, 81.67% were effectively controlled by conservative management like general first aid (43.33%), chemical cautery (10%), and nasal packings via anterior (21.67%) and posterior (6.67%).</p><p class="abstract"><strong>Conclusions:</strong> In 81.67% nasal bleeding was effectively controlled by conservative treatment measures and in 18.33% surgical measures were required. </p>

Perihematomal Edema After Intracerebral Hemorrhage: An Update on Pathogenesis, Risk Factors, and Therapeutic Advances

Intracerebral hemorrhage (ICH) has one of the worst prognoses among patients with stroke. Surgical measures have been adopted to relieve the mass effect of the hematoma, and developing targeted therapy against secondary brain injury (SBI) after ICH is equally essential. Numerous preclinical and clinical studies have demonstrated that perihematomal edema (PHE) is a quantifiable marker of SBI after ICH and is associated with a poor prognosis. Thus, PHE has been considered a promising therapeutic target for ICH. However, the findings derived from existing studies on PHE are disparate and unclear. Therefore, it is necessary to classify, compare, and summarize the existing studies on PHE. In this review, we describe the growth characteristics and relevant underlying mechanism of PHE, analyze the contributions of different risk factors to PHE, present the potential impact of PHE on patient outcomes, and discuss the currently available therapeutic strategies.

Management of high inguinal undescended testis: a review of literature

Background Undescended testis is one of the most common paediatric surgical diagnoses. A lot of research has been done to date, to standardise the surgical management of intra-abdominal and extra-abdominal undescended testis. High inguinal undescended testis is a unique clinical encounter which demands additional surgical measures over conventional orchidopexy for better surgical results. Main body of abstract Open inguinal orchidopexy is a routine and quite straightforward operation for the majority of extra-abdominal undescended testis. However, there are instances in which the testis, even though situated in the inguinal region, poses a challenge for surgeons, to bring it in the scrotum by routine open inguinal orchiopexy. High inguinal testis can be defined as “any intra-canalicular testis present higher up in the inguinal canal and cannot be brought down easily to the scrotum by routine surgery as in standard orchiopexy (open or laparoscopy) and require additional lengthening manoeuvres”. It needs additional surgical lengthening manoeuvres like Prentiss, along with the steps of routine orchiopexy to bring it down in the scrotum. This review article describes the various nomenclatures of undescended testis, appropriate investigations and also various additional surgical measures in the management of difficult high inguinal testis. Conclusion High inguinal undescended testis poses a unique technical challenge even to well-experienced surgeons. It is very important that surgeons dealing with this condition are well aware of the anatomy in this region and also various different manoeuvres described to date to bring the testis down in the scrotum.

Surgical Management of Choroidal Diseases

Accumulation of serous fluid in the suprachoroidal space, known as uveal effusion, and choroidal or suprachoroidal haemorrhage (SCH) following rupture of ciliary blood vessels are considered rare, but serious, events with extremely poor functional prognosis. As a result, uveal effusion, and expulsive suprachoroidal haemorrhage in particular, continue to be considered as more or less fatal complications. However, clinical experience demonstrates that both clinical entities can be managed by conservative as well as surgical strategies, depending on their severity and localisation, with sometimes surprisingly favourable visual outcome. In addition to prognostic factors, timely recognition and prompt, if possible preventive, acute care, as well as carefully considered timing of adequate surgical measures taking advantage of the specific characteristics of the choroidal tissue, are crucial to treatment success. Along with technical advances in the field of vitreoretinal surgery, numerous variants of therapeutic approaches to the treatment of choroidal effusion and suprachoroidal haemorrhage have been proposed to date. This review presents some of the most important surgical techniques and strategies in the field.

PROCEDURE AND ALGORITHMIZATION OF RATIONAL CHOICE OF REHABILITATION MEASURES DURING TREATMENT GYNECOLOGICAL DISEASES

С развитием высоких медицинских технологий возрастает роль лечащего врача (ЛВ), который по-прежнему остается лицом, принимающим решение (ЛПР). Однако применение математических методов моделирования и адаптивных методов принятия решений должно увязываться с логикой деятельности ЛВ, доступно для практического использования, освобождать ЛВ от "рутинной" работы и способствовать более целенаправленному и эффективному лечебному процессу. Вот почему, прежде всего, при выборе рациональных реабилитационных мероприятий в условиях неполной априорной информации требуется интеллектуальная поддержка принимаемых решений ЛВ. Реабилитационные мероприятия при лечении гинекологических заболеваний выбираются из определенного множества медикаментозных, физиотерапевтических и хирургических мероприятий. Задача управления лечением в виде оптимизационной задачи позволяет формализовать процесс принятия решений при неоднородности задачи управления на начальном этапе, однако, при выборе лечения имеют место разного рода неопределенности, что требует применения адаптивного подхода. Для интеллектуальной поддержки выбора тактики лечения гинекологических заболеваний в условиях неполной априорной информации и ряда неопределенностей рекомендуется использовать для повышения эффективности принимаемых решений методы формализации априорной информации, поступающей от ЛВ, для настройки вероятностей привлечения критериев оптимизации, вероятности использования того или иного вида лечебного воздействия, математических моделей процессов лечения гинекологических заболеваний для организации и реализации имитационного эксперимента по принимаемым ЛВ решениям на весь период лечения (стратегия лечения) с использованием ЭВМ в диалоговом режиме в ускоренном масштабе времени и на каждый шаг лечения (тактика лечения) в реальном масштабе времени как по информации, поступающей от ЛВ, так и с использованием адаптивных алгоритмов выбора текущих целей лечения, вида лечебных воздействий и их величины. Таким образом, в статье рассматриваются задачи рационального (оптимального) планирования и выбора реабилитационных мероприятий при лечении гинекологических заболеваний на основе автоматизированного принятия решений With the development of high medical technologies, the role of the attending physician (PD) increases, who remains the decision-maker (DM). However, the use of mathematical modeling methods and adaptive decision-making methods should be linked to the logic of the drug's activity, be available for practical use, free the drug from "routine" work and contribute to a more purposeful and effective treatment process. That is why, first of all, when choosing rational rehabilitation measures in conditions of incomplete a priori information, intellectual support for the decisions made by the dispensary is required. Rehabilitation measures in the treatment of gynecological diseases are selected from a certain set of medication, physiotherapy and surgical measures. The problem of treatment management in the form of an optimization problem allows one to formalize the decision-making process when the control problem is heterogeneous at the initial stage, however, when choosing a treatment, there are various kinds of uncertainties, which requires an adaptive approach. For intellectual support of the choice of tactics for the treatment of gynecological diseases in conditions of incomplete a priori information and a number of uncertainties, it is recommended to use methods of formalizing a priori information from the drug to increase the efficiency of decisions made, to adjust the probabilities of invoking optimization criteria, the likelihood of using one or another type of therapeutic effect, mathematical models processes of treatment of gynecological diseases for the organization and implementation of a simulation experiment on the decisions made by the drug for the entire treatment period (treatment strategy) using a computer in an interactive mode in an accelerated time scale and for each step of treatment (treatment tactics) in real time as according to information received from drugs, and using adaptive algorithms for choosing the current goals of treatment, the type of therapeutic effects and their magnitude. Thus, the article deals with the tasks of rational (optimal) planning and selection of rehabilitation measures in the treatment of gynecological diseases based on automated decision making

Palliative Modified Radical Mastectomy to Improve Quality of Life by Decreasing Disease Burden: A Case Report

In cases of advanced pathology, palliative medicine is able to confer a great deal of relief to the patient. In the same light, surgical intervention is able to provide increased quality of life in cases of extensive disease burden, providing palliation where curative measures cannot be achieved. In the case study therein, a patient presents with metastatic breast cancer with a localized fungating mass contributing to severe local and systemic symptomatology. In this setting, invasive management of her disease allowed for clinical improvement of the patient when medical management alone was not sufficient. The patient quickly demonstrated recovery of her symptoms in the post-operative phase when the local disease was resected. The utilization of invasive measures, as seen in this case, further proves the importance of multidisciplinary palliative care where surgical measures are included in patient care.

Nutrological Management in Bariatric Surgery: A Narrative Review

Nutrology based on the analysis of benefits and harms generated by the ingestion of nutrients and assessing individual organic needs promotes the maintenance of health and the reduction of disease risk, as well as the treatment of manifestations of deficiency or excess. Obesity is defined by a body mass index greater than 30 kg/m². Its manifestation is the sum of genetic and environmental factors, this through sedentary lifestyle and caloric intake greater than energy consumption. There are many ways to deal with obesity, from behavioral changes such as a balanced diet and physical exercises, pharmacological and even surgical measures of different modalities, with Roux-en-Y gastric bypass surgery being the most used technique in Brazil. The most common postoperative nutritional deficiencies are iron, protein, calcium, folate, thiamine, zinc, copper, and vitamins D, B12, A, C, and K. In this case, we present the importance of nutrology in monitoring patients after bariatric surgery. This research made use of a bibliographic survey, giving priority to articles dated from the last 5 years, using the databases Lilacs, Medline, bireme, where articles, dissertations, and theses were consulted, in search of the following keywords, obesity, bariatric surgery, and nutritional deficiency, post-bariatric feeding.

The Holistic Approach of Homoeopathy

The very foundation of homoeopathic practice considers man not only as an individual, but as a complete unit in himself, of which all his parts comprise a well-balanced whole. Homoeopathy, therefore, does not consider any one part as being ill, but considers the manifestation of illness in one part in its relation to the whole man. Homoeopathy has evolved as an logical, experimental science according to the method of inductive reasoning where in the exact observation, correct interpretation, rational explanation and scientific construction play a leading role. Homoeopathy accepts surgical measures when directed towards the removal of mechanical impediments to cure or of the morbid end-products of disease when they interfere with recovery. On the contrary Homoeopathy has played a pivotal role in avoiding surgeries and curing many such diseases where surgery was recommended.

Traumatic Optic Neuropathy

A host of different types of direct and indirect, primary and secondary injuries can affect different portions of the optic nerve(s). Thus, in the setting of penetrating as well as nonpenetrating head or facial trauma, a high index of suspicion should be maintained for the possibility of the presence of traumatic optic neuropathy (TON). TON is a clinical diagnosis, with imaging frequently adding clarification to the full nature/extent of the lesion(s) in question. Each pattern of injury carries its own unique prognosis and theoretical best treatment; however, the optimum management of patients with TON remains unclear. Indeed, further research is desperately needed to better understand TON. Observation, steroids, surgical measures, or a combination of these are current cornerstones of management, but statistically significant evidence supporting any particular approach for TON is absent in the literature. Nevertheless, it is likely that novel management strategies will emerge as more is understood about the converging pathways of various secondary and tertiary mechanisms of cell injury and death at play in TON. In the meantime, given our current deficiencies in knowledge regarding how to best manage TON, “primum non nocere” (first do no harm) is of utmost importance.