Couple Conflict and Music Utilisation

It is believed that conflict exists on a spectrum, which holds interest for many relationship researchers. However, it is not well understood how music is utilised within couples when they engage in conflict, considering music has been known to assist in reducing physiological, emotional, and social regulation. The proposed study explored how music was utilised in times of conflict for couples through a grounded theory approach. The main themes that emerged were: variability of choice, knowledge of partner's habits, communication, similarity of style, relational distance, repair attempt, music utilisation as relational engagement, emotional regulation, and hopeful togetherness. These themes are presented in a theoretical model of how couples utilise music to regulate social, emotional, and biological domains of their relationship.

Treatment of Rectovaginal Fistula Using Sphincteroplasty and Fistulectomy

Aim. To assess the results of the treatment of rectovaginal fistulas with incontinence and impaired anal tonus. Materials and Methods. This study comprised three rectovaginal fistula groups that were treated using sphincteroplasty and fistulectomy: group 1: eight women with simple rectovaginal fistula due to birth trauma; group 2: six rectovaginal fistula cases that were associated with chronic inflammatory diseases; and group 3: five cases with at least one failed repair attempt. In the second step, operations that took place before the year 2000 were compared to the operations that took place after the year 2000 in terms of demographic and clinical characteristics. Results. All of the simple rectovaginal fistula cases healed after the operation. Five of the group 2 patients healed after the operation. However, 1 patient with Crohn’s disease needed to undergo reoperation, but successfully healed after 6 months. On the contrary, 3 patients in group 3 healed (60%) whereas 2 of them failed to heal. Clinical characteristics of the patients were different between the groups (before and after the year 2000). Conclusion. The choice of operation must be done according to the patient’s underlying pathology. Proper management of associated inflammatory diseases and systemic disorders is recommended for necessary complex cases.

A case series of urogenital fistulas

Background: Urogenital fistula is an abnormal fistulous communication that occurs between the bladder and cervix or uterus; between the ureter and vagina, uterus, or cervix; and between the urethra and vagina. Most cases in developing countries are of obstetric etiology, resulting from prolonged neglected obstructed labour, and around 1–2 per 1000 deliveries may be affected. The majority of UGFs in developed countries are a consequence of gynecological surgery, mainly hysterectomies. Present study focuses on the various presentations and the different modalities of surgeries done for cases of urogenital fistulas at our institute.Methods: A total 19 cases of urogenital fistula were studied in detail as per proforma. Two patients were operated on emergency basis because of early presentation in postoperative period. For others a pre-operative waiting period of 3-6 months was followed after development of fistula. During this period initially bilateral DJ stenting was tried in all patients, in hope of spontaneous closure of fistulas. Two patients whose fistulas closed spontaneously are not subjected to surgery. Rest all cases were managed surgically by standard surgical procedures.Results: Study was conducted between, February 2015 to February 2017. A total 19 patients studied. In 2 patients, fistula healed spontaneously while in 17 patients, surgery was needed. Most common age group affected is 2nd decade of life about 47.36%. In our study gynecological surgeries predominate with 57.89% followed by obstetric cases in 26.31%. Most of patients presented with continues dribbling of urine through vagina with normal voiding pattern in about 78.94% of cases. Overall transabdominal procedures had nearly 100% success rate, mainly because of better dissection, visualization and use of vascularized graft which prevents recurrence. 1 recurrence was seen in transvesical extraperitoneal approach because of undiagnosed another fistulous tract. Ureteric reimplantation was 100% successful in ureterogenital fistulas. Vaginal approach with use of Mortius flap had 75% success rate with 1 recurrence because of flap necrosis. Mean duration of surgery was 120 minutes and mean hospital stay was 8 days..Conclusions: Urogenital fistulas are the most distressing complications of obstetric and gynecological surgeries. Obstetric causes predominate in developing countries while gynecological surgeries predominate in developed countries. Despite the good results of surgical repair, attempt should be focused on the prevention of VVF.

Cleft Lip Rhinoplasty

Cleft lip rhinoplasty may be performed as an endonasal or an open rhinoplasty procedure. It is helpful for the rhinoplasty surgeon to know the type of lip closure and the extent of nasal surgery performed at the time of primary lip repair. Current methods of primary lip repair attempt to create an esthetic lip scar and leave a minimal degree of nasal tip deformity to allow the child to avoid secondary lip and nasal tip surgery at the preschool age. Single cleft lip rhinoplasty has to deal more with asymmetry than double cleft lip rhinoplasty. The double cleft lip deformity has to deal with a true deficiency in the columella and the possible need for lip augmentation. Closure of the alveolar cleft and the cleft palate in both types of cleft lip and palate often creates scar tissue that retards maxillary growth and introduces the need for cephalometric analysis and possible orthognathic surgery.