Fan flaps for Cheiloplasty (lower lip reconstruction): A two year experience

Aim: To evaluate the fan flaps done during the past two years with regard to applicability, reliability, functional perspective and complications. Materials and Methods: All the fan flaps done were reviewed by inspecting case records and directly following up the patients (at periodic intervals). The indications, applicability to defect size, postoperative aesthetic and functional results and drawbacks were noted. Results: Eight fan flaps were done during this period. All were done for squamous cell carcinoma affecting lower lip. All the flaps survived. Two early cases of Gilles fan flap developed significant microstomia. Later flaps with neurovascular preservation maintained sensations with good commissural competence. Nakajima fan flaps gave good overall results. Conclusions: The fan flaps, especially the Nakajima modification with neurovascular preservation are safe and reliable flaps for lip reconstruction in terms of form and function

Fan flaps for Cheiloplasty (lower lip reconstruction): A two year experience

Aim: To evaluate the fan flaps done during the past two years with regard to applicability, reliability, functional perspective and complications. Materials and Methods: All the fan flaps done were reviewed by inspecting case records and directly following up the patients (at periodic intervals). The indications, applicability to defect size, postoperative aesthetic and functional results and drawbacks were noted. Results: Eight fan flaps were done during this period. All were done for squamous cell carcinoma affecting lower lip. All the flaps survived. Two early cases of Gilles fan flap developed significant microstomia. Later flaps with neurovascular preservation maintained sensations with good commissural competence. Nakajima fan flaps gave good overall results. Conclusions: The fan flaps, especially the Nakajima modification with neurovascular preservation are safe and reliable flaps for lip reconstruction in terms of form and function

Utility of arteriovenous loops before free tissue transfer for post-traumatic leg defects

Crush injuries of severe magnitude involving lower limbs require complex bone and soft tissue reconstructions in the form of microvascular free tissue transfers. However, satisfactory recipient vessels are often unavailable in the leg due to their vulnerability to trauma and post traumatic vessel disease (PTVD), which extends well beyond the site of original injury. In such situations, healthy recipient vessels for free flap anastomosis can be made available by constructing temporary arteriovenous loops with saphenous vein grafts, anastomosed to corresponding free flap vessels. Our study included 7 patients with severe crush injuries of leg due to rail and road traffic accidents. Long and short saphenous vein grafts were anastomosed to Femoral artery in the subsartorial canal in 2 cases and to large muscular branches and accompanying veins in rest of the cases. Free flap transfers were performed in the same sitting in 6 cases. One case showed insufficient dilatation of the vein loop and hence free flap transfer was staged. Free Latissimus dorsi, Gracilis and Rectus abdominis flaps were performed. There were two cases of flap necrosis - one in the case of a pathologic vein graft with staged flap transfer which showed vein thrombosis on re exploration. The other case of flap failure was caused by a hematoma underneath the flap. In another patient, secondary haemorrhage occurred on day 18, without any consequence to the flap. All the other cases had complete free flap survival. We consider the use of single stage arteriovenous loops, a valuable tool to increase the applications of free flap, whenever healthy recipient vessels are not available in the periphery of the trauma

Etiopathological Factors Associated with Gynecomastia Patients Seeking Surgical Correction in the South Indian Population

Background Although several medical conditions are associated with gynecomastia, around 60% of cases are idiopathic. The role of endocrine testing in idiopathic gynecomastia is controversial. This study was done to determine the etiological and lifestyle factors associated with different grades of gynecomastia. Patients and Methods This was a descriptive study conducted at the department of plastic surgery in a tertiary care hospital in South India between January 2014 and December 2016, among the patients seeking corrective surgery for gynecomastia. Results A total of 73 patients were included in the study with a mean age of 22.56 years. The majority of the patients displayed Simon's Grade IIa gynecomastia (56.2%). The etiological factors identified in this study were hormonal abnormalities (47.95%), hypogonadism (2.7%), and drug intake (1.4%). The most common hormonal abnormality discovered was high estradiol values (15.1%) followed by decreased testosterone levels (13.7%). The chi-squared test revealed no statistically significant relationship between the hormonal values, type of food, body mass index (BMI), or physical activity and the grades of gynecomastia. Conclusion Most of the patients (50.68%) in our study had idiopathic gynecomastia. The most common hormonal abnormality detected was high estradiol values. No correlation was found between the hormonal values, type of food, BMI, or physical activity and the grades of gynecomastia

SNAKE VENOM-DERIVED PEPTIDES AS PROSPECTIVE PHARMACOLOGICAL TOOLS: RECENT TRENDS

Small peptides from snake venom are studied as exceedingly selective, specific, effective and harmless therapeutics. This review article critically analyzes with numerous examples for the use of snake venom components as a potential therapeutic tool against various illnesses. The active components from numerous venoms are isolated, purified and used in assays to identify the specific therapeutic components that were categorized based on their biological goal and mechanism of action. This has paved the ways to use peptides from venom as therapeutic drugs. Peptide toxins are usually active orally, via subcutaneous, intramuscular or intravenous administrations. These peptides are targeting a wide range of membrane-bound protein channels and receptors. Peptides are recovered from the venom of diverse animals and most of these possess the possible prospects of safety after isolation and purification and venom-obtained peptides that can become practical drugs effectively, in future

Touraine Solente Gole syndrome: The elephant skin disease

Touraine Solente Gole syndrome is a rare hereditary syndrome of primary pachydermoperiostosis, with the characteristic triad of pachydermia (or elephant like skin), periostosis and acropachia. A 27-year-old patient presented with aesthetic deformity of forehead due to deep skin folds and coarsening of facial features due to progressive thickening of skin. Associated palmoplantar hyperkeratosis with broadened of finger and toe tips and digital clubbing were noticed. Dermatologic evaluation revealed cutis verticis gyrata of scalp, seborrhoeic hyperplasia of face and hyperhidrosis. Natural history of the disease and aetiopathogenesis were reviewed. Aesthetic correction of forehead through frontal rhytidectomy was attempted