Subcutaneous forehead island flap for nasal reconstruction

Reconstruction of nasal skin after tumor resection is imperative for full patient rehabilitation; and use of similar skin is necessary to achieve best esthetic and functional results. This clinical series study represent management of patients with large nasal defects [up to 4x7 cm] using subcutaneous pedicle island paramedian forehead flap, during a period of 2007-2009, 8 patients with large nasal defects were repaired with this flap, among them 5 patients were male and 3 patients were female with mean age of 53 years, all cases were reconstructed with island pedicle flap in a single stage. Good and satisfying results were achieved in all cases except for one case that was operated again for debulking of flap. Island paramedian forehead flap provides esthetic and functional results in a single stage reconstruction of defects with various sizes and locations. This variation of forehead flap is a good choice especially for those patients that have problems with cost or problem with multistage reconstruction of nasal defects

CPR training for nurses: how often is it necessary?

The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent, prepared and up-to-date in the emergency life-saving procedure of cardiopulmonary resuscitation [CPR]. This study aimed to determine the extent to which nurses acquire and retain CPR cognitive knowledge and psychomotor skills following CPR training courses. A quasi-experiment was used. CPR knowledge of 112 nurses was assessed via a questionnaire using valid multiple-choice questions. An observatory standard checklist was used and CPR performance on manikins was evaluated to assess psychomotor skills [before the course baseline, after the course, after 10 weeks and then 2 years after the 4 hours CPR training course]. Scores were based on a scale of 1 to 20. A mean baseline score of 10.67 [SD=3.06], a mean score of 17.81 [SD=1.41] after the course, 15.26 [SD=3.17] 10 weeks after and 12.86 [SD=2.25], 2 years after the 4 hours CPR training course was noticed. Acquisition of knowledge and psychomotor skills of the nurses following a four-hour training program was significant. However, significant deterioration in both CPR knowledge and psychomotor skills was observed 2 years after the training program among 42 nurses. The study findings present strong evidence to support the critical role of repetitive periodic CPR training courses to ensure that nurses were competent, up to date and confident responders in the event of a cardiac arrest

[Prevalence of oral and maxillofacial manifestations in patients with multiple sclerosis]

With regards to the high and increasing prevalence of Multiple Sclerosis [MS] and its demolishing effects on central nervous system and oro-facial nerves appearing oral and maxillofacial manifestations, this study was carried out on the prevalence of oral and maxillofacial manifestations and its related factors in MS patients in 2010.This cross-sectional study was performed on 400 MS patients that were selected by sequential sampling. Oral and maxillofacial manifestations evaluated were as follows: Trigerninal neuralgia, Dysarthria, Dysphagia, [TemporoMandibular Dysfunction] TMD, facial palsy and visual symptoms. Occurrence of each manifestation was determined and its confidence interval was evaluated within a probability of 95% and the role of the related factors was analyzed with the Chi-square test. 89.2% of the samples demonstrated oral and maxillofacial manifestation. The most frequent manifestations were: Visual symptoms 79.5%, Dysarthria 44. 3%, Dysphagia 21%, Facial Palsy 15.3%, and TMD 14.3% and the least frequent was Trigeminal neuralgia with 13.3%. The related individual and familial factors showed no relation to the incidence of these manifestations. However compared to the patients with no oral and maxillofacial symptoms, the ones with these symptoms were three times more likely to contract MS with duration of more than seven years. This study revealed a high incidence of oral and maxillofacial manifestations in MS patients therefore it cause for great concern