Limited Incision Rhinoplasty: An Approach for All Primary and Revision Cases.

INTRODUCTION: Rhinoplasty was one of the most frequently performed aesthetic surgeries in the USA in 2022. Traditionally, the open approach has been preferred by the majority of surgeons often due to familiarity and ease of visualization. However, patient interest in closed and preservation rhinoplasty is driving a resurgence in the popularity of endonasal techniques. We present a series of 100 consecutive endonasal primary and revision rhinoplasty cases using bilateral isolated modified rim incisions. METHODS: One-hundred consecutive patients underwent closed rhinoplasty via isolated modified rim incisions at a single-surgeon private practice. The senior author performs 100% endonasal rhinoplasty. A retrospective chart review was performed from 06/25/20 to 09/21/22. Information on demographics, complications, and need for revision was collected. RESULTS: Eighty-four patients underwent primary rhinoplasty, 11 underwent secondary rhinoplasty, 4 underwent tertiary rhinoplasty, and 1 underwent quaternary rhinoplasty. Isolated modified rim incisions were used in all cases except in cases of septoplasty when a unilateral Killian incision was added, or in cases of lateral osteotomy when vestibular stab incisions were added. Post-operatively, six (6.0%) patients required revision, all of which were performed under local anesthesia. CONCLUSION: Limited incision rhinoplasty is a reliable surgical approach that produces predictable results with a low revision rate. This technique is highly effective in minimizing soft tissue disruption to ensure safe, reliable, and effective outcomes in primary and revision rhinoplasty. It is an easier technique to learn compared to traditional endonasal and even arguably open rhinoplasty, thus lending itself to widespread adoption especially among novice rhinoplasty surgeons. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Efficacy of Massage on Pain Intensity in Post-Cesarean Women: a Systematic Review and Meta-Analysis.

Background: Cesarean section is a common surgical procedure that may be considered a safe alternative to natural birth and helps to resolve numerous obstetric conditions. Still, the Cesarean section is painful; relieving pain after a Cesarean section is crucial, therefore analgesia is necessary for the postoperative period. However, analgesia is not free of complications and contraindications, so massage may be a cost-effective method for decreasing pain post-Cesarean. Our study aims to determine the massage role in pain intensity after Cesarean sections. Methods: We searched five electronic databases for relevant studies. Data were extracted from the included studies after screening procedures. We calculated the pooled mean difference (MD) and standardized mean difference (SMD) for our continuous outcomes, using random or fixed-effect meta-analysis according to heterogenicity status. Interventional studies were assessed for methodological quality using the Cochrane risk-of-bias assessment tool, while observational studies were assessed using the National Institutes of Health's tools. Results: Our study included 10 RCTs and five observational studies conducted with over 1,595 post-Cesarean women. The pooled MDs for pain intensity considering baseline values either immediately or post 60-90 minutes were favoring the massagegroup over the control group as follows:(stand. MD = -2.64, 95% CI [-3.80, -1.48], p >.00001; MD = -2.64, 95% CI [-3.80, -1.48], p >.00001, respectively). While pooled MDsregarding post-intervention only eitherimmediately or post 60-90 minutes were:(stand. MD = -2.04, 95% CI [-3.26, -0.82], p =.001; stand. MD = -2.62, 95% CI [-3.52, -1.72],p > .00001, respectively). Conclusion: Our study found that using massage was superior to the control groups in decreasing pain intensity either when the pain was assessed immediately after or 60-90 minutes post-massage application.

Rhino-orbito-cerebral mucormycosis infection in a 4-year-old Egyptian girl.

Rhino-orbital cerebral mucormycosis is a rare, potentially fatal fungal infection that usually affects diabetic and immunocompromised adults. Recently, an increase in the frequency of this infection in children has been reported, especially in neutropenic patients and premature babies. In this article, we are reporting a case of rhino-orbital cerebral mucormycosis in a 4-year-old girl with a newly diagnosed diabetes mellitus. Tissue biopsy, fungal culture, and imaging were used to confirm the diagnosis. The infection was successfully treated with combined surgical debridement and antifungals.

Psychological effects of the COVID-19 pandemic: Perceived stress, anxiety, work-family imbalance, and coping strategies among healthcare professionals in Khartoum state hospitals, Sudan, 2021.

BACKGROUND: The 2019 novel coronavirus (COVID-19) is highly contagious and can spread a pandemic, so it is related to serious health issues and major public concerns, and is considered by the medical community to be the greatest concern because it is the greatest risk of infection. OBJECTIVE: To identify and assess the psychological effects of the COVID-19 pandemic on healthcare professionals in Khartoum state hospitals 2021. MATERIALS AND METHODS: Generalized Anxiety Scale (GAD-7), Perceived Stress Scale (PSS-10), and Work-Family Balance Measure Scale were used to assess the psychological impact of doctors and nurses working in four big hospitals in Sudan, by an online questionnaire, analyzed by the statistical package for social science (SPSS) during February. RESULTS: Most of the participants had minimal to mild anxiety according to GAD-7 score, 121 (35.2%) and 103 (29.9%), respectively. Using PSS-10, the cutoff point was determined as 19 as the mean for total score was 19.2 ± 6.2, accordingly, more than half had high levels of stress (scored 19 and above) 189 (54.9%). For the Work-Family Balance Scale, 10 was regarded as the cutoff point. There was a significant association between specialty and stress level p-value .032. No significant correlations were found between age and stress level, neither between age and anxiety level (r -.100, p-value .064 and r = -.022, p-value .683, respectively). CONCLUSION: More than half of healthcare professionals (54.9%) showed high levels of stress. Most of the healthcare professionals had poor work-family balance (60.2%).

Knowledge, attitude, and practice of iodized salt use in Al-Riyadh and Al-Ozozab areas, Khartoum, Sudan.

Iodine deficiency and subsequent iodine deficiency disorders have been a longstanding problem in many areas of the world, including Sudan, and still remains as the leading cause of preventable brain damage. According to the Sudan Household Health Survey, in 2006, the consumption of iodized salt in Sudan was 11%, only to deteriorate later on in 2011 to 9.5%. This is a descriptive cross sectional study which assesses the knowledge, attitude, and practice regarding the use of iodized salt in two socioeconomically different residential areas, Al-Riyadh and Al-Ozozab, Khartoum city, Sudan. From total of 152 participants selected from Al-Riyadh and Al-Ozozab areas (50% from each), there were 87 (57 %) females. Participants from Al-Riyadh had a higher educational and income level than those from Al-Ozozab, and better knowledge regarding the importance of regular iodized salt consumption to treat iodine deficiency (61% and 54%, respectively). However, only 39% of the participants were actually buying iodized salt. There was a significant relationship between residency and buying of iodized salt among the participants from Al-Riyadh (49%) and Al-Ozozab (30%) areas (p-value = 0.02). There was also significant association between the educational level and buying iodized salt (p-value = 0.014), but not with the income (p-value = 0.23). The consumption of potential goitrogenic foods (pearl millet or peanut butter) was high among the participants (n = 142) from Al-Riyadh and Al-Ozozab, and constituted 76% and 83%, respectively. Compulsory national salt specification needs to be established in Sudan, together with monitoring the market availability of iodized salt.