Minimizing Narcotic Use in Rhinoplasty: An Updated Narrative Review and Protocol.

Opioids are commonly used to reduce pain after surgery; however, there are severe side effects and complications associated with opioid use, with addiction being of particular concern. Recent practice has shifted to reduce opioid consumption in surgery, although a specific protocol for rhinoplasty is still in progress. This paper aims to expand on the protocol previously established by the senior author based on updated evidence and details.

Case Report: Treatment of Transplanted Renal Artery Anastomotic Pseudoaneurysm With Parallel Stent Grafting.

A 53 year old woman needed surgical management of an anastomotic pseudoaneurysm after renal transplant. Contrast enhanced computed tomography demonstrated a pseudoaneurysm arising off of the right external iliac artery. Considering the risk of potentially sacrificing her renal transplant, we elected to perform endovascular repair with parallel stent grafting.

Intralobar pulmonary sequestration: a rare cause of hemoptysis: a case report.

Overview And Significance: Pulmonary sequestration (PS) is a rare congenital anomaly characterized by aberrant formation of nonfunctional lung tissue with anomalous systemic blood supply. Despite its rarity, PS presents significant diagnostic and management challenges, often necessitating a multidisciplinary approach for optimal patient outcomes. This case report provides insights into the clinical presentation, diagnostic modalities, and management strategies for PS.

Case Report: Successful Treatment of Aberrant Left Subclavian Artery With a Right-Sided Aortic Arch.

Right sided aortic arches with concomitant aberrant left subclavian arteries are exceedingly rare anatomical variants. We present a case of a 45 year old male that presented with symptoms consistent with dysphagia and known right sided aortic arch with an aberrant left subclavian artery. Though previous reports of repair have indeed been reported, we confirm that a hybrid approach to these anatomic variants remain feasible and with symptom resolution for patients.

Imbrication of Anterior Digastric with Advancement of the Posterior Digastric and Its Implications in Neck Aesthetics.

To describe a novel technique to modify the proportional length of the anterior-to-posterior digastric muscles to improve neck aesthetics. To provide an objective measure to quantify neck rejuvenation and a novel technique to adjust the digastric ratio. We retrospectively compared 52 patients who had neck rejuvenation with or without digastric manipulation.

Snare assisted manual small-incision cataract surgery: Single solution for any grade of cataract.

Cataract surgery is constantly evolving with new techniques, machines, and procedures entering the lexicon. With the modernization, the cost of surgery is increasing with respect to the surgeon, patient, and the society. Early rehabilitation with modern minimal access techniques reduces the societal cost of intervention.

Sustainable management of municipal solid waste through waste-to-energy technologies.

Increasing municipal solid waste (MSW) generation and environmental concerns have sparked global interest in waste valorization through various waste-to-energy (WtE) to generate renewable energy sources and reduce dependency on fossil-derived fuels and chemicals. These technologies are vital for implementing the envisioned global "bioeconomy" through biorefineries. In light of that, a detailed overview of WtE technologies with their benefits and drawbacks is provided in this paper.

Organic solid waste: Biorefinery approach as a sustainable strategy in circular bioeconomy.

Waste generation is associated with numerous environmental consequences, making it a point of discussion in the environmental arena. Efforts have been made around the world to develop a systematic management approach coupled with a sustainable treatment technology to maximize resource utilization of organic solid waste. Biorefineries and bio-based products play a critical role in lowering total emissions and supporting energy systems.

Municipal solid waste management: Dynamics, risk assessment, ecological influence, advancements, constraints and perspectives.

Global energy consumption has been increasing in tandem with economic growth, putting pressure on the world's supply of renewable energy sources. Municipal Solid waste (MSW) has been reported contributing immensely to the improvement of a secure environment and renewable sources. Energy scarcity and conventional MSW disposal methods in developing countries lead towards many environmental and economic issues.

In-office Endonasal Minor Revision Rhinoplasty.

The revision rhinoplasty presents many unique challenges to the facial plastic surgeon. While many cases will require a full revision in the operating room, there are several isolated deformities which may be repaired in the office via an endonasal approach. This provides many benefits to the patient and surgeon including decreased cost, shorter recovery time, avoidance of general anesthesia, and less discomfort.

Detection of NDM-1 and VIM Genes in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Health-Care Center in Kathmandu, Nepal.

Background: Klebsiella pneumoniae is one of the leading causes of nosocomial infections. Carbapenems are used as the last resort for the treatment of multidrug resistant Gram-negative bacterial infections. In recent years, resistance to these lifesaving drugs has been increasingly reported due to the production of carbapenemase.

Prevalence of Colistin-resistant Gram-negative Isolates Carrying the mcr-1 Gene among Patients Visiting a Tertiary Care Center.

Introduction: Gram-negative isolates harboring mobilized colistin resistance (mcr-1) gene are a great threat to human health. They have been reported worldwide among various bacterial isolates. This work aimed to study the prevalence of colistin resistance among Gram-negative bacteria and the incidence of mcr-1 gene among these isolates.

Wastewater surveillance-based city zonation for effective COVID-19 pandemic preparedness powered by early warning: A perspectives of temporal variations in SARS-CoV-2-RNA in Ahmedabad, India.

Following the proven concept, capabilities, and limitations of detecting the RNA of Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) in wastewater, it is pertinent to understand the utility of wastewater surveillance data on various scale. In the present work, we put forward the first wastewater surveillance-based city zonation for effective COVID-19 pandemic preparedness. A three-month data of Surveillance of Wastewater for Early Epidemic Prediction (SWEEP) was generated for the world heritage city of Ahmedabad, Gujarat, India.

Quantitative Analysis of Tranexamic Acid Effects on Ecchymosis in Rhinoplasty.

Many methods have been described to reduce postoperative ecchymosis in rhinoplasty with tranexamic acid (TXA) remaining controversial. TXA remains a consideration for surgeons, however, may have serious side effects, including seizures, blood clots, and vision changes. A prospective study of primary rhinoplasty patients was performed from March 2019 to June 2019.

Processes and prospects on valorizing solid waste for the production of valuable products employing bio-routes: A systematic review.

Humanity is struggling against a major problem for a proper management of generated municipal solid waste. The collected waste causes natural issues like uncontrollable emission of greenhouse gases and others. Even though, escalation of waste results in minimizing the areas accessible for disposing the waste.

Frontier review on the propensity and repercussion of SARS-CoV-2 migration to aquatic environment.

Increased concern has recently emerged pertaining to the occurrence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in aquatic environment during the current coronavirus disease 2019 (COVID-19) pandemic. While infectious SARS-CoV-2 has yet to be identified in the aquatic environment, the virus potentially enters the wastewater stream from patient excretions and a precautionary approach dictates evaluating transmission pathways to ensure public health and safety. Although enveloped viruses have presumed low persistence in water and are generally susceptible to inactivation by environmental stressors, previously identified enveloped viruses persist in the aqueous environment from days to several weeks.

First proof of the capability of wastewater surveillance for COVID-19 in India through detection of genetic material of SARS-CoV-2.

We made the first ever successful effort in India to detect the genetic material of SARS-CoV-2 viruses to understand the capability and application of wastewater-based epidemiology (WBE) surveillance in India. Sampling was carried out on 8 and 27 May 2020 at the Old Pirana Waste Water Treatment Plant (WWTP) at Ahmedabad, Gujarat that receives effluent from Civil Hospital treating COVID-19 patients. All three, i.

Auricular acupuncture for adult tonsillectomy.

Objectives: Adult tonsillectomy causes significant postoperative pain that can last over 14 days, but narcotic regimens only provide a modest reduction in pain. Auricular acupuncture has been demonstrated to improve pain with minimal complications. This study compared acupuncture versus control for pain, opioid consumption, nausea, and return of diet and activity following tonsillectomy.

The Aging Face.

The aging face is a popular topic in modern medicine. To understand and treat unwanted signs of aging, it is imperative to understand the biological and physical causes and contributing factors to facial aging, preventative measures to avoid advanced facial aging, and current treatment options. Changes to the human face are progressive with time; however, there are many methods, both surgical and nonsurgical, to reduce the stigmata of aging and provide patients with the appearance they desire.

Combined carotid endarterectomy and transcatheter aortic valve replacement: Technique and outcomes.

Background: Stroke and transient ischemic attack after transcatheter aortic valve replacement results in significantly higher morbidity and mortality. Severe carotid artery disease may be a contributing factor to this increased risk. We report our technique and outcomes of combined carotid endarterectomy (CEA) with transcatheter aortic valve replacement (TAVR).

Golden roots to golden fruits of mental health in Gujarat.

Through the behavioral descriptions in age-old texts it is obvious that Mental Health problems exist since the existence of Homo Sapiens and humanity, with ever changing norms, contexts, definitions and hence their management. Gujarat state of India is one of the oldest land plateaus existing. It has been inhabited, ruled and governed by many different people, races, kings; and invaded through its longest sea-coast by Dutch, Portuguese, British.

Surgical Emphysema Following Canalplasty for Aural Exostoses.

Objective: To describe the presentation and management of surgical emphysema involving the temporomandibular joint and deep neck following exostoses removal.

Patient: A 60-year-old male surfer presented with hearing loss and recurrent infections in the right ear. An examination revealed obstructing bony exostoses in the right external auditory canal.

Facial trauma caused by electronic cigarette explosion.

Electronic cigarettes are increasingly popular as a supposed safer alternative to tobacco cigarettes or a smoking cessation tool. Research and debate have focused primarily on possible adverse effects caused by the inhaled aerosol produced by electronic cigarettes and on smoking cessation efficacy. Few reports in the medical literature describe injuries secondary to device malfunction.

The emerging role of deubiquitinating enzymes in genomic integrity, diseases, and therapeutics.

The addition of mono-ubiquitin or poly-ubiquitin chain to signaling proteins in response to DNA damage signal is thought to be a critical event that facilitates the recognition of DNA damage lesion site, the activation of checkpoint function, termination and checkpoint response and the recruitment of DNA repair proteins. Despite the ubiquitin modifiers, removal of ubiquitin from the functional proteins by the deubiquitinating enzymes (DUBs) plays an important role in orchestrating DNA damage response as well as DNA repair processes. Deregulated ubiquitination and deubiquitination could lead to genome instability that in turn causes tumorigenesis.