Attributes of a Good Microsurgeon-A Brief Counsel to the Up-and-Coming Prospects.

Microsurgery, which deservedly sits on top of the reconstruction ladder, has been a boon to plastic surgery. It is because of this marvelous tool that plastic surgeons the world over have been able to tackle many reconstructive dilemmas, which were once considered to be an improbability. Microsurgery-aided revolutions have rendered a new meaning to all forms of reconstruction-whether it is postoncological, posttraumatic, or postlymphedema reconstruction.

"Double Barrel" Lymphaticovenous Anastomosis: A Useful Addition to a Supermicrosurgeon's Repertoire.

Unlabelled: Microsurgical amelioration of lymphedema has gained much traction in recent years and is now an established modality of treatment for this condition. Despite the development of many newer techniques, lymphaticovenous anastomosis still remains the most frequently carried out microsurgical procedure for lymphedema. One of the most common hurdles faced by lymphatic surgeons while carrying out a lymphaticovenous anastomosis is a mismatch in sizes of the vein and the lymphatic vessels.

Chronic Fistulas of Thigh Presenting Unusually in an Operated Patient of Carcinoma Rectum. More Than What Meets the Eye!

Chronic skin lesions of the thigh (wounds, fistulas etc) are relatively uncommon, vis-à-vis, their notorious cousins over the distal limb. Even when present, the cause is usually obvious, mostly as trauma or a systemic affliction. We present an unusual case of chronic fistulas over the right thigh in a patient of carcinoma rectum for which anterior resection and an end colostomy was done 4 years earlier.

Experimental data on compressive strength and ultrasonic pulse velocity properties of sustainable mortar made with high content of GGBFS and CKD combinations.

The development in the construction sector and population growth requires an increase in the consumption of construction materials, mainly concrete. Cement is the binder in concrete, so increasing cement production will increase the energy consumed, as well as in the emission of carbon dioxide. This harmful effect of the environment led to the search for alternative materials for cement, as the waste or by-products of other industries is a promising solution in this case.

Hand amputations: epidemiology, management and resurfacing options for soft tissue coverage.

Objective: Agricultural hand injuries occur mainly among young adults, many affecting the dominant hand, thereby impeding patients' ability to work or cope with social obligations. This study was carried out with the aim of collecting data on the epidemiology and management of agricultural hand injuries in Indian subjects.

Method: The study was conducted in the Department of Plastic and Reconstructive Surgery, JN Medical College, AMU, Aligarh, India, from October 2009 to December 2013.

Actinomycetoma leg ulcers in north India.

Introduction: Actinomycetoma is a chronic subcutaneous infection caused by aerobic branching actinomycetes. Its clinical features are firm tumefaction of the affected site and the presence of abscesses, nodules, and sinuses that drain a seropurulent exudate containing filamenting granules. Cutaneous actinomycetoma has traditionally been deemed uncommon in the northern part of India, but recent studies have refuted this long-held notion.

Excision, skin grafting, corticosteroids, adjuvant radiotherapy, pressure therapy, and emancipation: the ESCAPE model for successful taming of giant auricular keloids.

The authors treated 24 giant auricular keloids (mean size, 11 cm) from January 2008 to July 2012 using a novel protocol consisting of complete excision, skin grafting, a 1-time intraoperative injection of triamcinolone, immediate radiotherapy, and sustained pressure therapy. At 1 year, the success rate was 87.5%.

Changes in sleep architecture after burn injury: 'Waking up' to this unaddressed aspect of postburn rehabilitation in the developing world.

Background: Changes in sleep architecture are common phenomena observed in post-traumatic patients; such altered sleeping patterns have negative implications on various phases of rehabilitation. Sleep is an essential process, without which one cannot function effectively and, hence, any aberrations in the quality of sleep in such patients need to be critically analyzed.

Objective: To probe the quality of sleep in postburn patients at one year compared with a group of adequately matched controls.

Superior gluteal artery perforator flap: a reliable method for sacral pressure ulcer reconstruction.

Objective: To study the feasibility and reliability of the superior gluteal artery perforator (SGAP) flap for the reconstruction of sacral pressure ulcers.

Method: A prospective study was conducted between 2009 and 2012 where a total of 15 patients with sacral pressure ulcers underwent reconstructive surgery with an islanded pedicled SGAP flap. Success of the flap reconstruction and primary healing were defined as a healed wound within 30 days of the procedure.

Management of post road traffic accident compound leg defects using fasciocutaneous flaps.

Objective: To highlight the role of fasciocutaneous flaps in the management of leg and foot defects sustained after trauma, in rural India.

Method: This was a prospective study conducted on patients with traumatic defects of the leg and foot, admitted between May 2001 and April 2007. Selection of flaps was done on the basis of defect size, site and condition of surrounding tissue.

Motorcycle muffler-induced "pillion burns" of distal leg: a persistent problem of increasing proportions in Indian settings.

Motorcycles have emerged as a viable mode of transport for millions in the third world. Mufflers (exhaust pipes in some countries) remain a potential "Achilles' tendon" or a designing flaw in the mass-produced, economical motorcycles of the developing world. Owing to the excessive temperature they attain while the hot exhaust gases pass through them and their proximity to the lower limbs while riding a motorcycle, they can lead to burns of varying nature in the lower leg.

Aspects of sexual life in patients after burn: the most neglected part of postburn rehabilitation in the developing world.

Burn patients are rendered with physical as well as mental scars; the latter usually are more protean in their manifestations. Rehabilitation after burn can be a grueling experience and the associated stress can blemish the patient's sexuality and intimacy. There is dearth of literature regarding the quality of sexual life after burn as well as sexual rehabilitation; it is fully known that a healthy sexual life is intricately related to a person's mental well being and a sexually compromised person can never be totally happy.

Routine use of urinary hCG test in adult burn females to detect "hidden" pregnancies: a review.

Burns occurring in conjunction with pregnancy can be a potentially life threatening scenario as it may lead to a rapid depletion of the already diminished maternal reserves. The management protocol in a pregnant burn female has to be tailored, taking into consideration the additional factor of fetal well being and the fetal susceptibility to various agents. For such alterations to be incorporated, it is imperative on part of the treating doctor to correctly ascertain the pregnant/non-pregnant status of an adult burn female.

Role of early radical debridement and skin cover in diabetic foot ulceration.

Objective: To assess the efficacy of radical debridement and skin grafting in treating diabetic foot ulceration, compared with conservative wound treatment.

Method: The medical notes for 30 patients who underwent skin grafting for diabetic foot ulceration (graft group) were retrospectively analysed and matched, according to age, gender, ankle brachial pressure index (ABPI) and comorbidities, with 30 other patients, who were treated conservatively (control group). Patients in the graft group underwent early, radical debridement to prepare the wound bed for grafting.

Comparative analysis of hemagglutinin of 2009 H1N1 influenza A pandemic indicates its evolution to 1918 H1N1 pandemic.

To gain insight into the possible origin of the hemagglutinin of 2009 outbreak, we performed its comparative analysis with hemagglutinin of influenza viral strains from 2005 to 2008 and the past pandemics of 1977, 1968, 1957 and 1918. This insilico analysis showed a maximum sequence similarity between 2009 and 1918 pandemics. Primary structure analysis, antigenic and glycosylation site analyses revealed that this protein has evolved from 1918 pandemic.

Comparison and agreement between venous and arterial gas analysis in cardiopulmonary patients in Kashmir valley of the Indian subcontinent.

Background: Arterial blood gas (ABG) analysis is routinely performed for sick patients but is fraught with complications, is painful, and is technically demanding.

Objective: To ascertain agreement between the arterial and peripheral venous measurement of pH, pCO(2), pO(2), and bicarbonate levels in sick patients with cardiopulmonary disorders in the valley of Kashmir in the Indian subcontinent, so as to use venous gas analysis instead of arterial for assessment of patients.

Setting: Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bedded tertiary care hospital in North India located at an altitude of 1584 m.