Lessons from Self-Assessment of Post-Rhinoplasty Complaints; Analysis of 192 Candidates of Secondary Rhinoplasty.

Background: Rhinoplasty as the most common aesthetic surgical operations aims to correct deformities of the different structures of the nose with each case its own challenges. We aimed to highlight the importance of self-assessment for rhino surgeons. Methods: This retrospective descriptive study was done on 192 patients in Ordibehesht Hospital, Isfahan, Iran from April 2017 to Jun 2021. candidate for secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previously undergone rhinoplasty with the same or another surgeon. Patients with initial rhinoplasty by the first author were assigned to group 1 (n=102) and the patients who were operated by the other surgeons were in the group 2 (n=90). Data were collected using an author made checklist divided into three parts: overall demographic questions, questions about the patients' aesthetic and functional complaints and objective evaluation by the surgeon. Results: The most frequent reported complaints led to their current rhinoplasty were about the nasal tip with 161 cases (83.9%), upper nasal part with 98 cases (51%) and mid-nose (middle nose) with 81 cases (42.2%). Besides, respiratory problem was observed in 58 patients (30.2%). Surgeon's skill was significantly associated with occurrence of these two complaints; so that these two complaints were more common in group2 than group1 (P value <0.05). Conclusion: Such assessments resulted to improve the surgical outcomes due to finding the more prevalent problems in own patients than the other surgeons' patients and determining the reasons that leads to change the techniques with regard to the researches and consulting with the colleagues.

The use of medicinal plants in the prevention of COVID-19 using the Health Belief Model: A survey based on the Iranian population.

BACKGROUND: Because of the spread of coronavirus disease 2019 (COVID-19), the preventive measures have increased, such as focusing on the use of medicinal plants in most communities, including Iran. The purpose of this study was to identify the knowledge, attitude, and performance of individuals toward the use of medicinal plants and to identify the predictors of the use of medicinal plants in the prevention of COVID-19. MATERIALS AND METHODS: This descriptive-analytical study (February-April 2021) was performed on 3840 Iranian men and women aged 20-70 years selected as a multi-stage cluster study. At the first stage, all provinces were divided into five regions: North, South, East, West, and Center. In the second stage, a provincial center and a city were randomly selected from each region (North: Sari, Babol; South: Bushehr, Bandar Genaveh; East: Mashhad, Sabzevar; West: Hamedan, Toisarkan; Center: Yazd, Ardakan). Data were collected by a researcher-made scale based on the Health Belief Model (HBM). Data analysis was performed applying Pearson correlation coefficient, logistic regression, and linear regression. RESULTS: The results showed that people have relatively high knowledge and positive attitude toward the use of medicinal plants in prevention of COVID-19. The most important reason for positive attitude was the perceived benefits with the mean of 75.06%. Also, half of the people had poor performance. Correlation coefficient showed that the use of medicinal plants with perceived sensitivity (p = 0.000, r = 0.3), perceived benefits (p = 0.012, r = 0.126), perceived barriers (p = 0.000, r = 0.179), and perceived self-efficacy (p = 0.000, r = 0.305) had a significant correlation. The strongest correlation between perceived self-efficacy was observed with the use of herbs in prevention of COVID-19. The HBM constructs can predict 26% of the variance for the use of medicinal plants in the prevention of COVID-19, among which perceived self-efficacy (ß = 0.230) was the most powerful predictor. CONCLUSION: Based on the results, the predictive role of self-efficacy constructs for the use of medicinal plants in prevention of COVID-19 has been confirmed according to the HBM. Therefore, methods of increasing self-efficacy such as training programs and providing appropriate intervention models can be used not only as promoters of using medicinal plants in prevention of COVID-19 but also for improving people's performance in the proper use of medicinal plants.

Comparative Study of the Incidence of Port Site Infection in Disposable Ports and Reprocessed Disposable Ports in Laparoscopic Cholecystectomy.

INTRODUCTION: Port site infection (PSI) is a rare complication of laparoscopic surgery that can reduce the benefits of this minimally invasive surgery and increase postoperative complications. As a variety of disposable ports (single-use ports) and reprocessed ports are used in laparoscopic surgeries, this study was conducted to compare the incidence of PSI in disposable ports and reprocessed disposable ports in laparoscopic cholecystectomy (LC). MATERIALS AND METHODS: In this prospective cohort study, 473 patients were studied. Two hundred fifteen and two hundred fifty eight were in the disposable port group and reprocessed disposable port group, respectively. The demographic characteristics and incidence of superficial and deep infection were evaluated using the researcher-made checklist of infection assessment standards at intervals of 3 to 5 and 5 to 14 days following LC using call and physical examination on day 14. Data analysis was performed using descriptive statistics and statistical tests in SPSS software. RESULTS: The incidence of PSI, 3 to 5 and 5 to 14 days after surgery in the reprocessed disposable port group was significantly higher than that in the disposable ports group. In both groups, all PSI accrued in the epigastric port area (where the gallbladder was removed) ( P < 0.05). CONCLUSION: On the basis of the results, our study suggests using disposable ports instead, and in the case of using reprocessed disposable ports in LC, upgrading of disinfection and sterilization techniques is necessary.

Evaluation of Lateral Crura Divergence Angle of Iranian Candidates for Primary Rhinoplasty.

BACKGROUND: Cephalic malposition of the lower lateral cartilages is a common nasal anatomic variation. Knowing the range of lateral crura (LC) divergence angle in Iranian population can help Middle East plastic surgeons. This study aimed to determine LC divergence angle of candidates for primary rhinoplasty in Iranian population. METHODS: This cross-sectional study was conducted on 256 candidates for primary rhinoplasty from November 2017 through May 2018. Two sides of LC divergence angle were measured intraoperatively by a researcher-made device. RESULTS: Totally, 211 female and 45 male patients with the mean age of 29.9±6.51 years were recruited. The mean LC divergence angle was 35.86±4.74° (between 20-50°). The mean LC divergence angle was 35.11° and 36.02° in male and females, respectively. There was no significant difference between males and females. In addition, there was no significant correlation between LC divergence angle and age. LC divergence angle had normal distribution and about 68% of the LC divergence angle were within one standard deviation of the mean (i.e. 32 to 40 degree). CONCLUSION: In 16% of studied people, the divergence angle of the lateral crus of the lower lateral cartilage was lower than 32° and was considered as malposition.

Secondary Rhinoplasty: Aesthetic and Functional Concerns.

BACKGROUND: Aesthetic and functional concerns, especially after multiple revision rhinoplasties, continue to provide a challenge even for the experienced surgeon. OBJECTIVE: This study aimed to report the results in terms of "secondary rhinoplasty," performed by the senior author after previous rhinoplasty. METHODS: This descriptive prospective study was carried on 150 patients with surgical indication of secondary rhinoplasty and they were asked to fill out the questionnaire divided into 3 parts: overall epidemiological questions, questions of patients' aesthetic and functional complaints, and objective evaluation by the surgeon. The nasal problems in the upper and middle regions were divided into high or low, broad or narrow, crooked, irregularity of nasal bridge, or other alterations. The patients included in the study had surgical programming of secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previous rhinoplasty with the same or different surgeon. RESULTS: There were 136 females and 14 males with the mean age of 31.52 (6.36) years. The most common complaints were related to the nose tip with 123 cases included deviated tip and pinched (bilateral) with 25.3%, 30.7%, and 25.3%, middle nose with 78 cases included mid vault deviation, inverted V, and polly beak with 31.3%, 18%, and 9.3%, and upper nasal region with 69 cases included dorsum irregularity and wide dorsum with the rates of 22.7% and 16.7%, respectively; respiratory problem was reported in 13 cases. CONCLUSION: Unilateral or bilateral twisting at the nasal tip had the highest percentages, and the lowest incidence was in relation to the complaints of the upper nasal part.

HISTORIQUE: Les problèmes esthétiques et fonctionnels, surtout après de multiples rhinoplasties de révision, continuent de poser problème, même chez le chirurgien expérimenté. OBJECTIF: La présente étude vise à rendre compte des résultats des « rhinoplasties secondaires ¼ effectuées par l'auteur principal après une rhinoplastie antérieure. MÉTHODOLOGIE: Les chercheurs ont réalisé la présente étude prospective descriptive sur 150 patients ayant une indication chirurgicale de rhinoplastie secondaire à qui ils ont demandé de remplir un questionnaire divisé en trois parties : questions épidémiologiques globales, questions sur les doléances esthétiques et fonctionnelles et évaluation objective du chirurgien. Ils ont divisé les problèmes nasaux des zones supérieure et médiane : haut ou bas, large ou étroit, croche, irrégularité de la fosse nasale ou autres altérations. Les patients participants devaient subir une rhinoplastie secondaire planifiée pour des fins esthétiques obligatoires et fonctionnelles optionnelles, et avaient déjà subi une rhinoplastie exécutée par le même chirurgien ou par un autre. RÉSULTATS: Au total, 136 femmes et 14 hommes d'un âge moyen de 31.52 ± 6.36 ans ont participé à l'étude. Les doléances les plus courantes étaient liées à la pointe du nez, soit 123 cas comportant une déviation et un pincement (bilatéral) de la pointe dans 25,3 %, 30,7 % et 25,3 % des cas. La zone moyenne du nez était touchée dans 78 cas, dont une déviation de la voûte nasale moyenne, un V inversé et un bec-de-perroquet dans 31,3 %, 18 % et 9,3 % des cas. La région supérieure du nez était en cause dans 69 cas, y compris une irrégularité du dos du nez et un dos large dans 22,7 % et 16,7 % des cas. Enfin, un problème respiratoire a été déclaré dans 13 cas. CONCLUSION: Une torsion unilatérale ou bilatérale de la pointe nasale présentait le plus grand nombre de problèmes, et l'incidence la plus basse était liée aux doléances de la partie supérieure du nez.

Oblique Split Rib Graft Surgery in Primary and Secondary Septorhinoplasty.

BACKGROUND: Rib cartilage is an outstanding material in reconstructive septorhinoplasty, especially in revision surgery with a low rate of complications compared to other materials. In this study, the results of oblique splitting of rib grafts were evaluated in 25 patients operated for primary and secondary septorhinoplasty. METHODS: The prospective case series were undertaken on 25 patients of saddle or crooked nose that referred to the senior author's private office between January 2015 and November 2017. They had primary and secondary septorhinoplasty using autologous costal cartilage carved by the oblique split method (OSM). The postoperative follow-up period ranged from 3 to 36 months (Mean follow up of 19 months). RESULTS: The problems seen in patients were saddle-nose deformity in 16 cases, crooked-nose deformity in 3, crooked nose and saddle nose in 3 and implant infection, inverted V-pinch, destruction of septum in 3 more cases. After oblique split rib grafts surgery and 3-36 month follow-up (an average of 19 months), the operative outcomes were successful and no severe resorption, infection, warping or displacement were observed related to graft and patients were also satisfied, and there was no complication of the donor-site. The patients did not have any post-operative complications and no complain of nasal distortion during follow up period. CONCLUSION: OSM allowed obtaining large quantities of graft material without the risk of warping due to inclusion of both peripheral and central portions of the rib cartilage.

Impact of Health Information Prescription on Self-care of Women with Breast Cancer.

BACKGROUND: Women with breast cancer experience various challenges. Prescription of health information provides appropriate information at appropriate time to the appropriate person and plays a role in empowering self-care and improving health. The current research aims to evaluate the effect of health information prescription on self-care power of women with breast cancer. MATERIALS AND METHODS: This semi-experimental quantitative study was done using pretest and posttest method in one group of 61 women with breast cancer selected from the Women's Cancer Center of Khatamolanbia Hospital using purposive sampling method. Data were collected by an author-made self-care questionnaire and patients' self-care score was calculated at the first visit (before health information prescription) and the second visit (after health information prescription). Data were analyzed using the SPSS version 23 software and analysis of variance at a statistical significance level of P < 0.05. RESULTS: Total mean score of self-care in women with breast cancer was 40.97 and 115.3 before and after health information prescription, respectively. Increase of mean was observed in all subscales of self-care score from pretest to posttest so that change in posttest was higher in subscales of effective implementation of treatment and prevention from disabilities and personal functioning regulation (39.44), specialized knowledge on breast cancer (30.46), searching medical services and cooperation with treatment group (28.59), and awareness and attention to impacts and results of breast cancer (16.81). CONCLUSION: Health information prescription improves self-care power of women with breast cancer, and it is necessary to provide health information services in order to support women's self-care by the health authorities.