Postmastectomy Immediate Implant-Based Breast Reconstruction with Scarless Latissimus Dorsi Flap-a Simple and Versatile Technique.

In low- and middle-income countries, breast reconstruction is not widely practiced due to a lack of specialized equipment, skilled personnel, and high costs. The scarless latissimus dorsi flap is a useful technique which can harvest a major portion of the latissimus dorsi muscle using the same mastectomy incision without requiring repositioning of the patient, to cover the lower pole of prosthesis for reconstruction. The aim of this study was to assess and evaluate the cosmetic results and complications of scarless LD flap used as a lower pole cover in post-mastectomy breast reconstruction with implants. This is a pilot study of 18 breast cancer patients who underwent implant-based scarless LD flap breast reconstructions during a period of 4 years from 2017 to 2021. A questionnaire based on relevant subscales of BREAST-Q scores was completed by all the patients and used for evaluation. A total of 18 patients who underwent 20 surgeries were evaluated for the study. The median age was 44.5 years. The mean operative time was observed to be 164.50 min. The mean length of hospital stay was 3.1 days. From the Breast Q subscales, the mean cosmetic score was 31 out of 36 (range 27-36) (higher score reflecting better cosmetic outcome), and the mean physical well-being score was 17.25 out of 54 (range 12-29) (lower score reflecting better outcome). Overall complications were observed to be 20% which included minimal flap necrosis in 2 patients which was managed conservatively, and seromas in 2 patients which needed ultrasound-guided aspirations twice. There were no major complications. The scarless LD flap provides an adequate lower pole muscle coverage for implants in breast reconstruction. It has less morbidity and good cosmetic outcomes. It is time and cost-effective, requires no patient repositioning, and uses standard breast instruments.

Impact of poor evidence management on DNA profiling in sexual assault and homicide: A case report.

Increasing numbers of female victims of violent sexual assaults are being murdered with the aim of concealing the identity of the perpetrator. Proper handling and analysis of evidence is very important in gaining a conviction in many criminal cases. After evidence is collected, due precautions must be taken to ensure that the integrity of the sample is maintained, and chances of contamination are minimised. This paper presents a case study where improper handling of biological evidence led to loss of evidentiary value, and the semen could not be located on the vaginal swabs and victim's garments due to improper preservation of samples. However, the DNA from the nail of a decomposed finger helped identify the victim, and the suspect was apprehended based on the clues given by her family.

Matricaria genus as a source of antimicrobial agents: From farm to pharmacy and food applications.

Matricaria is a widespread genus of flowering plants of the family Asteraceae that grow in temperate regions of Europe, Asia, America and Africa. Some of the species are also naturalized in Australia. Some species of this genus such as Chamomiles are recognized medicinal plants and cultivated in several countries for commercial purposes: to obtain its blue essence, as herbal tea, and for pharmaceutical or cosmeceutical uses. The phytochemical composition of Matricaria spp. includes volatile terpenoids (e.g., α-bisabolol, bisabolol oxide A and B, ß-trans-farnesene and chamazulene), sesquiterpene lactones such as matricin, and phenolic compounds (flavonoids, coumarins and phenolic acids). Their essential oil is obtained from the fresh or dried inflorescences by steam distillation, and additionally cohobation of the remaining water. The volatile composition of the essential oil, especially the content of the valuable components α-bisabolol and chamazulene, depends on the plant part, origin and quality of the source, genetic, and environmental factors. Moreover, other parameters, such as season of harvest and methods of extraction, can affect the extraction yield of the essential oils/extracts, their composition and, therefore, their bioactivity. Due to the importance of this genus and particularly M. recutita (M. chamomilla), this review focus on its cultivation, factor affecting essential oils' composition and their role in traditional medicine, as antibacterial agents and finally as food preservatives.

Ethnobotany of the genus Taraxacum-Phytochemicals and antimicrobial activity.

Plants belonging to the genus Taraxacum have been used in traditional healthcare to treat infectious diseases including food-borne infections. This review aims to summarize the available information on Taraxacum spp., focusing on plant cultivation, ethnomedicinal uses, bioactive phytochemicals, and antimicrobial properties. Phytochemicals present in Taraxacum spp. include sesquiterpene lactones, such as taraxacin, mongolicumin B, and taraxinic acid derivatives; triterpenoids, such as taraxasterol, taraxerol, and officinatrione; and phenolic derivatives, such as hydroxycinnamic acids (chlorogenic, chicoric, and caffeoyltartaric acids), coumarins (aesculin and cichoriin), lignans (mongolicumin A), and taraxacosides. Aqueous and organic extracts of different plant parts exhibit promising in vitro antimicrobial activity relevant for controlling fungi and Gram-positive and Gram-negative bacteria. Therefore, this genus represents a potential source of bioactive phytochemicals with broad-spectrum antimicrobial activity. However, so far, preclinical evidence for these activities has not been fully substantiated by clinical studies. Indeed, clinical evidence for the activity of Taraxacum bioactive compounds is still scant, at least for infectious diseases, and there is limited information on oral bioavailability, pharmacological activities, and safety of Taraxacum products in humans, though their traditional uses would suggest that these plants are safe.

Spatial and temporal patterns of precipitation and stream flow variations in Tigris-Euphrates river basin.

Tigris and Euphrates river basin (TERB) is one of the largest river basins in the Middle East, and the precipitation (in the form of snowfall) is a major source of streamflow. This study investigates the spatial and temporal variability of precipitation and streamflow in TERB to better understand the hydroclimatic variables and how they varied over time. The precipitation shows a decreasing trend with 1980s being wetter and 2000s being drier. A total of 55 and 40% reduction in high flows in Tigris and Euphrates rivers at T20 and E3 was seen in post-reservoir period. A lag time of 3 to 4 and 5 to 6 months was estimated between peak snowfall and runoff time periods. Decreasing precipitation and streamflow along with several planned dams could hamper the sustainability of several Mesopotamian marshlands that completely depend on the water from the Tigris and Euphrates rivers.

Reconstructing the historical water regime of the contributing basins to the Hawizeh marsh: Implications of water control structures.

The Hawizeh marsh, a unique wetland which is part of the Mesopotamian marshes, is recognized as a wetland of international importance. The marsh has been shrinking and there has been little research into its degradation. This study aims to reconstruct historical water regimes in the contributing basins (Tigris and Karkheh river Basins, TKRB) to investigate factors that have affected the wellbeing of the marsh. The Soil and Water Assessment Tool (SWAT) was used for this study. The model was calibrated and validated using nine river gauging stations. Results indicated that inflows to the marsh decreased by 65% and 80% in the '90s and 2000s, respectively, compared to the '80s. The reductions in streamflow were caused by decrease in precipitation and water abstraction. The annual precipitation decreased by 14% and 38% in the '90s and 2000s, respectively, compared to the '80s. Highest water abstraction was seen in Karkheh dam which caused a reduction of 45% in the annual streamflows. Average annual evaporative losses from Tharthar lake (2700km2) were very high (2260hm3 [cubic hectometer]). Although the Hawizeh marsh has been shrinking for the last three decades, recent satellite images (2013) have shown that the marsh has been reviving, mainly due to increased precipitation from 2011 to 2013. The revival of the marsh is promising; however, if the planned dams on TKRB are implemented, the future of the marsh remains uncertain. The sustainability of the Hawizeh marsh will require integrated water resources management among the riparian countries to rehabilitate and maintain this unique wetland.

Perioral age-related changes in smile dynamics along the vertical plane: a videographic cross-sectional study.

OBJECTIVE: To evaluate the changes in characteristics of perioral musculature at rest and when smiling, with respect to age and gender, measured along the vertical plane in a randomly selected sample of a North Indian population. MATERIALS AND METHODS: Perioral musculature of 195 subjects (divided into three age groups) was recorded using standardized videographic methods. Two frames of each subject-at rest and widest posed smile-were analyzed for a comprehensive list of parameters. Data was evaluated using SPSS version 16 software. Two-way analysis of variance and post hoc least significant difference tests were conducted. RESULTS: Significant observations were increased resting upper lip length for females; decreased upper lip thickness, maxillary incisor exposure, and lip elevation for males; and increased smiling upper lip length for both sexes. CONCLUSIONS: With age, the smile gets narrower vertically, especially for the male population. The pattern of change observed in the present study must be considered and incorporated during treatment planning to deliver healthier and long-lasting results to patients of all age groups.

Prevention of migraine in women throughout the life span.

Migraine is a common disorder in women. The 1-year prevalence of migraine is 18% in women compared with 6% in men. Migraine most commonly occurs during the reproductive years, affecting 27% of women 30 to 49 years of age. The predominance of this disorder and its social, functional, and economic consequences make migraine an important issue in women's health. The hormonal milieu has a substantial effect on migraine in women. An understanding of these hormonal influences in the various stages of life in females is essential to the management and prevention of migraines. This article reviews migraine prevention strategies with an emphasis on specific therapies for each stage of a woman's life.

Hormonal contraception update.

Unintended pregnancy continues to be a serious public health issue in the United States. Of the 3 million unplanned pregnancies per year, 60% occur in women using some form of contraception. Educating and helping women choose a contraceptive agent that best suits their needs will improve compliance and contraceptive efficacy. A multitude of new contraceptive agents are now available. We review new hormonal contraceptive options and discuss newer oral agents, extended-cycle contraception, and innovative delivery methods.

Health care maintenance in female adolescents.

The assessment and care of female adolescents by primary care physicians can be facilitated with increased knowledge about this stage of development, the health care risks faced by these patients, and the resources available to aid in their care. With a focus on preventive health maintenance, this concise review addresses these areas as well as how to build relationships with female adolescent patients, conduct age-appropriate interviews and tests, and maintain patient confidentiality.