This document provides an introduction to an audio course on improving one's American English accent. It discusses the content covered in Session One, including four common vowels, syllables, stress patterns, and stop and continuant consonants. It also defines linguistic terminology and provides exercises for practicing pronunciation of vowels, syllables, and stress.
This document discusses various techniques for reconstructing the forehead after trauma or tumor removal. It outlines the goals of forehead reconstruction as providing stable, non-hair bearing tissue of similar color while maintaining eyebrow position and shape. Reconstruction options include direct closure, closure by secondary intention, skin grafting, local flaps, distant flaps, tissue expansion, and free flaps. Specific techniques described include H-flaps, Worthen flaps, A-T flaps, transposition flaps, scalp expansile flaps, trapezius myocutaneous flaps, tissue expansion, and microvascular free flaps.
This document summarizes the experience with hypospadias repair at a single medical center in Pakistan between 2007-2011. It found that two-stage Bracka repair was the most common procedure (76.2% of cases) due to a relative lack of expertise in single-stage repairs. Post-operative complications included fistula formation (26.6%), edema (28.3%), and infection (4.2%). Fistula rates were higher for residents compared to specialists (33.1% vs 23.3%) and for two-stage versus single-stage repairs (66.9% vs 44.1%). The document recommends increasing expertise in single-stage repairs, revising guidelines to narrow the criteria for
This document discusses typhoid fever and its surgical complications. It provides background on the disease, including its history, distribution, risk factors, presentation and various complications. Intestinal perforation is a major complication that can require surgery. Other surgical complications mentioned include intestinal hemorrhage, typhoid cholecystitis, and chronic gallbladder carriage. The document emphasizes the importance of prompt treatment to improve prognosis from complications.
This document discusses wound classification and management. It defines acute and chronic wounds and describes simple, complex, and problem wounds. For problem wounds, it identifies key causative factors like infection, ischemia, and age. It recommends thorough debridement and discusses various adjunct treatments like negative pressure wound therapy, hyperbaric oxygen therapy, and different types of dressings. It provides guidance on managing specific wound types like pressure sores, diabetic wounds, and venous stasis ulcers.
Outcomes of primary unilateral cheiloplastyin same-day surgical settingsMansoor Khan
?
This study evaluated outcomes of primary unilateral cleft lip repair performed as single-day surgery in Pakistan. Of 23 patients, most clefts were mild (44.9%) or severe (40.2%). Fisher's technique was most commonly used. Postoperative outcomes were good in 89.8% of cases. Nasal symmetry outcomes improved over the study period. Single-day surgery reduced hospital costs by 19% without increasing complication rates compared to overnight admission. The study demonstrated primary unilateral cleft lip repair can be performed safely and cost-effectively as single-day surgery.
Trends in the management of LymphedemaMansoor Khan
?
The document summarizes trends in lymphedema management. It discusses the basics of the lymphatic system, embryology, anatomy, pathophysiology, etiology of primary and secondary lymphedema, presentation, investigations, and treatment including conservative therapies like manual lymphatic drainage and compression garments as well as surgical procedures. Worldwide, it is estimated that 140-250 million people have lymphedema with filariasis being the most common cause.
A 30-year old female presented to the emergency room with a laceration and bleeding in her right hand after falling on glass. She was right hand dominant and worked in telemarketing. Physical examination would focus on the extent of the laceration and potential injury to flexor tendons and nerves. Flexor tendon injuries can lead to loss of finger flexion and grip strength if not repaired properly. The goals of reconstruction are to anatomically repair the tendons with limited motion restrictions and adhere to post-operative rehabilitation to regain function and prevent complications like adhesions.
Peripheral Arterial Occlusive Disease (PAOD) is atherosclerosis of the arteries in the extremities, causing reduced blood flow and ischemia. It affects up to 10% of people over 65 in Western countries. Left untreated, mortality rates increase to 30% at 5 years, 50% at 10 years, and 70% at 15 years. Risk factors include diabetes, hypertension, smoking, and family history. Smoking is the greatest risk factor and cessation is paramount for treatment. Claudication, or muscle pain with exercise, is a common symptom as is rest pain, ulcers, and gangrene. Physical exams look for reduced pulses and blood flow to assess severity. Treatment focuses on risk factor modification, exercise,
The document discusses traumatic brain injury (TBI), providing details on:
1) TBI can be caused by closed or open head injuries from motor vehicle accidents, falls, assaults, and other external impacts, and is a major cause of death and disability.
2) Common types of TBI include concussions, contusions, hematomas, hemorrhages, and diffuse axonal injury.
3) Symptoms can range from mild headaches to coma, and treatment depends on injury severity and may involve monitoring, CT scans, surgery, or life support measures to control swelling.
This document summarizes the experience with hypospadias repair at a single medical center in Pakistan between 2007-2011. It found that two-stage Bracka repair was the most common procedure (76.2% of cases) due to a relative lack of expertise in single-stage repairs. Post-operative complications included fistula formation (26.6%), edema (28.3%), and infection (4.2%). Fistula rates were higher for residents compared to specialists (33.1% vs 23.3%) and for two-stage versus single-stage repairs (66.9% vs 44.1%). The document recommends increasing expertise in single-stage repairs, revising guidelines to narrow the criteria for
This document discusses typhoid fever and its surgical complications. It provides background on the disease, including its history, distribution, risk factors, presentation and various complications. Intestinal perforation is a major complication that can require surgery. Other surgical complications mentioned include intestinal hemorrhage, typhoid cholecystitis, and chronic gallbladder carriage. The document emphasizes the importance of prompt treatment to improve prognosis from complications.
This document discusses wound classification and management. It defines acute and chronic wounds and describes simple, complex, and problem wounds. For problem wounds, it identifies key causative factors like infection, ischemia, and age. It recommends thorough debridement and discusses various adjunct treatments like negative pressure wound therapy, hyperbaric oxygen therapy, and different types of dressings. It provides guidance on managing specific wound types like pressure sores, diabetic wounds, and venous stasis ulcers.
Outcomes of primary unilateral cheiloplastyin same-day surgical settingsMansoor Khan
?
This study evaluated outcomes of primary unilateral cleft lip repair performed as single-day surgery in Pakistan. Of 23 patients, most clefts were mild (44.9%) or severe (40.2%). Fisher's technique was most commonly used. Postoperative outcomes were good in 89.8% of cases. Nasal symmetry outcomes improved over the study period. Single-day surgery reduced hospital costs by 19% without increasing complication rates compared to overnight admission. The study demonstrated primary unilateral cleft lip repair can be performed safely and cost-effectively as single-day surgery.
Trends in the management of LymphedemaMansoor Khan
?
The document summarizes trends in lymphedema management. It discusses the basics of the lymphatic system, embryology, anatomy, pathophysiology, etiology of primary and secondary lymphedema, presentation, investigations, and treatment including conservative therapies like manual lymphatic drainage and compression garments as well as surgical procedures. Worldwide, it is estimated that 140-250 million people have lymphedema with filariasis being the most common cause.
A 30-year old female presented to the emergency room with a laceration and bleeding in her right hand after falling on glass. She was right hand dominant and worked in telemarketing. Physical examination would focus on the extent of the laceration and potential injury to flexor tendons and nerves. Flexor tendon injuries can lead to loss of finger flexion and grip strength if not repaired properly. The goals of reconstruction are to anatomically repair the tendons with limited motion restrictions and adhere to post-operative rehabilitation to regain function and prevent complications like adhesions.
Peripheral Arterial Occlusive Disease (PAOD) is atherosclerosis of the arteries in the extremities, causing reduced blood flow and ischemia. It affects up to 10% of people over 65 in Western countries. Left untreated, mortality rates increase to 30% at 5 years, 50% at 10 years, and 70% at 15 years. Risk factors include diabetes, hypertension, smoking, and family history. Smoking is the greatest risk factor and cessation is paramount for treatment. Claudication, or muscle pain with exercise, is a common symptom as is rest pain, ulcers, and gangrene. Physical exams look for reduced pulses and blood flow to assess severity. Treatment focuses on risk factor modification, exercise,
The document discusses traumatic brain injury (TBI), providing details on:
1) TBI can be caused by closed or open head injuries from motor vehicle accidents, falls, assaults, and other external impacts, and is a major cause of death and disability.
2) Common types of TBI include concussions, contusions, hematomas, hemorrhages, and diffuse axonal injury.
3) Symptoms can range from mild headaches to coma, and treatment depends on injury severity and may involve monitoring, CT scans, surgery, or life support measures to control swelling.