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Anatomy of The Nasal Cavity and Sinuses

Posterior dislocations with associated fractures, also known as complex posterior dislocations, often require open reduction and fixation (ORIF). These dislocations are often associated with significant ligamentous injury. In some cases, complex posterior elbow dislocations may be managed with closed reduction. Posterior elbow dislocations that are neglected, as is not uncommon in developing countries, can often be effectively treated with open reduction. [9] Delayed vascular compromise is an important complication after reduction. All patients should be observed for a period of approximately 2-3 hours after reduction. If no evidence of vascular compromise arises, patients can be sent home with appropriate follow-up and instructions to watch for further problems.

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http://www.paruresistreatment.norisk101.com Having trouble urinating in the presence of others? Is a friend or family member struggling with this problem? The following article offers some insight into this social anxiety disorder.
What is Shy Bladder Syndrome?
shy or bashful bladder syndrome, is properly titled Paruresis.It is a phobia that involves fear and avoidance of using public toilets. It should be mentioned that this form of urinary retention is not the result of a physical blockage in the body. People who suffer from paruresis have trouble urinating in the presence of others or put another way paruresis is the fear of not being able to urinate unless one is in absolute privacy.The symptoms can vary in severity . This social anxiety disorder can affect a person's quality of life in many ways. Paruretics are confronted with problems at work with a prime example being when they have to submit a urine sample for drug testing, traveling on long journeys via airplane or train to every day social situations that the rest of us take for granted.
What causes paruresis?
The cause of paruresis is hotly debated and not easily determined in some cases. It could start as a toddler in preschool, in adolescence, or even in adulthood. While not all paruretics can point to an event in their life that could have lit the fuse to their shy bladder syndrome, some look to a traumatic incident in their past including embarrassment by a parent, teasing by schoolmates or freinds and siblings, harassment in public bathrooms or even sexual abuse as the catalyst.
How common is Shy Bladder?
While definitive numbers are hard to find with regard to how many people suffer from shy bladder surveys performed over the last few decades show that the numbers could range from less than one percent to more than 25 percent of Americans. There was a study done in 1994 called the National Comorbidity Surveywhich showed that 6.6 percent (17 million people) of the populationare fearful of using the toilet away from home, although it is uncertain how many of these fears were related to the difficulties initiating urinating in public bathrooms.
Paruresis symptoms?
A common scenario for how shy bladder syndrome evolves in a person's life is as follows: After an initial unpleasant experience, the person anticipates difficulty urinating whenever entering a bathroom. After trying to make themselves overcome this fear and failing, the associated anxiety with performance reduces the individual's chances even further of the possibility of urinating in a public restroom. The sufferer then adjusts to the condition by urinating as much as possible while at home, restricting how much they drink and avoiding social events that will keep them away from home for too long.

How is Shy Bladder Syndrome treated?
It is recommended that a sufferer of paruresis should first visit a urologist to make sure there is nothing physically wrong with them.
The urologist will:
A) make sure there are no underlying physical problems.
B)Let the patient know they are not alone and that any other people suffer with the same problem
C) Offer guidance as to approaches for coping with the condition such as scheduling urination, and, for men making use of an enclosed cubicle as opposed to the urinal.
4) Discuss the possibility of self-catheterization if the patient feels that would work for them. It is a way to offer an instant way to improve their quality of life through being able to be more social.
5) Referring them out to a specialist dealing with anxiety disorders for cognitive and graduated exposure therapy.

There is new hope for sufferers of shy bladder syndrome with the "Paruresis Treatment System" which is helping people lead different and better lives.
To learn more visit:-
https://www.youtube.com/watch?v=j6TpU_0-ufw
~N

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This is my rhinoplasty before and after video

Watch my experience from initial consult to final result as I have an ethnic rhinoplasty procedure performed by Dr. Paul S. Nassif of Spalding Drive Cosmetic Surgery & Dermatology located in Beverly Hills.

The results are incredible! It's like a dream come true. I am so happy that I chose Dr. Nassif as my surgeon. He is truly a gifted and wonderful surgeon.

There where many procedures performed to get the incredible results I received including:
Deep Temporalis Fascia Harvesting
Septoplasty
Turbinoplasty
Open Rhinoplasty
Nasal Smas Excicion
Vestibular Tissue Release
Tip Cartilage Contouring / Cephalic Trim
Columella Strut Placement
Shield Graft
Ear (conchal) Cartilage Harvest
Rim Graft
Osteotomies
Narrowing of Nasal Dorsum
Build up of Radix & Dorsum (cartilage and fascia grafts)
Alar Base Reduction

Rhinoplasty in Los Angeles also specializes in ethnic rhinoplasty for African American, Hispanic and Asian patients. As part of his information campaign on cosmetic surgery in Beverly Hills, those who are interested in rhinoplasty and plastic surgery can get loads of up-to-date information straight from Dr. Nassif through his websites Media Page. This web page contains articles written by Dr. Nassif that have been published in famous plastic surgery journals and books.

The Media Page also contains actual rhinoplasty and revision rhinoplasty surgery captured on video. These videos were aired in Discovery Channel, ET, and other shows. Patients who want to know more about Dr. Paul Nassif can check out his curriculum vitae. Whether you decide to attempt this procedure or not, rhinoplastyspecialist.com can give you an accurate and detailed perspective.

AFRICAN AMERICAN NASAL ANATOMY:
1. Skin: Thick, Abundant Fibrofatty tissue
2. Radix: Deep, Inferiorly-Set & Low
3. Nasal Bridge & Dorsum: Short Nasal Bones, Wide & Flat
4. Tip: Bulbous, Thick-Skinned, Under-Projected, Derotated (Ptotic), Abundant Nasal Soft Tissue, Broad Domes, Minimal Definition
5. Base: Wide, Thick, Horizontal & Flaring Nostrils
6. Nasolabial Junction: Retracted, Under-Developed Nasal Spine
7. Maxilla: Usually Retrusive & Hypoplastic

HISPANIC NASAL ANATOMY:
1. Skin: Thick, Abundant Sebaceous Glands
2. Radix: Low to Normal
3. Nasal Bridge: Wide
4. Dorsum: Convex (Nasal Hump)
5. Tip: Bulbous, Thick-Skinned, Under-Projected, Occasionally Derotated to Normal, Abundant Nasal Soft Tissue, Broad Wide Domes, Minimal Definition
6. Columella: Short to Normal
7. Base: Wide, Thick, Horizontal & Flaring Nostrils
8. Maxilla: Within Normal Limits

ASIAN NASAL ANATOMY:
1. Skin: Heavy, Thick & Sebaceous
2. Radix: Deep & Flat
3. Nasal Bridge & Dorsum: Low, Wide & Flat
4. Tip: Bulbous, Thick-Skinned, Under-Projected, Ptotic, Abundant Fibrofatty Tissue, Broad Domes, Minimal Definition
5. Columella: Short, Minimal Show (Retracted)
6. Base: Wide, Thick, Oblique & Flaring Nostrils
7. Maxilla: Usually Retrusive

DESIRED RHINOPLASTY GOALS:
1. Bridge: Moderately Thinner
2. Dorsum: Higher (Augmented)
3. Tip: Refined, Increased Projection, Increased Rotation
4. Base: Vertical-Oblique Nostrils & Triangular Nasal Base
5. Columella: Increased Columellar Show & Length
6. Maxilla: Less Retrusive
7. Skin-Soft Tissue Envelope: Moderate Thickness that Provides Good Tip Definition African American Rhinoplasty
~NWLN

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Blind loop syndrome (BLS), commonly referred to in the literature as small intestinal bacterial overgrowth (SIBO) or bacterial overgrowth syndrome (BOS), is a state that occurs when the normal bacterial flora of the small intestine proliferates to numbers that cause significant derangement to the normal physiological ...

Haemorrhoids is one of the most common problems seen in surgical OPD. Open haemorrhoidectomy has remained the gold standard for a long time with a high post-operative morbidity. The quest for a better understanding of the pathology of haemorrhoids resulted in the evolvement of stapler haemorrhoidopexy. Our aim is to study the efficacy of stapler haemorrhoidopexy with regards to role of immediate post-operative morbidity. A prospective study of 50 patients (n = 50) with the second- and third-degree symptomatic haemorrhoids was done. The mean age of the patients was 44.1 years. Fourteen patients had co-morbid conditions. The average duration of the operation was 29 min. Patients with the second-degree haemorrhoids had higher rate of complication. The complication rate was 32%. Three patients had urinary retention. Two patients had minor bleeding, and one patient experienced transient discharge. The mean analgesic requirement was 2.4 tramadol, 50 mg injections. Ten patients had significant post-operative pain. Average length of hospital stay was 2.7 days. There were no symptomatic recurrences till date.

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