Malignant skin lesion in the face is one of the most common skin tumor, also its surgical excision represent the only cure and getting rid of tumor tissue but reconstruction of facial tumor represent a great challenges to the plastic and reconstructive surgeon, especially in the face. The face is the active part to interact with the society and may affect patient life style and sociality interaction. Also the face is divided into aesthetic unit and subunit, each of these units has its border, edges and appearances. So the surgeon should consider the cosmetic point during reconstruction, also complete excision of the malignant tumor with safety margin should be respected, I use many techniques to deal with various facial skin malignant lesion, considering the facial aesthetic units during reconstruction to get complete excision of malignant lesion and cosmetic appearance of the facial characters.
Magdy Ahmed Abd AlMoktader is a Professor of plastic & reconstructive surgery, Al Azhar University, Egypt. Active member of the Egyptian Society of Plastic and Reconstructive Surgeons. He has special interest in reconstructive surgery of head and neck, breast and extremities. He has been in private practice in Egypt since 2000. He participates as a speaker in many international conferences. He has Publications in international journals e.g Annals of plastic surgery, PRS, European journals of plastic surgery, journal of Burns and Egyptian journal of plastic surgery. His paper published in PRS gain the award of best African paper in 2016.
Intro: Wowing the patients (medically – non-medically) builds the organization’s reputation and overall brand including YOUR name. Most of your employees will not always understand this; therefore, it is IMPERATIVE that YOU or your management challenges employees and coaches them to a level beyond what they’re willing to do and beyond what others doing! Methods: It is imperative that employees have the proper attitudes as well as the capacity to act. It’s one thing to be willing to offer great patient relation, however willingness means nothing without action. Employees need to been couraged to take matters into their own hands and impress clients. Results: - If you can prevent 5% of your customers from leaving you can increase your bottom line profit by 25 – 95% - Harvard Business Review - 90 % of machine manufacturers said to defend against low cost competitors a greater percentage of their revenues must come from services; therefore, the way they service their clients is critical to their long-term success - Industry Week Conclusion: There are so many factors for a successful health practice, and the most important one is, IF you are a business owner or you care about the place you work right now, YOU should consider, how to deal with your client in away to make them come back to your practice and trust you as a doctor!
MAHRAN ASHOUR is a healthcare management consultant in Dubai, United Arab Emirates. Mahran has a rich and varied background in the operational and business aspects of healthcare operations and management. He has demonstrated success in the health care field as both a manager and consultant for over 11 years. In that time, he has worked in single and multi-specialty practices, aesthetic& cosmetics, primary care, surgical groups and academic medical centers. he has lead with a very hands-on approach to the daily operations of these organizations and has developed proven strategies in the management of start-up, business planning, insurance, billing, personnel, budgeting, marketing, contracting, accounts receivable, accounts payable and strategic planning. His initial introduction to health care began as an Patient Relation Ass. Managerat Emaar Health Care in 2008, where he ultimately managed a private outpatient clinic with more than 45 doctors and 127 employees in Dubai Mall Medical Center. he later moved on to work with practices ranging from solo practitioners to groups of 50+ physicians, and has used that experience to develop strategies that are key to the billing operations of S&S Healthcare Services. Ashour who is graduated from Cairo University in 2006, and in 2007, has obtained Healthcare Management Course at the University of Cairo and in 2008, Mr. Ashour has obtained his diploma in HealthCare Management Services and decided to relocate to Dubai to further his career. Before becoming a Director of Med Art Clinics (UAE - KSA), and before that Operations Manager of DUBAI POLYCLINICs, he worked for the largest providers of health care services in Dubai, such as EMAAR Healthcare, Methodist International USA and Neuro Spinal Hospital in DUBAI, besides being an independent consultant for cosmetic and primary healthcare providers in GCC & Meddle East. In 2014 in Berlin, Germany he received a quality award for the best director of medical institution (The Diamond Eye Award).During his work in healthcare management& consultancy, Ashour has developed new strategies to incorporate 5* hotel standards into healthcare provision ranging from reception and booking process, through the development of new methods of communication with customers, to the provision of quality medical services. Not forgetting, however, about the importance of right infrastructure with its exterior and interior design. Mahran has acquired great knowledge and deep understanding with regard to the healthcare management and related specialities, which includes among others insurance administration for corporate and individual clients, medical healthcare, provision of quality services to meet customer satisfaction, and development and maintenance of patient relations in line with the new standards.
The utilisation of carbon dioxide in medicine and balneotherapy has seen a long-year development. At the beginning the utilisation was purely empirical, but gradually a solid scientific basis was formed. Carboxytherapy – therapeutically applied carbon dioxide injections have been used in balneotherapy since 1932. In the last four years however, this treatment modality has become the centre of attention as a unique method applicable in dermatology, aesthetic dermatology and anti-aging medicine. Many renowned clinics of aesthetic medicine promote this unique method as minimum invasive and non-aggressive, comfortable for the patient and producing excellent effects without the risk of undesired side effects. Nowadays, this method is very popular and used in various offices around the globe. In aesthetic dermatology this method may be applied as a rejuvenation modality and is employed mainly due to its classic vasodilatation effect and its capacity to foster intradermal collagen restructuring. In classic dermatology it is used to treat patients with poor healing lower leg ulcers, in diabetic patients and in patients with poor healing surgical wounds. Carboxytherapy is efficient also in some psoriasis manifestations when combined with some other traditional approaches, in circumscript scleroderma, lichen verrucosus as well as hair loss. In aesthetic dermatology the effect is manifestquite soon (usually after two sessions already in the course of 7-14 days). It significantly and visibly improves the tonus of the skin as well as other aesthetic parameters (especially while treating skin laxity in abdomen area, inner arms and thighs, and double chin or saggy eyelids. Good effects also show following the application of carboxytherapy to treat stretch marks, cellulite, and scars (also older and more extensive scars after burns). Great effects are achieved in correcting the side effects of ill performed interventions such as liposuction, or in using carboxytherapy directly to shape problem body areas (thighs, hips and abdomen). The presentation demonstrated great therapeutic effects achieved in aesthetic dermatology and alopecia totalis, alopecia areata, keloids and other various diagnoses and combined methods with PRP.
Dr. H. Zelenkova has been active in the field of Dermatovenerology since 1973. Since 2000 she has been directing her own Private Clinic of Dermatovenereologywww.dost.sk. Professional orientation: aesthetic dermatology, acne and facial dermatoses, medicinal mycology (nail diseases), wound management, psoriasis, employment of Ichthyol and PRP in dermatology. Co-author of the dermatocosmetic formulae containing Ichthamol and glycyrrhizinic acid. More than 60 clinical studies testing pharmaceuticals and treatment materials were carried out at her clinic with results published in many international medical journals. She is a coordinator of many international multicentre trials. More than 500 expert lectures in the Slovak Republic as well as abroad, 360 scientific publications. Author of a publication on Ichthamol and Antioxidants on dermatological practice, In 2014 he wrote a monograph Carboxytherapy, which has so far published in English, Slovak, Polish and Russian. Associate editor of the journals Helios, Journal of Cosmetic Dermatology (Blackwell Publishing), Dermatologiaestetyczna, DERMA 3rd Millennium, DermatologiaKliniczna, ActadermatovenereologicaAlbanica, Cosmetic Dermatology (Germany), PsoInternational (Italy). Since 2000 founder and publisher of the scientific journal DERMA 3.tisicrocia (DERMA of the 3rd Millennium). Founder and President of the Slovak Society for Aesthetic and Cosmetic Dermatology (SSEDK), organizer and president of the traditional international DERMAPARTY congress. Since 2006 Vice-President European Society of Aesthetic and Cosmetic Dermatology, since 2007 President of the European Society of Aesthetic and Cosmetic Dermatology. Member of SSEDK, AAD, EADV, ISD, ESCAD, Slovak Dermatovenereology Society (SDS) and IACD.
I forward an observational case, I think the first case in the world, of a bedsore healed through exosomes from fat derived stem cells of homologous-allogenic origin, i.e. from a relative of the affected patient(!!). Having been dealing since many years with healing of trauma and burn wounds by adipose tissue transferred from patient himself (autologous fat transfer), I have had the occasion to treat a bedsore (skin ulcer due to compession) by a new method. It was a chance, and it worked. Through a Swiss stem cell factory which developed exosomes from ADSC (adipose derived stem cells), I had the opportunity to treat the bedsore of a woman with exosomes from ADSC of her husband, achieving a resolution in few days after some months of unsuccessful traditional plastic surgery care. It was a chanche based on well established references on the matter of homolous effectiveness of exosomes from MSC (mesenchimal stem cells). The aimed success of the procedure, always in condition of safety for the patient who was throughout informed on it, was achieved. Presently, it is only a single case report, but it should be of some use in order to overcome and go over the present condition of believe . I could seem to have faced a risky business, especially for the present absence of guidelines on homologous use of microvescicles from MSC, but in the present case report the homologous ADSC exosomes were applied topically (never injected) with no risk of general worsening of the whole body health of the patient, and the patient was checked every day. No special purpose is the aim of this observational case report , other than a suggestion for further studies on large number of patients after having well established preclinical evaluation. I think , in the present absence of specific guidelines on the use of microvescicles from homologous origin, that a peer to peer commission and a consensus conference would be set up, in order to avoid every attempt to forward a “miracle therapy” and every “pirate business” , but also to deliver to clinical use a safe and clever way to treat wounds. This observational case report was only a chance that was offered to the patient and to medical researchers, and because I happened to be in the right place at the right moment, I tried and I succeeded. A future deep interest from researchers should be devoted to the healing effect , even if made easy and supported by homing to affected and inflammed target tissue, in terms of a suggested (but not proven) induction by ADSC derived exosomes to any of the three germ layers derived stem cells, or in terms of a simple but important antinflammatory effect of these microvescicles on mesodermal layer only which then improves the whole bulk of affected tissue. In my point of view, only an improvement in antinflammatory potential of local tissue has happened, but this regenerative potential can be a new item in the neverending history of medical matter. It could work also on wounds from war fields and from car traumas and in burns and in the loss of tissue (especially for its clear antinflammatory potential)..and it means that fat tissue is farmost more important , and easy and less expensive to harvest, than bone marrow (..to say nothing on the importance of homologous tissue other than autologous tissue!!!). There had been a stop in the research trial becuse of items (maybe of economic business I don't know). The evidence of a business interest in this matter, should never make go lost the foremost importance of ethical issues connected with this homologous use of fat. Anyway, I have had the opportunity to observe this first case and I can witness it through the patient itself. As an observational case report it comes from bedside to bench but, I hope for researchers, then from bench to bedside in future.
Prof Erri Cippini got the Degree in Medicine and Surgery at Milan University (Italy) on 18.12.1981 with full marks and honour (110 cum Laude) and he won also the award for the best student with the highest marks during his fifth year of the sixth year academic duration Degree. Prof Cippini completed a full Residency program in Ob/Gyn at Milan University (Italy) and ten years experience in Oncology Gynecology at the University Hospital of Brescia (Italy) that progressively evolved towards Reconstructive Plastic Surgery after cancer and malformations, with special interest in Face Breast Abdomen (also Bariatric Surgery) and Female Genitalia that addressed him to a second full certified Residency in Plastic Reconstructive and Cosmetic Surgery at the same Milan University. In July 1990 he got the ECFMG certification (USA), then GMC (UK) certification also in the Specialist Register as Plastic Surgeon since February 2009, moreover FMH certification (Switzerland) both for Medical Degree and Plastic Surgery with licence to practice since 13 August 2009. Enrolled (one of fifteen Italian doctors) on 30 October 2012 in an international (European) study protocol on Azzalure (botulinum toxin A) from Galderma. Former Scientific director of a swiss settled Foundation on evolutive procedures for treatment of human ailments, with the first observational case of bedsore (pressure ulcer) resolved (under personal suggestion) with exosomes of mesenchimal stem cells from homologous-allogenic adipose tissue. Professor chief of Plastic Surgery Teaching Program (from yr 2006/2007 to yr 2010/2011 which is the complete duration of the program) at the University of Brescia, Faculty of Medicine and Surgery, for the Course Degree in Medical Biotechnology and former instructor of Anatomy at the Medicine Faculty of the same University.
Objective:To determine hyperlipidemia in patients with psoriasis. Study Design:Descriptive Cross-sectional study Setting:This study was conducted at department of dermatology Abbasi Shaheed Hospital Karachi in out patient department. Duration of study:The Data collection was done in 6 months after approval of synopsis. Subjects:Sample size of 95 adults subject(patients of Psoriasis)were required for above study on the basis of previous study shows that overall hyperlipidemia was determine among 57.1% patients of Psoriasis14 at 95% CI with 10% precision.UsingComputer program OpenEpi Version 2 for calculation the sample size. Methodology:After approval from ethical committee of hospital the study was conducted by researcher in OPD of department of dermatology Abbasi Shaheed Hospital. Patients meeting the inclusion criteria were included after taking written informed consent by researcher. A detailed family history regarding the ishemic heart disease, stroke and peripheral vascular disease was taken by researcher at their first visit. Patients were advised to come after 12 hours overnight fast and referred to laboratory and lipidlevels were estimated.The data was analyzed using SPSS version 15. Results:The study included a total of 95 patients. Of 95 patients 23(24.2%) are upto 30 years of age while 40(42.1%) were in 31-40years and 32(33.7%) patients belong to >40years(Table 1).All of them had psoriasis( 51 males and 44 females)(Table 1). Family history of ischemic heart disease was positive in 15 (15.8%) patients ,strokewas positive in 1(1.05%)patient and 79(83.2%) had no family history of ischemic heart disease or stroke(Table 1). The duration of disease ranged between 1 month to 25 years out of which 49(51.6%) had under 10years durations and 46(48.4%) had 10years or above(Table 1). Hyperlipidemia was present in 82(86.3%) patients out of which 43(84.3%) were males and 39(88.6%) were females(Table 1,fig 1). ). Plasma cholesterol and LDL levels were significantly increased in patients with psoriasis. There is also significant difference in lipid profile with duration of psoriasis. Conclusion: The psoriatic patients can also be considered as a group with increased atherosclerotic risk because of susceptibility in lipid profile,lipoprotein levels and increased oxidative stress. Dyslipidemia is also a factor contributing to an increased cornory heart disease in patients with psoriasis. A pathogenetic link also exists between these lipoprotein oxidative stress and psoriatic pathophysiology. This provides valuable information for appropriate medical intervention. Keywords: Psoriasis, serum lipids, lipoprotiens
Syed Shahmoona Faisal is a Consultant dermatologist at Southcity hospital, Patel Hospital Karachi.
Mesotherapy is a non surgical therapeutic option for treatment of hair loss. Mesotherapy is a Greek word, derived from meso- in between and therapeia- treat. It is a technique of involving injections of medications directly into the skin, was first coined by a French physician, Dr. Michel Pistor. In the era of internet Mesotherapy has attracted interest, inquisitiveness and publicity as a treatment modality for several cosmetic indications such as cellulite, aging skin and body contouring and Hair loss not only in professionals clinic but also in aesthetic , beauty and hair clinics which are also run by non professionals. Therefore a critical analysis is necessary to ascertain the role of this treatment in hair-loss. In a medline search there are very few clinical trials advocating the effectiveness of mesotherapy with active agents like minoxidil, dutasteride etc. In Google search there are reports of injections of cocktails of natural plant extracts, homoeopathic agents, vasodilators, finasteride and minoxidil . Evidences for their safety and efficacy in hair-loss have not been adequately and critically evaluated and documented in proper, peer-reviewed clinical trials. Currently there are no guidelines on the dosage and efficacy of the products. Well-designed controlled trials are required to see effectiveness of these products.
Deeptara Pathak Thapa, an Assistant Professor in Dermatology( M.B.B.S, M.D, F.A.M) has been trained in BPKIHS, Nepal one of the finest medical college in South East Asia. She has also done fellowship in Aesthetic medicine. She is the postgraduate coordinator in Dermatology. She has published articles on interesting topics in peer-reviewed journals and is a reviewer for many international journals including IJD. She has not only presented papers in national and international conferences but has also organized annual national conference as the scientific committee chairman. She is an active member of International societies like ICD, SARAD, DSI, IADVL and National Society, SODVELON. Her interest is in cosmetic and clinical dermatology.
Colored Facial Cosmetics are of importance to the dermatologist for their role in maintaining skin health, inducing dermatitis, and camouflaging surgical defects. They are intended to adorn eyes, lips & cheeks with color creating a fashionable appearance, highlighting certain desirable features, & camouflaging facial flaws. Colored Facial Cosmetics are: Facial foundations, Powders, Blushes, Eye shadows Facial cosmetics for camouflaging Facial defects requiring camouflaging are defects of pigmentation, contour, or a combination of both. Principle of Camouflaging of Facial Contour Abnormalities, Dark colors make protuberances appear to recede, Light colors make surface depressions appear more shallow. Creating an even-appearing surface on a scarred face. Pigmentation defects can be camouflaged either By Applying an opaque cosmetic that allows none of the abnormal underlying skin tones to be appreciated, Applying foundations of complementary colors to also yield brown tones
Dr.Iman Ahmad Abu Setta has taken her MD in dermatology in 2004. She is Consultant Dermatologist at Al haud Al Marsoud hospital in Egypt which is the biggest dermatology center in the Middle east.Dr Iman is also a Member of the Scientific Board of the Egyptian Fellowship of Dermatology.
Acne scarring is devastating and is psychologically distressing. Subscision and skin micro needling, both are safe and effective methods in the treatment. As micro needling targets superficial boxcar scar while subscision targets primarily rolling scars, use of combination of the two procedures give better results. Micro needling -Creates thousands of micro clefts in epidermis & papillary dermis leading to zone of superficial bleeding which initiates wound healing, release of growth factors promote collagen deposition , migration and proliferation of fibroblasts leads to elevation of scars. Subscision - a Safe, easy, well-tolerated and effective technique, an introduction of a hypodermic needle just under the dermis to release fibrous attachments leading to skin elevation, controlled trauma Initiates wound healing with formation of connective tissue augments the depressed site. Improvement in combination of use of subscision and micro needling in VAS by Patients at the end of the treatment 50% marked improvement (50-75%) , 44% moderate improvement (25-50%) and 6% minimal improvement (25%) and by Physician 50% marked improvement (50-75%) and 50% moderate improvement (25-50%) Post Inflammatory Hyper pigmentation was the most common side effects which faded by the end of follow up period. No other significant adverse effects were noted Conclusion Combining it with a single session of subscision can give better outcomes especially in - rolling and box type of scars.
Krishna debbarman has completed his MD at the age of 27 years from All India Institute of Medical Sciences, New Delhi. He is the faculty of Maulana Azad Medical College, Delhi University, Delhi, India. He has published more than 20 papers in reputed journals and has been reviewer of many reputed journals. He has presented papers in many national and international conferences.
The two most important factors that affect the outcome of burn are its depth & extent . The extent of tissue destruction depends on, temperature from the heat source-duration of contact & thickness of the involved skin. Any burn injury to the skin that extends into papillary dermis or deeper will form a permanent scars and complications which may be contractures , hypertrophic scars , malignant change in burn scars, keloids, hypopigmentations , hyperpigmentations, ulceration and post burn alopecia.Certain technical& surgical points can help to overcome some of these scars and complications. Many cases will be presented to demonstrate these tips and updating points in its management.
Dr. Khaled Nowair has completed MD,degree from Ain Shams University. Egypt. He is a Senior Consultant and Trainer of Plastic Surgery. He is the Head of Surgery Department. Al Mahalla Hospital. Egypt. He is an International Speaker in many International conferences. He is Egyption Fellowship Trainer and Senior lecturer since 2002. He is an Active member at ESPRS .(Egyption society of plastic and reconstructive surgeon). ESS. (Egyption society of surgeon).
Background: Dermatologists conduct different aesthetic and surgical procedures, with risk of infective complications. There is a need for sterilization equipment that is robust, affordable, reliable, safe, expedient, and simple to use in the chair-side setting. Objective: The aim of this trial was to determine if the glass bead sterilizer can eradicate microorganisms as effecitively as the autoclave. Methods: Forty-five comedone extractors were contaminated with 3 organisms: antibiotic-resistant Escherichia coli, Methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans. They were randomly assigned into 5 groups: Group A (contaminated extractors subjected to autoclave), Group B (contaminated extractors subjected to glass bead sterilization), Group C (positive control), Group D (negative controlA), and Group E (negative controlB). Presence of organisms was then assessed through appearance of turbidity and growth of organisms on agar plates. Results: No growth was observed for each type of organism: Antibiotic-resistant Escherichia coli, Methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans after autoclave sterilization and glass-bead sterilization. Conclusion: Findings of our study revealed that subjecting contaminated extractors to 20 minutes of glass bead sterilization is as effective as sterilization in an autoclave.
Dr. Marian T. Caligayahan obtained her medical degree from the University of Santo Tomas College of Medicine and Surgery, Philippines where she graduated Cum Laude with a Benemeritus in the oral examination. She is the current chief resident in the Department of Dermatology at St. Luke’s Medical Center, Philippines. After residency, she plans to pursue further training in the fields of Dermatopathology, Autoimmune bullous diseases and Connective tissue diseases.