A numerical study was conducted to investigate the effect of confinement on wall jets in a rectangular water basin using a slot inlet. The inlet slot creates a wall jet on the bottom of the basin with a recirculation zone on top of it. The classical wall jet behaviour is observed only up to the centre of the recirculation zone, beyond that point the momentum flux is not conserved and the wall jet behaviour is lost. Empirical expressions are developed to estimate the velocity decay and the jet spreading rates, and the maximum wall shear stress. The two outlet types and their location did not affect the wall jet and the recirculation zones, if the outlet is placed at a distance greater than the normal extent of the recirculation zone.

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Background and objectives:Vaginoplasty is a procedure for the reconstruction of vaginal canal. Various surgical techniques have been described for vaginal reconstruction with variable success. The aim of this study was to assess the use of sigmoid colon in vaginal reconstruction of patients with disorders of sex development. Methods:Eleven patients were included in this study from January 2009 to December 2016. All patients underwent karyotyping, pelvi-abdominal ultrasonography, endocrine and psychiatric assessment. Sigmoid neo-vaginoplasty was the procedure chosen for all the cases. Surgical and functional outcomes were assessed post-operatively over a period of 6 month to 6 years. Results:The preoperative diagnosis included 9 cases of aplasia of the Mullerian ducts or Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), 1 androgen insensitivity syndrome (AIS) and 1 pseudohermaphrodite case. The mean age of the study population was 22.5 years (range 15-30 yrs). No intra-operative or early postoperative complications occurred. The mean vaginal length achieved was 13.0 cm (range 10.5 -15 cm). Long term follow-up showed introital stenosis in 2 cases (17%) which resolved well to vaginal dilatation. One patient had pelvic abscess and treated by surgery. Sexual satisfaction was achieved in 10 cases, as 1 case was unmarried. Conclusion:For patients with disorders of sex development of various etiologies, sigmoid vaginoplasty is the preferred technique for vaginal reconstruction. It is a safe technique and provides the patient with a cosmetic neovagina of adequate caliber with satisfactory functional outcome.

The aim of this study is to assess the outcome of Pedicled extended Lateral arm flaps (PELAF)

Background: Diabetic patients frequently suffer from chronic non-healing ulcer on the sole of foot as a result of combined peripheral neuropathy and arterial insufficiency. Many of them end up in amputation. The aim of this study was to see the outcome of diabetic patients presenting with ulcers that showed no signs of healing in sole of the foot for 3 months or more treated with combination of peripheral vasodilators and surgical reconstruction.Methods: A cross sectional study of 249 patients who presented to Plastic surgery department in BIRDEM fromJanuary 2013 toDecember2015 was done. The patients who had existing associated chronic medical illness like Chronic Kidney Disease (CKD) requiring dialysis, malignancy, Status Asthmaticus and foot ulcer withWagner grade 4 and 5 and patients receiving drugs that cause immunosuppression like chemotherapeutic agents, steroids, and methotrexates were excluded from the study.Results: All patients presented with non-healing ulcerations average size of which was 1.48 cm (range, 0.68 to 4 cm) of more than 3 months in various parts of sole of the foot complicated by peripheral neuropathy and/or arterial insufficiency. After the use of peripheral vasodilators, these patients underwent a variety of surgical reconstructions such as simple skin graft, local flaps, regional flaps and distant flaps. In follow up of 3 to 36 months, 194 patients (77.91%) achieved good results, 55(22.08%) patients’ required secondary procedure such as flap revision, debridement or Split thickness skin graft (STSG) due to post operative complications.Conclusion: We conclude that chronic non-healing ulcers in diabetic patients can be successfully treated by combined approach of surgical reconstruction and peripheral vasodilators.Birdem Med J 2018; 8(2): 108-113