jective: Cyber bullying is a combination of the word cyber and bullying where cyber basically means the Internet or on-line. In this case, cyber bullying will focus on getting in action with bullying by using the Internet or modern technologies such as on-line chats, online media and short messaging texts through social media. The current review aims to compile and summarize the results of relevant publications related to “cyber bullying." The review also includes discussing on relevant variables related to cyber bullying. Methods: Information from relevant publications addresses the demographics, prevalence, differences between cyber bullying and traditional bullying, bullying motivation, avenues to overcome it, preventions, coping mechanisms in relation to “cyber bullying” were retrieved and summarized. Results: The prevalence of cyber bullying ranges from 30% - 55% and the contributing risk factors include positive association with perpetration, non-supportive school environment, and Internet risky behaviors. Both males and females have been equal weigh on being perpetrators and victims. The older groups with more technology exposures are more prone to be exposed to cyber bullying. With respect to individual components of bullying, repetition is less evident in cyber bullying and power imbalance is not measured by physicality but in terms of popularity and technical knowledge of the perpetrator. Conclusion: Due to the limited efforts centralized on the intervention, future researchers should focus on testing the efficacy of possible interventional programs and the effects of different roles in the intervention in ord

Purpose::Iatrogenic coracoid and clavicle fracture is a known complication of drilling bone tunnels during anatomic coracoclavicular ligament reconstruction (ACCR). This study aims to measure the dimensions of coracoid process and clavicle in an Asian population to evaluate the suitability of drilling coracoid and clavicle tunnels for ACCR in Asians.Methods::Width measurements of 196 coracoids and 189 clavicles were obtained after reviewing all computed tomography (CT) scans of the shoulder performed over a 6 years period. Coracoid measurements were made on the CT slice which showed the maximum cross sectional width of the coracoid base. Medial to lateral measurements of the coracoid width were taken on an axial view, 4 mm above the identified junction of the coracoid base and glenoid base. Antero-posterior clavicle width was measured through a point directly above the midpoint of the coracoid and perpendicular to the long axis of the clavicle.Results::The overall mean coracoid width was 14.8 mm ± 2.54 mm (range 9.2-23.3 mm) and clavicle width was 17.1 mm ± 2.72 mm (range 11.1-25.3 mm).Conclusion::The Asian coracoid process is smaller than its Western equivalent. More research is required to validate this conclusion as no cadaveric studies with equivalent measurement techniques have been performed on Asians. Given the potentially narrower dimensions of the Asian coracoid process, extra precautions are required to minimize the risk of iatrogenic coracoid and clavicle fractures.

Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for rectovaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap. The surgical goals in this patient were complete excision of the recto-vaginal fistula and introduction of fresh, vascularized muscle to seal the fistula. A defunctioning colostomy was performed 1 month prior to the present procedure. The gracilis muscle and tendon were mobilized, pulled through the freshened recto-vaginal fistula, passed through the anus, and anchored externally. Excess muscle and tendon were trimmed 1 week after the procedure. Follow-up at 4 weeks demonstrated complete mucosal coverage over an intact gracilis muscle, and no leakage. At 8 weeks post-procedure, the patient resumed sexual intercourse with no dyspareunia. At 6 months post-procedure, her stoma was closed. The patient reported transient fecal staining of her vagina after stoma reversal, which resolved with conservative treatment. The fistula had not recurred at 20 months post-procedure. The gracilis pull-through flap is a reliable technique for a scarred vagina with an attenuated rectovaginal septum. It can function as a well-vascularized tissue plug to promote healing.
Anal Canal ; Cicatrix ; Coitus ; Colorectal Surgery ; Colostomy ; Dyspareunia ; Female ; Fistula ; Follow-Up Studies ; Humans ; Reconstructive Surgical Procedures ; Rectovaginal Fistula ; Recurrence ; Tendons ; Vagina