The closure of any circular or asymmetric wound can result in puckering or an excess of tissue known as a 'dog ear'. Understanding the mechanism of dog ear formation is a fundamental requirement necessary to facilitate an appropriate treatment. Many solutions have been reported in the literature, but in all cases, the correction entails the extension of the scar and the sacrifice of the dermal plexus. Here, we propose a novel technique of dog ear correction by using a three-bite suture that sequentially pierces the deep fascial plane and each dog ear's margin, thus allowing for flattening the dog ear by anchoring the over-projecting tissue to the deep plane. The three-bite technique proved to be a fast, easy, and versatile method of immediate dog ear correction without extending the scar, while maintaining a full and complete local skin blood supply.
Animals ; Cicatrix ; Dogs* ; Ear* ; Reconstructive Surgical Procedures ; Skin ; Surgery, Plastic ; Sutures ; Wounds and Injuries

Objective: To investigate the susceptibility to some conventional and non-conventional insecticides in laboratory and field larval populations of the West Nile vector Culex pipiens L. (Cx. pipiens), the dominant species in Jeddah Province, Saudi Arabia.
Methods: The tested conventional insecticides were Actikil and Pesgard, while the non-conventional ones were Bacilod, Dudim and Baycidal. Probit analysis and photo-microscopical observations were carried out to shed light on acute toxicity in laboratory and field Cx. pipiens strains.
Results: Cx. pipiens were more susceptible to Pesgard (LC50: 0.045 and 0.032 mg/L) than Actikil (0.052 and 0.038 mg/L) and Bacilod (0.129 and 0.104 mg/L), for the field and laboratory strains, respectively. Results showed that treatments with the chitin syn-thesis inhibitor Dudim and Baycidal evoked morphological effects similar to those induced by other insect growth regulators. According to IC50 values obtained (concen-tration which to inhibit the emergence of 50%of mosquito adults), the compound Dudim (0.000 3 and 0.000 1 mg/L) was more effective against Cx. pipiens L. mosquitoes than Baycidal (0.000 4 and 0.000 3 mg/L) for both the field and laboratory strains, respectively.
Conclusions: Our results provide baseline data to enhance control programs and orient public health decisions on the selection of pesticides against mosquito vectors in Saudi Arabia.

BACKGROUND: Nipple-areolar complex (NAC) reconstruction is the final stage of breast reconstruction. Ideal reconstruction of the NAC requires symmetry in position, size, shape, texture, pigmentation, and permanent projection, and although many technical descriptions of NAC reconstruction exist in the medical literature, there is no gold standard technique. The technique devised by the authors is very versatile, with excellent results, and it enables 1-step reconstruction with optimal results in terms of shape and nipple projection. METHODS: Our technique consists of a combination of modified local flaps and a full-thickness skin graft. Patients were observed for 18 months to estimate the amount of retraction. This procedure was performed in 40 patients, four of them bilaterally. The duration of the follow-up was 30 months. Complications occurred in 10% of patients, and included infections (5%), ischemia (2.5%), and hematoma (2.5%). RESULTS: No cases of total nipple necrosis were reported. The NAC shape remained optimal in all cases, with a very small reduction of the vertical and horizontal diameters of the areola, which maintained its designed round shape well, and negligible retraction in the diameter and projection of the nipple. CONCLUSIONS: The oval technique represents a major step forward, involving a combination of existing techniques, such as the C-V flap and the cutaneous graft, to achieve excellent results regarding areola shape and nipple projection, significantly reducing the cases of nipple ischemia. These results were substantially obtained through subcutaneous equatorial sutures, skin grafting, and flattening of the apexes of the flap.
Breast ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Ischemia ; Mammaplasty ; Necrosis ; Nipples ; Pigmentation ; Skin ; Skin Transplantation ; Sutures ; Transplants

The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do not respond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergic transmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder and one with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125 mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergic mechanisms may be involved in counteracting PMDD symptoms.
Acetazolamide* ; Anxiety Disorders ; Carbonic Anhydrases ; Comorbidity ; Female ; Follow-Up Studies ; Humans ; Mood Disorders

Objective: To investigate the susceptibility to some conventional and non-conventional insecticides in laboratory and field larval populations of the West Nile vector Culex pipiens L. (Cx. pipiens), the dominant species in Jeddah Province, Saudi Arabia. Methods: The tested conventional insecticides were Actikil and Pesgard, while the non-conventional ones were Bacilod, Dudim and Baycidal. Probit analysis and photomicroscopical observations were carried out to shed light on acute toxicity in laboratory and field Cx. pipiens strains. Results: Cx. pipiens were more susceptible to Pesgard (LC

Objective: To evaluate the ovicidal, larvicidal and adulticidal potential of neem cake fractions of different polarity against the rural malaria vector Anopheles culicifacies (An. culicifacies). Methods: Neem cake fractions' total methanol extract (NTMeOH), total ethyl acetate extract (NTAcOEt), ethyl acetate fraction after repartition with NTMeOH (NRAcOEt), butanol fraction after repartition with NTMeOH (NRBuOH), and aqueous fraction after repartition of NTMeOH (NRH