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Most recent 19 results returned for keyword: necrotizing fasciitis (Search this on MAP)

https://plus.google.com/103857338049331429468 Abdie Seid : Diabetic female patient of 54 years old... BMI 40 kg/mt2 Necrotizing Fasciitis (flesh-eating bacteria...
Diabetic female patient of 54 years old... BMI 40 kg/mt2

Necrotizing Fasciitis (flesh-eating bacteria)...

Lower abdominal wall affected... in the image is shown abdominal rectus and external oblicuos... 

Starting 2015
12 days ago - Via Reshared Post - View -
https://plus.google.com/105113970512717875329 Dr Renaud Guichard : Using oxygen at high pressure for the treatment of individuals with severe soft tissue infection Cochrane...
Using oxygen at high pressure for the treatment of individuals with severe soft tissue infection
Cochrane : Severe soft tissue infection (necrotizing fasciitis) is life threatening, is associated with prolonged hospital stay and carries high risk of long-term loss of function. Routine treatment consists of immediate surgical removal of infected tissue ...
Using oxygen at high pressure for the treatment of individuals with severe soft tissue infection
Cochrane: Severe soft tissue infection (necrotizing fasciitis) is life threatening, is associated with prolonged hospital stay and carries high risk of long-term loss of function. Routine treatment consists of immediate surgi...
17 days ago - Via Google+ - View -
https://plus.google.com/116575931336412854648 OTORHINOLARYNGOLOGY : Alexandros G. Sfakianakis : Preseptal Orbital Cellulitis Complicated With Necrotizing Fasciitis and Preseptal Abscess Negative Pressure...
Preseptal Orbital Cellulitis Complicated With Necrotizing Fasciitis and Preseptal Abscess
Negative Pressure Wound Therapy in  by  Contreras-Ruiz, José; Ramos-Cadena, Angeles; Solis-Arias, Patricia; Lozano-Platonoff, Adriana; Lopez-García, Lirio A; Contreras-Barrera, Martha E; Saenz-Corral, Claudia; de-la-Cruz-Garcia, Isabel; Cárdenas-Mejía, Alex...
Preseptal Orbital Cellulitis Complicated With Necrotizing Fasciitis and Preseptal Abscess

21 days ago - Via Google+ - View -
https://plus.google.com/100277182385859250471 Wound Care Advisor : Necrotizing Fasciitis: Frightening Disease, Potentially Grim Prognosis http://woundcareadvisor.com/...
Necrotizing Fasciitis: Frightening Disease, Potentially Grim Prognosis

http://woundcareadvisor.com/necrotizing-fasciitis-frightening-disease-potentially-grim-prognosis/
Necrotizing fasciitis: Frightening disease, potentially grim prognosis | Wound Care Advisor
By Lydia Meyers, BSN, RN, CWCN. Necrotizing fasciitis (NF) results from an infection that attacks the fascia and subcutaneous tissues. The primary bacterial etiology is group A streptococcus, a facultative anaerobic bacterium. However, other bacteria may contribute.
23 days ago - Via - View -
https://plus.google.com/116300807522629940991 Mike Rashford : This game gave me...... Achondroplasia Acne Albinism Alcoholic hepatitis Allergy Alopecia Alzheimer's...
This game gave me......
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Watch the video: Tales from the Trench - Episode 20
https://lh4.googleusercontent.com/proxy/gkGHeGtYoY-XSu11bhNDnZLVrU3tD3Te356GhNbytpBBJD6Tx3p01NY0MHRfkZ-6UgigvnjO_tJeDxbdUMjU6iVW4HQ=w506-h284-n
If you like my shit and feel like supporting me whilst getting something back check here - http://www.patreon.com/rusts THIS GAME WAS PLAYED ON 2013-08-17 Th...
26 days ago - Via Reshared Post - View -
https://plus.google.com/108120749543778460364 arseye pezeshky : Diabetic female patient of 54 years old... BMI 40 kg/mt2 Necrotizing Fasciitis (flesh-eating bacteria...
Diabetic female patient of 54 years old... BMI 40 kg/mt2

Necrotizing Fasciitis (flesh-eating bacteria)...

Lower abdominal wall affected... in the image is shown abdominal rectus and external oblicuos... 

Starting 2015
30 days ago - Via Reshared Post - View -
https://plus.google.com/116488212374617020271 Juan de Dios Diaz-Rosales : Diabetic female patient of 54 years old... BMI 40 kg/mt2 Necrotizing Fasciitis (flesh-eating bacteria...
Diabetic female patient of 54 years old... BMI 40 kg/mt2

Necrotizing Fasciitis (flesh-eating bacteria)...

Lower abdominal wall affected... in the image is shown abdominal rectus and external oblicuos... 

Starting 2015
30 days ago - Via Community - View -
https://plus.google.com/101661790421609909136 pretty heart : SCARY FOR KIDS You are here: Home / Sad Stories / I Would Die For You I Would Die For You Last updated...
SCARY FOR KIDS
You are here: Home / Sad Stories / I Would Die For You
I Would Die For You

Last updated on April 29, 2013 by scary for kids

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I Would Die For You is a sad love story about a boy and a girl who were best friends before they fell for each other. However, circumstances beyond their control conspire to keep them apart. It is based on a story found on Youtube.



Have you ever Been in love with your best friend? If the answer is yes, then maybe this is something you will understand. There was a boy and girl who had been friends for years. After a while, they began spending more time together and their friendship grew more close and intimate. Eventually, they confessed their feelings for each other and fell truly, deeply, madly in love.

They would often talk for hours on the phone and texted each other all day long. Whenever they were together, everything seemed right with the world and not a single sad thought could cross their minds.

She would wake up in the morning and go to school just to see his smiling face. He would stay up late, waiting for her call and fall asleep listening to the sound of her voice. She would steal his notebook in class, just so he had to put his arms around her to get it back. Every time he heard a love song on the radio, he would think of her with every single line.

Then, one day, the girl didn’t show up for class. He tried to contact her to see what was wrong, but she never answered his text messages. He tried to call her, but she didn’t answer the phone. The boy became very worried that something was wrong.

That night, he lay down in bed and tried to sleep, but it was no use. He couldn’t stop thinking about her. Just then, his phone started ringing. It was her.

Boy: Hey, honey!
Girl: Hey.
Boy: I missed you at school today. Why weren’t you there?
Girl: I had to go to the doctor.
Boy: Oh really? Why?
Girl: Nothing. Just some flu shots, that’s all.
Boy: Well, you didn’t miss anything much.

Suddenly, the girl burst into tears.

Boy: What’s wrong? Why are you crying?
Girl: It doesn’t matter…
Boy: It does matter. I want to know why my baby is crying…
Girl: Can I ask you a question?
Boy: Of course…
Girl: Do you love me?
Boy: You know I do!
Girl: How much do you love me?
Boy: I love you more than anything in this world.
Girl: Would you do anything for me?
Boy: Yes, Babe. There’s nothing I wouldn’t do for you.
Girl: Would you die for me?
Boy: Yes. Is something wrong?

The girl started crying even harder.

Girl: Really?
Boy: Yes, really!
Girl: Let me hear you say it.
Boy: I would die for you. Now, please tell me what’s wrong.

For a moment, there was an awkward silence on the end of the line.

Girl: Nothing… I have to go.
Boy: Wait!
Girl: I can’t… I’ve really got to go…
Boy: Don’t leave me hanging like this.
Girl: Sorry…
Boy: So, I’ll see you tomorrow at school?
Girl: Maybe…
Boy: Alright, bye.
Girl: Goodbye.

The next day, when the boy turned up at school, the girl was nowhere to be found.

Boy: Hey, have you seen my girlfriend today?
Friend: No.
Boy: She wasn’t here yesterday, either. She was acting all weird on the phone last night.
Friend: Well, dude, you know how girls are sometimes…
Boy: Yeah, but not her.
Friend: I don’t know what else to say, man.
Boy: Okay, well I gotta get to English. I’ll see ya after school.
Friend: Yeah I gotta get to Science. Later.

That night, the boy got another call from his girlfriend.

Boy: Hello? Why weren’t you at school today?
Girl: I had another appointment with the doctor.
Boy: Are you sick?
Girl: Um, I have to go. My mom’s calling on the other line.
Boy: I’ll wait.
Girl: It may take a while. I’ll call you later.
Boy: No! I want you to tell me what is wrong.
Girl: I don’t think we should see each other anymore.
Boy: What? What do you mean? You want to break up?
Girl: It’s the best thing for us right now.
Boy: Please don’t do this to me, Babe… I love you so much… I don’t want our relationship to be over.
Girl: Neither do I…
Boy: What have I done wrong?
Girl: It’s not you… It’s me…
Boy: I can’t believe you’re doing this to me.
Girl: I love you. Bye…

For the next three weeks, the girl was absent from school. Whenever the boy tried to call her, she never answered her phone. One day, the boy was sitting alone in the cafeteria when his friend approached him.

Friend: Hey dude.
Boy: Hey. What’s up?
Friend: Um… Have you talked to your ex-girlfriend lately?
Boy: No.
Friend: So you didn’t hear?
Boy: Hear what?
Friend: I don’t know if I should be the one to tell you…
Boy: Dude, just tell me!
Friend: She’s in the hospital.
Boy: What? Why?
Friend: Just go to see her.
Boy: Okay, thanks!

After school, the boy rushed to the hospital. At the front desk, he asked the receptionist if his girlfriend was a patient there.

Receptionist: Yes, she’s one of our patients.
Boy: What’s wrong with her?
Receptionist: I’m sorry, Sir. We can’t give out confidential information about our patients.
Boy: Where is she?
Receptionist: She’s in the isolation ward.
Boy: Can I see her?
Receptionist: I’m sorry, Sir. That’s not possible. The isolation ward is off limits to visitors.
Boy: I have to see her! Get out of my way!
Receptionist: Wait! No! You can’t go in there!

The boy pushed past the receptionist and ran off down the hallway. Eventually, he came to the isolation ward. Behind a glass wall, he saw his girlfriend lying in bed. It was a pitiful sight.

She had tubes coming out of her nose and mouth. Surgeons were gathered around the bed, working on her. They were wearing protective clothing and their faces were covered by masks.

The boy banged on the glass and shouted her name. The girl turned her head and was shocked to see him standing there. He waved to her, but she didn’t wave back. He was disappointed. Then, he looked closer and realized, to his horror, that she didn’t have any arms or legs.

Boy: Oh my God, are you OK?
Girl: I didn’t want you to see me like this.
Boy: What have they done to you?
Girl: Don’t look at me, please.
Boy: Babe! What happened? Talk to me!
Girl: I…
Boy: You what?
Girl: I have flesh-eating disease.
Boy: What’s that?
Girl: The doctors call it Necrotizing Fasciitis. I’m on life support. The disease is eating me alive.

The boy burst into tears.

Boy: This can’t be happening.
Girl: The doctors said I must have caught it when I fell into that sewage tank. They had to remove my arms and legs, but that didn’t stop it from spreading. There’s nothing more they can do for me. They’re taking me off life support in one hour.
Boy: Why didn’t you tell me?
Girl: I wanted to… Really, I did…
Boy: Why didn’t you?
Girl: I couldn’t. I didn’t want to hurt you.
Boy: Why did you break up with me?
Girl: The disease is contagious. I didn’t want you to catch it.
Boy: I don’t care!
Girl: I couldn’t take that risk. I love you more than anything.
Boy: I can’t go on living without you!
Girl: Don’t be sad for me. Just remember this: I love you and I’ll always be there with you in your heart.

The boy fell to his knees, doubled over in pain. Hospital security grabbed him and carried him away. Later that night, the girl was taken off life support and she died.

The next day, the boy didn’t show up for school. His friends wondered where he was. Instead, he made his way to the local zoo. He bought a ticket and walked towards the wild animal enclosures.

He took out a bottle of ketchup and poured it all over himself. Then, he started rubbing it into his skin. After wiping a single tear from his cheek, he went over to the tigers’ cage and jumped in.

The wild beasts were hungry and within seconds, they pounced on him and began tearing him apart. His dying screams echoed around the zoo. With their razor-sharp teeth and their pointed claws, the tigers ripped into his flesh and started eating him alive.

By the time the zookeepers managed to get into the cage and subdue the ravenous tigers, the feeding-frenzy was over. There wasn’t much left but a pile of clothes and some gnawed, bloody bones. In the pocket of his jeans, they found a crumpled letter
It read:i will die for you

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1 month ago - Via - View -
https://plus.google.com/110109505797713349271 rayleen fletcher : Item #: SCP-046 Object Class: Euclid Special Containment Procedures: The land surrounding SCP-046 ...
Item #: SCP-046

Object Class: Euclid

Special Containment Procedures: The land surrounding SCP-046 has been purchased and surrounded by multiple layers of security, including fencing, barricades, and lethal-effect traps; multiple signs marking the area as private property are to be prominently displayed. The area is to be heavily guarded at all times to prevent access by civilians to SCP-046. All personnel working around or within a 50km radius of SCP-046 are to undergo rigorous medical testing to ensure the absence of any potentially life-threatening illnesses; additionally,  increased mental health examinations are to be administered to ensure that no personnel inclined or potentially inclined towards self-harm or self-destructive tendencies are allowed within the 50km radius. Any injured personnel are to be evacuated to a hospital outside of the 50km zone around SCP-046. All vegetation surrounding SCP-046 is to be destroyed and all animals attempting to access SCP-046 are to be terminated and destroyed before reaching its outer perimeter.

Any personnel showing unusual interest either in SCP-046 or in traveling to the region near SCP-046 are to undergo medical examinations as detailed above. Any modification to these containment procedures are to be approved by O5 command before being added to this containment document. Any personnel attempting to modify this document without appropriate authorization are to be demoted and reassigned.

Description: SCP-046 is a predatory botanical mass located in southwestern Kentucky. SCP-046 is composed of two parts. SCP-046-1 is a large mass of vegetative matter, composed largely of plants indigenous to the region, including Quercus alba, Ilex aquifolium, and Lonicera sempervirens, though several offshoots composed of other plant species are also present. SCP-046-2 is the land in the immediate vicinity of SCP-046-1, extending to a roughly circular area twenty meters in radius from its base. This area is SCP-046's primary feeding area. SCP-046 is capable of attracting prey within a 50km radius through hallucinogenic means; all evacuations of personnel should carry them outside of this radius to disable SCP-046's effect.

Animals (including humans) suffering from potentially life-threatening physical injuries or diseases, or who are afflicted by psychological disorders that induce self-destructive tendencies, feel a powerful compulsion to come to SCP-046-2 and lie in a prostrate position facing SCP-046-1. Individuals lying in such a position are rapidly attacked by an unusually powerful combination of saprophytic organisms and opportunistic infections, including several strains of methicillin-resistant Staphylococcus aureus (MRSA) known to induce necrotizing fasciitis, also known as "flesh-eating bacteria"; a form of fungal spore similar to Stachybotrys chartarum, or "black mold," which poisons prey organisms and induces paralysis; and finally, complete consumption by several heretofore unknown species of insect that emerge from the inside of SCP-046-1 during the final stage of feeding. SCP-046 appears to derive nutrition through the complete digestion of affected individuals, particularly larger mammals such as humans. It is unknown whether SCP-046 is capable of growth; as such, all steps are to be taken to ensure that SCP-046 is deprived of prey until more information is known about its abilities. These efforts are to include terminating individuals prior to their arrival at SCP-046 and disposing of their bodies in a separate location.
1 month ago - Via Google+ - View -
https://plus.google.com/116575931336412854648 OTORHINOLARYNGOLOGY : Alexandros G. Sfakianakis : Necrotizing fasciitis of the neck and anterior mediastinum The value of early intervention and a mul...
Necrotizing fasciitis of the neck and anterior mediastinum
The value of early intervention and a multidisciplinary approach in the management of necrotizing fasciitis of the neck and anterior mediastinum of odontogenic origin via  Oral and Maxillofacial Surgery Publication date:  Available online 30 December 2014 S...
Necrotizing fasciitis of the neck and anterior mediastinum

1 month ago - Via Google+ - View -
https://plus.google.com/108051756606296756586 Harsha Indrasena : Indrasena B, Doratiyawa L . Fatal necrotizing fasciitis following sclerotherapy for haemorrhoids. Chin...
Indrasena B, Doratiyawa L . Fatal necrotizing fasciitis following sclerotherapy for haemorrhoids. Chin Med J (Engl). 2013 Mar; 126(5): 982-3. 
Fatal necrotizing fasciitis following sclerotherapy for haemorrhoids. - PubMed - NCBI

Chin Med J (Engl). 2013 Mar;126(5):982-3. Case Reports
1 month ago - Via Google+ - View -
https://plus.google.com/101643621025814605516 ACCESSWIRE : Christmas Gift to People Worldwide Suffering From "Flesh Eating" Disease: NovaBay Pharmaceuticals and...
Christmas Gift to People Worldwide Suffering From "Flesh Eating" Disease: NovaBay Pharmaceuticals and the National Necrotizing Fasciitis Foundation Will Offer New Life- and Limb-Saving Treatment At No Charge to Patients Worldwide

Accesswire - Newswire service for online press release distribution, social media
releases, social media monitoring, online newsrooms, Public and Private companies


12/23/2014 [ACCESSWIRE]. Because of growing demand from doctors and patients, NovaBay Pharmaceuticals and its partners in China, Saudi Arabia, Egypt and Korea will donate and ship its life-saving NeutroPhase(R) product anywhere in the world, while also providing support to local doctors from ...
1 month ago - Via - View -
https://plus.google.com/101596801672701161247 Bernard Kandarah : this video gave me: Achondroplasia Acne AIDS Albinism Alcoholic hepatitis Allergy Alopecia Alzheimer's...
this video gave me:
Achondroplasia
Acne
AIDS
Albinism
Alcoholic hepatitis
Allergy
Alopecia
Alzheimer's disease
Amblyopia
Amebiasis
Anemia
Aneurdu
Anorexia
Anosmia
Anotia
Anthrax
Appendicitis
Apraxia
Argyria
Arthritis
Aseptic meningitis
Asthenia
Asthma
Astigmatism
Atherosclerosis
Athetosis
Atrophy
Bacterial meningitis
Barack Obama syndrome
Beriberi
Black Death
Botulism
Breast cancer
Bronchitis
Brucellosis
Bubonic plague
Bunion
Bella killer
Calculi
Campylobacter infection
Cancer
Candidiasis
Carbon monoxide poisoning
Celiacs disease
Cerebral palsy
Chagas disease
Chalazion
Chancroid
Chavia
Cherubism
Chickenpox
Child elongated penis syndrome
Chlamydia
Chlamydia trachomatis
Cholera
Chordoma
Chorea
Chronic fatigue syndrome
Circadian rhythm sleep disorder
Coccidioidomycosis
Colitis
Common cold
Condyloma
Congestive heart disease
Coronary heart disease
Cowpox
Cretinism
Crohn's Disease
Dengue
Diabetes mellitus
Diphtheria
Dehydration
Ear infection
Ebola
Encephalitis
Emphysema
Epilepsy
Erectile dysfunction
Foodborne illness
Gangrene
Gastroenteritis
Genital herpes
GERD
Goitre
Gonorrhea
Heart disease
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E
Hepatitis F (Childhood Herpes)
Histiocytosis (Childhood Cancer)
HIV
Human papillomavirus
Huntington's disease
Hypermetropia
Hyperopia
Hyperthyroidism
Hypothermia
Hypothyroid
Hypotonia
Impetigo
Infertility
Influenza
Interstitial cystitis
Iritis
Iron-deficiencyanemia
Irritable bowel syndrome
Ignious Syndrome
Jaundice
Keloids
Kuru
Kwashiorkor
Laryngitis
Lead poisoning
Leaking scrotum syndrome
Legionellosis
Leishmaniasis
Leprosy
Leptospirosis
Listeriosis
Leukemia
Lice
Loiasis
Lung cancer
Lupus erythematosus
Lyme disease
Lymphogranulomavenereum
Lymphoma
Malaria
Marburg fever
Measles
Melanoma
Melioidosis
Metastatic cancer
Ménière's disease
Meningitis
Migraine
Mononucleosis
Multiple myeloma
Multiple sclerosis
Mumps
Muscular dystrophy
Myasthenia gravis
Myelitis
Myoclonus
Myopia
Myxedema
Morquio Syndrome
Mattticular syndrome
Neoplasm
Niggeritis
Non-gonococcal urethritis
Necrotizing Fasciitis
Night blindness
Obesity
Osteoarthritis
Osteoporosis
Otitis
Palindromic rheumatism
Paratyphoid fever
Parkinson's disease
Pelvic inflammatory disease
Peritonitis
Periodontal disease
Pertussis
Phenylketonuria
Plague
Poliomyelitis
Porphyria
Progeria
Prostatitis
Psittacosis
Psoriasis
Pubic lice
Pulmonary embolism
Pilia
Q fever
Ques fever
Rabies
Repetitive strain injury
Rheumatic fever
Rheumatic heart
Rheumatism
Rheumatoid arthritis
Rickets
Rift Valley fever
Rocky Mountain spotted fever
Rubella
Salmonellosis
Sandy vagina
Scabies
Scarlet fever
Sciatica
Scleroderma
Scrapie
Scurvy
Sepsis
Septicemia
SARS
Shigellosis
Shin splints
Shingles
Sickle-cell anemia
Siderosis
SIDS
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https://plus.google.com/103646496613252246980 Melissa LeBlanc : Procedures, health effects Circumcisers, methods Anatomy of the vulva, showing the clitoral glans, clitoral...
Procedures, health effects
Circumcisers, methods
Anatomy of the vulva, showing the clitoral glans, clitoral crura, corpora cavernosa and vestibular bulbs
The procedures are generally performed by a traditional circumciser in the girls' homes, with or without anaesthesia. The circumciser is usually an older woman; in communities where the male barber has assumed the role of health worker, he will perform FGM too.[29] In Egypt, Sudan and Kenya, FGM is carried out by health professionals; surveys in Egypt in 1997–2011 indicated that 77 percent of FGM procedures were performed by medical professionals, often physicians.[30]
When traditional circumcisers are involved, non-sterile cutting devices are likely to be used, including knives, razors, scissors, glass, sharpened rocks and fingernails.[31] A nurse in Uganda, quoted in 2007 in The Lancet, said that a circumciser would use one knife to cut up to 30 girls at a time.[32]
Depending on the involvement of healthcare professionals, the procedures may include a local or general anaesthetic, or neither. Women in Egypt reported in 1995 that a local anaesthetic had been used on their daughters in 60 percent of cases, a general in 13 percent and neither in 25 percent.[33]
Classification
Typologies
The WHO, UNICEF and UNFPA issued a joint statement in April 1997 defining female genital mutilation as "all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons."[34]
The procedures vary considerably according to ethnicity and individual practitioners. English terms do not always correspond with local ones; in a survey in Niger in 1998, women responded with 50 different terms when asked what was done to them.[22] Translation problems are compounded by the women's confusion over which type of FGM they experienced, or even whether they experienced it. A study in Ghana in 2003 found that women had changed their responses during surveys; when asked if they had undergone FGM, four percent said no in 1995 but yes in 2000, and 11 percent switched in the other direction. In Tanzania in 2005, 66 percent reported FGM, but a medical exam found that 73 percent had undergone it.[35] In Sudan in 2006, a significant percentage of infibulated women and girls reported a less severe type.[36]
UNICEF divides FGM into (1) cut, no flesh removed (pricking or symbolic circumcision); (2) cut, some flesh removed; (3) sewn closed; and (4) type not determined/unsure/doesn't know.[37] The most common procedures fall within the "cut, some flesh removed" category, and involve complete or partial removal of the clitoris.[38]
WHO Types I–IV
How FGM Types I–III differ from normal female anatomy
The WHO has created a more detailed typology that describes how much tissue was removed. The WHO categories are Types I–III, and Type IV for symbolic circumcision and miscellaneous procedures.[39]
Type I is subdivided into Ia, the removal of the clitoral hood (rarely, if ever performed alone),[40] and the more common Ib (clitoridectomy), the complete or partial removal of the clitoris and clitoral hood.[41] (When discussing FGM, the WHO uses clitoris to refer to the clitoral glans, the external part of the clitoris.)[42] Susan Izett and Nahid Toubia write: "[T]he clitoris is held between the thumb and index finger, pulled out and amputated with one stroke of a sharp object."[43]
Type II (excision) is the complete or partial removal of the inner labia, with or without removal of the clitoris and outer labia. (Excision in French usually means any form of FGM.) Type II is subdivided into Type IIa, removal of the inner labia; IIb, removal of the clitoris and inner labia; and IIc, removal of the clitoris, inner and outer labia.[44]
Type III (infibulation), corresponding to UNICEF's "sewn closed" category, is the removal of the external genitalia and the fusion of the wound. The inner and/or outer labia are cut away, with or without removal of the clitoris. Type IIIa is the removal and closure of the inner labia and IIIb of the outer labia.[45] Over eight million women in Africa have experienced infibulation, which is common in Djibouti, Eritrea, Somalia and Sudan.[12]
Comfort Momoh, a midwife who specializes in FGM care, writes: "[E]lderly women, relatives and friends secure the girl in the lithotomy position. A deep incision is made rapidly on either side from the root of the clitoris to the fourchette, and a single cut of the razor excises the clitoris and both the labia majora and labia minora."[46] In Somalia the procedure is completed in two stages. The clitoris is removed and might be shown to the girl's senior female relatives, who decide whether enough has been amputated, and after this the labia are removed.[47]
A single hole of 2–3 mm is left for the passage of urine and menstrual blood by inserting something into the wound, such as a twig.[48] The vulva is then closed with surgical thread, agave or acacia thorns, or covered with a poultice, such as raw egg, herbs and sugar.[49] The parts that have been removed might be placed in a pouch for the girl to wear.[50] To help the tissue bond, the girl's legs are tied together, usually from ankle to hip; the bindings are loosened after a week and may be removed after two.[51] Momoh writes:
[As a result, the entrance to the vagina] is obliterated by a drum of skin extending across the orifice except for a small hole. Circumstances at the time may vary; the girl may struggle ferociously, in which case the incisions may become uncontrolled and haphazard. The girl may be pinned down so firmly that bones may fracture.[46]
Type IIIb
Virgin
Sexually active
— Swiss Medical Weekly, January 2011[9]
If the girl's family regard the remaining hole as too large, the procedure is repeated.[52] The vagina is opened for sexual intercourse, for the first time either by a midwife with a knife or by the woman's husband with his penis; in Somaliland female relatives of the bride and groom might watch the opening of the vagina to check that the girl is a virgin.[53] The woman is opened further for childbirth and closed afterwards, a process known as defibulation (or deinfibulation) and reinfibulation. Reinfibulation can involve cutting the vagina again to restore the size of the first infibulation; this might be performed before marriage, and after childbirth, divorce and widowhood.[54]
Psychologist Hanny Lightfoot-Klein interviewed hundreds of women and men in Sudan in the 1980s about sexual intercourse with Type III:
The penetration of the bride's infibulation takes anywhere from 3 or 4 days to several months. Some men are unable to penetrate their wives at all (in my study over 15%), and the task is often accomplished by a midwife under conditions of great secrecy, since this reflects negatively on the man's potency. Some who are unable to penetrate their wives manage to get them pregnant in spite of the infibulation, and the woman's vaginal passage is then cut open to allow birth to take place. ... Those men who do manage to penetrate their wives do so often, or perhaps always, with the help of the "little knife." This creates a tear which they gradually rip more and more until the opening is sufficient to admit the penis.[55]
Type IV is defined as "[a]ll other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization."[1] It includes nicking of the clitoris (symbolic circumcision), burning or scarring the genitals, and introducing substances into the vagina to tighten it.[56] A definition of FGM from the WHO in 1995 included gishiri cutting and angurya cutting, found in Nigeria and Niger; these were removed from the WHO's 2008 definition because of insufficient information about prevalence and consequences.[57] Gishiri cutting involves cutting the vagina's front or back wall with a blade or penknife, performed in response to infertility, obstructed labour and several other conditions; over 30 percent of women with gishiri cuts in a study by Nigerian physician Mairo Usman Mandara had vesicovaginal fistuale. Angurya cutting is excision of the hymen, usually performed seven days after birth.[58]
Labia stretching is also categorized as Type IV.[57] From the age of eight girls are encouraged to stretch their inner labia using sticks and massage, a practice common in southern and eastern Africa. The practice is supposed to enhance sexual pleasure for the man and add to the sense of a woman as a closed space. Girls in Uganda are told they may have difficulty giving birth without stretched labia.[59]
Complications
FGM has no known health benefits.[10] The immediate, short-term and late complications depend on several factors, principally the type of FGM performed. Factors include whether the practitioner had medical training, whether unsterilized or surgical single-use instruments were used, whether surgical thread was used instead of agave or acacia thorns, and whether antibiotics were available. In the case of Type III, other factors include how small a hole was left for the passage of urine and menstrual blood, and whether the procedure was performed more than once (for example, to close an opening regarded as too wide or re-open one too small).[9]
FGM ceremony in Indonesia
Preparations
Girl before procedure
Nine-month-old afterwards
 — Stephanie Sinclair, The New York Times[60]
Immediate complications include fatal bleeding, anaemia, acute urinary retention, urinary infection, wound infection, septicemia, tetanus, and transmission of hepatitis or HIV if instruments are non-sterile or reused.[9] Because fatalities are rarely reported – few records are kept and complications may not be recognized – it is not known how many girls and women die.[61] Short-term complications include necrotizing fasciitis (flesh-eating disease), delay in wound healing due to infection, endometritis and hepatitis.[62]
Late complications vary depending on the type of FGM performed. Jasmine Abdulcadir, a Swiss gynaecologist who offers specialist services to women with FGM, writes that a common complication with infibulation is painful periods, because the menstrual flow has been obstructed. Blood can collect and stagnate in the vagina and uterus. There may be difficult and painful urination; urine may collect underneath the scar and cause small stones to form. In an infibulated virgin the opening is 2–3 mm; in women who are sexually active or have given birth by vaginal delivery, the hole is larger but the urethra opening may still be obstructed by scar tissue.[9] There may be damage to the urethra and bladder, leading to infections and incontinence, pain during sexual intercourse and infertility.[62] Other complications include epidermoid cysts that may become infected, and neuroma formation (growth of nerve tissue) involving nerves that supplied the clitoris.[63]
Women with FGM are more likely to report reduced sexual feelings.[64] Psychological complications include depression and post-traumatic stress disorder.[31] Feelings of shame and betrayal can develop when the women move outside their traditional circles and learn that their condition is not the norm.[9]
FGM may complicate pregnancy and place women at higher risk for obstetrical problems, which are more common with the more extensive FGM procedures.[9] In women with Type III who have developed vesicovaginal or rectovaginal fistulae (holes that allow urine or faeces to seep into the vagina), it is difficult to obtain clear urine samples as part of prenatal care, making the diagnosis of conditions such as pre-eclampsia harder.[62] Cervical evaluation during labour may be impeded and labour prolonged. Third-degree laceration, anal-sphincter damage and emergency caesarean section are more common in infibulated women.[9] Neonatal mortality is increased. The WHO estimated in 2006 that an additional 10–20 babies die per 1,000 deliveries as a result of FGM. The estimate was based on a study conducted on 28,393 women attending delivery wards at 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan. In those settings all types of FGM were found to pose an increased risk of death to the baby: 15 percent higher for Type I, 32 percent for Type II and 55 percent for Type III.
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Necrotizing Fasciitis after Central Venous Catheter Placement
Necrotizing Fasciitis after Central Venous Catheter Placement by  Nico Leibig   via  Surgical Infections Surgical Infections , Vol. 0, No. 0.  Author information Nico Leibig ,  Christoph Hirche ,  Volker J. Schmidt ,  Amir K. Bigdeli ,  Ulrich Kneser , and ...
Necrotizing Fasciitis after Central Venous Catheter Placement

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