Background: Polydactyly is the most common hand congenital abnormality found, next after syndactyly. The presence of these extra fingers is not merely duplication but is accompanied by abnormal hypoplastic structures, abnormal joints, tendon anomalies, and anomly of the insertion of ligaments. There are many tehniques proposed to reconstruct polydactyly, from simple excision of bones, ligaments, and tendons to complex reconstructions. We report a case of polydactily, the patient had bone exicision of the duplicates when the patient was four-month-old, but that extra metacarpal with no phalanges resulted in a greater space of finger 1 and 2. Patient and Method: A 21-year-old woman complaining of difficulty in grasping because the space between first and second fingers is too far away, and the extra metacarpal bone is protruding that causes snagging and stumbling on other objects. She had a history of surgical removal of polydactyl when she was 4-month-old. The patient has a limitation in hand activities. Result: Six months after surgery, the patient was satisfied with the results. The fingers has better mobility, good appearance. No more prominent bone, and neuropathic problems, or other disorders were found. Conclusion: Polydactyly is a common congenital hand occurrence. Understanding the anatomy to guide the reconstructive actions is important. It is not only about which digit would be preserved, but we have to concern about what our patient need, improving the quality, patient's hand function, and the aesthetic aspect.
The study investigated counseling practices in monitoring vocational behaviors of students in tertiary institution.Two research questions and two hypotheses guided the study. The subjects for the study comprise 72 female and 43 male counselors drawn from both Nsukka and Obollo Afor education zones of Enugu State. The instrument for data collection was questionnaire, mean score, and t-test statistics were used in data analysis. Results showed that the approaches counselors use in equipping students with vocational information for career choice are media outlet, individual counseling, group counseling, career day/week, field trip/excursion, assemblies, seminars/workshop, and orientation. It equally revealed that counselors do not use any follow-up strategy in monitoring students' behaviour after imparting vocational information to them. Implications of the findings were highlighted and recommendations were made.
Background : A Surgeon should have good leadership. Leadership plays an important role in improving health services. Leadership can shape a better future. Method : A literature search was conducted in November 2019. Related keywords were applied to Pubmed, Medline, and SCOPUS for studies published in the last five years. Relevant research is taken to be used as the discussion material. Result : The key to surgical leadership is collaboration and cooperation, humanism and mentorship, and operational efficiency. Conclusion: Effective leadership in a surgical team has the following characteristics: (1) Defines the role of a leader clearly, especially in critical situations; (2) Leadership style that suits the clinical situation; (3) Clear directions to team members; (4) Consistently seeking input from team members; (5) Involving members in decision making.
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