Neck Area Research Articles

Effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers.

To compare the effects of 1-hour computer use on ulnar and median nerve conduction velocity and muscle activity in office workers with symptomatic neck pain and asymptomatic office workers. A total of 40 participants, both male and female office workers, with symptomatic neck pain (n = 20) and asymptomatic (n = 20), were recruited. Pain intensity, ulnar nerve conduction velocity, median nerve conduction velocity, and muscle activity were determined before and after 1 hour of computer use. There was a significant increase in pain intensity in the neck area in both groups (P < .001). The symptomatic neck pain group revealed a significant decrease in the sensory nerve conduction velocity of the ulnar nerve (P = .008), whereas there was no difference in the median nerve conduction velocity (P > .05). Comparing before and after computer use, the symptomatic neck pain group had less activity of the semispinalis muscles and higher activity of the anterior scalene muscle than the asymptomatic group (P < .05). The trapezius and wrist extensor muscles showed no significant differences in either group (P > .05). This study found signs of neuromuscular deficit of the ulnar nerve, semispinalis muscle, and anterior scalene muscle after 1hour of computer use among office workers with symptomatic neck pain, which may indicate the risk of neuromuscular impairment of the upper extremities. The recommendation of resting, and encouraging function and flexibility of the neuromuscular system after 1hour of computer use should be considered.

Space Infections in Children- A Case Report Series

Head and neck area infections in children can be severe, necessitating an immediate diagnosis and course of treatment. These infections are frequently brought on by periapical abscesses, dental trauma, untreated dental caries (cavities), or consequences from dental operations. Poor oral hygiene practices and postponed dental treatment in children might raise the risk. Swelling, discomfort, fever, trouble swallowing, trismus (inability to open the mouth), and occasionally difficulty breathing or speaking are common symptoms in children with head and neck region infections. Clinical examination, patient history, and imaging tests like dental radiographs (X-rays) and CT scans to map out the extent and location of the infection are commonly used by paediatric dentists and healthcare professionals to identify these illnesses. To manage the illness, broad-spectrum antibiotics are frequently administered. These infections, if ignored, can result in potentially fatal consequences such as cellulitis, Ludwig's angina, mediastinitis, and sepsis.

Pathological Portrait of a Submandibular Gland Lymphoepithelial Cyst in a Non HIV Patient: A Case Report

Lymphoepithelial Cysts (LEC) manifest as benign, unilocular to multilocular lesions predominantly in the head and neck areas. LEC typically localise in the salivary glands, with the parotid gland being more common and the submandibular gland being a rare occurrence. Additionally, they may be observed in the oral cavity, with a particular affinity for the floor of the mouth. It manifests as a painless, solitary cystic mass situated close to or within the salivary gland. It predominantly occurs in individuals infected with Human Immunodeficiency Virus (HIV). It typically arises as a consequence of lymphocyte-induced dilation of the cystic duct, and in accordance with index case, the definitive diagnosis is consistently confirmed through postoperative histopathological examination. They are infrequently observed in immunocompetent individuals and may have a connection to Sjögren’s syndrome. Numerous contemporary investigative methods are at our disposal, with Fine Needle Aspiration Cytology (FNAC) emerging as a swift diagnostic tool for promptly confirming a LEC. Additional diagnostic modalities encompass Ultrasonography (USG) and Computed Tomography (CT). The primary treatment for an LEC continues to be surgical intervention. Understanding the characteristics and behaviour of such cysts in non HIV patients is critical for accurate diagnosis, appropriate therapy, and, perhaps, enhancing the understanding of the spectrum of conditions associated with these cyst formations. Investigating LEC occurring in the rare location of the submandibular salivary gland, this work is distinctive in that it involves an immunocompetent individual. The present case is of a 42-year-old woman who elucidates the diagnostic pathway, encompassing both FNAC and histopathology.

SPOTTING THE UNSEEN: A NARRATIVE REVIEW OF CHILD ABUSE AND NEGLECT THROUGH DENTAL AND PSYCHIATRIC LENSES

The Centers for Disease Control and Prevention (CDC) define child maltreatment as any act or series of actions, whether through commission or omission, by a caregiver that poses a threat to or harms a child. Child neglect is generally characterized by a continuing failure to fulfill a child’s basic physical and/or psychological needs, which can significantly impair the child’s development or health. Specifically, dental neglect refers to the willful neglect by a caregiver or legal guardian to prevent the onset of oral diseases and the failure to seek necessary treatment to maintain proper oral health, functionality and freedom from pain and infection. Child maltreatment can be classified into several categories, which may occur independently or in combination. These categories include physical abuse, sexual abuse, emotional or psychological abuse and neglect, physical neglect, human trafficking, medical care and Munchausen syndrome by proxy. Child abuse and neglect are critical issues that extend beyond social contexts to significantly impact healthcare professionals who may encounter abused children. With over half of trauma cases occurring in the head and neck area, dental professionals are uniquely positioned to offer vital insights into instances of abuse and are essential in identifying oral signs indicative of neglect. This makes the detection and reporting of abuse not only a moral duty but also a legal obligation. This review focuses on assessing perioral and intraoral injuries, bite marks, infections, diseases and psychological distress that might indicate potential child abuse or neglect. Additionally, it notes that oral health problems may also be associated with victims of human trafficking.

Multimodal approach to rehabilitating a traumatic brachial plexus lesion in a Thoroughbred yearling

Forelimb peripheral neuropathy is uncommon and is usually caused by traumatic injury to the brachial plexus or nerves arising from it. Common clinical signs include instability of the shoulder, dropped elbow, inability to fully bear weight and difficulty in protraction. A 16-month-old Thoroughbred colt was found non-weight bearing in the field. The horse was referred to the Veterinary Teaching Hospital of the University of Perugia, Italy, after two days of treatment with anti-inflammatory drugs and stable rest without improvement. At admission, the horse was unable to bear weight on the limb. Diagnostic imaging was unremarkable and a diagnosis of brachial plexus injury with major involvement of suprascapular and radial nerves was made. The horse was treated with a combination of drugs, electrical modalities, physical therapy sessions and holistic techniques. Pharmacological treatment included gabapentin, dexamethasone, phenylbutazone and mesotherapy of the shoulder and neck area. Physical treatments, electrical modalities and holistic therapies included neuromuscular electrical stimulation, acupuncture, kinesiology taping, eccentric loading and dynamic mobilization exercises. The horse was discharged from the hospital after 26 days, having fully regained the ability to bear weight on the limb and the ability to walk normally, although a degree of shoulder instability was still present. Follow-up of the case showed that the horse made a full athletic recovery and raced successfully a year after discharge. This multimodal approach to severe peripheral neuropathy responsible for severe lameness resulted in a fast and efficient option for initial recovery while reducing the risk of complications such as contralateral limb laminitis.

Histologic Alterations in Salivary Glands Post Fine Needle Aspiration Cytology – A Diagnostic Challenge

Fine-needle aspiration (FNA) is used widely in the initial workup and diagnosis of both palpable and deep-seated masses. Salivary glands are among the most commonly aspirated locations in the head and neck area. Fine-needle aspiration cytology (FNAC) is a simple, safe and non-invasive ancillary diagnostic method that is relatively atraumatic. However, it can lead to histologic changes that may obscure the underlying pathology or mislead the unwary to render an erroneous diagnosis of malignancy. The tissue changes after FNAC include haemorrhage, squamous cell metaplasia, infarction and necrosis and needle track tumour seeding. Although tissue changes induced by FNAC are rare and account for only 7% and 10 % cases, awareness of these alterations will prevent the pathologist from overestimating the diagnosis. The aim of this review is to emphasize the importance of recognizing the histologic changes induced by FNAC and of obtaining the clinical history of a preoperative FNA procedure to avoid potential misdiagnosis.

Special at-rich sequence-binding protein 2 and its role in healing of the experimental mandible bone tissue defect filling with a synthetic bone graft material and electrical stimulation impact.

Aim: The purpose of the study was to identify the role of SATB2 in healing of the experimental mandible bone tissue defect filling with a synthetic bone graft material and electrical stimulation impact. Materials and Methods: An experiment was carried out on 48 mature male rats of the WAG population, which were divided into 4 groups. Each group included 12 experimental animals. Group 1 included rats that were modeled with a perforated defect of the lower jaw body. Group 2 included animals that were modeled with a perforated defect similar to group 1. In animals, a microdevice for electrical action was implanted subcutaneously in the neck area on the side of the simulated bone defect. The negative electrode connected to the negative pole of the battery was in contact with the bone defect. The battery and electrode were insulated with plastic heat shrink material. Group 3 included rats that were modeled with a perforated defect similar to previous groups, the cavity of which was filled with synthetic bone graft "Biomin GT" (RAPID, Ukraine). Group 4 included animals that were modeled with a perforated defect similar to groups 1-3, the cavity of which was filled with synthetic bone graft "Biomin GT" (RAPID, Ukraine). The simulation of electrical stimulation was the same as in group 2. The material for the morphological study was a fragment of the body of the lower jaw from the zone of the perforated defect. Immunohistochemical study was performed using rabbit anti-human SATB2 monoclonal antibody. Results: In the regenerate filling the defect in the bone tissue of the lower jaw of rats, there was an increase in SATB2 expression under conditions of electrical stimulation; filling the defect with a synthetic bone graft material; simultaneous filling the defect with a synthetic bone graft material and electrical stimulation. The most pronounced expression of SATB2 was observed under conditions of simultaneous filling the defect with a synthetic bone graft material and electrical stimulation; minimally expressed - in conditions of filling the defect with a synthetic bone graft material; moderately expressed - under conditions of electrical stimulation. In the regenerate, in cases of all treatment methods, SATB2 was expressed by immune cells, fibroblastic differon cells, osteoblasts, and in case of electrical stimulation, also by adipocytes, vascular pericytes and endothelial cells, epidermis. Conclusions: The activation of SATB2 expression identified by the authors is one of the mechanisms for stimulating reparative osteogenesis under the conditions of electrical stimulation; filling the defect with a synthetic bone graft material; simultaneous filling the defect with a synthetic bone graft material and electrical stimulation.

Влияние акубаротравмы на состояние слуха в условиях современного вооруженного конфликта

The blast shock wave is the main damaging factor in conditions of modern armed conflict. The effect on the body of a loud sound and a sharp increase in air pressure in the environment leads to the development of acubarotrauma. The value of sanitary losses of the otorhinolaryngological profile amounted to 6.5% of the total number of requests for medical care at the advanced stage of providing specialized care. Damage to the ENT organs by a blast wave with the development of acubarotrauma out of the total number of sanitary losses of the otorhinolaryngological profile was 38%. The development of protective equipment has changed the nature of damage to the head and neck area toward a significant decrease in the number of isolated damages of the auditory system. A combination of acubarotrauma with shrapnel wounds of the head was observed in 17% of cases; with closed-head injury, in 43%; with shrapnel wounds of the upper and lower extremities, in 26%; with mechanical injuries, in 13%. Depending on the location of the victim relative to the shelter, the remoteness of the damaging factor, distinctive complaints, the nature of damage to the tympanic membrane, and acumetry data, 4 types of acubarotrauma were identified that can be used to determine the medical and evacuation characteristics of the victims. Timely provision of medical care, depending on the nature of the acubarotrauma, will allow the most effective use of the rehabilitation potential of a particular victim at the following stages of treatment.

Survival Status and Predictors of Mortality Among Pediatrics Burn Victims Admitted to Burn Centers of Addis Ababa Public Hospitals, Ethiopia: A Retrospective Cohort Study.

Background. Burn is a major public health problem in pediatric populations worldwide. This study aimed to determine the survival status and predictors of mortality among pediatric burn victims admitted to burn centers in Ethiopia. Methods. A retrospective cohort study was conducted on the patient charts of 412 pediatric patients with burn injuries at burn centers in Addis Ababa from the 1st of January 2016 to the 30th of December 2019. Data was entered into the Epi-Data manager. Then, the data was exported to STATA V-14 for cleaning and analysis. For the analysis, the proportional hazard model was used. After the model fitness test, variables with a P-value of <.25 in the bivariate analysis were fitted to the multivariate analysis. Finally, statistical significance was decided at a P-value of <.05, and the hazard ratio was used to determine the strength of the association. Result. The study reported an overall incidence rate of 2.4 per 1000 child days. Additionally, it revealed that the median hospital length of stay was 25.00 days (95% CI: 21.57, 28.45). During the follow-up period, 8.25% of deaths occurred among pediatric patients with burn injuries. Specifically, having a full-thickness burn (adjusted hazard ratio [AHR] 2.51, 95% CI: 1.12, 5.62) and neck burn (AHR 2.82, 95% CI: 1.04, 7.68) were identified as significant predictors contributing to increased mortality among burn-injured pediatric individuals. Conclusion. The study highlighted significant mortality rates among pediatric patients suffering from burn injuries. Based on the findings a full-thickness burn injury and burns in the neck area are independent predictors of mortality in pediatric burn patients. Based on the identified predictors of mortality in pediatric burn patients, clinicians should prioritize early recognition, prompt intervention, multidisciplinary management, vigilant monitoring, and preventive strategies to optimize outcomes and reduce mortality rates in this vulnerable population.

Dual-Reference Source-Free Active Domain Adaptation for Nasopharyngeal Carcinoma Tumor Segmentation across Multiple Hospitals.

Nasopharyngeal carcinoma (NPC) is a prevalent and clinically significant malignancy that predominantly impacts the head and neck area. Precise delineation of the Gross Tumor Volume (GTV) plays a pivotal role in ensuring effective radiotherapy for NPC. Despite recent methods that have achieved promising results on GTV segmentation, they are still limited by lacking carefully-annotated data and hard-to-access data from multiple hospitals in clinical practice. Although some unsupervised domain adaptation (UDA) has been proposed to alleviate this problem, unconditionally mapping the distribution distorts the underlying structural information, leading to inferior performance. To address this challenge, we devise a novel Sourece-Free Active Domain Adaptation framework to facilitate domain adaptation for the GTV segmentation task. Specifically, we design a dual reference strategy to select domain-invariant and domain-specific representative samples from a specific target domain for annotation and model fine-tuning without relying on source-domain data. Our approach not only ensures data privacy but also reduces the workload for oncologists as it just requires annotating a few representative samples from the target domain and does not need to access the source data. We collect a large-scale clinical dataset comprising 1057 NPC patients from five hospitals to validate our approach. Experimental results show that our method outperforms the previous active learning (e.g., AADA and MHPL) and UDA (e.g., Tent and CPR) methods, and achieves comparable results to the fully supervised upper bound, even with few annotations, highlighting the significant medical utility of our approach. In addition, there is no public dataset about multi-center NPC segmentation, we will release code and dataset for future research (Git).

Case series: Using laryngeal mask airway to enhance the radiological evaluation and staging of cancers involving the larynx: A novel technique

AbstractThe diagnosis and staging of head and neck tumors requires proper clinical, endoscopic, and radiological evaluation. Currently, imaging techniques such as Magnetic Resonance Imagining (MRI) and Computed Tomography (CT) are used for head and neck tumors but are limited in showing involvement of different hypopharyngeal sub‐compartments. Several maneuvers have been developed to improve visualization of the head and neck area; however, they demonstrated minimal benefit. In this case series, patients with tumors involving the hypopharynx are studied. A laryngeal mask airway was used to stent the hypopharynx to assess the extent of the disease by creating real space between mucosal surfaces. This case series aims to describe the impact of using laryngeal mask airway on the evaluation of cancers involving the hypopharynx.

A Comparative Study of Demographic and Clinical Criteria Between Male and Female Patients With Pemphigus Referred to a Referral Hospital in Iran.

Background: Pemphigus is a rare autoimmune disease characterized by the formation of blisters on the skin and mucous membranes, caused by autoantibodies against desmoglein, a key protein in cell adhesion. This study aims to compare demographic and clinical criteria between male and female patients with pemphigus referred to a referral hospital, utilizing data from the pemphigus diseases registry. Method: This retrospective cross-sectional analysis focused on several key aspects age at disease onset, severity (measured by the Pemphigus Disease Area Index [PDAI]), types of pemphigus, duration of disease, and diagnostic criteria including the presence of antidesmoglein antibodies and findings from direct immunofluorescence (DIF). By examining these variables among a cohort selected based on their diagnosis of pemphigus, the study aimed to identify significant gender differences in disease manifestation, diagnosis, and progression. This approach is crucial for tailoring more effective gender-specific management and treatment strategies for this rare autoimmune condition. Results: In a comprehensive analysis of 1218 pemphigus patients in the year 2021 from the hospital's registry, comprising 543 males (44.6%) and 675 females (55.4%), significant gender differences were identified in 9 out of 44 variables examined. The study revealed that males had a higher age at disease onset, more frequent clinical manifestations in the head, neck, and trunk areas, and greater severity of disease as measured by the PDAI score compared to females. Conversely, females exhibited higher instances of mucosal manifestations and a higher PDAI score for mucosal erosion blister of the lower gingiva. No significant gender differences were found in 21 variables, including the overall age of patients, specific clinical manifestations across various mucous membranes, types of pemphigus, and PDAI scores for mucosal erosions in particular locations, indicating a nuanced gender impact on the presentation and severity of pemphigus that necessitates tailored clinical approaches. Conclusion: The study highlights significant gender differences in the presentation and severity of pemphigus, underscoring the importance of gender-specific approaches in the diagnosis and management of this condition. The findings contribute valuable insights into the complex nature of pemphigus and underline the necessity for further research to understand the underlying mechanisms driving these differences.

Bone mineral density and related clinical and laboratory factors in peritoneal dialysis patients: Implications for bone health management.

End-stage renal disease (ESRD) patients often experience accelerated bone turnover, leading to osteoporosis and osteopenia. This study aimed to determine the prevalence of osteoporosis in Peritoneal Dialysis (PD) patients using bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DEXA) scan and to explore any possible associations with clinical and biochemical factors. In this cross-sectional study, we enrolled 76 peritoneal dialysis patients from the dialysis center at An-Najah National University Hospital in Nablus, Palestine. We used the DEXA scan to measure BMD at the lumbar spine and hip, with values expressed as T-scores. We conducted a multivariate analysis to explore the relationship between BMD and clinical and biochemical parameters. Over half (52.6%) of the PD patients had osteoporosis, with a higher prevalence observed among patients with lower BMI (p<0.001). Higher alkaline phosphatase levels were found among osteoporotic patients compared to non-osteoporotic patients (p = 0.045). Vitamin D deficiency was also prevalent in this population, affecting 86.6% of patients. No significant correlation was found between 25 vitamin D levels and BMD. No significant correlation was found between Parathyroid hormone (PTH) levels and BMD. A notable proportion of PD patients experience reduced BMD. Our study found no correlation between vitamin D levels and BMD, but it highlighted the significant vitamin D deficiency in this population. Furthermore, our analysis indicated a positive correlation between BMI and BMD, especially in the femoral neck area. This underscores the significance of addressing bone health in PD patients to mitigate the risk of fractures and improve their overall well-being.

Stress distribution evaluation at localized necking area using the virtual fields method with digital image correlation

Stress distribution evaluation at localized necking area using the virtual fields method with digital image correlation

Management of Nodular Nasal Basal Cell Carcinoma with Wide Excision, Transpositional Median Forehead Flap, Forehead Split Thickness Skin Graft: Case Report

Introduction: Basal cell carcinoma (BCC) is the most common skin type cancer with an incidence rate of around 75-80%. The most common location is in the head and neck area around 70-80% and followed by other body parts around 25% consist of the penis, vulva or perianal area and 5% on the skin. BCC occurs more frequently in light-skinned individuals compared to dark-skinned individuals. The incidence rate is relatively lower in Asians, blacks ethnic, and Hispanics.&#x0D; Case Presentation: A 66 years-old woman complained of scabs on the right side of her nose which had become increasingly widespread for the past 2 years. The wound was initially the size of a mole and was scratched until it spread until the patient was hospitalized. Physical examination showed a wound in the nasal area measuring 4 x 5 x 1 cm, irregular wound edges, cartilaginous wound base with necrotic tissue and pus. The first biopsy examination showed poorly differentiated basal cell carcinoma. The patient was treated with Nasal Reconstruction surgery consisting of wide excision was performed by surgical oncologist, transpositional median forehead Flap and forehead Split Thickness Skin Graft were performed by reconstructive plastic surgeon.&#x0D; Discussion: The diagnosis of BCC in this patient was based on regarding history taking, physical examination and histopathological examination. However, for defects with a diameter of more than 1.5 to 2 cm, generally recommended using axial pattern flaps such as forehead flaps, nasolabial flaps and dorsal nose flaps. In this case, the patient was treated with wide excision followed by nasal reconstruction with a transpositional forehead flap and forehead split thickness skin graft.&#x0D; Conclusion: Nevertheless, regional flaps remain the recommended procedure for nasal reconstruction after wide excision of the tumor. Accurate analysis of the damage combined with evaluation of the patient's clinical condition is necessary to select the best surgical technique. Thorough knowledge of regional vascular anatomy and a comprehensive multidisciplinary approach are important first steps for proper treatment of nasal skin cancer, so that the procedure for wide excision of nasal basal cell carcinoma followed by nasal reconstruction with transpositional forehead flap and split thickness skin graft, can provide satisfactory result.

Variations in the Branching Pattern of Facial Nerve

The seventh cranial nerve, known as the facial nerve, is situated in the head and neck region and governs the mimic muscles responsible for facial expressions. The anatomy of the facial nerve exhibits variations, a matter of particular interest for surgeons operating in the head and neck areas. Incidents of facial nerve injury during such surgeries are frequent and can significantly impact the patient’s quality of life, potentially leading to facial nerve paralysis. The facial nerve’s main trunk emerges from the stylomastoid foramen which passes through the parotid gland, and divides into upper (temporofacial) and lower (cervicofacial) divisions which further gives rise to five terminal branches: temporal, zygomatic, buccal, marginal mandibular, and cervical. A comprehensive understanding of the branching and anastomosis patterns of the facial nerve is of significant importance for the surgeons to avoid inadvertent injury to the facia nerve which has devastating effects.

Principles, Recent Developmentsand Perspectives in Boron NeutronCapture Therapy (BNCT)

For decades, BNCT was seen as an attractive concept and an intellectual challenge with no prospect of widespread clinical application. This situation has changed fundamentally in just a few years with the progress in accelerator technology. Low-energy, high-intensity neutron sources can now be integrated into hospitals and are therefore directly available for patient treatment. A pioneer in this field is the development in Japan, where patients are already being treated in three hospitals, using in-house accelerator-based systems. Furthermore, the costs associated with the BNCT treatment of recurrent tumors in the head and neck area are already covered by the healthcare system. It is time to keep up to date with this technology and work to make it available to patients in high-tech medicine in other countries, especially in Europe and North America. This short article summarizes the main principles of BNCT, outlines some aspects of its history and mentions ongoing projects as well as some hurdles that need to be overcome, as well as the scientific questions that need to be addressed for wider availability of the method.

Investigation of musculoskeletal disorders prevalence and the correlation of Visual Analog Scale with McGill Pain Questionnaire in dental students of Tehran universities

Introduction: Work-related musculoskeletal disorders are one of the most common occupational complaints among dentists. This study aims to investigate the prevalence of musculoskeletal disorders and evaluate the correlation of the Visual Analogue Scale with the different dimensions of the McGill Pain Questionnaire in dental students in Tehran. Understanding this correlation leads to improved pain control by increasing the effectiveness of pain assessment.&#x0D; Materials and Methods: This cross-sectional descriptive-correlation study was conducted among 120 dental students in Tehran in 2020-2021. Data related to musculoskeletal disorders were collected through a Nordic questionnaire. Pain assessment was done using the Visual Analogue Scale and McGill Pain Questionnaire. The data were analyzed using SPSS version 26 software and chi-square, Spearman, and Pearson correlation tests to check the relationship between the two scales.&#x0D; Results: In this study, the highest prevalence of disorders was observed in the neck area (42.5%), upper back (35%), and waist (31.7%). Discomfort and pain in the neck in the last 12 months caused a decrease in work activity among the participants more than any other area. A significant correlation was observed between the visual pain scale and the sensory, affective, and evaluative pain perception group of the McGill Pain Questionnaire.&#x0D; Conclusion: The present study shows that work-related musculoskeletal disorders are common in dental students. It is recommended that corrective and educational measures using ergonomic science be on the agenda.

Physical abuse in the newborn with congenital hypothyroidism: A Case report

Background: Global estimates of child homicide suggest that infants and young children are at most significant risk, with rates for the 0 - 4-year age group. Physical abuse of a child is defined as the intentional use of physical force against a child that results in or has a high likelihood of resulting in harm to the child's health, survival, and development. Case presentation: Here presented baby 0 days old with a wide laceration on the neck. The baby was born spontaneously in the bathroom. The baby was brought in with an injury to the neck area with a two-wound size of 4cmx3cm and a scratch mark on the stomach. The mother said that the baby was fallen and hit by ceramic after the baby was delivered. At the hospital, 10 hours after birth, pediatric surgery did the debridement procedure by primary hecting. This case handled by the Integrated Service Center for the Empowerment of Women and Children, the edge of the wound is sharp, flat, with many angles, and the number of wounds is more than one, indicating sharp violence carried out by sliding. Conclusions: The outcome of child abuse can result from short and long term consequences. At the same time, there are child protection policies that protect the child from any abuse.

Assessment of the Impact of Inaccuracies in the Head and Neck Tumors Patient Positioning on the Halcyon Accelerator by the Amount of Dose-Volumetric Characteristics When Planning Radiotherapy

Purpouse. To evaluate the impact of inaccuracies in patient positioning during irradiation of tumors in the head and neck region under the control of a portal imaging device on the Halcyon accelerator on the value of CTV-PTV offsets at the contouring stage.&#x0D; Material and methods. Treatment of patients and monitoring of the position of 35 patients on the therapeutic table using a portal visualization device during each irradiation session was carried out on a Halcyon tunnel-type electron accelerator, including an irradiation planning system (Eclipse version 16.1) and the Aria oncology information system (version 15.5).&#x0D; Resuits. Based on the results of positioning and analysis of a sample of 35 patients, it was concluded that it is possible to change the CTV-PTV offsets during contouring to a smaller side for the head area and a larger one for the neck area below the C3 vertebra. These results are explained by the strong fixation of the head in the thermoplastic mask, and the high mobility of the neck due to air gaps.&#x0D; Conclusions. When creating a treatment plan, changing the CTV PTV offsets leads to a reduction in the volume of the target and moving it away from critical structures. This makes it possible to increase the accuracy of the treatment and reduce the dose load on the normal tissues surrounding the tumor. The results obtained have high practical value.