AIMSThe aims of this article are to provide an overview of the technique of phalloplasty by radial forearm free flap in the context of female-to-male gender reassignment surgery, with a specific ...focus on surgical technical details and the prevention of postoperative complications. METHODSIn the light of our 30 years of experience in caring for female-to-male transgender individuals and conducting a critical review of the literature, we exhaustively present our technique of radial forearm free flap phalloplasty in female-to-male gender reassignment surgery. RESULTSThe technique of radial forearm free flap phalloplasty, utilizing a one-stage approach for neourethral and neophallus construction based on the "tube within a tube" principle, not only achieves an aesthetically pleasing appearance of the neophallus resembling a normal penis with tactile and erogenous sensitivities but also yields a functional neourethra and satisfactory penile rigidity using implants for standing voiding and sexual intercourse. This intricate surgical procedure demands not only meticulous execution of all surgical maneuvers but also high-level postoperative care. Despite refinements in technique over recent decades, aesthetic sequelae at the donor site of the flap remain subject to criticism, and postoperative complications, particularly of vascular and urological nature, remain significant. CONCLUSIONFuture optimization of the surgical technique for this procedure will be imperative to minimize postoperative complications and establish a true technical "gold standard" for phalloplasty in female-to-male transgender individuals.
The development planning in India has been started from First five year plan in 1951. There was focused on the agriculture. Later on, Industries, education, poverty, unemployment and health etc. all ...the sectors have been touched. Today, there is going on 12th five year plan. But, it is an illusively higher truth that even with the introduction of a number and varied development programs in India, the country in general and backward areas in particular, have not tasted the fruits of development as yet due to serious reasons (Purohit, 1986). The mountains are not good at the flat land conditions which do not attract more to the agricultural and industrial developments. There are 70.64% of marginal land holder out of total holdings and 17.77% of small land holder out of total holdings (Mittal, 2008). So we need to utilize the agricultural field very carefully. Thus, rural out-migration is dominant in Uttarakhand due to the negative relationship between population and regional development (Bhandari, 2007).Therefore, the figure of socio-economic structure is carried out and the study area is characterized by different developmental zones in this paper.
Insufficient stand establishment of winter wheat is a major problem in the rainfed region of the Uttarakhand hills. In order to increase germination and early establishment in the field under rainfed ...condition of hilly tracts this study was conducted at college of forestry VCSG University of Horticulture and Forestry, Ranichauri, Tehri Garhwal, Uttarakhand, India. The ten treatments were laid out in randomized block design with three replications in field. The treatments were VL 892 primed for 12 hrs with normal water, VL 892 primed for 24 hrs with normal water, VL 892 primed for 12 hrs with lemon water, VL 892 primed for 24 hrs with lemon water, VL 829 primed for 12 hrs with normal water, VL 829 primed for 24 hrs with normal water, VL 829 primed for 12 hrs with lemon water, VL 829 primed for 24 hrs with lemon water, VL 892 with no priming, and VL 829 with no priming. Significantly higher grain Yield of wheat was recorded in VL 829 primed with normal water for 24 hours which was statistically on par with VL 829 primed for 12 hrs with normal water, VL 892 primed for 24 hrs with normal water and VL 892 primed for 12 hrs with normal water. Significantly higher grain yield was recorded in case of priming with normal water than the priming with lime water.
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