ABDOMINOPLASTY - TUMMY TUCK SURGERY

ABDOMINOPLASTY - TUMMY TUCK SURGERY ABDOMINOPLASTY TUMMY TUCK SURGERY Abdominoplasty or dermolipectomy (â€Å"tummy tuck†) is a procedure by which excess skin and subdermal tissue from the abdomen (so called hanging belly) are removed. Complete musculature of the abdominal wall is tightened. â€Å"Hanging belly† happens mostly to individuals who have lost a significant amount of weight or women who gave several births. Of course, hereditary elements play an important part. TUMMY TUCK CANDIDATES If you want to know if you are a candidate for dermolipectomy, you need to follow these indications: limp and loose belly, excess skin and fatty tissue on the belly, striae on the lower part of the belly and loose and separated muscles of the abdominal wall. PREOPERATIVE ASSESSMENT Patient preparation for the tummy tuck surgery usually starts during the first examination. The first step in preparation for the surgery is the patient’s consent. Very important part is to create that feeling of trust in the doctor-patient relationship. The patient will be informed of surgery process and what surgery includes. During the initial examination you’ll be asked to look in the mirror and show precisely what kind of change you would like to be done to your belly. During the examination you will give data of your medical history of illnesses or surgical treatments you had previously, medicine allergies, chronic infections, hypertension, diabetes, anemia. It is important to provide your doctor with complete information i.e. are you using some medication such as aspirin, estrogen, vitamin C, etc. Examination is performed in standing and lying position. During the examination, level of excess skin and subdermal fatty tissue has to be determined as well as degree of looseness of abdomen wall musculature and possible existence of ventral hernia. TUMMY TUCK PROCEDURE Tummy tuck incision is horizontally-oriented and is made in lower zone of the belly above pubic hairline and spreads lateral in the direction of pelvic bones. Length of the incision is determined by the level of looseness and skin excess. In general, incision is in line with the bathing suit, it is hidden so it can’t be seen on the beach. The complete complex of skin and subdermal tissue are prepared all the way to muscular fascia and up to ribs. Abdominal muscles are tightened and they are connected (plicated) shaping and forming new beautiful body contours. After that excess skin and subdermal tissue are tightened all the way up to navel which is removed. Then a new navel is created and has to look like the real one. Sometimes liposuction needs to be combined with this procedure. Drains are placed that are left for a few days. POSTOPERATIVE TREATMENT Drains will be removed after few days. Until then patient has to be in the position with bent legs. Sutures stay in place about 14 days. After tummy tuck surgery patient need to wear special corsets for a month after the surgery and to avoid physical strains for a month. One day after the surgery short walk is recommended. Patient has to get out of bed and go for a walk in bent position in order to increase blood circulation. Patient must avoid straining, sudden straightening and physical activities. Recommended time for having intercourse is at least after two weeks after the surgery. COMPLICATIONS Complications rarely occur. They are classified as early and late. Early complications include infection, hematoma, necrosis around the incision and usually occur with diabetics and smokers. Seroma can be developed after the surgery. It can accumulate under the skin and in lower parts of abdomen and can be there for a few months after the procedure. Later complications include appearance of hypertrophic scar. TUMMY TUCK COST Tummy tuck with muscle repair (dermolipectomia) 3000â‚ ¬

Fraud, Errors and Illegal Acts Term Paper Example | Topics and Well Written Essays - 1250 words

Fraud, Errors and Illegal Acts - Term Paper Example Internal control, proper reporting mechanism and the implementation of sound accounting policies and procedures shall rest with the management due to which, role of management has increased. A forensic accountant must have an in-depth study of the documents presented and should have the command to use computer software and so on. Forensic auditors must have excellent written and oral communication skill. Auditors must be aware of IT application and business processes to have a grip on IT related frauds. To nab the tax dodgers, Internal Revenue Service has number of trained people who gather information from different sources / channels to be used to detect tax frauds. IRS has the power to confiscate property of the tax defaulter / tax dodger in order to pressurize them to clear their tax liabilities. FRAUD, ERRORS AND ILLEGAL ACTS The Auditors’ Responsibilities to Detect Fraud, Errors and Illegal Acts The basic responsibility of an auditor is to detect fraud, errors and illega l acts that takes place in an organization and report it to the competent committee for audit to take appropriate measures to prevent fraud, errors and illegal acts (Alleyne & Howard 2005). ... controls, absence of controls, ineffective controls and overriding of controls by the management that culminates fraudulent expenses and skimmed of assets; to pinpoint the individual(s) that are involved in fraudulent transaction, their attitude and past history; identify the loopholes attracting fraud(s) and to suggest management / competent committee of the Board to plug in the identified loopholes (AICPA 2002). After the debacle of Enron and World Com, the American legislatures drafted and promulgated an act named as â€Å"Sarbanes Oxley Act-2002† just to restore the investor’s confidence. The act sets the new pattern of accountability and imposition of penalties for the wrongdoers (Alleyne & Howard 2005). According to laid down criteria, auditors have to take into account the mentioned criterion while auditing an enterprise. Auditors who have conducted audit of an organization shall keep audit reviews for a period of five years. Auditors are to certify the effective ness of internal controls of an entity wherein they conducted audit. They have to advise the management to form a team of experts from finance, audit, information technology, operation, risk management and legal to evolve comprehensive procedure for an effective control on financial transactions (Alleyne & Howard 2005). The team of experts should directly be reporting to the CEO/CFO of the company for necessary guidance and instructions in light of the audit reports. Management should bear the cost of compliance to improve / revamp existing system for an effective internal control. Auditors should not encroach upon the discretions of management for implementation of comprehensive procedure concerning effective internal controls or overcome the internal control deficiencies.  

Church Government Research Paper Example | Topics and Well Written Essays - 1500 words

Church Government - Research Paper Example On the other hand, the congregational polity is one where there is autonomy of local churches in that these churches have no affiliation to any other church. The other form of church governance is the single elder polity in which there is the pastor is the main source of guidance and decision making organ. Lastly, the plural-led polity is the most applicable form of church governance as it involves both the clergy and the elders being on the same level of governance. Comparison between the five models Presbyterian Ideally, this form of church governance existed in the olden days of the bible to which many of the present day churches have adopted. Presently, the application of this church governance involves the congregation voting in the elders that they feel would lead them in a just manner. However, the aspect of these elected leaders having the entire decision on how to govern the congregation posses some challenges as the decision of the elders chosen is unquestionable. As compar ed to congregational churches, the decision making process partly involves the congregation making this form of church leadership be one way. On the contrary, this polity evokes some democracy aspects as the judgment on church matters does not lie in the shoulders of one elder as compared to the single elder polity. ... This makes the session have accountability towards higher authority hence making them exercise responsible leadership as compared to one elder polity. Single Elder polity In this form of church governance, the church congregation tends to have equal stature among all members meaning that an individual is superior to others in the church. Over time, this form of church governance has elicited critic as the most humble of the congregation takes up the leadership role. This makes them more special than the rest of the church because this serves as an impediment to access to God. Additionally, the scripture has no illustration of this aspect as the Bible 2 tends to have widespread application of the Presbyterian leadership as kings had sessions of elders that helped them in governance and decision-making. Others consider this as a form of secular polity as its rise was during the American expansion period due to the travels that the missionaries experienced. This meant that the Americans involved in the spreading of the gospel could not be under a specified region like in the Presbyterian polity hence influencing this form of church governance. Therefore, this encompassed service to a large fraction of society under the leadership of a single individual. Congregational polity Arguably, this is a sovereign form of church governance witnessed among contemporary churches in which the absolute decision power lies in the congregation itself 3. This has distinctive features as c compared to the above-mentioned polities in which the final decision making responsibilities tend to vary between congregations. This form of polity has also attracted critic as the congregation makes decisions for itself hence implying that they may negate God’s law in their