Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world by causing acute COVID-19 infection. After recovery, a significant number of patients experience prolonged symptoms, long COVID syndrome. The prevalence of long COVID syndrome, its symptoms, severity and relation between clinical parameters and long COVID syndrome, and its impact were not studied in Myanmar. Methods: A prospective study was conducted via telecommunication to patients with positive SARS COV 2 PCR from nasopharyngeal swab during the third wave from end of May to August 2021. Data were collected by using standardized forms and analysis was done. A chi-square test of independence was performed to examine the relation between age groups, gender, body mass index (BMI), vaccination status, comorbidity status, severity of initial symptoms, oxygen requirement status, and symptoms of long covid syndrome. Results: Though initial recruitment included 18,709 patients with PCR confirmed COVID-19 infection, only 853 patients with recovery were analyzed. Long COVID syndrome was recorded in nearly 40% (333/853) of them; sixty percent of them (520/853) did not experienced symptoms following recovery. The common presenting symptoms in order of frequency were fatigue 58.9% (196/333), insomnia 27.3% (91/333), palpitation 17.1% (57/333), poor concentration 15.6% (52/333), anxiety 8.7% (29/333), myalgia 6.6% (22/333), chest pain 5.1% (17/333), persistent cough 4.2% (14/333), rash 3% (10/333), headache 2.7% (9/333), diarrhea 1.8% (6/333), anosmia 1.5% (5/333), sensory symptoms 0.9% (3/333) and dyspnea 0.9% (3/333). The majority 70% described as mild- not disturbing daily activity or job; however, 3% had severe symptoms- disturbing daily activity or job. Minority of cases 3% (10/333) required oxygen therapy for 2 months. Age, sex and BMI were not related with long COVID syndrome. However, initial multiple symptoms more than 2, co-morbidity, vaccination and initial oxygen requirement had significantly relationship with development of long COVID syndrome. Conclusions: In this study, the prevalence of long COVID syndrome among survivors was 40%; the common presenting symptoms in order of frequency were fatigue, insomnia, palpitation and poor concentration. Most of the cases had mild symptoms- not disturb job or daily routine activity. Nearly 80% of them admitted that their health status was not back to pre-COVID condition. Not only the patients with COVID-19 infection having initial multiple symptoms, co-morbidity, no vaccination and initial oxygen requirement but also their care givers should be warned about possible long COVID syndrome; and the necessary for follow up. Vaccination may prevent long COVID syndrome; it should be prioritized to those with comorbidity. It highlighted the need for systematic follow-up after hospitalisation with COVID-19 with multi-disciplinary team, rehabilitation and further investigation.

It is complex to understand all the mechanisms by which tumor cells use for their survival. The aim of the present review is to propose the mechanisms by which metformin would be beneficial in the context of cancer through the inhibition of the Warburg effect. A literature review of the Warburg effect and the mechanism of action of metformin was carried out to determine a theoretical relationship between metformin consumption and inhibition of tumor cell metabolism. There are several mechanisms through which metformin could antagonize tumor cells. As authors, we consider it of vital importance to know these effects in order to extrapolate them to experimental studies and seek the maximum benefit for patients, using the resources we have to date.

WHO recommendations for the management of Community Acquired Pneumonia (CAP) have been revised since 2014, amoxicillin is recommended as first choice for oral antibiotic therapy in domiciliary treatment of children. This study was planned to compare cure rate of oral amoxicillin plus clavulanic acid vs oral amoxicillin in children with CAP. Children aged 6- 36 mo, presenting with the clinical features consistent with the diagnosis of CAP were enrolled. Patients were given oral amoxicillin or amoxycillin plus clavulanic acid for 5 d and followed at 48h, 5th d and 2 mo. The cure rate, adverse reactions and recurrence were assessed and analysed for these two drugs. The cure rate of CAP in amoxicillin plus clavulanic acid group was significantly higher as compared to amoxicillin group (93.88% vs 79.17%, p 0.013). The chances of cure rate increased by 15.3% for children receiving oral amoxicillin plus clavulanic acid. Only mild side effects like diarrhea (22.1%), nausea (9.6%), vomiting (5.7%), and maculo-papular rash (2.9%) were observed in both the groups. All the cured children were followed up to 2 mo and none had recurrence of symptoms.

Aim: Interpretation of cardiac arrhythmias in detecting cardiac disorders and diseases is crucial. The immediate interpretation of cardiac arrhythmias is one of the most important clinical skills of medical and nursing staff. With the increasing use of training based on modern techniques in medical education, this study was performed to design and evaluate the efficacy of cardiac arrhythmias simulator application on critical care nurses’ learning and satisfaction in comparison with the booklet. Design: This quasi-experimental study with a control group was carried out in 2018 on 80 critical care nurses that were allocated in two groups. Methods: The interventions involved mobile learning via a researchers-designed application and learning via a booklet on the interpretation of cardiac arrhythmias. Four weeks following the interventions, both groups were evaluated and the results from both groups were compared and analyzed by descriptive and inferential statistics (independent sample t-test, paired sample t-test, and ANCOVA). Results: The research results revealed that the mean knowledge and skill scores of the participants by are searcher made questioner in the mobile learning and booklet groups, before intervention were 17.6 4.565 and 19.00 4.630 (P-value=0.201), and after intervention were 21.33 2.693 and 19.27 4.596 (P-value=0.018), respectively. The statistical analyses also revealed that the mean post-intervention learning scores of the mobile learning group were significantly higher than the mean pre-intervention learning scores of this group (P-value<0.001). However, no significant difference was observed between the pre and post-intervention scores of the booklet group (P-value=0.249). Besides, the mean satisfaction of the critical care nurses participating in this research with the arrhythmia simulator mobile application was approximately 85.72% and their satisfaction with the booklet was 78.05%, reflecting the acceptable level of satisfaction. Conclusions: in this study researchers designed and developed an arrhythmia simulator mobile application and a booklet on the interpretation of cardiac arrhythmias according to the predetermined principles, instructional design, and learning goals. The research results revealed that mobile learning in this field leads to more efficiency, positive impact, and more satisfaction rather than learning via booklet. Hence, Mobile learning can be considered as an appropriate educational strategy to train cardiac arrhythmia interpretation skills in health care providers and learners.

Introduction: Mobbing syndrome is frequently observed in health care settings. Inadequate management has a profound effect on victims since they demonstrate difficulties in defending themselves while causing them physical, psychological, social and work-related consequences. Aim: To measure the occurrence of this phenomenon among nursing staff in the midst of a covid-19 pandemic. Methodology: The Negative Acts Questionnaire- Revised (NAQ-R), an instrument designed to measure exposure to bullying in the workplace was used. It consisted of a total of 31 questions. Chrobanch alpha reliability coefficient was (a)= .898. Questionnaires were distributed via Google Forms online platform due to the Covid- 19 pandemic. A total of 216 nurses participated in the study. SPSS v.25 was used for the statistical analysis. Results: The vast majority of the sample (76.9%) were victims of mobbing. The score ranged from 27-90 with a mean of 54.44. The results showed that younger nurses (p<0.05), who resided in rural areas (p<0.05), were single (p<0.05), did not hold an administrative position (p<0.05), had less professional experience (p<0.05) and an annual income of 10,001-20,000€ (p<0.05) scored higher. Conclusions: The percentage of nurses who suffered moral harassment is particularly alarming and therefore it is necessary to inform and take preventive and safety measures for employees that are victims of mobbing.

Indian dahi, its history of origin, uses and benefits are reviewed. Studies were undertaken to observe effects of fermented milk in control of diarrhoea in children. India with high prevalence and severity of malnutrition, overpopulation and mainly vegetarian society are in need to develop protein sources with richness of minerals and vitamins; thus dahi (made with- lactobacillus bulgaricus and streptococcus thermophilus) and other vegetable source Berseem leaves (Trifolium Alexandrium) were studied in children patients suffering from protein energy malnutrition needing hospitalization, for acceptability and improvement in health i.e. appetite, weight gain, increase in haemoglobin. Study patients had clinical or laboratory evidence of infection, but only 32% patients were CRP positive (blunted response). The T cell lymphocytes CD3, CD4 and CD8 were in normal range and supplementation did not alter the counts. The baseline cytokine levels (TNFa, IFN?, IL-10 and IL-4) were high in malnourished children. On feeding dahi and LPC diets the serum proinflammatory (TNFa, IFN?), and anti-inflammatory (IL-10) cytokine levels, increased. The increase in IL-10 was higher in children receiving dahi diet. On comparing dahi diet against milk diet IL-1, IL-6 levels increased significantly on day 15th and at 6 weeks (p<0.001), in both the groups. However, IL-10 showed rise on day 15th and 6 weeks on dahi diet, in contrast milk diet patients showed fall on 15th day with subsequent rise at 6 weeks. The mean initial absolute lymphocyte counts were 3707±1551 and 4553±1776/ µl on dahi and milk diets, after 6weeks of treatment the corresponding values increased to 6312±1937 and 3493±1418 µl, respectively, (p=0.004). Similar, trend was observed for CD3+, CD4+, CD8+, CD19+ and CD56+ cells in two treatment groups. These observations demonstrate that dahi has immunonutrient properties.

Research methods of any postgraduate study entail a description of a population of interest from which the target population and the sample are derived. A clear distinction between these concepts is essential for research studies, but it also extends to academic and business writing. The importance of differentiating between the population and target population in research cannot be overemphasised as these provide a backbone of any research study.

Involvement of the ovary by malignant lymphoma is well known as the late manifestation of disseminated disease. Primary ovarian lymphoma(POL) is extremely rare , accounting for 0.5 % of all NHLs and 1.5% of all malignant neoplasms1 . We here in describe a case of Primary ovarian Large B cell Lymphoma involving bilateral ovaries in a 34 year old female.Preoperative CT imaging showed a bilateral heterogenous soft tissue masses with cystic areas involving both ovaries. She underwent bilateral Ovarian cystectomy. Current diagnosis is based on histopathological immunohistochemical analysis. Patient died within one month of diagnosis.

In endodontic practice, procedural mishaps are encountered that might impact the prognosis of root canal treatment. One of these procedural mishaps is endodontic perforation. The success of perforation treatment is determined by whether the perforation can be repaired to avoid or eliminate bacterial infection at the perforated site. Materials used in perforation repair include Hemostatics, barrier materials and restoratives. The bioceramic restorative materials are broadly classified into three generations. This review paper summarizes the various bioceramic perforation repair materials and their effect on blood contamination.

Medical causes of death written by a doctor are important to be documented for each death, especially in relation to public health, research, surveys, epidemiology, prevention programs, public safety, medicine, and health administration. This is a retrospective descriptive study that aims to describe the causes of medical death in confirmed Covid-19 deaths, as well as compare the writing of causes of medical death based on the WHO International Classification of Disease (ICD) 10 standard. From this study, it is known that more than half of the information on the medical cause of death form written by doctors still does not comply with the WHO ICD-10 standard. The most common medical causes of death that have a direct impact on the death of confirmed Covid-19 patients was acute respiratory distress syndrome. Writing the cause of death according to the WHO ICD 10 standard is very necessary in obtaining accurate information on deaths related to COVID-19.

This review paper is about development and evolution of nanocomposites to smart materials. With the idea of formulating dental materials with long lasting maintenance and functionality, it is important to incorporate certain features such as polymer nanofibers, natural fibers, natural clay, nanoclays, metal oxides, carbon nano fillers, metallic particles and sulphides of different ions. Therefore, it helps nanocomposites to deal with both external as well as internal stimuli in order to maintain its structural and functional integrity.

Introduction: Osteoporosis is a chronic, progressive skeletal disease characterized by low bone mineral density and deterioration of bone structure. There are multiple risk factors, both modifiable and non-modifiable. The main complication is fractures, which is why it must be diagnosed early and in a timely manner. Material and methods: Fourteen articles and one book on the diagnosis and treatment of osteoporosis were chosen in order to compare the best plan to follow in these patients in the different bibliographies reviewed. Discussion: The gold standard for diagnosing osteoporosis is the measurement of bone density with the dual energy X-ray absorptiometry device, using the T-score. The use of different biomarkers is useful both for early diagnosis and for monitoring the reaction to treatment, but it is necessary to take into account that the main objective is to prevent the disease and to improve the quality of life of the patients. On the other hand, the main and early treatment consists of physical activity adapted to each patient, diet rich in calcium, magnesium and vitamins that promote bone health, the pharmacological part of the treatment has different areas that depends on the situation of each patient, considering gender such as estrogens and progestogens in postmenopausal women, tolerance to drugs such as Denosumab, and in general, bisphosphonate is used as the first line of treatment due to the increase in bone mineral density that it produces, helping to prevent fractures and improving the quality of life of each patient. Conclusion: Osteoporosis is one of the diseases that can prevent the realization of basic activities, for this disease there are different methods of diagnosis and treatment, the main objective is to detect risk factors and make an early diagnosis to avoid complications that entails, relying on tools such as the FRAX calculator and the use of biomarkers, all this to reach the conclusion of the investigation, to use the different options and tools to provide appropriate treatment, this publication being an update on the options that are available today to treat this condition.

The “severe acute respiratory syndrome coronavirus type 2” (SARS-CoV-2) is also known as “coronavirus disease 19” (COVID-19). It originated in Wuhan, Hubei province, People’s Republic of China, in December 2019; and, it spread worldwide causing a global pandemic. Genetic variants of SARS-CoV-2 have been emerging and circulating around the world throughout the COVID-19 pandemic. The original (wild-type) SARS-CoV-2 coronavirus that causes COVID-19 has been changing; and, it has reproduced several new variants- the original (wild-type), the Alpha variant, the Beta variant, the Delta variant, the Gamma variant and the Omicron. the Omicron variant was first detected in South Africa in late November; and, it was found in Myanmar in January 2022 (Pyar, 2022).

The recent COVID-19 Pandemic has created havoc in the order of the world in terms of health care, well being as well as economy. India has also been affected adversely by this pandemic. The adverse effects are evident in health of the people; their well being is negatively affected because of this deadly virus. Apart from the health aspect, the lockdown that happened as a precautionary measure in time of the pandemic affected the economy of the nation in a negative way. The GDP of our country has dropped significantly lower which is most adversely affecting the working professionals of our country. Due to the sinking economy employment instability has increased manifold. People have either lost their jobs or are very apprehensive about the fact that they might lose their jobs in future. The currently working professionals are also not being paid full salaries; their salary is either cut to some amount or is reduced to half. These uncertainties in jobs are affecting people’s financial condition. Already people are physically affected by corona conditions and psychologically also there is a lot of apprehension regarding the corona virus conditions and when will the situations be normal. All these aspects are affecting the quality of life of working professionals. Quality of life as defined by WHO is the individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals. The quality of life of an individual is mainly assessed in terms of physical aspect, psychological aspect, social relationships and environmental aspect. These aspects, in light of the covid situation’s impact on working professionals, are discussed in detail further in the paper.

Over the past years, female sexual function and dysfunction has acquired a growing body of research. Some studies have indicated that links may exist among the sexual function of women, their body image and anxiety. The purpose of this study is to examine the direct impact of self-report anxiety and body image on female sexual function but also the potential association of the age, the marital status, the occupation, the education level and the existence of a psychological disorder diagnosis with the self-reported anxiety, the body-esteem and the female sexual function. The sample consisted of sixty women from general population. Three questionnaires were used to measure each variable (Greek version of Zungs Self Anxiety Scale, Body–Esteem Scale for Adolescents and Adults, Female Sexual Function Index GR). The results showed that the correlations among anxiety, body image and sexual function were not statistically significant. From the demographic characteristics, only occupation status was significantly associated with the sexual function which was found significantly greater for private employees compared to university students (p = .001), with the last’s total score in FSFI being below the cutoff point. This result is constant with previous researched which have found women University students at risk of experiencing a sexual dysfunction.

Objectives: To determine the stress level and coping level among GNM students of all batches in regard to covid 19 lockdown. To find out the association between stress level with their selected socio- demographic variable. To find out the association between coping level by the GNM student with their selected socio-demographic variable. Method: this is a cross sectional Quantitative study design; non experimental survey research approach was used. Data collected by means online questioners which is consisting of three sections-socio-demographic data tool, perceived stress scale, Brief coping scale. Result: In the study majority that is 70% of students were 21-25 years old and only 1% were 20 and above and 29% were between 17-20 years, for years of education majority were that is 63% were from 1st year, 24% were from 2nd year and 13% were 3rd year students. Sample were predominantly dominated by Hindu religion which was 92%, 6% were Christian and 2% were Muslim. 77% were hostellers, 14% were residing with family, 4% were with relatives and 5% were residing other. For basic qualification 99% had higher secondary education, 1% were graduate. And 99% were belongs to nuclear family, 10% were belongs to joint family. In parents occupation 83% were pvt. Employee, 13% were govt. employee, 2% were self-employee and 2% were unemployed. Samples 88% had no any co- morbidity condition and 12% present had co-morbidity condition. Most of the students had source of information for covid-19 from internet, 23% from television, 4% from peers, and 2% from other sources. Residing presently was significantly associated with the stress level of the student with p value 0.038, type of family significantly associated with stress level with p value 0.013, and co-morbidity significantly associated with stress level with p value 0.000. Religion was significantly associated with coping level with p value 0.006, Residing present significantly associated with coping level with p value 0.011, Type of family significantly associated with coping level with p value 0.001, co-morbidity was significantly associated with coping level with p value 0.000. Conclusion: The findings of the study revealed that residing presently; type of family, co-morbidity has a significant association with stress level. Religion, residing presently, type of family, co-morbidity has a significant association with coping level. I have found that 12% were high stress score and majority 80% had moderate stress and 17% had low coping, 8% had high coping score. So it is crucial to give psychological support to all nursing students to overcome the stress in this pandemic.

Background: Public Health Centers (Puskesmas) is a functional organization that runs integrated, comprehensive, evenly acceptable, and reachable health services for the community. Puskesmas are required to have better quality in accordance with the potential problems in its working area each. Along with the progress of the community, service delivery demand is getting more complex and critical (Zaidin, 2012). This becomes a burden for nurses in performing services for complex demands without being followed by balanced numbers of workers, infrastructure, and other factors. Purpose: To examine the workload and the performance of nurses in Puskesmas Banjarnegara District. Methods: the study is a descriptive correlational study with a cross-sectional design. The population was nurses in Puskesmas Wanayasa 1 and 2, Puskesmas Batur 1 and 2, Puskesmas Karangkobar, Puskesmas Kalibening, Puskesmas Pandanarum and Pukesmas Pejawaran with a total of 39 nurses. Samples were determined using a total sampling technique in accordance with the inclusion and exclusion criteria. Data were collected using a questionnaire. Then, the data were analyzed using bivariate and univariate analysis with the Spearman rank test. Results: Most nurses experienced a high workload with a total of 16 respondents (41%). The majority of nurses had a fairly good performance with a total of 22 respondents (56.4%). The results showed a value of 0.000 with a significance value of 0.05 and have a negative correlation. Conclusion: The workload and the performance of Puskesmas nurses have a significant relation.

Doppler ultrasound is the initial non-invasive study for the evaluation of the carotid vasculature, it will help us to establish the presence of tortuous paths, the presentation variable, the flow velocities, and if there is a hemodynamic repercussion. In this pictorial review article, the different presentations of carotid tortuosities will be discussed, as well as the correct evaluation of color and spectral Doppler.

Coronavirus disease-19 (COVID-19) which is an enveloped RNA beta coronavirus. First emerged in December 2019 in China and rapidly spread worldwide. Although various studies have reported that COVID-19 is associated with a hypercoagulable state and thrombotic complications in critically ill patients. The current SARS-CoV-2 pandemic is causing high morbidity and mortality, its main affectation is at the pulmonary level, however, the virus also affects the cardiovascular system. The vasculature is affected directly by the virus and indirectly by a storm of inflammatory cytokines, causing an excessive inflammatory process, platelet activation, endothelial dysfunction and stasis. Biochemically it manifests itself with altered coagulation parameters, increased levels of D-dimer and Ferritin, which are the most common laboratory abnormalities related to mortality. In our investigation, acroischemic lesions were found in critically ill patients with severe limb ischemia.

Mesenchymal stem cells have a proven potent immunomodulatory effect both in vitro and in vivo. We report a case of a 67-year-old male patient, first diagnosed with sarcoidosis in 2005, that responded well clinically and biologically to ImmunoARTTM (developed by Educell Ltd.) allogenic, HLA-incompatible, and non-related bone marrow-derived MSCs in a dose of 106/kg. The patient presented to St. Catherine Specialty Hospital in 2021 with an exacerbation of respiratory symptoms. After a clinical and radiological examination with laboratory workup, radiological findings were consistent with pulmonary sarcoidosis, while laboratory work revealed increased leucocytes at 14.2 g/L, CRP at 51.2 mg/L, and lymphocytes at 4.25 g/L. The patient was then administered intravenous application of MSCs on three occasions in the out-patient clinic. MSC doses were prepared from a young, healthy donor who agreed to donate bone marrow for allogeneic treatment and who was negative for viral markers (HBs Ag, HBc Ab, HCV Ab, HIV 1-2 Ab, TPHA, HBV NAT, HCV NAT, HIV NAT) according to EU legislation. Cells were prepared in a controlled and verified laboratory for “Hospital exemption” cell preparation in the cleanroom facility in safety cabinet class A and expressed CD105, CD 73, and CD 90 but lacked the expression of CD45 and CD34. Before the treatment, standard print and detailed verbal information were provided to patients undergoing treatment. Immediately after the informed consent form (ICF) was signed by the patient. Throughout MSC therapy, the patient showed an improvement clinically and biologically with a decrease in inflammatory parameters. Laboratory values were assessed on days 2, 5, and 7. On day 7, leucocytes were 11.2 g/L, CRP 5.1 mg/L, and lymphocytes 4.0 g/L. In the follow-up period, the patient felt subjectively better, without any side effects of the MSC therapy. Unfortunately, the patient dropped out from follow-up, therefore, the prolonged effects of this therapy were not able to be assessed. Therefore, systemic MSC therapy presents an opportunity to treat sarcoidosis that needs to be further researched.

Vision is one of the most valuable senses humans have. However, there are quite a few clinical conditions that threaten and compromise its function. Advances in the development of therapeutic strategies have led us to use stem cells to treat from chronic-degenerative pathologies to infectious-contagious diseases. Taking this into account, it is of vital importance to evaluate the possibility of future therapeutic strategies using stem cells to treat and manage ophthalmic pathologies.

The 50-year-old patient presented to our clinic for the first time in March 2019, complaining of an altered general condition, inflammatory pain in the small joints of her left hand, right fist and bilateral forefoot, morning stiffness of over 60 minutes, swelling of the right carpal and bilateral metatarsophalangeal joints and finger III left hand dactylitis. The patient is an employee and denies alcohol and tobacco use. From the hereditary antecedents we point a sister diagnosed with psoriasis vulgaris, another sister who died of a gastric neoplasm and her father having cardiovascular diseases.

Objective: carry out an anatomical-clinical review of updates on the diagnosis and treatment of SCT, comparing them and evaluating their advantages and disadvantages. Methods: a bibliographic review of original articles in English extracted from different databases such as PubMed and Google Scholar was carried out. Books from the Access Medicine platform: Orthopedics, Diagnosis and Treatment, and a Medical Refresher Course were also used. Results: the surgical treatment is superior and the one of choice for the SCT, since it improves the quality of life of the patient. Conclusion: there are methods for the diagnosis of SCT such as electromyography or ultrasound, which provide valuable information. Although pharmacological or conservative treatment is considered a first-line therapy, it is important that it be individualized.

Background: Vulvar cancer is a rare malignancy representing about 4% of all genital cancers in women. Historically, the gold standard for treatment of squamous cell carcinoma of the vulva was en bloc radical vulvectomy with bilateral inguinofemoral lymphadenectomy. For the reconstruction the options are primary closure, skin grafts, or local and distant flaps. In this case we used the gluteal fold fasciocutaneous V-Y advancement flap that is sensate and thin with a reliable blood supply, can be advanced easily, and can be performed in a single-stage procedure. Care Report: We present a clinical case of an 82- year old female patient who had an exophytic vulvar lesion, which grew progressively with the histopathologic diagnosis of invasive vulvar squamous cell carcinoma. It was decided to perform radical vulvectomy with right unilateral lymphadenectomy and reconstruction with Gluteal Fold V-Y Advancement Flap. During the post-surgical period it recurred with wound dehiscence and finally skin necrosis developed in the area of the left thigh. Surgical debridement, escharectomy, harvesting and application of skin graft, and closure of the femoral hernia with omentum patch were performed with no associated complications. Follow-up was carried out during the next 3 months after surgery. She presented adequate evolution of the flap and left thigh area. Conclusions: The Gluteal Fold V-Y Advancement Flap is an excellent option for the reconstruction of the vulvovaginoperineal area after a radical vulvectomy. It provides us with a good prognosis and quality of life for the patient.