We are going to go ahead and get started. I'm not entirely sure how long it will take to set the computer up. I hope not long because I don't really have a lot to say. But first of all, I'd like to welcome you all out to our patient grand rounds. I can tell by the size of the audience that having Alan Crandall on the docket is a big draw, whether he wants to admit it or not. I was actually a little nervous as we were, I didn't see him for the first couple of minutes. Unfortunately, he was stuck in a meeting upstairs. And if you know Alan, you know he was actually stuck because he would never be in a meeting by his own choice. Anyway, I thought I was going to have to get up and present and I felt really, really bad because that's kind of the old bait and switch, you know, you tell someone to come in for something really spectacular and then you switch it to something completely pedestrian like my talk. So the point of all is this is really to foster discussion. So please at any point raise your hand, ask questions. He'll be presenting some cases. I, this last week, had the opportunity to spend a week with Alan and Guatemala and I must say it was one of the true gems of my entire, both honestly personal life and also professional life. He's someone I look up to. He's still the person that I go to with any strange questions. And in Guatemala, where about 20 to 25 percent of the patients had pseudo-exfoliation in addition to their white cataracts, it was really nice to have him there to sort of help us along. So without further ado, Alan Crandall, and thank you all for coming. Very good. So I thought I'd start off sort of with a few basics. Whenever you give me these kind of talks, you should also mention your potential conflicts. Can you guys hear me? Okay, potential conflicts. Most of these don't relate to this discussion today, but it is something you have to consider. So I thought we'd talk a little bit about some of the sort of common things that we see in practice. And also, it depends on how weird we want to get. I have a few extra cases that I'd like some input from everybody as well. So when we're talking about this type of stuff, we need to look about things like what are the support devices that we have available? Iris hooks, which have been around a long time. There it is. I like the McCull hooks, but lately I've been using the MST hooks more frequently than before. The Mortar hooks. I'm happy to say that we're testing a new device. Is Bala here? Bala's redesigned. He's not here. He's redesigned a device that is similar to the Ahmed segment but has two holes. It's a little bit longer. Has two hooks that come above. And actually may be quite useful for some of these more challenging cases. There are contradictions for the use of CTRs. Of course, there's the anterior-capsular-terra, posterior-capsular-rent, unless you can convert it to a posterior-circular-full-capsular-terra-rexis, but we can do that. One of the questions we often get is when do you put in CTRs? One of our faculty, of course, is Ken Rosenthal of New York City, and he was the first to make a statement, I think, as late as you can, but as early as you need to. We've done lots of Miyake view studies here looking at the reasons for doing that, but basically, if you do it prior to paper, you do have better nuclear stability, but it does make it very difficult with the dense nuclei. I have a case that I went to show from yesterday, which is not edited, but shows a couple interesting things about dealing with those type of decisions. And it also makes cortical removal heart more difficult, so if you can do it after fake, it's a much better device. And remember the theory behind them. I use the biggest one I can have available. So if you have a very short eye, use a short one. Otherwise, just use the 14-sized C, so the eyelids overlap. That's the best. And they do help both early and late lens rotation, centration, and it's designed to maintain the contour in the face of these zonular weakness. And I'm not just presenting here to a group. This is all our partners. I'm just trying to get everybody to stop, and if they disagree or want to further some point, everybody in the audience, please pop up. Randy? So the one thing I'm seeing with CTRs, and I think I'll go around, you're seeing a lot of stories of them now.  Yeah, I think it's a good point, because that's why with pseudo-exfoliation, for example, it's a generalized zonulopathy and you are not stopping the disease process. In fact, it helps center. There's lots of times when the CTR does make a lot of sense. I don't have a picture of Bala's new product. I've just used it in a couple of cases, and it's been very helpful. It's similar to Ike's thing except it has, instead of the islet being just here, it has another islet over here trying to get a mortuary to kind of raise the islet. So it's a little bit easier to use, but it's going to be another nice addition. And you can use those. I like to use temporarily as a supporter for the bag while you do your case.  But if the bag is not usable or it's already loose, then you shouldn't just put in a CTR. You can use those, of course, to suture them to the sclera. And we're doing a lot of that. The MST hooks are very nice for those that haven't used them. I like them a lot better than... This is the McCool hook, which is definitely better than iris hooks, because the iris hooks are not designed for the bag, and they often have... Here is a little bit sharp, and you can pop a capsule with it. So you can use it occasionally. I'll use those for when I'm doing a Marfan syndrome, for example, to help move the lens while you're doing the case so that you can actually complete your rexis. But these are much better for that. And I like these a lot, and you can bend them very easily to kind of help you with the device. Now, one of the things I want to emphasize, one of the things I'm doing differently this year, what are the six things I do differently for suit exfoliation than last year? Well, one of them is to make sure we're doing a lot more... I'm using lens epithelial removers on all of those cases. It doesn't help with PCO. Aliyo Study in Spain showed that, but it definitely did help in their subgroup, and I've seen it in mine, decreasing capsule primosus, which we hope five or six years from now may make it... may have less, you know, less... let's say, late dislocations, but we won't know that for a long time. And then the other thing is to make sure I do bimanual rotation of the nucleus to decrease zonular stress. Again, studies that Liliana and I did showing how much zonular stress on the zonules occurs. If you use bimanual, you'll just make sure that the rotation that you're within the capsule bag and that there's no movement of the lens. It sometimes helps to debulk a little bit when you do that, and then you can use bisco dissection to further release pressure on the zonules and make the rotation a much more elegant technique for your removal. We're working with a couple companies to get a little bit nicer design. Mastel is making a really nice one. It's really designed to go in easier. And it's surprising when you look at how many cells we leave behind with the present technique. Nick, you want to comment on that? There's some studies with the group. Yeah, we're designing one a little. I think that fits the bag a little better rather than these that are all one-sided. It should go out a little further. When you're putting in a CTR, first of all, I think the new one from Mortu is a really nice way to do it. It makes it very easy. They come in L and R, and don't remember the L and R. The L and R is not for left eyes and right eyes. It's for how it comes out of the shooter. So what you want to do when you're putting devices in, if you have a generalized zonuleopathy, it doesn't matter. If you have a weakness here, then you would want to use the good zonules in order to help it go around. If you put it into the bad side, it can sometimes tear out further and sometimes won't go around. The other thing to do is you can rotate this tip a little bit towards that side to get it started. Sometimes you can even use a Sinsky hook to get the bend to start. Another good trick is to put a 10.09 on the shooter through there and you can actually drag it around if they're really weak, if you need that support early on in a case. This is a modification that I think is really... This is one of the other things that we're definitely doing now. We've all seen this. This is sort of a modified version of a beautiful video that Liliana did. I think it's critical to think about this when we're doing our surgeries. When you are doing... I've been obviously teaching the wrong way for 25 years, but if you look up here, this is a beautiful view. This... There's no... This is a cortex only. Now watch as you go away. Stress on your here, no stress, no stress, no stress. What's the point? You don't... There are a couple of things you don't do. One is as little radial aspirations as you possibly can. You can see there's cellular stress. And the other thing is the bouncing motion that we frequently do is a wasted maneuver. It doesn't do anything. The best way to do it is to do a tangential rotation. So again here at high mag, you can see there's annular stress. This is the cortex only not holding on to the bag itself. So again, you see as you go away from the area here, here's your zonular stress. As you go away, there's no stress on the zonular. So here's a good view of the radial view of that. And you just watch as you go around. The other thing is that if you do this correctly, you can go all the way around in one or two moves and it saves you quite a bit of time going to the center and back, to the center and back. And the subincision was a little bit trickier, but we're working on ways of doing that. But the trick is being at the top of the rexis, not inside the bag and pulling tangentially. Just show a few cases. These are in the OR. I usually like to start out this side over here and then you just kind of keep it in... You see, you don't need a lot of vacuum, you just keep it occluded and it'll go around and it saves you probably, I don't know, quite a bit of time. Everything flows very easily because you're interned. This is the other thing that I'm doing more on every case is making sure that I have a corneal marker so that I know my rexis size. So I have usually a 575 that if I have a pseudo-exfoliation, I might want to go a little bigger in that to decrease the stress if I have a really hard cataract, a little bit bigger than that type of stuff, so you can do that. Then you get the lens epithelial cell removals afterwards. So here again is another case. Again, keeping the tip, it doesn't matter whether you have a straight tip or a curved tip, just use yesterday the new MST single use things which we may be using more and more if we're going to run into the issues with sterilization that we have. You can see you don't need to make any movement to the center of the pulling so there's no zonular stress. And teach yourself to do this on all your easy cases so you do it every single time on something case where it is mandatory which is any case that you have pseudo-exfoliation cases. Nick, you guys want to comment on... Liliana, are you here? Do you want to comment on any of those? Right. It's a beautiful video and it's been translated into how many different languages. Yep. And let's see, a little bit... I want to skip down a couple of these to pseudo-exfoliation. So in pseudo-exfoliation which we see here, by the way, I was... We had a beautiful trip and our team did a great job. It was shocking to see the amount of pathology in Guatemala and one of the most interesting things to me is once again, we go to some place we've never been and all of the Mayan background, we had 70% of our patients had pseudo-exfoliation. 70. Chey and I sit down, 10 of the first 15 each of us did that first day, we were going, oh my God, you're kidding me. Just like our first trip to Ethiopia.  Yes. Yep. So remember, the small pupil and pseudo-exfoliation is really a marker for the possibility of a zone of weakness. This is particularly true when you go into like Ethiopia and other places like that. And it's... In that setting, it's probably... I think it's better to convert to an SICS in those areas because we don't have all the devices. Jeff, do you want to come in on that? SICS. So if you're doing a pseudo-exfoliation, immediately look for wrinkly into the capsule, it gives you a clue that there's a zone of weakness. I still think every case you should do, you should do it as elegantly as you can and you train yourself, obviously to do that for the resident standpoint in every single case. And don't be afraid to use a dye, particularly in pseudo-exfoliation that makes it a lot easier to see the different cases or the different areas that are weak. Cortical cleaving is really nice to do. I don't do hydro-delineation in pseudo-exfoliation because I think it makes the rotation more difficult and it makes the INA tends to be a little bit more difficult. Do you want to minimize your zoning or stress when you're doing these? If you're going to use a divide-and-conquer technique, make sure that you use enough power so that the nucleus itself does not move. Take off less tissue as you go, use more power, make all those deals. Pre-chop is really good and this is one thing that's going to be interesting to see, but I think the femtosecond laser may have some value in these kind of cases because one, you get a good rexess and two, it softens it up so it may decrease the amount of zoning or stress. It's interesting to see I hope we'll be doing some studies where we'll be able to kind of evaluate that as the time goes on and vertical chopping in smaller pupils. Nowadays, and one of the things I'm going to talk about at the Academy is it's silly I remember giving courses 20 years ago and I know you did too, Randy, on how to do a FACO through a 1mm cataract. You can do it. There's no issue with that. We can do that, but it's silly to do that when we have devices now that will allow us to expand the pupil because what happens when you do the small pupil FACO, you can't get all the cortex out. You don't get all the cortex out. I don't think. There's no reason not to expand your pupil big enough so you can do the axis, big enough so you can see the cortex and then you can see this weakness if you get into that type of deal. And then the other thing is definitely do not do tangential cortical removing on this. Here's just a case. This is a case I knew that had the lens was moving prior to surgery so I knew it. You don't need to watch the whole thing, but the point is stain. You can see the nucleus move as the rexus start the rexus and you can see as you're doing around you can watch the in front of the rexus, you look out here and you'll see wrinkling and that wrinkling when it goes around is a suggestion that you have zonular weakness in that area. So once you get a good rexus then you can do a number of things. But in this case do viscodes section to create some space and then I'm going to use Ahmed segments in both areas because then you have an anchor on both sides that allows you to do that. So you just simply put in one segment. Yeah. Not really, I like to use the question is dispersive versus cohesive, correct? So in that case I generally use a cohesive because I can create a little bit more space and I like I don't want but I don't want a Helan GV. I mean Helan 5 I don't want for sure because it's impossible to really get it out of the way. So here you can see you have two anchors. Randy or Nick you guys want to anybody comment on their choice of viscoelastics during that? Those are different opinions. Right. Yeah. Yeah. Yeah, so don't you know any of the any of the Provis, Helan, Helan GV is probably okay. Then you can see this turns it into now this Randy is a case where I agree with you 100%. This is a loose on your case. So at the end what I'm not I could put a CTR in or you could put things in that would work but I didn't feel like that was enough. So in this case I go ahead and put in I do an iris iris fixation bag put the optic in the bag but iris fixate the eye well because I think that's a good that's a good point in that person. Yeah. Yeah. Yeah. So you don't do that. Now this is this I found was an interesting case. Obviously this is a pseudo affiliation case. And because you see I marked it this is going to be a it was going to be a toy cleanse. And there was no zonular issues beforehand. I watch as I do this. I didn't believe it. I go what? I go oh crud. Game plan. So this is game plan B. So we got about 180. Now the reason I want to show this is if you have a now you can ring in you cannot do some of the manipulations.  So take them out and in this case it's much easier to convert to a more standard type of iris and you can get further out on those. So in this case I'll fortunately the the zonular weakness was only in 180 degrees. So I just put a ring in with a CTR and iris fixated. So that's an this again shows I love to show this video. This is a fantastic day. Nick and Leon and I in the OR. You see nothing moving with the ultra chopper which is a really good thing but I want you to get to the one case that changed the way I do FACO in pseudo exfoliation patients because we saw this occur now I want you to see this is a pseudo exfoliation case. You can tell it's a cell rexis. The zonules look a little weak but as you look through here when we get to this rotational motion look at that. So what's the most dangerous thing that I've been doing incorrectly all this time? Rotation. That's why I do them by manual. That's why I'm putting pseudo acts. Why I'm not rotating if there's any hint that it doesn't spin absolutely beautifully. Debulk it bring the hemisections up technique or whatever but decrease your rotations with pseudo exfoliation and there's a 360 zonulopathy so you could say well you could rotate toward that and use the good zonules. There are no good zonules and I think that I have been causing some of these late dislocations because I've been small rexis not getting out of the cortex not removing the lens epithelial cells and doing what I thought was nice rotation but not good rotation. Comments you guys? Yeah absolutely. So just one more for those you know since we now have the new centurion the centurion has two ports one where you can leave an ultra chopper on and you don't need to take it out and transform it so this is a white this is a cataract. You can see here that you get a nice rexis size 5 don't get a small rexis on these cases and then what I'm going to do here is I'll use the ultra chopper to thin it out or not to thin it out but to debulk as well as allow me to break it so you'll be able to use these with the centurion you can use it with any of the alkan units anywhere I used it both in Guatemala and a lot in Tanzania and Ethiopia we didn't have different places we do but as you rotate again you debulk a little bit make sure the rotations are very nice I won't bore you with the rest of these you can see here that get to a nice number quadrants and you can develop a little thinner pre chopper so you can get the open easily make sure that you have a crack all the way down before you do anything because if the bottom fibers are really tight it's very difficult to get those pieces out and then make sure you change your standard you got to make sure you're using a burst mode or a mode that's more effective in making sure that you have an efficient way of debulking use and no problem with don't ever come out of the eye without filling the bag with Bisco elastic first so if you're going to come out you want to change anything around so the second sixth thing I do differently with Sudo X is I never come out of the eye without filling the eye with something beforehand because the bag is going backwards and forwards and I think you have a good chance of decreasing the problems then on the last piece decrease your flow rate here I've got a slow you know 33 aspiration things that want to have happen on the last quadrant decrease that to 20 or 25 so that you have good control of the pieces and I'll often change the amount of time on 90 milliseconds average sometimes 110 gives you a little bit more of a stroke pattern and Randy can probably talk more about this the efficiency of different on-off patterns on that you want to go ahead and say anything about well there's a whole series of work and right now the way the centurions set up for that point it's a 30 pulse per second on-off with about six seconds on you can obviously alter that based on what you want so trauma if you're doing traumatic cases if you see six millimeter or six zonules you add two on each side because they're probably weak out there and you can use these beautiful devices the again those were MST hooks they allow you to do lots of different things I did want to show one other one other interesting case this is just using not this one so I want to present this case this was an interesting case this patient was referred down from Idaho what had happened was the surgeon had planned on doing a PECO I step this is a case of pseudo exfoliation not self exfoliation I still don't know the problem but he had bilateral zonules so when the surgeon started the case the lens moved and he decided he didn't know how to finish that so he just sent him down this is actually the second eye the first eye was more interesting and so you'll see here as I just go in here in this case the femtosecond I have a great video to show that the first eye I thought I could use it to chop it but the lens moved so I had to abort the lens X portion of it because you don't know how far down it could have gone out but it does the rexis so it does a beautiful rexis in these kind of cases you can also de-center it for your Marfan's cases so you get it widely dilated de-center the nucleus then you can set it down to four millimeters three and a half, four millimeters, whatever you want to have and so this is post lens X and you'll see here so I've moved him back into the OR let's get the thing going there we go so just to show you what what that allowed is the rexis is often one of the most difficult things to do in these cases and so here you'll watch the as I put the viscoelastic and you'll see the chamber you'll see the lens move back so you really should not totally out of out of the difficulty here but even here I still very careful not to pull central because you want to make sure that you have a free floating one so you can do the necessary devices and so in this case because I'm going to end up doing a trap at the end of this but I don't remember whether to do a straight trap or whatever but these are good times to have those MST hooks available in these other cases because these are kind of difficult to do otherwise let me just move ahead just to show you sort of as we get going so here using the MST hooks again putting those in allows you to really basically do the same case you have to watch your flows because remember the bag is relatively free well it's not relatively free it is free and in this case at the end I did two Ahmed segments to the sclera because I was going to do glaucoma surgery so I have one case that I wanted to show from yesterday to show you how to screw up so this is turned out okay but it was well actually let me show this one this one I would have I would have that's the end so this is this is the wrong guy sorry I'm sorry that was another one from yesterday where did the other one go it's a very interesting case that I thought would be kind of interesting to discuss where is he, does anybody see it talk amongst yourselves say something while I look for this damn case we haven't been doing that a lot till recently and I've seen a few but not all Nick you want to discuss that I think it's still here I'll find it in a second let me just show you this so this is I thought this was an interesting case because this is a one-eyed gentleman who has end stage not end stage but glaucoma he was referred down and of course he was as you might guess a little bit nervous and so they waited until the case was a fairly hard rock so I just this is unfortunately this was yesterday afternoon so I haven't had a chance to edit it now you say that's a great pupil but this is a very hard cataract so what I'm going to do here is I'm going to use a Mayugan because I want to make sure that I have a bigger enough space now that's great but the problem was I should have used the 7.25 Mayugan so what I ended up doing was I had to cut this out to really bring some of those pieces through towards the end of the case so I get a fairly nice Rexus there and then I'm going to do the ultra chopper and then I'm going to bi-manually rotate with the ultra chopper to make sure that there's no zonules so this part's good so I taught myself something we'll get through to the I'm going to go to the very end and you see I get a really nice crack and so I think this is great able to bring these pieces forward but in actual fact what I hadn't done is I hadn't gotten all of the fibers in the very back to debulk a little bit more to get this to come out and I want to go to the very end because the rest of it is just a piece of cake but you see here I'm struggling to get this through out these pieces these pieces are large pieces and I want to make sure that I don't flip or bring them forward so they're still on the attachment posterior to that so then I end up at the ultimately you see dislocating this piece at this point you just got to stop come out and I'll cut that cut that out take it out of the eye so then I can complete the whole thing so I should have used a 7-2 or it probably I may have been okay without it because the so make sure when you're coming out don't try to pull it out in your normal technique because it'll move things all around and then the rest of the case was relatively simple and the new machine is very efficient on this type of device it's like we have time for one quick thing I still can't find that one I just wanted to know what everybody else would do with this gentleman's eye any questions or comments before I yes we don't know we'll know that the next time around these were this was the first time in that region it's a region of 800,000 people they have one ophthalmologist for 800,000 and all of the Mayan subgroup that we saw which you know mixed between Spanish and Mayan those the ones that we saw were in fact pseudo-acts and many of them very very very rock hard eyes we didn't have any complications by the way those of you that saw the Sunday Meet the Press the numbers they gave were in fact correct our team did 200 and I'm not a mathematician but I might be wrong but I don't think that 10 means dozens they said Dr. Paul did dozens cases 10 was dozens okay I cannot I just have to make that statement but we did do 200 and we had a really successful trip and we'll be going back there more often and I promise I had that video somewhere and it's hidden because it churns down it's a very interesting case I'll show it some other time so any since almost time for clinic any questions or comments I think that these are kind of cases you have to think in advance but if you train yourself to do the correct thing on the easy cases then you can deal with the hard ones from the resident standpoint that's why we bitch and moan about hand position, foot position and understanding everything that you're trying to do because if you don't do it well on these ones you'll never be able to do anything on these more difficult cases so just watch carefully for the second year residents let me make a suggestion go to the OR and don't look at the video watch how they're holding their instruments don't even look at the video you know what the fakle tip is doing it's moving one millimeter you want to know how that person is getting their control of the hand piece and the chamber depth and all other stuff watch their hands don't watch the fakle I don't want to do an advertising of that big thumb that comes out and Larry lacks sorry I was a little disorganized I didn't know I was doing this till last night I didn't organize it this morning sorry thank you guys Jeff I gave you some props were you here when I said talk about it thanks have you actually used it yeah it's going to be yeah could you sell it no I did how can we do more with that patient having a choice so looking at systemic associated disorders so elastic disorders what are you talking about so you realize this is a totally agreeable


What's up everyone? It's your girl, Kenzie here from Layton Sports Cards and I am ripping two personal boxes here for Gabriel C. We've got two 2022 Bowman Baseball Sapphire editions. All right, best of luck, Gabriel. Here we go. Martin Jimenez first. Hendry Mendez first. Willemyn Diaz and Cooper Kenny. Logan Cerny first. Diego Rickoniz first. Daryl Herneas first and Andrew Lara first. Nice first back there. Warming Bernabelle first. Rockies, Brett Fady, Luis Angelacunha and Robert Hassel. Marcella Meyer, Kalil Watson first. There. Pinango and Quintero first comes. Josuar Garcia first. We've got Aqua, Darren Baker first to 55. And Orange first auto. Warming Bernabelle to 25. 14 of 25. We'll bag that one for you and a Harry Ford. Very nice. Gonzalez Hendrick. We've got Jonathan Classe first and Lizaraga first. Sanquinen first and Noel B. Marte. Pastrano first and CJ Abrams. Cavadas first, Pete Crowe Armstrong, Alexander Ramirez and Carlos Aguirre first. Harry's solid first box there for you Gabriel. Box to make your son empty. Angela's first. Anthony Rodriguez first. Luca Tresh first and a Ruffella first. Another four first back there. Fernandez Alvin Guzman first. Jeter Downes and Jay Allen. Alejandro Pia first. Cespedes, a Diego Carriotta and Mackay Backstrom first. We are full. I just called it full. Yeah, we've got, I'm hoping to get through everything. I don't know if I will though. Colton Couser, Amador Nunez and Justice Thompson first. Bunch of orders today. I do appreciate all the orders. I again, I will try my best to get through everything. Robert Dominguez first. Orange first to 50. Diego Rancones. Color match there for the Giants. Abralin Haraba first auto brewers. Will be your second auto there for you Gabriel. And Jose Ramos Vargas, a Benjamin Bailey first. Garrett Mitchell and Christian Roa first reds. Manuel Rodriguez, Maximo Costa, Junior Sanchez first and Raquel Vendecastro. Nope. No personal Sunday night. So next person that will go will be tomorrow night after group race. Elijah Tatis, Simon Muziotti first, Ronnie Mauricio and Colson Montgomery first. All right, Gabriel, solid two boxes there for you. Thanks as always for hopping in and for your support. We'll get these right out to you.


The last few decades in India's contemporary history have been marked by exciting changes. With the spread of modern education and rapid expansion of socio-economic opportunities, many familiar images are going through a metamorphosis all over the country. One such picture is that of the Indian woman making deep inroads into areas hitherto dominated by men, be it technology, sports or rural development. As society gradually accepts the changing nature of relationships, both at home and outside, women all over India actively get down to the business of redefining their destiny. For the women of this region, water pump installation and repair now forms a part of the larger process of reformulating their role in rural society. From elementary technology of water pumps to precision engineering, women today are exploring all the frontiers of modern life. The realm of adventure, a male preserved for a long time, has been stormed by Indian women in no uncertain terms. Mountaineering has become popular with a large number of women all over India, an Indian women's expedition climbed the Everest successfully in 1993. With eight members reaching the summit, this expedition proved to be a great source of inspiration for women mountaineers. It is this change in outlook which has brought women out of their homes to enter areas dominated by men. In Thelonia, learning a technical skill has resulted in a definite enhancement in self-esteem for rural women. The social outlook of the entire community has also undergone a remarkable change due to the efforts of the social work and research centre. Acquiring technical skills has meant involvement in decision making for the women of this area. Women's groups collectively decide where a new water pump should be installed. Social work and research centre has also trained women in masonry work, thus making them completely independent in water pump management. These are achievements to be proud of, but they haven't come without a struggle. Every person thinks that the women who work for us are doing something wrong, and we shouldn't have to do that. And the power of men is very strange in themselves, and we must accept certain obstacles to stop them.  Keep quiet. Changing relationships is the highlight of all those work areas where women have taken the initiative to take the reins in their own hands. Aarti Kaveriappa has evolved a good understanding with the mechanics of her workshop. They differentiate. In the beginning maybe they found it strange that a woman was telling them to do something, but I think that was hardly for a couple of hours. When it comes to mountaineering, I think basically you should be able to carry your own weight. If you have to climb a rock, it's your own weight that you have to carry up, and as long as you can do that, it's enough. Adventure in life, and life as an adventure. Indian women have successfully chalked out a new game plan for themselves for the next century.


I'm moving on to sports. A former entering president of DR Congo's conflagration of African football, Konstant Omari, has been banned from all football-related activities for the next 12 months. This is the culmination of a lengthy investigation into the terms of a revised television contract signed in 2016 between CAF and French marketing company Lagadaire Sports. A report by the New York Times last November has prompted FIFA to open a formal procedure in January.


I have been so excited to do this video which is all about gifts for the guys in your life. I can't wait to show you all of these because first of all they're hubby-approved. My husband loves all of them. Bill put his little stamp of approval on them. So let's get into it and go through about 21 unique gifts for guys that I think that they will love so much. Hello friends I'm so glad that you're here with me today because this is a very special video. Normally we're all about beauty on this channel or fashion or lifestyle. This time we're gonna hone in on the guy in your life or guys in your life and all of these gifts as I went through them my husband Bill was like those are cooler than and he uses an expletive but he really loves all of these things that we came up with together. I thought they were great. I hope that you do too. Before we get started I can tell you all about my shirt. Today I'm not going to show you myself in it full length. I will show you a picture of it but I really do like this cute shirt. It's got a zipper on the front. It has the white piping on it and then it has just the jersey material so very comfortable. It just feels like a t-shirt but it has the fun cold shoulder on it too and then my earrings. I can also show these are drop-leaf earrings very long and dangly. I think they're so cute and my bracelet. I can link to that as well. I think I've talked about that bracelet on my channel several times. I know I've worn it several times. I'll leave all the links for that, the makeup I'm wearing and my finger and a polish. All of those good things down in the description box below. Speaking of links right here in the corner of my screen you're going to see a number. That number corresponds to whatever I am showing, whatever product that I am holding up at that minute. If it was a cup I would have a cup here. If it said two you would go down into the description box. You'd look for the number two. You don't have to worry about the name of the cup. You just look for the number two and then next to it would be the cup with its name and the link if you choose to shop that way and I do appreciate that so much. All right we're going to start out with grilling outdoors. It seems like our dads or the guys in our life always get relegated to grill duty. I don't know why that is but my dad did the same thing. My husband does the same thing. My kids love to grill. My boys love to grill. So one of the things that I've shown on my channel before and you all seem to absolutely love them are these automatic grinders for salt and pepper. And the reason I put this under grilling is because it'd be great for dad to have these next to him as he was grilling. But you know it's not the typical grinder. They have a glass bottle. They have the great stainless steel on them. But what is really cool about them now watch right here what is really cool about them is these will grind the salt for you. Now I have this on a very fine grind. It will come out really fast if you tip it over but it comes out slower if you just tip it over a little bit. But you can see that blue light that's to show you how much you're grinding up. My husband flipped over these. My sons flipped over these and my son-in-law flipped over these. They thought they were the coolest things. I think they're cool. They're just something that you can give away as a gift to a couple that's getting married or the grill master in your life. I just think they're fantastic. The second thing that I thought was so great and I was so impressed when I got this home. This is a grilling kit and it has in it everything that the grill master might need. Look at all these tools. Holy moly. I don't think that my husband could even figure out what all of these tools were for. But when I got this I got it very recently because we're coming into there goes all the skewers. Okay you get a huge carving knife. You get the grill grate or the grill cleaner and you get a refill for that. You get eight different of kind of like I don't know. These are like forks for like the meat when okay there goes another grill. Okay there went another skewer. All right let's try to keep skewers in the box. Then there is a grass that you can these two handled grass that you can pick up roast with. You have the baster right here which is silicone. You also have the meat stabber thing. I don't know what that's called. The meat fork and then you have the spatula and then you have the heavy duty tongs. This okay all the skewers are going to go on the floor. So this is an awesome kit to give anybody in your life that loves to grill. It has absolutely everything in here. I thought it was great how big it is, how heavy duty and really well made they were. I was really impressed by that as well. Now the next thing my husband went gaga over. These are seasonings from Pit Master. Now if any of you watch Pit Master on TV my husband every single time they come on he thinks he's got to go out and he's got to grill something or he's got to smoke it. Now if you can see those I don't want them to come out but there are individual little seasonings that are just specifically that those people on Pit Master use. I thought this was such a great gift. I mean there is a ton in here and this wasn't a fairly expensive thing but I think that would be a great gift for your grill master as well. This particular one was not my husband's. This is my son's and he loves this knife. My son carries a knife with him when he works. He works in the HVAC industry and so he needed a pretty heavy duty knife. This is a beautiful knife. I do have to say that the way that the embossing or the carving or whatever they put on there it really is nice and then they have you have the hook that they can put it on their belt and then you also have the wood grain right here. Now he does love that knife so much and it's really heavy in the hand but this right here is something that he asked me to get for him which I'm so glad that I did. This is a knife sharpener. Now my dad used to have the old stone that he wore down over I don't know how long but he used to clean or sharpen his knives on that old stone. That's kind of basically what this concept is. So I thought I'd put these two together so that you could see beautiful knife if you have somebody in your life that is a hunter or has a job where they need that and then also the sharpener. I thought those were two great gifts. Now how about grooming? We all probably have a guy in our life that loves to do the man escape and he loves to keep his beard trimmed. All those fun things. This right here I bought this for my husband. This came on sale at Amazon and I was like I'm getting that because he has had a shaver and a trimmer and a nose trimmer and he has them all over the place and he loses half the attachments that go with him. Well here it is all in one. So this is from Prytek and this is a three in one. This trimmer or shaver will actually do wet and dry and he was so excited about that that he just had me order him a mirror that can go in the shower. So this is what it is right here. It's very slim and sleek and it has a pretty good ergonomical design for grip and it only has three heads right here but my husband, the reason that he loves this so much is he's a long haul trucker as some of you know. He just does this while it goes down the road and he just loves this thing and he has a bald head and he has the mustache. He occasionally grows a beard out which is something I'm going to show you in a second but this is great because you can take off the top of it and then you can just pop on the other attachments. Now this is the trimmer right here that you can pop on. Oops I turned it on. That you can pop on pretty easily and then it becomes a trimmer. And then the last one is the nose trimmer. So you got them covered here. This really is a great thing for my husband because it does everything. It's very portable. Everything fits into this little satchel right here. It's just been one that he really, really has liked. So my husband does use the trimmer on the go but when he's home he does like to get a little bit closer shave at times. Now there is a company called Harry's and I got him last year around the holidays. A Harry's kit and had a bunch of shavers in it or razor refills and then it had the razor and then it had this shaving gel and this shaving gel quickly became his favorite. He has a bald head and that's a lot of area to cover when you're looking at a razor like this. So he thinks that this shaving gel is probably the best he's ever used and I have to agree because he doesn't have to rake so much. It just seems to really either moisturize those hairs or soften up those hairs so that he can you know go over it very quickly and get a pretty close shave. It's a great product for him. He's had me reorder the big one in the three pack several times so far and he just really likes that brand of razor too. He's the razor itself less longer and it's just a really good brand. And then last year around the holidays I did introduce you all to this Beard grooming kit and I think it's called Full Light Tech and this is such a nice kit. I actually just purchased this one again because my heavy he has used in the past six months his stuff all up. So the Men's Beard Kit comes with the Cleans and Refresh, the softened and smooth. That's what he's used. I think it comes with two softened and smooth beard oils and then the Beard Balm and this one is the Beard Wash. It comes with this great brush that you know it's got a kind of a coarser hair on there and beard hair is pretty coarse and that's great. It comes with the trimmers or the scissors and then it also comes with the comb for the mustache or if they want to use it for their hair or whatever. This is a really nice kit. Now most of it will fit right down and the little there's a little burlap sack that comes in the bottom of there. This is just a really great one for the man that loves to keep his beard looking nice. Now another one that is into the grooming category is this nail kit that I bought for him. I specifically bought this because I am not a person that likes to do feet. I don't even really like to do my own feet although I do but he was always asking me can I get your clippers? Oh honey here you use them on me please. So I'm like okay where's yours? So I went and got him this one and I love this too. This is a great kit that has three different size clippers in it. It also has the cuticle trimmers if you need those that pinch a little bit sideways there. It has a file in here. It has the little tiny scissors in here, the tweezers in here. I actually have used this many times after sterilizing it with alcohol on a big sliver that he got at work or a blister that he got at work or whatever at the time. And my husband again likes it because it's so slim and sleek. He can throw this in his bag when he goes on the road and it doesn't take up much room. So he loves that. Now I'm going to share with you something that my son actually asked me to buy for him and I almost stole him from him. If you guys have never seen this this is such a cool invention. This is a neck fan and my son loves this when it gets hot outside. This is rechargeable. It has a port right there and it comes with its own charger and you just turn the fan on. It sits right there and all of these vents right across here they blow cool air. And I don't know if you can hear it or not but I do have it on right now and it is it's very very nice. I love this. This would be so perfect for any woman that was having hot flashes too but my son loves this because his head is the thing that sweats more than anything when he's out working. So it's rechargeable. He recharges it at night and then when it gets hotter in the afternoon he uses this and he absolutely loves it. The next one is one that my husband fell in love with and I actually surprised him with this because I knew that this was something that he would love. There we go. Now you can see it. Okay this is a wood box. First of all the you know the outside of it is very sturdy. It's very sleek and it really blends into my decor and my bedroom. Great. It has the temperature. It has the month in the day. Obviously this is off and it has time that you can do in military time or you can do it just in regular time. And the thing is is that not only is this a really nice addition to the decor because it is the white box. It comes in black. I think it comes in the bamboo color and I think it comes in a brown. So you can get it in just about anything to match your decor but what else it does is you just lay your phone on top of it and my phone just started to charge when I did that. So that is so cool that you can do that with your phone. He doesn't have to worry about where's his plug. He gets so grumpy when he can't find his plug to his phone. So this eliminates that altogether. This is a great thing for him. He loves this. The next one is actually my grown son's gaming headphones. And I know you have somebody in your life that absolutely loves to game and they love to game on the internet and my son was so excited about these when he got them. First of all it has the microphone so you can talk to whoever you need to while you're gaming. But these are noise canceling as well and he had us listen to a song that we love by ELO. I don't know if any of you guys like ELO or not but he had us listen me and my husband to these and the sound is phenomenal that comes through them. It is so great. So when I bought these for him he was over the moon but then later on down the road he's telling me mom because he has a pretty big head that sweats.  So these pads right here they really do have that mesh fabric on them that really does help with that. So this is such a good gift for somebody that's in your life that loves to do that and you really want to treat them if they like gaming and such good quality. That's what I was really surprised about how great quality they are. All right let's switch over to fashion for the guys in our life. I don't have a lot of things that my husband gets off of Amazon although right now I'm going to show you one of the cutest things ever and that is this shirt. My husband absolutely loves this shirt. He gets so many comments on it when he is around. It's a ripped ab shirt that looks like the shirt has been ripped itself and he absolutely loves this. So this is really fun. It runs true to size. He's wearing an extra large and that's what he normally wears. I love this t-shirt too and I'll show it to you a little bit closer up. It's just so much fun and it's a really good quality t-shirt too. I was really surprised at how great the quality is. Now the next one is something I completely randomly ran across on Amazon and I was just laughing so hard when I found it. This is the coolest gift. Okay so it looks like a deluxe burger box that you get at a burger joint and you open it up and it still looks like a deluxe burger that you get at a burger joint. I mean they have paid attention to detail where they even put the little wrapper around it like normally. This is socks and what they have done is they have picked out different socks on the layers that look like the meat and the bun and the lettuce and the tomato and then you can take them apart and wear them if you want to. I about died when I saw these. I was cracking up. They have ones that are in the form of a taco where they put them like a taco. They have other ones that they've done in the style of pizza. This is just the cutest dang thing and if you again if you have a dad in your life or a guy in your life that really loves to just have fun and be silly what a great gift and you know you want to get him some socks. Well yeah but this is not the typical sock thing. Recently I have been trying to deck out my husband got a new truck because his old one took a dump so we've been kind of outfitting his truck for all different kinds of things. This right here I am so impressed by. I actually have one of these in my car too. This is a garbage can that I found. This can go around the center console that you have in a truck or car and it just clips and then it can hang off of that in the back. It's a garbage can yes because it has the top and you can just you know I got so tired of people just watching you know the straw wrappers up and throwing it behind them or whatever. I mean oh goodness. Anyway but what's really nice about this is you can use it as other things too. It has a pocket right here which you can put like cell phones down, water bottles in if you feel like it. It also opens up and inside you can see that it has the waterproof lining in there and what's great about that is if you're going on a short trip and you throw a couple ice packs in here it'll hold a six pack can of pop or whatever you're wanting in there. So I just thought this was a really great idea really ingenious and we both have them in our vehicles. Now the next thing I actually almost selfishly bought for his truck. This is a tissue holder that you put over your visor and it can go on either side whichever you want but it has also the refills that you can buy that fit in here. I am always him too. He's always needing a tissue. I'm always needing a tissue. There's never enough McDonald's napkins in our card to have him there for his both but this way you never run out of tissues. Like I said you can open it up. You can put the refills in there. I just thought that this was great for him to have an his truck as well. And then the next thing for his truck is this mirror that goes in on a visor. This is a huge mirror huge wide and again this is almost selfish of me but I got this for him because I was always in his truck and I always could not see in that little bitty mirror. I swear that little big mirror is like one and a half by three inches in his truck. So this is a lighted mirror as well so it has a ton of settings on there and when I first got it I'm like I will never be able to do my makeup in there because that thing is so bright but then I figured out it has a dimmable feature on it so you can dim these lights as much as you want or bring them back up as much as you want. So I thought this was great. It is one that I really have loved having in his truck. He actually thinks this is pretty cool too. So that one is a really good one. And then the last thing for his truck that I'm going to show you is something that I did show last year as well for GIFs and it is this tactical kit. Now first of all it comes in a really heavy duty box and that's nice because you know when you throw in your trunk or you throw it behind your seat or whatever you're going to do it really is not going to get banged up or anything that's got that hard case. But what's in it is phenomenal. First of all this is a pan but it's also on this end one of those things that you can break your window with if you know you have the need to do that because there has been times when people get stuck in cars so that has that tool on that side. It also has a spork a fork spork whatever you call them but on the inside of that it has a pretty good not good size knife for you know if you get into whatever you know problems you have and then it also has a flashlight in there which is great. It also has this knife in it as well which lots of times when you're working on cars your car breaks down or something you need that knife. But on this end right here that tool right there goes into a seat belt and can cut a seat belt to get somebody loose out of a car as well. But it's a pretty nice survival kit to have. There's a level in here. There's a compass in here. There is you know bottle openers. There's steak drivers or you know anything you need in here it's in here. One of those aluminum blankets that you can use. There's lines that you can use for fishing and there's different cutting tools. It's just a huge kit full of all kinds of things that you may need if you get into a car accident god forbid or you get you know stranded somewhere. But yeah this was a really great gift. I actually purchased one for his truck one for my car and all of my kids because I think that this is something that just about all of us need to have in our vehicles if we get into a pinch. Alright the last category that we're going to go into is health. A lot of you know that my husband has quite a few health problems and my husband's not a small guy.  I mean he's not heavy or anything but he's a big guy. And so I would I got him a heating pad a while back and that thing did not hardly cover his whole back. So I decided I'm going to go get the Mac Daddy of all heating pads. This baby is so nice. The fabric on it is so plush and soft and it is not like other ones that I have tried before. You know they you get the one that stuffs down into the really thin fabric case or whatever.  I think it goes from one or I think it goes from zero to seven one to seven whatever you want to say. But it really is good because it's huge and it can cover a person's back. I mean I've got this up to the top of my head and it's down like into my lap and at the top of my thighs. So it's really big. He loves it. Those aching bones really appreciate having this. This is our percussion massager or deep tissue massager. This is one of those massagers that people pay the big bucks for. This has seven or eight different settings and it really does just go into that deep muscle. And I love this too but this is so good for him because he sits all day and his back is shot. And he really loves having this. The charger is right there. So this is really something that's nice for anybody in your life that has those aches and pains and these deep tissue guns go for so much. And I happen to find this one on sale. I don't know if it'll be on sale right now but fingers crossed hopefully it will be. The next one was like a blast from the past. Now I know that most of you raised boys that had a Game Boy and this is a Game Boy mug. It's the cutest dang mug anyway. But what I really thought about it that was so much fun is you know it's laid out like the Game Boy was. But right here where it has the gaming screen when this gets full of the hot of your hot liquid or you know coffee tea whatever they're drinking it actually will turn and it will show that it has right here on the box. It will show Mario and Luigi I believe is who it is on there. What a great gift right for our boys. How nostalgic is this as far as you know them remembering the good old days when there was just a silly old Game Boy that had very small graphics on it. But wow they about killed themselves to get this. So I think this is a really great gift too. Okay and then the very last item I have shown on my channel before but I want to show it to you again because this is something that the whole family can use but my husband uses it more than anybody and that is this face mask ice pack and the reason that this is so good for him is he has really bad sinuses. Gosh I'm making the guy out to sound like he's barely living. But his sinuses are really bad and this can go in your freezer. It freezes very quickly. It also can be put in your microwave for a few seconds and it just straps on and it alleviates so much of his face pain when he's in the middle of one of those really bad sinus attacks. It's really good and then it does come with another gel another gel pack that you can put on the back of your neck while you're using this and it really helps. I love this for my migraines and my son uses it for his really bad tension headaches too. So this is just one of those things that I feel like even though it might not be the most glorious of gifts you know take this maybe some hairy shaving gel maybe this little tissue thing put it into a little packet for the guy in your life and even though you haven't spent a lot of money it really does look like you've you've really put a lot of thought into your gift and I think that that is great and you could do that with any of these if you like to. So that is the last one. We covered a lot of area in this video. Thank you so much for being with me today. I hope that you did enjoy it. If you did please give it a thumbs up. Right now what I'm going to do is I'm going to put up one of my other videos so that you can see that video and you can go over to it and decide whether or not there's something that maybe not on this list that you might want to try anyway. Thank you so much for tuning in today. I hope that you are all happy and healthy and please come back around very soon for my next video. I love you all very much. Take care. Bye bye.