Category: Principles of Surgery in General

Explosion hazards in theatre

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EXPLOSION HAZARDS EXPLOSION HAZARDS DURING GENERAL ANESTHESIA AND ENDOSCOPIC SURGERIES : Although the use of inflammable anesthetic agents has declined greatly over the last two or three decades, ether is still used in some countries, the risk of fires or explosions has not been eliminated. However, bowel gas consisting of methane, hydrogen and hydrogen sulfide […]

Monitoring during anaesthesia

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MONITORING OF THE ANESTHEITIZED PATIENT Standards For Basic Intraoperative Monitoring These standards apply to all anesthesia care although, in emergency circumstances, appropriate life support measures take precedence. These standards may be exceeded at any time based on the Judgment of the responsible anesthesiologist. They are intended to encourage quality patient care, but observing them cannot […]

Conduct of anaesthesia

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The Practical conduct of anaesthesia Planning the conduct of anaesthesia starts normally after details concerning the surgical procedure and the medical condition of the patient have been ascertained, at the preoperative visit. PREPARATION FOR ANESTHESIA Before starting the anaesthetic, consideration should be given to the induction and maintenance of anesthesia, the position of the patient […]

Patient positioning during surgery

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PATIENT POSITIONING, NERVE AND OTHER INJURIES DURING ANESTHESIA Introduction Man, who is well adapted to function for long periods of time in the upright position, assumes the horizontal position for rest, recuperation and sleep.  The sympathetic nervous system, which sustains the cardiovascular system in the upright position, gets the necessary time for recovery in the horizontal […]

Pre operative assessment

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PRE OPERATIVE ASSESSMENT All patients scheduled to undergo surgery should be assessed in advance with a view to planning optimal preparation and preoperative management. Failure to undertake this activity places the patient at increased risk of preoperative morbidity or mortality AIM OF PREOPERATIVE ASSESSMENT : – Confirm that the surgery proposed is realistic when compared with  the […]

Diabetic foot

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DIABETIC FOOT Diabetes mellitus is associated with more than half of all non-traumatic lower limb amputations.  The major pathophysiological factors are ischaemia, neuropathy, infection and wound healing factor.  They operate concurrently and sequentially, enhancing the risk for amputation fifteen-fold in diabetic subjects compared to non-diabetics.  Since the `diabetic foot’ is the sequel of interaction of a […]

Surgery in the diabetic patient

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SURGERY IN DIABETES MELLITUS Diabetics are considered to be at increased risk of preoperative morbidity and mortality because of the involvement of their vital organs the autonomic nervous system in the natural course of the disease. Poor metabolic control results in dangerous acute metabolic complications due to surgical stress. The infection that develops in them […]

Extra -pulmonary TB and the RNTCP

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Extra-pulmonary TB Extra-pulmonary TB and the Revised National Tuberculosis Control Programme India : diagnosis, treatment and outcomes Introduction In spite of the fact that many of the basic scientific precepts of the WHO recommended DOTS (Directly Observed Treatment, Short-course) program were discovered in India, tuberculosis (TB) remains a serious public health problem, accounting for nearly […]

Drug protocols in extra pulmonary TB

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Treatment of Extrapulmonary Tuberculosis   Extrapulmonary TB is a paucibacillary condition and the yield of positive smear or culture may be low (30-50%).  Conventionally, extra pulmonary tuberculosis is classified into severe and non- severe forms. Meningeal tuberculosis, neurouberculosis, spinal tuberculosis, abdominal tuberculosis, bilateral pleural effusion, pericardial effusion, and bone and joint tubersulosis at more than one site […]

Introduction to extra pulmonary TB

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EXTRA-PULMONARY TUBERCULOSIS   Introduction We regard Tuberculosis (TB) as primarily as a disease of the lungs. Epidemiological and public health considerations have dominated thinking on tuberculosis over the past two decades with a great deal of research into pulmonary TB, especially infective pulmonary TB. Extra pulmonary tuberculosis (EPTB)is seldom dealt with as an entity on its […]