A day in Medical College

Continuation of Blowing my Own Trumpet

                Chapter 3
The first class I attended was Anatomy.All my childhood dream about college life shattered  the moment I saw the 'prison'- so called medical college.

'So this is the place where I'm sentenced to five year in prison',my mind voice monologue inside.

This is my first class,but I came here a day before for registration and other formalities.We were brought by an agent.A big fat Indian lady,mother of all fraud with an ugly boy hair cut.I never knew that  all she said was a lie until I came here.Till this day,I always wish to dedicate all the vulgar words in this word specially and solely for her.

We went to a hall which they claimed it as The Meeting Hall.The whole building looks like a building that was left by British Colony few decades ago.It was seriously that old -and bad too.Just a two storey building with few blocks joined together.I wonder if this building will stand an earthquake that registers 2.0 on the Richter scale. A part from this old building,the college had a very large government hospital.Despite a huge hospital,it still look dirty with a bad architectures. The wall and the surrounding look so dusty.I'm sure that anyone allergic to dust will die within five minutes once they enter the building.Only God knows when is the last time they paint the walls.

Within 15 minutes inside the hall,a college staff rushed in and asked us to run outside,away from the college.It was such an adrenaline rush situation.To my horror,I got to know later that someone called the college administration and informed that there is a bomb in the college,right inside the meeting hall.-the hall that we were in few minutes ago. 

Thank God it was just a prank to postpone the final year exam.If it wasn't,then my story would end that day itself or comes with a different story line.I would name it  'A day in medical college' then.

to be continue..



#medicalstudent#firstyear#travelling#journey#lifestory#college#classroom#hospital#building

Blowing my Own Trumpet

Continuation of Journey between heaven and earth

            Chapter 2

A fat Malay man,in his 40's with Transnasional  uniform, holding a piece of white paper came to check the passenger.He scanned the paper and passenger simultaneously with his big round eyes.From his appearance,I could make a smart guess that he is the driver.
'Semua sudah naik?' he asked in a loud tone.
No body response verbally to him.All just looked at his face for few second and continue doing what they were doing before-nothing.

I just batted my eyelids as a reply to his question.The driver played a lame P.Ramlee song and started the journey.I just covered the window with the curtain since it was an extreme sunny day.I guess this will be the weather condition until  April because the Sun is directly above the earth's middle line.Few minutes later,I started my usual  routine,day dreaming.There were few question kept repeating in my head.Will this work?What if it doesn't?Another disappointment?I try to calm myself and try to take a nap.Well,being complicated and over think are God's gift to me.Since I'm a Piscean and numerologically my birth date is 20,so I'm a number two guy.

Basically being a number two case(that's how few girls addressed me once)I always over thinks,being restless  all the time,can't stick to a decision and many more negativity within me,Maybe that's my nature but putting blame on my zodiac eases the guilty feeling in me.In the future ,I will ask my wife never deliver my kids on any number two dates like 2, 11 and 20. At least  my kids will leads a peaceful life.How did my life as medical student start?During my secondary school time,I told my mother that I would never leave Penang to further my studies,Now,I'm a final year medical student from Chittagong Medical  College,Bangladesh.

People look down on me when I told them where am I'm studying.It's up to them,but just by being a medical student,the total number of stitches that I had given up to today-304. Uncountable finger amputation ,5 lower limb amputation,numerous biopsy,mostly breast tissue and lump biopsy,assist 7 appendectomy,various trauma surgery,vaginal delivery and cesarean section,4 skin graft and more which I can't recall now.I done most of it during my 4th year..Fortunately nothing goes wrong-so far.

Being a student with this much of experiences is priceless. No medical student would done this.Maybe for many,they might feel that I'm blowing own trumpet,but this is the placed that gave me priceless memories which I will never get at any other places. How this happened ?A deep question arises in me.Since it will be a long journey,jumping into my dream world would kill some time I guess.


to be continue...

#medicalstudent#firstyear#travelling#journey#lifestory#memories

Journey between heaven and earth

A journey of an ordinary,below average,middle class Indian medical student..

               Chapter 1

It will be a 9 hour journey to reach my destination.I still can't believe that I'm actually doing this.
FA is my seat number.Luckily,seat by the window same row with the driver's seat.The bus looked half occupied.I don't know whether this is the total passenger that going to travel with me or the bus will pick up more passenger on the way.However,it doesn't  matter since I got a comfortable window side seat.I didn't notice much about other passenger except these two.

One was behind me and another one was the same column  with me,on the left side.A teenager with a cap and headset already 'parked' on his head.He wore a black T-shirt with a batman logo on it.His music was blasting beyond his headset.Maybe the volume is at maximum. The passenger behind me was a Chinese lady,maybe about 40,with a nerdy spectacles looks like a veteran school teacher.All I can see was a pink girlish umbrella and a nice handbag.She noticed that I'm looking at her,I just smiled.She  stared and literally hugged her handbag.Maybe my charming smile threaten  her.It never surprise me.That type of face reaction is quite normal for me since I'm a Hindu.Being dark skinned guy is a minus point for me to make friends with strangers.

to be continue..



#medicalstudent#firstyear#travelling#journey#lifestory

.my/ Indians

continuation of Two days back..

It's a trend nowadays..whatever crime or,can just make it  -take it easy word -
'incident' happens in front of you..Few scenario might take place,which can be classified into another few according to time period like our culture..(which constantly changing according to time)

Scenario 1
Few years back-
basically when no smart phones..people run away from the place..some will still manage to hide and watch it.It's solely for gossip purpose-.with taman friends later laarh...And a simple grey shades will become 50 shades of grey.Stories will spread as fast as radiowaves..


Scenario 2
Now,present time-
People take few step away,take their smart phone and become an instant cameraman.Just for facebook publicity purpose larrh..apa lagi..-record,upload kat facebook,100likes,20 shares,400 views,become critics of the nation for 3 days.- .They stand,record,and enjoy the show like a thriller drama..Every drama has it's own karma la bro..Do you wana be a part of that karma..?Up to you..Atleast run and seek for help laarh...and with pillar like support of social medias ,news spreads faster than  nuclearwaves...The fun part is,the same incident will have many varieties of story line.If you sit and listen to all of them,it will be very entertaining ..am I right?


One idiot is provoking racial issues,one bunch of psychos torturing a dog,one team of stupids will kill each other with the name of gangs..Artist will be whacked infront of everyone..about 50-70 people near by will enjoy the show while showing their concern and will remember the incident as a unforgettable memories..They will proudly share it with their grandkids one day ..because they was there what..standing,doing nothing,gaining memories.worth sharing laarh tu..
and if any sort of violence happens around us,we see it,read it,two days later(maximum a week laarh),then amnesia pulak...as a plus point,mother nature will show it colors at times in the form of tsunami ,earth quake etc.

All the while..we will be the best audience..we won't use our brain,..Just stand there and watch..One side will blame police and another group will blame the whole races..
Weeii,.take a chair laarh if u find someone with parang,or look for something near by ,or atleast activate you fight or flight system and move accordingly.If can,run,seek help.If an incident happens in front of group of peoples,don't la lari..You won't mati  pun...All attack them as a group laaarh...If the same thing happen to your loved one,and if people are just watching..Don't blame others..it's you karma laaarh...enjoy it..

If I hurt any one's feeling,please forgive me..Please laarh..please think and act...Consequences can be good..or can be bad..It depends on us people.

By
Lakdhes

Two days back.

two day's back:
continuation of Religion isn't a matter in health.

..I went again to ward number 30,just to visit this lady..She's 52 years old and a post operative patient..She just undergone a total hysterectomy with bilateral salpingo-oophorectomy with total omentectomy..Quite a long name to remember right..I first met this lady a week ago...She was my patient during a long case class exam..She looks innocent,a face that you won't forget easily once you saw.I was taking history generally..

First thing I told her was,"Aunty,ammi bideshi manuss,ammi bengali janne,kintu kup balo nei..ammi akon porikhar ashei..Please ammar'ke  help korein.
(Aunty,I'm a foreigner and my Bengali is not that good..Please help me.I'm having exam..)

First thing she asked  was,'what is your religion..?
I said, hindu..

She seems excited because she is a hindu too.A cooperative patient actually..Then madam came..

she asked ,
'are you a foreigner?..

I said ,'yes madam..'
then she said a word that i can't recall..and she asked me do you know the meaning?

I said,No.

She said,it means you..a student that is not regular to classes and lazy..

I kept quiet  and  then i said,i admit that i'm a problematic student.But,this is my favorite ward,so i'm regular here..  *checkmate -i didn't realize that my stupid bold move will leads me to checkmate.

Since that,every question she asked was just to lock me down..In the end,she said,my diagnosis was wrong..I just nodded and stand in silences.*one more heroic attempt,then i will stay here for another 10 years without passing gynecology. 

At last,madam went..

Before I leave,I gave her some money..she neglected it until I  forced her to take it.. 

Since then,at times,I will visit her...Two days back is the latest.She was very happy to see me..I just smile and asked 

how are you aunty?

She said she is fine now..The pain is no more and she said doctor asked her to go to this place which she don't know then (it's the radiology department for radiotherapy since she is suffering from metastatic ovarion tumor).Without knowing what it is,she said,i'm going back tomorrow and i will be fine and will die when i'm 80..I just smiled.. 

Then she ask, don't you have class tomorrow?
i said ,yes aunty,why? 
'Then how are  you spending time visiting me..
Why aunty?why not?,I asked .
She said,'other student said they don't even have time to eat,but you came here this night to visit me?
I just smiled..wonder..

"No time at all for medical student,It's like drinking water from a  big hose pipe.."

Is this true?Should ask my dearest med student friends out there one day.

From my own experiences,medical sciene  has never been easy-said by one of my close friend.
A true and wise word.For some,it might be easy,for some it might be hard..but there's no such thing as being too busy .If you really  want something,you will make time for it..I want to see her.I want it the most at that time.

Basically,'most'-(i really meant most-,not all medical student)
medical student will love humans.They love to interact with patient in a gentle manner-(except the one that drives you nut..usually laa..)

I love humans too..I really do, except  humans under few criteria..Those idiots killing each other in the name of religion and bastard kids that rape,fight,causing fucking nuisance,and killing each other.-for various fucking reasons like drug,fucked  up relationships,stupid boy love stupid girl and vice verse ,in the name of gangs that  never gives you even  half cent  and so many idiotic reason.

#medstudent out there,If i'm wrong or my words hurt any one's feeling,please forgive me.

by 
Lakdhes

Egoist medical student

A conversation between two medical student:
(quite interesting..So,just wana share it here..)

Student A :which book is good  for  better understanding of surgery?
Student  B:I don't know about others,but for me SRB's Manual of Sugery is good..

Student A:Do you think you are smarter than other student?(Sarcastic tone) 
Student B:I'm sorry..What?(blur look)

Student A :u got me aren't you..
Student B :hmmm..no such thing by the way..

Student A:Then let me test you...hallmark sign of increase icp?
Student B :answered.

Student  A:what could be the diagnosis of a lady with a continuous dribbling of urine..
Student B:answered 

Student A:What is caput medusae?
Student B:answered.

Student A:What is povisep?
Student B:answered 

Student A:What is sedil?
Student B: answered 

Student A:What will happened incase of hyperbilirubinemia in premature babies?
Student B:answered 

Student A:What will happen if a patient with hypothyroidism is going for surgery without management of the hypothyroidism?
Student B:answered    

Student A:Hmmm..Ok,yet by answering all this ,does it make u smarter than others?
Student B:Ok,let me ask you a question..What is bili light?It's uses?

Student A:Not sure bro..
Student B:Not sure or you don't know..?

Student A:quiet..
Student B:Atleast,do you have any idea to which question of yours does this bili light connected?

Student A:No idea bro..
Student B:What I know,u might don't know,and what you know,i might don't know..So,who is smarter here?
No one..All are equal..Stop testing and study for your test.

Religion isn't a matter in health.

Listening to songs with a cup of tea with extra sugar and it is drizzling outside..what a night..Nothing much to share..It's gynecology ward placement this month..A peaceful ward actually..Most of the doctors are female..Even some are quite strict,yet they are more friendly than the sirs. Yesterday,I went early to the hospital..so was just checking the patient's files..Then I met this lady..I can't recall her name,but just got married a year ago..She is a post operative ectopic pregnancy patient,done a laparotomy with a drainage tube in situ.When I saw the surgical procedure,the doctor preserved the right ovary along with the fallopian tube..

It was her first baby unfortunately .She asked me,whether she will be able to become a mother in the future or not with tears.Even she is a muslim,she hold my hand,asked me that question with tears..So many people having so many problem,but some idiots fighting and killing each other in the name of religion.How sad and stupid..Just wonder why there are doing so..When a Hindu needs an emergency blood transfusion,he take it from a Muslim,while when a Muslim needs bloods,they get it from a Chinese...and vice versa..Even there are few foods that prohibited by each religion,when we need blood,organ,any form of help,without thinking twice,we get it from other religion..Indeed,they never bring the issue of religion in such scenario ..AT ALL..does any of them reject the blood or any sort of donation in such scenario? No..but when they are healthy,fine,nothing much to think and worry about,they fighting in the name of religion..How pathetic..It is so clear that human created religion so that,the group of people will be in the right path and manner,obviously not  to kill each other..Maybe world will be a much peaceful place if human are classified just according their blood groups..

Hope people will change..Even health is not favoring me this year,hope it will for others.Take care.

Medical Facts

1.Your tongue has a unique print similar to your fingerprints.
2.Your brain is more active at night than during the day.
3.If you squeezed out all of the bacteria from your intestines, you could almost fill up a coffee mug.
4.Undertakers report that human bodies do not deteriorate as quickly as they used to. The reason, they believe, is that the modern diet contains so many preservatives that these chemicals tend to prevent the body from decomposition too rapidly after death.
5.Facial hair grows faster than any other hair on the human body, which explains the 5 o clock shadow that men get.
6.The storage capacity of human brain exceeds 4 Terabytes.
7.The acid in your stomach, that which helps digest your food, is strong enough to dissolve razor blades.
8.Women’s hearts beat faster than men’s due to having a smaller area to pump blood to.
9.Your stomach lining replaces itself every three to four days. If it did not do this your stomach would digest itself.
10.A scientist  discovered this weird medical fact – the left lung is smaller than the right lung to make room for the heart.
11.During your lifetime you will produce enough saliva to full up two swimming pools.
12.Every time you sneeze it reaches speeds of over 100mph, which is why people struggle to keep their eyes open when they sneeze.
13.This random medical fact is one for the ladies – women have a better sense of smell than men and continue to have a better sense of smell throughout their lives.
14.Everyone has a unique smell, except for identical twins.
15.The attachment of the human skin to muscles is what causes dimples.
16.In 1972, a group of scientists reported that you could cure the common cold by freezing the big toe.
17.The number one cause of blindness in the United States is diabetes.
18.People who laugh a lot are much healthier than those who don't. Dr. Lee Berk at the Loma Linda School of Public Health in California found that laughing lowers levels of stress hormones, and strengthens the immune system. Six-year-olds have it best - they laugh an average of 300 times a day. Adults only laugh 15 to 100 times a day.
19.In 1815 French chemist Michael Eugene Chevreul realized the first link between diabetes and sugar metabolism when he discovered that the urine of a diabetic was identical to grape sugar.
20,The first Band-Aid Brand Adhesive Bandages were three inches wide and eighteen inches long. You made your own bandage by cutting off as much as you needed.
21.According to the Centers for Disease Control and Prevention (CDC), 18 million courses of antibiotics are prescribed for the common cold in the United States per year. Research shows that colds are caused by viruses. 50 million unnecessary antibiotics are prescribed for viral respiratory infections.
22.It takes an interaction of 72 different muscles to produce human speech.
23.The first known heart medicine was discovered in an English garden. In 1799, physician John Ferriar noted the effect of dried leaves of the common plant, digitalis purpurea, on heart action. Still used in heart medications, digitalis slows the pulse and increases the force of heart contractions and the amount of blood pumped per heartbeat.
24. The lungs contain over 300,000 million capillaries (tiny blood vessels). If they were laid end to end, they would stretch 2400km (1500 miles).
25.. A mans testicles manufacture 10 million new sperm cells each day – enough that he could repopulate the entire planet in only 6 months.
26. Human bone is as strong as granite in supporting weight. A block of bone the size of a matchbox can support 9 tonnes – that is four times as much as concrete can support.
27. Each finger and toenail takes six months to grow from base to tip.
28.The largest organ in the body is the skin. In an adult man it covers about 1.9m2 (20sq ft). The skin constantly flakes away – in a lifetime each person sheds around 18kg (40 lb) of skin.
29. When you sleep, you grow by about 8mm (0.3in). The next day you shrink back to your former height. The reason is that your cartilage discs are squeezed like sponges by the force of gravity when you stand or sit.
30. The average person in the West eats 50 tonnes of food and drinks 50,000 liters (11,000 gallons) of liquid during his life.
31.. Each kidney contains 1 million individual filters. They filter an average of around 1.3 liters (2.2 pints) of blood per minute, and expel up to 1.4 liters (2.5 pints) a day of urine.
32.. The focusing muscles of the eyes move around 100,000 times a day. To give your leg muscles the same workout, you would need to walk 80km (50 miles) every day.
33. In 30 minutes, the average body gives off enough heat (combined) to bring a half gallon of water to boil.
34. A single human blood cell takes only 60 seconds to make a complete circuit of the body.
35. A foreskin, the size of a postage stamp, from circumcised babies take only 21 days to grow skin that can cover three (3) basketball courts. Amazing isn’t it. Thanks to science. The laboratory-grown skin is used in treating burn patients.
35.The eyes receive approximately 90 percent of all our information, making us basically visual creatures.
36. The female ovaries contain nearly half-a-million egg cells, yet only 400 or so will ever get the opportunity to create a new life.
Sources: Reader’s Digest Book of Facts

Hope all the facts are true. ;)

Free medical Camp :P

Missing this place already! 

Glasgow Coma Scale

The Glasgow Coma Scale  is a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment.

The scale is composed of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person).

Eye response (E)
There are four grades starting with the most severe:

1.No eye opening
2.Eye opening in response to pain stimulus. (a peripheral pain stimulus, such as squeezing the lunula area of the patient's fingernail is more effective than a central stimulus such as a trapezius squeeze, due to a grimacing effect).
3.Eye opening to speech. (Not to be confused with the awakening of a sleeping person; such patients receive a score of 4, not 3.)
4.Eyes opening spontaneously

Verbal response (V)
There are five grades starting with the most severe:

1.No verbal response
2.Incomprehensible sounds. (Moaning but no words.)
3.Inappropriate words. (Random or exclamatory articulated speech, but no conversational exchange. Speaks words but no sentences.)
4.Confused. (The patient responds to questions coherently but there is some disorientation and confusion.)
5.Oriented. (Patient responds coherently and appropriately to questions such as the patient’s name and age, where they are and why, the year, month, etc.)

Motor response (M)
There are six grades:

1.No motor response
2.Decerebrate posturing accentuated by pain (extensor response: adduction of arm, internal rotation of shoulder, pronation of forearm and extension at elbow, flexion of wrist and fingers, leg extension, plantarflexion of foot)
3.Decorticate posturing accentuated by pain (flexor response: internal rotation of shoulder, flexion of forearm and wrist with clenched fist, leg extension, plantarflexion of foot)
4.Withdrawal from pain (Absence of abnormal posturing; unable to lift hand past chin with supra-orbital pain but does pull away when nailbed is pinched)
5.Localizes to pain (Purposeful movements towards painful stimuli; e.g., brings hand up beyond chin when supra-orbital pressure applied.)
6.Obeys commands (The patient does simple things as asked.)


Interpretation

Individual elements as well as the sum of the score are important. Hence, the score is expressed in the form "GCS 9 = E2 V4 M3 at 07:35".

Generally, brain injury is classified as:

Severe, with GCS < 8-9
Moderate, GCS 8 or 9–12
Minor, GCS ≥ 13.
Generally when a patient is in a decline of their GCS score, the nurse or medical staff should assess the cranial nerves and determine which of the twelve have been affected.

Holiday Package

At last, I'm back home..It was a tiring journey but I do love traveling alone  for the first time..
Let me share some of the pictures..

My study table..a night before I left..still couldn't finish clean it.. 

Was thinking how I'm going to bring all this back one day..It's only half of the collection.. 

Chittagong airport..International departure..

KLIA2 (domestic departure area)

to penang..

penang 2nd bridge 

a gift from my sis..maybe it's to early to call me dr..let wait and see whether I really make it or not..

Lakdhes

Menstrual disturbances

Menstrual disturbances

1.Menorrhagia-cyclic bleeding coming monthly, lasting for longer time  or excessive amount. (Disturbance usually in uterus).

2.Polymenorrhoea-cyclic bleeding coming too frequently and lasting for normal duration (problem usually in ovaries).

3.Polymenorrhagia-cyclic bleeding coming too frequently and too excessive.

4.Metrorrhgia-acyclic bleeding having no menstrual pattern. 

Appendicitis

Appendicectomy

is the surgical removal of the vermiform appendix. This procedure is normally performed as an emergency procedure, when the patient is suffering from acute appendicitis. In the absence of surgical facilities, intravenous antibiotics are used to delay or prevent the onset of sepsis.

Indications: Acute appendicitis, recurrent appendicitis

Acute appendicitis
is the  inflammation of the appendix .

Symptoms:
Pain first, vomiting next and fever last has been described as the classic presentation of acute appendicitis. Since the innervation of the appendix enters the spinal cord at the same level as the umbilicus ), the pain begins stomach-high. Later, as the appendix becomes more swollen and irritates the adjoining abdominal wall, it tends to localize over several hours into the right lower quadrant, except in children under three years. This pain can be elicited through various signs and can be severe. Signs include localized findings in the right iliac fossa. The abdominal wall becomes very sensitive to gentle pressure (palpation). Also, there is severe pain on sudden release of deep pressure in the lower abdomen (rebound tenderness). In case of a retrocecal appendix (appendix localized behind the cecum), however, even deep pressure in the right lower quadrant may fail to elicit tenderness (silent appendix) because the cecum, distended with gas, protects the inflamed appendix from pressure. Similarly, if the appendix lies entirely within the pelvis, there is usually complete absence of abdominal rigidity. In such cases, a digital rectal examination elicits tenderness in the rectovesical pouch. Coughing causes point tenderness in this area (McBurney's point).


Procedure:
Incision:
Types:
1.Grid iron incision
2.Lanz incision
3.Rigth paramedian incision

McBurney point
an imaginary line joining anterior superior iliac spine and umbilical.The point is at 1/3 lateral and 2/3 medially

McBurney's grid incision is the most popular incision. it is right angles to the spino-umbilical line placed at Mcburney's point.It is about 6-8cm in length.
Lanz incision are cosmetically better than McBurney's.
Right paramedian incision is made when diagnosis is in doubt as a part of exploratomy laparotomy.



Layers opened:
1.skin
2.two layers of subcutaneous tissue: Camper's, Scampa's.
external oblique aponeurosis running downwards and medially.it is incised in the direction of the fibres
3.Internal and transverse abdominal muscles are split
4.Peritoneum.

Surgical procedure:
1.Antibiotics are given immediately if there are signs of sepsis; otherwise, a single dose of prophylactic intravenous antibiotics is given immediately before surgery.
2.General anaesthesia is induced, with endotracheal intubation and full muscle relaxation, and the patient is positioned supine.
3.The abdomen is prepared and draped and is examined under anesthesia.
4.If a mass is present, the incision is made over the mass; otherwise, the incision is made over McBurney's point.(this represents the position of the base of the appendix .The position of the tip is variable).
5.The various layers of the abdominal wall are opened.

6.Appendix is gently held at mesoappendix by using Babcock's forceps and blood vessels in the mesoappendix are divided.These include appendicular artery, branch of ileocolic artery.Once the appendix is freed upto the base (caecum), a purse string suture is applied all round appendix, taking bites from caecum , using 2-0 atraumatic silk.

Appendix is crushed at the base and is held 1cm above the crush. A tight silk ligature is applied at the crushed site and appendix is cut in between.Stump is cleaned with spirit.invaginated and purse string is tightened.This is called burial of the stump.Perfect haemostasis is obtained.

Closure

1.Peritoneum -continous 2-0 catgut/vicryl

2.Split muscles -sutured together by a few interrupted suteres using chromic catgut/vicryl

3.External oblique is sutured with silk

4.Subcutaneous fat is sutured with vicryl 

5.Skin with interrupted silk .Instead of catgut, 2-0 silk , 2-0 vicryl is being used more often nowadays.

6.The wound is dressed.

7.The patient is brought to the recovery room.
Corrugated red rubber drain is not kept routinely unless there is gangrenous appendicitis or a lot of pus in the peritoneal cavity. 

Recovery

Recovery time from the operation varies from person to person. Some will take up to three weeks before being completely active; for others it can be a matter of days. In the case of a laparoscopic operation, the patient will have three stapled scars of about an inch in length, between the navel and pubic hair line. When an open appendectomy has been performed the patient will have a 2–3 inch scar, which will initially be heavily bruise.

by Lakdhes

Urinary Tract Infection

Urinary Tract Infection

A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a simple cystitis (a bladder infection) and when it affects the upper urinary tract it is known as pyelonephritis (a kidney infection).

Causes of UTI:

1.Bacteria:


-E.coli
-Pseudomonas
-Proteus 
-streptococci
-staphylococcus epidermidis and saprophyticus

2.Virus
-adeno virus

3.Fungus
-candida albicans

4.Parasites:
-schistosoma haematobium
-wuchereria bancrofti

Predisposing factor for UTI
1.incomplete bladder emptying 
-bladder outflow obstruction
-neurological problem such as multiple sclerosis ,diabetic neuropathy )
-gynaecological abnormalities such as uterine prolapse.
-vesico ureteric reflux

2.Foreign bodies
-urethral catheter or uterine stent

3.Loss of host defences
-atrophic urethritis and vaginitis in post menopausal women
-diabetes mellitus

Spectrum of presentation of urinary tract infection
-asymptomatic bacteriuria
-symptomatic acute urethritis and cystitis
-acute pyelonephritis
acute prostatitis
-septicaemia

Typical features of UTI
-abrupt onset of frequency of micturition 
-scalding pain in the urethra during micturition 
-suprapubic pain during and after voiding
-intense desire to pass more urine after micturition 
-urine may appear cloudy and unpleasant odour
-visible haematuria



Antibiotics used in case of UTI
1.Upper UTI 
Trimethoprim
nitrofurantoin
co amoxiclav
ciprofloxacin
norfloxacin
gentamicin

2.Lower UTI
Trimethoprim 
ciprofloxacin
norfloxacin

3.Prophylactic 
Trimethoprim
co amoxiclav 
cefalexin 

And before I end my post, let me share why UTI is more common in females..
1.the distance between urethra and the anus is near
2.female urethra is shorter than male
3.female dont have bactericidal prostatic secretions. 


by Lakdhes

Diabetic lipoatrophy

Diabetic lipoatrophy:

Localised atrophy of subcutaneous fat due to repeated injection of pork insulin.

Treatment:
Injection of pure human insulin at the margin and centre of the affected area which results in restoration of normal contour.

by Lakdhes