The economic recession has started showing it's effect in academic activity in the engineering stream at least, in India.Now students are preferring admission to more traditional branches than once much much envied IT sector.But the fact is that the IT sector was providing employment to all the streams in engineering course.Even if one opts for other branches the employment generating sector will remain with the IT sectors.But in fact one will certainly have a choice at the entry level though less in number to engage many.We will have to wait still for some more time.
I do not remember if I have seen bilateral orchitis in the recent past that I saw to-day.The enlargement is quite remarkable.May be it is due to the delay in arrival to the hospital.Orchitis is inflammation of testis commonly by bacteria in an adult but in tropical countries usually filarial. .In children it is usually of viral in origin.Here the testis enlarges and becomes painful accompanied by fever.Epididymis is also involved most of the times.It follows an urinary tract infection through backward infection. Support of testis,analgesics to relieve the pain and antibiotics to control infection are required.Investigations like urine examination along with culture and sensitivity test and ultrasonography of testis and abdomen are important to support treatment.
A large chunk of death is due to fear after a snake bite.This is due to shock following fear.Most of the bites are from non-poisonous snakes.Snakes are there for ecological balance.They are friend of farmer in the sense that they protect his grains from rats by preying on them.They bite out of fear only.Otherwise they are on their way.But the look at them is shivering , a chill travels in the spine and that kills the victim. Personally I am afraid of them.Snakes are either poisonous or non-poisonous .Poisonous are again divided into neurotoxic which attack the nervous system or haemotoxic which cause disturbance in blood coagulation system. But pure neurotoxic and pure haemotoxic does not occur.Mostly they remain mixed but one component may be in excess to other. The poison occurs in the saliva of snakes primarily to kill or paralyze the prey to make swallowing easier. Symptoms of of poisoning appears depending on the amount of toxin liberated to the blood stream.That in tern depends on the type of fang the snake has and other barriers to injection of venom like clothing present. Immediate symptoms include sensation in body, numbness and bleeding from the site of bite,reeling of head,weakness,frothing ,difficulty in respiration and loss of consciouness.If less of neurotoxin present then late symptoms like swelling of the part,bleeding ,blood in urine,kidney failure and respiratory problems will appear. First-aid in form of immobility of the part,washing of the part,sucking of venom by person without having mouth injury,taking T.Toxoid and antibiotics are important.Application of a tight bandage above a joint nearer to the bite called a tourniquet is to done which is to be relaxed in each 10 minutes to allow blood flow to the part below the tourniquet till patient reaches a hospital. Treatment should commence at once when patient reaches a hospital.A blood sample should be collected for clot retraction test.Here the killed snake if was possible is to be produced for identification of the poisonous nature. Since the venom contains a mixture of different types of toxins a polyvalent anti-venom is administered after due sensitivity testing and according to the advice of treating physician. A patients not in so late condition usually recovers.
Here one paradox in relation to dog bite is that there dog is not to be killed immediately and here snake is to be killed and produced for identification if at all possible.
Sometime back I was asking my son to create such a button that in one click the recent post in one's blog will be posted to different sites and also in the same way that can be book marked.In one sentence it is a sort of multi-linking. Fortunately while wandering in different pages in web I came to know one site called Onlywire.com where some of bookmarking features searched by me are present.Here one has to configure the sites from the list of sites presented by the web site and add a button in his website. After writing a post and switching on the button rest of sharing work will be taken over by the Onlywire. But still it can not link to certain other sites .Will any developer look into it.I think one day that will be there.A blogger can save time in posting a blog to different sites he ownsin one go.But till that time one should try testing the Onlywire.
A patient having low grade fever ,headache,malaise and some amount of cough usually not given much importance thinking it to be common cold or some minor viral fever.But if has a history of exposure to the bite or saliva contact of an unimmunized domestic pet like dog,rabbit,monkey,cat or mongoose or an exposure to wolf ,monkey or jackel has to be viewed seriously.If these symptoms occur near about the 10th day of such exposure it adds weight to warrant a close observation for Rabies.If it is so the patient will go to the next phage of the disease i.e.forgetfulness,stiffness,loss /reduced sensation on some part of body,muscle twitching and hypersensitivity to cold ,even gentle breeze ,sound or even to gentle touch.
The classical symptom of hydrophobia is seen about more then 50% of cases and is diagnostic.Here the patient becomes afraid of even the sight of water leave aside the drinking of it.There after the patient goes to convulsions,coma and dies usually of respiratory arrest.
It is very much painful to watch the site and diagnose the disease as cure is a remote possibility. After about 10 days to 1 year of contact with rabid animal , depending the virus load,site of injury and immunization status the victim the disease may manifest.The mean time is around 2 months.This rabies virus travels along the nerve tissue to the Grey matter of brain to multiply there and come back to periphery to manifest.There occurs severe spasm of wind pipe making it difficult to take respiration.
First aid includes through washing, using soap water and if cetrimide solution is available it is good.Immunization for Tetanus and some antibiotics and dressing of the wound are required.Then specific treatment should be sought .It is in form of passive immunization by Rabies Immunoglobin(RIG) according to the assessment of the doctor.Active immunization by HDCV(Human Diploid Cell Culture Vaccine) is by far the best and lack many adverse effect of other available vaccines.Other vaccines include a Vera cell/Chick embryo cell culture vaccine.The sheep brain culture vaccine is no longer preferred.The vaccine is taken in intramuscular route on 0,3,7,14,21 to 30 and another on 90th day.Day 0 means the day of bite or when the person first reports.
A Rabies Patient
Those persons are at the risk of contact(occupational Hazard) such as veterinary people should get immunized with 3 doses and booster on 2nd year for their protection. Useful tips is to restraint the suspected animal after the bite ,if feasible.And keep under observation for 10 days in which period mostly they die or show symptoms of disease in them.They should not be killed in anger immediately after bite.If they show symptoms of disease or die their brain should be sent for recovery of virus to confirm the disease in them. It is also seen that some healthy carrier animals are also there.So I think it is better if one is immunized than to wait for other things.Immunization of pet is an important step for animal lovers and persons having occupational hazard.
I choose a little different color to mark the occasion of the second decade birth anniversary of the Blogger.In the meanwhile I have covered a little distance in the blogging platform and acquired many new friends.Many must not be knowing my background and some might be interested in knowing a little bit more about me. So I am a surgeon working in a Port Trust Hospital i.e. Paradip Port Trust,Paradip which is the deepest port in the eastern coast of India where The Bay Of Bengal touches Orissa( which is one of the states of India).Orissa is a mineral rich state and most of the export is coal and iron ore .And yet it is one of the poorest states of India. I started my career as a Asst.Surgeon in Govt. Of Orissa .Completed my post graduation in general surgery. After about 11 years of service in the Govt. set up, I joined the Port hospital for various reasons and continuing here.I live with my nice wife and two sober sons.My elder son has now completed his bachelors degree in IT and waiting to get his certificates.My second son is in the verge of joining an engineering stream .
Hello !
Now I shall narrate the actual journey to blogging. We went for a PC( desktop) some two years back and got internet connection. My two sons went on doing many things.I created my e-mail ID in Gmail first as per the recommendation of my elder son.For some reasons I now want to join in some other health care job. And as usual registered my name in different job portals and started surfing the net.By the by I came across different virus attack of computers and advertisement for different softwares.Then I became interested in those and virtually became a software tester by downloading ,installing and uninstalling ,again searching for newer ones and like that.Some times I get interested in some software and start researching on it without knowing in detail.And I loved to be troubled in many occasions and obviously sought the help of my elder son. In the process I created many e-mail IDs for me and registered in many sites.I think first I noticed blogging probably in wordpress.com or ibibo.com and wrote some posts, but left it .Seeing all these fruitless work as a so called software tester my elder son suggested to write some health tips or some sort of medical writing in form of blogging.And I told him that I already have it but not
regular.Then it is he who suggested to open a blogging platform in Bloggers .Now I had become a little acquainted to and created one page for me giving name surgispotdrpp.When he came home and knew about the name he did not like and wanted to create a better name for my site. In my presence a page was created in the name of medspot. And he optimised everything for me feeding in different blog directories ,Feedburner and Googlesearch engine which were not known to me.So I started posting blogs.I thought that was sufficient. But only two to three persons could read it. Me become active now.The medspot did not sound good to me. And I changed it to Clinispot.blogspot which is the present one. Latter on I could add it to some more blog directories and optimizing by trial and error .I succeeded many times and lost sometimes in the wilderness.Thereafter I become interested in blogging and opened pages in some more sites namely in opensocial.org and myspace.com etc.Then I started knowing the importance of broadcasting it in different forums such as Twitter,Blogcatalog,facebook and many more.Now my traffic improved.I got many friends in the net.I think my best friend in net is Gabriele who owns web sites and is learned person in blogging technology. Still now I am going on experimenting in my sites.In the course of time I new the importance of pictures in blog posts and started collecting from the google images,stored in my computer and used those even though may not be very matching to the posts.And the know how of blogging tips grew as I came across firefox addons like Zemanta,Clipmark,Photobucket ,Apature and many more.They actually decorated my blogs and I love to see the real time picture being collected by them.Now sometimes I give information to my engineer son about the blogging utilities as he owns at least two sites one which I follow is Techfuzon.com. This is a long blogger's journey.From a surgeon to a blogger.I have now become interested in HTML writing and probably start reading the e-book provided by my son.Now I am the smallest of small blogger and my google page rank is 2.
Working Of Page Rank
I sincerely thank Google for his platform and support.The next platform according to me is Wordpress.com but it is a little tight one ,not flexible like Blogspot.Of course it goes without saying that my wife tolerated me when I sit long before the PC in doing these odd business .I am very slow in typing and the blunders I do while doing something takes a lot of time to correct.Then, of course my elder son's technical support and younger son's appreciation of content took me a long way in writing health related issues. I got encouragement from some of my net friends from which the name of Gabriele is worth mentioning.And last but not the least the contribution of free hosting blog directories like Blogcatalog and the developers who create addons and different widgets are worth mentioning.
I think what I am forgetting to mention is that the "Buzz" about the second decade birth anniversary of blogger in August which prompted me to share my experience of " Journey from a surgeon to a mini blogger " with all my friends and well wishers.
To-day knew about e-cigarette.It contains the same nicotine which has addictive potential.Let us watch.Really strange ideas.It is non the less harmful than tobacco.
Small discrete hard nodules beneth the skin is a common finding for which patients approach me.They are sometimes more than one and of varied size ,movable,hard and painless.Though usually found in the skin can occur anywhere in the body . These are benign tumours of nerve sheath called Neurofibroma. Multiple neurofibromas may me seen in some called Vonrecklinghousen's disease.Treatment is not at all satisfactory .If a superficially placed neurofibroma grows to a large size it needs to be surgically removed.But sometimes they occur at critical places causing pressure symptoms to the neighbourhood and has to be carefully removed.
A Hindu mythology is linked to it in India. Rahu & Ketu two demons took nectar in disguise while being distributed by The Almighty Bishnu to the Gods and goddesses ..And the Sun God new that and indicated to Bishnu who in turn chopped off their heads from neck . But by that time the demons had drunk the nectar up to their throat and remained alive.When they knew that the Sun God was behind it they rushed to engulf Him.But as they lacked their body from the throat the God could emerge again.And for that time period the Sun is not visible .And the same is the story for the Moon GOD.And the solar and lunar eclipse.
Many fast in this part of world to share the sorrow and the unholy moment.But one good thing is that body is deprived of some calorie at least.Also Indian observe so many occasions in fasting.Probably that keeps them a little trimmed.
A new research to know from saliva test about the premature birth.Before hand it was being searched to get cells for DNA sampling in forensic study.
clipped from news.bbc.co.uk
Saliva test for early birth risk
A simple saliva test could help spot which expectant women are likely to go into premature labour, experts believe.
It is still unknown why about 40,000 UK women a year give birth prematurely
Early identification would enable these mothers to be given steroids which help in the development of the baby's lungs, preventing disability and death.
When they studied 92 women deemed to be at increased risk of having a preterm birth, they found the women who delivered spontaneously before 34 weeks had much lower salivary levels of progesterone than those giving birth at term, after 37 weeks.
This measurable difference in progesterone was apparent at all gestational ages from 24 weeks onwards.
This is a very nasty disease to me.Somehow I am not comfortable to treat this one.Patient comes with a painful swelling near to anus,fever and prostration .On examination a painful swelling will be found near the anal opening.Once drained a large amount of foul swelling pus will come out and relief the patient to a considerable extent. And this cycle goes on unless the patient is not throughly investigated for possibility of Fistula-In-Ano. It is a condition where there is build up of a tunnelled connection ,of course small in caliber between interior of lower gut and the exterior i.e. skin.This occurs from an infection of anal glands located inside the anus and rectum and gradually enlarge to burst to the out side.With passing of time the inside of the fistula or tunnel matures and continuously discharges pus.That is why I call a nasty disease. Fistula may also manifestation of some diseases like TB,Ulcerative Colitis,Chron's Disease ,A rectal cancer and some other diseases.These are of various types and classified in various manner. Most accepted being superficiel,deep,intershincteric,transphencteric and high etc.which is required for the treating doctors.Treatment of more complex fistulas are not very much satisfactioy.A fistulogram gives good idea of it's extension to help in operation.Besides trans rectal ultrasonogram is helpful.Tuberculosis if suspected should be searched for the primary site of infection .A simple per rectal examination is helpful to supect a cancer inside. Surgery is the option for most of fistulas except TB and some other diseases.Here the whole tract is excised leaving a raw area to heal from the depth. And if dressing done properly and wound heals fromthe depth probably the surgeon should be able to sleep cmfortably.The excised specimen is to be subjected to histopathological study to exclude associated cancer and TB in the tract.And in that case furhter treatment for the specific disease to be taken up.
Most common complication of surgery is inardverent injury to the anal sphincture making the patient incompetent to hold faecal matter.And the next is recurrance. So this surgey many times brings down the ranking of the surgeon's popualrity.People taking non-veg diet and suffering fron constipation are prone for this disease.
My patient of Appendicular Lump is recovering from the grave situation.Now the fever has subsided,vomiting reduced and appetite is returning.She was on conservative management.But full oral feed has not been allowed .I think she can take normal diet after another two days. In case she has not improved I would have been forced to discontinue the conservative management in favor of intervention.Now the intervention would have meant drainage of pus from the lump and if possible closing of the stump of the apendix.It could have drawn me to the possible worst complications namely perforation of intestine and damage to the nearby structures.
But as things improved now I plan to go for an interval appendectomy after a lapse of six weeks.By this time the lump of conglomerated intestines would have resolved exposing the appendix.Adhesion if any would have matured to be safely dissected out .Patient's general condition must have improved a lot .The infection would have gone. Let us hope for the best.
A news in The CNN was about the late pregnancy.What tought is that pregnancy after the age of 35 is likely to produce congenital anomalies in the baby.Most common linkage was to Down's Syndrome the mean average age of mother at childbirth is 37 years.Birth of babies with this syndrome increases with mother's age.Down's Syndrome is due to chromosomal defect i.e. addition of extra piece of chromosome to the chromosome no 21 .These babies can be identified in the infancy.They are characterized by round head,less developed nasal bridge,upward and outward slanting eyes,low set ear and small ear lobule,a hanging mouth ,heavy fissured tongue,short little finger and eye lens opacity etc.These are mentally retarded and may have heart defects.later in the life predisposed to early Alzheimer's disease and blood cancer.These defects can be diagnosed while the fetus is inside the womb.And pregnancy is discontinued.
Karyotype of trisomy Down's Syndrome
Also older mothers get childbirth problems.In a pre-collected ovum and sperm (Frozen)using the method of IVF ,one can become mother, it is stated.But again hormonal support and mothers general body status is to be looked into.
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