The objectives of intravesical therapy in bladder cancer is to: avoid post-TURB (Transurethral resection of bladder) implantation of tumor cells eradicate residual disease prevent tumor recurrence delay or reduce tumor progression Indications of BCG in bladder cancer: Intravesical treatment and prophylaxis of bladder CIS Prophylaxis of primary or recurrent stage Ta and/or…
Tag: General Surgery
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Chest Tube Insertion or Tube Thoracostomy
Indications of chest tube insertion Pneumothorax: In any ventilated patient (positive airway pressure will force air into the pleural cavity and produce tension pneumothorax) Tension pneumothorax after initial needle thoracocentesis Persistent or Recurrent pneumothorax after simple aspiration Large secondary spontaneous pneumothorax in patients >50 years Pleural effusion: Malignant pleural effusion…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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NG tube insertion
Indications Gastric decompression Gavage (feeding) Gastric lavage (irrigation or dilution of gastric contents) Sampling of the gastric contents for analysis Sometimes used to instil air into the stomach to detect a gastric perforation on erect CXR Contraindications Basilar skull fractures (Risk of NG reaching brain) Facial fractures (risk of cribiform…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Aspirin and Clopidegrol : Perioperative Guidelines
The average lifespan of platelets is 7 to 10 days. Aspirin and Clopidegrol inhibits platelets for around 21 days. Hence, when these agents are stopped 7 days before the surgery, it allows 33% regeneration of platelets. Stents and coronary lesions act as unstable plaque until they are completely covered by…
Case Reports
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Acute Pancreatitis – Case Discussion
Cases of Acute Pancreatitis Case 1 32 years old male came to emergency department with complaint of: Upper abdominal pain X 3 days Vomiting X 2 episode (3 days back) Yellowish discoloration of urine and decreased urine output X 2 days Vitals: Pulse rate BP RR TPR SpO2 Triage Level…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Simplified Approach to Parotid Enlargement
Diagnosis and management of a case of parotid enlargement requires systematic approach. Here, I have tried to present a simplified approach to parotid enlargement. A) DIFFERENTIAL DIAGNOSES OF PAROTID ENLARGEMENT: 1. Infectious: Child: Mumps, Coxsackie Adult: S.aureus 2. Non-infectious benign: Epithelial: Pleomorphic adenoma, Warthin tumor, Oncocytoma, Monomorphic adenoma Non-epithelial: Lymph…
Emergency Medicine
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The Continuum: SIRS, Severe Sepsis and Septic Shock
SIRS criteria are mostly used as a screening tool to identify patients that may need further workup for sepsis and severe sepsis. In the emergency department it is a triage tool that helps determine patient acuity and identify patients that are potentially septic and in need of further screening. Septic…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Strawberry Gallbladder (Cholesterolosis)
Synonyms: Strawberry gallbladder is also known as hyperplastic cholecystoses. Hyperplastic cholecystoses are a spectrum of non-neoplastic proliferative disorders caused by deposition of cholesterol-laden macrophages within the wall of the gall bladder. The cholecystose range from abnormalities of the gallbladder wall (adenomyomatosis and strawberry gall bladder) to gallbladder polyps extending into…