DOCSLIB.ORG

Sample Chapters for Personal Use Only

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sample Chapters for Personal Use Only Chaptersonly use Sample personal For Review of Surgery for Students AUTHORS Dr. Krishna Adit Agarwal, MBBS Alumnus of Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India Founder, I-MediSTAR Innovation in Medical Science, Technology and Research only www.IMediSTChaptersAR.com AND MBBS use Dr. Avantika Singh, Alumna of Vardhman Mahavir Medical College and SampleSafdarjung Hospital, New Delhi, India Founder, I-MediSTAR Innovation in Medical Science, Technology and Research personalwww.IMediSTAR.com For PEEPEE PUBLISHERS AND DISTRIBUTORS (P) LTD. Review of Surgery for Students Published by Pawaninder P. Vij and Anupam Vij Peepee Publishers and Distributors (P) Ltd. Head Office: 160, Shakti Vihar, Pitam Pura Delhi-110034 (India) Correspondence Address: 7/31, First Floor, Ansari Road Daryaganj, New Delhi-110002 (India) Ph: 65195868, 23246245, 9811156083 e-mail: [email protected] e-mail: [email protected] only e-mail: [email protected] Chapters www.peepeepub.com use © 2014 Peepee Publishers and Distributors (P) Ltd. All rightsSample reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopy, recording, translated, or any information storage and retrieval system, without permission in writing from the editor and the publisherpersonal. This book has been published in good faith that the material provided by authors/contributors is original. Every effort is made to ensure accuracy of material, but publisher and printer will not be held responsible for any inadvertent errors.For In case of any dispute, all legal matters to be settled under Delhi jurisdiction only. First Edition : 2014 ISBN: 978-81-8445-167-2 FOREWORD Dr. Devi Prasad Shetty Chairman and Founder Narayana Health Healthcare delivery in India is at a tipping point requiring major interventions. Even if investments are made available to create the necessary infrastructure, the big challenge of creating skilled manpower remains an uphill task. For a country with a population of 1.21 billion, we might have the largest number of medical colleges producing 50,000 doctors, yet, today we have only 18,000 surgeons in the country, i.e., one surgeon for 67,000 people! Due to the vast gap in demand and supply of post-graduate seats, entry into higher medical education has remained elusive to majority of MBBS graduates. In spite of large number of medical graduates, we are contending with only 2,030 post-graduate seats in General Surgery. With the scenario tough and competitive, the aspirants for General Surgery course need well-organizedonly material for preparation and better outcomes in the entrance tests.Chapters In this direction, the book ‘Review of Surgery for Students’ by Dr. Krishna Adit Agarwal and Dr. Avantika Singh should come handy. With well classified and clearly laid out content, the effort of the young authorsuse in their maiden publication deserves admiration. I am sure they will be able to enrich subsequent editions with valuable feedback from students and faculty alike. I wish Samplethe authors as also the students a resounding success. Dr. Devi Prasad Shettypersonal For Chaptersonly use Sample personal For INTRODUCTION TO THE AUTHORS Dr. Krishna Adit Agarwal Dr. Avantika Singh Krishna is a recent medical graduate Avantika is a recent medical graduate of Vardhman Mahavir Medical College from Vardhman Mahavir Medical and Safdarjung Hospital, New Delhi. College and Safdarjung Hospital, New He aspires to specialize in the field of Delhi. She aspires to specialize in the Renal Medicine and has been offered field of Neonatal Medicine and has a position at the prestigious Beth been offered a position at the Israel Deaconess Medical Center (a teaching affiliate of prestigious Boston Children’s Hospital (a teaching affiliate Harvard Medical School) as a Research Fellow from of Harvard Medical School) as a Research Fellow from August 2014. August 2014. He has consistently performed well in his medical school Avantika has excelled in her medical school, winning examinations and displayed the ability to approach numerous accolades. She topped the University in the academic and practical problems in a logical, analytical third and final professional examinations. She was awarded and systemic manner. gold medals in Community Medicine and Obstetrics and Gynecology, silver medals in Pediatrics, Surgery, He has also undertaken several initiatives for the medical Ophthalmology and ENT, and bronze medal in Internal students like envisioning and organizing the Medical Medicine besides a distinction in Pharmacology. Students’ International Conference (MEDSICON) at VMMC. As the founder of the first MEDSICON conducted in 2011, Besides excelling in academics, she has founded an Krishna aimed at providing undergraduate (bio) medical organization – Innovation in Medical Science, Technology students an opportunity to showcase their research and Research (I-MediSTAR). The organization provides potential and take their research ideas forward. It has mentorship to medical students and graduatesonly seeking grown over the past three years and now receivesChapters a to sharpen their clinical and research skills. It conducts handsome international and national participation. various skill-based hands-on workshops to help students learn the science and art of medicine. Krishna has also been a co-founder of Innovation in Medical Avantika has alsouse been the co-founder of Medical Science, Technology and Research (I-MediSTAR) which is an organization providing medical students and Students’ International Conference (MEDSICON) and graduates with various opportunities to hone their clinical organized it at VMMC for the past three years. The and research skills. He has also been instrumental in conference provided the much-needed platform to young setting up of the ‘Journal of Young Medical Researchers’ researchers to share their research ideas with the medical Sample community. She is also the Student Editorial Board (JYMR), an open access journal providing an exclusive avenue for young researchers to publish their work. Coordinator at the Journal of Young Medical Researchers (JYMR). Krishna is a highly intellectual, dedicated and practical thinking doctor who excelspersonal in thinking beyond the Avantika is a brilliant doctor, who strives to excel in life. boundaries of the fixed academic curriculum. She is compassionate and caring towards her patients and has the ability to make the best possible medical For decisions. Prof. Dr. Renuka Sharma Professor, Dept. of Physiology VMMC and SJH, New Delhi Chaptersonly use Sample personal For PREFACE Review of Surgery for Students is aimed at providing the most concise and high-yielding information to undergraduate students preparing for their surgery final professional examination in India and abroad. There are a lot of surgery textbooks available in the market but no review book was so far available to help the students properly revise what they have learnt at their medical school. Our book is based on the Indian examination pattern and features a point-wise approach to topics. It is a book that has been written keeping in mind the last minute examination stress faced by students and it strives to help them retain the matter and answer well in the examinations. Only the must-know line diagrams have been included in the book. These diagrams are easy to remember as well as draw in the exam and will help achieve higher scores. We have consulted the standard surgery textbooks, Bailey and Love’s Short Practice of Surgery (26th Ed.) and Manipal Manual of Surgery (3rd Ed.) alongwith various online resources in preparing this review book. Although, we have tried our best to include the latest guidelines and management protocols but these guidelines are continuously being updated and we encourage our readers to keep themselves up-to-date with the future advances in surgery. Being the first edition, there might be some inadvertent errors in the book. We request our readers to kindly email us any corrections, suggestions and contributions in the form of latest protocols, line diagrams, newer topics asked in exams etc. to surgery@imedistar .com . We welcome your feedback and will surely incorporate it inonly the next edition of this book. Chapters “Let the young know they will never find a moreuse interesting, more instructive book than the patient himself” Sample - Giorgio Baglivi Most importantly, attendpersonal your clinics and listen to the patient, for the patient teaches you far more than any book ever can!For Dr. Krishna Adit Agarwal Dr. Avantika Singh New Delhi, India Chaptersonly use Sample personal For ACKNOWLEDGEMENTS We are thankful to… Gods in Heaven Gods on Earth, Our Parents Our Gurus, Guides and Mentors Dr. Jayashree Bhattacharjee Dr. Chintamani, Dr. Harish Chellani Dr. Renuka Sharma, Dr. Rajeev Tiwari Dr. Sugandha Arya, Dr. Harpreet Singh Our great friends, especially Manmohan for igniting the spark to write this book Our Dear Readers Chaptersand only The awesome team at Peepee Publishers and Distributors Pvt. Ltd. use for their wonderful work with this book. Sample personal For Chaptersonly use Sample personal For CONTRIBUTING AUTHORS Joyutpal Biswas Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi Arteries, Veins & Lymphatics and Burns Akriti Sinha Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi Miscellaneous Questions asked in exams Arushi Devgan Vardhman Mahavir Medical College and Safdarjung Hospital,
Load more

Recommended publications
  • Breast-Reconstruction-For-Deformities
    ASPS Recommended Insurance Coverage Criteria for Third-Party Payers Breast Reconstruction for Deformities Unrelated to AMERICAN SOCIETY OF PLASTIC SURGEONS Cancer Treatment BACKGROUND Burn of breast: For women, the function of the breast, aside from the brief periods when it ■ Late effect of burns of other specified sites 906.8 serves for lactation, is an organ of female sexual identity. The female ■ Acquired absence of breast V45.71 breast is a major component of a woman’s self image and is important to her psychological sense of femininity and sexuality. Both men and women TREATMENT with abnormal breast structure(s) often suffer from a severe negative A variety of reconstruction techniques are available to accommodate a impact on their self esteem, which may adversely affect his or her well- wide range of breast defects. The technique(s) selected are dependent on being. the nature of the defect, the patient’s individual circumstances and the surgeon’s judgment. When developing the surgical plan, the surgeon must Breast deformities unrelated to cancer treatment occur in both men and correct underlying deficiencies as well as take into consideration the goal women and may present either bilaterally or unilaterally. These of achieving bilateral symmetry. Depending on the individual patient deformities result from congenital anomalies, trauma, disease, or mal- circumstances, surgery on the contralateral breast may be necessary to development. Because breast deformities often result in abnormally achieve symmetry. Surgical procedures on the opposite breast may asymmetrical breasts, surgery of the contralateral breast, as well as the include reduction mammaplasty and mastopexy with or without affected breast, may be required to achieve symmetry.
    [Show full text]
  • Breast Infection: a Review of Diagnosis and Management Practices
    Review Eur J Breast Health 2018; 14: 136-143 DOI: 10.5152/ejbh.2018.3871 Breast Infection: A Review of Diagnosis and Management Practices Eve Boakes1 , Amy Woods2 , Natalie Johnson1 , Naim Kadoglou1 1Department of General Surgery, London North West Healthcare NHS Trust, Northwick Park Hospital, Middlesex, Londan 2Department of Medicine, Croydon University Hospital, Croydon, London ABSTRACT Mastitis is a common condition that predominates during the puerperium. Breast abscesses are less common, however when they do develop, delays in specialist referral may occur due to lack of clear protocols. In secondary care abscesses can be diagnosed by ultrasound scan and in the past the management has been dependent on the receiving surgeon. Management options include aspiration under local anesthetic or more invasive incision and drainage (I&D). Over recent years the availability of bedside/clinic based ultrasound scan has made diagnosis easier and minimally invasive procedures have become the cornerstone of breast abscess management. We review the diagnosis and management of breast infection in the primary and secondary care setting, highlighting the importance of early referral for severe infection/breast abscesses. As a clear guideline on the manage- ment of breast infection is lacking, this review provides useful guidance for those who rarely see breast infection to help avoid long-term morbidity. Keywords: Mastitis, abscess, infection, lactation Cite this article as: Boakes E, Woods A, Johnson N, Kadoglou. Breast Infection: A Review of Diagnosis and Management Practices. Eur J Breast Health 2018; 14: 136-143. Introduction Mastitis is a relatively common breast condition; it can affect patients at any time but predominates in women during the breast-feeding period (1).
    [Show full text]
  • Nipple Discharge-1
    Nipple Discharge Epworth Healthcare Benign Breast Disease Symposium November 12th 2016 Jane O’Brien Specialist Breast and Oncoplastic Surgeon What is Nipple Discharge? Nipple discharge is the release of fluid from the nipple Based on the characteristics of presentation Nipple Discharge is categorized as: • Physiologic nipple discharge • Normal milk production (lactation) • Pathologic nipple discharge 27-Jun-20 2 • Nipple discharge is the one of the most commonly encountered breast complaints • 5-10% percent of women referred because of symptoms of a breast disorder have nipple discharge • Nipple discharge is the third most common presenting symptom to breast clinics (behind lump/lumpiness and breast pain) • Most nipple discharge is of benign origin 27-Jun-20 3 • Less than 5% of women with breast cancer have nipple discharge, and most of these women have other symptoms, such as a lump or newly inverted nipple, as well as the nipple discharge • Mammography and ultrasound have a low sensitivity and specificity for diagnosing the cause of nipple discharge • Nipple smear cytology has a low sensitivity and positive predictive value • The risk of an underlying malignancy is increased if the nipple discharge is spontaneous and single duct 27-Jun-20 4 Physiological Nipple Discharge • Fluid can be obtained from the nipples of 50–80% of asymptomatic women when massage/squeezing used. • This discharge of fluid from a normal breast is referred to as 'physiological discharge' • It is usually yellow, milky, or green in appearance; does not occur spontaneously;
    [Show full text]
  • New and Emerging Technology 147 111. The
    Chapters with icon are web-only 11. BASIC SURGICAL SKILLS: NEW AND EMERGING TECHNOLOGY 147 Chapter 10: Abdominal Wall Incisions and Repair CARE OF THE SURGICAL Including Release 148 Stephen R. T Evans and Parag Bhanot Chapter 11: Laparoscopic Suturing and Stapling 163 1: Metabolic and Idammatory Responses to andInfection 2 Daniel B. Jones and Henry Lin Hubbard ibnmJulia Wamheril, Wbj. Chapter 12: Ultrasonography by Surgeons 180 Junji Machi Managemenk Practical is of Risk, and Future Chapter 13: Cancer Ablation: Understanding the Technologies and 'Iheir Applications 196 Salomao Faintuch, Muneeb Ahmed, and S. Nahum Goldberg Jeremy W Cannon, and Jas#E. Beher 3: Enteral Nutrition Support 56 Chapter 14: Upper and Lower Gastrointestinal Endoscopy 205 rand Laura E Maturese Jefiey L. Ponsky andJonathan l? Pearl r 4: Crvdiov8scular Monitoring and Support 65 Chapter 15: Soft Tissue Reconstruction with Flap Kron adGorav Ailawadi Techniques 214 and Ventilatory Support 83 Luis 0. Vasconez,Salman AshruJ; and Franziska Huettner Chapter 16: Hand Surgery: Traumatic Injuries of the Hand 243 :Hemorrhagic Risk and Blood Kevin C. Chung mdan and Amy Evenson Chapter 17: Robotic Surgery 256 Santiago Horgan andMichael E Sedrak ter 7: Perioperative Antimicrobial Prophylaxis and ment of Surgical Infection 117 Chapter 18: Diagnostic Laparoscopy 264 Kevin C. Conlon and Paul E: Ridgway Chapter 8: 'Ihe Multiple Organ Dysfunction Syndrome: 111. THE HEAD AND NECK 271 y Prevention and CLinical Management 127 John C. Marshall Chapter 19: Anatomy of the Head and Neck 272 Aaron Ruhalter Chapter 9: Immunosuppression in Organ Transplantation 140 Chapter 20: Surgery of the Submandibular and I Sublingual Salivary Glands 296 Carol M Lewis and M~chaelE.
    [Show full text]
  • Mesh in the Hiatus: a Controversial Issue
    REVIEW ARTICLE Mesh in the Hiatus A Controversial Issue Eduardo M. Targarona, MD, PhD; Gali Bendahan, MD; Carmen Balague, MD, PhD; Jordi Garriga, MD; Manuel Trias, MD, PhD Objective: To analyze the experience acquired to date cedure have been published to date. The information avail- on the use of prosthetic mesh to prevent recurrence af- able showed that the use of a mesh for hiatal repair was ter laparoscopic repair of paraesophageal hernia. safe and prevented recurrence. However, data on the long- term results were lacking, and infrequent but severe com- Data Sources: Current English-language literature re- plications may arise. view. Conclusions: The mesh should be used selectively, and Study Selection: Case reports, series, and opinion ar- the decision to proceed should be based on clinical ex- ticles on the use of mesh for paraesophageal hernia repair. perience. In light of the evidence available, however, it appears to be safe, and the fears expressed in the past have Data Extraction and Synthesis: Study type and re- not been confirmed. sults were analyzed. Most articles were short case series. Few comparative or randomized trials assessing the pro- Arch Surg. 2004;139:1286-1296 UCCESS IN THE DEVELOPMENT THE PROBLEM of laparoscopic fundoplica- tion has made this procedure a valid alternative to medical Laparoscopic repair of PEH and mixed hi- therapy for the treatment of atal hernias is a feasible, safe, but complex gastroesophageal reflux. Thanks to the ex- procedure. The experience during the past S 15 years suggests that viscera reduction, perience acquired, the laparoscopic ap- proach is now used to treat more complex sac excision, retrogastric crural closure, situations, such as paraesophageal hernia and fundoplication are the key technical 1-8 (PEH) or type III (mixed) hiatal hernia.1-8 factors.
    [Show full text]
  • Periductal Mastitis in a Male Breast1
    J Korean Radiol Soc 2006;55:305-308 Periductal Mastitis in a Male Breast1 Changsuk Park, M.D., Jung Im Jung, M.D.2, Bong Joo Kang, M.D.2, Ahwon Lee, M.D.3, Woo Chan Park, M.D.4, Seong Tai Hahn, M.D.2 Periductal mastitis and mammary duct ectasia are now considered as separate dis- ease entities in the female breast, and these two diseases affect different age groups and have different etiologies and clinical symptoms. These two entities have very rarely been reported in the male breast and they have long been considered as the same disease as that in the female breast without any differentiation. We report here on the radiologic findings of a rare case of periductal mastitis that developed during the course of chemotherapy for lung cancer in a 50-year-old male. On ultrasonography, there was a partially defined mass with adjacent duct dilatation and intraductal hypoe- chogenicity, and this correlated with an immature abscess with a pus-filled, dilated duct and periductal inflammation on the pathologic examination. Index words : Breast, male Breast, US Breast, ducts Periductal mastitis and mammary duct ectasia in the the literature (3-9). We report here on a rare case of female breast are now considered as separate disease periductal mastitis in a male who had been treated with entities, and these diseases affect different age groups chemotherapy for lung cancer. and have different etiologies and clinical symptoms (1, 2). These two entities have very rarely been reported in Case Report the male breast, and they have long been considered as the same disease as that in the female breast without A 50-year-old male presented with a mass of several any differentiation (3-9).
    [Show full text]
  • Breast Diseases in Children: the Spectrum of Radiologic Findings in a Cohort Study
    Diagn Interv Radiol 2017; 23:407–413 BREAST IMAGING © Turkish Society of Radiology 2017 ORIGINAL ARTICLE Breast diseases in children: the spectrum of radiologic findings in a cohort study Emel Durmaz PURPOSE Murat Alp Öztek We aimed to investigate the spectrum of radiologic findings and referral reasons for breast dis- Hatice Arıöz Habibi eases in children considering age-appropriate presentation. Uğur Kesimal METHODS Hakkı Timur Sindel Our retrospective cohort study included 348 consecutive pediatric patients aged <19 years (me- dian, 13 years) referred to radiology with a clinical presentation between 2005 and 2016. Radio- logic findings were reviewed in four age ranges (0–2 years, 2–8 years, 8–15 years, >15 years). RESULTS Of 348 patients, 257 had a referral reason. The most frequent referral reason was a palpable mass (35%). Developmental abnormalities accounted for 48% of all radiologic findings in 348 patients. We did not detect any breast malignancy. According to age groups, the most common radiologic findings were neonatal hypertrophy (0–2 years), early breast development (2–8 years), develop- mental abnormalities by a majority of gynecomastia (8–15 years), and normal findings or devel- opmental abnormalities (>15 years). Interestingly, the frequency of gynecomastia was only 4% in neonatal period or early childhood. Fibroadenomas and fibroadenoma-like solid masses were seen after 8 years and constituted the majority of solid masses (65%). Cysts were seen at a rate of 7% and majority of them were of simple type, which tends to resolve in time. CONCLUSION In our study, the most common referral reason to radiology was a palpable breast mass.
    [Show full text]
  • SSAT Abstract Book 1.Indb
    THE SOCIETY FOR SURGERY OF THE ALIMENTARY TRACT 54th Annual Meeting May 17-21, 2013 Orange County Convention Center Orlando, Florida ABSTRACT SUPPLEMENT Table of Contents Schedule-at-a-Glance .............................................................................................................2 Sunday Plenary, Video, and Quick Shot Session Abstracts ....................................................6 Monday Plenary, Video, and Quick Shot Session Abstracts ................................................22 Tuesday Plenary Session Abstracts .......................................................................................50 Sunday Poster Session Abstracts ..........................................................................................59 Monday Poster Session Abstracts .......................................................................................112 Tuesday Poster Session Abstracts .......................................................................................166 THE SOCIETY FOR SURGERY OF THE ALIMENTARY TRACT PROGRAM BOOK ABSTRACT SUPPLEMENT FIFTY-FOURTH ANNUAL MEETING Orange County Convention Center Orlando, Florida May 17–21, 2013 THE SOCIETY FOR SURGERY OF THE ALIMENTARY TRACT Schedule-at-a-Glance FRI, MAY 17, 2013 SATURDAY, MAY 18, 2013 300 208ABC Other 6:30 AM 6:45 AM 7:00 AM 7:15 AM 7:30 AM 7:45 AM 8:00 AM 8:15 AM 8:30 AM 8:45 AM 9:00 AM 9:15 AM 9:30 AM 9:45 AM 10:00 AM 10:15 AM 10:30 AM 10:45 AM NAFLD DDW CCS: 11:00 AM Therapeutic 11:15 AM Approaches in 11:30 AM 11:45 AM (by invitation only)
    [Show full text]
  • Breast Lesions in Children and Adolescents
    Pictorial Essay | Pediatric Imaging https://doi.org/10.3348/kjr.2018.19.5.978 pISSN 1229-6929 · eISSN 2005-8330 Korean J Radiol 2018;19(5):978-991 Breast Lesions in Children and Adolescents: Diagnosis and Management Eun Ji Lee, MD, Yun-Woo Chang, MD, PhD, Jung Hee Oh, MD, Jiyoung Hwang, MD, Seong Sook Hong, MD, PhD, Hyun-joo Kim, MD, PhD All authors: Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.
    [Show full text]
  • Aesthetic Breast Surgery GM Ref: GM006-GM010 Version: 4.3 (16 Sept 2020)
    Greater Manchester EUR Policy Statement on: Aesthetic Breast Surgery GM Ref: GM006-GM010 Version: 4.3 (16 Sept 2020) Commissioning Statement Aesthetic Breast Surgery Policy Reconstructive surgery following cancer, trauma or another significant clinical event is Exclusions not covered by this policy and is routinely commissioned across Greater Manchester. (Alternative commissioning Treatment/procedures undertaken as part of an externally funded trial or as a part of arrangements apply) locally agreed contracts / or pathways of care are excluded from this policy, i.e. locally agreed pathways take precedent over this policy (the EUR Team should be informed of any local pathway for this exclusion to take effect). Our definition All surgery involving incision into healthy tissue, in this case a healthy breast whatever of Aesthetic its size and shape, is considered to be aesthetic. This includes cases where there are symptoms, external to the breast that are attributed to, or exacerbated by, the size of the breast(s). Policy Breast Augmentation Inclusion All surgery involving incision into healthy tissue in this case a healthy breast whatever Criteria its size and shape is considered to be aesthetic. Surgery to augment the size and or shape of a breast(s) is not routinely commissioned, with the exception of proven amastia or amazia. There should be confirmation either in the form of a consultant letter or an ultrasound report that there is an absence of breast tissue. This policy applies equally to all women including those who have completed gender realignment. The period of oestrogen therapy on the realignment pathway is considered, for the purposes of this policy, to equate to the period of hormonal increase experienced in puberty.
    [Show full text]
  • Breastfeeding 101 for Pediatric Practices
    BREASTFEEDING 101 FOR PEDIATRIC PRACTICES Jennifer A. Hudson, MD Medical Director, Newborn Services Greenville Health System SC Chapter of AAP, July 2018 Introduction Disclosures • I have no commercial interests or relevant relationships to disclose Objectives • Utilize basic strategies to support breastfeeding couplets in the outpatient setting • Observe and assess a breastfeeding session using a World Health Organization framework Why breastfeeding is important How breastfeeding works Assessing a breastfeed Observing a breastfeed Listening and learning Breast conditions Breastfeeding Counselling: A Training Course. World Health Organization. Breastfeeding Rates The American Academy YOU ARE HERE of Pediatrics recommends exclusive breastfeeding for 6 months. CDC Breastfeeding Report Card, 2016 Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. Breastfeeding and the Use of Human Milk. AAP, 2012 Those not breastfed experience more… minor, major, acute and chronic …health problems The Surgeon General’s Call to Action to Support Breastfeeding, 2011 National Goals Baby-Friendly 47.5% 23.7% Why Women Don’t Low education Formula Lack of role marketing models Lack of Work or experience school Hospital Embarrassed practices Modern Poor support lifestyle No confidence Formula • Inherent weaknesses – Nutrient degradation, expiration – Powder not sterile, requires clean water – Susceptible to manufacturing
    [Show full text]
  • Jadu Fatima M 201211 Phd T
    Development and Application of a Technique for Three-Dimensional Sialography Using Cone Beam Computed Tomography By Fatima M. Jadu BDS, MSc A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Oral Radiology Graduate Department of Dentistry University of Toronto © Copyright by Fatima M. Jadu BDS, MSc 2012 Development and Application of a Technique for Three-Dimensional Sialography Using Cone Beam Computed Tomography Fatima M. Jadu BDS, MSc Doctor of Philosophy Graduate Department of Dentistry University of Toronto 2012 ABSTRACT Introduction: Salivary gland obstructive conditions are common and may necessitate imaging of the glands for diagnosis and management purposes. Many imaging options are available but all have limitations. Sialography is considered the gold standard for examining obstructive conditions of the parotid and submandibular glands but it is largely influenced by the imaging technique to which it is coupled. Cone beam computed tomography (cbCT) is a relatively new and very promising imaging modality that has overcome many of the inherent limitations of other imaging modalities used in the past for sialography. Materials and methods: A RANDO®Man imaging phantom was used to determine the effective radiation doses from the series of plain film images that represent the current standard of practice for sialography. Similar experiments were then undertaken to determine the effective radiation doses from cbCT when varying the field-of-view (FOV) size and center, x-ray tube peak kilovoltage (kVp) and milliamperage (mA). Next, cbCT image quality, measured using the signal-difference-to-noise-ratio (SDNR) was used to determine those technical factors that optimized image quality.
    [Show full text]