Latest Procedure Of Laparoscopic cholecystectomy

Procedure:

• To begin the operation, the patient is placed in the supine position on the operating table and anesthetized.

• Disinfect the skin of patient using antiseptic lotion like savlon,betadin,spirit.

• Maintain the sterile technique during procedure.

•  A scalpel is used to make a small incision at the umbilicus

•  Using either a Veress needle or Hasson technique the abdominal cavity is entered.

• The surgeon inflates the abdominal cavity with carbon dioxide to create a working space.

• The camera is placed through the umbilical port and the abdominal cavity is inspected.

• Additional ports are opened inferior to the ribs at the epigastric, midclavicular, and anterior axillary positions.

• The gallbladder fundus is identified, grasped, and retracted superiorly. 

• With a second grasper, the gallbladder infundibulum is retracted laterally to expose and open Calot's Triangle (the area bound by the cystic artery, cystic duct, and common hepatic duct). 

• The triangle is gently dissected to clear the peritoneal covering and obtain a view of the underlying structures.

• The cystic duct and the cystic artery are identified, clipped with tiny titanium clips and cut.

• Then the gallbladder is dissected away from the liver bed and removed through one of the ports

Recently, this procedure is performed through a single incision in the patient's umbilicus. This advanced technique is called Laparoendoscopic Single Site Surgery or "LESS".

AIDS Definition Defference between HIV and AIDS Symptoms Transmitted And Prevention

Definition of AIDS:

Acquired immune deficiency syndrome, or AIDS, is a condition that describes an advanced state of HIV infection. With AIDS, the virus has progressed, causing significant loss of white blood cells (CD4 cells) or infections that result from immune system damage. 

Difference between HIV and AIDS:

• HIV is the virus which attacks the T-cells in the immune system.But AIDS is the syndrome which appears in advanced stages of HIV infection. 

• HIV is a virus. But AIDS is a medical condition. 

• HIV testing can identify infection in the early stages. This allows the patient to use prophylactic (preventive) drugs which will slow the rate at which the virus replicates, delaying the onset of AIDS. But AIDS patients still have the HIV virus and are still infectious. Someone with AIDS can pass HIV to someone else. 

Symptoms:

Symptoms of early HIV infection may include: 

• Fever 
• Chills 
• Joint pain 
• Muscle ache 
• Sore throat 
• Sweats (particularly at night) 
• Enlarged glands 
• A red rash 
• Tiredness 
• Weakness 
• Weight loss 

Signs and symptoms of late-stage HIV infection may include:

• Blurred vision 
• Diarrhea, which is usually persistent or chronic 
• Dry cough 
• Fever of above 37C (100F) lasting for weeks 
• Night sweats 
• Permanent tiredness 
• Shortness of breath 
• Swollen glands lasting for weeks 
• Weight loss 
• White spots on the tongue or mouth 

Transmitted:

HIV can be transmitted through:

• Sexual transmission: It can happen when there is contact with infected sexual secretions (rectal, genital or oral mucous membranes). This can happen while having unprotected sex, including vaginal, oral and anal sex or sharing sex toys with someone infected with HIV. 

• Perinatal transmission: The mother can pass the infection on to her child during childbirth, pregnancy, and also through breastfeeding. 

• Blood transmission: The risk of transmitting HIV through blood transfusion is nowadays extremely low in developed countries, thanks to meticulous screening and precautions. Among drug users, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.

The virus CANNOT be transmitted from:

• Shaking hands 
• Hugging 
• Casual kissing 
• Sneezing 
• Touching unbroken skin 
• Using the same toilet 
• Sharing towels 
• Sharing cutlery 
• Mouth-to-mouth resuscitation 

Prevention: 

• Protected sex: Having sex without a condom can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs). HIV can be spread by having unprotected sex (vaginal, oral and anal sex). It can also be caught from sharing sex toys with someone infected with HIV. 

• Drug abuse nd neeadle sharing: Intravenous drug use is an important factor in HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C.

• Body fluid exposure: Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood. At all times, health care workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection. 

• Pregnancy: Anti-HIV medicines can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby. Precautions have to be taken to protect the baby´s health. Delivery through caesarean section may be necessary. Breastfeeding may have to give way to bottle-feeding if the mother is infected. A study by scientists from Columbia University, New York, found that breastfeeding for 6+ months with antiretroviral therapy could help reduce mother-to-child HIV transmission as well as improve chances of infant's survival. 

• Education. Health education is an important factor in reducing risky behavior. 

List Of Latest HIV Medicines

List of HIV medicine:

• Nucleoside analog reverse transcriptase inhibitors- These drugs can block HIV's ability to copy a cell's DNA. Without complete DNA, HIV can't make new virus copies. These HIV medicines include the following:

1. Zidovudine, also known as AZT (brand name: Retrovir)
2. Didanosine, also known as ddI (brand name: Videx)
3. Zalcitabine, also known as ddC (brand name: Hivid)
4. Lamivudine, also known as 3TC (brand name: Epivir)
5. Stavudine, also known as d4T (brand name: Zerit)
6. Abacavir, also known as ABC (brand name: Ziagen

• Non-nucleoside reverse transcriptase inhibitor- Also doing same function as above but better way and faster. These HIV medicines include the following.

1. Delavirdine (brand name: Rescriptor)
2. Nevirapine (brand name: Viramune)
3. Efavirenz, also known as EFV

• Protease inhibitors- Will prevent infected cells from releasing HIV Medicine into the body. Type of medicinesare following-

1. Saquinavir (brand name: Invirase)
2. Indinavir (brand name: Crixivan)
3. Nelfinavir (brand name: Viracept)
4. Ritonavir (brand name: Norvir)
5. Amprenavir (brand name: Agenerase)

Fusion inhibitors- Prevent HIV from entering in to CD4 cells- Examples-

Enfuvirtide (brand name: Fuzeon)

NOTE:Please to be used after Doctor advice.

Gastroenteritis Definition Cause Symptoms Treatment Prevention And Vaccination

Definition:
Gastroenteritis is a medical condition characterized by inflammation of the gastrointestinal tract that involves both the stomach and the small intestine.

Causes:

Gastroenteritis has many causes. Viruses and bacteria are the most common.Gastroenteritis caused by viruses may last 1-2 days. On the other hand, bacterial cases can last a week or more.

Bacteria: These are the most common bacterial causes:

• Escherichia coli - Traveler’s diarrhea, food poisoning, dysentery, colitis, or uremic syndrome.
• Salmonella - Typhoid fever; handling poultry or reptiles such as turtles that carry the germs.
• Campylobacter - Undercooked meat, unpasteurized milk.
• Shigella - Dysentery

Viruses: Viral outbreaks (30-40% of cases in children) can spread rapidly through close contact among children in day care and schools. Poor handwashing habits can spread viruses. Common viral causes include the following:

• Adenoviruses
• Rotaviruses
• Caliciviruses
• Astroviruses
• Norovirus 

Parasites and protozoans: These tiny organisms are less frequently responsible for intestinal irritation.May pick up one of these by drinking contaminated water. Swimming pools are common places to come in contact with these parasites. Common parasites include these:

• Giardia - The most frequent cause of waterborne diarrhea causing giardiasis.
• Cryptosporidium - Affects mostly people with weakened immune systems, causes watery diarrhea

Other common causes: Chemical toxins most often found in seafood, food allergies, heavy metals, antibiotics, and other medications also may be responsible for bouts of gastroenteritis that are not infectious to others.

Medications:

• Aspirin
• Nonsteroidal anti-inflammatory medicines (such as Motrin or Advil)
• Antibiotics
• Caffeine
• Steroids - Excessive use or a sudden change in frequency or dosage
• Laxatives

Symptoms:

• Abdominal gas, bloating or belching
• Abdominal pain or cramps
• Blood-streaked stools
• Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)
• Nausea, which may be described as feelings of wooziness, queasiness, retching, sea-sickness, car-sickness, or an upset stomach
• Vomiting including multiple episodes
• Watery diarrhea including multiple episodes
• Weakness

Treatment:

Treatment generally involves a multifaceted plan that addresses the cause; minimizes the discomfort of nausea, vomiting, and diarrhea; and decreases the risk of dehydration.

• Not eating solid foods to rest the stomach and intestines until symptoms have passed.

• Drinking plenty of fluids (water or rehydrating fluid, such as Pedialyte) to ensure adequate hydration.

• In some cases, medications are used to treat gastroenteritis. Antibiotics may be prescribed when gastroenteritis is caused by a bacterial infection, such as in bacterial food poisoning due to Shigella,Salmonella, or Campylobacter infection.

Treatment of severe gastroenteritis that does not resolve or leads to dehydration may require hospitalization and rehydration with intravenous fluids.

Prevention:

• A supply of easily accessible uncontaminated water and good sanitation practices are important for reducing rates of infection and clinically significant gastroenteritis.

• Personal measures (such as hand washing) have been found to decrease incidence and prevalence rates of gastroenteritis in both the developing and developed world by as much as 30%. Alcohol-based gels may also be effective.

• Breastfeeding is important, especially in places with poor hygiene, as is improvement of hygiene generally.

• Breast milk reduces both the frequency of infections and their duration.

• Avoiding contaminated food or drink should also be effective.

Vaccination:

Due to both its effectiveness and safety, in 2009 the World Health Organization recommended that the rotavirus vaccine be offered to all children globally Two commercial rotavirus vaccines exist and several more are in development. In Africa and Asia these vaccines reduced severe disease among infants and countries that have put in place national immunization programs have seen a decline in the rates and severity of disease.This vaccine may also prevent illness in non-vaccinated children by reducing the number of circulating infections.Since 2000, the implementation of a rotavirus vaccination program in the United States has substantially decreased the number of cases of diarrhea by as much as 80 percent. The first dose of vaccine should be given to infants between 6 and 15 weeks of age.The oral cholera vaccine has been found to be 50–60% effective over 2 years.