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electrosurgery 4



Electro surgery is the use of a high frequency electrical energy in the radio transmission frequency band applied directly to tissue to induce histological effects.Current is in the range 1.5-7.5 million per second or megahertz


High frequency electro surgery works by using electrical current and make it pass through the body tissue so as to create the desired clinical effect. Occurring biological in nature once the current is converted into heat ,the tissue will have thermal damage.It is important to note that there should be a sufficient amount of frequency to avoid causing muscle contraction .With inappropriate amount of frequency ,it can stop the heart from beating.Contrarily instead of merely causing heat through electrical current,  electro cautery involves the usage of a hand held element to apply the heat directly to the affected area.Other modalities that can be combined are electro surgery such as scalpel, scissors and curette. In combining there a specimen can be preserved for  histo pathological examination and this can also have better hold into the coverage of detruction


  • Electro surgery offers less operating time and limited bleeding,which is advantageous to parents
  • Compared to laser surgery this procedure is also much cheaper
  • A less post operative time for recovery can also be expected
  • Recurrence rates are reported to be low


  • Because of utilization of electric currents ,electric shock can be a risk when there is no grounding pad and if the current is being randomly sent to any part of the body
  • Burns can also be evident
  • In order to prevent burns , the skin must be cleaned and then a conductive gel should be used to enhance the contact with return electrode
  • All in all to avoid any unwanted side effects, proper handling of equipment and precise way of executing should always be achieved

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Prepared by :Dr Sajna Hamza





Cryosurgery is a type of surgery that involves the use of extreme cold to destroy abnormal tissue such as tumors.The surgery most often involves the use of liquid nitrogen ,although carbon dioxide and argon may also be used


It is used to treat several types of cancer and some precancerous or noncancerous conditions.In addition to prostate and liver tumors cryosurgery can be an effective treatment for

  • Retinoblastoma- childhood cancer that affect retina of eye
  • Early stage skin cancers
  • Precancerous skin growths known as actinic keratosis
  • Precancerous conditions of the cervix known as cervical intra epithelial neoplasia
  • Low grade cancerous and non cancerous tumors of the bone


  • It is less invasive than surgery  involving only a small incision or insertion of the cryoprobe through the skin
  • Consequently pain,bleeding and other complications of surgery are minimized
  • Cryosurgery is less expensive than other treatments and requires shorter recovery time and a shorter hospital stay
  •  Some times it can be done using  only local anesthesia
  • Because physicians can focus cryosurgical treatment on a limited area,they can avoid the destruction of nearby areas
  • Treatment can be safely repeated and may be used along with standard treatments such as surgery,chemotherapy,hormone therapy and radiation
  • It can be used for patients who are not good candidates for conventional surgery because of their age or other medical conditions


The major disadvantage of cryosurgery is the uncertainty surrounding its long term effectiveness.While cryosurgery may be effective in treating tumors the physician can see by using imaging tests,it can miss microscopic cancer spread


Your doctor will place liquid nitrogen on your skin using a cotton swab or spray.A numbing medicine may be used to prevent any pain or discomfort.

If an internal area is being treated your surgeon will use a scope which is a flexible tube that can fit into various openings in your body such as urethra,rectum or a surgical incision.The liquid nitrogen is fed to the area under treatment and applied to the targeted cells.The cells freeze ,die and then will be slowly absorbed in your body.Your doctor will use imaging equipment such as ultrasound as a guide for carrying out the procedure


Risk include

  • blisters
  • damage of nearby healthy tissue
  • Pain
  • Scarring
  • Sexual dysfunction
  • Ulcers
  • White skin at the site of surgery

For getting opinion from our network of hospitals visit or send email to

Prepared by : Dr Sajna Hamza


robot 3


Robotic surgery or robot assisted surgery allows doctors to perform many types of complex procedures  with more precision ,flexibility and control than is possible with conventional techniques.Robotic surgery is usually associated with minimally invasive surgery procedures performed through tiny incision


Robotic surgery has been rapidly adopted y hospitals in US and Europe for use in the treatment of a wide range of conditions

The most widely used clinical robotic surgical system includes a camera arm and mechanical arm with surgical instruments attached to them.The surgeon controls the arms while seated at a computer console near the operating table.The console gives the surgeon a high definition ,magnified 3-D view of the surgical site.The surgeon leads other team members who assist during the operation


Surgeons who use the robotic system find that for many  procedures it enhances precision,flexibility and control during the operation and allows  them to better see the site compared with traditional techniques.Using robotic surgery ,surgeons can perform delicate and complex procedures

  • Fewer complications such s surgical site infection
  • Less pain and blood loss
  • Quicker recovery
  • Smaller ,less noticeable scars


Robotic surgery involves risk ,some which may be similar to those of convectional open surgery such as a small risk of infection and other complications


There are many conditions that have had success with robotic surgery .The following are types of surgeries that have been successfully performed with the help of robotic surgical systems

  • Heart surgery
  • Urologic surgery
  • Endometriosis
  • Gynaecological surgery
  • Thoracic surgery
  • General surgery
  • Colorectal surgery
  • Head and neck surgery


Robotic surgery and its safety depends on the surgeon who is performing it.People confuse the robotic surgical system by assuming that it is a robot that does the actual decision making.But that is not the case. It is the surgeon every single time.Robotic surgery is safe when the surgeon has been given proper training to control the robotic surgical system and he is given information about how to use it thoroughly

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Prepared by :Dr Sajna Hamza


proton therapy 1

Proton therapy also called proton beam therapy is a type of radiation therapy.It uses protons rather than x rays to treat cancer

A proton is a positively charged particle.At high energy protons can destroy cancer cells.Like x-ray radiation , proton therapy is a type of external beam radiation therapy.It painlessly delivers radiation through skin from a machine outside the body


A machine called synchroton or cyclotron speeds up protons.The high speed of the protons creates high energy.This energy makes the protons travel to the desired depth in the body.The protons then give the targeted radiation dose in the tumor


It is useful for treating tumors that have not spread and are near important parts of body

Proton therapy also may be used to treat these cancers

  • Central nervous system cancers including chordoma,chordosarcoma and malignant meningeoma
  • Eye cancer including uveal melanoma or choroidal melanoma
  • Head and neck cancers including nasal cavity and paranasal sinus cancers and nasopharyngeal cancers
  • Lung cancer
  • Liver cancer
  • Prostate cancer
  • Spinal and pelvic sarcomas
  • Non cancerous brain tumors


The treatment itself is painless.Afterwards you  may experience fatigue.You may also have skin problems including redness,irritation,swelling ,dryness,or blistering and peeling.The side effects of the proton therapy depend on the part of the body being treated ,the size of the tuor and the types of healthy tissue near the tumor


Compare with x-ray radiation therapy proton therapy has several benefits.

  • Usually upto 60% less radiation can be delivered to the healthy tissues around the tumor.This lowers the risk of radiation damage to these tissues
  • It may allow for a higher radiation dose to the tumor.This increases the chances that all of these tumor cells targeted by the proton therapy will be destroyed
  • It may cause fewer and less severe side effects such as low blood counts, fatigue and nausea during and after treatment

But there are also some drawbacks to proton therapy

  • Because proton therapy requires highly specialized and costly equipments.It is available at just a few medical centers.
  • Cost is high compared to x ray radiation therapy
  • Not all cancers can be treated with proton therapy

For getting opinion from our network of hospitals visit or  to

Prepared by Dr Sajna Hamza



surgery to treat

Surgery is used to treat many types of cancer .It works best for solid tumors that are contained in one area.


  • Prevention : If you have a high risk of developing cancer in certain tissues or organs your Doctor my recommend removing those tissues or organs before cancer develops.
  • Diagnosis: Your doctor may use a form of cancer surgery to remove all or part of a tumor allowing to be studied under microscope to determine whether it is cancerous or not
  • Staging : It helps in determining the stage of cancer .By evaluating the size and extend of spread Doctor can able to determine the current stage
  • Primary treatment :If cancer is localized and didnt spread much the doctor can to remove that part completely
  • Debulking: Surgery helps in debulking the cancerous tumor if it is very large
  • Helps in relieving symptoms or side effects


Cost depend  on many factors, including

  • The type of surgery you have
  • How many specialists are involved in your surgery
  • If you need local regional or general anesthesia
  • Where you have surgery
  • If you need to stay in hospital and for how long


In general most cancer operations carry a risk of

  • Pain -It is the common side effect of mast operations
  • Infections-The site of your surgery can become infected.Your health care team will show you how to care for your wound after surgery.Follow this routine closely to avoid infection
  • Loss of organ function-In order to remove your cancer,the surgeon may need to remove an entire organ
  • Bleeding
  • Blood clots-While you are recovering from surgery you are at an increased risk of developing blood clot.Though the risk is small this complication can be serious
  • Altered bowel and bladder functions-Immediately after your surgery you may experience difficulty having a bowel movement or emptying your bladder.This typically resolves in a few days ,depending on your specific operation.

For getting opinion from our network of hospitals visit or send email to

Prepared by:Dr Sajna Hamza





It is a bacterial disease that affects humans and animals.It is caused by bacteria of the genus Leptospira. In humans, it can cause a wide range of symptoms.Some infected persons, however may have no symptoms at all.


Various members of the species L.interrogans can cause leptospirosis. L.icterohemorrhagiae cause the particularly severe type called Well’s disease.The organism can survive for weeks to months in contaminated water or soil.It enters the human body through the abraded skin mostly due to occupational exposure to rat urine contaminated soil or water


It causes endothelial damage to the small blood vessels,resulting in vital organ damage


The manifestations have a bi phasic pattern

  • After an incubation period of 7-12 days, the first phase is septicemic phase due to leptospiremia lasting for a few days to a week.It is characterized by fever, conjunctival suffussion, severe myalgia and rashes. Lymphadenopathy and hepatosplenomegaly may be there
  • The person may be relatively well for 1-3 days
  • Now the immune phase starts with recurrence of fever

The immune phase may remain just as a non specific fever or progress to:

  1. Aseptic meningitis or
  2. Wells disease( jaundice, hemorrhage and renal failure). There may be hematuria, oliguria, proteinuria, casts and raised urea


Complications of leptospirosis include aseptic meningitis, hepatic failure, renal failure, bleeding from various sites etc


  1. Liver enzymes are only mildly elevated as compared to viral hepatitis.
  2. Creatine phosphokinase is elevated to very high levels.
  3. Serological test by slide agglutination may be positive after the second week.False positive results are common
  4. Detection of specific antibody and its rise in convalescent serum is diagnostic
  5. Identification by dark ground illumination is plagued by frequent false positive results
  6. Cultures take weeks and is difficult to perform


  • Treatment should be started within first week itself if it is to be effective.Intravenous benzyl penicillin for 7 days is the treatment of choice
  • Tetracycline for  7 days is an option for the grown up child
  • Prophylaxis with weekly doxycycline may be considered if occupational exposure is likely

Prepared by:Dr  Sajna Hamza A





##On march 16 th every year, India observes National Vaccination Day.It was on this day in 1995 that the first dose of Oral Polio Vaccine was given in India##



Dengue is a mosquito borne viral disease. It is transmitted by female mosquitoes mainly of species Aedes aegypti to a lesser extent Aedes albopictus. These mosquitoes are also vectors of chikungunya,yellow fever etc


Symptoms range from mild to severe


Symptoms can appear upto 7 days after being bitten by the mosquito that carries the virus

They include

  • aching muscles and joints
  • body rash that can disappear and then reappear
  • high fever
  • intense headache
  • pain behind the eyes
  • vomiting and feeling nauseous

Symptoms usually disappear after a week and mild dengue rarely involves serious or fatal complications


At first symptoms may be mild but they gradually worsen within a few days.s well as mild dengue symptoms there may be signs of internal bleeding.

  • bleeding from mouth,gums or nose
  • clammy skin
  • damage to lymph and blood vessels
  • internal bleeding which can lead to black vomit and feces or stools
  • a lower number of platelets in the blood
  • sensitive stomach
  • small blood spots under the skin
  • weak pulse


It is a severe form of dengue.Apart from symptoms of mild dengue fever,the person may experience

  • intense stomach pain
  • disorientation
  • sudden hypotension or a fast drop in blood pressure
  • heavy bleeding
  • regular vomiting
  • blood vessels leaking fluid


Dengue is a viral disease,so there is no specific treatment or cure.However intervention can help depending upon how severe the disease is

For milder forms ,treatment include

  • Preventing dehydration-The person should drink clean water. Re hydration salts can also help replace fluids and minerals
  • Pain killers such as Tylenol or paracetamol.They can help lower pain and fever

More severe form of dengue fever may need

  • Intravenous(IV) fluid supplementation or drip , if the person cannot take fluid by mouth
  • blood transfusion, for patients with severe dehydration


  • Central and South America
  • The Caribbean
  • Tropical Asia,including Bangladesh,Indonesia and parts of China
  • Northern Australia


  • Clothing :Reduce the amount of skin exposed by wearing long pants,long sleeved shirts and socks
  • Use of mosquito repellents
  • Use of mosquito traps and nets
  • Door and window screens
  • Timing:Try to avoid being outside at dawn,dusk and early morning
  • Stagnant water-Cleaning stagnant water can help to reduce risk

Prepared by Dr Sajna Hamza




Its a degenerative joint disease.It can be caused by aging,hereditary,injury,trauma,and another diseases.It is a form of arthritis that features the breakdown and eventual loss of the cartilage of one or more joints.It is the most common joint disease



  • With aging the water content of the cartilage increases and the protein makeup of the cartilage degenerates as a function of biologic processes
  • Eventually cartilage begins to degenerate by faking or forming tiny crevasses
  • In advanced osteoarthritis,there is a total loss of the cartilage cushion between the bones of the joint
  • Repetitive use of the worn joints over the years can mechanically irritate and inflame the cartilage causing joint pain and swelling
  • Loss of cartilage cushion causes friction between the bones leading to pain and limitation of joint mobility
  • inflammation of the cartilage can also stimulate new bone outgrowth


It is a form of OA that is caused by another disease or condition.It includes

  • Obesity
  • Repeated trauma or surgery to the structures
  • Abnormal joints at birth
  • Gout
  • Diabetes
  • Other hormone disorders


  • Pain and stiffness with loss of range of movement and function
  • Swelling
  • Warmth
  • Creaking of the affected joints


  • No blood test for the diagnosis of OA
  • X-ray of the affected joints can be used to diagnose OA


  • Rest
  • Exercise
  • Diet control with weight loss
  • Physical therapy
  • mechanical support devices such as knee braces


  • Oral medications
  • Topical treatments applied to the skin surface surrounding the joint affected by OA include anti inflammatory lotions
  • Surgical treatments for knee include arthroscopy,cartilage repair,osteotomy and knee arthroplasty

For getting opinion from our network of hospitals visit or send a email to

Prepared by: Dr Sajna Hamza




Iron is most important among the is the most common deficiency among females.Adult human body has about 3-4 gm,,in that 60-70% is present in blood and the remaining part in liver as storage


  1. It is essential in formation of hemoglobin
  2. It regulates the body temperature
  3. Muscle activity is dependent on the status of iron
  4. It helps in catacholamine metabolism
  5. It boosts up immune system
  6. It is a constituent of myoglobin,cytochromes, catalyses and certain enzymes
  7. The most important point ,it helps in oxygen transport and cell respiration


Animal origin haem iron-Liver,meat,poultry and fish.They are readily absorbed due to absence of inhibitors

Plant origin no haem iron-Cereals,green leafy vegetables,legumes,nuts,jaggery. Absorption is hampered by inhibitors ie,phytates,oxalates,carbonates,phosphates and dietery fibers


Ascorbic acid is a promoter ,which helps absorption of iron.Absorption is more when there is enhanced demand.


Stored in

  • Liver
  • Spleen
  • Bone marrow
  • Kidney


  1. Hemorrhage-Physiological -menstruation,child birth-pathologically by hook worm ,malaria,hemorrhoids,peptic ulcer
  2. Basal losses-urine,sweat,bile,IUCD


  • 1st stage-decreased iron store
  • 2nd stage-latent iron deficiency ie exhausted iron store
  • 3rd stage-iron deficiency in blood ie Anemia

Anemia-mild 10-11.9 gm%

Moderate – 8-9.9 gm%

Severe – below 8 gm %


  1. Malaise
  2. Breathlessness
  3. Weight loss
  4. oedema
  5. pallor
  6. angular stomatitis
  7. glossitis
  8. brittle finger nails
  9. bald tngue


Blood test

  • Hb% Normal value 12-14 g%-females,14-16 g% in males
  • serum iron concentration 0.8-1.8 mg/L normal
  • serum ferritin value below 10 mcg/L indicate absence of stored iron
  • serum transferin saturation -it should be above 16%,normal is 30%


Prepared by: Dr SAJNA HAMZA A