scholarly journals TRIVIDHI KARMA IN SURGERY (SHALY TANTRA)

Author(s):  
Shan Sonakshi ◽  
Bharti Neeru

Detailed description about surgical procedure was given by Acharya Sushrut. Purva Karma, Pradhan Karma, and Paschat Karma are Trividhi Karma. Shastra Chikitsa is one of the prime equipment in which Trividh Karma i.e. Purva Karma (Pre-operative), Pradhan Karama (Operative, main action) and Paschat Karma play a crucial role in order to get fruitful result after surgery. According to Sushrut, Purva Karma means preparation of the patient along with collecting all the materials during Pradhan Karma. Asthvidhishastra Karma is included in Pradhan Karma. Paschat Karma includes all post-operative care. Paschat Karma includes care after surgery i.e., post-operative care of the patient. Every surgery is done under these Trividh Karma so that there will be better outcome after surgery. Acharya Sushrut well known as father of surgery in Ayurveda selected these three Karma wholly and solely for the benefit of patients who undergo through any surgical procedure because surgery not only includes main action (operation) but also care of the patient before and after surgery. He has also emphasized that aseptic and antiseptic precautions should be taken. The wound should be protected from dangerous and invisible creatures. Every surgical procedure is done under these three parts only. Each Karma has got its own importance. We cannot skip any of them and it is very important in order to get good result. Acharya Sushrut also emphasised on diet which is given before and after any surgery. He also explained about septic and antiseptic precautions to be done before, during and after surgery. He also mentioned about fumigation of patients ward after 7-10 days of surgery.

2021 ◽  
pp. 1-7
Author(s):  
Alina Reicherz ◽  
Rüveyde Sahin ◽  
Lorine Häuser ◽  
Joachim Noldus ◽  
Peter Bach

<b><i>Purpose:</i></b> The guidelines of the German, European, and American Urological Associations on urolithiasis advise against general ureteral stenting before and after an uncomplicated ureterorenoscopy (URS). However, German and European guidelines state that stenting prior to URS facilitates stone extraction and reduces intraoperative complications. According to the published literature, German practice seems to deviate from recommendations. This nationwide survey aimed to evaluate the treatment modalities of urolithiasis. <b><i>Methods:</i></b> In November 2018 and March 2019, a total of 199 urological hospital departments in Germany were anonymously surveyed about operative care of symptomatic urolithiasis. The response rate was 72.9%. The survey consisted of 25 questions about diagnostics, surgical technique, and aftercare of the URS. This questionnaire is available in the appendix. <b><i>Results:</i></b> A primary URS is performed in ≤10% in 49.6% of the hospitals. In every second urological department (49.7%), the German Diagnosis Related Group (G-DRG) system influences the period of pre-stenting before a secondary URS. After a secondary URS, which is performed in 53.8% of the departments in over 80% of the patients, 14% of the departments omit stenting. The standard for stenting seems to be a 28-cm-long 7 Charrière double-J stent in Germany. <b><i>Conclusion:</i></b> In Germany, the percentage of primary URS is low, and a ureter stenting is performed in most of the urological departments after URS. Delaying therapy due to economic aspects is the standard in almost half of all urological departments.


2020 ◽  
Vol 7 (4) ◽  
pp. 464-482
Author(s):  
H. Bahadır Türk

The leader of the Kurdistan Workers’ Party ( Partiya Karkerên Kurdistan or PKK), Abdullah Öcalan, has played a crucial role in shaping the road map of the PKK since the founding of the organization in 1978. His ideas have substantially influenced the structure of the PKK. This article analyzes whether Abdullah Öcalan’s perspective on violence changed over the period between the founding of the PKK and the present. Using an interpretive–textual method, the study examines Öcalan’s approach to the question of violence before and after his imprisonment on the island of İmralı in 1999. The study attempts to make sense of how his perspective on violence was constructed and developed during these two periods. To achieve this goal, the study demonstrates the differences and similarities in Öcalan’s approach to the concept of violence during these two periods. Accordingly, it is argued that Öcalan’s perspective on violence is marked by continuity rather than a rupture.


Author(s):  
Sangita Santosh Nimbalkar ◽  
Manish R. Malani

Introduction: management and prevention of wounds after a surgical procedure, are important and debatable topics. Optimal adoption of guidelines for proper prevention and management of post-surgical wounds must be carried out by any surgeon or institute. Postoperative wound care is done by cleaning and dressing the wounds after the surgical procedure, preventing them from getting contaminated with the external surfaces or the microorganisms on the patient’s body. Surgical Site Infection (SSI) is the infection associated with healthcare in which the infection occurs in the wound after an invasive surgical procedure. A minimum of 5% of the patients who undergo surgical procedures will develop surgical site infections. This study draws the attention of the clinicians to a proper set of guidelines for post-operative care to minimize post-operative complications. Materials and Methods: this study is a Retrospective Cohort design. The study was considered 92 patients who had various types of surgery from during the period of 10 months. The patients who had intra-abdominal surgery are only included. The study divided 92 patients into 2 groups. In each group, 46 patients were assigned based on following NICE guidelines on postoperative wound management. Patients, for whom the NICE guidelines were followed properly at every aspect, were assigned to the first group (Group 1). Otherwise, the patients were assigned to the second group (Group 2). The study adopted a list comprising of NICE guidelines which are applicable to this study. The study assessment was done by observing the appearance of Surgical Site Infection among the patients, 3 to 7 days post-surgery. Results: it as found that 91.30% of the Group 1 patients showed significant improvement in terms of resolution while only 13.04% of the patients in improved significant without any surgical site infection (SSI). Conclusion: the study results show that the patients who were given post-operative care according to NICE guidelines had much lesser Surgical Site Infection (SSI) as compared to those who were not given post-operative care according to NICE guidelines. Keywords: surgical site infection, postoperative care, nice guidelines, wound management


2021 ◽  
Author(s):  
Sigfried Gold ◽  
Harold Lehmann ◽  
Lisa Schilling ◽  
Wayne Lutters

Objective: Code sets play a central role in analytic work with clinical data warehouses, as components of phenotype, cohort, or analytic variable algorithms representing specific clinical phenomena. Code set quality has received critical attention and repositories for sharing and reusing code sets have been seen as a way to improve quality and reduce redundant effort. Nonetheless, concerns regarding code set quality persist. In order to better understand ongoing challenges in code set quality and reuse, and address them with software and infrastructure recommendations, we determined it was necessary to learn how code sets are constructed and validated in real-world settings. Methods: Survey and field study using semi-structured interviews of a purposive sample of code set practitioners. Open coding and thematic analysis on interview transcripts, interview notes, and answers to open-ended survey questions. Results: Thirty-six respondents completed the survey, of whom 15 participated in follow-up interviews. We found great variability in the methods, degree of formality, tools, expertise, and data used in code set construction and validation. We found universal agreement that crafting high-quality code sets is difficult, but very different ideas about how this can be achieved and validated. A primary divide exists between those who rely on empirical techniques using patient-level data and those who only rely on expertise and semantic data. We formulated a method- and process-based model able to account for observed variability in formality, thoroughness, resources, and techniques. Conclusion: Our model provides a structure for organizing a set of recommendations to facilitate reuse based on metadata capture during the code set development process. It classifies validation methods by the data they depend on — semantic, empirical, and derived — as they are applied over a sequence of phases: (1) code collection; (2) code evaluation; (3) code set evaluation; (4) code set acceptance; and, optionally, (5) reporting of methods used and validation results. This schematization of real-world practices informs our analysis of and response to persistent challenges in code set development. Potential re-users of existing code sets can find little evidence to support trust in their quality and fitness for use, particularly when reusing a code set in a new study or database context. Rather than allowing code set sharing and reuse to remain separate activities, occurring before and after the main action of code set development, sharing and reuse must permeate every step of the process in order to produce reliable evidence of quality and fitness for use.


Author(s):  
Cátia Cristiane Matte Dezordi ◽  
Sabrina Wagner Benetti ◽  
Carolina Renz Pretto ◽  
Sandra Emilia Drews ◽  
Alcione Carla Meier ◽  
...  

Aim: To evaluate attitudes about the safety atmosphere of a surgery staff before and after an educational action for the implementation of the safe surgery checklist. Method: Quantitative research of experimental type in the period of December 2016 to November 2017. A questionnaire of Safety Attitudes was applied, Surgical Center version for 101 professionals that work in the surgical center of a general hospital before and after na educational action for the implementation of the safe surgery checklist. The data analysis was done with the use of descriptive statistics. Results: Most of the items belonging to the SAQ/CC obtained increase in averages after the educational action. “Communication in the Surgical Atmosphere” was the most approached domain highlighted in the educational action and presented an increase of the averages in all itens; the item that didn´t obtain a satisfactory score in this domain was “The equipments of the surgical center are adequate”. The most pontuated descriptive measure after the educational action was “The transmission of information among professionals of the surgical center before the realization of a surgical procedure is important for the security of the patient”, with a lower deviant pattern. Conclusion: The educational action developed aiming at the implementation of the safe surgery checklist is importante to qualify the assistance to the patient in the surgical period with safety.


Phonology ◽  
1990 ◽  
Vol 7 (1) ◽  
pp. 121-158 ◽  
Author(s):  
Jerzy Rubach ◽  
Geert Booij

This study deals with syllable structure in Polish. The central theme is the question of when and how syllabification rules apply in the lexical phonology of Polish. In § i we lay the ground for our subsequent discussion by giving the basic syllable patterns of Polish. We also propose here a first version of the syllabification algorithm for Polish. In §2 we show that syllabification applies cyclically, because certain cyciic phonological rules make crucial use of information about the prosodic structure of their potential inputs. § 3 then shows that the syllabification algorithm has to apply both before and after the application of cyclic phonological rules on one cycle, and that syllabification is therefore a continuous process. In § we argue that the syllabification algorithm proposed in § i must be modified to enable us to predict whether a high [-consonantal] segment will surface as a vowel or as a glide. Since the distinction between vowels and glides is crucial for the application of certain cyclic phonological rules of Polish, this again shows that syllabification has to apply cyclically. § defends the hypothesis that resyllabification is restricted to Coda Erasure (and the subsequent syllabification of the desyllabified consonants). Again, the (un)predictability of the vowel/glide distinction plays a crucial role here. We summarise our conclusions in §6


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Macneal ◽  
S Brar ◽  
S Dassanayake ◽  
K Jones ◽  
A Ghareib ◽  
...  

Abstract Introduction The availability of operation notes is crucial to provide high-quality post-operative care. This clinical audit evaluates the availability of operation notes at post-operative follow-up, in a Tertiary Hand Unit, before and after implementation of electronic operation notes. Method This was a prospective audit analysing the availability of operation notes at the first post-operative hand surgery appointment. The initial data collection was over a 6-week period (July – August 2019). Following this, a standardised electronic operation note template was created in line with BSSH Hand Trauma Guidelines and RCS Good Surgical Practice. Six months later, a re-audit was conducted over a 4-week period (March 2020). Results The initial audit included 104 adult patients, with operation notes available for 64% (n = 67) of patients, and 94% (n = 63) of those were in paper format. Following implementation of electronic operation notes, the re-audit included 53 adult patients. For these patients, 96% (n = 51) of their operation notes were available, and 96% (n = 49) of the operation notes were electronic. Conclusions These findings demonstrate that electronic operation notes greatly increased the availability of operation notes at follow-up This innovation has significant implications for upholding well-coordinated continuity of care for patients undergoing surgery.


2020 ◽  
Vol 48 ◽  
Author(s):  
Maria Eduarda Dos Santos Lopes Fernandes ◽  
Luiza De Albuquerque Carvalho ◽  
Marina Galindo Chenard ◽  
Cícero Araújo Pitombo ◽  
Orlei Justen Dos Santos ◽  
...  

Background: Flexural deformities are anatomical deviations, in varying degrees, of one or more joints, and may have a congenital or acquired origin. Congenital contracture of the deep digital flexor tendon (DDFT) affects newborn calves and results in hyperflexion of the metacarpal-phalangeal joint, which in severe cases means that the animal must support its own weight on its fetlock joints. The aim of this study is to report the rapid and successful result of applying bilateral total tenotomy technique on a newborn bovine that had been diagnosed with severe bilateral DDFT contracture in the thoracic limbs.Case: A 3-week-old male bovine with a history of difficulty in maintaining a quadrupedal position was attended at the Veterinary Hospital of the Federal University of Tocantins. The animal had severe bilateral locomotor alterations in the thoracic members to the point that he walked on his fetlock joints. The physical examination revealed clinical parameters within the normal range. However, the locomotor system examination showed severe flexor deformity in the bilateral metacarpal-phalangeal joints, and the limbs were being supported on the dorsal face of the fetlock joints, which presented ulcerations, and was suggestive of a shortening of the DDFT. Based on the patient's history and clinical examination, as well as the severity of the tendon contractures, surgical treatment using the DDFT bilateral total tenotomy technique was decided upon. Postoperative treatment consisted of 2.5 mg/kg of enrofloxacin intramuscularly (IM), SID, for 5 days and 0.5 mg/kg meloxicam via IM, SID, for 3 days; as well as a dressing (cotton, medical bandage and a PVC mold) on the thoracic limbs to provide support and allow the animal to walk, until its complete recovery. One day after the surgery, the animal was able to walk with difficulty and some trembling; however, on the third day after the surgical procedure, it could stand up by itself, walk and graze normally. The surgical stitches were removed seven days after the operation, as the surgical wounds had healed adequately. The animal was followed-up for a one-month period after the total tenotomy, with no recurrence of any of the clinical signs, and the thoracic limbs had regained normal biomechanics.Discussion: Congenital flexural deformities are common in newborn calves of different breeds and their incidence is mainly in the thoracic limbs, especially in the carpal, distal interphalangeal and metacarpal-phalangeal joints as was reported in the animal in this study. The history and anamnesis of the animal, along with a thorough physical examination, in order to rule out any other congenital alterations, was extremely important in the diagnosis, and the classification of the severity of the deformity along with the choice of appropriate treatment in the present study. Although total tenotomy is rarely reported in the literature, and there are controversial results with calves, the surgical treatment was chosen in the present case due to the severity of the case. The DDFT bilateral total tenotomy surgical technique gave satisfactory results for the correction of severe bilateral flexor deformity in the thoracic limbs of the newborn crossbred calf. Complete recovery of the limb biomechanics was rapid, and there was no post-surgical complications, thus ensuring the animal could have a good and healthy life. Total DDFT tenotomy is considered a viable surgical procedure for calves with severe congenital flexor deformities; however, post-operative care is also important to ensure good final results.


2017 ◽  
Vol 221 (2) ◽  
pp. 61-78
Author(s):  
Dr. Noman Amro

The Moroccan diplomacy gave Palestine a significant importance, and they paid more attention to it since Islam entered Morocco by Otba Bin Nafeh in 670 A.C.. The importance of Palestine to the Moroccan diplomacy flows from the position of Jerusalem in Islam. The Moroccan diplomacy along with The other countries of the Arab world played a crucial role in the Palestinian-Israeli conflict because the Palestinian issue was a priority on the top of the agenda of the world diplomacy.  In this study , the researcher discusses the support the Moroccans gave to the Palestinian issue before and after independence. The Palestinian issue was only considered as an Arab issue, it was also considered as a national Moroccan issue adopted by both the people and the politicians. The Moroccan support reached its peak when the Moroccan diplomacy admitted P.L.O as the legitimate and the only representative of the Palestinians in 1974.


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