Surgery Clinics and Academics by Prof. M. L. Saha Exam Oriented Theory and Practical Class' for Post Graduate Trainees (MS and DNB). Whole Range of Long Cases and Discussion, Ward Round Scenarios, Operative Procedures, Seminars, Journal Clubs and Faculty Lectures on Recent Advances and other important Topics. Sessions taken by Prof. M. L. Saha along with renowned National Faculty. Live Class' every Tuesday, Thursday and Saturday.
Alterations in the symptoms or appearance of other symptoms is suggestive of a complication or change in the nature of original disease ie malignant process especially if there are constitutional symptoms such as loss of appetite or weight loss. I think history be combined with physical signs to arrive at the DD. I am afraid our respected teachers of the past like myself placed too much importance to the history in an era of minimal investigations like US, CT, endoscopy etc. with due respect to the worthy examiners post graduate studies are about management options, sequels of treatment and prognosis.
Jaundice due to benign obstruction is usually intermittent, slow and the bilirubin is moderately high ie 4-6mg/ dl. Whereas a malignant condition causes progressive obstruction to biliary outflow, hence jaundice is continuous, progressive and bilirubin increases ie 10-20 mg/ dl, even higher. Besides intrahepatic bil channels are dilated mostly in a malignant process.
Vagotomy surgery should banned During hiatus hernia surgery My posterior vagus nerve damage Very very difficult for me now I got many multiple symptoms
A previous subcostal incision for an open cholecystectomy which may have lead to damage of a few subcostal neurovascular bundles may well have been an additional contributing factor besides others that have been discussed for development of a large incisional hernia with loss of domain.
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Sir I am Very very obliged to both of you professsors and also the Post Graduation persuing sir for making this presentation. I am a final year student MBBS and this presentation helped me a lot to get my vision clean and clear for my professional exams 🙏 Respect From RIMS, Ranchi
