All of us make little health mistakes that cause damage to our bodies in the long
run – simply because we are unaware we are doing something wrong. Here are
some of the most common mistakes made by many of us
• Crossing our legs
: Do you cross your legs at your knees when sitting? Although we may believe that this is the lady-like elegant way to sit, sitting this way cuts down circulation to your legs. If you don’t want varicose veins to mar the beauty of your legs and compromise your health, uncross your legs every time you realize you have one knee on top of the other. The best way to sit is to simply place both legs together on the floor, balancing your weight equally. If you feel like changing position, instead of crossing your legs, simply move both legs together to one side. As an alternative, you could also consider crossing your legs loosely at the ankles. This is a classically elegant way to sit, and is far better for your legs and your health than sitting with your legs crossed at your knees.
• Not changing our toothbrush
: How often do you change your toothbrush? Most of us wait until most of the bristles have either fallen off, or are in such bad shape that we’d be embarrassed to pull out our brush in public. However, since not many of us need to pull out our brush in public, we carry on with our frayed one until we lose it. Replace your toothbrush often. Damaged bristles can harm the enamel, and don’t massage your gums well..If you find brushing your teeth a pain like I do, but know you must do it, you might as well be doing it right. Imagine going through the annoyance of brushing your teeth twice a day only to find out that you’re damaging your enamel every time you clean your teeth. Also, use a brush with soft bristles unless your dentist has advised otherwise.
• Eating out often
: There are oils that are high in cholesterol, and oils that cause little harm and are better for your heart. However, no matter how light the oil is, it is never a good idea to eat too much of it. Avoid fried foods. Remember that in all probability your favourite Indian food restaurant throws a huge, HUGE chunk of butter in a tiny bowl of dal. Rita, who worked in the kitchen of a 5 star hotel, was shocked when she saw the cook chop a 500gmbutter slab in half, and throw half into a Paneer Makhani dish. No wonder the customers left licking their fingers. And no wonder they felt so stuffed and heavy afterwards. Limit outdoor eating unless you know that you’re getting served light and healthy food.
• Skipping breakfast
: Never, ever skip breakfast. Remember, when you wake up in the morning it’s been around 10-12 hours since your last meal. Your body needs food now, more than at any other time. Eat a heavy breakfast. You will then be busy through the day, and the calories will get expended quickly. If you are trying to diet, eat a light dinner. Here are some more common health mistakes we make. Being informed and making a few changes can help make us feel a whole lot better.
• High heels
: High heels sure look great, but they're murder for your back. This however doesn't mean you should steer clear of stilettos. Wear them, but not when you know you will be walking around a lot. Wear them when going out for lunch or dinner -when the only walking you will be doing is to your car, to the table, and back.. Avoid high heels when you are going somewhere on foot. If you are constantly tempted to wear your heels, take a good look at your flats. Is there something about them you dislike? Invest in a new pair of beautiful flats or shoes with a low heel. Buy something you love, that you will enjoy wearing. If possible, get a matching bag. You will then enjoy your flats as much as you do your heels.
• Sleeping on a soft bed
: You don't have to sleep on the floor be kind to your back, but do make sure you have a firm mattress. Although a mattress on springs is soft and lovely to sink into, it's bad for your back. If you already have an old bed with springs, you don't need to invest in a new one - simply get a thick wooden plank put over the springs, and place the mattress on the plank. Similarly, if your mattress is old and lumpy, throw it out and get a new one. Your neck and your back will thank you. The same rule applies to sofas. If you will be spending hours on a sofa, get a firm yet comfortable one. Sofas you completely sink into are not the best idea.
• Pillows
: No matter how comfortable sleeping with ten cushions is, have pity on your neck and resist. Sleep with one pillow, and make sure it is not too thick. If your pillow gets lumpy, discard it and go for a new one. Get a thin pillow if you sleep on your stomach and something a little thicker if you sleep on your back, to give your neck adequate support
• Not exercising
: So all of us know we should exercise more, but many of us don't. This is a health mistake we consciously make! And why is that? Simply because we refuse to admit the damage we are causing to our bodies by not working out.. A number of people only start working out once they've experienced a warning signal. Don't wait for a heart attack to strike before you decide to opt for a lifestyle change. Make the change now. You don't need to train for the marathon to be in top shape. Half an hour of brisk walking three to four times a week will make a world of difference to your health. You could then increase this to forty minutes, four times a week - and you're all set. If you haven't exercised for a week, you're making a mistake.
Sunday, February 12, 2012
Thursday, February 9, 2012
TIPS ON PUMPING PETROL
Only buy or fill up your car or truck in the early morning when the ground temperature is still cold. Remember that all service stations have their storage tanks buried below ground. The colder the ground the more dense the petrol, when it gets warmer petrol expands, so buying in the afternoon or in the evening....your litre is not exactly a litre. In the petroleum business, the specific gravity and the temperature of the petrol, diesel and jet fuel, ethanol and other petroleum products plays an important role.
A 1-degree rise in temperature is a big deal for this business. But the service stations do not have temperature compensation at the pumps.
When you're filling up do not squeeze the trigger of the nozzle to a fast mode If you look you will see that the trigger has three (3) stages: low, middle, and high. You should be pumping on low mode, thereby minimizing the vapours that are created while you are pumping. All hoses at the pump have a vapour return. If you are pumping on the fast rate, some of the liquid that goes to your tank becomes vapour. Those vapours are being sucked up and back into the underground storage tank so you're getting less worth for your money.
One of the most important tips is to fill up when your Petrol tank is HALF FULL. The reason for this is the more Petrol you have in your tank the less air occupying its empty space. Petrol evaporates faster than you can imagine. Petrol storage tanks have an internal floating roof. This roof serves as zero clearance between the Petrol and the atmosphere, so it minimizes the evaporation. Unlike service stations, here where I work, every truck that we load is temperature compensated so that every liter is actually the exact amount.
Another reminder, if there is a petrol truck pumping into the storage tanks when you stop to buy Petrol, DO NOT fill up; most likely the petrol is being stirred up as the Petrol is being delivered, and you might pick up some of the dirt that normally settles on the bottom.
A 1-degree rise in temperature is a big deal for this business. But the service stations do not have temperature compensation at the pumps.
When you're filling up do not squeeze the trigger of the nozzle to a fast mode If you look you will see that the trigger has three (3) stages: low, middle, and high. You should be pumping on low mode, thereby minimizing the vapours that are created while you are pumping. All hoses at the pump have a vapour return. If you are pumping on the fast rate, some of the liquid that goes to your tank becomes vapour. Those vapours are being sucked up and back into the underground storage tank so you're getting less worth for your money.
One of the most important tips is to fill up when your Petrol tank is HALF FULL. The reason for this is the more Petrol you have in your tank the less air occupying its empty space. Petrol evaporates faster than you can imagine. Petrol storage tanks have an internal floating roof. This roof serves as zero clearance between the Petrol and the atmosphere, so it minimizes the evaporation. Unlike service stations, here where I work, every truck that we load is temperature compensated so that every liter is actually the exact amount.
Another reminder, if there is a petrol truck pumping into the storage tanks when you stop to buy Petrol, DO NOT fill up; most likely the petrol is being stirred up as the Petrol is being delivered, and you might pick up some of the dirt that normally settles on the bottom.
Monday, December 19, 2011
FAITH...
An atheist professor of philosophy speaks to his class on the problem science has with God, the Almighty.
He asks one of his new students to stand and.....
Prof: So you believe in God?
Student: Absolutely, sir.
Prof: Is God good?
Student: Sure.
Prof: Is God all-powerful?
Student: Yes.
Prof: My brother died of cancer even though he prayed to God to heal him.
Most of us would attempt to help others who are ill. But God didn't. How is this God good then?
(Student is silent.)
Prof: You can't answer, can you? Let's start again, young fellow. Is God good?
Student: Yes.
Prof: Is Satan good?
Student: No.
Prof: Where does Satan come from?
Student: From...God...
Prof: That's right. Tell me son, is there evil in this world?
Student: Yes.
Prof: Evil is everywhere, isn't it? And God did make everything. Correct?
Student: Yes.
Prof: So who created evil?
(Student does not answer.)
Prof: Is there sickness, Immorality, Hatred & Ugliness? All these terrible things exist in the world, don't they?
Student: Yes, sir.
Prof: So, who created them?
(Student has no answer.)
Prof: Science says you have 5 senses you use to identify and observe the world around you.Tell me, son...Have you ever seen God?
Student: No, sir.
Prof: Tell us if you have ever heard your God?
Student: No, sir.
Prof: Have you ever felt your God, tasted your God, smelt your God? Have you ever had any sensory perception of God for that matter?
Student: No, sir. I'm afraid I haven't.
Prof: Yet you still believe in Him?
Student: Yes.
Prof: According to empirical, testable, demonstrable protocol, science says your GOD doesn’t exist. What do you say to that, son?
Student: Nothing. I only have my faith.
Prof: Yes, Faith & that is the problem science has.
Student: Professor, is there such a thing as heat?
Prof: Yes.
Student: And is there such a thing as cold?
Prof: Yes.
Student: No sir. There isn't.
(The lecture theatre becomes very quiet with this turn of events.)
Student: Sir, you can have lots of heat, even more heat, superheat, mega heat, white heat, a little heat or no heat. But we don't have anything called cold. We can hit 458 degrees below zero which is no heat, but we can't go any further after that. There is no such thing as cold. Cold is only a word we use to describe the absence of heat, we cannot measure cold. Heat is energy. Cold is not the opposite of heat, sir, just the absence of it.
(There is pin-drop silence in the lecture theatre.)
Student: What about darkness, Professor? Is there such a thing as darkness?
Prof: Yes. What is night if there isn't darkness?
Student: You're wrong again, sir. Darkness is the absence of something. You can have low light, normal light, bright light, flashing light....But if you have no light constantly, you have nothing and its called darkness, isn't it? In reality, darkness isn't. If it were you would be able to make darkness darker, wouldn't you?
Prof: So what is the point you are making, young man?
Student: Sir, my point is your philosophical premise is flawed.
Prof: Flawed? Can you explain how?
Student: Sir, you are working on the premise of duality. You argue there is life and then there is death, a good God and a bad God. You are viewing the concept of God as something finite, something we can measure. Sir, science can't even explain a thought. It uses electricity and magnetism, but has never seen, much less fully understood either one.To view death as the opposite of life is to be ignorant of the fact that death cannot exist as a substantive thing. Death is not the opposite of life; just the absence of it. Now tell me, Professor. Do you teach your students that they evolved from a monkey?
Prof: If you are referring to the natural evolutionary process, yes, of course, I do.
Student: Have you ever observed evolution with your own eyes, sir?
(The Professor shakes his head with a smile, beginning to realize where the argument is going.)
Student: Since no one has ever observed the process of evolution at work & cannot even prove that this process is an on-going endeavour, are you not teaching your opinion, sir? Are you not a scientist but a preacher? (The class is in uproar.) Is there anyone in the class who has ever seen the Professor's brain? (The class breaks out into laughter.) Is there anyone here who has ever heard the Professor's brain, felt it, touched or smelt it? No one appears to have done so. So, according to the established rules of empirical, stable, demonstrable protocol, science says that you have no brain sir, with all due respect, sir, how do we then trust your lectures, sir?
(The room is silent. The professor stares at the student, his face unfathomable.)
Prof: I guess you'll have to take them on faith, son.
Student: That is it sir... The link between man & god is FAITH. That is all that keeps things moving & alive.
NB: this is a true story, and the student was none other than...........
APJ Abdul Kalam, the former president of India.
Thursday, December 8, 2011
karni Mata mandir (rat temple)
Imagine yourself standing in the middle of thouands of rats, out of which some are scampering over your feet and the others are simply dining and playing with you. How would you react? Yes, you said it right it will either run a chill down your spine or absolutely petrify you. But to your surprise, this is not merely a wild imagination but a real life setting of a temple located in a small northwestern city of Rajasthan, Deshnoke. This ornate, isolated Hindu temple is called Karni Mata Temple. The temple was constructed by Maharaja Ganga Singh in the early 1900's as a tribute to the rat goddess, Karni Mata. The rats in the temple are known as Kabas. Though there are Intricate marble panels at the entrance and the floors of the temple, and silver and gold decorations are found throughout, but by far the most intriguing aspect of the interior is the 20,000-odd rats that call this temple home. Many people from all over the world travel great distances to pay their homage to them.
According to a parable, Karni Mata was an incarnation of Durga, once the child of one of her clansmen died. She attempted to restore the dead child back to life from Yama(God of Death) but she was told by him that the child had already been reincarnated. From that point forward, Mata announced that no one from her Tribe would ever fall into Yama's hands again instead they would be reborn as rats until being born back in to the tribe. Since then all her clansmen turned rats seeking shelter in this temple and with the blessings of Karni Mata they get their food, shelter, lodging and their lifestyle continues inside the temple itself. Despite being inumerable in number these kabas never come out of the premises of the temple.
One of the most outstanding facts about these Kabas is that they are completely innocuous and never disturb the devotees who visit the temple rather they silently play with them, eat with them, run around them, and sit on their laps which the devotees consider to be the benediction of the Goddess. There is one rare blessing that draws the most attention, and that is the sight of a white rat. Out of all of the thousands of rats in the temple, there are said to be four or five white rats, which are considered to be the holiest. They are believed be the spiritual manifestations of Karni Mata herself and her kin. Sighting them is a blessing in itself, and visitors put in extensive efforts just to catch a glimpse of these rats by luring them with sweets and milk.
It is astonishing to know that despite the presence of so many rats in the temple, no diseases related to rats have been reported till date. Neither the temple stinks of foul smell nor it is dirty anywhere. Rather the offerings like milk, sweets, and ground nuts are first offered to these kabas and then distributed to the devotees as mata's 'Prasad'. The water that these Kabas drink is considered very holy and auspicious. Another most interesting fact is that there has been no trace of these rats being reproduced. It is believed that all the kabas present in this temple are of same size, weight and body proportion without any change down the ages and there is no sign of baby rats inside the temple.
Though the rats are considered as one of the shyest animals found on earth that are scared of human beings but here in this temple the kabas roam about freely and often play with the devotees and at times dine with them or sit on their shoulders. The most ironic truth is that although we do not consider rats reverent enough and we kill them if ever we see them sharing some space in our homes and yet when we step in to this temple we worship them and even feel blessed eating and drinking their leftovers. Strangely the leftovers would not make us fall sick or catch any deadly disease instead it’s consumed as holy prasad of the temple.
All these incredible and astounding facts about the temple make it one of the most visited places in the Bikaner city of Rajasthan. People from everywhere come to see this temple. Some come out of sheer curiosity, some out of reverence and others simply come to enjoy and experience the feel of this strange, stupendous and one of its kind temple.
Wednesday, November 23, 2011
Not all thieves are stupid, So be carefull
This gives us something to think about with all our new electronic technology.
GPS
A couple of weeks ago a friend told me that someone he knew had their car broken into while they were at a football game. Their car was parked on the green which was adjacent to the football stadium and specially allotted to football fans. Things stolen from the car included a garage door remote control, some money and a GPS which had been prominently mounted on the dashboard.
When the victims got home, they found that their house had been ransacked and just about everything worth anything had been stolen. The thieves had used the GPS to guide them to the house. They then used the garage remote control to open the garage door and gain entry to the house. The thieves knew the owners were at the football game, they knew what time
the game was scheduled to finish and so they knew how much time they had to clean out the house. It would appear that they had brought a truck to empty the house of its contents.
Something to consider if you have a GPS - don't put your home address in it. Put a nearby address (like a store or gas station) so you can still find your way home if you need to, but no one else would know where you live if your GPS were stolen.
MOBILE PHONES
I never thought of this.......
This lady has now changed her habit of how she lists her names on her mobile phone after her handbag was stolen. Her handbag, which contained her cell phone, credit card, wallet... etc, was stolen.
20 minutes later when she called her hubby, from a pay phone telling him what had happened, hubby says 'I received your text asking about our Pin number and I've replied a little while ago.' When they rushed down to the bank, the bank staff told them all the money was already withdrawn. The thief had actually used the stolen cell phone to text 'hubby' in
the contact list and got hold of the pin number. Within 20 minutes he had withdrawn all the money from their bank account.
Moral of the lesson
Do not disclose the relationship between you and the people in your contact list.
Avoid using names like Home, Honey, Hubby, Sweetheart, Dad, Mom, etc,
And very importantly, when sensitive info is being asked through texts, CONFIRM by calling back
Also, when you're being texted by friends or family to meet them somewhere, be sure to call back to confirm that the message came from them. If you don't reach them, be very careful about going places to meet family and friends' who text you.
GPS
A couple of weeks ago a friend told me that someone he knew had their car broken into while they were at a football game. Their car was parked on the green which was adjacent to the football stadium and specially allotted to football fans. Things stolen from the car included a garage door remote control, some money and a GPS which had been prominently mounted on the dashboard.
When the victims got home, they found that their house had been ransacked and just about everything worth anything had been stolen. The thieves had used the GPS to guide them to the house. They then used the garage remote control to open the garage door and gain entry to the house. The thieves knew the owners were at the football game, they knew what time
the game was scheduled to finish and so they knew how much time they had to clean out the house. It would appear that they had brought a truck to empty the house of its contents.
Something to consider if you have a GPS - don't put your home address in it. Put a nearby address (like a store or gas station) so you can still find your way home if you need to, but no one else would know where you live if your GPS were stolen.
MOBILE PHONES
I never thought of this.......
This lady has now changed her habit of how she lists her names on her mobile phone after her handbag was stolen. Her handbag, which contained her cell phone, credit card, wallet... etc, was stolen.
20 minutes later when she called her hubby, from a pay phone telling him what had happened, hubby says 'I received your text asking about our Pin number and I've replied a little while ago.' When they rushed down to the bank, the bank staff told them all the money was already withdrawn. The thief had actually used the stolen cell phone to text 'hubby' in
the contact list and got hold of the pin number. Within 20 minutes he had withdrawn all the money from their bank account.
Moral of the lesson
Do not disclose the relationship between you and the people in your contact list.
Avoid using names like Home, Honey, Hubby, Sweetheart, Dad, Mom, etc,
And very importantly, when sensitive info is being asked through texts, CONFIRM by calling back
Also, when you're being texted by friends or family to meet them somewhere, be sure to call back to confirm that the message came from them. If you don't reach them, be very careful about going places to meet family and friends' who text you.
Wednesday, November 16, 2011
10 Laws Newton Forgot To State
Here are 10 laws that Isaac Newton failed to share with the world…
1. LAW OF QUEUE: If you change queues, the one you have left will start to move faster than the one you are in now.
**********
2. LAW OF TELEPHONE: When you dial a wrong number, you never get an engaged one.
**********
3. LAW OF MECHANICAL REPAIR: After your hands become coated with grease, your nose will begin to itch.
**********
4. LAW OF THE WORKSHOP: Any tool, when dropped, will roll to the least accessible corner.
**********
5. LAW OF THE ALIBI: If you tell the boss you were late for work because you had a flat tire, the next morning you will have a flat tire.
**********
6. BATH THEOREM: When the body is immersed in water, the telephone rings.
**********
7. LAW OF ENCOUNTERS: The probability of meeting someone you know increases when you are with someone you don’t want to be seen with.
**********
8. LAW OF THE RESULT: When you try to prove to someone that a machine won’t work, it will!
**********
9. LAW OF BIO MECHANICS: The severity of the itch is inversely proportional to the reach.
**********
10. LAW OF COFFEE: As soon as you sit down for a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.
**********
1. LAW OF QUEUE: If you change queues, the one you have left will start to move faster than the one you are in now.
**********
2. LAW OF TELEPHONE: When you dial a wrong number, you never get an engaged one.
**********
3. LAW OF MECHANICAL REPAIR: After your hands become coated with grease, your nose will begin to itch.
**********
4. LAW OF THE WORKSHOP: Any tool, when dropped, will roll to the least accessible corner.
**********
5. LAW OF THE ALIBI: If you tell the boss you were late for work because you had a flat tire, the next morning you will have a flat tire.
**********
6. BATH THEOREM: When the body is immersed in water, the telephone rings.
**********
7. LAW OF ENCOUNTERS: The probability of meeting someone you know increases when you are with someone you don’t want to be seen with.
**********
8. LAW OF THE RESULT: When you try to prove to someone that a machine won’t work, it will!
**********
9. LAW OF BIO MECHANICS: The severity of the itch is inversely proportional to the reach.
**********
10. LAW OF COFFEE: As soon as you sit down for a cup of hot coffee, your boss will ask you to do something which will last until the coffee is cold.
**********
Thursday, November 10, 2011
Appendicitis & Appendectomy
The appendix is a small, worm-like appendage attached to the colon.
What is the appendix?
The appendix is a closed-ended, narrow, worm-like tube up to several inches in length that attaches to the cecum (the first part of the colon). (The anatomical name for the appendix, vermiform appendix, means worm-like appendage.) The wall of the appendix contains lymphatic tissue that is part of the immune system that makes antibodies.
Appendicitis occurs when bacteria invade and infect the wall of the appendix.
What is appendicitis?
Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix, or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening of the appendix into the cecum. If the blockage continues, bacteria that are normally present within the appendix invade (infect) the wall of the appendix. This causes inflammation in the wall of the appendix, and, as a result, the wall of the appendix begins to die, which finally results in the appendix bursting.
Appendicitis is a common condition that affects 6% of the population.
Who is affected by appendicitis?
Appendicitis is a common condition that affects 6% of the population. It most commonly occurs among those 10-30 years of age, though it can occur at any age. Increased vigilance in recognizing and treating potential cases of appendicitis is required for the very young and old who have a higher rate of complications.
The most common complications of appendicitis are perforation, abscess, and peritonitis.
What are the most frequent complications of appendicitis?
The most frequent complication of appendicitis is perforation. Perforation of the appendix can lead to a periappendiceal abscess (a collection of infected pus) or diffuse peritonitis (infection of the entire lining of the abdomen and the pelvis). The major reason for appendiceal perforation is delay in diagnosis and treatment. In general, the longer the delay between diagnosis and surgery, the more likely is perforation. The risk of perforation 36 hours after the onset of symptoms is at least 15%. Therefore, once appendicitis is diagnosed, surgery should be done without unnecessary delay.
A less common complication of appendicitis is blockage of the intestine.
What is another complication of appendicitis?
Blockage occurs when the inflammation surrounding the appendix causes the intestinal muscle to stop working, and this prevents the intestinal contents from passing. If the intestine above the blockage begins to fill with liquid and gas, the abdomen distends and nausea and vomiting may occur. It then may be necessary to drain the contents of the intestine through a tube passed through the nose and esophagus and into the stomach and intestine.
The main symptom of appendicitis is abdominal pain.
What are the symptoms of appendicitis?
The abdominal pain is at first not confined to one spot. The pain is so difficult to pinpoint that when asked to point to the area of the pain, most people indicate the location of the pain with a circular motion of their hand around the central part of their abdomen. A second, common, early symptom of appendicitis is loss of appetite which may progress to nausea and even vomiting. Nausea and vomiting also may occur later due to intestinal obstruction.
The diagnosis of appendicitis begins with a thorough history and physical examination.
How is appendicitis diagnosed?
Patients often have an elevated temperature, and there usually will be moderate to severe tenderness in the right lower abdomen when the doctor pushes there. If inflammation has spread to the peritoneum, there is frequently rebound tenderness. Rebound tenderness is pain that is worse when the doctor quickly releases his hand after gently pressing on the abdomen over the area of tenderness.
Treatment usually consists of appendectomy (surgical removal of the appendix).
How is appendicitis treated?
Once a diagnosis of appendicitis is made, an appendectomy usually is performed (surgical removal of the appendix). Antibiotics almost always are begun prior to surgery and as soon as appendicitis is suspected. On the next several slides we'll take a look at an actual step-by-step laparoscopic appendectomy procedure being performed.
Step 1 of 8: The appendix is located in the lower abdomen.
Appendectomy: Step 1 of 8.
This is a normal appendix in a female patient found to have an infection of the reproductive organs. Since the appendix serves no useful function, it will be removed to save her from getting appendicitis in the future.
Step 2 of 8: The mesentery (the tissue that suspends the appendix and carries blood vessels to the appendix) is divided from the appendix.
Appendectomy: Step 2 of 8.
The next step is to free up the appendix down to where it is attached to the large bowel. This requires dividing the mesentery which contains the blood vessels that supply the appendix. Bipolar forceps apply an electric current which seals the blood vessels and prevents bleeding.
Step 3 of 8: Scissors are used to free the appendix from its mesenteric attachment to the abdomen and colon.
Appendectomy: Step 3 of 8.
Next, scissors are used to divide the mesentery. Alternating application of the bipolar electrocautery forceps and scissors allow complete mobilization of the appendix down to its base.
Step 4 of 8: The base of the appendix is tied off using a pre-tied suture.
Appendectomy: Step 4 of 8.
Now the base of the appendix is tied off using a pre-tied suture which is now being positioned.
Step 5 of 8: The suture is now tightened using a fisherman's knot, which cannot loosen on its own.
Appendectomy: Step 5 of 8.
The suture has now been tightened and appears secure. The knot is a fisherman's knot, which can be tightened but will not loosen on its own.
Step 6 of 8: The suture is cut using scissors.
Appendectomy: Step 6 of 8.
As shown in this picture, the suture is now cut with the scissors.
Step 7 of 8: The appendix is cut free and ready to be removed.
Using the same scissors, the appendix is cut free and ready to be removed.
Step 8 of 8: The operation is complete and inspected.
Appendectomy: Step 8 of 8.
The operation is complete, and the area is inspected one final time to make sure there is no bleeding.
An example of an infected appendix that has been removed (left) and the resulting incisional scar from an appendectomy (right).
Are there complications and/or long-term consequences of appendectomy?
The most common complication of appendectomy is infection of the wound, that is, of the surgical incision. Such infections vary in severity from mild, with only redness and perhaps some tenderness over the incision, to moderate, requiring only antibiotics.
It is not clear if the appendix has an important role in the body in older children and adults. There are no major long-term health problems resulting from removing the appendix, although a slight increase in some diseases has been noted, for example, Crohn's disease (a chronic inflammatory disease of the intestines).
What is the appendix?
The appendix is a closed-ended, narrow, worm-like tube up to several inches in length that attaches to the cecum (the first part of the colon). (The anatomical name for the appendix, vermiform appendix, means worm-like appendage.) The wall of the appendix contains lymphatic tissue that is part of the immune system that makes antibodies.
Appendicitis occurs when bacteria invade and infect the wall of the appendix.
What is appendicitis?
Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix, or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening of the appendix into the cecum. If the blockage continues, bacteria that are normally present within the appendix invade (infect) the wall of the appendix. This causes inflammation in the wall of the appendix, and, as a result, the wall of the appendix begins to die, which finally results in the appendix bursting.
Appendicitis is a common condition that affects 6% of the population.
Who is affected by appendicitis?
Appendicitis is a common condition that affects 6% of the population. It most commonly occurs among those 10-30 years of age, though it can occur at any age. Increased vigilance in recognizing and treating potential cases of appendicitis is required for the very young and old who have a higher rate of complications.
The most common complications of appendicitis are perforation, abscess, and peritonitis.
What are the most frequent complications of appendicitis?
The most frequent complication of appendicitis is perforation. Perforation of the appendix can lead to a periappendiceal abscess (a collection of infected pus) or diffuse peritonitis (infection of the entire lining of the abdomen and the pelvis). The major reason for appendiceal perforation is delay in diagnosis and treatment. In general, the longer the delay between diagnosis and surgery, the more likely is perforation. The risk of perforation 36 hours after the onset of symptoms is at least 15%. Therefore, once appendicitis is diagnosed, surgery should be done without unnecessary delay.
A less common complication of appendicitis is blockage of the intestine.
What is another complication of appendicitis?
Blockage occurs when the inflammation surrounding the appendix causes the intestinal muscle to stop working, and this prevents the intestinal contents from passing. If the intestine above the blockage begins to fill with liquid and gas, the abdomen distends and nausea and vomiting may occur. It then may be necessary to drain the contents of the intestine through a tube passed through the nose and esophagus and into the stomach and intestine.
The main symptom of appendicitis is abdominal pain.
What are the symptoms of appendicitis?
The abdominal pain is at first not confined to one spot. The pain is so difficult to pinpoint that when asked to point to the area of the pain, most people indicate the location of the pain with a circular motion of their hand around the central part of their abdomen. A second, common, early symptom of appendicitis is loss of appetite which may progress to nausea and even vomiting. Nausea and vomiting also may occur later due to intestinal obstruction.
The diagnosis of appendicitis begins with a thorough history and physical examination.
How is appendicitis diagnosed?
Patients often have an elevated temperature, and there usually will be moderate to severe tenderness in the right lower abdomen when the doctor pushes there. If inflammation has spread to the peritoneum, there is frequently rebound tenderness. Rebound tenderness is pain that is worse when the doctor quickly releases his hand after gently pressing on the abdomen over the area of tenderness.
Treatment usually consists of appendectomy (surgical removal of the appendix).
How is appendicitis treated?
Once a diagnosis of appendicitis is made, an appendectomy usually is performed (surgical removal of the appendix). Antibiotics almost always are begun prior to surgery and as soon as appendicitis is suspected. On the next several slides we'll take a look at an actual step-by-step laparoscopic appendectomy procedure being performed.
Step 1 of 8: The appendix is located in the lower abdomen.
Appendectomy: Step 1 of 8.
This is a normal appendix in a female patient found to have an infection of the reproductive organs. Since the appendix serves no useful function, it will be removed to save her from getting appendicitis in the future.
Step 2 of 8: The mesentery (the tissue that suspends the appendix and carries blood vessels to the appendix) is divided from the appendix.
Appendectomy: Step 2 of 8.
The next step is to free up the appendix down to where it is attached to the large bowel. This requires dividing the mesentery which contains the blood vessels that supply the appendix. Bipolar forceps apply an electric current which seals the blood vessels and prevents bleeding.
Step 3 of 8: Scissors are used to free the appendix from its mesenteric attachment to the abdomen and colon.
Appendectomy: Step 3 of 8.
Next, scissors are used to divide the mesentery. Alternating application of the bipolar electrocautery forceps and scissors allow complete mobilization of the appendix down to its base.
Step 4 of 8: The base of the appendix is tied off using a pre-tied suture.
Appendectomy: Step 4 of 8.
Now the base of the appendix is tied off using a pre-tied suture which is now being positioned.
Step 5 of 8: The suture is now tightened using a fisherman's knot, which cannot loosen on its own.
Appendectomy: Step 5 of 8.
The suture has now been tightened and appears secure. The knot is a fisherman's knot, which can be tightened but will not loosen on its own.
Step 6 of 8: The suture is cut using scissors.
Appendectomy: Step 6 of 8.
As shown in this picture, the suture is now cut with the scissors.
Step 7 of 8: The appendix is cut free and ready to be removed.
Using the same scissors, the appendix is cut free and ready to be removed.
Step 8 of 8: The operation is complete and inspected.
Appendectomy: Step 8 of 8.
The operation is complete, and the area is inspected one final time to make sure there is no bleeding.
An example of an infected appendix that has been removed (left) and the resulting incisional scar from an appendectomy (right).
Are there complications and/or long-term consequences of appendectomy?
The most common complication of appendectomy is infection of the wound, that is, of the surgical incision. Such infections vary in severity from mild, with only redness and perhaps some tenderness over the incision, to moderate, requiring only antibiotics.
It is not clear if the appendix has an important role in the body in older children and adults. There are no major long-term health problems resulting from removing the appendix, although a slight increase in some diseases has been noted, for example, Crohn's disease (a chronic inflammatory disease of the intestines).
Subscribe to:
Posts (Atom)