Tuberculosis in epididymal cyst

A few days ago I operated on a patient who had a vaginal hydrocele and an epididymal cyst. I did eversion of sac and exicission of cyst. But the epidymal cyst was mostly solid when it was cut and arouse suspicion. It was sent for biopsy. Patient developed moderate wound infection post operatively. biopsy report came as Koch's granulomatous lesion. I have not gone through literature yet. I do not expect to get much reference.

that's my son RIK

a good hosewife

What do you expect from a good house wife. YOU DONOT EXPECT HER TO EARN. Then what? you just want her to take care of small family matters which will ensure smooth running of your life. Like? Suppose you are in a hurry to go to office and you are not getting your pen,your wife should find that quickly. You are about to  dye your hair  your wife should know where the pair gloves is. Your dinner should be ready before your are terribly hungry. If you are a tea addict your wife shouldn't keep you waiting for hours for a cup of tea.

Things are terrible in life when just the reverse happens. when you rose in the morning at 6 am and would go to do a operation  and you found nobody with a cup of tea. you brought home some hundreds of pens and when you needed them badly you got a careless response. after a days hard work you were back home  tired and hungry nobody had started to prepare the dinner.

Untitled

In surgery courage and patience is most important. If that is coupled with knowledge and discipline success should be following you.

In open cholecystectomy one should always skelitonise cystic duct until one is sure about it. That means if you are sure about it at the beginning you can ligate and cut it without much dissection. If you are not sure then clean it until you can see it entering into GB or you can see junction of three.

Partial cholecystectomy is good option only it is not safe to go for total cholecystectomy. Partial  cholecystectomy patients complains of more postoperative pain ad morbidity as they suffer from traumatic cholecystities. Partial cholecystectomy  if done should be noted in OT note and discharge certificate to avoid litigation. Number of partial cholecystectomy should not be more than 10 percent.  Otherwise your surgical skill will be questioned.

That's it

how i wonder what you are

underdoc

Consevative mangement of acute appendicites. Sounds distubing. Yes it is possible in more than 80 percent cases. Ofcourse it excludes perforated cases. Then perforated appendicites is a separate disease entity. During era of modern antibiotics appendix never perforates during conservative management. On antibiotic it will either resolve or form a lump.