Sunday, 13 May 2012
History and nature of MBBS
The degree is currently awarded in various forms in institutions in Australia, Bahrain, Bangladesh, Barbados, China, Egypt, Fiji, Ghana, Guyana, Hong Kong, India, Indonesia, Iran, Iraq, Ireland, Jamaica, Jordan, Kenya, Kuwait, Libya, Malawi, Philippines, Malaysia, Mauritius, Mexico, Myanmar, Nepal, New Zealand, Nigeria, Pakistan, Papua New Guinea, Samoa, Saudi Arabia, Sierra Leone, Singapore, South Africa, Sri Lanka, Sudan, Tanzania, Trinidad and Tobago, Uganda, the United Arab Emirates, the United Kingdom, Zambia and Zimbabwe.[1]
Historically, Bachelor of Medicine was also the primary medical degree conferred by institutions in the United States and Canada, such as University of Pennsylvania, Harvard, University of Toronto, University of Maryland, and Columbia. Several early North American medical schools were (for the most part) founded by physicians and surgeons who had trained in England and Scotland. University medical education in England culminated with the Bachelor of Medicine qualification, and in Scotland the Doctor of Medicine, until the mid-19th century when the public bodies that regulated medical practice at the time required practitioners in Scotland as well as England to hold the dual Bachelor of Medicine and Bachelor of Surgery degrees. Throughout the 19th century, North American medical schools switched to the tradition of the Ancient universities of Scotland and began conferring Doctor of Medicine rather than Bachelor of Medicine, the first institution to make such a switch being King's College (now Columbia University) in New York.[2]
In the countries that award bachelors' degrees in medicine, however, Doctor of Medicine denotes a holder of a higher doctorate and is reserved for medical practitioners who undertake research and submit a thesis in the field of medicine. Nevertheless, those holding Bachelor of Medicine, Bachelor of Surgery are usually referred to by the courtesy title of "Doctor" and use the prefix "Dr", whether or not they also hold a PhD or DSc. The reason is found in a parallel tradition for those who are post-graduate specialists in Surgery; on acceptance into a College of Surgeons, they stop styling themselves "Doctor" and revert to "Mister" (Mr). This curious situation, where an elevation in professional rank is signified by dropping the title of Doctor, came about because historically a "surgeon" was an ordinary workman, usually a Barber, not trained in medicine but performing dissections and surgery under the direction of a gowned academic who was the actual "Doctor".
Despite their styling as two degrees, Bachelor of Medicine and Bachelor of Surgery are usually conferred together. At some institutions, such as Oxford and Cambridge, it was possible in the past to be awarded the two degrees in different years.[citation needed]
In many countries, the degrees are awarded after an undergraduate course lasting five or six years. In some cases, a graduate in another discipline may subsequently enter a special graduate-entry medical course, reduced in duration to account for relevant material covered or learning skills acquired during the first degree. In some cases the old first year courses (for six year degrees) in the basic sciences of physics, chemistry and biology have been abolished, and that standard has to be reached by means of school examinations before entry. However, in most countries a newly graduated Bachelor of Medicine and Surgery must spend a specified period in internship before they can obtain full qualification as a medical practitioner.
Sunday, 14 August 2011
EXCELLENT TRUTHS BRINGING TEARS TO MY OWN EYES @70+.
U GOT ONLY LAST 8 DAYS 2 PRAY FOR MERCY FROM HIM[SWT] FOR ME!
Me & My Father
When I was 4 Yrs Old : My father is THE BEST
When I was 6 Yrs Old : My father seems to know everyone
When I was 10 Yrs Old : My father is excellent but he is short tempered
When I was 12 Yrs Old : My father was nice when I was little
When I was 14 Yrs Old : My father started being too sensitive
When I was 16 Yrs Old : My father can't keep up with modern time
When I was 18 Yrs Old : My father is getting less tolerant as the days pass by
When I was 20 Yrs Old : It is too hard to forgive my father, how could my Mum stand him all these years
When I was 25 Yrs Old : My father seems to be objecting to everything I do
When I was 30 Yrs Old: It's very difficult to be in agreement with my father, I wonder if my Grandfather was troubled by my father when he was a youth
When I was 40 Yrs Old: My father brought me up with a lot of discipline, I must do the same
When I was 45 Yrs Old: I am puzzled, how did my father manage to raise all of us
When I was 50 Yrs Old : It's rather difficult to control my kids, how much did my father suffer for the sake of upbringing and protecting us
When I was 55 Yrs Old: My father was far looking and had wide plans for us, he was gentle and outstanding.
When I became 60 Yrs Old: My father is THE BEST
Note that it took 56 Yrs to complete the cycle and return to the starting point "My father is THE BEST "
Let's be good to our parents before it's too late and pray to God that our own children will treat us even better than the way we treated our parents.....
2011 QAREEME
W/S YOUNGER MAMOON UNCLE!!!
----- Original Message -----
From: MCL FREIGHT
To: Undisclosed-Recipient:;
Sent: Wednesday, August 03, 2011 10:41 AM
Subject: My father is THE BEST....
Me & My Father
When I was 4 Yrs Old : My father is THE BEST
When I was 6 Yrs Old : My father seems to know everyone
When I was 10 Yrs Old : My father is excellent but he is short tempered
When I was 12 Yrs Old : My father was nice when I was little
When I was 14 Yrs Old : My father started being too sensitive
When I was 16 Yrs Old : My father can't keep up with modern time
When I was 18 Yrs Old : My father is getting less tolerant as the days pass by
When I was 20 Yrs Old : It is too hard to forgive my father, how could my Mum stand him all these years
When I was 25 Yrs Old : My father seems to be objecting to everything I do
When I was 30 Yrs Old: It's very difficult to be in agreement with my father, I wonder if my Grandfather was troubled by my father when he was a youth
When I was 40 Yrs Old: My father brought me up with a lot of discipline, I must do the same
When I was 45 Yrs Old: I am puzzled, how did my father manage to raise all of us
When I was 50 Yrs Old : It's rather difficult to control my kids, how much did my father suffer for the sake of upbringing and protecting us
When I was 55 Yrs Old: My father was far looking and had wide plans for us, he was gentle and outstanding.
When I became 60 Yrs Old: My father is THE BEST
Note that it took 56 Yrs to complete the cycle and return to the starting point "My father is THE BEST "
Let's be good to our parents before it's too late and pray to God that our own children will treat us even better than the way we treated our parents.....
2011 QAREEME
W/S YOUNGER MAMOON UNCLE!!!
----- Original Message -----
From: MCL FREIGHT
To: Undisclosed-Recipient:;
Sent: Wednesday, August 03, 2011 10:41 AM
Subject: My father is THE BEST....
Monday, 4 July 2011
Sunday, 26 June 2011
Treatment
The initial treatment requires performing a "leveling" colostomy in the most distal colon with ganglion cells present. This requires exploration laparatomy with multiple seromuscular biopsies of the colon wall to determine the exact extend of the aganglionosis. The colostomy is placed above the transition zone. Placement of the colostomy in an area of aganglionosis will lead to persistent obstruction
Once the child has reached an adequate size and age (6-12 months; 20 pounds or more), a formal pull-through procedure is done. Three pull-through procedures are currently in use for treating Hirschsprung's disease. The first of these is the original Swenson procedure, in which the aganglionic rectum is carefully dissected in the pelvis and removed down to the anus. The ganglionic colon is then anastomosed to the anus via a perineal approach. In the Duhamel procedure, dissection outside the rectum is confined to the retrorectal space, and the ganglionic colon is anastomosed posteriorly just
above the anus. The anterior wall of the ganglionic colon and the posterior wall of the aganglionic rectum are anastomosed, using a stapling device. In Soave's operation, dissection is entirely within the rectum. The rectal mucosa is stripped from the muscular sleeve, and the ganglionic colon is brought through this sleeve and anastomosed to the anus. Complications with all procedures include enterocolitis, constipation and anastomotic stricture, but long-term results with the three procedures are comparable and generally excellent in experienced hands. These three procedures also can be
adapted for total colonic aganglionosis; the ileum is used for the pull-through or anastomosed to the aganglionic segment of distal colon and rectum to improve absorption.
The initial treatment requires performing a "leveling" colostomy in the most distal colon with ganglion cells present. This requires exploration laparatomy with multiple seromuscular biopsies of the colon wall to determine the exact extend of the aganglionosis. The colostomy is placed above the transition zone. Placement of the colostomy in an area of aganglionosis will lead to persistent obstruction
Once the child has reached an adequate size and age (6-12 months; 20 pounds or more), a formal pull-through procedure is done. Three pull-through procedures are currently in use for treating Hirschsprung's disease. The first of these is the original Swenson procedure, in which the aganglionic rectum is carefully dissected in the pelvis and removed down to the anus. The ganglionic colon is then anastomosed to the anus via a perineal approach. In the Duhamel procedure, dissection outside the rectum is confined to the retrorectal space, and the ganglionic colon is anastomosed posteriorly just
above the anus. The anterior wall of the ganglionic colon and the posterior wall of the aganglionic rectum are anastomosed, using a stapling device. In Soave's operation, dissection is entirely within the rectum. The rectal mucosa is stripped from the muscular sleeve, and the ganglionic colon is brought through this sleeve and anastomosed to the anus. Complications with all procedures include enterocolitis, constipation and anastomotic stricture, but long-term results with the three procedures are comparable and generally excellent in experienced hands. These three procedures also can be
adapted for total colonic aganglionosis; the ileum is used for the pull-through or anastomosed to the aganglionic segment of distal colon and rectum to improve absorption.
Thursday, 23 June 2011
Wednesday, 22 June 2011
Investigation
Infants with Hirschsprung's disease usually will fail to pass meconium in the first 24 h of life, although this history is often difficult to obtain. Barium enema may be unreliable in diagnosing Hirschsprung's disease in the newborn infant because the colon is not dilated enough to show a transition zone. In older infants and children, barium enema will show the size difference between the dilated ganglionic colon and the distal constricted aganglionic rectal segment. The barium enema in total colonic aganglionous usually shows a markedly shortened colon.
Rectal biopsy makes the definitive diagnosis of Hirschsprung's disease. Suction rectal biopsy provides a small piece of mucosa and submucosa without the requirement for anesthesia. Occasionally the suction biopsy is not diagnostic and a full-thickness biopsy is required. The histopathology of Hirschsprung's disease is the absence of ganglion cells in the myenteric plexuses, increased staining of a cholinesterase stain and the presence of hypertrophied nerve bundles. Some surgeons have found the use of rectal manometry helpful, particularly in older children, but it is not as accurate a diagnostic tool as is rectal biopsy. Some centers employ manometry, histochemical studies or special stains for diagnosis. These special studies are only as good as the person performing them and interpreting the results
Infants with Hirschsprung's disease usually will fail to pass meconium in the first 24 h of life, although this history is often difficult to obtain. Barium enema may be unreliable in diagnosing Hirschsprung's disease in the newborn infant because the colon is not dilated enough to show a transition zone. In older infants and children, barium enema will show the size difference between the dilated ganglionic colon and the distal constricted aganglionic rectal segment. The barium enema in total colonic aganglionous usually shows a markedly shortened colon.
Rectal biopsy makes the definitive diagnosis of Hirschsprung's disease. Suction rectal biopsy provides a small piece of mucosa and submucosa without the requirement for anesthesia. Occasionally the suction biopsy is not diagnostic and a full-thickness biopsy is required. The histopathology of Hirschsprung's disease is the absence of ganglion cells in the myenteric plexuses, increased staining of a cholinesterase stain and the presence of hypertrophied nerve bundles. Some surgeons have found the use of rectal manometry helpful, particularly in older children, but it is not as accurate a diagnostic tool as is rectal biopsy. Some centers employ manometry, histochemical studies or special stains for diagnosis. These special studies are only as good as the person performing them and interpreting the results
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