Fine Needle Aspiration Cytology is a very safe, minor surgical procedure used for diagnosing and investigating palpable mass lesions. It is mainly used for the cytological study of organs that do not shed spontaneous cell. Following are the parts of the body mainly diagnosed using FNAC Bone marrow, spleen, liver, breast, thyroid gland, lymph node
Medical technologist with familiarity in general anatomy and sharp skills with knowledge of surgical pathology should be required to take the test. He will be requiring needle, disposable syringes, glass slides, Syringe handle, FNAC reporting form, Coplin jar, and tray for carrying the slides. The patient should not have taken food for more than 2 hours before the procedure. He should not have taken aspirin or any steroid medication before 2 weeks of the procedure. The procedure will be explained to the patient and a written consent will be taken from them to perform the procedure. Result of the test will be obtained within few days from the procedure.
FNAC is mainly performed by medical professional for any of the below reasons -A biopsy is performed on a lump or a tissue mass to assess if its malign or cancerous. -In the case of known tumor, to assess the effect of treatment based on different stages and the medication to be used for treating the cancer or tumor. - Obtain tissue for special studies in research and development.
The clean glass slides are kept on the table. The coplin jars are filled with isopropyl alcohol. The patient should lie on the aspiration table in supine position or any position which will expose the desired aspiration site. The aspiration site should be cleaned with spirit swab from center outwards in concentric fashion. The needle will be placed in the syringe holder. The lump should be pricked by the vertical technique, in which the needle is peripheral to the skin. The lump will be aspirated by pulling the piston and rotating the needle. The needle will be introduced into the swollen area which causes negative pressure within the syringe by aspiration holding the tissue against the needle. The needle cuts the tissue and sample gets accumulated within the lumen of the needle. A sample slide will be transferred to the staining table in the lab for microscopic view to assess the lesion.
Fine Needle Aspiration Cytology Aspirated Tissue
All age groups
Observations are reported by the pathologist
No matter how much information there is available about AIDS and HIV, the thought of it makes a person shudder. The Human Immunodeficiency Virus or HIV is the virus responsible for AIDS or Acquired Immune Deficiency Syndrome. This virus attacks the immune system and over time leaves the body defenseless against other infections and types of cancer. Till date, there is no cure for HIV or AIDS. However, what we do know is how the disease can be transmitted from one person to another. Knowing this enables us to control the transmission of the disease.
Unlike other viruses, HIV cannot be transmitted through air, water etc. This virus can only be transmitted through:
Receiving blood transfusions from an HIV positive person is sure to put you at risk of suffering from the disease as well. For this reason, it is essential to only take blood from registered blood banks that run HIV screening tests. This holds true for organ and tissue transplants as well. Being stuck with an HIV infected needle can also put you at risk of coming in contact the virus. In some cases, direct contact between broken skin, wounds and mucus membranes can also lead to the transferring of HIV cells from one person to another. HIV does not spread through saliva, however, if while kissing, both partners suffer from bleeding gums and one partner is HIV positive, there is a risk of the transference of HIV from one person to the other.
Bodily fluids such as semen and vaginal fluids-
The only way to prevent the transmission of the HIV virus from one partner to another while having intercourse is by using a condom. This creates a barrier between the bodily fluids of both partners and keeps them safe. A condom is needed even if the couple is engaging in anal sex. In fact when comparing anal and vaginal intercourse; anal sex puts HIV negative partners at a higher risk of getting in contact the virus than vaginal sex. Theoretically, this virus can be transmitted even through oral sex is a HIV positive man ejaculates into the woman's mouth. However, this is a rare occurrence.
From a mother to an unborn child-
A HIV positive mother can transmit the virus to her child when pregnant, at birth or while breastfeeding. However, if the mother follows HIV treatment, the chances of her passing on this virus to her child are significantly lowered.
The above are the only three ways HIV can be transferred from one person to another. HIV cannot be transmitted by sharing utensils, drinking the same water, through mosquito bites or by shaking hands etc. Thus, there is no reason to ostracize an HIV infected person. If you wish to discuss about any specific problem, you can ask a free question.
Adverse respiratory events (AREs) are leading causes of post-operative morbidity and mortality. Anesthesia is the use of medicine to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures (such as getting stitches). Giving as an injection or through inhaled gases or vapours, different types of anesthesia affect the nervous system in various ways by blocking nerve impulses and, therefore, pain.
Anesthesia can help control your breathing, blood pressure, blood flow, and heart rate. It may be used to:
Adverse Respiratory Events (ARE)
Adverse outcomes of such events are fatal and lead to Death & Brain Damage. Three mechanisms of injury are reported to account for highest adverse respiratory events:
Inadequate Ventilation: Insufficient Gas Exchange can produce the adverse outcome. Esophageal Intubation: Incubation between the two sides of the esophagus inadvertently.
Difficult tracheal intubation: Tracheal Intubation is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway. It is performed facilitate ventilation of lungs in severely ill, anesthetized patients.
Other’s are as listed below:
Residual neuromuscular blockade is an important postoperative complication associated to the use of neuromuscular blocking drugs and is commonly observed in the post-anesthesia care unit (PACU) after non-depolarizing neuromuscular blocking agents (NMBAs) are administered intra-operatively. Incomplete neuromuscular recovery can be minimized with acceleromyography monitoring. The risk of adverse respiratory events during early recovery from anesthesia can be reduced by intra-operative acceleromyography use.
Reintubation is a serious adverse respiratory event and the consequences include increased cardiac and respiratory complications, prolonged length of stay at the PACU, intensive care unit (ICU) and hospital, prolonged mechanical ventilator support, higher costs, and increased mortality. Overweight and obesity have also been identified as risk factors for postoperative respiratory complications. Most adverse respiratory events are considered preventable with improved monitoring such as:
Closed observation of the clinical factors and appropriate monitoring by well trained people are factors necessary to prevent adverse outcome. If you wish to discuss about any specific problem, you can consult a General Surgeon.
Sciatica is defined as pain or discomfort associated with the sciatic nerve which runs from the lower back, down the back of the legs to the feet. It most commonly occurs in adults aged 20 to 60 years. It is estimated that up to 40% of the new zealand population will experience sciatica at some point in their lives.
The sciatic nerve is the largest and longest nerve in the body. It originates in the lower spine, branches into the pelvis, then travels through the buttocks, down the back of the legs and branches into the lower legs and feet. Sciatic pain occurs when there is pressure on, or damage to, the sciatic nerve.
The most common cause of sciatica is disc prolapse (also known as disc herniation or slipped disc). This occurs when one of the soft, gel-filled discs between the vertebrae of the spine bulges or ruptures, compressing and/or irritating the sciatic nerve.
Muscle spasms can also cause sciatica by compressing the sciatic nerve as it travels through the muscles. One such condition is piriformis syndrome, where the piriformis muscle irritates the sciatic nerve. Other less common causes of sciatica include:
In older age groups, sciatica commonly occurs as the result of conditions caused by spinal degeneration, such as spinal stenosis. This is where the pathways through which the sciatic nerve travels are narrowed. Again, this causes compression and/or irritation of the sciatic nerve.
Factors that increase the likelihood of developing sciatica include.
Essentially, any injury or process which causes compression of the sciatic nerve can cause sciatic pain. In many cases however, no specific cause for the sciatic pain can be identified.
Signs and symptoms.
Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee.
Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. There are 2 types of arthritis the knee joint in the human body can get afflicted with. They are:
The form of arthritis which, with increasing pain, slowly wears down the joint cartilages is called osteoarthritis. This form of arthritis usually affects people after the age 40. The symptoms of osteoarthritis include:
Rheumatoid arthritis is a chronic form of arthritis caused because of the knee joint inflammations. This form of arthritis can occur at any age. Being an auto-immune disease, its symptoms include, but are not limited to:
Doctors are still doubtful about what exactly causes the disease; but the deformation of the immune system might cause the damage of the joints, causing people who are already suffering from obesity, smokers, and women, in general, more prone to this disease.
If regular treatments do not work, you might opt for knee-replacement surgery and osteotomy (the process of cutting a bone with the help of surgery) which might better the alignment of the knee by transforming the bone shapes.
Physiotherapy for knee arthritis
Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions. The main goals of physiotherapy for your knee arthritis are:
It can be disheartening to find out that you're infertile, especially when you thought that everything was normal. There are many reasons why a man is not able to contribute to the conception process and, consequently, there are options that can assist with male infertility.
Here are the treatment options available for male infertility.
1. Vasectomy Reversal
In recent years many men are opting to have children after a vasectomy. Luckily, a vasectomy is not necessarily a permanent issue anymore. It can be reversed. It takes a simple surgical procedure that restores the flow of sperm. There are certain factors that affect the success rates of vasectomy reversals such as your age, the presence of antisperm antibodies, time elapsed since the vasectomy and the age of the woman. Although this procedure is an option it is generally not encourage.
2. Sperm Aspiration
This is a group of procedures which is used to get viable sperm from the man. The sperm is used with Intra Cytoplasmic Sperm Injection (ICSI). This option is suitable for men who have severe types of male infertility. For example, if there is no sperm in their ejaculate, where sperm is dead or there is no motility. With this group of procedures there are four techniques that can be used to obtain the sperm. It is important to keep in mind that each technique is not suitable for everyone. These techniques are mentioned in the next four points.
3. Testicular Sperm Extraction
In this technique the fertility doctor removes a small piece of testicular tissue through a half inch skin incision. Sperm is liberated from the seminiferous tubules (where they are produced). This procedure can be performed in the doctor's surgery or the operating room and a mild sedation is recommended for comfort. The sperm harvested with this technique can be stored for later use.
4. Microsurgical Epididymal Sperm Aspiration
If you have a reproductive tract blockage then this technique is an option. During this technique an operating microscope is used to examine the tubules that contain sperm. The fluid containing the sperm is collected and the quality is examined. Thereafter it is taken to the IVF laboratory for use.
5.Testicular Sperm Aspiration
This technique uses a needle biopsy of the testicle. The procedure is performed under local anaesthesia in a doctor's surgery. The sperm is extracted through the testicle but the amount obtained can be low because the needle cuts a thin layer of the tissue. This procedure is usually quite successful and less invasive than other methods.