Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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13 108 Surgery and Healing in the Developing World Bibliography 1. Eltringham RJ, Varvinski A. The Oxygent: An anesthetic machine designed to be used in developing countries and difficult situations. Anesthesia 1997. 2. Shresthesa BM, Tweed WA, Basnyat NB et al. A modification of the bain system for ambient air-oxygen inhalation. Anesthesia 1994. 3. Perderson J, Nyrop M. Anesthesia equipment for a developing country. Br J Anesthesia 1991. 4. Jarious D, Bock-Utre J. Use of an oxygen concentration linked to a draw over vaporizer (Anesthesia delivery system for underdeveloped nations). Anesthesia and Analgesia 1991. 5. Whitten CE. Experiences in third world anesthesia: Peacetime training for operational deployment. Military Medicine 1988. 6. Stewart FC. Anesthesia, operation smile cleft lip palate interdisciplinary training manual. Operation Smile 1999. 7. Samuels S, Wyner J, Brodsky JB et al. Inteoplast: A successful model for anesthesia and plastic surgery in developing countries. JAMA 1984. 8. Stewart F. Ibid. 9. Samuels S et al. Ibid. 10. Samuels S et al. Ibid.
CHAPTER 1 CHAPTER 14 Outpatient Assessment of the Pregnant Patient: Dilatation and Curettage Kedrick D. Pickering The encounter with an anxious bleeding pregnant woman is a common occurence for any physician exposed to the general practice of medicine. The surgeon working in the developing world will undoubtedly be so exposed. The outpatient assessment of such a patient should be interpreted in the culture and clinical context in which the surgeon is working. It is common for women in the developing world to interpret any episode of vaginal bleeding as a normal menstrual period, this even in the context of other obvious manifestations of a pregnancy. It will often take the most patient and tolerant clinician to convince some women that they are, in fact, pregnant. Because bleeding in pregnancy can be a very ominous sign, leading to massive hemorrhage with complicating sepsis, it is useful to be equipped with the knowledge to diagnose and subsequently treat abnormal pregnancy. This chapter deals with the diagnosis of pregnancy and its complications in the outpatient setting. Careful history, taken using a high index of suspicion, is necessary; it is useful to remind one’s self that a sexually active female with a period of amenorrhae is pregnant until proven otherwise. An abnormal pregnancy often requires a surgical approach to management. This chapter deals with the diagnosis of those patients who will benefit from a dilatation and curettage, a procedure that can be successfully performed under local anesthesia. This everyday procedure for a regular gynaecological practice, “dilatation and curettage” would be a useful tool in the hands of the surgeon in an isolated area. Introduction There are three cardinal features of pregnancy: 1. Sexual activity (with or without contraception) 2. Amenorrhae 3. Enlarged uterus Pregnancy can, of course, be confirmed with a positive urinary gonadotrophin. There is however, an equivocal zone before six weeks of amenorrhea, rendering the test false negative in some critical situations. It is a safe clinical approach that any bleeding in pregnancy is abnormal, especially in the first trimester. An abnormal intrauterine gestation and extrauterine one require a different approach in surgical intervention, the former a dilatation and curettage, the latter a laparotomy. Dilatation and curettage is a process of removing the contents of the uterine cavity. In the modern era the procedure can be performed safely under both general Surgery and Healing in the Developing World, edited by Glenn Geelhoed.
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Surgery and Healing in the Developi
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Contents Foreword .................
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25. Dentistry .....................
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Editor Contributors Harold P. Adolp
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Foreword Surgery and Healing in the
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“poor, but modern”, as for exam
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There may be at least one considera
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It is that higher accountability th
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1 2 Surgery and Healing in the Deve
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CHAPTER 2 Surgery in Developing Cou
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2 10 Surgery and Healing in the Dev
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CHAPTER 4 International Surgical Ed
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17 158 Surgery and Healing in the D
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CHAPTER 20 Chronic Pyogenic Osteomy
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CHAPTER 23 Cleft Lip and Palate Sur
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CHAPTER 24 Outreach Dentistry: A Wo
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CHAPTER 1 CHAPTER 26 Reconstructive
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Reconstructive Surgery in the Tropi
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CHAPTER 1 CHAPTER 27 Factors Influe
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Distribution and Incidence of Tropi
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CHAPTER 1 CHAPTER 28 Population Dyn
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Population Dynamics Of Surgical Tro
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Metabolic Maladaptation 289 Introdu
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Metabolic Maladaptation 291 some of
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Metabolic Maladaptation 293 In this
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Metabolic Maladaptation Table 1. Si
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Metabolic Maladaptation Table 4. Go
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Metabolic Maladaptation 299 the rev
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Metabolic Maladaptation Table 5. As
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Metabolic Maladaptation Table 6. Co
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Metabolic Maladaptation 305 the ris
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Metabolic Maladaptation Table 8. Go
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Metabolic Maladaptation Table 10. G
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Metabolic Maladaptation Table 12. C
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Metabolic Maladaptation 313 cell an
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Metabolic Maladaptation 315 Biologi
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Metabolic Maladaptation 317 from io
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Metabolic Maladaptation 319 25. Lon
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CHAPTER 1 CHAPTER 30 Nutrition and
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Nutrition and Development in Africa
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CHAPTER 1 CHAPTER 31 Uterine Ruptur
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Uterine Ruptures in Rural Zaire Tab
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Uterine Ruptures in Rural Zaire 329
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CHAPTER 1 CHAPTER 32 Vesicovaginal
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Vesicovaginal Fistula in Democratic
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CHAPTER 1 CHAPTER 33 Ophthalmology
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Ophthalmology Figure 2. Refractive
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Ophthalmology Figure 4. A tonometer
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Ophthalmology 341 ml of 40 mg/ml IV
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Ophthalmology Figure 6. Axis determ
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Ophthalmology 345 thalmic set prepa
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Ophthalmology 347 Procedures Region
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Accommodating Deficits in Material
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Abscesses and Other Infections Trea
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CHAPTER 1 CHAPTER 36 Surgical Train
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Surgical Training of Nurses for Rur
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Training of Medical Assitants in Mo
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CHAPTER 1 CHAPTER 38 Training Surge
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Training Surgeons in the Developing
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Mobile Surgery Figure 1. 405 of tec
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Mobile Surgery Figure 3. 407 Childr
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Mobile Surgery 409 We have realized
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CHAPTER 1 CHAPTER 40 Public Health
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Public Health Problems on Burma Fro
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Medical Adventures in the Nigerian
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CHAPTER 1 CHAPTER 42 Wanted Glenn G
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Wanted 431 Studies Center (//www.am
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Wanted 433 MacArthur (The John D. a
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Wanted 435 most pathologic presenta
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Wanted 437 “outliers” in the he
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World Health 439 challenge: name fo
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CHAPTER 1 CHAPTER 44 Treating Other
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Treating Others: Human Sciences in
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Treating Others: Human Sciences in
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CHAPTER 1 CHAPTER 45 The Impact of
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The Impact of a Volunteer Medical M
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CHAPTER 1 CHAPTER 46 Field Notes on
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Field Notes on a Typical Day in a H
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Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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