Surgery – The Way I Teach! Lecture Notes on Basic Principles of Surgery

big18Authors

Prof. Shyam Parashar is a 1959 medical graduate from G.R. Medical College, Gwalior and Vikram University in India. In 1962 he obtained the degree of Master of Surgery [M.S.] from the same University. For next seven years he continued his further training at All India Institute of Medical Sciences in New Delhi, India, and in various hospitals of England.

He obtained the Fellowship of Royal College of Surgeons of Edinburgh [FRCS Ed.] in 1966, and returned to India to join Goa Medical College in 1969. In ten years he reached the highest rank of full Professor and Head of the Department of Surgery at the same college.

From1981, he worked as Professor of Surgery at King Faisal University [later named as University of Dammam], and senior Consultant Surgeon at King Fahd Teaching Hospital. For twenty five years he also held the position of ‘Director for Postgraduate Training Program in Surgery’.

He left Saudi Arabia in 2013, but continues to hold the position of ‘Emeritus Professor’.

Prof. Parashar has been a very popular teacher and well known surgeon amongst his students, trainees, colleagues and community in Goa as well as in Saudi Arabia. His students have been occupying very senior positions in India and abroad.

He lives with his wife in USA; however he spends a lot of his leisurely time at his beautiful resort home at Dona Paula in Goa, India.

You can contact Prof. Parashar at the following address:
1, Monet court, Monmouth Junction, NJ 08552, USA
5, Sagar colony, Dona Paula, Goa, 403004, India
E-mail: skparashars@yahoo.com

Description

This work is my attempt to simplify and teach basic sciences and their application in clinical decision making.

Students of surgery must know that communication skills, mannerism and ethics play a very significant role in the learning phase of their life. Any student in a white coat with a stethoscope around the neck and hammer and tuning fork peeking out of the coat pocket cannot disguise the fact that they are still students and that they have to win the trust of their patients before they can obtain the required information related to their history and physical examination.

Students must introduce themselves to their patients, take their permission, maintain privacy, and respect confidentiality of the information provided. They must keep the conversation simple, focused, specific and relevant to the patients’ problems, and use uncomplicated understandable terms. Students should not independently discuss the diagnosis, prognosis and management with the patient or any member of their family. Any curiosity and questions in this respect should be directed to the treating surgeon.

There is no substitute for modest appearance and courteous behavior. Be gentle to your patients who must already be suffering. That is often why they seek medical help. While examining them do not do anything that may increase their pain or suffering. Remember the dictum: “If you cannot do any good, please do not do any harm”.

Surgical examination includes examination of private parts and internal examinations. Seek permission before proceeding. A cooperative patient can help solve many of students’ problems. Most surgical patients have wounds that require dressings. Do not expose wounds repeatedly. Follow instructions from the teacher or the nurse. Pay attention to hygiene and patients’ comforts. Wash your hands, use gloves where necessary. Do not expose or move your patient unnecessarily. Prepare a scheme for examination before you expose the patient. Thus you can complete the examination and accomplish the objectives within the shortest time and with minimal discomfort for the patient.

Finally, students should note that all major problems in general surgery can be covered in following TEN groups. Once they master the basics of these ten subjects from a book like this and the details from their text books, they would have covered almost all common general surgical conditions which they are likely to encounter in their practice. These TEN groups are:
1. General principles of surgery
2. Non-specific surgical conditions
3. Trauma
4. Abdomen: Acute abdomen and Abdominal masses
5. Ano-rectum
6. Hernias
7. Cervico-facial surgical conditions
8. Breast lumps
9. Acute chest pain and dyspnoea, of surgical origin
10. Limbs and Peripheral Vascular Diseases [including diabetic foot]

This book focuses on applied anatomy, Patho-physiology and principles of management of these ten groups, based on my experience and understanding.

Contents

Introduction
General Principles of Clinical Practice
Communication Skills
Professional Ethics
Safety in Clinical Practice
General Principles of Surgery
Non Specific Surgical Conditions
The Pain
The Wounds
Scars
Haemorrhages
Surgical Infections
Tumors
Cysts
Common Lesions of Skin and Subcutaneous Tissue
Moles/Naevi
Peri-Operative Care
Preoperative Preparation
Intra-Operative Care
Postoperative Complications and Management
Swellings and Ulcers
Swellings
Ulcers
Sinuses and Fistulae
Trauma
Burns and Scalds
Severe External Haemorrhage
The Abdomen
Developmental Defects of Abdominal Wall
Surgical Abdomen
Acute Abdomen
Sub-Acute, Chronic and Recurrent Obstructions
Adynamic Obstruction
Mesenteric Ischaemia
Abdominal Masses [Including Tumors]
Tumors of Colon
Colon Cancers
Section 2 
Ano-Rectum
Anal Fissure
Internal Haemorrhoids
Important Facts and Observations about Internal Haemorrhoids
Peri-Anal Haematoma [External Haemorrhoid is Wrong Term]
Ano-Rectal Sepsis
Fistula-in-ano
Rectal Prolapse
Inflammations
Non Specific Peri-Anal Swellings
Ano-Rectal Tumors
Diagnosis of Ano-Rectal Problems
Ano-Rectal Mystery
Reminder
Pilonidal Sinus [PNS]
The Hernia
Head and Neck
Oral Cavity
Salivary Glands
The Neck
Thyroid Gland [Goitre]
Parathyroids
The Breast
Breast Tumors
Breasts in Males
The Chest
Trauma
Airway Obstructions
Tension Pneumothorax
Open Pneumothorax
Haemothorax
Flail Chest
Cardiac Tamponade
Rupture of Diaphragm
Oesophageal Rupture
Non Traumatic Chest Conditions of Surgical Interest
Oesophageal Tumors
Achalasia Cardia
The Limbs
The Hand Infections
Ganglion
Dupuytren’s Contracture
The Foot
Diabetic Foot
Other Lesions of Foot
Peripheral Vascular Disorders [PVD]
Malformations
Arterial Disorders
Disorders of Veins
Surgery in Tropics
Parasitic Diseases
Bacterial and Viral Diseases
Neoplasms
Blood Diseases
Useful Hints for Diagnosis [Easy to Remember]
Pain
Rare Pictures for Spot Diagnosis
On a Lighter Note
Culinary Metaphors in Medicine [Fascination of Medical Fraternity with Food]
Summary 
If you want to read this book, you can find it in SciencePG.
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