In adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival.

Ergonomics is the science of best suiting the worker to his job, or to make the setting and surroundings favorable for the laparoscopic surgeon. The term was formally defi ned in 1949 and has brought benefi t and safety to many areas of human endeavor.1 The importance of ergonomics in the setting of laparoscopy cannot be overemphasized. Studies have shown that correct ergonomics can reduce suturing time.2 Pressurerelated chronic pain has been shown to be relieved by the use of ergonomically designed products.3 This article on ergonomics reviews the basic concepts and techniques, for example, triangulation, optimal coaxial alignment, drawbacks for the surgeon and the patient, and how to overcome these diffi culties by recent advances in technology.

Background: Chronic kidney disease (CKD) is a long term condition caused by damage to both kidneys. The benefits of arteriovenous fistulas over other forms of chronic access are: Arteriovenous fistulas are associated with decreased morbidity and mortality among hemodialysis patients compared with arteriovenous grafts and central venous catheters. Objectives of the study were o choose the proper sites for formation of arteriovenous fistula, to find out the success rate at various sites and to study the complications of arteriovenous fistula.Methods: This prospective study was carried out on total 150 patients over the duration of two years. The fistulae were created using radial artery and cephalic vein side to side (Radiocephalic AVF) and brachial artery and cephalic vein side to side anastomosis (Brachiocephalic AVF). Doppler studies were done before and after every procedure to demonstrate the velocity, volume of blood flow, depth from the skin, diameter of vessels and to access the time of maturation of AVF. Patients were followed up to first dialysis by AVF to assess the overall outcomes and various complications.Results: Brachiocephalic AVF matured earlier than Radiocephalic AVF (mean maturation time Brachiocephalic 38.02 days and Radiocephalic 43.26 days) which was statistically significant. Brachiocephalic AVF matured earlier than Radiocephalic AVF with more flow rate. Complication rate was more at wrist (Radiocephalic AVF with 66.67% of overall complication) than at elbow (Brachiocephalic AVF with 33.33% of overall complication).Conclusions: We concluded that the Brachiocephalic AVF maturation time was significantly less than the maturation time of Radiocephalic AVF and rate of complication was less in Brachiocephalic AVF. The utility of pre-operative colour Doppler to select the vessels for AVF creation was found to be as an essential parameter of pre-operative work up.

Aims And Objectives:To study the Efficacy of Vitamin C therapy on burn patients. Material And Methods:We enrolled 20adult patients with severe burns (more than 30%) from January 2020 to October 2021 at Plastic Surgery and Burns Hospital, Dhule. Patients with co- morbidities and with pre existing diseases were excluded from the study. Results: Fluid requirement in Group A was 3.74 ± 0.57 ml/kg/% of burns and in Group B was 2.46 ± 0.54 ml/kg/% of burns.Urine output was 1.05 ± 0.28 ml/kg/h in Group A, and in Group B,it was 1.42 ± 0.39 ml/kg/h. Fluid retention and body weight gain were lower in Group B.MDA levels were significantly lower at 36 h in Group B. Discussion:The initial fluid resuscitation in major burn trauma is intravenous infusion of crystalloids solutions to correct hypovolemia and to improve peripheral tissue perfusion.[14] The accepted norms are to monitor the adequacy of resuscitation with urine output of 0.5–1.0 ml/kg/h of body weight and stable hemodynamic status. There have been reports of over resuscitation of burn patients leading to problems such as anasarca,abdominal compartment syndrome, prolonged mechanical ventilation,and pneumonias.This has been termed as “fluid creep”phenomenon. Conclusions: In our study, we found that when high dose Vitamin C (12-15gram) is given as adjuvant therapy in resuscitating the burn patients in the first 48 h,it decreases fluid requirement,increases urine output,and decreases fluid retention in body.

Accurate diagnosis and staging are crucial in defining an effective plan of management in intra-abdominal malignancies. Despite the availability of a wide array of imaging techniques, a high incidence of nontherapeutic procedures have been observed. Laparoscopy finds its utility in reducing this discrepancy by an accurate assessment of the extent of the disease. This review article explores applications of laparoscopy in the staging and diagnosis of abdominal malignancy and its comparative advantages against imaging studies and conventional laparotomy.

Introduction: A diagnostic surprise or finding a tumor unresectable at laparotomy is an undesirable situation for every surgeon. A surgeon should never regret for having done a laparotomy on a patient which otherwise was avoidable. Many surgeons worldwide have had challenging experiences of facing an uncertain diagnosis or staging of abdominal malignancies. History-taking, physical examination, laboratory tests, and advanced noninvasive imaging studies might provide some help but are insufficient for accurate diagnosis and staging of abdominal tumors. Aim: To assess the role of diagnostic staging laparoscopy in abdominal malignancies. Objectives: To evaluate the role of laparoscopy as a diagnostic tool in abdominal malignancies. To compare the findings of laparoscopy with noninvasive imaging modalities. To assess the efficacy of laparoscopy as a definitive tool in the evaluation of staging and operability before definitive intervention. Materials and methods: This is a prospective observational study with a sample size of 250 patients. The study duration was 3.5 years from July 2013 to October 2016 and was conducted at Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Meghe), Wardha. Results: Due to the use of diagnostic laparoscopy, out of 250 cases of abdominal malignancies, in 120 (48%) patients, nontherapeutic laparotomy could be avoided. Conclusion:This study highlights the emphatic utility of diagnostic laparoscopy procedures in staging and management of abdominal malignancy. Laparoscopic evaluation of a patient with intra-abdominal malignancies is a desirable tool against imaging modalities in improving the detection of metastatic disease and accurate staging of the disease process.

Summary – A 83 year old male presented with lump in right lower quadrant of abdomen since 1 year. It was associated with pain since 3 months and was of pricking type. No other associated complaints. On HPE the lump was Spindle cell neoplasm. After thorough evaluation he was subjected to chemotherapy and then underwent surgery and the huge defect was reconstructed using pedicled ALT flap.

The field of laparoscopic surgery has experienced tremendous growth in the last three decades. The important events among them have been the invention of incandescent bulbs by Thomas Edison, the development of lens scopes (1870–1980s), the invention of rod lens system by Hopkins (1950s), the fiberoptic cold light transmission (1960s), and the computer chip video camera (1980s).Technological advancements have produced progressively smaller laparoscopic instruments and higher quality imaging that allow laparoscopic surgeons to perform precise dissection with minimal bleeding through most dissection planes, and the major limitations of standard laparoscopy procedures are overcome with these advances.The introduction and evolution of minimally invasive surgery has drastically changed the entire scenario of the ways in which surgeons are treating the patients. With the introduction of various innovative technologies like high-definition television, video systems, integrated digital reporting, head-mounted displays, surgical robotics, virtual reality training, and the integration of various modalities, such as ultrasound, computed tomography, and magnetic resonance imaging, the surgeon has better knowledge of the disease, thereby, treating the patient more effectively.In this review article, we explore the evolution of laparoscopy through the ages, thereby, making way for further development in the field of minimal access surgery.