Sunday, November 14, 2010


A hordeolum is a common disorder of the eyelid. It is an acute focal infection (usually staphylococcal) involving either the glands of Zeis (external hordeola, or styes) or, less frequently, the meibomian glands (internal hordeola).
Hordeolum (Sty): Infection involving hair follicle of the eyelash.

Internal hordeolum (relatively large, affecting the meibomian glands; may point toward the skin or toward the conjunctive) and external hordeolum (also known as a "sty;" smaller and more superficial; an infection of the glands of Moll or Zeiss; painful; always points toward the skin side of the lid margin).

There is usually underlying meibomitis with thickening and stasis of gland secretions with resultant inspissation of the Zeis or meibomian gland orifices. Stasis of the secretions leads to secondary infection, usually by Staphylococcus aureus. Histologically, hordeola represent focal collections of polymorphonuclear leukocytes and necrotic debris (ie, an abscess).

Hordeola should not be confused with chalazia, which represent focal, chronic, lipogranulomatous inflammation of the Zeis or meibomian glands. Chalazia form when underlying meibomitis results in stasis of gland secretions, and the contents of the glands (sebum) are released into the tarsus and adjacent tissues to incite a noninfectious inflammatory reaction. Histologically, chalazia appear as a granulomatous reaction (ie, histiocytes, multinucleated giant cells) surrounding clear spaces that were once occupied by sebum/lipid before they were dissolved by the solvents used for tissue processing, hence the term lipogranuloma.

Both types of hordeola are treated with warm compresses for 10-15 minutes 3-4 times a day; if the condition does not improve within 48 hours, incision and drainage of the pus is indicated. Antibacterial ophthalmic ointment is also helpful.

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A Practice of Anesthesia for Infants and Children

Extensively revised and updated, and in full-color throughout, the new edition of this popular text delivers practical advice on the safe, effective administration of general and regional anesthesia to infants and children. More than 50 internationally renowned experts-and a brand-new editor-discuss standard techniques as well as the very latest advances in pediatric anesthesiology, keeping you on the cusp of today’s best practices. Chapter after chapter, you’ll find authoritative guidance on everything from preoperative evaluation through neonatal emergencies to the PACU, as well as more than 1,000 illustrations that clarify concepts. And, as an Expert Consult title, this thoroughly updated 4th edition comes with access to the complete fully searchable contents online as well as video clips of pediatric anesthesia procedures, pediatric drug dosage calculators, extended references, and downloadable images for use in electronic presentations.

* Reviews underlying scientific information and addresses preoperative assessment and anesthesia management in detail to help you make better informed decisions.
* Provides guidelines for postoperative care, emergencies, and special procedures in one single source for your reference convenience.
* Includes access to the complete fully searchable contents online as well as video clips of pediatric anesthesia procedures, pediatric drug dosage calculators, extended references, and downloadable images.
* Discusses the full range of pediatric anesthesiology from preoperative evaluation through neonatal emergencies to the PACU to prepare you for any situation you encounter.
* Incorporates sweeping revisions and updates throughout, including new chapters on congenital heart disease, conscious sedation, and anesthesia in developing countries that keep you apprised of the latest techniques and procedures.
* Features a new editor, Dr. Jerrold Lerman, who contributes a wealth of experience in pediatric anesthesiology.
* Provides new insights from neonatologists and neonatal pharmacologists who give you a clear, up-to-date picture of the pharmacologic responses of neonates.
* Incorporates numerous figures and tables throughout for easy retention of information.
* Presents a new full-color format and hundreds of new color illustrations that clarify complex principles of techniques.

For Download :

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Fournier's Gangrene Reconstructed By Pedicle Thigh Flap(step by step photo images)

Fournier's gangrene is a rare condition and delayed treatment results in fatal outcome. We managed a case of Fournier's gangrene by initial radical debridement followed by scrotal reconstruction using pedicle thigh flap to cover the bare testes with excellent results.

35-year-old male presented in the emergency department with the swelling over scrotum and watery discharge ......

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