Resected GB and Stones                                                                Anatomy of GB

Gallbladder is situated below the liver, it accumulates excess bile. Bile is required for the digestion of fatty food. Bile is produced in the liver, gallbladder does not produce bile. In some patients stones are formed in the Gallbladder. Fatty food, obesity and female sex are some of the factors  to develop stones. Symptoms of gallbladder stones are fullness after food, pain Right upper part of abdomen.Some stones remain asymptomatic. Ultrasound of abdomen can detect Gallbladder stone. Gallbladder may not cause any harm immediately but it can also cause life threatening complication like acute biliary pancreatitis.

Treatment is done by Laparoscopic cholecystectomy, this is a minimally invasive procedure and patient can go home on the same day after the surgical procedure.

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Mental Health During COVID-19

Written By
Sahar Z Sheikh 
MA (Psychology)
University of Toledo, USA

The outbreak of coronavirus disease has affected our mental health significantly. As it is concerning each individual differently, most people are stressed about predicaments such as unemployment, social isolation, and altered daily routines. Most importantly, something that is causing most distress is likely to be the uncertainty of returning to our normal lives. Moreover, there is a constant fear of getting into contact with someone who may be infected with the virus. It is certainly a difficult time that we are going through, nevertheless, it is unprecedented, and nobody was fully prepared to cope during the pandemic. Therefore, it is totally normal to experience anxiety, worry, and stress. It is a learning process for most of us and we are learning every day about the Novel Coronavirus. As we are staying at home, there should be no mandatory reason to be overly productive rather we can also use this time to only focus on our self-care and mental health. However, this time is ideal to strategize and create a plan for the future by making a list that you would like to do after the lockdown is over. Additionally, we can make a “bucket list” of places that we would like to visit or plan a fun event with family and friends after the pandemic is over.

It is very easy to be in our minds all day; however, if it causes clinically significant distress or impairment in social, or occupational life, primarily it would be a crucial time that we consult a mental health professional or a medical doctor to talk about the factors that are causing stress, anxiety or fear. In the time of coronavirus, it may not be possible to meet face to face with a professional due to the COVID-19 government rules, however with the help of internet call, it is possible to receive a professional opinion. In Bangladesh, visiting a mental health professional is usually being frowned upon, nevertheless mental health should be as important as our physical health. Mental health is equally integral to live a healthy and balanced life. If we can visit a doctor for physical health, then it is also significant that we take care of our mental health by consulting a professional. The stay-at-home order is impacting the well-being of people and leading to issues such as loneliness, depression, and concerns about their health. Although, it is difficult for many to stay at home, however staying at home can certainly save not just one but many lives especially if you belong to the high-risk category. During this time, we are able to complete some projects such as gardening, art, writing, or catching up with readings.

Furthermore, we can use this time by making connections with others through video calls, phone calls, or texts. As we are all in quarantine and are staying at home, it would be a good time to check on friends who we have not spoken with for a long time due to our busy schedules. We can also practice self-compassion by not pressurizing ourselves to always think positive. It is certain that negative thoughts would come to our mind and we can certainly use specific coping mechanisms to avoid irrational thoughts. Similarly, it is also substantial to show compassion to others as they might also be going through their own battle during this difficult time.

We also tend to use social media right after we wake up which may cause an overload of information. Therefore, it is important to limit our usage of social media during the day. It may be useful to set aside a specific time where you can be away from all your devices and are able to spend time with family or yourself. Activities such as yoga and meditation can help us to focus on ourselves rather than focusing on the negativity. As we all have different preferences and we are comfortable in doing different activities such as singing, dancing, or reading books. As the quote says “Nature is the best physician” we can go in open spaces such as parks for some fresh air by maintaining the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) or the government guidelines.

Acute Surgical Diseases and Accidents During COVID 19

What is COVID 19?

This is a new virus, infects human being. by touching contaminated surfaces and then touching nose, mouth or eye. The person may get this infection by staying in a crowded area for long time. While someone is going out and not maintaining social distance of 6 feet and if the person is not wearing a mask.

What are the Symptoms?

Throat pain,

Fever,

Dry cough,

Distaste for food,

Difficulty in breathing

Diarrhea

What you should do to prevent getting infected with this dangerous virus?

✦ Stay at home as far as possible

✦ Maintain Social distancing, 6 feet form an unknown person,

✦ Use of mask, hand gloves and head cap can be protective.

✦ Wash hands after touching unknown surfaces with soap for at least 20 seconds.

✦ Eat healthy food, exercise at home, do not watch news for a long time, talk to your near and dear ones.

What Surgical problem you may have during this time?

The common surgical problem one may encounter at this time are as follows

• Acute Appendicitis: Presents with Lower abdominal pain, distaste for food and vomiting
• Acute Cholecystitis: Upper abdominal pain, vomiting.
• Acute Intestinal Obstruction, Strangulated hernia, Thrombosed hemorrhoids, Acute anal Fissure, Abscess etc.
• Malignant conditions like, Breast cancer, Colon cancer and Stomach Cancer.

Accident

If any one sustain an accident , the person should be brought to Emergency to a nearby Hospital subject to maintenance of health regulation.

What will you do if any one suffer from those Urgent or Emergency Surgical Condition?

You must contact a Doctor who can help you to get prompt and accurate care of your patient.