HSG is an operative procedure whereby a radiographic study of the interior of the uterotubal anatomy is made using a contrast media.

Hysterosalpingography : Normal

Indications of HSG

1. To note the tubal patency in case of Infertility or following the tubal operation
2. To detect uterine malformation in the recurrent mid trimester abortion
3. To diagnose the cervical incompetency
4. To identify the translocated IUD wheter lying inside or outside the uterine cavity
5. To diagnose the uterine Synechiae
6. To confirm the diagnosis of secondary abdominal pregnancy
7. Incidental diagnosis of submucous fibroid or an uterine polyp or hydrosalpinx or nodular tube is an additional gain.

Steps in the Procedure

1. Procedure room- Radiology department
2. Anesthesia : Not required
3. Patient is askes to empty her bladder.
4. She is placed on dorsal position with the buttocks on the edge
5. Internal examination is the done
6. Posterior vaginal speculum is introduced and the anterior lip of the cervix is held with Vulsellum
7. Uterine sound is passed
8. Hysterosalpigographic cannula is fitted with a syringe containing radio-opaque dye- Urografin- Sodium Ditriazoate. About 5-10 ml .
9. Speculum and vulsellum are removed but the cannula is kept intact.
10. Immedicately X-ray is done in AP view. Cannula is removed and after 10 minues another Xray is done.
11. The tubal patency is evidenced by spillage of dye.

Complications

1. Peritoneal Irriation and pelvic pain
2. Vasovagal attack
3. Intravastation of Dye in venous or lymphatics
4. Flaring of Pelvic infection

Hysterosalpingography Procedure Video

Tonsillectomy Video:  Watch online

Indications of Tonsillectomy:

1.Patients with 3 or more infections of tonsils and/or adenoids per year despite adequate medical therapy.
2. Hypertrophy (enlargement) causing dental malocclusion or adversely affecting oral-facial (mouth-face) growth documented by orthodontist.
3. Hypertrophy causing upper airway obstruction (sleep apnea) View Abstract View Abstract, severe dysphagia (trouble swallowing), sleep disorders, or cardiopulmonary complications.
4. Peritonsillar abscess unresponsive to medical management and drainage documented by surgeon, unless surgery performed during acute stage. View Tonsillectomy Surgery Video View Drainage Surgery Video
5. Persistent foul taste or breath due to chronic tonsillitis not responsive to medical therapy.
6. Chronic or recurrent tonsillitis associated with the streptococcal carrier state and not responding to beta-lactamase-resistant antibiotics.
7. Unilateral tonsil hypertrophy presumed euplastic. Although without other indications (abnormal appearance, physical examination, symptoms or history) most asymmetries can be followed conservatively.
8. Recurrent acute otitis media or chronic serous otitis media.

Source : http://www.entusa.com

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Tonsils after removal

Level of Block

Operations

Indications:

1. Abdominal & vaginal hysterectomies
2. Laparoscopy Assisted Vaginal Hysterectomies (LAVH) combined with general anaesthesia
3. Caesarean sections
4. Hernia (inguinal or epigastric)
5. Piles fistulae & fissures
6. orthopaedic surgeries on the pelvis, femur, tibia and the ankle
7. nephrectomy
8. cholecystectomies
9. trauma surgery on the lower limbs, especially if the patient is full-stomach
10. Open tubectomies
11. Trans-urethral resection of prostate

Complications

• * Spinal shock.
• * Cauda equina injury.
• * Cardiac arrest.
• * Hypothermia.
• * Broken needle.
• * Bleeding resulting in hematoma, with or without subsequent neurological sequelae due to compression of the spinal nerves
• * Infection: immediate within six hours of the spinl anaesthetic manifesting as meningism or meningitis or late, at the site of injection, in the form of pus discharge, due to improper sterilization of the LP set.
• * PDPH:post dural puncture head ache or post spinal head ache

Source : Youtube Video