Being underdeveloped country with huge and massive numbers in the form of majority as populace, have in addition, scuffled financial strain and difficulty so, to manage their day to day medical and surgical reservation with parallel rise in the form of fees on behalf of clinicians.

Resultant! Is the similar rise of ailing humanity with summing dreadful restrains?

Under such circumstances method to liquidate and treat such patients in dire need, is a necessity and obligation of time and being a professional and oath holder, I consider it a duty to console and benefit the community with the knowledge and qualification that has been granted and certified to me by virtue of this medical profession.

It is true in the contest that, this net based technology is the cake for different class of people, but to summarize, it is a chain of system among people that works at their marginal domain and thus liquidate the same knowledge at lower level of liquidation, so to impart their share of services by floating and delivering as and when required.

Although it is an easy task to float and disseminate knowledge if the receiver end is familiar with the subject as professional but digging modes to express your feel and idea in terms to educate and info populace, who are not familiar with the subject and terminology, (as non professional or lay man), specially if the topic of discussion has magnitude of problem that has devastating and drastic variation in the contest of disease as threat and its incidence as specialized subject, is a real menace and painstaking.

However I have tried to simplify the issue, that require skill and technique in operating theater, in to words so that, creation of anxiety, unforeseen fate and panic may be curtailed by large population un familiar to the term and destiny of the disease .

If I overlook the figures and fact being topic of my research and almost conduction of more than 500 similar cases of the requisite disease and its variant presentation and thereof after seeing different approaches to diagnosis by different consultant, I have a feeling that most of the cases being performed nowadays may have been avoided in terms of operative interventions.

In my opinion many such cases could have been curtailed by expertise ,good clinical approach, and professionalism as expert ,though, were and are made a deliberate fate perhaps misdirecting intentionally or as inexpertise in clinical judgment or by self motivated desire ,utilizing lack of knowledge of patient and as incentive to the hospital or as monthly requisite and necessity to run daily affairs .

Ever changing trends and transformation of subject field of medicine in to a platform of marketing and business has irrationally indulged many professionals , to open a new era of malpractice in the contest of said emergency ,making this catastrophe as the bread and butter of the consultant at large at the cost and sacrifice of professionalism ,and patients.

Please see subject platform of reservation as article, is to instruct and info a large population unfamiliar with the terms and nomenclature of medicine and, as such medical terminology and diagnosis will now and onward in the article would be made easier and understandable so that any one unaware( being non professional )unfamiliar to the contest can have the idea to read a consultant ,if at all in future being put by fate, thus engaging and disembarking any misuse and malpractice if at all, suspected or in desire, by some un ethical and unprofessional hospitals and business owners.

Here, the theme is not to float the line of treatment but it’s a writer view, and is not a mandatory protocol of practice and in no way the writer shares the responsibility in any mode whatsoever.

For any query, in case of exposure of the same threat as disease, it is advised to consult nearest hospitals and clinics as it is the only ethical mode of consultation and treatment. Any question regarding your queries at site is always welcome and appreciably, be taken, so to provide and update as part of my services to this ailing humanity.

Please be cautious, article on the subject is to brief and aware the masses and under no means to refrain or omit clinician advice, which is the mandatory asylum as relief.

Appendicitis

Appendicitis is the most common surgical emergency since decades.

It is a disease extensively common in Pakistan and perhaps India extensively known at stretch  in a layman terminology as the word “appendix”.

This layman terminology” appendix” is normally considered if some one with a sudden onset pain in right lower abdomen is a complainant.

The next episode of his treatment at home and thereafter in hospital, is always in the contest of the disease and his kin and relatives become mentally and psychologically of the opinion, that the eventual outcome will be the operative intervention for perhaps the same disease.

It is the theme of prior belief and mind set, which is utilized by these business goons and unprofessional culprits for their motivated desire, since they have minimal point of hindrance to bring relative to the point of surgical intervention due to their established concept.

Although this subject is extensive as regard to the pathology and its fate, but dictation as reservation in terms of deliberate negligence of medical professional will not be justified, if I start delivering the same to a person as layman or attendant, since it will not support the logical direction of thoughts so to exercise ease and knowledge to the sufferer.

In the upcoming paras, I will discuss the issue as layman so to give the family of sufferer an idea that may benefit them in future, unforeseen event.

The Real disease

It is common in all age group. A curative disease which require surgical intervention, in almost every case of early diagnosis.

Late diagnosis, are serious issues, resolved by continuous monitoring and surveillance, as per clinical parameters and monitoring, with increase hospital stay, and budgeting.

Delayed operation of Appendicectomy, known as interval Appendicectomy, is again the choice as only cure from relapses, or cases going through the process of conservative treatment, and follow ups, in cases of delayed presentation and diagnosis.

More common in female, and are even more subjected to intervention due to mimicking of some similar diseases and monthly cyclical pain.

Therefore concerned relative should inquire about any coincidence of finding as menses and secluded attachments with relation.

Ideal is, that every female with such symptoms should go through the ultra sound abdomen, as blood cell; levels as indicator may not be much supportive.

Please see decisions are the prerogative of clinician, and under no circumstances, decisions can be toppled or disregard.

Questionnaire

Few questions can take you to suspicion of disease and early consultation at your own side.

Ask about last meal.(patient may have history of unhygienic food and associated problems that may drag sense towards nonsense.)

Ask about burning micturation (urination and any sensation of burning being perceived while voiding, there is also a suspicion that urinary tract infection or renal stone). This is cardinal and should never be omitted as inquisition.

Take a History of loose motions. (The same can be another deceiving point for unwanted induction)

Ask him /her if he has desire for food (diseases involving gut and abdomen effect desire of food and if patient is desirous to take food there is a lack of chance that he is suffering from gut problem or appendicitis).

Hydration (thirst) status can be seen by your self, look in to the tongue, is it dry or wet. (Urinary track infection and kidney problems are associated with, dryness of tongue).

Check yourself whether patient is rolling or changing position with pain. (If he is rolling chances are that he may have a kidney pain and not appendicitis, however exceptions are there. Patient with appendicitis do not roll in bed, but stays calm so to restrict his mobility).

Ask about whether his bowel habits (defecation or expelling out faeces or stool is normal).

Is he passing flatus (farting).

 Did he had any previous history of his similar pain and when and how did it resolved?

Please ensure! Any patient with abdominal pain suspected of appendicitis or any other disease, should never start taking meal or fluid orally, till it has been advised by doctor. (Nothing per oral).

Similarly! Strictly avoid pain killers, till advised by doctor.(As it will mask the disease sign) 

There is no need to panic as ample of time is there to take decision once you are in hospital.

Following investigation in almost every protocol of treatment will be needed.

CP(Complete blood picture), Serum Sugar, urea, electrolyte ,creatinine ,blood sampling in rare cases ,ultra sound abdomen ,X-ray abdomen whereas at advance and well groomed institute ,more sophisticated modules are also available .(Ranges of limits are always shown in different laboratory protocol slips and is a reasonable way to inquire clinician for the same )

Please allow clinician to perform requisite mandatory test as routine and essential.

Please see there are multiple criteria and scales to evaluate and diagnose this disease and these are only essentialities that is being floated to aware the direction of treatment and it has not relation to create rift between doctor patient relations.

Your doctor is a responsible person and you got to believe him, however, rarities need to encountered and the only way to counter is to know the basic of the subject.

At hospital patient will be evaluated, as per protocol, with requisite treatment that is essential.

Please do not mess situations by saying that no treatment has been initiated. Prior to operation protocol of treatment in most cases is, to hydrate patient with fluids, a cover of anti biotic and after diagnosis a pain killer.

A doctor can be insisted to start infusion at earliest ,if patient has no restrictions in terms of associated diseases.

Do not put pressure to give pain killer to the patient as it will, before diagnosis, would masked the actual pathology putting your patient in misdirection.

Doctors are more concerned about well being of their legitimate patients and will prescribe what ever would be and when, best for their patient.

Once the decision for operation is taken do not panic as it is always a piece of cake as far as this operation Appendectomy, is concerned.

Surgeons are very much used to this operation and they knew that, what to do, and when to do.

If patient presenting with such pain are advised by specialist to monitor for 24 hrs, try to manage as some times early decisions are missed diagnosis.

There is no harm to the patient in hospital as far as protocols are followed.

Patient with Appendicectomy are discharge after 48 to 72 hours and in some cases of advance surgical intervention as laparoscopy a bit earlier.

Anesthesia causes delayed arousal and there is no hurry to wake your patient if he had been transferred to the ward by anesthetist. Wait he will revert to you with response in few hours.

The first sight of desire of food by the patient and first bowel after the feed is a satisfactory sign for discharge and is experienced with in 48 hrs. 7 to 10 days are needed to remove stitches.

Mild discomfort at the site of operation is a routine and any symptoms not relieved by painkiller, fever, pain at site of operation; wet dressing with colored discharge is sign of infected wound that need attention and dressing as suggested.

It is suggested that you should mobilize your patient early, as soon as he gains complete consciousness.

Please do not insist on feeding your patient his required calories as mandatory are always nourished by infusions.

It is advised to start liquid diet, till it is recommended by your specialist .You have prerogative to inquire the same for your relief.

Mild sensational loss is experienced at the site of operation and is a routine which will be recovered with in 6month to 1 year.

Many sign and symptoms on the issue have not been highlighted as in my opinion; they will not support the patient and their attendant, as a means of knowledge.

Similarly statistical evaluation, incidence, pathology, treatment protocol, are the domain of professionals and would not benefit in the contest of education.

It is again emphasized that the article is meant to aware basics on the issue and under no means can be taken as mandatory in lieu of consultation.