Ten surgical conditions

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University of Dar es Salaam
I am grateful to have had this opportunity of training in surgery for three years. This period has given me a key to learn from any source, surgical knowledge and skills in every day of my life, and has strengthened my dedication to save mankind. The ten surgical conditions studied in this dissertation were chosen as a result of my personal interests and reflections that arose from my working experience and observations for a total of six years as a medical officer in this country. They do not reflect the frequency of occurrence although some topics like Head injuries and Fractures of femoral shaft have been discussed because of their striking rise in incidence. In other subjects like Pancreatic pseudocysts, Achalasia of the Cardia, Benign prostatic hypertrophy and Congenital talipese quinovarus, the surgical modalities/techniques adopted as compared to the outcome were so rewarding that beginner in surgery like myself really taste the role of surgery in "healing". Surgeons in our country are frustrated by late presentation of cases particularly in malignant conditions like Cancer of the female breast and Cancer of the urinary bladder such that surgery has only palliative role or no role in advanced cases. Such delay could have been minimized if the role of primary prevention of the disease was taken seriously. Worldwide, surgeons are also frustrated by the world pandemic of the Acquired immune deficiency syndrome which has altered the statistics, the pathophysiology, the surgical techniques/approaches and the outcome of surgically treatable conditions. In Pericardial Effusion for example, I encountered higher rate of association with AIDS and that surgery only postponed death for a short period. Opportunity to work in different medical units is helpful in growing new interests, in acquiring more skills and in change of attitudes toward disease control to a better performance. During my rotation in obstetrics and gynecology at the Kilimanjaro Christian Medical Centre, I had an opportunity to participate in the management of VVF/RVF patients whose a etiology was mainly obstructed labour. National health economic planning greatly contributes to the disease pattern as reflected by lack of facilities, staff and motivation to care the VVF patient as an example. In discussing these ten surgical conditions I therefore looked broadly into the disease spectrum and frequently gave recommendations towards the end of each condition on how best we could improve their management.
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Surgery, Surgery, Operative
Mkiramweni, J. P (1993) Ten surgical conditions, Masters dissertation, University of Dar es Salaam. Available at (