Day after prayer day, it starts to be quite busy. The 100 yrs old man with gangrene, infected foot returned. One of his family members is a doctor. He talked with the family and advised them to take him back for amputation. They understood and accepted the risk of OT. But our German anaesthetist, Jorg was not too happy to take him for operation. It seems that he and the previous surgeon thought it was too risky for operation and so not offering to them before. But for me, although there is 10 to 20 percent chance, compared to zero with no operation, it’s my duty to tell the family the options and let them to decide, even though he will only live for one month or more after operation. We are going to have amputation for him tomorrow. But we were discussing this case during dinner. I don’t think we can refuse the operation right now. Then I saw two emergency cases, one rectal prolapsed which I reduced, one buttock abscess with incision and drainage in afternoon. Later, one 3 years old child came to ER in very bad shape with malnutrition and gross dehydration. Blood sugar was close to zero. We resuscitated before lunch and the child started sucking in afternoon already. It’s amazing. Late afternoon, we received a woman referred from Razeh, 5 hours drive journey to Al Tahl. She has term pregnancy and ante-partum haemorrhage. The presumptive diagnosis is placenta praevia (placenta lies on cervix ) which may cause dangerous bleeding during delivery. There is no surgical facility over there so that they referred her to us for management. Although I am not good at ultrasonography, I have to do one on her tomorrow to assess her presentation and position of placenta. Hope I can do it right like the boy with road traffic accident.
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