Nather is of the National University Hospital Bone Bank, Singapore.
Sometimes in medicine the only way to know what is truly going on in a patient is to operate, to look inside with one's own eyes. This book is exploratory surgery on medicine itself, laying bare a science not in its idealized form but as it actually is -- complicated, perplexing, and profoundly human.
Atul Gawande offers an unflinching view from the scalpel's edge, where science is ambiguous, information is limited, the stakes are high, yet decisions must be made. In dramatic and revealing stories of patients and doctors, he explores how deadly mistakes occur and why good surgeons go bad. He also shows us what happens when medicine comes up against the inexplicable: an architect with incapacitating back pain for which there is no physical cause; a young woman with nausea that won't go away; a television newscaster whose blushing is so severe that she cannot do her job. Gawande offers a richly detailed portrait of the people and the science, even as he tackles the paradoxes and imperfections inherent in caring for human lives.
At once tough-minded and humane, Complications is a new kind of medical writing, nuanced and lucid, unafraid to confront the conflicts and uncertainties that lie at the heart of modern medicine, yet always alive to the possibilities of wisdom in this extraordinary endeavor.
Complications is a 2002 National Book Award Finalist for Nonfiction.
The struggle to perform well is universal: each one of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives are on the line with every decision. In his new book, Atul Gawande explores how doctors strive to close the gap between best intentions and best performance in the face of obstacles that sometimes seem insurmountable.
Gawande's gripping stories of diligence, ingenuity, and what it means to do right by people take us to battlefield surgical tents in Iraq, to labor and delivery rooms in Boston, to a polio outbreak in India, and to malpractice courtrooms around the country. He discusses the ethical dilemmas of doctors' participation in lethal injections, examines the influence of money on modern medicine, and recounts the astoundingly contentious history of hand washing. And as in all his writing, Gawande gives us an inside look at his own life as a practicing surgeon, offering a searingly honest firsthand account of work in a field where mistakes are both unavoidable and unthinkable.
At once unflinching and compassionate, Better is an exhilarating journey narrated by "arguably the best nonfiction doctor-writer around" (Salon). Gawande's investigation into medical professionals and how they progress from merely good to great provides rare insight into the elements of success, illuminating every area of human endeavor.
The amnion comes close to being the ideal biological membrane or dressing — readily available, inexpensive to procure and process. Its basic science is discussed in detail — anatomy, biological and biomechanical properties.
It can be procured from the placenta in normal vaginal deliveries and from Caesarean Sections. Processing is by freeze-drying or by air-drying process with sterilisation using gamma irradiation.
The product has low antigenicity, has anti-microbial properties with ability to enhance epithelisation with marked relief of pain. It is useful as a dressing for wounds — flap wounds, burn wounds, injury wounds, diabetic ulcers, leprous ulcers and post-surgery wounds and post-radiation wounds. It is also used as a biological scaffold for cells in tissue engineering. Its ophthalmic applications include treatment of corneal ulcers and conjunctival tumours. Oral uses include gingiva depigmentation and periodontal regeneration.Contents: Section I: Introduction: IAEA Programmes in Tissue Banking in Asia-Pacific Region (Nazly Hilmy and Norimah Yusof)Tissue Banking in Asia Pacific Region: Past, Present, Future (Aziz Nather, Foong Shi Yun Mandy, Tan Ning and Wang Kaiying)Training Tissue Bank Operators — 20 Years of Experience by IAEA/NUS Regional Training Centre (Aziz Nather and Wo Yu Jun)Section II: Historical Development and Basic Science: Historical Development of Amnion (Norimah Yusof and Nazly Hilmy)Anatomy and Histology of Amnion (Nazly Hilmy and Norimah Yusof)Biological Properties and Functions of Amnion (Paramita Pandansari, Retno Dwijartini Tantin, Basril Abbas and Nazly Hilmy)Physical Properties of Amnion (Norimah Yusof and Nazly Hilmy)Section III: Screening, Procurement and Processing: Transmissible Diseases (Aziz Nather, Sherilyn Leong Li Juan and Wo Yu Jun)Donor Suitability (Aziz Nather, Wo Yu Jun, Sherilyn Leong Li Juan, Norimah Yusof and Nazly Hilmy)Procurement and Processing of Amniotic Membrane (Nazly Hilmy and Norimah Yusof)Section IV: Sterilisation and Quality Control: Sterilisation of Amnion (Norimah Yusof and Nazly Hilmy)Routine Quality Control of Processed Amniotic Membrane (Norimah Yusof and Nazly Hilmy)Section V: Clinical Applications: Management of Wounds: Use of Amnion in Plastic Surgery (Ahmad Sukari Halim, Leow Aik Ming, Aravazhi Ananda Dorai and Wan Azman Wan Sulaiman)Role of Amnion for Treating Burns (Hasim Mohamad)Role of Amnion for Healing of Wounds (Menkher Manjas, Petrus Tarusaraya and Nazly Hilmy)Amnion Dressing in the Management of Radiation Skin Reaction Following Post Radiotherapy (Menkher Manjas)Ophthalmic Applications: Freeze-Dried Irradiated Amnion in Ophthalmic Surgery (Nazly Hilmy, Paramita Pandansari, Getry Sukmawati Ibrahim, S Indira, S Bambang, Radiah Sunarti and Susi Heryati)Multi Layer Amniotic Membrane Transplantation (MLAMT) for Ocular Reconstruction (Getry Sukmawati Ibrahim and Havriza Vitresia)Oral Cavity Applications: Gingiva Depigmentation Using Amniotic Membrane (Retno Dwijartini Tantin, Basril Abbas, Paramita Pandansari and Nazly Hilmy)Amniotic Membrane in Periodontal Regeneration (Shaila Kothiwale)