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Ega. E.E. {BarooM.A.,Ph.D.
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PATTENTS GUIDE TO SAFE SURGERY
By
Dr. M.C. ParekhM.D., F.I.C.S., L.L.M"
INDIAN SOCIETY OF ANAESTHESIOLOGISTSSOLAPIJR CITY BRANCH
ca(Edited by:Dr. Sou. Yidya A.JeurkarC-1,Nath Pride,Samarth nagar,
SOLAPUR-413 OO3
Fh: (0127) 2319998
("franslated by:frr" B.ts. PujariSangameshwar CollegeSOLAPUR- 413001
(Copies :1 000
(Printedby:Mrs. Suj atha Subhash ShastryNew Kalyan P. Printing Press
94/223,Iodbhavi PethSOLAPUR -413 OO3
Ph: (021 7)26004AL
(Frice:40/-
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a-oo$rdd1 De_:bg_d" udaa*n Joe{ urbdroe.r_. dr de-ridabo
d;ot^: Do$o$raaod d.radgl egdded dEd; o3oerl, {aJuaeoCEddd$4 sedz,Jerarbd_d. elfldd: "qd> doe dreOd dar? ! Edddddrr dadroJs.:dd droenrl doe{ r-ad>d_d. €dm duidddoen "eufdaerfe.:t dt{ da$o$ ziedt. "adood "qdd eaoeo$rld
d;eei doraaal: ecr$d xat'*dor;d:{d.
4) dddo$ gtreart):
dddo$d) a,cd> do&dod uadd;san te.:d drodqd. *d:qdd-d$4 difldd drrasd d,:{rl"os,tr udabo dedd ao_ l:arfrlerlod{;mdrl$ aJmed $)qEbd de.tdddl drec$d_C. drdoJcd ue:a'&d,:oJmerarf agraa-aoC,:t of,'.raed, idraeacJO_ Ce*do:, rir dae.: . -r do c C "a o g oJr rl+i roo$r {a$d dadooJsa rbdd,l o e..b.
5) ddJi (t,ungs):
wqldaod -qgfdrld: ;rosaddeod aaofu#dto ddd,:e, d d 0_d es a$ a
"i d a3 d1 i o
1i b a do Sgd_ d. dd dcl> n c d z-l o d d { il S4
d: { do e ;i: d_d. marl,ra d o e d dO_ dcdsaroa rbd ra ur af * dr- u {, *l d
dd1 taaoid t}ood dJ}dr? Dd)d_d. dddd r^3.st., 6-rdd cr',
dd-s.o$rl dwoat ....... / 11J,J
dn d,neDoCn doerlrlg{d ryraasoj:osd dduooarc da& eJrbd d"
a"ed ar*oS, ;3ldl -Q-qJnr(dl uoddood> ude':ozl:'d'
* dEd doerlrf$r :
o dd-d,nd-d (HYPertension) i
:o$adroon 120i80 MMofug u,{d dooSad t",d-ddoc3>
dorlr6nerond. I40190 t og q, dd-d t d-dc{d, doenoi doed*
droa e*dd* r-cdra d>cdls 8dd erudzrod dmdzSerorb{d" "eond
{rOorUrA d:rrldO- dd-dod-C t-oc3'l do{ d$iro3sand' udd
rcdorl .add oflearif.e 'ad:dae-:-- e{ood eldorl (,d> ged:
udr$de "ae.r-. ud$ de.: U{;}C'>oSr doed*o$ ddro$dCI- doeflri
B. P. .r {a1 rlooUtd-c. eldd* odro{ de rodr")'a e-6{do u dd1
aa,o$d,>o a3ddo"deN6d$ "rodo ddoJrerori;d-d' eeddu osoeil,
edd nee Oo$o$ea a$ndoar$d-d" "adQ hoJ':o$eo dsadn{d.add "aoQo$dd dred udd fq dOmad> eroourorir{d' drdo$d
dreej da3: ud-d trdl dr3l do&ons' alncds"Sea-arh{d' drdoJrd
m*o$rrld $eeJ ddg t-{d ?i(d)qd. eCdu dt3; ryraaaoJxnd*rid, cr$rd-d" uc$ ,ldaoyl doenrl addoe{ ud;d-C' e:rl
(9d) ae)-a{d mauir **ro' udud'rd'> (Infraotion) eldood
drdond qnlfderl d{ daa3r udeJd)cb, "au-d Do-Dd)ub, 'sdood
dddo$d. a-oc$r d*dld dad,>oJsartddl. "edd dordad> -add
Iago$d$ dree-lo 'sr$$&. crodspd Edfrl$: dd dd;d'nd-d
6a{.ra dddo$d g.Ero3, dcee3.doma* zsed:{d' u{ood d!}od'>
ddarrl d{dod-daod dd-ryd dr.?,o eod>*d dd-Bd elrlzrd>d:
tldilD ds;t:F sg3ar6" srlud>cb.dqd dd-d'nd-d "adldddr ho3rDld eludrrod
ajdo$e3eu-arb6.,d. UiJ$o*ddrl a-ono dodd doc5a DdcdJ
8dd drfdrdog*uJeFrdre'-d. dd;gofrrl d'ncje':r 3ed)
d;GCrzuaddo6{d.ro EdQ $orleo {e-:.,, sedr deadudlcb'
di Eo3crl d$oe,3 ....... /'12J-:lJ
*dudoJcdoerieeee{ededd *Aimn ddo$aieaadd dddo$ drd:6das-ondz'3edc.
dddo$ drd:,daandaqd doedd "edd cado$drlgrl d{ €Bddd
iool'aR e7${)6o-. el$ noo$an doi dr-od>{6e,'- u{oodeloded Eddacd d{dJad-d aarln dddo$d goSto$ d>ee3 demad>
urf,:{d$o boC doeaded. e*Cr"in dodo$d doeS*dsoa, E.C.G.
drlC), eldd {&do3:$o ggcnEodoz3eror$d-d. deld de-: xduaodele
dddo$ doed uoadud>d>, z^:dd ie-: dddo$d =aood>iid d>ed
t-d-d uod> xa,oJr.iJd a3>eeJ aarLo dddo$d d{ €odufoil d:ee5
domaa$ sdudrCn. no$ :iaio3:dO- doeno$ ,4j* a3rcd:aazl
code8 dqd; tnddoddor:od Edt' Dedd& eldrod eli'ldraand-.q.
erd& drdc$d $eeJ dad> dema* ce&d Eddd$4 uSioqd.
* ulddoedd doed e e e e . ,.
enodBod doeddo a3eaaaoSll x,rid-C. udc d{d dlarcodd
ae-:- erorlrlgrl doen dl:t,s"rd-d" uga-aorl endEJE ua-idoedd
d.oerlaorscn m.eaaco$o d6* gdlDsadq dedd* x,r$d-C. "edood
e*mo$ esi$d'xaCod "ad.
1) drra :
oJ:adde iodt'rd{ doeflrl drlao$add zsod dsadd
a-odro s d; d ne-:-. et dd d{$ of;os; i o d qlr dO doe n rt drleoJndd
d#u,, ddt, dtdt.:drcb.' erdood d,nefld,: €erod dL dad)
esri:dd;ct-t. u{ood dr{€a de*Cro,tdddri d4jo} duod
C,n&{rt, t dr,o$d). dgd:dud-O- "ac: dt:1n dod:trdld-d-
2t ddosr ua ddroedd doerf :'a5
dd$e, d;3;u "aQ1 .u-gddoedi d;eej ndodd iomad>dd>o
tred.:d-d. "adocC erc-fd'raedd Labd d6$odndou-d" digabri;:iuot3 ugnd"aedC en:#?.rcddraa l{o3: :isri d${rd> esrldo. *dq
ry.ri.d1*5,iT*""=?=1:tTn'.4t -di s oirrl ul:cozt ...."." I 13JIJ
3) dcfrdced lnianetis; :
.qoad adrldO_ a$fr,:dredd crodd dd*d doerld giduaredzo nd. deddO_ .aosdne)no $do, dBdt e:erorl a$t'odtedu dt d_d. mdef g oSrJ dO_ "a aF dn O if doJoroa rld_d. el d>. d r d de)doJ:aroa rt d d d*d o$ gi dlo ea d d:o D o$ o $ ro dO_dr g_d. i d*d o$ $4dL"J, doddO* dod,Brir:d_d. .qifdrre)ep dBdl -.g;*Drade)_
wd.,8_oJsadd dd*domod ,c,rl,)d dS_o$o dadr qfdsaradO_wdre_o3nrbd_d. a'odo idrdo$ €dor esa{oJrorbd_d- "edoodddud doeri eruoororil{d. dd_ aaSoDrl$o wutrd_d. dd- gidnead&dro3sdrd_C. dtdl dedd dcee3 dom-oa$aadrd_d. adedaandrdo3t, dm$"lod, drogrld d,>eeJ dedt dom-oa3taarird_d.dlt';d,:ed z"od; sdodobd 6'JobeJ. eir -eg -dod-soob-elea -ddrn ud*-dcnrf drfidtedsdd doed* droado{ded:. adodd&o_od,n .edd e-:d*rorldt rord-atd)ao_. zyodgcf eldafdO d)ddcftdled id_cd (stress) eod t-dtuel wlid,rai e.a*+udrdr.
an$abedd0 addr gir-odried : loci: r,Sd*docra RiloduouoCci. .edr ei;bdobdasand; ud$ riozpedarond,:{C.
d$crrf duod-"ndr-dodd ndd;an ddddo$ €ulnra***SoeB .ssrd.,,aO;f doene doduieuorb{d. udt eJe ddod gidmradedloJrodd *edd* aaDcJrorla.rd)c$.* z.loerl (Obesity):
.+^N. r ^:ftriodo,.ra-ooj;u;oojre dodrf d,C.orteausa! vJo'\t lt IUUJd 'gsiJUUJJUcJ( U D
gdcno$aaaidrd-d. do?d dedd dodoooah drdoC;d dreeJ
r.d_d duor$d_C. a#odd ddCo$d CJaq dedd* eq B*neadO.,d{" €pddd Crcdz3ea-odtd_,C. a3eaamo3ocd erld, dtrc dld-d.
:,3e m "adrd ddS_rldO_ d3_dr?d_d, drdcJ:doerl, *f:d>:ddzsr*n dod: uoeC. xddd ecs-Jd dod*nq elO_ udf dadr
{i ;3:a radO_d)d_d. ecdooorn eldd* g xgddedd;e_ de o S fl irl*rfaohdsocd;d :3oz.3d dzQ- docd:uoad.
.aiorl eso;qJ crCra-ril dzdr {;SrcrocJO trd#
3J
SeCz3eaarbdd. erdoooaR epdcb ozddmrlsr dz$ ddo$ zSearbdd.3L'2JJ
er$ z3rrzo "ad;ddd$o aD&rlornod u3O,l, u3Oor>od dijc$ a3%r?
dooddo$arbdd. uodeE aarto dd S03) adddqo z3nzoV d.E derlr 3) - Eg 6r"-uoo$d nozpd .ad:d^d.
* dod3wod (smoking) :
fod3mr drod)ai drE-rf erodgd Se6)a-Jil erdded
dtc orl udd udzidrldr ud,:d d. adodd douoEdO "ed,)dm
Cdoet3sr dtdo raurao doaara oDcc$ erud e rd d d-oorsaflJ.\)J,Jd
doeflo3; dd_dod_d drdl drdo$-dtdddd dreeJ dom-odtaah
o)e-:_ eldc3:dilerfl dd_d dpdrdo3o lidnea dadtoJron'r-d_d.
eldoooan asa ra;rooj:rsa' dduuart dad;ojmn ue-:Eoea'dJ
AJ \JJ {' (.J .J
dd dO dtd dedoerf,n erlasde) rouroo doe;naa cacoeo-o..]dtjr d.drosadO ded;d d. deddoedrlerl t;dc rdddd,>?J J m 3 o ----a
de-::"ldt;J dod ded,nerfro e$il6 dmcdtd_d. udooodddx"yanojre tgedd.roedrl*rf e;dt add (a3,eaaraoJo; dad;o J-: -9ilIlJ\9 G,).r
doerrrl "edd uode "edodae;-. adodd aaqadea
io,$ goJ)O adr zje d.ee ecdc esd; add ,s,rfud d. ud,>Q m eJ c^J m r-'-
nasai$d-d. esdd uodgd De&ord dzit esdt esddC errfd-rx3---d.sd;d^d. urf sd; xddC f,.odd srbd^d. etddod "aod doenridJ-J
drts- erurbd)rl9t dS.,- ce e)oJran dtd_d. u{ood ero ded d W,fdd drodnd crd; xddd d.ayosaddr $9drd,n$e-:t d;$;srrfld d.r - r, q , eJ-- -r---
-'r ^---)' --^r6?f\ ua ior$dr udd iodeddbee-:acnd:d d.lCJdtneNU. oJ _ Y dUsJ(UJN<Jf E/qJc.JI llJ. J
erdoonaR erO dd dzrcR yJis.oi)r? elddd erDo€Jr dr".ddd.. - J iJ d J -------r--'
ue-: C ddr:,, Cd), , 6){)xC dceil nd de3: d;$aaade) dodlal6d-d.m Cr' IJ J ------- -- r---uCr-o*R o3oexa;ud*uod dt'eoJtrl d,:to?,3 5 ooa 8
aodrldddrl dradgaad s)t^U ?,:d)dod doenri iod nederrrfud_d.
u!!,osrrf d*oal ....... / 15
i cDodoiDdrcb dd aar$d d.Qcjr
epg dzs d zdzlEoood ixsdorlo
*oJ.tJ
* ilfrw-od (Alcohol)
d,oeflo$r d>drmd d,iboJsnqd eedarl eroded ted)-rrJ8ed8o umo$ ldtd-d. drdr*adaod oS:drd (.t;d-doed) d dreeJ
dq., doraad:aarbd-d. ad-doedde) EddC €gC. ddd> d,omodd
ddoJ>r.9-drd-d d:dl- dodrl d;o$.rodd d*avaodd d.odrf
d,nerbd-d. oidddd go$rds- daaboltrdd eodeE Eddd dor6ad)
udd d.od}"ad>{d. ue-r-d e'odsd aec$mrlem otoer! gldneodo-.
Dcde) doeaaariod,d. dd- ddr-rJtJ"rdod €drd qid:aradO-
dad:oSnCd d{t,ol:o$O- dz31 d{Bd urfid-d. oiuud togd:)-
#>o d, "r
odrJdl n-a* eoJc a-orlc d ;io tJdD dl d-d " el ddo d 6a tu d o$J9
€dnead dasorrri.:d-C.
d.rd:dori e:oded aed)arl dzd; idlotod Eddnedt.3emri,>d-d. e*dooo'oh uddc aufdd* ude-:c dC: ddco$
zJea-cdrd-d
* dne&r? q?dm ad) r . e .
;>;dr*tod dd:rl doe$d doded,lrb{d- doedd ae,' ddo$
J,nesd doded drro*dodrrld a$ood (tudd) us} rud:ed
udr-d-d. srl da$rf doeDd ec$tfC urbd-d.
a:drcJ,) zJB ed eDc$9d qrcrl;:and' "acb uj{e-nzrd add"re'
rpcrlr(sod dpod>dod: D;drd> ddrisrJn ddad)d-d. e3doolu:l
a,oCdd;eeJood: Coee:,d 30 ae.:;zbd. fro-tdrigod doadl{d-
"adrl# ddd DISC dodd ?Parl ed:*C. "ac$ md uuiddcfdod de-rd dr;d)d-d.
. cdodoeg cdr=e $aaddabo u{dddrf dea-cde)- $oaiq>
aadrecJojoe etdeoeg DDd)gd dodeCJrlddro doedd CodCe
ryodd* ao3 o$rl9rl de-liCod aDo&drlo gdu sadri:d.
ai d) I d ao o$ r rl d d5 i o d e d d rl $ di A e d o -^* d t-o c; r d d1
(,o#9d 8dt'aod nO rizJd)dr "add* xddor ude"leaC5J uda-J
io{prer eo d9d adlose-d.
di 6o3rr? $>oal ....... l'16-JJ
a.
I
I
i
edo C Jsdr$tugro$ dJgdO_ .e%d scdrd;ueoo$ ddd-J
f,.gdO- eroieE Dea dodedddd$4 &)cberf $qdod d:adudod.
"add* oerdor udieAoJro ufraro eJoede:o ude{aoJro .tod;t'dofuo1d.
* add.o {o-.rdd soded d{so*$o dede-: a{;}oJ;Coid:ro$dO_ drc$ u9$aa_d. dodd doen dod'Odod .ae-r
dodeddrlCCi $s.tea_i.€pcar €otcl8 ddd deenrl o$addra u4dddO_ "acbQ16e-:_.
di So$o$O eded d,nedr "cdtdrOe;. "ad doed$ dcedr&aadd:P - m O - <t------v'-
8dt'rl9od ndmdd dnderor$d_C.
* epod$d/tpodsd {aadrfst . e e , i
doedl CandrJri e*Cea, erum-aoJtrfsd. q]3o3ooCtwaaCtd0_ ercqJ-u-c& ;dd-o "ed. doefirl C:-od eruano$&od
dd1 aae "lem clc?.$ddlo Sgdtdraod; erodsd dEd; 8ddned)e1d. oaoroodacn dc-qJDrar c+odgd ted;{ddo rdds6e.ldf,eaoJlo o.:d: ddoj*ea d. aLJd "sd;ilJrle;,n dornrl di toit
Qrzj-J.)inde-u ;odr. er-dd o(e:dc:s udiebCn dod:so d.
tl{AgorgO#gdeqeee-qCde) d'oenrl md b€ uobC Bdt'd$d1 d{uo$dO_
*.n d:q,d. do e Qt D drdd a;a r(n xioS d +Cr1 b e e-: rlo 9i; d I d dd eb4
&(d)si_d. dr oeg d'aed1 dbd-bee xaoo3m- otrLa oouqOderodgdrl dpnaE z3edtd" eid{ acCr ddoJrtso d. ;oooJw
bqe dr::,>o ooh drae ft o3sa$ de :6e ot{ u etrra d,l{r A e-:_. el dO oooR
d-14i ob oS,n e rl, O e g d) o L5 d;o ge-:i aa drasc rb {d.tlod*dobod d*do$, d4€dJd, saoioeuauid dlee3
doraa#rai-ari:d_C. oJdd')". soito$d;afcJt, s;G rJGd.to$&:danri dt41 dt, tooji o$dc{ dt, .a Ce.:_dd1 eeo ded dqdt
il
!
al,.ra e a d.ro s!sa_d" dd g d: T* n qn { a C qrl d;> a;o o dd d-o g d olc c deJEt;66 Sed)Q)ci, dd_ a;cd,o elrid*arod qidr, dotolraf ; duod;;:ex6
di-s.o$rl d:roal ......" 117u-.tJ
&ed)d)d), A$6' giaadd doDt.txprrlge)_ adrdo$d $o3;, dd_Ce)_d
ryraano3>ad 5!dl-oro, mzJF;Jc d, ud^ra0 qidrora, dc,n$C
giaScro, r3d d>oead caded Ddo$rl$$d elagdp-oco3nn dneado$o
z3ea-or$d_d
a Au;raReo$/xa nd eod9d/Oerdef eldet' eboJra :,,QQr'e-:dpdc, rjoefln' {pror eroatqa' Sees')aildJ
umoJ:u-oooSsorbd-d. ed"5r de.:{ doenrJdr azd dannd} d{jobdnaxEed.e-u "ad. dd>go^d. eldorl xqDd "ae.:_d azponeoJ: eto*ed
C/EJJQ
Sederri$d_d.
Drd:drugoo$ ddr{dr &d.>rd doSo$od de;d ;Jsadlqd.do9 d:oeradd erSam dpdwc drldd Dqd d-d sogd_d. do$d,rde&3leJall d,)6ud uoEcorl a$-d_ $d%sc dd8"iDd_d. eldoegdodeddrldr &)c$gdddrf d,nerfidddl nodfloo d:ne-:d 8dq'
-q J^.J-J-..JtG, c'JC, ;.l 6J6J(JJ.
L*re; dsqpriaod tuc$$: rrev eJdorJ (Spinal cord)oarbd_d. mado z3dtooced ddzdde)_ ddef,ooad,rd_d. alc$S,>
a-orio tud)du9a "a{ uod; dd (iozSg ED)obdef qi_ollar) d0_ird&daandrd_d" dt dd vot6 errtrdoodddod te-ri dsod>d_d.
tudr*J rJgeoi addo u80bod erds dodd xoox d}ne-:d eeodg8
Edfddl Dec$qd. &>d>Srus*,Cr 1!dde)- dr 8dfr oJrou:
drgdddrl iedrd_doSoe u a$qd ddr? dedd fdqrorl erodsErl
e. S no rlc d_d. :J g - s" d doa d- do e { rl I i o d e d d n dr d a e-:_" aaoc3:t
bQe.r;rori>d_d" doenodo u z;rorldd;o ele.:rrroade-:r nodr&e-:_. urparl ddo doedd rErrlde.:- aoc$ d,oenrl erai,:d-C.
& dqeofD nadrodr;san do{o$ ddq:arrd d{3o$rleronwdo$>d_aond. dr dqeobod x-*d d>dt drdo$d *te3 d{ea
€q:a;S ecrbdBe_. z.ode Edfddr naodd*oo dloe-:d .leE
uodedoJldl ddr^:dtd,>. udraon ryrdoodd d,raodd "ad:ddorl *dcj 3 uod$ d c3,nerd6"oojrond.aJ
"aO_ d"oeRo$o azfldmncbeld. ednoC ,ro idaad Prrbd_d
di s.ojrrl dr>o?,, ....... /'184.)
J
!.\i
dod doenddr ddr, dedtporl coau0danR eoded (t'ood)rf
l drron d; #do u de-:.do$ d.,a4 dd d d:a d> $ a e.:-. "a d dO- d i9 o3,
ddoart :doenrl iod-$qOd dox6g rloqt$.9-dtd-d. 'ncli elo-
doenderl Soadt$6e.1-. dr epodgfoJrdl z.odood dtod'>
a:bridddrl atn$ Eodel sadr. erdsood dt$de$ ddo$Dd d$o$rl* ddgo$ egodqd Aed>drae.:.
"*rro.l q*r** tuiu* dodcaarl dd- do8o3:d1u$loe-{dr. epdood 5id r.do doenrl deJzied udre-d1. *decs deo i.,or3o$$ u$:bao d. ecdood deit"Sed "ee aDRd. "adoodca Gt r (v)
x-eo$dO e,.Jeb,doesd d.dmeo dzArbd^d aou d{r", dozrdoud.rJ---- - -- -- 4 .j L, r
ud8, rscDdse.:.6
e*oded secd)d "eJ,ooodr dqeocrd. eldd* .ladgdefeldefCe:,o3ra a$oqd. "adde2 dn oo dod*d url>{ae-:-. dld}qid foedrd)6e:-. -rdood del$oe$ ud,>{6el-. l
.add a$uood d{o$odd "aadn def eldm doroa di aDcbsj)
rJspdo$ eddead d,Jadnd mriCO (.e&dradde>o {rrr) nadgdefdnaolood drq r-a^Seuld doadol xadr. dr mrdetsd afuodrc0 0'a#drl$ ddrt "sde) md*ad. .sdd d>lae:d tcodgf, ddd$dld.oden&d-d. .aCd doms{p dd xlooodef tlCIdedo$ode .a&{d.
.lde dd 8o$d1 doeQlds"d $doernnoj:n uddudlcJo.e
* doe$ dE d dorl*rbaif zsd" Dedr{cb dt?rd *eddd t-od a$d{d marl,ra
t'soddaad *eaaDn*. e:dd dr el$tt'ddd.:o ddo$e-:: drag
qg maodd;rt d do e dd1 .er $ rJcdaJeuar${d.
1893 UO- cst. eroas irtre 'ad& sdrge oo3ro cnr5oS>
aot:fo$ dort iodtlrde)- d,ne{ Daaddron 8o ed,nepdtrrz^l$,r,dd.. dori dne$ daaboliadodo. erdf* cnr,;3ndod dndou$.uCd udog/d rosdO d{ dd eo$D erd.goc$ t'sdf;darDRd0o .
*orrosl *oe613a.oann{d'adg doJ aoa> uddaooJrcaori er$-rod-d. crded FJo$oedt Sotcd t$o$aod dC*sa^d.
di s ojcrl dr>ozl ....... I 192r
tl
etdd: doed$4 idd a3:ad{ao. dorl i$o$do- eeded o-JEao$Dd
C. d.rldr, mdoE e d:il$t doe ddO- Sdar eaacr$d-d. doeslo d-J--s-'--', -dqd ud-d a-orto dtpordo$de-dcd dlrilDrl a3eaaaoJuDd
iduoadd-O- doodd er{t^:d>d:.
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tr * do'"9$looan'ld eDryn'gl :
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d{!,oJcri aJ:cozf ....... / 23
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dd s.o3orl aboal ....... / 27gJ
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s4DearAnaesthesiologist . . . .
Yours is probably the noblestSpeciality amongst
The noblest profession.For you,
. Work silenfly withoutPomp & Limelight,
Yet you bear theTorch of life.May your speciality BetterUnderstood by the averageLayman & may be greafly
Rewarded by God almighty.
-Annonymous
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