Medical hand hygiene refers to hygiene practices related to medical procedures. Efforts to comply with emergency preparedness procedures and international guideline requirements continued. Paralegals perform tasks requiring knowledge of the law and legal procedures. Others address issues related to federal authority or modify government processes and procedures. They can include medications, medical procedures, or surgery. One of the first surgical procedures developed was percutaneous tenotomy. Cocaine also causes vasoconstriction, thus reducing bleeding during minor surgical procedures. No documentation of informed consent for these procedures was found. Silicone personal lubricants are also available for use in medical procedures or sexual activity. Circumcision is one of the world's most widely performed medical procedures. The accident was attributed to improper maintenance procedures. There were lapses on implementing Government of India procedures. It made 108 recommendations for changes in LAPD policies and procedures. Research into CLSM techniques for endoscopic procedures (endomicroscopy) is also showing promise. Taxonomists are also concerned with classification, including its principles, procedures and rules.