A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
Dr Neerav Goyal discusses the various aspects of acute liver failure that includes the criteria, pre transplant issues, critical care management, overall survival.
Acute kidney injury (AKI) is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days.It's most common in those who are critically ill and already hospitalized.
Complications of anesthesia
This topic aim to provide information on some common clinical condition that occur to the patients after anesthetized required procedure
A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
Dr Neerav Goyal discusses the various aspects of acute liver failure that includes the criteria, pre transplant issues, critical care management, overall survival.
Acute kidney injury (AKI) is a sudden episode of kidney failure or kidney damage that happens within a few hours or a few days.It's most common in those who are critically ill and already hospitalized.
Complications of anesthesia
This topic aim to provide information on some common clinical condition that occur to the patients after anesthetized required procedure
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Basic Civil Engineering Notes of Chapter-6, Topic- Ecosystem, Biodiversity Green house effect & Hydrological cycle
Types of Ecosystem
(1) Natural Ecosystem
(2) Artificial Ecosystem
component of ecosystem
Biotic Components
Abiotic Components
Producers
Consumers
Decomposers
Functions of Ecosystem
Types of Biodiversity
Genetic Biodiversity
Species Biodiversity
Ecological Biodiversity
Importance of Biodiversity
Hydrological Cycle
Green House Effect
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2. objectives
• At end of this lecture you will able to know :
• Definitions and pharmacology of Isoniazid
• Toxicology characteristic of Isoniazid
• How to diagnosis of Isoniazid toxicity
• How to Management
3. Definition
• Isoniazid (INH) was introduced in 1952 and remains the
antibiotic most commonly used in the treatment of
tuberculosis.
• It is first-line treatment for both latent tuberculosis and in
combination with other agents for active tuberculosis.
4. PHARMACOLOGY
• Dosage : 5 mg / kg/ day , Up to 10 mg/kg/day
• Absorption : rapidly absorbed from gastrointestinal tract GIT
• Peak serum concentrations : 3 – 5 µg / ml within 1 – 2 hrs.
• Half life is about 1 – 3 hrs.
• Metabolism in liver via acetylation.
5. • Hydrazine a component of rocket fuel that is also touted as an
alternative treatment for cancer, and monomethylhydrazine,
the toxic component of Gyromitra mushrooms, are derivatives
of INH.
• They produce neurotoxicity and hepatotoxicity in a similar
manner.
• INH is an inhibitor of several cytochrome P-450– mediated
functions, particularly demethylation, oxidation, and
hydroxylation.
• Significant drug interactions exist with INH.
6.
7. • INH has a significant effect on several biochemical pathways.
8. CLINICAL TOXICOLOGY
• Adverse Events
• The most common :
1. Rash
2. Neuropsychiatric abnormalities,
3. Abnormal liver function with the appearance of jaundice
9. Riskfactor for inducehepatotoxicity
• INH-induced liver enzyme elevation occurs in up to 20% of
patients and in most cases is asymptomatic.
• 1- Older patients and in slow acetylators
• 2- Alcoholism and active hepatitis B infection
• 3- Multidrug antitubercular regimens
10. • Acute pancreatitis has also been associated with INH use but
is rare.
• Approximately 25% of those taking INH develop antinuclear
antibodies
• Peripheral neuritis has been observed in up to 20% of those
taking INH at doses greater than 6 mg/kg. (patients with poor
nutritional status, alcoholism, pregnancy, or hemodialysis-
requiring renal disease at greater risk)
11. Acute Intoxication
• Acute ingestion of 2 to 3 g of INH leads to toxicity.
• whereas ingestion of more than 10 to 15 g or 80 mg/kg is
usually fatal without aggressive treatment.
• Severe INH toxicity correlates with serum INH concentrations
of greater than 30 mg/L.
• Clinical manifestations appear as early as 30 minutes after
ingestion
12. signs and symptoms
• Nausea,
• Vomiting
• Slurred Speech
• Dizziness
• Mydriasis
• Tachycardia
• A subsequent cascade of biochemical events soon leads to the
striking clinical features that characterize INH intoxication,
namely, recurrent seizures, severe metabolic acidosis, and
coma.
13. • Seizures after INH overdose are episodic and tend to occur at
regular intervals.
• Once they begin, seizures are difficult to control despite the
administration of anticonvulsants.
• Seizures refractory to conventional anticonvulsant therapy
are a hallmark of INH intoxication
14. Severe metabolic acidosis is another prominent feature of INH
overdose.
• surviving victims may present with a systemic pH as low as
6.49.
Coma may be protracted after overdose (lasting more than 24
hours) and may continue after seizures have abated and
metabolic acidosis has been corrected.
Other clinical effects of acute INH intoxication :
• severe hypotension, hyperglycemia, acetonuria,
• abnormal results of liver function tests, and renal failure
15. DIAGNOSIS
• In the absence of a history of overdose, INH overdose may be
suspected in patients who present with the characteristic
symptom complex.
• Only INH overdose has recurrent seizures as its hallmark
• 1- The differential diagnosis of severe metabolic acidosis
• Diabetic ketoacidosis and the ingestion of cyanide, methanol,
• ethylene glycol, iron, ibuprofen, or salicylates.
16. laboratory tests
1. An Arterial Blood Gas Determination
2. Electrocardiogram,
3. Electrolyte Measurements,
4. Liver Function Tests,
5. Creatine Phosphokinase Determination,
6. Urinalysis
17. MANAGEMENT
• The initial management of INH intoxication :
• Stabilization of vital signs with provision
• of a patent airway, oxygen,
• cardiovascular
• support with intravenous fluids,
• and administration of sodium
• bicarbonate to treat metabolic acidosis
18. • Activated charcoal with a cathartic is indicated when patient
arrive emergency department within 1 hour of ingestion.
• Ipecac-induced emesis is contraindicated owing to the
potentially rapid onset of seizures and risk for airway
compromise.
19. • Intravenous pyridoxine has been shown to be highly effective for
INH intoxication and should be administered to all symptomatic
patients.
• The milligram dose of pyridoxine should equal the ingested dose of
• INH.
• When the quantity of ingested INH is unknown, a pyridoxine dose of
5 g (75 mg/kg in children) should be administered.
• Repeated doses of pyridoxine may be required based on the
resolution of signs and symptoms.
• Pyridoxine is commonly dispensed
• as 100 mg/mL solution with a pH ranging from 2 to 3.8.
20. • Anticonvulsants remain important in the early treatment of
seizures
• ( The benzodiazepines are agents of choice ).
• Prophylactic administration of benzodiazepines has no proven
efficacy.
• INH has a small volume of distribution and low protein
binding, pharmacokinetic features that make it amenable to
hemodialysis and peritoneal dialysis.
21. References
• Haddad and Winchester's clinical management of
poisoning and drug overdose 4th edition.