Modern surgery has its foundations in the 18th century work of John Hunter, considered the father of scientific surgery. He conducted experiments and built a collection of over 13,000 specimens to advance surgical knowledge. Important later figures included Pott who described tuberculosis of the spine and Cooper who performed the first successful abdominal aorta ligation. In the mid-19th century, the discovery of anesthesia like ether and chloroform transformed surgery by relieving patient suffering and enabling more complex internal operations.
This presentation of introduction of laparoscopic surgery made by Dr. R.K. Mishra Director and chief surgeon World Laparoscopy Hospital. Dr. Mishra in this presentation has explained present pas and future of laparoscopic surgery. Laparoscopy is a surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body, or to perform certain operations. World Laparoscopy Hospital is the center of excellence for laparoscopic and da vinci robotic surgery training and considered as one of the best institute in the world. For more detail about laparoscopic surgery please visit: http://www.laparoscopyhospital.com
This slide gives information about the various dressing techniques and materials available. Also information on traditional dressing materials is available. Vacuum assisted dressing has been well discussed.
What is MIS?
A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these struct uresIncludes laparoscopic, endoscopic, and other approaches.
Why MIS?
Decreased patient pain
Decreased patient recovery period
Possible decrease in inflammatory response in the patient which may prove to have a better outcome in oncologic operations.
Distant future
In the distant future, there will be a para- digm shift with the development of non-inva- sive surgical techniques in combination with nanotechnologies and a new era in the devel- opment of surgery, and subsequently in surgi- cal techniques, will be opened.
Nanotechnology is an umbrella term for materials and devices that operate at the nanoskill (1 billionth of a meter). In terms of scale, a nanometer is approximately one 1/8000 of a human hair or 10 times the diam- eter of a hydrogen atom. The size of the device can vary but starts from a ten thou- sand-logic element system that will occupy a cube of no more than one hundred nanome- ters. This is a volume slightly larger than 0.001 cubic microns. This would be sufficient to hold a small computer. For example, if red blood cells are approximately eight microns in diameter, the 100 nanomicroprocessor will be 80 times smaller than a red blood cell. Devices this size could easily fit into the circulatory system and could even conceivably enter indi- vidual cells.
This presentation of introduction of laparoscopic surgery made by Dr. R.K. Mishra Director and chief surgeon World Laparoscopy Hospital. Dr. Mishra in this presentation has explained present pas and future of laparoscopic surgery. Laparoscopy is a surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body, or to perform certain operations. World Laparoscopy Hospital is the center of excellence for laparoscopic and da vinci robotic surgery training and considered as one of the best institute in the world. For more detail about laparoscopic surgery please visit: http://www.laparoscopyhospital.com
This slide gives information about the various dressing techniques and materials available. Also information on traditional dressing materials is available. Vacuum assisted dressing has been well discussed.
What is MIS?
A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these struct uresIncludes laparoscopic, endoscopic, and other approaches.
Why MIS?
Decreased patient pain
Decreased patient recovery period
Possible decrease in inflammatory response in the patient which may prove to have a better outcome in oncologic operations.
Distant future
In the distant future, there will be a para- digm shift with the development of non-inva- sive surgical techniques in combination with nanotechnologies and a new era in the devel- opment of surgery, and subsequently in surgi- cal techniques, will be opened.
Nanotechnology is an umbrella term for materials and devices that operate at the nanoskill (1 billionth of a meter). In terms of scale, a nanometer is approximately one 1/8000 of a human hair or 10 times the diam- eter of a hydrogen atom. The size of the device can vary but starts from a ten thou- sand-logic element system that will occupy a cube of no more than one hundred nanome- ters. This is a volume slightly larger than 0.001 cubic microns. This would be sufficient to hold a small computer. For example, if red blood cells are approximately eight microns in diameter, the 100 nanomicroprocessor will be 80 times smaller than a red blood cell. Devices this size could easily fit into the circulatory system and could even conceivably enter indi- vidual cells.
HI THIS IS A NICE SEMINAR DESCRIBING ABOUT THE ORTHOGNATHIC SURGERY MAINLY RELATED TO ORTHODONTICS VIEWPOINT AND CEPH TRACING ITS INDICATION AND DIFFERENT TYPES OF SURGERIES. JUST HAVE A LOOK TO IT
Trends and issues in medical surgical nursing pptseema dhiman
current trends and issues in medical surgical nursing is quite important on the basis of improvement of care based on new technologies and situation.
Trends and issues in medical-surgical nursing
What do you mean by issues?
What do you mean by trends?
INTRODUCTION- Nursing has been called the oldest of the art, and the youngest of the profession. As such, it has gone through many stages and has been an integral part of social movements. Nursing has been involved in in the existing culture, shaped by it and yet beeping to develop it. The trend analysis and future scenarios provide a basis for sound decision making through mapping of possible futures and aiming to create preferred futures.
The world health organization (who) has been considering the future and predicts that by 2000 the world experiences:
Major growth in the elderly population
Decline in birth rate, especially in western counteries
Increase in chronic illness
Continuing social unrest
AIDS a major problem
Many infectious diseases under control
Mental health a key issue
Poverty continuing to plague mach of the world
TRENDS IN NURSING: Education changes due to changes in demographics
2. Embracing of technology
3. Advancements in communication and technology
4. Working with more educated consumers
5. Increasing complexity of patient care
. Increased cost of health care
7. Changes in federal and state regulation
8. Interdisciplinary skills
9. Nurses working beyond retirement age
10. Advances in nursing and science research.
TRANSITIONS TAKING PLACE IN HEALTH CARE: Curative - Preventive approach
Specialized care - Primary health care
Medical diagnosis - Patient emphasis
Discipline stovepipes - Programme stovepipes
Professional identity - Team identity
Trial and error - Evidence based practice
Self – regulation - Questioning of professions
Focus on quality - Focus on costs
IN THE WORKPLACE: High tech - Humanistic
Competition - Cooperation
Need to supervise - Caching, mentoring
Hierarchies - Decentralized approach
IN NURSING: Continued competencies - Competencies a condition
Hospital environment - Community environment
Quality as excellence - Quality as safe
Clear role - Blurring roles
Surgery is the branch of medicine that deals with the physical manipulation of a bodily structure to diagnose, prevent, or cure an ailment.
Ambroise Paré, a 16th-century French surgeon, stated that to perform surgery is, "To eliminate that which is superfluous, restore that which has been dislocated, separate that which has been united, join that which has been divided and repair the defects of nature.“
The presentation reveals the role of medical profession in ancient Egypt,the great advances in surgery and dentistry .The role of Egyptian medical papyri and herbal medicine in medical practice in enriching medical knowledge in various civilizations is illustrated .
A presentation on various instruments used in surgery..The presentation is about type of instruments their uses and any modifications. It's helpful for a surgery pg student.
WHO APPEARED FIRST IN OTOLARYNGOLOGY: CLINICIANS, ANATOMISTS OR HISTOLOGISTS?...ANCA MARIA CIMPEAN
HISTORICAL REVIEW
Otolaryngology is mainly associated with clinical practice. Despite of this actual evidence, otolaryngology can be considered, from historical point of view as a complex speciality made up of a mixture of several preclinical specialities as anatomy, histology, pathology and physiology. Several scientists who studied these specialities first, became then otolaryngologists and others were known in the medical literature because of their studies in other specialities than otolaryngology. Most of the historical papers were focused on the ear, other regions being neglected. This review presents the forgotten part of otolaryngology, especially its preclinical facts with importance in etiology and pathogenesis of various disease of the ear, nose and throat structures and thus, present work can be considered as a particular overview of „forgotten” otolaryngology.
Key words: otolaryngology, anatomy, histology, pathology
We know that the past is our foundation for future developments. We must build upon it so that we too can act as a stable foundation for future generations. One must be aware of the way surgeons in the past have contributed to Orthopaedics.
This presentation is a brief historical review Mankind's cumulative experience in fracture management which was Started by the Ancient very primitive trials and ended by the presence of Robotic and Telesurgery the so called Remote surgery.
The practice of medicine in ancient civilizationsReed O'Brien
Lecture by Prof. Osama Shukir Muhammed Amin FRCP(Edin), FRCP(Glasg), FRCP(Ire), FRCP(Lond), FACP, FAHA about the history of medicine in ancient civilizations; Mesopotamia, Egypt, Greece, Rome, Indus Valley, and Africa.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. Surgery
• Surgery (from the Greek: χειρουργική
cheirourgikē (composed of χείρ, "hand", and
ἔργον, "work"), via Latin: chirurgiae, meaning
"hand work") is an ancient medical specialty
that uses operative manual and instrumental
techniques on a patient to investigate and/or
treat a pathological condition such as disease
or injury, to help improve bodily function or
appearance or to repair unwanted ruptured
areas (for example, a perforated ear drum).
12. surgery of the ancient world
• Mesopotamia
• Berossus, a 3rd-century BCE Assyrian philosopher
wrote considerably about the traditional
Babylonian medical techniques (principally in the
archives of Borsippa) and went on to assert that
the god Oannes taught the Sumerian people all
that was to be known about civilization and that
nothing new had been invented. This assertion
seemed hyperbolic until analysis of Sumerian
tablets showed that the Mesopotamian
civilization had developed or invented numerous
medical techniques thousands of years before
they were re-developed or re-invented by the
Europeans.
13. • Some 4000 BCE the Sumerian civilization was
established in Mesopotamia between the Tigris and
Euphrates rivers, creating the oldest form of
writing, cuneiform. Of the 30,000 or so cuneiform
tablets that have been discovered, about 800 of
them deal with medical themes (one of these being
the first prescription known to have been written).
The name of the first surgeon is Urlugaledin, from
the 4000 BCE, whose personal seal depicts two
knives encircled by medicinal plants. This seal is
now housed in the Louvre.
14. • The Sumerians saw sickness as a divine
punishment imposed by different demons when
an individual broke a rule. For this reason, to be
a physician, one had to learn to identify
approximately 6,000 possible demons that
might cause health problems. To do this, the
Sumerians employed divining techniques based
on the flight of birds, position of the stars and
the livers of certain animals. In this way,
medicine was intimately linked to priests,
relegating surgery to a second-class medical
specialty.
15.
16.
17.
18. Hammurabi's Code itself
contains specific
legislation regulating
surgeons and medical
compensation as well as
malpractice and victim's
compensation.
19. • Egypt
• Around 3100 BCE Egyptian civilization began to flourish when
Narmer, the first Pharaoh of Egypt, established the capital of
Memphis. Just as cuneiform tablets preserved the knowledge
of the ancient Sumerians, hieroglyphics preserved the
Egyptian's.
• In the first monarchic age (2700 BCE) the first treaty on
surgery was written by Imhotep, the vizier of Pharaoh Djoser,
priest, astronomer, physician and first notable architect. So
much was he famed for his medical skill that he was deified,
becoming the Egyptian god of medicine.[15] Other famous
physicians from the Ancient Empire (from 2500 to 2100 BCE)
were Sachmet, the physician of Pharaoh Sahure and
Nesmenau, whose office resembled that of a medical director
surgery of the ancient world
20.
21.
22.
23. • On one of the doorjambs of the entrance to the Temple
of Memphis there is the oldest recorded engraving of a
medical procedure: circumcision and engravings in Kom
Ombo, Egypt depict surgical tools. Still of all the
discoveries made in ancient Egypt, the most important
discovery relating to ancient Egyptian knowledge of
medicine is the Ebers Papyrus, named after its
discoverer Georg Ebers. The Ebers Papyrus, conserved
at the University of Leipzig, is considered one of the
oldest treaties on medicine and the most important
medical papyri. The text is dated to about 1550 BCE
and measures 20 meters in length. The text includes
recipes, a pharmacopoeia and descriptions of
numerous diseases as well as cosmetic treatments. It
mentions how to surgically treat crocodile bites and
serious burns, recommending the drainage of pus-filled
inflammation but warns against certain diseased skin.
26. • India
• Archaeologists made the discovery that the
people of Indus Valley Civilization, even from the
early Harappan periods (c. 3300 BCE), had
knowledge of medicine and dentistry. The
physical anthropologist that carried out the
examinations, Professor Andrea Cucina from the
University of Missouri-Columbia, made the
discovery when he was cleaning the teeth from
one of the men. Later research in the same area
found evidence of teeth having been drilled,
dating back 9,000 years to 7000 BCE.
surgery of the ancient world
27. • Sushruta (c. 600 BCE other dates range from 1000
BCE to 900 CE) was an early innovator of plastic
surgery who taught and practiced surgery on the
banks of the Ganges in the area that corresponds
to the present day city of Benares in Northern
India. Much of what is known about Sushruta is in
Sanskrit contained in a series of volumes he
authored, which are collectively known as the
Sushrutha Samhita. It is the oldest known surgical
text and it describes in detail the examination,
diagnosis, treatment, and prognosis of numerous
ailments, as well as procedures on performing
various forms of cosmetic surgery, plastic surgery
and rhinoplasty.
32. surgery of the Middle Ages
• Abulcasis (936–1013) (Abu al-Qasim Khalaf ibn al-Abbas Al-
Zahrawi) was an Andalusian-Arab physician and scientist who
practised in the Zahra suburb of Cordoba. He is considered a great
medieval surgeon, though he added little to Greek surgical
practices.[16] His works on surgery were influential.
• In Europe, the demand grew for surgeons to formally study for
many years before practicing; universities such as Montpellier,
Padua and Bologna were particularly renowned. Hugh of Lucca
(1150−1257) founded the Bologna School and rejected "laudable
pus". Guy de Chauliac (1298–1368) was one of the most eminent
surgeons of the Middle Ages. His Chirurgia Magna or Great
Surgery (1363) was a standard text for surgeons until well into the
seventeenth century."
33. • In the 15th century, Rogerius Salernitanus
composed his Chirurgia, laying the foundation for
modern Western surgical manuals. Barber-
surgeons generally had a bad reputation that was
not to improve until the development of academic
surgery as a specialty of medicine, rather than an
accessory field. Basic surgical principles for asepsis
etc., are known as Halsteads principles. Roger
seems to have been influenced more by the 6th-
century Aëtius and Alexander of Tralles, and the
7th-century Paul of Aegina, than by the Arabs.[38]
Roland of Parma and Surgery of the Four Masters
were responsible for spreading Roger's work to
Italy, France, and England.
35. History of aseptic and antiseptics
• The first "antiseptic" methods can be found in many
descriptions of work of doctors in ancient times. In 500
years BC in India it was known that smooth healing of
wounds possibly only after their careful cleaning of foreign
matters. In Ancient Greece Hippocrates surely covered an
operational field with pure fabric, during operation used
only boiled water. In traditional medicine within several
centuries for antiseptics used to myrrh, an incense, a
camomile, a wormwood, an aloe, a dogrose, alcohol,
honey, sugar, sulfur, kerosene, salt, etc. However
purposeful, intelligent actions of surgeons according to the
prevention of purulent complications began much later —
only in the middle of the XIX century.
36. • Ignaz Semmelweis suggested to process before
internal research hands chloric lime and
achieved phenomenal results: at the beginning of
1847 the postnatal lethality owing to
development of sepsis made 18,3%, in the
second half of year decreased to 3%, and the
next year — to 1,3%. However Zemmelveys
wasn't supported, and persecution and indignity
which he suffered, led to that the obstetrician
was placed in a psychiatric clinic, and then, on a
twist of fate, in 1865 died of sepsis owing to the
felon which developed after wound of a finger
during performance of one of operations.
38. • Nikolay Ivanovich Pirogov didn't create the
integral doctrine about antiseptics, but he was
close to that. N. I. Pirogov applied in some cases
to treatment of wounds antiseptics — silver
nitrate, chloric lime, zinc sulfate, wine and
camphor alcohols.
39. • Nikolay Ivanovich Pirogov tried to solve
organizationally a problem of prevention of
surgical infections, demanding the structure of
"special office" for infectious patients. He
formulated one of the main postulates of
modern antiseptics: principle of division of
streams into "pure" and "purulent" patients
40. Nikolay Pirogov in 1870
Born in 25 November
1810
Moscow, Russian Empire
Died in5 December 1881
(aged 71)
Vishnya, Russian Empire
(now Vinnytsia, Ukraine)
41. History of general anesthesia
• Attempts at producing a state of general anaesthesia can be traced
throughout recorded history in the writings of the ancient Sumerians,
Babylonians, Assyrians, Egyptians, Greeks, Romans, Indians, and Chinese.
During the Middle Ages, scientists and other scholars made significant
advances in the Eastern world, while their European counterparts also
made important advances.
• The European Renaissance saw significant advances in anatomy and
surgical technique. However, despite all this progress, surgery remained a
treatment of last resort. Largely because of the associated pain, many
patients with surgical disorders chose certain death rather than undergo
surgery. Although there has been a great deal of debate as to who
deserves the most credit for the discovery of general anaesthesia, it is
generally agreed that certain scientific discoveries in the late 18th and
early 19th centuries were critical to the eventual introduction and
development of modern anaesthetic techniques.
42. • Two enormous leaps occurred in the late 19th
century, which together allowed the transition to
modern surgery. An appreciation of the germ
theory of disease led rapidly to the development
and application of antiseptic techniques in
surgery. Antisepsis, which soon gave way to
asepsis, reduced the overall morbidity and
mortality of surgery to a far more acceptable rate
than in previous eras. Concurrent with these
developments were the significant advances in
pharmacology and physiology which led to the
development of general anaesthesia and the
control of pain.
43. • In the 20th century, the safety and efficacy of
general anaesthesia was improved by the routine
use of tracheal intubation and other advanced
airway management techniques. Significant
advances in monitoring and new anaesthetic
agents with improved pharmacokinetic and
pharmacodynamic characteristics also
contributed to this trend. Finally, standardized
training programs for anaesthesiologists and
nurse anaesthetists emerged during this period.
45. Blood type
• The two most significant blood group systems were discovered by
Karl Landsteiner during early experiments with blood transfusion:
the ABO group in 1901 and in co-operation with Alexander S.
Wiener the Rhesus group in 1937. Development of the Coombs
test in 1945, the advent of transfusion medicine, and the
understanding of ABO hemolytic disease of the newborn led to
discovery of more blood groups, and now 33 human blood group
systems are recognized by the International Society of Blood
Transfusion (ISBT), and across the 33 blood groups, over 600
different blood group antigens have been found; many of these
are very rare or are mainly found in certain ethnic groups. Blood
types have been used in forensic science and were formerly used
to demonstrate impossibility of paternity (e.g., a type AB man
cannot be the father of a type O infant), but both of these uses are
being replaced by genetic fingerprinting, which provides greater
certainty.
46. Karl Landsteiner
Born June 14, 1868
Baden bei Wien, near
Vienna,
Austria-Hungary
Died June 26, 1943
(aged 75)
New York City
48. Modern surgery
• The discipline of surgery was put on a sound, scientific
footing during the Age of Enlightenment in Europe. An
important figure in this regard was the English surgical
scientist, John Hunter, generally regarded as the father
of modern scientific surgery. He brought an empirical
and experimental approach to the science and was
renowned around Europe for the quality of his research
and his written works. Hunter reconstructed surgical
knowledge from scratch; refusing to rely on the
testimonies of others he conducted his own surgical
experiments to determine the truth of the matter. To aid
comparative analysis, he built up a collection of over
13,000 specimens of separate organ systems, from the
simplest plants and animals to humans.
49. Painted by John Jackson,
1813, after Sir Joshua
Reynolds, 1786
Born 13 February 1728
Long Calderwood near East
Kilbride,
Scotland
Died 16 October 1793 (aged
65)
London, England
50. • He greatly advanced knowledge of venereal
disease and introduced many new techniques of
surgery, including new methods for repairing
damage to the Achilles tendon and a more
effective method for applying ligature of the
arteries in case of an aneurysm. He was also one
of the first to understand the importance of
pathology, the danger of the spread of infection
and how the problem of inflammation of the
wound, bone lesions and even tuberculosis often
undid any benefit that was gained from the
intervention. He consequently adopted the
position that all surgical procedures should be
used only as a last resort.
52. • Other important 18th and early 19th century
surgeons included Percival Pott (1713 -1788)
who described tuberculosis on the spine and first
demonstrated that a cancer may be caused by an
environmental carcinogen - (he noticed a
connection between chimney sweep's exposure
to soot and their high incidence of scrotal cancer.
Astley Paston Cooper (1768-1841) first
performed a successful ligation of the abdominal
aorta, and James Syme (1799-1870) pioneered
the Symes Amputation for the ankle joint and
successfully carried out the first hip
disarticulation.
53. Exhibit room of the
Hunterian
Museum in 1853,
housing the
collection of John
Hunter,
a father of modern
surgery.
54. • Modern pain control through anesthesia was discovered in
the mid-19th century. Before the advent of anesthesia,
surgery was a traumatically painful procedure and
surgeons were encouraged to be as swift as possible to
minimize patient suffering. This also meant that operations
were largely restricted to amputations and external growth
removals. Beginning in the 1840s, surgery began to change
dramatically in character with the discovery of effective
and practical anaesthetic chemicals such as ether, first used
by the American surgeon Crawford Long, and chloroform,
discovered by James Young Simpson and later pioneered by
John Snow, physician to Queen Victoria.[26] In addition to
relieving patient suffering, anaesthesia allowed more
intricate operations in the internal regions of the human
body. In addition, the discovery of muscle relaxants such as
curare allowed for safer applications.
55. Description of surgical procedure
• Location
• At a hospital, modern surgery is often done in an operating theater
using surgical instruments, an operating table for the patient, and
other equipment. The environment and procedures used in surgery
are governed by the principles of aseptic technique: the strict
separation of "sterile" (free of microorganisms) things from
"unsterile" or "contaminated" things. All surgical instruments must be
sterilized, and an instrument must be replaced or re-sterilized if it
becomes contaminated (i.e. handled in an unsterile manner, or
allowed to touch an unsterile surface). Operating room staff must
wear sterile attire (scrubs, a scrub cap, a sterile surgical gown, sterile
latex or non-latex polymer gloves and a surgical mask), and they must
scrub hands and arms with an approved disinfectant agent before
each procedure. There is moderate-quality evidence that usage of
two layers of gloves compared to single gloving during surgery
reduces perforations and blood stains on the skin, indicating a
decrease in percutaneous exposure incidents.