1) Peripheral artery disease (PAD) is common in patients with diabetes and a leading cause of lower limb amputation.
2) Endovascular therapy is now the preferred initial approach for revascularization in diabetic foot patients with PAD, as it is less invasive and risky compared to surgery.
3) Techniques like balloon angioplasty and stenting have high success rates for revascularization and allow salvaging over 90% of threatened limbs, even in high-risk patients, when combined with good diabetic control, wound debridement, and antibiotics.
Get the facts on Angioplasty (procedure to unblock arteries of heart), types, recovery, benefits and right candidate for Angioplasty, best Angioplasty hospitals in India and introducing free guidance on Angioplasty treatment by experienced patient advisors.
Coronary Balloon Angioplasty and Stents Procedure Information by We CareP Nagpal
Balloon Angioplasty Surgery India,Cost Balloon Angioplasty Surgery Delhi,Balloon Angioplasty Surgery Cost In India Info On Cost Balloon Angioplasty Surgery Mumbai Delhi Bangalore India,Balloon Angioplasty Surgery Center Hospitals India,Balloon Angioplasty Surgery Surgeon India,Balloon Angioplasty Surgery Doctors Mumbai India
Basics you need to know about heart disease and stentsZeena Nackerdien
This infographic is a starting point for people wishing to educate themselves about heart disease and stents. It is not meant to serve as medical advice. Please consult your doctor for any condition.
Get the facts on Angioplasty (procedure to unblock arteries of heart), types, recovery, benefits and right candidate for Angioplasty, best Angioplasty hospitals in India and introducing free guidance on Angioplasty treatment by experienced patient advisors.
Coronary Balloon Angioplasty and Stents Procedure Information by We CareP Nagpal
Balloon Angioplasty Surgery India,Cost Balloon Angioplasty Surgery Delhi,Balloon Angioplasty Surgery Cost In India Info On Cost Balloon Angioplasty Surgery Mumbai Delhi Bangalore India,Balloon Angioplasty Surgery Center Hospitals India,Balloon Angioplasty Surgery Surgeon India,Balloon Angioplasty Surgery Doctors Mumbai India
Basics you need to know about heart disease and stentsZeena Nackerdien
This infographic is a starting point for people wishing to educate themselves about heart disease and stents. It is not meant to serve as medical advice. Please consult your doctor for any condition.
Innovations in Percutaneous Intervention, 1977-2007. Slides created by Simon H. Stertzer, MD, FACC, FAHA, Professor Emeritus, Stanford University School of Medicine.
This slide will provide illustrative information regarding coronary angioplasty . It also focus on practical area knowledge of cardiac catheterization which one should focus while caring patient with coronary angioplasty.
Heart surgery is done to treat complications of ischemic heart disease, correct congenital heart disease from various causes including endocarditis and rheumatic heart disease. It also includes heart transplantation.
Surgical repair of patent ductus arteriosus history timelineRamachandra Barik
Congenital cardiac surgery is one of the most challenging and fascinating branches of modern medicine which continues to
advance in areas and improving outcomes, post-operative and pre-operative care.
Patent Ductus Arteriosus was the first congenital heart lesion to be successfully corrected surgically. The landmark surgery was
performed by Dr. Robert E. Gross in 1938 and opened up the possibility of subsequent surgical correction of various other lesions,
which were considered to be untreatable previously. The first successful surgical closure of persistent ductus arteriosus (PDA)
was preceded by years of work and contributed by various surgeons, physicians, and anatomists, dating all the way back to
the 1st century. They are all worthy of recognition and praise.
This article covers the important events related to PDA lesions including its first identification, followed by its description
in various texts and sources over the course of time, failed attempts at surgical correction, and disputes regarding credits.
These contributions to the branch cannot be overstated and serves as an inspiration to cardiac surgeons all over the world
and to students, interns, and newly graduated doctors as well, who would one day like to be part of this fascinating branch.
Innovations in Percutaneous Intervention, 1977-2007. Slides created by Simon H. Stertzer, MD, FACC, FAHA, Professor Emeritus, Stanford University School of Medicine.
This slide will provide illustrative information regarding coronary angioplasty . It also focus on practical area knowledge of cardiac catheterization which one should focus while caring patient with coronary angioplasty.
Heart surgery is done to treat complications of ischemic heart disease, correct congenital heart disease from various causes including endocarditis and rheumatic heart disease. It also includes heart transplantation.
Surgical repair of patent ductus arteriosus history timelineRamachandra Barik
Congenital cardiac surgery is one of the most challenging and fascinating branches of modern medicine which continues to
advance in areas and improving outcomes, post-operative and pre-operative care.
Patent Ductus Arteriosus was the first congenital heart lesion to be successfully corrected surgically. The landmark surgery was
performed by Dr. Robert E. Gross in 1938 and opened up the possibility of subsequent surgical correction of various other lesions,
which were considered to be untreatable previously. The first successful surgical closure of persistent ductus arteriosus (PDA)
was preceded by years of work and contributed by various surgeons, physicians, and anatomists, dating all the way back to
the 1st century. They are all worthy of recognition and praise.
This article covers the important events related to PDA lesions including its first identification, followed by its description
in various texts and sources over the course of time, failed attempts at surgical correction, and disputes regarding credits.
These contributions to the branch cannot be overstated and serves as an inspiration to cardiac surgeons all over the world
and to students, interns, and newly graduated doctors as well, who would one day like to be part of this fascinating branch.
APPROACH TO VASCULAR REPAIR, VASCULAR GRAFTS.pptxBipul Thakur
This presentation discusses briefly on Vascular Injuty, their tyoes, different types of Vascular repair, anastomosis and Various typea of Vascular frafts and their compostion, uses and the possible complicayiona of vascular injury including compartment syndrome, reperfusion injury and management including Fasciotomy.
Problem associated with drug eluting stentPRAVEEN GUPTA
This ppt will tell us about the problem which a cardiologist has to face after implantation of Drug eluting stent in a patient of coronary artery diseases. Although there are lots of problem but i am going to describe only three major problem.
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
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
1362573078 dr. rajdeep agrawal
1. Endovascular Therapy For Vascular
Insufficiency Of Lower Limbs
Dr. Rajdeep Agrawal, MD, DM
Interventional Cardiologist &
Vascular Interventionist,
Sir H N Hospital,Mumbai
Wockhardt Hospital
S R Mehta & Sir Kikabhai Hosp.
2. PAD is one of the commonest manifest.
of DM
15-20% of diabetic pts have PAD
Along with neuropathy & infection of
foot, it is a leading cause of amputation
Modality of Revascularisation
SX
Endovascular therapy
3. Goals of Revascularisation
Functional limb salvage
Functional limb salvage & not necessarily long term vessel
patency.Once the initial wound heals, even if there is
recurrence ,it is clinically well tolerated. The further limb loss
can be prevented with appropriate lifestyle modification,
control of risk factors & proper foot care.
In pts with Diabetes with e/o tissue loss ,every attempt should
be made to obtain functional limb salvage as many of these
pts.are critically ill, have multisystem involvement.Loss of a
limb adds markedly to their morbidity & sometimes mortality.
4. Ante grade Straight Line flow is
generally necessary for the healing of
ischemic non-healing ulcer or gangrene.
In CLI with Diabetic foot
revascularisation should generally
precede surgical foot care
Goal of Revascularisation
5. Indications of Angioplasty in
PAD in 2006
Life style limiting claudication
Critical ischemia / limb threatening
ischemia (rest pain, nocturnal pain,
non healing ulcer, gangrene)
Acute ischemia of lower limb
6. Critical Limb Ischemia
History
Severe claudication/Rest pain/Nocturnal pain.
Physical Exam.
Blanching on elevation & rubor on dependency
A – B index < 0.5
Capillary filling time > 15sec.
Venous filling time > 40sec.
Non – Invasive Tests
Ankle press. < 50mmHg
Toe pressure < 30mmHg
TcO2 < 20mmHg
Duplex scan /Color Doppler
7. Percutaneous Transluminal
Angioplasty
A new nonsurgical technique designed
to increase the lumen of the vessel &
thus prevent ischemia & its
complications
Mechanism
Inflated balloon exerts circumferential
pressure on the plaque
1. Plaque splitting & disruption
2. Stretching of the vessel wall
3. Compression of the atheroma
11. A LASER produces an
intense beam of light in
uniform wavelength that
can be precisely focused to
deliver high energy levels to
a small area
It converts solid plaque to
gas which is soluble in
blood
Laser Directed Angioplasty
12. Stent
An expandable metallic spring like
device which is permanently
implanted in the artery .
Mechanism
The prosthesis acts as a scaffold
to hold the artery open
Prevents recoil of the vessel
Reduces Restenosis
14. CUTTING BALLOON
CBA involves conventional
angioplasty with microsurgical
technology in an attempt to minimize
vessel trauma and injury during
balloon dilation.
CB consists of microsurgical blades or
atherotomes ( 3-4 in no. )mounted
longitudinally on the outer surface of
a non-compliant balloon. On balloon
inflation, these microblades score
the plaque at the lesion site &
accomplish dilation at lower pressure
than a conventional balloon. Also
acute gain is achieved primarily via
plaque compression & to a lesser
extent via vessel wall expansion &
hence less elastic recoil
FOLDING
SPRING 1cm ATHEROTOME
15. Cryoplasty
ANGIOPLASTY SYSTEM THAT
SIMULTANEOUSLY DILATES AND COOLS THE
PLAQUES AND VESSEL WALL
Using conventional technique, Cryoplasty balloon
is filled with NO2 & dilated at 6 atm.
The plaque & vessel wall is cooled at temp. – 2 C
to finally – 10C. This induces SMC apoptosis
thereby inhibiting neo-intimal proliferation.
16. 75/M Post CABG, Severe LV Dysfunction,Renal Insuff.
LT.Great Toe Gangrene
35. Advantages Of Angioplasty
1.Minimally invasive
Short hospital stay
Faster recovery
2. Low risk with significantly less
morbidity & mortality(<0.5 –1.0 %)
3. Comparable patency rates
4. Can be performed again if recurrence
occurs
38. Advantages Of Angioplasty cont..
5. Option of Sx always remains in the
event of failure of angioplasty.
6. Less cost
39. Disadvantages Of SX
1.Significantly higher morbidity &
mortality(risk increases further in high risk cases)
2. Option of angioplasty becomes difficult
in the event of failure of Sx
3. Nonavailability of venous conduit in pts
with bilat.varicose veins or in post
CABG pts.
4. Higher cost (specially with synthetic grafts)
40. Conclusion
In Diabetic foot, PAD contributes to
amputation by impeding the delivery of
antibiotics, Oxygen, nutrients & by
delaying wound healing & the ability to
fight infection.
Aggressive therapy with debridement,
antibiotics,good control of Diabetes &
when indicated revascularisation results
in salvage of > 90% of threatened limbs
even in high risk patients
41. Conclusion cont…
In the last few years, endovasc.
therapy has emerged as an equally
effective,less invasive, less risky (even
in high risk subset ) and overall a
better initial approach to achieve
revascularisation in majority of pts. Of
Diabetic foot Therefore, it should be the
first choice to achieve revascularisation
in most of the pts. If it fails then the
option of surgery should be considered.
For many years,Sx remained the mainstay to achieve Revascularisation in PAD of lower limbs; however last decade has seen emergence of endovascular therapy as an equally effective and less risky alternative
CLI denotes advanced or severe form of PAD with imminent limb loss.It may result in the development of rest pain or breakdown of skin. Sudden progression from IC to CLI occurs in about 19% of the diabetics with 21% risk of major amputation.CLI is a marker for premature death with 25 % mortality at 1 yr
2.The risk & morbidity is significantly less even high risk subset from sx view point.this subset includes pt. With
* severe CAD , LV dysfunction
* renal insufficiency
*critically ill pts,presence of infection/septicemia
2.Because of accelarated atherosclerosis , following sx there is progression of disease proximally, sometimes resulting into long segment total occlusion which makes the option of angioplasty dififcult.
3.In post CABG pts.specially elderly people(generally LIMA+SVG ¬ LIMA/RIMA) or pts with with bilat. Varicose veins the venous conduit may not be available