2 dr mm-begani-day-care-surgery-in-india_ncas_2011
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This document discusses the benefits and necessity of day care surgery in India. It notes that day care surgery provides high quality surgery at affordable costs, providing both time and cost savings. It establishes that day care surgery can reduce costs to patients by at least 30% compared to corporate hospitals. The document then outlines various statistics that demonstrate the need for more accessible and affordable healthcare options in India, given factors like population size, income levels, and lack of public spending on health. It provides details on the work of the Indian Association of Day Surgery to promote and establish standards and protocols for day care centers across various medical specialties.
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This document summarizes the history and current state of ambulatory surgery centers (ASCs) in the United States. It discusses how the first ASC opened in 1970 in Arizona and how the industry has grown significantly since then, with over 5,300 ASCs operating today. The document provides data on ASC procedures, specialties, ownership trends, and regulatory bodies like CMS that oversee ASCs.
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This document summarizes the history and current state of ambulatory surgery centers (ASCs) in the United States. It discusses how the first ASC opened in 1970 in Arizona and how the industry has grown significantly since then, with over 5,300 ASCs operating today. The document provides data on ASC procedures, specialties, ownership trends, and regulatory bodies like CMS that oversee ASCs.
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1. Safety is everybody’s business. According the Hippocratic oath from 5th century : “ Never do harm to anyone” Safer Surgery can be defined as a reduction in avoidable harm to a surgical patient
2. It is a part of medical specialty that uses operative manual and instrumental technique on a patient to investigate or treat a pathological condition. Surgical team: 1. Surgeon 2. Surgeon’s assistance 3. Anesthetist 4. Scrub nurse 5. Scouting nurse 6. Surgical technologist
3. Time or duration when patient admitted and discharge after completion of surgery. So, surgical safety has broadly included in different phases: 1. Preoperative(Diagnosis, investigation) 2. Per operative 3. Postoperative(Up to discharge)
4. 1. Adverse events: An incident which result in harm to the patient. 2. Near Miss: An incident which could resulted in unwanted harm but did not. 3. No-harm events: An incident that occur and reach to the patient but result in no injury.
5. An article in the Gurdian newspaper UK in March 2013 claimed that “five worst medical” nightmares a Pt faces, three related to surgery: 1. Wrong site surgery 2. Wrong patient surgery 3. Retained instruments and swabs The rate of harm in surgical patient is unknown but probably occur in about 10% surgical patient, though much of this harm will be minor.
6. 1. Patients themselves. 2. Healthcare professional 3. System failure. 4. Medical complexity
7. Patients Themselves 1. A variety of presentation. 2. Differing co-morbidities 3. Differing response to treatment 4. Patients are reluctant to speak up. 5. Refuse to co-operate 6. Hide and seek
8. Healthcare professional 1. Inadequate Pt assessment(delay or error in Diagnosis) 2. Failure to use or interpret appropriate test 3. Error in performance of an operation and test. 4. Inadequate monitoring or follow-up. 5. Deficient training or experience 6. Fatigue, overwork or time pressure. 7. Personal or psychological factor i.e. drug abuse or depression. 8. Lack of recognition of the danger of medical errors.
9. System failure 1. Poor communication between healthcare provider. 2. Inadequate staffing level 3. Overreliance on investigation 4. Lack of coordination at handover 5. Drug similarities. 6. Equipment failure due to lack of skilled operators. 7. Inadequate system to report and review patient safety incident.
10. Medical complexity 1. Advance and new technologies(laparoscopic, robotic surgery) 2. Potent drug and their side effects and interaction. 3. Working environment- Surgical ICU, HDU and Operation theatre
11. Surgery is one of the most complex health intervention to deliver. More than 100 million people worldwide require surgical treatment every year for different reason. Great Professor of Surgery Sir Alfred Cuschieri and other describes surgical errors in different categories that committed by the surgeons during care of the Patients.
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1. Safety is everybody’s business. According the Hippocratic oath from 5th century : “ Never do harm to anyone” Safer Surgery can be defined as a reduction in avoidable harm to a surgical patient
2. It is a part of medical specialty that uses operative manual and instrumental technique on a patient to investigate or treat a pathological condition. Surgical team: 1. Surgeon 2. Surgeon’s assistance 3. Anesthetist 4. Scrub nurse 5. Scouting nurse 6. Surgical technologist
3. Time or duration when patient admitted and discharge after completion of surgery. So, surgical safety has broadly included in different phases: 1. Preoperative(Diagnosis, investigation) 2. Per operative 3. Postoperative(Up to discharge)
4. 1. Adverse events: An incident which result in harm to the patient. 2. Near Miss: An incident which could resulted in unwanted harm but did not. 3. No-harm events: An incident that occur and reach to the patient but result in no injury.
5. An article in the Gurdian newspaper UK in March 2013 claimed that “five worst medical” nightmares a Pt faces, three related to surgery: 1. Wrong site surgery 2. Wrong patient surgery 3. Retained instruments and swabs The rate of harm in surgical patient is unknown but probably occur in about 10% surgical patient, though much of this harm will be minor.
6. 1. Patients themselves. 2. Healthcare professional 3. System failure. 4. Medical complexity
7. Patients Themselves 1. A variety of presentation. 2. Differing co-morbidities 3. Differing response to treatment 4. Patients are reluctant to speak up. 5. Refuse to co-operate 6. Hide and seek
8. Healthcare professional 1. Inadequate Pt assessment(delay or error in Diagnosis) 2. Failure to use or interpret appropriate test 3. Error in performance of an operation and test. 4. Inadequate monitoring or follow-up. 5. Deficient training or experience 6. Fatigue, overwork or time pressure. 7. Personal or psychological factor i.e. drug abuse or depression. 8. Lack of recognition of the danger of medical errors.
9. System failure 1. Poor communication between healthcare provider. 2. Inadequate staffing level 3. Overreliance on investigation 4. Lack of coordination at handover 5. Drug similarities. 6. Equipment failure due to lack of skilled operators. 7. Inadequate system to report and review patient safety incident.
10. Medical complexity 1. Advance and new technologies(laparoscopic, robotic surgery) 2. Potent drug and their side effects and interaction. 3. Working environment- Surgical ICU, HDU and Operation theatre
11. Surgery is one of the most complex health intervention to deliver. More than 100 million people worldwide require surgical treatment every year for different reason. Great Professor of Surgery Sir Alfred Cuschieri and other describes surgical errors in different categories that committed by the surgeons during care of the Patients.
12. 1. Diagnosis and management erro
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This document discusses surgical safety and errors. It notes that 234 million operations are performed globally each year, with 1 million deaths and 7 million disabling complications, over 50% of which are preventable. Common errors include wrong site, patient, procedure and retained instruments. Causes include lack of protocols, training, supervision, staffing issues and communication breakdowns. Aviation safety practices are presented as a model, with mandatory reporting and a non-punitive culture. The WHO surgical safety checklist is summarized, which was tested in 8 countries and significantly reduced complications and death rates. Universal adoption of checklists and a culture of safety are recommended to improve patient outcomes during surgery.
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This document summarizes an educational session on infection prevention in emerging ambulatory care delivery models. It discusses trends driving the shift to outpatient care like declining inpatient volumes and growing outpatient encounters. Emerging models described include micro-hospitals, ambulatory surgery centers, and "hospital at home" programs. These models require new staffing approaches for infection prevention. The document outlines challenges for infection preventionists in these settings and resources available to assist them.
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Troy Stockman is a healthcare leader seeking a new leadership role. He has over 25 years of experience in healthcare administration, including managing physician practices, designing new hospitals, and leading regional service lines. His resume summarizes his roles as CEO of a spine hospital and director of neuroscience and diagnostic services. He demonstrates expertise in areas like population health, EHR implementation, and quality programs.
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The document provides registry data from Monroe Carell Jr. Children's Hospital at Vanderbilt for 2015, including:
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- The non-surgical admission rate was 3%, overtriage rate was 47%, and undertriage rate was 11%.
- Level I trauma activations made up 10% of total activations, with Level II at 34% and consult at 56%.
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This document provides guidelines for orthopaedic trauma best practices. It was developed by a panel of experts based on evidence and expert opinion. The goals are to offer guidance on practical care at most institutions, increase delivery of good care, eliminate variability, and use metrics with a rationale. Performance improvement indicators are included. Specific guidelines are provided for topics like open fractures, pelvic fractures, geriatric hip fractures, and more. Hospitals are encouraged to track metrics over time to identify opportunities for improvement in orthopaedic trauma care.
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The document provides an operating theatre (OT) checklist to help ensure patient safety during surgical procedures. It lists several checks that the operating team should complete in the ward and theatre before surgery, including correctly identifying the patient, marking the intended surgical site, checking for allergies and previous medical history, and confirming critical patient information has been exchanged. The goal is for the team to operate on the right patient and site, take appropriate precautions, and communicate effectively to safely conduct the surgery and prevent errors.
Device Expertise
Max Neeman International is India’s leading contract research organization providing full range of clinical development services to small, mid-size and global pharmaceutical, biotech and medical device companies. The portfolio of the services include comprehensive Phase II-III clinical trials, regulatory submissions, phase IV post approval programs & commercialization services.
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Preoperative patient education involves a team effort to make patients knowledgeable and active participants in their care through multiple teaching modalities. The goals are to improve understanding of the disease/operation and ensure active participation, while also obtaining informed consent. Key topics covered include the planned procedure, risks/alternatives, postoperative expectations like pain management, and procedure-specific details. Teaching tools can include verbal instructions, written materials, web-based resources, and visual aids.
Know About Organ Donation
Organ donation involves donating biological tissues or organs from living or deceased donors to recipients in need of transplants. While it can save many lives, there is a large shortage of organs available for transplant globally and in India specifically. Effective organ donation programs require addressing issues like lack of public awareness, legal and ethical concerns, and ensuring transparency to prevent exploitation. Models like the one in Tamil Nadu aim to maximize cadaveric organ donation through a centralized allocation system and free transplants to reduce costs as barriers. Kerala has guidelines for organ donation but still faces challenges in identifying brain dead donors, public awareness, funding, and monitoring the program. Increased education and empathy could help address myths and shortages to benefit more patients.
systemic inflammatory response syndrome (SIRS)
The document discusses the systemic inflammatory response that occurs after injury or infection. It describes two phases: an acute pro-inflammatory phase aimed at restoring function and fighting infection, and an anti-inflammatory phase that modulates the pro-inflammatory response to prevent excess and restore homeostasis. It then defines terms related to infection and inflammation and discusses the central nervous system regulation of inflammation through hormonal and neuronal pathways.
Git Endoscopic Ultrasound.
EUS can be used to stage cancers of the esophagus, stomach, rectum, lung and diagnose pancreatic cancer. It allows evaluation of abnormalities in the GI tract wall and adjacent structures. EUS guided FNA biopsy enables cytopathological diagnosis of cancers and nodal metastases. EUS is well-suited for TNM tumor staging as it can assess depth of tumor penetration, locoregional nodal spread and vascular invasion. It also has applications in diagnosis of cholangiocarcinoma, evaluation of pancreatic cysts and masses, and celiac plexus neurolysis for pain relief.
Capsule endoscopy
The document discusses capsule endoscopy, a medical procedure where a patient swallows a small capsule containing a camera to provide internal images of the gastrointestinal tract. Specifically, it focuses on the PillCam ESO capsule used to examine the esophagus. It describes how the capsule works, capturing images as it passes through the esophagus. It also outlines the procedure, including swallowing the capsule, wearing an external recorder, and physicians reviewing the images afterwards.
Anatomy of an ambulatory surgery center
This document summarizes a presentation on the differences between syndication and physician recruitment for ambulatory surgery centers (ASCs). Syndication involves the sale of ownership interests in an ASC to physicians, while recruitment involves convincing physicians to perform cases without ownership. When considering syndication or recruitment, ASCs should prepare by evaluating when such strategies are appropriate given the center's situation and goals. The presentation also discusses strategies for recruitment, methods for valuing shares during syndication, and regulatory risks associated with these activities.
Modular ot presentation
This document provides information about a company that manufactures and services medical equipment. It offers pre-fabricated modular operating theaters, ICUs, and various other medical devices. The company has been in business since 1998 and employs 25 people. It prides itself on supreme quality, competitive prices, and innovative products. The document provides details on several of the medical equipment items it manufactures and services, including operating theaters, air filtration systems, control panels, x-ray viewing panels, scrub sinks, and more. Specification details are given for some of the key product offerings.
Cholecystectomy
A cholecystectomy involves the surgical removal of the gallbladder. The gallbladder stores and concentrates bile produced by the liver to aid in fat digestion. Cholecystectomy is commonly performed to treat gallstones and related complications like gallbladder inflammation. The surgery can be performed through traditional open surgery or through laparoscopic methods involving small incisions. Conditions that may require open rather than laparoscopic cholecystectomy include severe inflammation, abdominal lining inflammation, liver cirrhosis, late-stage pregnancy, or bleeding disorders.
Radionuclide imaging
This document discusses various applications of radionuclide imaging. It begins with an overview of types of ionizing radiation and how different radionuclides are used in nuclear medicine. Examples are given of specific radiotracers used in cardiac, cerebral, and oncologic imaging. The document then focuses on applications of nuclear medicine in evaluating the gastrointestinal system and hepatobiliary system, including imaging of the liver, spleen, and detection of Meckel's diverticulum and gastrointestinal bleeding. Safety considerations of radiotracer administration are also reviewed.
Sirs Mods
The document discusses systemic inflammatory response syndrome (SIRS) and its relationship to sepsis. It defines SIRS as a systemic response to various stresses and outlines its diagnostic criteria. SIRS can progress to sepsis if an infection is involved. Sepsis is defined as a systemic response to infection along with signs of organ dysfunction. More severe stages include severe sepsis and septic shock. Risk factors, sources of infection, and specific infectious agents associated with sepsis are also reviewed.
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Health care Sector
The document discusses the healthcare sector in India. It provides an overview of the key components of the Indian healthcare system, including public and private sectors. Some key points:
- The public sector focuses on primary healthcare in rural areas, while the private sector dominates secondary/tertiary care in cities.
- India has a large, skilled workforce and lower costs compared to other countries, which are competitive advantages.
- The market is growing rapidly at over 20% annually and expected to reach $280 billion by 2020. Rural areas represent a major demand source.
- Opportunities exist in increasing bed capacity and developing medical tourism. Alternative medicine also ensures treatment availability nationwide.
Health Care in Service Industry
The healthcare sector in India is rapidly expanding due to factors such as a growing population and an expanding middle class. However, there are also significant challenges facing the sector. The physical infrastructure is inadequate to meet current demands and a large portion of the population still lacks access to quality care. While the private sector accounts for over 80% of healthcare spending, government efforts aim to increase capabilities and access at primary care facilities in rural areas. Overall, the Indian healthcare system can be viewed as both facing substantial challenges but also possessing opportunities for growth.
Services
The document provides an overview of the marketing mix strategies for 4 sectors within the healthcare industry: hospitals, ayurvedic, health and beauty, and health clinics. It summarizes the key aspects of the marketing mix - product, price, place, promotion, people, process, and physical evidence - for each sector. For example, it describes the products and services offered by hospitals include various medical specialties. It also outlines the location, promotional activities, and emphasis on qualified medical professionals for the sectors.
The 10 most recommended superspeciality hospitals in india
Insights Success through this edition, ‘The10 Most Recommended Superspeciality Hospitals in India, 2020’
wishes to highlight some of the stories from the medical fraternity that are making a difference through their outstanding medical services.
We have brought a collection of tales that display various super specialty hospitals’ abilities in terms of the services they facilitate.
Outpatient Surgery Centers Market in India l In-depth Analysis l By Mirdul Amin
The Outpatient surgery; which also known as ambulatory surgery, day case, or day surgery, is a kind of surgery procedure which require the patient to stay in the hospital/healthcare institution for less than 24 hours. The outpatient surgery does not require an overnight hospital stay
The term “outpatient” arises from the fact that surgery patients may go home and do not need an overnight hospital bed. The purpose of outpatient surgery is to keep hospital costs down, as well as saving the patient time that would otherwise be wasted in the hospital
Outpatient surgery has grown in popularity due to the rise in outpatient surgery centers and improved technology
With shorter medical procedure duration and fewer complications it makes sense to let patients go home sooner. About 55% of all surgical procedures are done on an outpatient basis
The outpatient surgery allows the patient to return home on the same day after a surgical procedure is performed, could be a novel platform for the Indian healthcare industry to grow
In coming years, the healthcare industry would have a number of players in the sector
The outpatient surgery platform/centers increase the accessibility and affordability of surgery to the common patient and the sector has huge potential in India
Bariatric surgery in india
Medical tourism or Medical Travel is growing rapidly as people from all over the world are travelling to other countries to obtain medical treatments & surgeries at very low cost in their own country. Medsoul is a one stop solution for your medical and travel related component.
Narayana Hrudayalaya Heart Hospital - Cardiac Care For the Poor
Based on case study "Narayana Hrudayalaya Heart Hospital: Cardiac Care for the poor" by Harvard Cases.
To get a copy of this report, share your views about the presentation with your email id in Comments section... I keep on updating my presentations and documents. To ensure that you don't miss any update or new upload don't forget to press the "FOLLOW" and "LIKE" button. You can also mail me at manigarg21@gmail.com
Medical tourism
This document discusses medical tourism, which involves traveling abroad for medical treatment. It provides an overview of the scope and components of medical tourism, including treatment types, wellness, and reproduction services. India is highlighted as a major destination for medical tourism due to its high-quality care at low costs compared to other countries. Challenges and opportunities for India's medical tourism industry are examined through a SWOT analysis. The roles of the Indian government and private sector in promoting medical tourism are also outlined.
ARAVIND EYE CARE
All you need to know about the existence and sustainability of the great Aravind eye care by Dr. V. a very comprehensive and appropriate description about this business.
InnoHEALTH magazine volume 4 issue 1 - January to March 2019
The theme of this issue of the InnoHEALTH magazine is diabetes. Following are the highlights of this magazine issue.
1) Exclusive interview of H.E Klas Molin, Ambassador of Sweden to India on “Sweden-India collaboration in health sector”
2) Recent breakthroughs in diabetic research
2) Faster diagnostic tests for tuberculosis
3) Digital healthcare
4) DISHA: Need of the hour. How crucial is DISHA (Act) for the healthcare industry?
Most reliable diagnostic and pathology center to watch..
This edition of Most Reliable Diagnostic and Pathology Centres to Watch places the spotlight on healthcare service providers that are leveraging such revolutionary technologies to deliver the best to those seeking their services.
The Most Trusted Hospitals in India July2023.pdf
This edition features a handful of The Most Trusted Hospitals in India July2023 that are leading us into a digital future.
Health insurance
Health insurance covers medical expenses when a person incurs them. It works in two ways - the insured pays costs upfront and is reimbursed, or the insurer pays providers directly. The insured is the policy owner, and providers include doctors, hospitals, and pharmacies. Health insurance grew in India due to economic liberalization and awareness. It protects against high, unexpected costs and makes quality treatment affordable. Having health insurance keeps savings intact, encourages preventive care, and assures coverage for the family. It is essential as health costs rise and lifespans increase. The Indian health insurance market is growing rapidly but potential remains in semi-urban areas due to low coverage currently. Issues for insurers include a high claim ratio and
Medic yatra overview
MedicYatra.com is an India-based company that provides medical tourism services, connecting patients from other countries with affordable, high-quality healthcare in India. It works with accredited hospitals across India to offer procedures at a fraction of the cost in other countries. Examples given include heart bypass for $10,000 in India compared to $130,000 in the US. The document discusses the growth of medical tourism to India and quality standards of hospitals, and provides an overview of services offered by MedicYatra.com to facilitate affordable healthcare for international patients.
Aravind eye hospital
Dr. Govindappa Venkataswamy or Dr. V as he was affectionately called brought about a revolution in eye care in the southern state of Tamil Nadu in India. His achievements are spectacular enough for Harvard University to have done a case study on him for its graduate students.
Medical malpractices (1)
Medical malpractice is a serious issue in India. The document discusses several ways in which medical malpractice occurs, including doctors deliberately prescribing unnecessary expensive tests and procedures to earn more money. It also discusses issues like overpriced branded drugs where generics are available for much cheaper. The relationship between doctors and patients is one of trust, but some doctors violate this trust. The document outlines several cases of medical negligence and discusses what can be done to address the problem, including increasing government healthcare spending, promoting generic drugs, and empowering regulatory bodies like the Medical Council of India.
Beyond Borders E Magazine - September 2018
This document discusses India's rising status on the global stage through several articles. It begins with an article about Dr. Zulekha Daud, one of the first doctors in the UAE who helped establish modern healthcare there. Her organization, Zulekha Healthcare Group, now employs over 3,000 people across multiple hospitals and clinics in the UAE and India. Another article discusses how crowdfunding is becoming an important way to make healthcare more accessible and affordable in India. The document also contains articles on topics like the relationship between India and UAE, the potential for India to become a true global power, the role of women in business, and the rise of Indian cuisine and chefs on the global stage.
Gp today & tomorrow
The document discusses the past, present and future of general practice in medicine. It touches on essential tools like stethoscopes, the differences in interiors and locations of practices over time, the increasing commercialization and competition in the field, and how technologies like telemedicine, computers, new tests and gadgets are changing patient care. It also addresses issues like insurance factors, financial aspects, legal regulations, and the need for ongoing learning. The conclusion emphasizes that physicians must be accountable while organizing care through networks on a not-for-profit basis focused on quality, safety and the patient's whole health.
Arul vel arasan
This document provides an overview of a proposed health insurance plan targeted at rural and semi-urban populations in India. The plan would offer health insurance for Rs. 2 per day per person, covering all medical expenses without hidden clauses. It aims to make quality healthcare accessible to all regardless of financial status. The target market is people in rural and semi-urban areas with a monthly family income above Rs. 3000 who are currently not covered by other insurance plans. The proposed plan would use the law of large numbers to provide high quality coverage at an affordable price through standardized treatments and a streamlined claims process.
eNext ICU Services
We provide TeleICU Services 24*7 critical care expertise and support at the point of care anywhere in health system. Our experienced critical care specialists engages clinically within minutes of alerts to evaluate the patient status and needs of the patient, just as any ICU would manage their patients.
We provide:
1. Complete 24×7 clinical support by experienced critical care specialists
2. Real-time TeleICU monitoring
3. Critical care trainings of ICU nurses and doctors
4. Emergency call support
5. Enhanced clinical decision support
6. Integration of Best ICU practices
7. Support on admission, transfers and step-down decisions
8. Outsourced Critical Care
Along with this, We aim at providing short-term and long-term accredited courses to doctors, nurses and paramedics practicing medicine particularly in the field of “Critical Care Medicine” and contribute to “Quality in Healthcare” as both these are very closely linked.
Tap to know more: https://enexticu.com/
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The 10 most recommended superspeciality hospitals in india
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InnoHEALTH magazine volume 4 issue 1 - January to March 2019
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More from Nova Medical Centers
Golden era-of-ambulatory-surgery ncas-2011
This document discusses advances in ambulatory surgery, specifically related to urology. It highlights key developments in areas like minimal access and non-invasive surgery techniques, diagnostic and imaging technologies, peri-operative anesthesia, and improved patient experience management. These advances have helped urological procedures transition from traditional in-patient settings to ambulatory settings, allowing for shorter hospital stays, earlier return to normal activities, and cost savings, while still providing enhanced patient comfort. Laser prostate surgery is presented as one example of a urological procedure that has benefited from these trends towards ambulatory surgery.
Dr vsn-raju haematoma-block-a-boon-ncas_2011
The document discusses haematoma block, a technique for anesthetizing fractures using local injection of lignocaine into the fracture haematoma. It describes haematoma block as a boon for ambulatory orthopedic surgery as it allows for shorter hospital stays, reduced costs, and faster return to work compared to general anesthesia. The document outlines the patient populations best suited for haematoma block, the procedure and risks, and concludes that when properly applied it can benefit both patients and hospitals by improving bed turnover rates while providing satisfied patients.
Dr lalit-mohan-parashar laryngeal-surgery-well-suited-to-ambulatory-practice-...
Dr lalit-mohan-parashar laryngeal-surgery-well-suited-to-ambulatory-practice-...Nova Medical Centers
This document discusses laryngeal surgery and its suitability for outpatient procedures. It begins by noting the airway involvement in laryngeal surgery and potential need for immediate interventions. It then outlines various ENT procedures like tonsillectomies and laryngoscopies. The document focuses on advances in laryngeal surgery diagnosis, understanding of diseases, surgical technologies, and factors that allow patients to be discharged home after surgery like effective communication and transportation. It provides details on diagnosis techniques, microsurgery procedures, anesthesia considerations, equipment needs, and treatments for issues like vocal fold augmentation and laryngo-tracheal trauma.Dr lalit-mohan-parashar laryngeal-surgery-an-overview-ncas_2011
This document provides an overview of laryngeal surgery. It discusses various problems affecting the larynx that may require surgery, including hoarseness, breathing difficulties, and cancers. Effective diagnosis involves examination in the ENT clinic and use of endoscopy with or without stroboscopy. Surgeries described include extirpation of lesions, vocal fold augmentation, repositioning, and framework manipulation. Complicated cases like laryngotracheal trauma are also discussed, along with approaches for managing different types and severities of injury. The goal of surgical techniques is to restore normal laryngeal function and cover exposed cartilage to prevent resorption or granulation.
Dr lalit-mohan-parashar laryngeal-surgery-ambulatory-surgery-ncas_2011
This document discusses laryngeal surgery and its suitability for outpatient or ambulatory practice. It notes that laryngeal surgery involves the airway and may require immediate solutions, trained staff, and possibly tracheostomy. Most ENT surgeries also involve the airway. The document then lists various types of ENT surgeries performed in different areas like the ear, nose, throat, and head and neck. These include procedures like tonsillectomy, septoplasty, cochlear implants, and thyroid surgeries.
8 dr anita-krishnan-ambulatory-ent-surgery_ncas_2011
Dr. Anita Krishnan presented on her experience with 220 ENT surgeries performed at Nova Medical Center from July 2009 to August 2011. The most common nasal surgeries were septoplasty, FESS, and turbinoplasty. Common ear surgeries included tympanoplasty and mastoidectomy. Three cases (1.2%) had complications including bleeding, laryngobronchospasm, and epistaxis, all of which were managed successfully. Nova Medical Center provides benefits for ambulatory surgery including experienced staff, minimal cancellations, and good instrumentation. The key learning is that communication is important for ambulatory surgery.
7 nanda rajaneesh-anorectal-surgeries_ncas_2011
This document summarizes anorectal surgeries performed at Nova Medical Centers in Bangalore, India between August 2009 and August 2011. A total of 110 surgeries were performed, including stapled hemorrhoidectomies, fistulectomies, and abscess drainages. Most patients were discharged on the same day. Post-operative outcomes were good, with only 3 patients experiencing urinary retention and all patients following up regularly. The aim was to evaluate operating anorectal procedures in an outpatient surgery center.
6 dr mg-bhat-ambulatory-hernia-surgery_ncas_2011
The document discusses ambulatory hernia surgery. 88 hernia repairs were performed between March 2010 and August 2011, with 66 being inguinal hernias. Procedures included open, TEP and TAPP repairs. Most patients were discharged within 6-14 hours, with only a few requiring overnight or longer stays. Complications were few. The document advocates for stand-alone ambulatory surgical centers and notes selection criteria, anesthesia protocols, benefits over traditional inpatient surgery, and literature reviews on ambulatory hernia repair outcomes and safety.
5 dr jaya-bhat-an-audit-of-gynaecological-ambulatory-surgery_ncas_2011
This document summarizes an audit of gynecological ambulatory surgery cases from June 2009 to June 2011. It presents data on 461 total gynecology cases, of which 319 were from a single physician. Major surgeries like hysterectomies comprised 31 cases, while other procedures like laparoscopy, D&C, and MTP comprised the remaining 258 cases. Patients typically had a 2-night stay for major surgeries and same-day discharge for other procedures. There were 2 reported complications. Literature reviews on similar studies found mixed results regarding patient satisfaction with ambulatory vs. inpatient surgery. The goal is to introduce ICD coding, protocols and a registry to further improve outcomes.
4 dr shikha-sharma-nutrition-in-post-surgical-recovery_ncas_2011
Nutrition plays an important role in post-surgical recovery by supporting the various phases of wound healing. Several nutrients have been shown to specifically aid the inflammatory, proliferative, and remodeling phases. A balanced diet high in protein, antioxidants, fiber, and certain supplements can help reduce healing time, morbidity, and length of hospital stay. Research demonstrates nutritional support leads to improved outcomes and reduced costs for patients who are nutritionally depleted after surgery.
6 rr sharma-professionalism-in-health-care_ncas_2011
The document discusses professionalism in healthcare. It emphasizes that healthcare is a noble profession aimed at caring for living beings. Medical professionals owe a duty of care to their patients and must perform their duties according to principles of good medical practice using modern medical training. They should approach their work with passion, develop meaningful interest in their duties, think rationally, and communicate skillfully. Teamwork, respect, trust, and life-long learning are essential to achieve the aims of the profession.
5 bm hedge-doctors-on-strike-health-improves_ncas_2011
This document contains a quote from Professor B.M. Hegde stating that knowledge advances not by repeating known facts but by refuting false dogmas. It then lists Professor Hegde's credentials and experience in medical science and education. It goes on to list topics related to advancing medical science such as the need for a new scientific model beyond randomized controlled trials and peer review, recognizing that the human body works as a whole rather than focusing on individual parts, and redefining what health means.
7 ravindra pai-marketing-a-necessity-in-healthcare-delivery_ncas_2011
The document discusses the healthcare sector in India and the need for healthcare marketing. It notes that while India has a large population, only 25% have access to quality healthcare as most hospitals and resources are urban-focused. The sector is growing rapidly but more investment is needed to improve infrastructure and access. Healthcare marketing can help increase revenues, connect patients with providers, and promote a positive experience. It discusses how marketing addresses the unique challenges in healthcare like legal barriers and influencing non-end users. The conclusion is that healthcare marketing is necessary to realize the large potential of India's healthcare sector.
1 dr hg-doctor-ambulatory-surgery-requirements_ncas_2011
Ambulatory surgery involves performing planned surgical procedures on patients who are admitted and discharged on the same day. The concept began in the early 1900s and benefits were better realized after WWII. Key requirements include appropriate facilities, patient selection, pre-operative assessments, standardized procedures, oral post-op medications, and guidelines to ensure safety. Benefits include high quality care, lower infection rates, reduced costs, faster recovery and return to work, and less burden on inpatient facilities. Ambulatory surgery is now a global trend performed for over 70% of elective cases in the US and 65% in the UK.
5 dr daya-thirumala-rao-ambulatory-spine-surgery_ncas_2011
Nova Medical Centers provides ambulatory spine surgery, also known as day care spine surgery, in Bangalore, Delhi, and Mumbai, India. Advances in surgical techniques and technology have allowed many spinal procedures that previously required long hospital stays to now be routinely performed on an outpatient basis. Key procedures discussed include percutaneous endoscopic lumbar discectomy (PELD) for herniated discs, nucleoplasty for contained disc herniations, kyphoplasty for osteoporotic vertebral fractures, and percutaneous endoscopic transforaminal lumbar interbody fusion (Pe-TLIF) for severe degenerative lumbar disc disease.
14 james pavletich-international-accreditation_ncas_2011
The document discusses international accreditation through the Accreditation Association for Ambulatory Health Care (AAAHC). It outlines AAAHC's philosophy of cultural adaptation when providing accreditation internationally. This includes privately meeting with international clinics to understand their systems, customizing standards, and establishing a comprehensive international surveyor program. It also notes AAAHC's goal of providing accreditation in an economically efficient and affordable manner.
13 vikram kashyap-quality-management-systems_ncas_2011
This document discusses quality management systems and accreditation to NABH SHCO standards for ambulatory surgical centres. It outlines key steps to start a quality department including establishing a team, resources, authority, competence and conducting internal audits. It also covers compliance with legal, patient, employee and hospital policy requirements. Finally, it provides an overview of the NABH accreditation process and SHCO standards for small healthcare organizations with 20-50 beds or day care and ambulatory surgical centres.
12 dr mg-bhat-risks-and-fears-ambulatory-surgery_ncas_2011
Ambulatory surgery has become a popular and efficient form of surgical healthcare delivery in the US and Europe. In India, ambulatory surgery is growing with the development of small, standalone centers equipped with state-of-the-art facilities. While surgery poses risks and fears for patients, ensuring safety is key for the success of ambulatory surgery. Factors that contribute to safety include analyzing and addressing risks and patient fears, employing qualified staff, complying with regulations, incident reporting, and providing continuous patient care and support.
10 chandrashekara anaesthesia-in-ambulatory-surgery_ncas_2011
This document discusses day care (ambulatory) anesthesia. It notes that 70% of surgeries are now ambulatory, including many procedures on children. Advances in short-acting anesthetics and analgesics, as well as less invasive surgical techniques, have enabled more outpatient surgery. The challenges of day care anesthesia include assessing pain in children, lack of experience in standalone centers, and undiagnosed medical conditions in patients. Proper patient selection, planning, anesthetic techniques and post-operative management are keys to success. A multimodal approach to pain management improves outcomes over traditional opiate techniques. Strict discharge criteria focus on stability, orientation and adequate pain control to allow patients to recover at home.
8 shiva belavadi-insurance_ncas_2011
The document discusses the Indian healthcare market and health insurance industry. It notes that less than 20% of the total Indian population is covered for health, and health insurance penetration is only 2%. It also describes the roles of insurance companies, third party administrators, and key issues facing the industry like lack of data and standardized treatment protocols. Going forward, the industry may see regulated growth, more self-funded corporate plans, and a focus on increasing insurance penetration and developing care management products.
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SENSORY NEEDS B.SC. NURSING SEMESTER II.
Sensation is the neurological process by which we become aware of surrounding environment.
The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
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2 dr mm-begani-day-care-surgery-in-india_ncas_2011
- 1. Dr. M. M. Begani Founder President, The Indian Association of Day Surgery Director, Abhishek Day Care Institute & MRC, Mumbai Associate Professor & Consultant Surgeon, Bombay Hospital Institute of Medical Sciences (University of Mumbai) Vice President – Association of Colorectal Surgeons of India (ACRSI) Founder & Chief Promoter – National Counter Terror & Trauma Care (NCTTC)
- 2. Why Day Care Surgery? Day Care Surgery is a necessity in a developing country like India. It provides high quality surgery at affordable cost. It provides economy of time and money. A true Day Surgery should provide a reduction in cost by at least 30% to the patient as compared to a Corporate Hospital. Day Surgery is the need of the day, Not a gimmick.
- 3. Problems Population: 1,o73,000,000 (over a billion) • Urban : 26.13% • Rural : 73.87% 60% in Metropolitan city live in poor housing and slums. Per capita income of an average family is around Rs. 30,000/- Bed : Patient ration: 1 : 1246.
- 4. Statistics: Expenditure Expenditure Population Public 18% 60% Private 82% 40% Public Private Total of GDP India: 0.94% 4.2% 5.14%
- 5. India on the sick bed Public spending on health-lowest in the world. 90% ‘Out-of-pocket’ on medical expenditure. 39 mn pushed into poverty from ill health, yearly. 32% Indians refuse t/t due to high cost. 35% Indians take loans & sell assets for t/t. 3 times increase in cost of hospitalisation in 15 yrs.
- 6. The Indian Association of Day Surgery Founded in 2003. Life members – more than 350. Across – 18 states. Executive committee has more than 200 presentations and publications. Regular workshops. National Conferences. Protocols. Journal/News Letter.
- 7. National Conferences ADSCON 2005: “Day Care Surgery: Future of Modern Surgery”- 29 Guest lectures covering all surgical specialties. ADSCON 2006: “Progress & Dilemmas in Day Surgery” ADSCON 2007: “Super-speciality as Day Care” ADSCON 2008: “Towards Day Care Millennium” ADSCON 2010: “A new Revolution” ADSCON 2012: 22nd April-Hyderabad
- 8. Day Surgery Journal of India
- 9. Protocols of a Day Care Surgery Centre
- 10. First Day Cover Indian Postal Dept.
- 11. Sticker & Badge
- 14. Oration Dr. Ved Prakesh Mishra Dr. N. K. Deshmukh
- 15. Lectures
- 16. Workshops
- 17. Press meets
- 18. Press coverage
- 19. Across the Specialty Indian Medical Association. Associations of Surgeons of India. Association of Colon & Rectal Surgeons of India. Urological Society of India. Ophthalmic Surgeons of India. Plastic and Reconstructive Surgeons Associations. Federation of Obstetrics & Gynaecologist Society of India. Anaesthesiology Society of India. Orthopaedic Surgeons of India. Ayurvedic Surgical Society of India. Rotary Club. Antwerp University Hospital – Belgium Mahaveer International Various National & International Conferences
- 20. Insurance Royal Sundaram Alliance Insurance Company Limited.
- 21. We shall not indemnify you for any Insurance period of hospitalisation of less than 24 hours except for the 126 Day Care procedures the list of which is annexed Bajaj Allianz Insurance New India Assurance Company Limited
- 22. Any other Surgeries / Insurance Procedures agreed by TPA / COMPANY which requires less than 24 hours hospitalisation due to subsequent advancement in Medical Technology.
- 23. Abhishek Day Care Centre Stand Alone. Multispecialty. ISO Compliant & Certified. Fully Equipped Recognised for Insurance Claims
- 25. In the pipeline CM / Health Minister / Health Secretary / Director. Corporate Social Responsibility. Charity. Medical Council of India. Training programs for Nurses and Surgeons.
- 26. Internationally 7th International Congress on Ambulatory Surgery Amsterdam, the Netherlands, 2007.
- 27. Internationally 8th International Congress on Ambulatory Surgery. Brisbane, Australia. 2009.
- 28. Participating In Anna Hazare Movement
- 29. Thank you.