Laparoscopic and open adrenalectomy are surgical procedures to remove one or both adrenal glands. Laparoscopic adrenalectomy is preferred for benign tumors. Open adrenalectomy is used for large tumors or suspected cancer. The adrenal glands are located near the kidneys and removal involves carefully dissecting and ligating the adrenal vein. Potential complications include insufficient hormone production, bleeding, infections, and injury to nearby organs. Adrenalectomy is usually performed for conditions like Conn syndrome, Cushing syndrome, pheochromocytoma, adrenocortical carcinoma, or neuroblastoma.
Prostatectomy Surgery abroad in India info on cost Prostatectomy Surgery India,Prostatectomy male Surgery hospitals India,Prostatectomy surgeons India.
Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
Prostatectomy Surgery abroad in India info on cost Prostatectomy Surgery India,Prostatectomy male Surgery hospitals India,Prostatectomy surgeons India.
Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.
Establishing the need for a surgical intervention
Confirmation of relevant physical findings and review of the clinical history and laboratory investigations that support the need of surgical intervention
Type of approach- Benefits & Risks of surgical procedure
The incision site- ease of surgery as well as cosmetic considerations
Type of anesthesia
An incision in the abdomen is an opening or a cut made by the surgeon. An incision in the abdomen is an opening or a cut made by the surgeon. It is done to permit access to abdominal organs for surgery. The selection of an incision depends on. Underlying condition prompting the surgery.
Presentation on different levels of amputation of upper limb including hand amputations., thumb reconstructions, kruckenberg amputation, thumb poloicization.
An incision in the abdomen is an opening or a cut made by the surgeon. An incision in the abdomen is an opening or a cut made by the surgeon. It is done to permit access to abdominal organs for surgery. The selection of an incision depends on. Underlying condition prompting the surgery.
Presentation on different levels of amputation of upper limb including hand amputations., thumb reconstructions, kruckenberg amputation, thumb poloicization.
Adrenal Gland and its Disorders with surgical management.Manish Shetty
Short and brief description of adrenal gland and its disorder.
it involves the basic anatomy, physiology and metabolism of adrenal hormones.
.Adrenal gland tumor like adrenal cortical tumor phaechromocytoma, incidentalaoma are mentioned in this PPT.
it explains the clinical symptoms, investigation and desired management of adrenal gland disorders.
Surgical management of Carcinoma EsophagusLoveleen Garg
A detailed dicussion on surgical procedures & steps to be followed during surgery for Carcinoma esophagus.
Source- Schwartz's Principles of Surgery, 9th Edition
Excretionurography
Also known as intravenous urography (IVU).
Most frequently employed radiologic investigation of renal rainage.
The contrast material is administered intravenously.
Best method for adults unless use of other methods is specified and is used in examinations of upper urinary tracts of infants and children.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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
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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.
3. ANATOMY
Weight = 4g
2 adrenal gland,
right and left
2 component ; inner
adrenal medulla and
outer adrenal cortex
Situated near upper
poles of kidneys in
retro peritoneum,
within Gerota’s
capsule
4. ANATOMY CON’T
Right adrenal
gland
– between
right liver
lobe and
diaphragm
Left adrenal gland
– close to upper
pole of left kidney
and renal pedicle,
covered by
pancreatic tail and
spleen
6. DEFINITION
Adrenalectomy is the surgical removal of
one or both (bilateraladrenalectomy) adrenal
glands.
• It is usually advised for patients with tumors
of the adrenal glands.
• The procedure can be performed using an
open incision (laparotomy)
or laparoscopic technique.
8. 1. Conn syndrome
• Primary aldosteronism, also
known as primary
hyperaldosteronism or Co
nn's syndrome, is excess
production of the hormone
aldosterone by the adrenal
glands resulting in low renin
levels.
• Often it produces
few symptoms. Most
people have high blood
pressure which may cause
poor vision or headaches.
9. 2. CUSHING’S SYNDROME
• Cushing's syndrome is
caused by either
excessive cortisol-like
medication such as
prednisone or a tumor
that either produces or
results in the
production of excessive
cortisol by the adrenal
glands.
10. 3.PHEOCHROMOCYTOMA
• Pheochromocytoma is
a rare tumor of adrenal
gland tissue.
• It results in the release
of too much
epinephrine and
norepinephrine,
hormones that control
heart rate, metabolism,
and blood pressure.
11. 4. LARGE MYELOLIPOMA
• Myelolipoma (myelo-,
from the ancient greek
marrow;
lipo, meaning of, or
pertaining to, fat; -
oma meaning tumor or
mass) is a benign
tumor-like lesion
composed of mature
adipose (fat) tissue and
haematopoietic (blood-
forming) elements in
12. 4. METASTASTIC TUMORS
• Metastasis is the
spread of cancer cells to
new areas of the body
(often by way of the
lymph system or
bloodstream).
• A metastatic cancer,
or metastatic tumor, is
one which has spread
from the primary site of
origin (where it started)
into different area(s) of
13. 5. ADRENO CORTICAL
CARCINOMA
• Adrenocortical
carcinoma is a rare
disease in which
malignant (cancer) cells
form in the outer layer
of theadrenal gland.
• There are
two adrenal glands.
Theadrenal glands are
small and shaped like a
triangle.
One adrenal gland sits
14. 6. NEUROBLASTOMA
• Neuroblastoma (NB) is
a type of cancer that
forms in certain types of
nerve tissue. It most
frequently starts from
one of the adrenal
glands, but can also
develop in the neck,
chest, abdomen, or
spine. ..
16. SURGERY OF THE ADRENAL
GLANDS
LAPAROSCOPIC ADRENALECTOMY:
RIGHT ADRENALECTOMY
LEFT ADRENALECTOMY
RETROPERITONEOSCOPIC
ADRENALECTOMY
OPEN ADRENALECTOMY
17. TYPES OF ADRENALECTOMY
The two types of adrenalectomy
1. Open adrenalectomy
2. Laparoscopic adrenalectomy
18. OPEN ADRENALECTOMY
An open adrenalectomy is often required
when either the adrenal glands or the
tumors are abnormally large.
In this procedure a single incision is made
either in the abdominal wall just under
the ribcage, or the back or sides.
19. OPEN ADRENALECTOMY
Malignant adrenal tumour suspected
Rt side: hepatic flexure of the colon is
mobilised & the rt liver lobe is cranially
retracted to achieve an optimal
exposure of the IVC & the adrenal gland
Lf side: AG can be exposed after
mobilisation of the splenic flexure of the
colon,through the transverse mesocolon/
the gastrocolic ligament
Resection of regional lymph node is
recommended and should include
resection of the tissue between the renal
20. LAPROSCOPIC ADRENALECTOMY
Laparoscopic adrenalectomy is the procedure
of choice for benign (non-cancerous) adrenal
tumors.
Laparoscopic surgery has proved to be a
major advancement for the management of
adrenal tumors.
21. RIGHT ADRENALECTOMY
Position: right side up,with table brake
Dissection start at the level of the periadrenal
fat
Peritoneum is divided 2cm below the edge of
liver
• from medial(IVC) to the lateral abdominal wall
Flap of peritoneum can be used to retract the
liver up & off the adrenal
Identify the gland and mobilise gently,
securing the vein with a clip/using one of
the available energy device
23. LEFT ADRENALECTOMY
Position: right side
Mobilisation of the spleen will displace
the pancreatic tail medially
Incison of Gerota’s fascia is followed by
• identification of the adrenal vein
The resection is completed by mobilising the
• adrenal gland at the level of the periadrenal
fat
Remove the gland in a bag
25. RETROPERITONEOSCOPIC
ADRENALECTOMY
1ST port: distal end of the 12th rib(prone
• position)
Digital dissection into the retroperitoneum,
• Gerota’s fascia is displaced ventrally
RAV is covered by the retrocaval posterior
aspect of the adrenal gland
LAV is located at the medial inferior pole of the
• adrenal gland
High inflation pressures allow bloodless
• dissection effectively tamponading the veins
26.
27. COMPLICATIONS
• Insufficient cortisol production.
• Decreases in blood pressure.
• Bleeding.
• Infections in the wound, urinary tract, or
lungs.
• Blood clots in the legs.
• Injury to nearby organs or structures.
• Adverse reaction to anesthesia.