The document provides an overview of hemorrhoids including their definition, etiology, classification, clinical presentation, diagnosis, and treatment options. Some key points include:
- Hemorrhoids are symptomatic enlargement of the anal cushions and the most common symptom is rectal bleeding with bowel movements.
- Risk factors include constipation, pregnancy, and increased pelvic pressure. Hemorrhoids are classified based on their location and severity.
- Clinical evaluation involves physical examination and anoscopy. Treatment depends on severity but includes dietary and lifestyle changes, minimally invasive procedures like rubber band ligation, and surgery for advanced cases. Surgical recovery involves pain management and preventing complications.
Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
EPIDIDYMAL CYST
VARICOCELE
Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
EPIDIDYMAL CYST
VARICOCELE
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Hello!
This is a quick review PPT for medical students.
It includes description at a glance of all the commonly occuring benign anal and perianal conditions like; haemorrhoids, fissure in ano, fistula in ano etc.
Hope this is worth sharing
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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.
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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.
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.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
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- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Anorectal diseases
1. Done BY : Sara Al-Ghanem | 208009915
Supervised BY: Dr. M. Yasser
1
2. To understand surgical anatomy of anus and rectum in relation
to surgical disease and treatment
To understand the pathology, CF, investigations, D/Ds and
treatment
To appreciate that ano-rectal disease is common and conservative
treatment may be appropriate before surgery
To understand that too aggressive or inappropriate surgery may
be dangerous
Benign diseases overview: Anal Fissure, Haemorrhoid, Pilonidal
Sinus
Anorectal suppurations: Absesses & Fistulas.
Rectal prolapse
Per Rectal Examination 2
3. A 60 year old man known to have hemorrhoids
complains of anal itching & discomfort , particularly
toward the end of the day .
He has mild perianal pain when sitting down & finds
him self sitting away to avoid the discomfort .
3
5. 12-16 cm in length,
starting at about the sacral
promontory extending to
dentate line of anal canal
Anterior aspect of the upper 4-
6 cm is intraperitoneal with
serosal surface.
Lower (majority of) rectum
lies within extraperitoneal
pelvis, with no serosa.
5
6. No taenia coli.
Taeniae coli spread out at rectosigmoid junction to form a continuous,
external longitudinal muscle layer
No Sacculations.
No appendices apiploicae
transverse folds
6
7. Superior rectal valve
Middle rectal valve
Inferior rectal valve
Three submucosal
folds ( the valves of
Houston )
7
9. The superior rectal the terminal branch of the inferior
artery mesenteric artery
(superior hemorrhoidal artery)
The middle rectal artery The internal Iliac artery
(middle hemorrhoidal artery)
from the internal pudendal artery,
The inferior rectal artery which is a branch of the internal
(inferior hemorrhoidal artery)
iliac artery.
9
11. The superior into the portal system via the inferior
rectal vein mesenteric
The middle
into the internal iliac vein
rectal vein
The inferior into the internal pudendal vein, and
rectal vein subsequently into the internal iliac
11
12. I- inferior mesenteric nodes
Lymph from the upper and
middle rectum flows in channels
that parallel the arterial supply
and is filtered by the inferior
mesenteric nodes.
II- the internal iliac lymph nodes
Lymph from the distal rectum
flows into channels adjacent to
the middle and inferior rectal
arteries. These
channels drain to iliac nodes.
12
16. It is the terminal part of the large intestine.
It lies below the pelvic diaphragm level, in the ANAL
TRIANGLE OF PERINEUM, between the ischiorectal fossae.
The anatomical anal canal extends from the perineal skin to
the linea dentata.
The surgical anal canal measures 4 to 5cm in length and
It begins at the anorectal junction ( anorectal ring ) and terminates at
the anal verge.
The anorectal ring This is the circular upper border of the
puborectal muscle which is digitally palpable upon rectal ex.
It lies approximately 1-1.5 cm above the linea dentata.
16
18. The dentate or pectinate line:
marks the transition point between columnar rectal mucosa and
squamous anoderm.
The anal transition zone:
The 1 to 2 cm of mucosa just proximal to the dentate line shares
histologic characteristics of columnar, cuboidal, and squamous
epithelium.
The columns of Morgagni:
The dentate line is surrounded by longitudinal mucosal folds,
known as the columns of Morgagni, into which the anal crypts
empty. These crypts are the source of cryptoglandular abscesses
18
19. Canal includes dentate line, anal glands, internal and external
sphincter muscles, and hemorrhoidal vessels .
The anal canal is lined by anoderm, a specialized epithelium
that is devoid of hair follicles, sebaceous glands, or sweat glands
but has a rich nerve supply.
The junction between the anoderm and perianal skin is the anal
verge.
19
21. The anal sphincter is comprised of three layers:
Internal sphincter: continuance of the circular smooth
muscle of the rectum, involuntary and contracted
during rest, relaxes at defecation.
Intersphincteric space. Small anal glands are located
between the internal and external sphincters and
communicate with the anal crypts via anal ducts.
External sphincter: voluntary striated muscle, divided
in three layers that function as one unit.
These three layers are continuous cranially with the
puborectal muscle and levator ani. 21
22. Above The dentate line Below The dentate line
Arterial blood supply Superior rectal artery Middle rectal artery
inferior rectal artery
Venous drainage Superior rectal vein middle & inferior rectal
(Portal) veins (systemic )
Lymphatic drainage upper part of anal canal: Lower part of anal canal
Internal iliac nodes into Superficial
inguinal nodes.
Innervations Autonomic Somatic
22
23. Internal & external venous plexus.
Internal or hemorroideal venous plexus lies in submucosa,
external lies outside the muscle coat of canal.
Both communicates with each other so it is a site of
portocaval anastomoses.
Superior rectal (Portal) anastomoses freely with middle
& inferior rectal veins (systemic ) •23
27. Hemorrhoids basically means "blood flow"
[Greek 'haima' meaning "blood" + 'rhoia' meaning
"flow"].
Hemorrhoids are defined as the symptomatic
enlargement and distal displacement
of the normal anal cushions. The most
common symptom of hemorrhoids is rectal
bleeding associated with bowel movement. 27
28. Hemorrhoids: Hemorrhoids are cushions of
submucosal tissue containing venules, arterioles,
and smooth muscle fiber. They are thought to play a
role in maintaining continence.
They are located in the left lateral , right anterior
and right posterior.
This normal tissue protects the sphincter during
defecation and permits complete closure of the anus
during rest.
Risk factors: Constipation, pregnancy, increased
pelvic pressure (ascites,tumors), portal hypertension
28
37. Bleeding from first- and second-degree hemorrhoids
often improves with the addition of :
dietary fiber
stool softeners
Sitz bath
increased fluid intake
avoidance of straining.
Associated pruritus may often improve with
improved hygiene
37
38. Rubber band ligation Cryosurgery
Bipolar, infrared, and laser
Laser hemorrhoidectomy
coagulation
Doppler-guided
Sclerotherapy hemorrhoidal artery
ligation
38
39. Failure of medical and nonoperative therapy
Symptomatic third-degree, fourth-degree
mixed internal and external hemorrhoids
Fibrosed hemorrhoids
External hemorrhoids
Symptomatic hemorrhoids in the presence of a
concomitant anorectal condition that requires surgery
Patient preference after discussion of the treatment
options with the referring physician and surgeon.
39
41. Early Late
Secondary
Pain
hemorrhage
Acute
retention of Anal fissure
urine
Reactionary Anal
hemorrhage stricture
Incontinence
41
42. Anorectal diseases lecture ,Dr.M.Yasser Daoud
Anatomy of rectum & anus , Dr. MOHD. IMTIYAZ
Netter’s surgical anatomy review
Schwartzs.Principles.of.Surgery.9Ed
NMS Surgery
First Aid Surgery
Uptodate
42