Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
This presentation gives a fine description about stoma and ostomy. This contains the details regarding types, complications and the advices that you should give to a patient with a stoma.
Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. Hemorrhoids are also called piles.
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
This presentation gives a fine description about stoma and ostomy. This contains the details regarding types, complications and the advices that you should give to a patient with a stoma.
Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. Hemorrhoids are also called piles.
LAPAROSCOPIC APPENDICECTOMY- OPERATIVE SURGERY
Dear Viewers,
Greetings from “Surgical Educator”
In this episode I am talking about how to do Laparoscopic Appendicectomy. This is not the real surgery video, but I am discussing the theoretical aspect of the Laparoscopic Appendicectomy. I am discussing about the indications, positioning of patient & surgeon, port placement, creation of pneumoperitoneum and the sequential steps in doing Laparoscopic Appendicectomy. After watching this video, I recommend my viewers to watch the actual real Laparoscopic Appendicectomy surgery, which I have included at the end of this video as one of the end cards. In this way you can do a mental rehearsal of the various steps of the surgery before you are actually going to do it. You can watch the videos in the following Links:
Surgicaleducator.blogspot.com
Youtube.com/c/surgicaleducator
Thank you for watching the video.
Appendicitis is characterized by inflammation of the appendix. it is most common abdominal emergency encountered in children. most common symptom is pain., vomiting and low - grade fever. Here, nurses play an important role in managing the problem before the doctor arrives. so read this out and it will help you in the future.
Acute appendicitis is a condition in which appendix get inflammed and cause extreme pain , we can diagnose it clinically by different clinical tests and decide whether to treat it medically or go for surgery. Further different types of appendix surgery i.e. open appendectomy and laproscopic appendectomy are also explained. All the steps of appendectomy are also explained in it.
visit my youtube channel ' medical tribe ' for more medical related content, here is the link of it ; https://www.youtube.com/channel/UCM19PdhYFnUTWvKnq2PoLAQ
Describes the concept of a surgical abdomen, acute abdominal pain, emergency intervention and approach to management, including the controversial use of analgesic and antibiotics in emergency room.
Appendicitis refers to acute inflammation of the appendix, and is the most common cause of acute abdomen requiring emergency surgery. It typically presents with periumbilical pain, which migrates to the right lower quadrant (RLQ), associated with fever, vomiting, anorexia, and malaise.
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
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
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.
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
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- 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
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.
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
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.
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
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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.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. Anatomy • A blind muscular tube with
mucosal, submucosal,
muscular and serosal layers
• Position of the base of the
appendix is constant, being
found at the confluence of
the three taeniae coli of the
caecum, which fuse to form
the outer longitudinal muscle
coat of the appendix.
WHAT IS APPENDIX?
3. Various positions of the appendix:
• Vascularisation
Appendicular
artery, a branch of
the lower division of
the ileocolic artery,
4. APPENDICITIS:-
Definition:
• An inflammation of the vermiform
appendix
Aetiology:
• Decreased dietary fibre and increased
consumption of refined carbohydrates
• Obstruction of the appendix lumen
– Fecolith (composed of inspissated
faecal material, calcium phosphates,
bacteria, epithelial debris, rarely a
foreign body)
– Tumour (carcinoma of caecum)
– Intestinal parasites (Oxyuris /
Enterobius vermicularis – pinworm)
5. Pathophysiology of Appendicitis
• Lymphoid hyperplasia leads to luminal
obstruction
• Often follows viral illness
• Epithelial cells secrete mucus
• Appendix distends, bacteria multiply
• Visceral pain begins an average of 17
hours after obstruction
6. History
• Primary symptom: abdominal pain
• ½ to 2/3 of patients have the classical
presentation
• Pain beginning in epigastrium or
periumbilical area that is vague and hard
to localize
7. History
• Associated symptoms: indigestion,
discomfort, flatus, need to defecate,
anorexia, nausea, vomiting
• As the illness progresses RLQ localization
typically occurs
• RLQ pain was 81 % sensitive and 53%
specific for diagnosis
8. History
• Migration of pain from initial periumbilical
to RLQ was 64% sensitive and 82%
specific
• Anorexia is the most common of
associated symptoms
• Vomiting is more variable, occuring in
about ½ of patients
11. CLINICAL SIGNS
• Psoas sign: place patient in L lateral
decubitus and extend R leg at the hip. If
there is pain with this movement, then the
sign is positive.
• Obturator sign: passively flex the R hip
and knee and internally rotate the hip. If
there is increased pain then the sign is
positive
14. Diagnosis
• Acute appendicitis should be suspected in
anyone with epigastric, periumbilical, right
flank, or right sided abd pain who has not
had an appendectomy
15. Diagnostic Scoring
• Diagnosis is essentially clinical
• HOWEVER a decision to
operate based on clinical
suspicion only can lead to the
removal of a normal appendix.
• A number of clinical and
laboratory-based scoring
systems have been devised to
assist diagnosis.
• The most widely used
is Alvarado score.
16. The Alvarado (MANTRELS)
Score
Score
Symptoms
•Migratory RIF pain
•Anorexia
•Nausea and vomiting
1
1
1
Signs
•Tenderness (RIF)
•Rebound tenderness
•Elevated temperature
2
1
1
Laboratory
•Leucocytosis
•Shift to the left (segmented
neutrophils)
2
1
TOTAL 10
• < 5 is strongly against a diagnosis of appendicitis
• 7 or more is strongly predictive of acute appendicitis
• In patients with an equivocal score of 5 or 6, abdominal
USG or contrast-enhanced CT scan is used to further
reduce the rate of negative appendicectomy
21. Treatment
• Intravenous fluids
• to establish adequate urine output
• Appropriate antibiotics
• Reduces the incidence of
postoperative wound infection
• When peritonitis is suspected,
therapeutic intravenous antibiotics
to cover Gram-negative bacilli as
well as anaerobic cocci should be
given
• Salicylates
• Appendicectomy
22. Treatment
• Appendicectomy is the standard of care
• Patients should be NPO, given IVF, and
preoperative antibiotics
• Antibiotics are most effective when given
preoperatively and they decrease post-op
infections and abscess formation
23. Treatment
• There are multiple acceptable antibiotics to
use as long there is anaerobic flora,
enterococci and gram(-) intestinal flora
coverage
• One sample monotherapy regimen is
Zosyn (piperacillin+ tazobactam) 3.375g or
Unasyn (ampicillin and Salbactam) 3g
• Also, short acting narcotics should be used
for pain management
24. Epidemiology of
Appendicectomy
• The incidence of appendicectomy appears
to be declining due to more accurate
preoperative diagnosis
• Despite newer imaging techniques, acute
appendicitis can be very difficult to
diagnose
26. Conventional Appendicectomy
Gridiron incision :
right angles to a line
joining the ASIS to the
umbilicus. Centred on
McBurney’s point
Lanz incision : 2 cm
below the umbilicus
centred on the mid-
clavicular-mid
inguinal line
2/
31/
3
2
cm
31. Problems Encountered During
Appendicectomy
Problems Management
A normal appendix is
found
Demands careful exclusion of
other possible diagnosis
Remove the appendix to avoid
future diagnostic difficulties
The appendix cannot be
found
Caecum should be mobilised,
and the taeniae coli should be
traced to their confluence on the
caecum before the diagnosis of
‘absent appendix’ is made
An appendicular tumour
is found
Small tumours (< 2.0 cm in
diameter) can be removed by
appendicectomy
Larger tumours should be treated
by a right hemicolectomy
An appendix abscess is
found and the appendix
cannot be removed
easily
Should be treated by local
peritoneal toilet, drainage of an
abscess and intravenous
antibiotics
34. • Position the patient on the OR table
• Skin preparation
• Induction of anesthesia
• Procedures done aseptically
• Closing of the incision
• Dressing of the site
INTRAOPERATIVE NURSING
CARE
35. • Monitor vital signs for sign of infection and
shock such as fever, hypotension and
tachycardia.
• Monitor I and O for sign of imbalance,
dehydration, and shock.
• Assess abdomen for increased pain,
distention, rigidity, and rebound tenderness
because these may indicate postoperative
complications.
• Evaluate dressing and incision.
• Evaluate the passing of flatus or feces.
POST OPERATIVE MANAGEMENT
AND NURSING CARE
36. • Monitor for nausea and vomiting.
• Laboratory values are monitored and patient is
evaluated for sign and symptoms of electrolyte
imbalances.
• Wound drains, I.V, and all other catheter are
monitored and evaluated for signs of infections.
• Turning , coughing, deep breathing, and
incentive spirometry are performed every 2
hours.
• Diet is advised as ordered.
• Administration of medications as ordered
37. Patient Education and Health Maintenance
oInstruct patient to avoid heavy lifting for 4 to
6 weeks after surgery.
oInstruct patient to report symptoms of
anorexia, nausea, vomiting, fever, abdominal
pain, incision area redness and drainage
postoperatively.
Microscopic anatomy:
- average length is between 7.5 and 10 cm
- lumen is irregular, being encroached upon by multiple longitudinal folds of mucous membrane lined by columnar cell intestinal mucosa of colonic type
- Crypts are present but not numerous. In the base of the crypts lie argentaffin cells (Kulchitsky cells)
- submucosa contains numerous lymphatic aggregations or follicles.
CT findings of appendicitis fall into 3 categories
1. appendiceal changes
2. cecal apical changes
3. inflammatory changes in the right lower quadrant