This document discusses various techniques for providing anesthesia that can save resources and reduce waste. It describes low flow anesthesia which uses only 30% of the typical gas flow, saving significant costs if implemented widely. It also discusses total intravenous anesthesia (TIVA) using intravenous drugs instead of gas, allowing for immediate recovery and less postoperative vomiting while being pollution-free. Finally, it summarizes techniques for managing waste anesthesia gases including closed circuit anesthesia and modified Bains circuits that vent gases out of the operating room.
Anesth considerations of pediatric patient with cardiac shunt for non cardiac...Bhavna Gupta
The large and growing population of patients who are living with CHD requires anaesthesia for non-cardiac surgeries and other procedures.
Knowledge of the pathophysiology of the common CHD lesions, as well as careful preoperative assessment and preparation, and communication with the patient’s cardiologist and surgeon, are essential to provide optimal care in the best setting for these patients.
Anesth considerations of pediatric patient with cardiac shunt for non cardiac...Bhavna Gupta
The large and growing population of patients who are living with CHD requires anaesthesia for non-cardiac surgeries and other procedures.
Knowledge of the pathophysiology of the common CHD lesions, as well as careful preoperative assessment and preparation, and communication with the patient’s cardiologist and surgeon, are essential to provide optimal care in the best setting for these patients.
Intra Operative and ICU Management of Transurethral Resection of Prostrate Sy...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
For over a decade, TIVA Healthcare has helped healthcare facilities and physician practices manage their physician staffing needs by offering cost-effective recruiting and staffing solutions.
At TIVA, we’re equally passionate about achieving the needs of our clients, the goals of our clinicians, and improving the level of care and satisfaction for patients. We place the highest-qualified clinicians in specialty-specific jobs quickly and with seamless integration—ensuring safety and continuity of patient care.
Intra Operative and ICU Management of Transurethral Resection of Prostrate Sy...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
For over a decade, TIVA Healthcare has helped healthcare facilities and physician practices manage their physician staffing needs by offering cost-effective recruiting and staffing solutions.
At TIVA, we’re equally passionate about achieving the needs of our clients, the goals of our clinicians, and improving the level of care and satisfaction for patients. We place the highest-qualified clinicians in specialty-specific jobs quickly and with seamless integration—ensuring safety and continuity of patient care.
The medical specialty of anesthesiology is founded on patient experience and patient safety. Having major surgery would be a very different experience without anesthesia. Before the advent of safe anesthesia techniques, the world of surgery was basically limited to amputations and other attempts at life-saving maneuvers. Dr. Bigelow’s publication describing the safe administration of ether changed everything, and the New England Journal of Medicine called this the most important article in its history. With this article, the science and clinical practice of anesthesiology, as well as the modern era of surgery, were born. Understanding and appreciating the rich history of anesthesiology will help guide the future direction of this specialty. Physician anesthesiologists have the skills necessary to take the quality of perioperative medicine to the next level, combat the opioid epidemic, and redesign the surgical experience,
By the end of this session, learners will be able to discuss:
1. The "learning curve" for regional anesthesia;
2. Technology for teaching and learning; and
3. Technology for assessment.
A Practical Approach to Ionotropes and vasopressors Aneesh Bhandary
Vasopressors are a powerful class of drugs that induce vasoconstriction and Inotropes increase cardiac contractility. Choice of an agent should be based upon the suspected underlying etiology of shock.
This presentation deals with the practical issues and controversies surrounding the use of these agents
Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – O...info622939
Embark on a compelling exploration of anesthesia innovation with our presentation on 'Awake Fiberoptic Intubation with Sedation in Cardiac (High-Risk) Patients – Our Experience.' Delve into the intricacies of this specialized technique, tailored for high-risk cardiac patients, as we share our unique insights and experiences.
To provide the respiratory therapist a set of guidelines and therapies specific for volume expansion and prevention/mobilization of secretions. This Slideshow focuses on the MetaNeb Device, it's benefits and procedures; it also highlights its indications and contraindications. Enjoy.
Summary:
Regional anesthetic techniques are increasing in popularity because of the improved recovery profiles
Intravenous adjuvants can provide patient comfort
Titrated infusion of rapid and short acting sedative drugs should enhance patient safety
Vigilant monitoring, supplemental oxygen, and the availability ressucitation equipment are strongly recommended
These slides represent how to manage patients on a mechanical ventilator? Easy understanding of using ventilators. indication of mechanical ventilator use. How to wean a patient from a mechanical ventilator? How to fine-tune the ventilator settings?
A case study is a written analysis of an actual clinical phenomeno.docxransayo
A case study is a written analysis of an actual clinical phenomenon or problem. This assignment involves a discussion of the related topic and should include citing research and background information supporting the issue. The analysis should also include possible solutions or how the issue was resolved.
The purpose of the clinical case study is to complement didactic information and present actual patient encounters. Please follow the following guidelines. 1. Maximum of 10 pages, double – spaced, including references/ bibliography. 2. Bibliography should include current literature (within the past 5 years) as well as textbooks on anesthesia practice and should follow APA format.
Master of Science Program in Anesthesiology
SRNA: Date: JUNE 22, 2016
Pre-op Diagnosis: LT ureteral stone
Planned Surgical Procedure: Cystoscopy: ureteroscopy, laser litherotripsy and stent placement to left side
Patient Demographics
Age: 62
HT: 160cm
WT: 95kg
BMI: 37
Gender: F
NPO since: MN 9hrs
Allergies: Tramadol
Airway Assessment
Mallampati Class: 2; soft palate, faces, portion of uvula
Neck Movement: (FULL ROM)
Mouth Opening: >3 Finger-breadth
Dentition: 2 lower loose teeth
Thyromental Distance: >3 Finger-breadth
ASA Class: 2; able to see pillars and soft palate, only part of uvula
METS: <4 slow walking (2mph)
Review of Systems
RESP: B/L breath sounds clear on auscultation
CV: SR on cardiac monitor, no mummers heard. S1/ S2
CNS: AAOX4
HEP/RENAL: Kindey stone
ENDOCRINE: (—)
GI: (—)
OTHER: Rt breast cancer
HISTORY:
Medical/Surgical: Rt breast Lumpectomy
Anesthetic: GETA
Social: patient denies
Family: No family history with problems with anesthesia
Medications / Dosage / Classification
Anesthetic Implications
1. Hyzaar 100/12.5; Antihypertensive; angiotensin II receptor antagonists combined with a thiazide diuretic
2. Baby aspirin; antipyretics; nonopioid analgesics; salicylates
3. omeprazole; antiulcer agents; proton pump inhibitors
4. Pyridium; nonopioid analgesics; urinary tract analgesics
1. losartan 100 mg; given alone or with other agents in the management of hypertension. Treatment of diabetic nephropathy in patients with type 2 diabetes. Prevention of stroke in patients with hypertension and left ventricular hypertrophy. hydrochlorothiazide 12.5 mg; Increases excretion of sodium and water by inhibiting sodium reabsorption in the distal tubule. Promotes excretion of chloride, potassium, hydrogen, magnesium, phosphate, calcium and bicarbonate. May produce arteriolar dilation.
2. Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreases platelet aggregation.
Reduction of inflammation. Reduction of fever. Decreased incidence of transient ischemic attacks and MI.
3. Binds to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen.
4. Acts locally on the urinary tract mucosa to produce analgesic .
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.
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.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
3. Low / Minimal Flow
Anaesthesia
❖ Classically we use >4-5 L per minute of a mixture of
Oxygen and Nitrous Oxide gas to provide safe General
Anaesthesia to our patients.
❖ However it is possible to utilise only 0.5-1 L per minute of
these gases now and this is known as Low Flow
Anaesthesia.
❖ Advantages: 1. Economical 2. Low OT pollution
❖ Not used widely: 1. Monitoring 2. Habits 3. Training
5. TIVA
❖ As the name suggests Anaesthesia is provided by a
continuous controlled intravenous infusion of drugs.
❖ Uses an Electronic Infusion Pump.
❖ Advantages : 1. Immediate recovery 2. Less Post-Op vomiting
❖ 3. Pollution free
❖ Not used widely: 1. Training 2. Device needed
9. Laryngeal Mask Airways
❖ Classical General Anaesthesia uses Tracheal Intubation
❖ New LMAs now considered safe , better alternative for
most surgeries (except Head and neck surgeries & Obstetrics)
❖ Advantages: 1. Haemodynamics 2. Safer ( Infections ) 3. Less Soar Throat
❖ Not used widely: 1. Training 2. Availability 4. No difference to anaesthesiologist
10.
11. Patient on Deliberate Hypotensive Anaesthesia BP
96/42
Delibrate
Hypotensive
Anaesthesia
SBP 80- 90mmHg
MAP 50-60 mmHg
MAP reduction by 20-30%
