1) Blast injuries can cause a wide range of damage depending on factors like the type of explosive, distance from the blast, and presence of barriers. Primary injuries result directly from blast wave overpressure and include blast lung and traumatic brain injury.
2) Secondary injuries are caused by bomb fragments and debris that can penetrate the body. Tertiary injuries occur when the victim's body is propelled by the blast, often causing fractures and amputations upon impact. Quaternary injuries include burns, crush injuries, and complications from toxic inhalation/contamination.
3) Blast lung is a common primary injury where the rapid pressure change ruptures the lungs. Symptoms include hypoxemia. Treatment involves oxygen supplementation
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
injury to thorax and abdomen. tension pneumothorax , cardiac tamponade, rupture of kidney, rupture of liver, intestinal perforation, foreign body in rectum
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
injury to thorax and abdomen. tension pneumothorax , cardiac tamponade, rupture of kidney, rupture of liver, intestinal perforation, foreign body in rectum
On September 11, Corporal Robert Tye, Oklahoma County Sheriff’s Office, provided the OFFSHC a presentation about improvised explosive devices (IED). He discussed the components of and how to recognize an IED. Corporal Tye also displayed examples of inert IEDs that the Oklahoma County Sheriff may have recognized in Oklahoma.
A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA, DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY, GOVT. MEDICAL COLLEGE, JAMMU (JAMMU AND KASHMIR)
ON
INSANITY
Deals with the post-mortem examination (autopsy) particularly the internal examinations of the various organs based on Virchow's technique of organ removal.
Global Medical Cures™ | Explosions & Blast Injuries
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
BLAST INJURIES, An approach towards a patient that has suffered a blast injury.Dr. RIFFAT KHATTAK
"A blast injury", is a complex type of physical trauma resulting from direct or indirect exposure to an explosion. Blast injuries range from internal organ injuries, including lung and traumatic brain injury (TBI), to extremity injuries, burns, hearing, and vision injuries. Explosions cause familiar trauma .There may be LOTS of casualties with LOTS of injuries. Secondary blast trauma is the biggest killer. The efficiency of the Emergency Response Teams, in how quickly they could identify the injuries and their ability to shift the patients the a proper healthcare facility for timely surgical interventions can save lives.
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!
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.
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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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.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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.
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
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
3. High-Yield Explosives
Military grade (for example, C4, Hand-grenades,
landmines, and explosive artillery shells)
Commercial grade explosives
Primary high explosives (for example, nitroglycerin,
lead azide and tetrazene)
Secondary high explosives (for example, TNT and
dynamite)
Non-conventional (for example, nitrogen-fertilizer
mixes and calcium carbide)
4. M&M
Injury patterns are dependent on factors such as:
Composition and the amount of explosive used
Location of the detonation
Surrounding environment
Distance between the victim and the blast
Any intervening protective barriers or environmental
hazards
5. M&M
How people die in ground combat:
31% Penetrating Head Trauma
25% Surgically Uncorrectable Torso Trauma
10% Potentially Correctable Surgical Trauma
9% Exsanguination from Extremity Wounds
7% Mutilating Blast Trauma
5% Tension Pneumothorax 2nd
1% Airway Problems 3rd
<5% Died of Wounds (Mostly infections and complications of
shock)
14. Secondary Blast Effects
Penetrating trauma caused by
acceleration of shrapnel or blast debris
Any body part can be affected
Responsible for the majority of the
casualties
Types of injuries:
Penetrating ballistic (fragmentation)
Blunt injuries
Eye injuries
15.
16.
17. Tertiary Blast Effects
• Occurs when victim is propelled through the air
• Typical patterns of blunt trauma occurring on
impact with a solid object or the ground
• Blast wind may propel a 75kg adult with an
acceleration of close to 15G’s
• Any body part could be affected
• Types of injuries:
• Fracture and traumatic amputation
• Closed and open brain injuries
18. Quatenary Blast Injuries
• All explosion related injuries, illnesses, or diseases
which are not due to the other three categories
• Injuries primarily include exacerbation or
complications of existing conditions
• Types of injuries:
• Burns
• Crush injuries
• Closed or open brain injuries
• Restrictive Airway Disease, Acute Respiratory Distress (ARD)
syndrome, or other breathing problems from dust, smoke, or
toxic fumes
19.
20.
21.
22. Quinary Blast Effects
• Refers to the clinical consequences of "post
detonation environmental contaminants"
including:
• Bacteria (deliberate and commensally, with or without
sepsis)
• Radiation (dirty bombs)
• Tissue reactions to fuel and metals
• Types of injuries:
• Infections
• Contamination
• Fragmentation wounds
23. Primary
Pulmonary Injury Symptoms
Most often, blast effect on the lungs results in a "shock lung."
This may range from mild, pleuritic chest pain with
radiographic evidence of ARDS, but with normal oxygenation;
through pneumothorax or hemopneumothorax; to full blown
ARDS with hypoxemia and relatively normal to deranged
carbon dioxide levels.
Pulmonary Injury Treatment
Treat mild shock lung conservatively, while closely following
the patient for deterioration of pulmonary function or
evidence of hypoxemia.
If patient's condition continues to worsen, intubation and
assisted ventilation with PEEP may be required.
24.
25. Primary
Gastrointestinal Injury Symptoms
Clinical signs of abdominal injuries may be absent until the
onset of complications. The colon is the most common site
of both hemorrhage and perforation.
Symptoms that may indicate abdominal injury include:
Nausea
Vomiting
Rectal pain
Hematemesis
Tenesmus
Testicular pain
Unexplained hypovolemia
26. Primary
Gastrointestinal Injury Treatment
Computed Tomography (CT) scans or abdominal
x-ray series should be done if abdominal pain
persists and vomiting develops.
Symptoms of pulmonary contusion and intestinal
hematoma may take 12 to 48 hours to develop,
and the CT scans or x-rays may not be able to
make an early detection.
27. Secondary
• Fragments or other shattered objects may travel at
initial speeds of up to 5,000 feet/second
• Injuries may be minimal or extensive, penetrating any
part of the body
• Neck, chest, and abdominal wounds are a frequent cause
of death
• May also produce other hazards by severing electrical
lines, rupturing tanks or gas lines, and further weakening
structures
28.
29.
30. Secondary
Fragment Injuries
Symptoms
Wounds caused by fragmented material traveling at a high rate of speed
Injuries may be minimal to severe.
Penetrating wounds are a frequent cause of death.
Metal fragments pose the additional risk of producing heavy metal
poisoning.
Treatment
Should be treated as high-velocity missile injuries.
Contaminated wounds must be decontaminated before being treated.
Contaminated wounds with heavy metal that cannot be removed may
require patient to be returned for observation and follow-up assessment.
31. Tertiary
• Occur as objects flying from the blast hit victims.
• Blast winds may cause victims to become flying
objects themselves
It is rare that victims are thrown through the air and
suffer secondary blunt or penetrating trauma
Most frequently, victims sustain cuts, bruises, abrasions and
fractures from tumbling along the ground
32. Quaternary
Thermal Effects
• Primary thermal effects are the least common of the
effects of explosives.
• Occur only to people closest to the blast
• Unless caught in the fireball, or a secondary fire,
most thermal injuries are superficial flash burns as
from clothing that catches fire
33. Quaternary
Thermal Injuries
Symptoms
Primary thermal injuries are usually first- or second-degree
“thickness burns” unless clothing is ignited.
Victims enclosed in structures may suffer not only severe thermal
burns, but may develop thermal inhalation injuries.
Treatment
Thermal injuries due to explosions should be treated as any burn.
Topical antibiotics and silver impregnated dressings reduce the
likelihood of secondary infections.
Inhalation injuries will require rapid intubation prior to onset of
airway edema.
34. Quaternary
Crush injuries are the result of a compressed force
crushing the fascia-encapsulated muscle groups.
Symptoms
Crush injuries may result in:
• compartment syndrome of the upper or lower extremities,
• muscle necrosis,
• hyperkalemia,
• myoglobinuria,
• possible renal failure
35. Quaternary
Treatment
Check serum and urinanalysis in any patient entrapped
as the result of an explosion.
If renal function is intact, hyperkalemia will correct itself
without treatment unless severe.
Myoglobinuria treatment centers on preventing
myoglobin precipitation in the urine by maintaining a
brisk alkaline diuresis.
Administer saline loading immediately to patients with volume
depletion.
Consider follow up with mannitol to induce a diuresis, supported by
adequate IV fluids.
36. Blast Lung
The instantaneous rise in pressure caused by blast
wave induces injury by two basic mechanisms:
(1) compression and deformation of the chest wall by pressure
wave
(2) direct transmission of the blast wave into the body causing
damage by spalling, implosion and inertia.
37. Blast Lung
The most frequent and life threatening injury is
acute pulmonary hemorrhage from disruption of the
alveolar septa and pulmonary capillaries.
Lung injury is a major cause of death in patients who
survived initial resuscitation after exposure to Blast
Over Pressure (BOP).
Blast lung injury can cause severe hypoxemia, which
can be improved significantly with supplemental
oxygen.
38. Blast Lung: Experimental Model
The most consistent lesions after exposure to 120 kPa
BOP were scattered surface petechiation and
hemorrhage.
Survival rate in animals exposed to 120 kPa BOP was
90%.
In the lungs 2 hours postblast:
trace injury and petechial surface spots.
24 and 48 hours postexposure:
intensity of lung injury progressed to moderate level
scattered hemorrhagic lesions.
Later, lung lesions disappeared and at 192 hours
postexposure there were no visible signs of injury.
39. Blast Lung Injury Treatment
Tube thoracostomy alone is adequate
treatment for most simple lung parenchymal
injuries.
Large air leaks not responding to chest tubes or that
do not allow adequate ventilation will require open
repair (see tracheobronchial tree below).
Posterolateral thoracotomy is preferred for
isolated lung injuries. Anterior thoracotomy may
also be used.
40. Blast Lung Injury Treatment
Control simple bleeding with absorbable suture on a
tapered needle. Alternatively, staples (TA-90) may be
used for bleeding lung tears.
Resection for bleeding may be indicated with severe
parenchymal injury.
Anatomic resections are not indicated and simple
stapled wedge excisions recommended.
Uncontrolled parenchymal/hilar bleeding, or complex
hilar injuries with massive air leak should be controlled
with hilar clamping and repair attempted.
Pneumonectomy is performed as a last resort (90%
mortality).
41. References
Warden, D., MD., (2006). Military TBI During the Iraq
and Afghanistan Wars, Journal of Head Trauma
Rehabilitation, Vol. 21, No. 5, pp 398-402.
Chavko, M., Lung injury and recovery after
exposure to blast overpressure. J Trauma.
2006 Oct;61(4):933-42
Greenfield's Surgery: Scientific Principles &
Practice
Emergency War Surgery: Third United States
Revision, 2004