This document contains 7 articles written by Dr. Syed M. Raza discussing various topics in acute elderly care and cardiology. The articles debate whether separate elderly care units are needed, the benefits of competition in healthcare, the roles and responsibilities of doctors, induction programs for new doctors, and challenges in diagnosing indolent endocarditis.
A presentation by Sven Erik Gisvold at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
The implication of the 'covenant'' of care - are we on the same page? by A.Pr...SMACC Conference
This paper explores whether surgeons and intensivists differ through the effect of the “surgical covenant of care”. This covenant is very much a product of the shared journey taken by both surgeon and patient and is well described in medical literature. This literature is reviewed and learnings highlighted. In addition to this covenant, a number of other differences that may impact on how surgeons behave are also explored. These include the culture of surgeons and their training, models of administration for ICU units, the nature of professional decision making and the effects that age, experience and visiting surgical appointments might have on Intensivist- Surgeon relationships in an ICU. Finally, a number of pointers to better inter-professional practice are offered.
Marina Kastelan, Neuro Oncology Care Coordinator,
Sydney Neuro Oncology Group, RNSH presents at the Brain Tumour Patient Forum, hosted by the Cure Brain Cancer Foundation.
A presentation by Sven Erik Gisvold at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
The implication of the 'covenant'' of care - are we on the same page? by A.Pr...SMACC Conference
This paper explores whether surgeons and intensivists differ through the effect of the “surgical covenant of care”. This covenant is very much a product of the shared journey taken by both surgeon and patient and is well described in medical literature. This literature is reviewed and learnings highlighted. In addition to this covenant, a number of other differences that may impact on how surgeons behave are also explored. These include the culture of surgeons and their training, models of administration for ICU units, the nature of professional decision making and the effects that age, experience and visiting surgical appointments might have on Intensivist- Surgeon relationships in an ICU. Finally, a number of pointers to better inter-professional practice are offered.
Marina Kastelan, Neuro Oncology Care Coordinator,
Sydney Neuro Oncology Group, RNSH presents at the Brain Tumour Patient Forum, hosted by the Cure Brain Cancer Foundation.
ANEMIA IS ASSOCIATED WITH GREATER MORBIDITY AND RESOURCE UTILIZATION IN PEDIA...Texas Children's Hospital
Design: Retrospective cohort study querying the Pediatric Health Information System (PHIS) database, comprised of 50 children’s hospitals over 10 years (01/2008 to 12/2017).
Admissions of patients aged < 21 years (yr) with ICD-9/10 codes for systolic HF were included. Patients with congenital heart disease (CHD) codes were excluded to avoid confounding by polycythemia due to cyanotic CHD.
Demographic and clinical features and procedures during admission reviewed using ICD-9/10 coding.
Outcomes: Primary outcome was composite cardiac death (CCD, defined as ventricular assist device (VAD), heart transplant (HTx), or death during admission), and the secondary outcomes were hospital length of stay (LOS) and billed charges.
Univariate and multivariable analyses performed using generalized estimating equations (GEE) for categorical outcomes and mixed modeling for continuous outcomes, to account for clustering by hospitals - factors with p<0.2 on univariate analysis included in the initial multivariable model, and factors with p<0.05 retained in successive models.
In a hospital admission of a pediatric patient with systolic HF without CHD, anemia is associated with more systemic comorbidities, and greater resource utilization (longer LOS and higher billed charges).
This suggests a need for examining anemia management strategies to optimize pediatric HF outcomes.
[03/2019]
As surgical and medical outcomes of children with congenital heart disease improve, it is expected that the pediatric population with heart failure (HF) will increase.
To describe the characteristics and inpatient outcomes of HF patients across USA
Type of study: Retrospective cohort study
Database: Pediatric Health Information System Study period: January 2004 - December 2017
Inclusion criteria: All HF ICD 9/10 codes in patients ≤ 21 y/o from 50 different hospitals across USA
Contributors, complications, and causative factors for central venous cathete...Texas Children's Hospital
Central venous catheter (CVC) use is common in the management of critically ill children, especially those with congenital or acquired heart disease (CHD).
Prior studies suggest that the presence of a CVC augments the risk of deep vein thrombosis (DVT) in adults and children.
In recent years, the reported incidence of VTE in children has increased dramatically.
How CVC-associated DVTs contribute to morbidity and mortality in this high risk patient population is unknown
Do you need palliative care services at Home?NelonPty
Palliative Care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Elevated Tissue Doppler E/E' on Index Admission Can Help Identify Patients at...crimsonpublishersOJCHD
Readmissions for congestive Heart Failure (CHF) are a major healthcare problem that contributes significantly to the overall healthcare expenditure. About 24% of patients are readmitted to the hospital within 30 days of discharge. We investigated whether a non-invasive estimate of left atrial filling pressure, an elevated ratio of early trans mitral flow velocity to early diastolic mitral annular velocity (E/E'), during the index admission for CHF could independently predict 30 day readmission.
The goal of this webinar was to educate physicians and healthcare professionals about hospice eligibility and benefits for patients with advanced cardiac disease (ACD).
ANEMIA IS ASSOCIATED WITH GREATER MORBIDITY AND RESOURCE UTILIZATION IN PEDIA...Texas Children's Hospital
Design: Retrospective cohort study querying the Pediatric Health Information System (PHIS) database, comprised of 50 children’s hospitals over 10 years (01/2008 to 12/2017).
Admissions of patients aged < 21 years (yr) with ICD-9/10 codes for systolic HF were included. Patients with congenital heart disease (CHD) codes were excluded to avoid confounding by polycythemia due to cyanotic CHD.
Demographic and clinical features and procedures during admission reviewed using ICD-9/10 coding.
Outcomes: Primary outcome was composite cardiac death (CCD, defined as ventricular assist device (VAD), heart transplant (HTx), or death during admission), and the secondary outcomes were hospital length of stay (LOS) and billed charges.
Univariate and multivariable analyses performed using generalized estimating equations (GEE) for categorical outcomes and mixed modeling for continuous outcomes, to account for clustering by hospitals - factors with p<0.2 on univariate analysis included in the initial multivariable model, and factors with p<0.05 retained in successive models.
In a hospital admission of a pediatric patient with systolic HF without CHD, anemia is associated with more systemic comorbidities, and greater resource utilization (longer LOS and higher billed charges).
This suggests a need for examining anemia management strategies to optimize pediatric HF outcomes.
[03/2019]
As surgical and medical outcomes of children with congenital heart disease improve, it is expected that the pediatric population with heart failure (HF) will increase.
To describe the characteristics and inpatient outcomes of HF patients across USA
Type of study: Retrospective cohort study
Database: Pediatric Health Information System Study period: January 2004 - December 2017
Inclusion criteria: All HF ICD 9/10 codes in patients ≤ 21 y/o from 50 different hospitals across USA
Contributors, complications, and causative factors for central venous cathete...Texas Children's Hospital
Central venous catheter (CVC) use is common in the management of critically ill children, especially those with congenital or acquired heart disease (CHD).
Prior studies suggest that the presence of a CVC augments the risk of deep vein thrombosis (DVT) in adults and children.
In recent years, the reported incidence of VTE in children has increased dramatically.
How CVC-associated DVTs contribute to morbidity and mortality in this high risk patient population is unknown
Do you need palliative care services at Home?NelonPty
Palliative Care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Elevated Tissue Doppler E/E' on Index Admission Can Help Identify Patients at...crimsonpublishersOJCHD
Readmissions for congestive Heart Failure (CHF) are a major healthcare problem that contributes significantly to the overall healthcare expenditure. About 24% of patients are readmitted to the hospital within 30 days of discharge. We investigated whether a non-invasive estimate of left atrial filling pressure, an elevated ratio of early trans mitral flow velocity to early diastolic mitral annular velocity (E/E'), during the index admission for CHF could independently predict 30 day readmission.
The goal of this webinar was to educate physicians and healthcare professionals about hospice eligibility and benefits for patients with advanced cardiac disease (ACD).
Scholarly video journals to increase productivity in research and educationNASIG
The biological and medical research chronically suffers from the low reproducibility of experimental studies since the traditional text format of science journals cannot provide an adequate description of details and nuances of complex experimental procedures. This creates a critical “bottleneck” problem of knowledge transfer for research and education. Addressing this challenge, a new generation of science journals employs video online to provide a systematic visualized publication of experimental studies. Visualization through video greatly facilitates the understanding and learning of experimental procedures enhancing knowledge transfer and productivity in research and education. The video-based publication in the rigorous academic format requires a new set of concepts and technical approaches to production, publication and dissemination processes. As the publisher of Journal of Visualized Experiments (JoVE), the first video journal for biological sciences indexed in MEDLINE and PubMed, I would like to provide an overview of the growing field of video publication and discuss its technical challenges, implications for scholarly communication and acceptance in the academic and library community.
Presenters: Moshe Pritsker, JoVE
This presentation was used to explain how Wolfram Alpha was born, how it can be used in many fields and create a discussion thread on what kind of implications can computational knowledge have in the future.
Companion presentation to Elsevier's free TrainingDesk online session. This training covers what ScienceDirect is, how to search, what can you do in the system (i.e., download multiple full-text articles at one time, view related articles, etc), and personalization options. You can sign up for a free live online session or view the narrated tutorial featured on http://www.trainingdesk.elsevier.com/)
With our issue “The Most Proficient Surgeons to Watch 2019”, we present you with some of the masters in the field of surgery. These surgeons with their dedication and skills have become the epitomes of success and compassion in their respective fields.
The most proficient surgeons to watch 2019insightscare
With our issue “The Most Proficient Surgeons to Watch 2019”, we present you with some of the masters in the field of surgery. These surgeons with their dedication and skills have become the epitomes of success and compassion in their respective fields.
Surgical Risk Assessment is an Important Factor in any Surgical TreatmentJohnJulie1
Surgical risk is a form of assessing the clinical conditions and health conditions of a person who will undergo surgery, so that the risks of complications are identified throughout the period before, during and after surgery. It is calculated through a physician’s clinical assessment and the requirement for some tests, but to facilitate the assessment, there are also some protocols which have better directing in medical thinking. Any doctor can make this assessment, but most often it is done by a general practitioner, a cardiologist and an anesthesiologist. In this way, it is possible for each person to receive some attention before the surgery, such as seeking more appropriate tests or performing treatments to reduce the risk.
Surgical Risk Assessment is an Important Factor in any Surgical Treatmentsuppubs1pubs1
Surgical risk is a form of assessing the clinical conditions and health conditions of a person who will undergo surgery, so that the risks of complications are identified throughout the period before, during and after surgery. It is calculated through a physician’s clinical assessment and the requirement for some tests, but to facilitate the assessment, there are also some protocols which have better directing in medical thinking. Any doctor can make this assessment, but most often it is done by a general practitioner, a cardiologist and an anesthesiologist. In this way, it is possible for each person to receive some attention before the surgery, such as seeking more appropriate tests or performing treatments to reduce the risk.
One of the books, published when I was Founding Director and General Manager at SingHealth Academy.
It chronicles stories about Blood Stem Cell Transplants at SingHealth and the excellent work of healthcare professionals, the ecosystem of support for patients and the journeys of patients.
Medical ethics have witnessed evolution since the ancient times of Hammurabi (1750 BC), Hippocrates (450 BC), passing through the 9th century Islamic scholars al Ruhawi الروحاوي and al Razi الرازي till modern day. Islamic medical ethics are based on Islamic principles and morals. This presentation is an attempt to shed light on Islamic medical ethics regarding modern day issues like consent, breaking bad news, resuscitation and abortion. It is based on the “Code of Ethics for Healthcare Practitioners" published by the Saudi Council For Health Specialties (SCFHS). It was presented in Al Hammadi Hospital-Suwaidi in Riyadh, KSA as part of the hospital's educational programme by the author.
Do Not Resuscitate Orders : What They Mean ?SMSRAZA
Most doctors working in Acute areas know when and how to do CPR. However, most get stuck when it comes to ' When not to do CPR' due to cultural, social, ethical and legal issues attached.
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.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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
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
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.
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
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Bmj
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1. Acute Elderly Care Unit- Do We Need One?
o SYED RAZA, SpR Acute Medicine &Cardiology
DEWSBURY, United Kingdom
Acute Medical Units in most hospitals admit patients aged 16 and above. A fair proportion of
patients are 'frail elderly' reaching 100th birthday and beyond. These patients have multiple co-
morbidities with complex needs. Very often the admissions are deemed 'inappropriate' or
unnecessary. Dealing with these patients do require expertise for which all acute physicians are
not adequately trained. It is often noted that these patients are either under or over treated. They
often suffer complications which are iatrogenic. They also tend to stay longer on the Acute
Medical Assessment Unit which leaves the units with fewer beds for younger but more sicker
patients.
Keeping the above in mind, should there be a separate unit that would cater the needs of these
elderly patients? Do we need trained acute geriatricians? Should there be a compulsory period of
training for all acute medicine trainees?
Competing interests: None declared
Submit rapid response
Published 22 December 2007
1. Survival of the fittest
o SYED M RAZA, Consultant Cardiologist
Dr Sulaiman Al Habib Hospital, KSA
2. It is without any doubt that competition which is healthy and with a clear vision is always
beneficial. This holds true for competition in any sphere of life including healthcare.
It is essential that there is a clear goal as to why one is competing. Any competition in a healthy
spirit is always mutually rewarding. As far as the healthcare setting is concerned this certainly
would lead to improvement in services, better provision of care and patient satisfaction. The
competition should not merely be to grab the funding but to survive as the fittest!
Competing interests: None declared
Submit rapid response
Published 6 July 2011
1. Are doctors Jacks of all trades?
o SYED M RAZA, Consultant Cardiologist
Dr Sulaiman Al Habib Hospital, KSA
This is in reply to the recently published view, 'if we as doctors should be reporting potential
terrorists.' In my view this is common sense that any and every potential threat must be reported.
Doctors have been seen in various roles i.e. teacher, manager, clinical leader, and so on.
Having said that, one must not assume that we as doctors can play the role of a police or
investigating officer and actively look for any suspected potential terrorist. We are just doctors
and not a Jack of all trades.
Competing interests: None declared
Submit rapid response
Published 21 July 2011
1. Re:GMC Induction Program: Welcome but more fundamental
action needed.
o SYED M RAZA, Consultant Cardiologist
Dr Sulaiman Al Habib Hospital, KSA
Safety for patients is the paramount issue for all NHS hospitals today. GMC has issued several
key statements and guidelines as how to be a competent and safe doctor. Despite this there are
several untoward incidents and 'near misses’ in NHS hospitals countrywide of which many go
unreported.
3. Induction program for new doctors being introduced by GMC is welcome by all medical fraternity
but I feel this came too late. There are several countries worldwide which introduced this
programme a long time ago.
The recruitment process for employing new doctors should be more stringent. This should also
hold true for hiring locum doctors. Currently, there is very little induction programme for locum
doctors. The locum doctors must show a sense of responsibility towards patients' care and more
importantly must demonstrate that they are capable and safe doctors. Unfortunately, the pre-
employment assessment process for the above is lacking.
Competing interests: None declared
Submit rapid response
Published 21 September 2011
1. Re: Indolent endocarditis missed despite several admissions
o SYED M S RAZA, Consultant Cardiologist, MD,MRCP(UK)
Dr Sulaiman Al Habib Hospital, KSA
Prosthetic valve infective endocarditis affects 2-3% of patients after surgery. The acute
endocarditis usually develops within 2-3 months of surgery and is usually caused by more
virulent and antibiotic resistant organisms. Late-onset infections on the other hand are caused
mainly by contamination with low-virulence organisms during surgery or by transient
asymptomatic bacteremias, most often with streptococci; S. epidermidis; diphtheroids; and the
fastidious gram-negative bacilli, Haemophilus sp, Actinobacillus actinomycetemcomitans, and
Cardiobacterium hominis.The later is usually more difficult to diagnose.
Although Transoesophageal Echocardiogram(TOE) has much higher sensitivity in identifying
endocarditis vegetation and abscesses compared to Transthotracic Echocardiography (TTE)-
97% versus 67%, it can occasionally miss anterior aortic root abscess which is in fact better
picked up by TTE.
Competing interests: None declared
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Published 27 December 2010
