This document discusses various intravenous anesthetics including thiopental, propofol, ketamine, benzodiazepines, and neurolept anesthesia. Thiopental and propofol are used for induction and maintenance of general anesthesia due to their CNS depressant effects. Ketamine provides analgesia and maintains airway reflexes while increasing blood pressure. Benzodiazepines are used for sedation, muscle relaxation, and anterograde amnesia. Neurolept anesthesia combines nitrous oxide, fentanyl, and droperidol to induce deep sedation and analgesia. Preanesthetic medications are given before anesthesia to reduce anxiety, provide analgesia and prevent nausea and vomiting.
Principles and Practice of Sedation in Intensive Care Unit (ICU)Apollo Hospitals
Distress is common amongst critically ill patients in ICU, especially those who are intubated or have difficulty communicating with their caregivers [1]. Distress in ICU generally presents as agitation. It needs to be treated for patient comfort & if left untreated increases sympathetic tone with untoward physiologic effects [2].
Before a sedative agent is initiated to manage agitation, the cause of distress should be identified & treated. Common causes of distress in critically ill patients include:-anxiety, pain, delirium, dyspnoea and neuromuscular paralysis. These etiologies may occur separately or in combination.
Principles and Practice of Sedation in Intensive Care Unit (ICU)Apollo Hospitals
Distress is common amongst critically ill patients in ICU, especially those who are intubated or have difficulty communicating with their caregivers [1]. Distress in ICU generally presents as agitation. It needs to be treated for patient comfort & if left untreated increases sympathetic tone with untoward physiologic effects [2].
Before a sedative agent is initiated to manage agitation, the cause of distress should be identified & treated. Common causes of distress in critically ill patients include:-anxiety, pain, delirium, dyspnoea and neuromuscular paralysis. These etiologies may occur separately or in combination.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
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
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!
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
2. THIOPENTAL
1-Ultrashort acting Barbiturate
2-For induction
Pharmacological effects:
CNS depression (sedation to general anesthesia)
↓ Cerebral blood flow , ↓ICP
↓ in arterial BP
Respiratory depression
3. THIOPENTAL
Clinical uses:
1-Induction (less than 30sec)
2-Methohexital per rectum(mentally retarded ,uncooperative pediatric)
Adverse effects:
1-Intra-arterial injection : Pain, vasoconstriction & gangrene.
2-Respiratory depression
3-Laryngospasm or bronchospasm
4-Peripheral vasodilation
Contraindicated in acute intermittent porphyria
4. PROPOFOL
1-Induction and maintenance of anesthesia (30-40 sec)
2-Vasodilation
3-Bronchodilation
4-Hypnosis but no analgesic effect
5- ↓cerebral blood flow and ICP
6-Antiemetic effect
5. PROPOFOL
Clinical uses:
1-Induction and maintenance
2-Total I/V anesthesia with opioids
3-Sedation of patients in ICU
4-Short procedures (endoscopy, colonoscopy)
5-Low dose for postoperative nausea and vomiting
Adverse effects:
1-Profound hypotension
2-Respiratory depression
3-Pain at injection site
6. KETAMINE
1-Analgesia
2-“dissociative anesthesia”
3-Blocks NMDA-R in CNS, ↓ excitatory effects of glutamate.
4-↑ cerebral blood flow↑ ICP
5-↑ BP, heart rate, and cardiac output
6-Bronchodilation
7-Airway reflexes are maintained
8- I/V, I/M, oral, rectal, epidural routes
7. CLINICAL USES OF KETAMINE
1- Dissociative anesthesia – cataleptic state
Analgesia, catatonia, amnesia, hypnosis, eyes open but unresponsive to
painful stimuli, respiring spontaneously
2- Short surgical procedures (Analgesia)
3-I/V anesthetic of choice in
A-Children
B-Old persons with poor CVS reserves
C-Septic shock, Cardiogenic shock, Bleeding
D- COPD
4-Arthritic pain (Topical)
8. ADVERSE EFFECTS OF KETAMINE
1-IHD-avoided
2-Emergence delirium
During recovery hallucinations, illusions and dream like state
Hallucinations, nightmares and delirium may last up to 24 hrs.
3-I/V injection Necrosis, Thrombophlebitis, nerve damage
4-Intrarterial injection Vasospasm gangrene
5-↑ IOP, ICP, BP , HR
6- Contraindicated in head injuries
9. BENZODIAZEPINES
1-Sedation and anterograde amnesia
2-Muscle relaxing and anticonvulsant property
Clinical uses:
1- Intraoperative sedation
2- Part of general anesthesia
3- Pre-anesthetic medication
4- Day care surgery
11. PREANESTHETIC MEDICATIONS
It refers to use of drugs before anesthesia to make it pleasant and safe.
1-Sedative/Hypnotics/Anxiolytics
BZD, Barbiturates
2-Opioid analgesics
3- Antiemetics
4-Anti histamines
5-Anticholinergics
6-Proton pump inhibitors / H2 antagonists
14. PREANESTHETIC MEDICATIONS
5-Anticholinergics
Atropine, Hyoscine
↓Salivary and bronchial secretions,
Hyoscine amnesia and antiemetic effect
6-Proton pump inhibitors/ H2 blockers
Omeprazole ,Pantoprazole/ Ranitidine ,Famotidine
Given night before and in the morning
↓ its gastric acid ,↓ chances of regurgitation
Editor's Notes
Methohexital (3times more potent than thiopental
Patient is disassociated from surroundings, appears awake but cannot perceive what is going on around him, so called dissociative anesthesia.
2-To avoid this BZD administered( diazepam or midazolam)
Patient remains responsive to simple commands and questions but does not respond to painful stimuli or retain memory of procedure.
