MEDICAL PRACTITIONER
means an individual who practices the art of
allopathic system of modern medicine .
REGISTERED
MEDICAL PRACTITIONER ( means Medical
Practitioner whose name appears i n the official register kept for the purpose
in accordance with the law of the land to which one belongs
infanticide are quite common in India because of illiteracy as well as the female child unwanted . Now a days female sexual assault and murder is getting common in north Indian society
MEDICAL PRACTITIONER
means an individual who practices the art of
allopathic system of modern medicine .
REGISTERED
MEDICAL PRACTITIONER ( means Medical
Practitioner whose name appears i n the official register kept for the purpose
in accordance with the law of the land to which one belongs
infanticide are quite common in India because of illiteracy as well as the female child unwanted . Now a days female sexual assault and murder is getting common in north Indian society
Professional negligence by Doctors, Medical negligence, Malpraxis, Malpractice, Reasons for charges of negligence against Doctors, Tort, 4 D's of negligence, Civil negligence, Criminal negligence, Ethical negligence, Doctrine of Res ipsa loquitur, Corporate negligence, Contributory negligence, Vicarious liability, Borrowed servant doctrine, Products liability, Novus actus interveniens, Defences against negligence, error of judgment.
Thanatology
Types of transplants
Cause, Mechanism of Death
Manner of death
Anoxia
Signs of Death
Immediate Changes (Somatic Death)
Early Changes (Molecular Death)
Algor Mortis ......
Reference
Asphyxia
Classification of Asphyxia
Mechanical Asphyxia
Mugging/ throttling
Mechanical Asphyxia
Pathological Asphyxia
Toxic or chemical Asphyxia
Environmental Asphyxia
Traumatic Asphyxia
Positional/postural Asphyxia
Iatrogenic Asphyxia
Tardieu’s or Bayard’s ecchymosis/spots
Hanging
Classification of Hanging
Cause of Death in Hanging
Fatal period in Hanging
Factors which influence the appearance of ligature mark ??
Judicial Hanging
Hangman’s fracture
Strangulation
ligature strangulation
Cause of death
Throttling or Manual Strangulation
Hyoid Bone Fractures
AUTOEROTIC
CHEMICAL Asphyxia
CHOKING
SMOTHERING Asphyxia
POSITIONAL Asphyxia
Drowning
Classification of Drowning
Typical or wet drowning
Mechanism of fresh water drowning
Mechanism of death in fresh water drowning
Mechanism of sea water drowning
Mechanism of death in sea water drowning
Atypical drowning
Dry drowning
Immersion syndrome
Near drowning
Shallow water drowning
Epidemiology of drowning
Cause of Death
Postmortem Examination
Froth
Reference
Professional negligence by Doctors, Medical negligence, Malpraxis, Malpractice, Reasons for charges of negligence against Doctors, Tort, 4 D's of negligence, Civil negligence, Criminal negligence, Ethical negligence, Doctrine of Res ipsa loquitur, Corporate negligence, Contributory negligence, Vicarious liability, Borrowed servant doctrine, Products liability, Novus actus interveniens, Defences against negligence, error of judgment.
Thanatology
Types of transplants
Cause, Mechanism of Death
Manner of death
Anoxia
Signs of Death
Immediate Changes (Somatic Death)
Early Changes (Molecular Death)
Algor Mortis ......
Reference
Asphyxia
Classification of Asphyxia
Mechanical Asphyxia
Mugging/ throttling
Mechanical Asphyxia
Pathological Asphyxia
Toxic or chemical Asphyxia
Environmental Asphyxia
Traumatic Asphyxia
Positional/postural Asphyxia
Iatrogenic Asphyxia
Tardieu’s or Bayard’s ecchymosis/spots
Hanging
Classification of Hanging
Cause of Death in Hanging
Fatal period in Hanging
Factors which influence the appearance of ligature mark ??
Judicial Hanging
Hangman’s fracture
Strangulation
ligature strangulation
Cause of death
Throttling or Manual Strangulation
Hyoid Bone Fractures
AUTOEROTIC
CHEMICAL Asphyxia
CHOKING
SMOTHERING Asphyxia
POSITIONAL Asphyxia
Drowning
Classification of Drowning
Typical or wet drowning
Mechanism of fresh water drowning
Mechanism of death in fresh water drowning
Mechanism of sea water drowning
Mechanism of death in sea water drowning
Atypical drowning
Dry drowning
Immersion syndrome
Near drowning
Shallow water drowning
Epidemiology of drowning
Cause of Death
Postmortem Examination
Froth
Reference
Presentation by Ewen Stewart, on death certification and HIV. This was presented at the Scottish HIV and AIDS Group annual meeting on 26 June 2015. Copyright Ewen Stewart.
ETHICAL GUIDELINES FOR BIOMEDICAL RESEARCH ON HUMAN PARTICIPANTSjyothibhat21
This presentation highlights the regulations on Ethical requirements for conducting clinical research in India. This is the guiding regulation for the Ethics Committees in India.
The viewers are requested to give their feedback on the utility of the presentation.
Death and life sustaining treatments AND MEDICAL AND LEGAL ETHICAL VIEW OVER IT.Var Dan
death and life sustaining treatments and complete detail about brain death and udda act made by uniform law commission and the whole presentation is based on united states medical system and government.
Medical records means and includes the record pertaining to the admission, diagnosis, treatment, investigation, daily progress, operations, consultations
"whenever any medico-legal case comes to the hospital, the medical officer on duty should inform the Duty Constable, giving the name, age, sex of the patient and the place of occurrence of the incident and should start the treatment of the patient.
It will be the duty of the said Constable to inform the nearest concerned police station or higher police functionaries for further action.
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
Chapter 17End-of-Life IssuesWhen we finally know we are EstelaJeffery653
Chapter 17
End-of-Life Issues
When we finally know we are dying,
And all other sentient beings are dying with us,
We start to have a burning,
almost heart-breaking sense
of the fragility and preciousness of each moment and each being,
and from this can grow
a deep, clear, limitless compassion for all beings.
—Sogyal Rinpoche
Learning Objectives
Discuss the human struggle to survive and the right to autonomous decision making.
Describe how patient autonomy has been impacted by case law and legislative enactments.
Discuss the following concepts: preservation of life with limits, euthanasia, advance directives, futility of treatment, withholding and withdrawal of treatment, and do-not-resuscitate orders.
Learning Objectives, cont’d
Explain end-of-life issues as they relate to autopsy, organ donations, research, experimentation, and clinical trials.
Describe how human genetics and stem cell research can have an impact on end-of-life issues.
Dreams of Immortality
Human Struggle to Survive
Desire to Prevent & Cure Illness
Advances in Medicine & Power to Prolong Life
Ethical & Legal Issues
Involving entire life span
From right to be born to right to die
Patient Autonomy
Right to make one’s own decisions
Patient has the right to accept or refuse care even if it is beneficial to saving his or her life.
Autonomy may be inapplicable in certain cases.
Affected by one’s disabilities, mental status, maturity, or incapacity to make decisions
No right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestioned authority of law.
—Union Pac. Ry. Co. v. Botsford (1891)
Every human being of adult years and sound mind has a right to determine what shall be done with his own body and a surgeon who performs an operation without his patient’s consent commits an assault, for which he is liable in damages, except in cases of emergency where the patient is unconscious and where it is necessary to operate before consent can be obtained.
—Schloendorff v. Society of New York Hospital (1914)
Why Courts Get Involved
End-of-Life Issues
Family members disagree as to the incompetent’s wishes.
Physicians disagree on the prognosis.
A patient’s wishes are unknown because he or she has always been incompetent.
Evidence exists of wrongful motives or malpractice.
In re Quinlan (1976)
Constitutional right to privacy protects patient’s right to self-determination.
A state’s interest does not justify interference with one’s right to refuse treatment.
In re Storar (1981)
Every human being of adult years and sound mind has the right to determine what shall be done with his or her own body.
Superintendent of Belchertown State School v. Saikewicz (1977)
Saikewicz allowed to refuse treatment.
Questions of life and death with regard to an incompetent ...
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
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
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
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.
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.
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 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
2. Definition
Total stoppage of circulation of the blood &
consequent thereupon cessation of the
animal and vital functions.
Somatic death : complete loss of sensivity
and the ability to move and there is
complete cessation of the functions of the
heart, the brain and the lungs.
Molecular death : death of the tissue and
the cells individually.
3. Legal definition
Death. means the permanent
disappearance of all evidence of life at
any time after live-birth has taken
place.
(The Registration of Births and Deaths
Act, 1969 )
4. Legal definition
“Deceased person” means a person in whom
permanent disappearance of all evidence of
life occurs, by reason of brain-stem death or
in a cardio-pulmonary sense, at any time
after live birth has taken place.
Brain-stem death” means the stage at which
all functions of the brain stem have
permanently and irreversibly ceased.
(the transplantation of human organs act,
1994)
5. Gordon`s classification of deaths
Medico-legal deaths : - the cessation of the
vital functions depends upon tissue anoxia
which is brought about in the following four
different ways
1. Defective oxygenation of the blood in the
lung. (anoxic anoxia)
2. Reduced O2 carrying capacity of blood.
3. Depression of oxidative process in tissue.
4. Inefficient circulation through the tissue.
6. Gordon`s classification of deaths
Post mortem findings should be divided in
two groups
1. The basic pathological change of
circulatory failure.
2. The special pathological changes
depending upon the particular type of
death.
9. Death certificate
Part I :- records (a) immediate cause and
(b) the morbid condition, if any, giving rise
to the immediate cause
Part II :- records any other significant
condition ( if important ) contributing to
death but not related to the immediate
cause of death.
10.
11.
12. Duty of the doctor
Who attended the person in last 7 days.
Fill the prescribe format form 4.
No refusal / no delay.
No fee.
Forward to the registering authority.
Symptomatology or modes of death should
not be recorded as cause of death without
mentioning the underlying pathological
cause.
13. Duty of the doctor
In any of the domiciliary deaths not
attended by a medical person before death,
a statement from the relatives of the
deceased should be obtained in writing to
that effect, clearly mentioning the morbidity
condition with sign and symptoms prevailed
preceding death, with duration of such
illness so that the most possible cause of
death could be entered.
14. When not to issue
The injured is brought dead
2. A crime has already been registering by
the police.
3. The police has already been informed
about the case.
4. The cause of death is unknown.
1.
16. Test to certify brain-stem death
1.
2.
3.
4.
5.
6.
Pupillary reflex
Extra-ocular movements
Corneal reflex
Gag reflex
Cough reflex
EEG
17. Who will certify
Board of medical experts consist of four
doctors.
Examine the person on two occasion.
18. Withholding life support(legality)
1. Does the right to refuse treatment extend to
refusal of life supporting systems?
2. Does it extend to the extent that the individual
can insist on the removal of life supporting
systems?
3. Does the exercise of these rights, at any point
cease to be the exercise to lawful (if not
fundamental) rights and enter the forbidden
zone of suicide?
19. Withholding life support(legality)
4. If an individual, to begin with, has these rights,
then, does he lose them when he becomes
incompetent for decision-making as in a state
of unconsciousness?
5. In cases of unconscious patients or patients
who cannot interact or communicate their
decisions who is entitled to exercise these
rights for and on behalf of these patients?
20. Withholding life support(legality)
Indian Law has no clearly stated position on
any of these issues. The opinion of
professional bodies must therefore precede
the evolution of legal provisions in matters
concerning life-supporting interventions, as
no relevant case laws exist in the country.
21. Supreme court of india
In the casse of L.B.Joshi v/s T.B.Ghodbole
SCI held that “ the law requires the
practitioner must bring to his task a
reasonable degree of skill and knowledge
and he must exercise a reasonable degree
of care, neither the very highest nor the
very low degree of care and his
competence is judged in the light of the
particular circumstances of each case.
22.
The test of the reasonableness of the
decision of the doctor would essentially
depend upon the norms set out and
announced by the professional bodies.
23. Guidelines for limiting life-prolonging
interventions and providing palliative
care (ISCCM)
1. The physician has a moral obligation to inform the
capable patient/family, with honesty and clarity, the poor
prognostic status of the patient when further aggressive
support appears non-beneficial. The physician is
expected to initiate discussions on the treatment options
available including the option of no specific treatment.
2. When the fully informed capable patient/family desires
to consider comfort care, the physician should explicitly
communicate the available modalities of limiting life
prolonging interventions
24. Guidelines for limiting life-prolonging
interventions and providing palliative
care (ISCCM)
3. The physician must discuss the implications of forgoing
aggressive interventions through formal counseling
sessions with the capable patient/family, and work
towards a shared decision-making process. Thus, he
accepts patient’s autonomy in making an informed
choice of therapy, while he fulfills his obligation of
providing beneficent care.
4. Pending consensus decisions or in the event of conflicts
between the physician’s approach and the family’s
wishes, all existingsupportive interventions should
continue. The physician however, is not morally obliged
to institute new therapies against his better clinical
judgment.
25. Guidelines for limiting life-prolonging
interventions and providing palliative
care (ISCCM)
5. The proceedings of the counseling sessions, the
decision-making process, and the final decision should
be clearly documented in the case records, to ensure
transparency and to avoid future misunderstandings.
6. The overall responsibility for the decision rests with the
attending physician /intensivist of the patient, who must
ensure that all members of the caregiver team including
the medical and nursing staff represent the same
approach to the care of the patient.
26. Guidelines for limiting life-prolonging
interventions and providing palliative
care (ISCCM)
7. If the capable patient/family consistently desires that life
support be withdrawn, in situations in which the
physician considers aggressive treatment nonbeneficial, the treating team is ethically bound to
consider withdrawal within the limits of existing laws.
8. In the event of withdrawal or withholding of support, it is
the physician’s obligation to provide compassionate and
effective palliative care to the patient as well as attend
to the emotional needs of the family.