This document discusses a case of cholelithiasis, or gallstones, in a 36-year-old female patient. It provides background on gallbladder function and cholelithiasis. The patient presented with abdominal pain and was diagnosed with cholelithiasis and a dilated common bile duct. She underwent a laparoscopic cholecystectomy to remove her gallbladder. The document details her medical history, lab results, nutritional assessments and requirements, sample menus provided during her hospital stay, and specific post-operative dietary guidelines including limiting fat and fiber supplementation.
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
etiology ,classifications of gall stones & causes,risk factors,presentations, clinical examinations ,investigations including radiological (role of ERCP and MRCP ) and serological ,treatment including surgical and non surgical ,post cholecystectomy syndrome and its management ,Iindicatrions for cholecystectomy and cholecystotomy & when to perform ,complications of gall stones ,preventions of gall stone disease
Choledocholithiasis is one of the main causes for Obstructive Jaundice.In this ppt presentation, I have discussed the etiology, clinical features, complications, investigations and management of Choledocholithiasis. I have also included a mindmap and 2 algorithms for Choledocholithiasis. I hope you will find it very useful and interesting.
Gallstones are small, pebble-like substances that develop in the
gallbladder. The gallbladder is a small, pear-shaped sac located below
your liver in the right upper abdomen. Gallstones form when liquid
stored in the gallbladder hardens into pieces of stone-like material.
The liquid—called bile—helps the body digest fats. Bile is made in the
liver, then stored in the gallbladder until the body needs it. The
gallbladder contracts and pushes the bile into a tube—called the common
bile duct—that carries it to the small intestine, where it helps with
digestion.
Bile contains water, cholesterol, fats, bile salts, proteins, and
bilirubin—a waste product.
Bile salts break up fat, and bilirubin gives bile and stool a
yellowish-brown color. If the liquid bile contains too much cholesterol,
bile salts, or bilirubin, it can harden into gallstones.
The two types of gallstones are cholesterol stones and pigment
stones. Cholesterol stones are usually yellow-green and are made
primarily of hardened cholesterol. They account for about 80 percent of
gallstones. Pigment stones are small, dark stones made of bilirubin.
Gallstones can be as small as a grain of sand or as large as a golf
ball. The gallbladder can develop just one large stone, hundreds of tiny
stones, or a combination of the two.
etiology ,classifications of gall stones & causes,risk factors,presentations, clinical examinations ,investigations including radiological (role of ERCP and MRCP ) and serological ,treatment including surgical and non surgical ,post cholecystectomy syndrome and its management ,Iindicatrions for cholecystectomy and cholecystotomy & when to perform ,complications of gall stones ,preventions of gall stone disease
Choledocholithiasis is one of the main causes for Obstructive Jaundice.In this ppt presentation, I have discussed the etiology, clinical features, complications, investigations and management of Choledocholithiasis. I have also included a mindmap and 2 algorithms for Choledocholithiasis. I hope you will find it very useful and interesting.
Gallstones are small, pebble-like substances that develop in the
gallbladder. The gallbladder is a small, pear-shaped sac located below
your liver in the right upper abdomen. Gallstones form when liquid
stored in the gallbladder hardens into pieces of stone-like material.
The liquid—called bile—helps the body digest fats. Bile is made in the
liver, then stored in the gallbladder until the body needs it. The
gallbladder contracts and pushes the bile into a tube—called the common
bile duct—that carries it to the small intestine, where it helps with
digestion.
Bile contains water, cholesterol, fats, bile salts, proteins, and
bilirubin—a waste product.
Bile salts break up fat, and bilirubin gives bile and stool a
yellowish-brown color. If the liquid bile contains too much cholesterol,
bile salts, or bilirubin, it can harden into gallstones.
The two types of gallstones are cholesterol stones and pigment
stones. Cholesterol stones are usually yellow-green and are made
primarily of hardened cholesterol. They account for about 80 percent of
gallstones. Pigment stones are small, dark stones made of bilirubin.
Gallstones can be as small as a grain of sand or as large as a golf
ball. The gallbladder can develop just one large stone, hundreds of tiny
stones, or a combination of the two.
Bethany Doerfler MS, RD, LDN discusses top nutrition concerns of scleroderma patients, as well as the results of a recent medical nutrition therapy study. She also discusses strategies for healthy eating, combating GI issues, maintaining muscle, a Mediterranean diet, supplements and more.
BIO150 – Nutrition Unit 4 Assignment Functions of Fats.docxSusanaFurman449
BIO150 – Nutrition
Unit 4 Assignment: Functions of Fats Assignment
Copyright 2022 Post University, ALL RIGHTS RESERVED
Due Date: 11:59 pm EST Sunday of Unit 4
Points: 50
Overview:
For this assignment, you will analyze good fats and bad fats.
Instructions:
• Watch the “7 Ways to Optimize Your Cholesterol” video in this week’s Readings
and Resources.
• Name and describe five functions of fat.
• List the five different types of fat.
• From the video, choose and describe two pieces of information that surprised
you about lowering cholesterol.
o Include in your description an explanation about why each surprised you.
• Choose three healthy cooking oils/fats and explain how you can incorporate them
into your daily diet.
• Reviewing your All Daily Report, identify where the majority of your fats come
from.
o Are they healthy fats or unhealthy fats?
o List the benefits of increasing your healthy fats and the health issues that
can arise from eating too many unhealthy fats.
Requirements:
• Submit a Word document in APA format.
• RE-submit the PDF document containing all of the areas listed for the
NutritionCalc Report.
Be sure to read the criteria below by which your work will be evaluated before
you write and again after you write.
Copyright 2022 Post University, ALL RIGHTS RESERVED
Evaluation Rubric for Unit 4 Assignment
CRITERIA Deficient Needs
Improvement
Proficient Exemplary
(0-8 points) (9-14 points) (15-18 points) (19-20 points)
Five
Functions of
Fats and Five
Different
Types of Fat
The five
functions of fat
and the five
different types
of fat are not
listed.
One or two of
the five
functions of fat
and the five
different types
of fat are listed.
Three or four of
the five
functions of fat
and the five
different types
of fat are listed.
All five
functions of fat
and the five
different types
of fat are listed.
Lowering
Cholesterol
The
information
about lowering
cholesterol is
not included.
The
information
about lowering
cholesterol is
included but is
missing an
explanation.
The
information
about lowering
cholesterol is
included, but
lacks details.
The
information
about lowering
cholesterol is
written in a
clear and
detailed
manner.
Healthy
Cooking
Oils/Fats
The healthy
cooking
oils/fats are not
included.
The healthy
cooking
oils/fats are
included, but
no explanation
about
incorporation
into the diet is
written.
The healthy
cooking
oils/fats are
included, but
the section is
lacking details.
The healthy
cooking
oils/fats and
explanation
about
incorporation
into the diet are
written in a
clear and
detailed
manner.
Analysis of
All Daily
Report
The analysis of
the All Daily
Report is not
included.
The analysis of
the All Daily
Report is
included, but
only some
areas are
addressed.
The analysis of
the All Daily
Report is
included, and
mo.
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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
2. Gall bladder
• Gall bladder is a pear shaped hollow organ
located just below the liver in the right
abdomen.
• Functions :
Store & concentrate the bile.
Alteration of bile.
Helps in fat digestion.
4. Clinical presentation
1. DEMOGRAPHIC DATA
• AGE : 36 Yrs
• D.O.A : 29/04/2019
• D.O.D : 03/05/2019
• NO.OF HOSPITAL DAYS : 5 days
• ROOM NO : 1511
5. Medical History
PAST MEDICAL HISTORY:
• S/P Lower segment caesarean section (LSCS)
in 2012 & 2019 (January).
• S/P Right breast incision and drainage in 2012.
6. PRESENT COMPLAINTS
• P2L2 with H/O of gall stones.
• Case of upper abdominal pain more in right
hypochondrium region.
• One episode of vomitting on 28/04/19.
PROVISIONAL DIAGNOSIS:
• Cholelithiasis with dilated common bile duct
7. LAPAROSCOPIC CHOLECYSTECTOMY
• Surgical procedure to remove gall bladder.
• It is recommended if patients have
1. Cholelithiasis
2. Choledocholithiasis
3. Cholecystitis
4. Pancreatitis
8. Anthropometric Data
• Height : 162 cm
• Weight : 52 Kg
• Body Mass Index : 20 Kg/m2 (WHO)
(BMI) classification : Normal weight (18.5-24.9)
• Ideal Body Weight : 62 Kg ( Broca Index)
(IBW)
10. Subjective Assessment Tool (SGA)
• No weight loss - 1
• Sub optimal solid diet - 2
• No GI symptoms - 1
• Functional capacity (none) - 1
• Co- morbidity ( Healthy) - 1
• No decreased fat store or - 1
Subcutaneous loss
• No signs of muscle wasting - 1
SCORE : 8 WELL NOURISHED
13. 1 DAY OF ADMISSION : CLEAR LIQUID DIET
TIMING MENU QUANTITY
ENERGY
(Kcal)
CHO (g) PROTEIN(g) FAT (g)
6 AM
TENDER
COCONUT
WATER
200ml 30.59 6.32 0.52 0.32
8 AM
TROPICANA
APPLE JUICE
200ml 94 22.9 o.4 0
10 AM
VEGETABLE
SOUP
200ml 98 12 4.1 4.4
12 PM RICE KANJI 200ml 142 53.9 5.3 0.4
2 PM CLEAR SOUP 200ml 86 10.6 3.1 0.4
4 PM BLACK TEA 200ml 0 0 0 0
6 PM RICE KANJI 200ml 142 53.9 5.3 0.4
8 PM
TENDER
COCONUT
WATER
200ml 30.59 6.32 0.52 0.32
10 PM
TROPICANA
APPLE JUICE
100%
200ml 140 34 1 0
SUB TOTAL 763kcal 200g 20.24g 6.24g
14. 3Day on Admission: Fat free soft diet
TIMING MENU QUANTITY ENERGY
(Kcal)
CHO(g) PROTEIN(
g)
FAT(g)
EARLY
MORNING
(6 AM)
TENDER
COCNUT
WATER
200 ml
30.59 6.32 0.52 0.32
BREAKFAST
(8AM)
TROPICANA
APPLE JUICE
200 ml
94 22.9 o.4 0
MIDMORNI
G (10 AM)
VEGETABLE
SOUP
150 ml
98 12 4.1 4.4
LUNCH
(1PM)
DAL RICE
BOILED
VEGETABLES
1 cup
1 cup
293
147
48
23.19
13
5.06
5.8
3.88
TEA TIME
(4PM)
MILK 150 ml 109.35 7.41 4.89 6.72
DINNER
(7PM)
IDLY
SAMBAR
4 No.
1 cup
132.09
66.56
27.28
11.09
4.68
3.98
0.34
0.49
SUB TOTAL 971KCAL 158.2g 36.7g 22g
15. 4DAY ON ADMISSION : FAT FREE SOFT SOLID DIET
TIMING MENU QUANTITY ENERGY
(Kcal)
CHO (g) PROTEIN (g) FAT (g)
EARLY
MORNING
(6 AM)
MILK 200 ml 109.35 7.41 4.89 6.72
BREAKFAST
(8AM)
IDLY
SAMBAR
4 No.
1 cup
132.09
66.56
27.28
11.09
4.68
3.98
0.34
0.49
MIDMORNIG
(10 AM)
VEGETABLE
SOUP
BANANA
150 ml
1No.
98
110.66
12
24.95
4.1
1.25
4.4
0.32
LUNCH (1PM) SOFT RICE
SAMBAR
BOILED
VEGETABLE
KOOTU
CURD
1 cup
1 cup
1 cup
1 cup
50 ml
181.63
66.56
147
90.39
30
39.88
11.09
23.19
7.76
1.5
4.05
3.98
5.06
3.29
1.55
0.27
0.49
3.88
4.98
2
TEA TIME
(4PM)
MILK 150 ml 109.35 7.41 4.89 6.72
DINNER (7PM) IDLY
UPMA
SAMBAR
2 No.
1 cup
1 cup
100.39
160.63
66.56
20.74
19.31
11.09
3.56
4.16
3.98
0.26
7.17
0.49
16. SUMMARY
DATE MENU ENERGY
(Kcal)
PROTEIN (g) CHO(g) FAT (g)
30/04/19 CLEAR LIQUID
DIET
763 20.24 200 6.24
02/05/19 FAT FREE SOFT
DIET
971 158.2 36.7 22
03/05/19 FAT FREE SOFT
SOLID DIET
1478 224.7 53.42 38.8
17. RECOMMENDED DIET: FAT FREE SOFT SOLID DIET
TIMING MENU QUANTITY ENERGY
(Kcal)
CHO (g) PROTEIN (g) FAT (g)
EARLY
MORNING
(6 AM)
MILK 200 ml 109.35 7.41 4.89 6.72
BREAKFAST
(8AM)
IDLY
SAMBAR
EGG WHITE
4 No.
1 cup
1 No.
132.09
66.56
17
27.28
11.09
0.2
4.68
3.98
3.6
0.34
0.49
0.1
MIDMORNIG
(10 AM)
VEGETABLE SOUP
BANANA
150 ml
1No.
98
110.66
12
24.95
4.1
1.25
4.4
0.32
LUNCH (1PM) RICE
SAMBAR
BOILED VEGETABLE
KOOTU
1 cup
1 cup
1 cup
1 cup
181.63
66.56
147
90.39
39.88
11.09
23.19
7.76
4.05
3.98
5.06
3.29
0.27
0.49
3.88
4.98
TEA TIME
(4PM)
MILK 150 ml 109.35 7.41 4.89 6.72
DINNER (7PM) CHAPATHI
VEGETABLE
KOORMA
3No.
1 cup
2O4.75
109.47
51.99
11.04
9.35
2.58
2.48
5.98
SUB TOTAL 1506.2Kcal 236g 50g 37.1g
18. SPECIFIC GUIDELINES
• A number of post surgical complication – DIARRHEA due to
bile in large bowel.
• No standard guideline for post cholecystectomy.
• Fat intake is limited
• Use coconut oil – Medium chain Fatty acids
used for energy than stored.
breakdown without bile
• FIBER - Normalize bowel movement
soluble fiber act as sequestering agent
bind with bile to avoid gastritis
• Avoid alcohol, caffeine, citrus foods, chocolate and onion.
• Supplement with choline – absorption of fat & cholesterol
work with bile gas & bloating.