The document discusses the history, epidemiology, signs, symptoms, and diagnosis of acute appendicitis. It covers differential diagnosis for different patient populations. Treatment options are discussed including appendectomy techniques. Special circumstances for appendicitis in different populations like children, elderly, and pregnant patients are addressed. Postoperative care, complications, and rare conditions involving the appendix are also summarized.
Basic principles of ultrasound.
Terms used in ultrasound.
Advantages of ultrasound.
Definition of acute abdomen.
Differential Diagnosis.
Abdominal ultrasound technique.
USG findings in most common pathologies.
Conclusion.
It is a complete presentation on carcinoma penis, covering all aspects starting from premalignant lesions to details of squamous cell carcinoma penis including recent NCCN guidelines and steps of penectomy and lymph node dissection
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
Surgical management of colorectal cancer.pptxHamSayshi1
Surgical treatment of Colorectal Cancer Current Treatment Guidelines 2024...A reveiw of literature
palliative management of CRC and Mechanical bowel preparation in case of CRC alongwith Treatment guidleines of grade 4 CRC in presence of metastasis
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Basic principles of ultrasound.
Terms used in ultrasound.
Advantages of ultrasound.
Definition of acute abdomen.
Differential Diagnosis.
Abdominal ultrasound technique.
USG findings in most common pathologies.
Conclusion.
It is a complete presentation on carcinoma penis, covering all aspects starting from premalignant lesions to details of squamous cell carcinoma penis including recent NCCN guidelines and steps of penectomy and lymph node dissection
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
Surgical management of colorectal cancer.pptxHamSayshi1
Surgical treatment of Colorectal Cancer Current Treatment Guidelines 2024...A reveiw of literature
palliative management of CRC and Mechanical bowel preparation in case of CRC alongwith Treatment guidleines of grade 4 CRC in presence of metastasis
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
2. Historical Background
• Appendiceal disease is a frequent reason for emergency hospital
admission, and appendectomy is one of the most common emergency
procedures performed in contemporary medicine.
• the human appendix was not noted until 1492. Leonardo da Vinci
depicted the appendix in his anatomic drawings, but these were not
published until the eighteenth century.
3. Historical Background
• In 1886, Reginald H. Fitz presented his findings regarding appendicitis
and recommended consideration for operative treatment.
• In 1889, Charles McBurney published his landmark paper in the New
York State Medical Journal describing the indications for early
laparotomy for the treatment of appendicitis.
4. Epidemilogy
• incidence rate of about 100 per 100,000 inhabitants. Lifetime risk for
appendicitis is 8.6% for males and 6.7% for females, with the highest
incidence in the second decade of life.
7. Differential Diagnosis
• Pediatric Patient. Acute mesenteric adenitis is the disease most often
confused with acute appendicitis in children. Almost invariably, an
upper respiratory tract infection is present or has recently subsided.
The pain usually is diffuse, and tenderness is not as sharply localized
as in appendicitis.
• Elderly Patient. Diverticulitis or perforating carcinoma of the cecum or
of a portion of the sigmoid that overlies the right lower abdomen may
be impossible to distinguish from appendicitis
8. • Female Patient. Diseases of the female internal reproductive organs
that may erroneously be diagnosed as appendicitis are, in
approximate descending order of frequency, pelvic inflammatory
disease, ruptured graafian follicle, twisted ovarian cyst or tumor,
endometriosis, and ruptured ectopic pregnancy
9. • Computed tomography scan has improved diagnostic accuracy in
individual studies. However, in population-wide studies, the rate of
misdiagnosis of appendicitis remains constant. Rates of misdiagnosis
are highest in female patients of child-bearing age and patients on the
extremes of age (i.e., very young and very old)
10.
11.
12.
13. • Perforated or complicated appendicitis is more common in the very
young (age 65 years)
• Single-incision appendectomy provides no obvious advantage over
standard laparoscopic appendectomy. Natural orifice transluminal
endoscopic surgery remains an investigational procedure
• The incidence of fetal loss following normal appendectomy in
pregnant patients is 4%, and the risk of premature delivery is 10%
• Antibiotic prophylaxis is effective in the prevention of postoperative
surgical site infection. Postoperative antibiotics are unnecessary
following uncomplicated appendicitis. For complicated appendicitis, a
treatment duration of 4 to 7 days is recommended
14.
15.
16.
17. Special Circumstances
Acute Appendicitis In The Young
• diagnostic delays by both parents and physicians, and the frequency
of gastrointestinal distress.
• In children, the physical examination findings of maximal tenderness
in the right lower quadrant, the inability to walk or walking with a limp,
and pain with percussion, coughing, and hopping were found to have
the highest sensitivity for appendicitis.
18. • The treatment regimen for perforated appendicitis generally includes
immediate appendectomy. Antibiotic coverage is limited to 24 to 48
hours in cases of nonperforated appendicitis.
• Laparoscopic appendectomy has been shown to be safe and effective
for the treatment of appendicitis in children.
19. ACUTE APPENDICITIS IN THE ELDERLY
• Compared with younger adults, elderly patients with
appendi_x0002_citis often pose a more difficult diagnostic problem
because of the atypical presentation, expanded differential diagnosis,
and communication difficulty
the perforation rate appears to increase with age greater than 80
years
As a result of increased comorbidities and an increased rate of
perforation, postoperative morbidity, mortality, and hoSpital length of
stay are increased in the elderly compared with younger populations
with appendicitis.
20. ACUTE APPENDICITIS DURING
PREGNANCY
• Acute appendicitis can occur at any time during pregnancy but is rare in the
third trimester.110 The overall negative appendectomy rate during
pregnancy is approximately 25% and appears to be higher than the rate
seen in nonpregnant
women
• Recent data suggest that the incidence of perforated or complex
appendicitis is not increased in pregnant patients.
• Another option is magnetic resonance imaging, which has no known
deleterious effects on the fetus. The American College of Radiology
recommends the use of nonionizing radiation techniques for front-line
21. POSTOPERATIVE CARE AND
COMPLICATIONS
• Following uncomplicated appendectomy, complication rates are low,114
and most patients can quickly be started on a diet and discharged home
the same day or the following day.
• Patients should be continued on broad-spectrum antibiotics for 4 to 7 days.
22. SURGICAL SITE INFECTION
• Following laparoscopic appendectomy, the extraction port site is the most
common site of surgical site infection. Patients with cellulitis can be started on
antibiotics. The cultured organisms are typically bowel flora, as opposed to
skin flora.
• Small abscesses can be simply treated with antibiotics; however, larger
abscesses require drainage. Most commonly, percutaneous drainage with CT
or ultrasound guid_x0002_ance is effective. For abscesses not amenable to
percutaneous drainage, laparoscopic abscess drainage is a viable option.
23. STUMP APPENDICITIS
• A review of literature has revealed only 60 reports of this phenomenon.
Likely, incom_x0002_plete appendectomy is underreported, and the true
prevalence is much higher. Reported as “stump appendicitis,” patients
typically present with recurrent symptoms of appendicitis
approxi_x0002_mately 9 years after their initial surgery.
• There was no difference in initial surgery between laparoscopic and open
procedures
• The key to avoiding stump appendicitis is prevention. Use of the
“appendiceal critical view” (appendix placed at 10 o’clock, taenia
coli/libera at 3 o’clock, and terminal ileum at 6 o’clock) and identification
of where the taeniae coli merge and disappear is paramount to identifying
and ligating the base of the appendix during the initial operation
24. INCIDENTAL APPENDECTOMY
• During this period, an average of 250,000 cases of appendicitis and
310,000 incidental appendectomies occurred annually in the United
States. It was esti_x0002_mated that 36 incidental appendectomies
had to be performed to prevent one patient from developing
appendicitis.
• In view of the added costs and risk of morbidity for each extension of
a surgical intervention, this does not seem to justify incidental
appendectomy.
25. PREVALENCE OF NEOPLASMS
• The prevalence of identifying a mass within the appendix is less than
1%. Appendiceal carcinoid and appendiceal adenomas are the most
common lesions identi
• In older patients, the prevalence of identifying colon can_x0002_cer
appearing as appendicitis has been reported in a single study with a
prevalence of less than 1%. The mean age in this case series was 69
years (range, 42 to 89 years).
26. CARCINOID
• Carcinoid syndrome is rarely associated with appendiceal carcinoid
unless widespread metastases are present, which occur in 2.9% of
cases Symptoms attributable directly to the carcinoid are rare,
although the tumor can occasionally obstruct the appendiceal lumen
much like a fecalith and result in acute appendiciti
• The mean tumor size for carcinoids is 2.5 cm
• epidemiology, and end results data indicate that proper surgery for
carcinoids is not performed at least 28% of the time.
27. ADENOCARCINOMA
• Primary adenocarcinoma of the appendix is a rare neoplasm with
three major histologic subtypes: mucinous adenocarcinoma, colonic
adenocarcinoma, and adenocarcinoid.
• appendiceal adenocarcinoma are at significant risk for both
synchronous and metachronous neoplasms, approximately half of
which will originate from the gastrointestinal tract.
28. MUCOCELE
• A mucocele of the appendix is an obstructive dilatation by intraluminal
accumulation of mucoid material. Mucoceles may be caused by one of
four processes: retention cysts, mucosal hyperplasia, cystadenomas,
and cystadenocarcinomas
• a more aggressive approach to ruptured appendiceal neoplasms has
been advocated. This approach includes a thorough but
mini_x0002_mally aggressive approach at initial laparotomy, as
described earlier, with subsequent referral to a specialized center for
con_x0002_sideration of reexploration and hyperthermic
intraperitoneal chemotherapy
29. LYMPHOMA
• The gas_x0002_trointestinal tract is the most frequently involved
extranodal
• site for non-Hodgkin’s lymphoma.Other types of appendiceal
lymphoma, such as Burkitt’s lymphoma, as well as leukemia, have
also been reporte.