This document discusses deep neck space infections. It describes how the neck is divided into several fascial compartments including the peritonsillar, submandibular, parapharyngeal, retropharyngeal, and parotid spaces. Deep neck infections often involve multiple spaces. Anaerobic bacteria are major pathogens of these infections and can cause tissue necrosis. Imaging such as CT scans is important for diagnosis and determining the involved spaces. Proper treatment involves adequate drainage of infected areas and intravenous antibiotics.
This powerpoint describes the types of maxillectomy & operative steps for total maxillectomy. It also enumerates various flaps used for reconstruction of maxillectomy defect.
This powerpoint describes the types of maxillectomy & operative steps for total maxillectomy. It also enumerates various flaps used for reconstruction of maxillectomy defect.
Cavity obliteration is a procedure done at the end of Mastoidectomy to get a cavity-less mastoid cavity thus solving the problem of discharging post-operative cavity.
Cavity obliteration is a procedure done at the end of Mastoidectomy to get a cavity-less mastoid cavity thus solving the problem of discharging post-operative cavity.
the fascial planes of the neck is very important in the spread and containment of infections, as well as being surgical dissection plane during neck surgery.
infections are rare but need to be identified early and treated appropriately to reduce the mortality and morbidity
this is a slightly well illustrated ppt of the previously uploaded one in february 2015
Histology of oral mucous membrane including gingiva/certified fixed orthodon...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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Meningitis is the inflammation of the tissues surrounding the brain and spinal cord. It is usually caused by infection. It can be fatal and requires immediate medical care. Meningitis can be caused by several species of bacteria, viruses, fungi and parasites. Most infections can be transmitted from person to person.
Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and other types of infections also can cause meningitis.
This week, cerebrospinal meningitis is on the news. This disease, which is majorly prevalent during the dry season has been reported to be ravaging five states in the North-West region of Nigeria including- Zamfara, Sokoto, Kebbi, Katsina and Niger States.
Neck space infections taken from PL. DHINGRA and other sources to cover all o...lordskywalker7878
This presentation covers the important ENT topics of neck space infections with their management and image illustrations. The source is mainly PL. DHINGRA however other sources have been mentioned in the presentation, especially on the images. It is divided into superficial and deep neck infections for clear distinction between the two categories. It is an extremely important topic especially if your goal is towards surgical side of ENT.
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.
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.
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- 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
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.
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
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 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.
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!
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
4. Importance of fascial compartments
Understanding inter-fascial
spaces for pathogenesis , clinical
manifestation and potential
results of spread of infections
involving these spaces
4Dr. Naim Manhas
7. Anaeorbic bacteria are major constiuents of
normal human flora.
Anaerobic bacteria contains a number of
virulence factors, including toxins, are often
associated with tissue necrosis and abscess
formation.
Usually involves all anatomic sites including
cerebral, dental,peritonsilliar, lung ,
intraabdominal, tubo-ovarian prostatic and
cutaneous abscesses.
7Dr. Naim Manhas
9. Presence of Gas in the tissue is another clue
to the presence of anaerobic bacteria, but it is
not considered diagnostic as sometimes we
do get aerobic bacteria producing gas.
The putrid odor of discharge of infections or
discharge is present.
Detected by palpation, radiography or
scanning techinques.
9Dr. Naim Manhas
12. Presentation
Unusual presentation :-
Wide spread use of antibiotics
Profond immunosupression
Cellullitis
Necrotizing cellulitis
Associated with
thrombophelibitis (Lemierre’s )
12Dr. Naim Manhas
13. The widespread
use of
antibiotcs and
/or profound
immunosppress
ion , the classic
signs of
erythema,
edma,
flauctuance
may be absent
Dr. Naim Manhas 13
20. RECOMMENDATIONS
Aspiration :-
1. depends upon the site
2. no clear differentiation
between cellulitis and abscess
3. diagnostic confirmation
Premature incision into an area of cellulitis
may actually worsen the situation by
breaking down the natural defenses (barriers)
, thus hastening spread of infection
20Dr. Naim Manhas
21. PERITONSILLAR ABSCESS
peritonsillar cellulitis :-
Inflammatory reaction of the
tissue between the capsule of
the palatine tonsil and the
pharyngeal muscles.
Peritonsillar abscess :-
Collection of abscess between
the capsule of the tonsil and the
pharyngeal muscles.
Dr. Naim Manhas 21
27. parapharyngeal space
Parapharyngeal
space infections
are potentially
life threatening if
not treated in
time.
Presence of
important
structures in para
pharyngeal space
.
Source of
infection from
dental abscess,
peritonsillar
abscess.
27Dr. Naim Manhas
31. RETROPHARYNGEAL ABSCESS
Retropharyngeal
abscesses are among the
most serious of deep neck
infections.
Infection can extend
directly to anterior or
posterior regions of
mediastinum.
Common in infants and
children .
In adults due to impacted
foreign body or due to
“potts disease.
Dr. Naim Manhas 31
32. RETROPHARYNGEAL ABSCESS
Ct scan showing
extension of
retropharyngeal
abscess in upper
mediastium
Can cause acute
necrotizing
mediastinitis
Mortality becomes
high 25% in adults.
Dr. Naim Manhas 32
33. Antimicrobial agents
Oral or odontogenic source
Amoxicillin-clavulanic acid (beta lactamase
inhibitor) 1.2 G I/V every 8-12 hours
Metroniadiazole 500mg I/V every 6-8 hours
OR
Clindamycin 600mg I/V every 6-8 hours
33Dr. Naim Manhas
34. Rhinogenic or otogenic source
Ceftriaxone 1 G I/V every 24 hours
Metroniadazole 500mg I/V every 6-8 hours
OR
Ceprofloxacin 400mg I/V every 12 hours
Clindamycin 600mg I/V every 6-8 hours
34Dr. Naim Manhas
35. Immunocompromised patients
Cefepime 2G I/V every 12 hours
Metroniadazole 500mg I/V every 6-8 hours
OR
Imipenem 500mg I/V every 6 hours
OR
Meropenem 1G I/V every 8 hours
(carbapenem group of antibiotics )
35Dr. Naim Manhas
36. Objectives of Management
aspiration
Adequate drainage
Incisional
Antimicrobial therapy
Supportive care
36Dr. Naim Manhas
39. NECROTIZING SOFT TISSUE INFECTIONS
necrotizing forms of cellulitis , faciitis and
myositis.
Characterized by fulminanat tissue
destruction,systemic signs of toxcity and high
mortality.
Early recognition is critical, rapid progression
to extensive destruction leading to systemic
toxicity .
39Dr. Naim Manhas
40. Clinical presentation
Within 3-5 days after
onset, skin breaksdown
with bullae formation.
Thrombosis of small
blood vessels with pain
sensation is decreased
due to destruction of
superficial nerves.
Dr. Naim Manhas 40
41. NECROTIZING SOFT TISSUE INFECTIONS
Type 1.
Usually in immunocompromised patients
Polymicrobial infection:- usually anaerobic
species
Bacteriodes, clostridum or
peptostreptococcus in addition to anaerobic
streptococcus.
Dr. Naim Manhas 41
42. NECROTIZING SOFT TISSUE INFECTIONS
Type 2.
Mainly due to Group A Streptococcus (GAS)
Either alone or in combination with either
species most commonly S.aureus
Can occur among healthy individuals in any
age group
Dr. Naim Manhas 42
43. Predisposing factors:-
H/o skin injury
Laceration
Burn
Blunt trauma
Recent surgery
Injection drug use
In case above factors are absent then
pathogenesis of infection likely consists of
hematogenous translocation of GAS from throat
(aymptomatic or symptomatic Pharyngitis)
Dr. Naim Manhas 43
45. NECROTIZING SOFT TISSUE INFECTIONS
Aggressive debriment of all
Necrotic tissue until healthy,
viable (bleeding) tissue is
reached.
Reevaluated after 24 hours
and if necrotic tissue is
present needs agreessive
debriment again.
Once the wound is healthy
then reconstruction is done.
Dr. Naim Manhas 45
46. ANTIBIOTIC THERAPY
Acceptable regimes:-
“carbapenem” group
Imipenem 500mg I/V every 6 hours
OR
Meropenem 1G I/V every8 hours
Clindamycin 600-900 mg I/V every 8 hours
Vancomycin 15-20mg/Kg /I/V every 8-12 hours
OR
Linezolid 600 mg I/V every 12 hours.
Dr. Naim Manhas 46