this presentation deals with various types of endourology, upper urinary tract endoscopy, rigid and flexible endoscopy, lower urinary tract endoscopy, ureteroscopy, care and sterilization of instruments and endoscops. use as therapeutic and diagnostic modalities.
this presentation deals with various types of endourology, upper urinary tract endoscopy, rigid and flexible endoscopy, lower urinary tract endoscopy, ureteroscopy, care and sterilization of instruments and endoscops. use as therapeutic and diagnostic modalities.
Dr Ho Siew Hong shared his experience on how to perform the ideal puncture for PCNL in a lecture to Asian urologists during the Advanced Urology Course 2008 in Singapore
What is New In Minimally Invasive Surgery for UrologySiewhong Ho
Dr Ho Siew Hong gave a series of Continous Medical Education lectures to doctors of Gleneagles, Mount Elizabeth and East Shore Hospitals on the latest in Urology surgery
Use focusing Shock Waves to breakdown
a stone into small pieces.
Shock waves are acoustic pulses.
Pass through better in water and solid but
not in air.
Introduce in 1980 by Dornier which is a supersonic aircraft company
Every upcoming surgeon practising minimal access surgery should know the basics of urology , so that he or she can put his or her,s capabilities as a surgeon
Instruments that apply energy to cut, coagulate and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality.
Retrograde Intrarenal Ureteroscopic Surgery (RIRS)Urovideo.org
Gerhard J. Fuchs, M.D., Dr. med., F.A.C.S.
Professor of Urology, UCLA School of Medicine
Vice Chair, Cedars Sinai Department of Surgery
Medallion Chair in Minimally Invasive Urology
Cedars-Sinai Medical Center
Los Angeles, USA
Dr Ho Siew Hong shared his experience on how to perform the ideal puncture for PCNL in a lecture to Asian urologists during the Advanced Urology Course 2008 in Singapore
What is New In Minimally Invasive Surgery for UrologySiewhong Ho
Dr Ho Siew Hong gave a series of Continous Medical Education lectures to doctors of Gleneagles, Mount Elizabeth and East Shore Hospitals on the latest in Urology surgery
Use focusing Shock Waves to breakdown
a stone into small pieces.
Shock waves are acoustic pulses.
Pass through better in water and solid but
not in air.
Introduce in 1980 by Dornier which is a supersonic aircraft company
Every upcoming surgeon practising minimal access surgery should know the basics of urology , so that he or she can put his or her,s capabilities as a surgeon
Instruments that apply energy to cut, coagulate and dissect tissue with minimal bleeding facilitate surgery. The improper use of energy devices may increase patient morbidity and mortality.
Retrograde Intrarenal Ureteroscopic Surgery (RIRS)Urovideo.org
Gerhard J. Fuchs, M.D., Dr. med., F.A.C.S.
Professor of Urology, UCLA School of Medicine
Vice Chair, Cedars Sinai Department of Surgery
Medallion Chair in Minimally Invasive Urology
Cedars-Sinai Medical Center
Los Angeles, USA
A range of energy sources are used in gynecologic laparoscopy. These energy sources include monopolar electrosurgery, bipolar electrosurgery (including “advanced bipolar” devices that incorporate tissue feedback monitoring), and various types of laser and ultrasonic technologies
Various types of Energy Sources used in Surgery are discussed In this presentation,like Radio frequency ablation,Ultrasound Energy, Argon beam Coagulation etc
Dr H V Shivaram, HOD-Surgery & Allied Specialties, Aster CMI Hospital, Bangalore
Haemostasis is very important in laparoscopic surgery. Vessel sealing with energy devises play a major role in keeping the surgical field clear. Energy devices are also used for tissue sealing and transection. Despite never types of energy devises electro-surgery is still very popular in gynaecological laparoscopy. Desiccation, dissection, and coagulation are the main effects of electro-surgery that are used for various purposes. Higher thermal injury with monopolar devices lead to the invention of bipolar devices with less tissue damage. Ligasure, pk gyrus, ENSEAL are some of the more advanced bipolar devices. Ultrasonic devices have the capability of coagulation and cutting tissues. During the process it can produce significant thermal injury. Thunderbeat combines bipolar and ultrasonic energy for coagulation and cutting respectively for more precise effects. Laser devices emit a beam of photons with a high degree of spatial and temporal coherence with tissue effects depending on the time of exposure and power density. CO2, Argon, Nd: YAG, KTP-532 are different laser types with different properties. Plasma is the fourth state of matter following solid, liquid and gas. Argon neutral plasma (System 7550TM ABC, Cardioblate) can produce energy in 3 forms including light, heat and kinetic energy. Laser and plasma energy are gaining more popularity for endometriosis surgery due to its localised effects and better preservation of ovarian follicles.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
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
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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.
1. Energy Sources in Urology
-Dr. Shubham Lavania
30/06/2017
“HEAT CURES WHEN EVERYTHING ELSE FAILS”- Hippocrates
Tissue Dissection and Cauterization
Intracorporeal Lithotripters
ESWL
2. • Electrosurgery ??
Classification -Type of Generator Used:
A. Simple generator: mono/ Bipolar cautery
B. Advanced Bipolar System:
I. Ligasure
II. PK system
III. Enseal
C. Ultrasonic
D. Integrated US & ABS
E. Argon Beam coagulator
F. Lasers
G. Others: radiofrequency, microwave, Cryo
3. Mono polar:
•Circuit
•100 W of power to the tissue
at voltages ranging from 100
to 5000 volts
•Cut, Coagulate, blend
•Fulgration , dessiccation
Bipolar:
Circuit
Safety:
1. Patient pad placement
2. Demodulated current (250-2000KHz)
3. Direct application
4. Direct coupling
5. Insulation failure
6. Capacitative coupling
4. Ligasure:-
• Combines pressure and energy
• Uses higer current & low voltage
• Vs upto 7mm
Gyrus PK tissue management sysytem:-
• Vapour pulse coagulation
Enseal:-
• Patented blade & smart electrode technology
5. Physics of US:
2types: Low power: CUSA
High power(55.5 kHz): Harmonic
– Working
– Advantage
Integrated US and ABG: Thunderbeat
Argon beam Coagulation: uses radiofrequency
electrical energy.
• Properties of Argon
• Non contact, monopolar electrothermal
hemostases.
• Use/ drawback
6. Radiofrequency ablation: probe+ radiofrequency
generator= >100⁰C
Use in tumor ablation
Microwave ablation: ultra high speed
(2450MHz) alternating field current.
Cryotherapy: rapid cooling of cell and thawing.
Limited uses
7. Lasers
• “light amplification by stimulated emission of
electromagnetic radiation.”
• Each wave exists as a bundle of energy
• Properties :
– Monochromatic
– Coherent
– Directionality
• Pulsed or continous
• The power of the laser is equal to the energy over
time
• Light-Tissue Interaction-
8. Types of Lasers
Neodymium:Yttrium-Aluminum-Garnet:
– wavelength of 1064 nm
– Penetration- 1 cm
Potassium Titanyl Phosphate
– wavelength to 532 nm
Holmium:YAG
– 2140-nm pulsed laser
– Ts pene-0.5mm
Thulium:YAG
– 2000 nm
– Diode laser
11. Extracorporeal Shock wave Lithotripsy
Physical Principles
• Shock wave focusing-sufficient strength only
at the target (F2)
• Generator type:
1. Electro hydrolic
2. Electro megnetic
3. peizoelectric
12.
13. Imaging Systems
1. Fluoroscopy
2. Ultrasound
3. Combined
Anesthesia
• discomfort experienced~energy density &
size of F2
• Narcotic, sedative-hypnotics
• EMLA cream
14. •shock wave profile
•Mechanics of stone fragmentation
1. Spall fracture
2. Squeezing-splitting or
circumferential compression
3. Shear stress
4. Superfocusing
5. Cavitation
6. Dynamic fracture process
15. Bioeffects: Clinical Studies
• Acute extra renal damage: Liver, spleen pancreas,
cardiac, muscles.
• Acute Renal Injury: hematuria, subcapsular
hematoma
• Chronic Renal Injury: systemic blood pressure,
↓renal function, ↑ rate of stone recurrence, and
the induction of brushite stone disease
Risk Factors for Shock Wave Lithotripsy
• Age Obesity
• Coagulopathies Thrombocytopenia
• Diabetes mellitus Coronary heart disease
• Preexisting hypertension
16. Aggravating Factors
• Number of shocks
• Period of shock wave administration: Shorter period
increases damage
• Accelerating voltage: Higher voltage increases damage
• Type of shock wave generator: First- versus
second/third-generation devices
• Kidney size: Juvenile versus adult
• Preexisting renal impairment
Mitigating Factors
• Pretreatment with 100 to 500 shocks at low energy
level to reduce lesion size
• Treatment at a slow rate of shock wave delivery (≤60
shocks/min)
17. AUA Recommendations
• Clinicians should inform patients that SWL is the
procedure with the least morbidity and lowest
complication rate. S R; Grade B
• Routine stenting should not be performed in patients
undergoing SWL. S R;Grade B
• In symptomatic patients with a total non-lower pole
renal stone burden ≤ 20 mm, clinicians may offer SWL
or URS. SR grade B
• Clinicians should offer SWL or URS to patients with
symptomatic ≤ 10 mm lower pole renal stones
• In pediatric patients with a total renal stone burden
≤20mm, clinicians may offer SWL or URS as first-line
therapy. MR; Grade C