DIABETES AND ITS ANAESTHETIC IMPLICATIONSSelva Kumar
This presentation deals with diabetes mellitus and its anaesthetic implications. All about preoperative investigations and intra-operative management are discussed.
A basic overview on the management of intra-operative bronchospasm: the risk factors, triggers, diagnosis, prevention and management. Includes a case scenario – discussion.
DIABETES AND ITS ANAESTHETIC IMPLICATIONSSelva Kumar
This presentation deals with diabetes mellitus and its anaesthetic implications. All about preoperative investigations and intra-operative management are discussed.
A basic overview on the management of intra-operative bronchospasm: the risk factors, triggers, diagnosis, prevention and management. Includes a case scenario – discussion.
The transversus abdominis plane, more commonly referred to as the TAP block,
Places local anesthetic in the lateral abdominal wall in a plane between the internal oblique and the transversus abdominis muscles.
Here, the local anesthetic block can block many of the abdominal nerves as they pass to the abdominal structures.
Inhalational Anesthetics; Isoflurane and Sevoflurane.pptxMahmood Hasan Taha
Isoflurane (Furane) 1979, Sevoflurane (Ultane) 1990s
general description ,physical properties and anesthetic properties .
Effects on organ system, contraindications, drug interaction.
The transversus abdominis plane, more commonly referred to as the TAP block,
Places local anesthetic in the lateral abdominal wall in a plane between the internal oblique and the transversus abdominis muscles.
Here, the local anesthetic block can block many of the abdominal nerves as they pass to the abdominal structures.
Inhalational Anesthetics; Isoflurane and Sevoflurane.pptxMahmood Hasan Taha
Isoflurane (Furane) 1979, Sevoflurane (Ultane) 1990s
general description ,physical properties and anesthetic properties .
Effects on organ system, contraindications, drug interaction.
Regional anesthesia is anesthesia affecting only a specific area of the body when the patient is conscious, e.g. foot, arm, lower extremities, insensate to stimulus of surgery or other instrumentation.
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
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
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
- 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
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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
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
Are There Any Natural Remedies To Treat Syphilis.pdf
Epidural anesthesia & analgesia
1.
2. Epidural Anesthesia/Analgesia
Local anaesthetic solutions are deposited in
the epidural space between the Dura mater
and the periosteum lining the vertebral canal.
The epidural space contains adipose tissue,
lymphatics and blood vessels. The injected
local anaesthetic solution produces analgesia
by blocking conduction at the intradural spinal
nerve roots.
2
3. Wide application
Epidural block can be performed at the
sacral(caudal), lumbar, thoracic or cervical levels.
Epidural techniques are widely used for operative
anesthesia, obstetric analgesia, postoperative
pain control, and chronic pain management.
Dose judgment could be single shot, intermittent
bolus or continuous infusion or combined.
4. Epidural Anesthesia
Indication and Contraindication:
the same of spinal anaesthesia.
Additional indication is the post operative
Paine management using the epidural catheter
technique.
Complications: the same of spinal
anaesthesia, except the post dural puncture
headache.
4
5. 5
Differences between Spinal and Epidural Anesthesia
Spinal anaesthesia Extradural Anaesthesia
Level: below L1/L2, where the spinal cord ends Level: at any level of the vertebral column.
Injection: subarachnoid space i.e. puncture of
the Dura mater
Injection: epidural space (between Ligamentum
flavum and dura mater) i.e without puncture of
the dura mater
Identification of the subarachnoid space: When
CSF appears
Identification of the Epidural space: Using the
Loss of Resistance technique.
Dose: 2.5- 3.5 ml bupivacaine 0.5% heavy Dose: 15- 20 ml bupivacaine 0.5%
Onset of action: rapid (2-5 min) Onset of action: slow (15-20 min)
Density of block: more dense Density of block: less dense
Hypotension: rapid Hypotension: slow
Headache: is a probably complication Headache: is not a probable.
6. Differential block:
By using relatively dilute concentrations of
local anesthetic combined with an opiate, an
epidural can block the smaller sympathetic
and sensory fibers wile sparing the larger
motor fibers.
7. Segmental block:
Due to local anesthetic is not spread readily
in CSF as spinal anesthesia, a well-defined
band of anesthesia at certain nerve roots
without those above and below blocked can
be achieved with epidural techniques.
8. 8
Epidural Anesthesia continue
Technique:
Loss of resistance technique to identify
the epidural space.
0.5% Bupivacaine (mainly) or
lidocaine (2.0%) is usually used to
produce epidural anaesthesia.
20. Advantages in conjugation
with GA
CV systems:
Blockade of cardiac sympathetic innervation
(arise atT1-T4) with dilute local anesthetic
postoperatively via a thoracic epidural
catheter can reduce myocardial ischemia in
patients with coronary artery disease.
21. Respiratory system
Thoracic or upper abdominal surgery is
associated with
1.decreased diaphragmatic function
postoperatively from decreased phrenic
nerve activity
2. decreased FRC
these can lead to atelectasis and hypoxia via
V/Q mismatch
22. Some evidence suggests that
postoperative thoracic epidural
analgesia in high-risk patients can
improve pulmonary outcome by
decreasing the incidence of
pneumonia and respiratory failure,
improving oxygenation, and
decreasing the duration of
mechanical ventilatory support
23. Metabolic and endocrine
system
Surgical trauma produces increases in ACTH,
cortisol, epinephrine, norepinephrine and
vasopressin and activate RAA system.
Neuraxial blockade can partially suppress (during
major invasive surgery) or totally block (during
lower extremity surgery) this stress response and
then reduce perioperative arrhythmias and the
incidence ischemia possibly. AT11 block can block
adrenal pathways and blunt hyperglycemia.
24. Complication of neuraxial
block
Backache
Headache
Urinary retention
Maternal fever
Transient neurologic symptoms (TNS):
back pain radiating to the legs without sensory or
motor deficits, occurring after the resolution of
spinal block and resolving spontaneously within
several days
25. High or total spinal anesthesia
Subdural injection
Cardiac arrest
Systemic toxicity
Cauda equina syndrome & other neurologic
deficits, transient or permanent
Maningitis & arachnoiditis
Epidural abscess
Spinal & Epidural hematoma