Fournier's gangrene is a necrotizing fasciitis of the genital region that can be caused by various urogenital, anorectal, cutaneous or other infections. It is characterized by pain, swelling and skin necrosis, and can progress rapidly without treatment. The infection involves multiple types of bacteria and causes tissue death through vascular thrombosis. Aggressive surgical debridement and broad-spectrum antibiotics are needed to treat the infection and prevent high mortality rates.
NECROTISING FASCIITIS- the flesh eating infection
#surgicaleducator #necrotisingfasciitis #surgicaltutor #babysurgeon #usmle
· Dear Viewers
· Greetings from “Surgical Educator”
· Today in this episode I have discussed about Necrotising Fasciitis- the flesh eating infection
· It is common in immunocompromised patients even after trivial trauma.
· I have discussed about the overview,etiology,types,clinical features,complications and treatment of Necrotising Fasciitis
· I hope this video is interesting and also useful to all of you
· You can watch the video in the following links:
· surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
Thank you for watching the video
SIGMOID VOLVULUS- GENERALISED ABDOMINAL PAIN
#surgicaleducator #generalisedabdominalpain #sigmoidvolvuus #usmle #babysurgeon #surgicaltutor
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
• Dear Viewers,
• Greetings from “Surgical Educator”
• Today I have uploaded a video on Sigmoid Volvulus- a didactic lecture.
• It is one of the life-threatening surgical problems you see in surgical wards.
• I have discussed the various causes for Generalised Abdominal Pain, epidemiology, etiology, pathology, clinical features, investigations, and treatment of Sigmoid volvulus.
• I have also included a mind map, diagnostic algorithm and a treatment algorithm for Sigmoid Volvulus.
• I hope the video will be very useful and you will enjoy it.
• You can watch all my surgical teaching videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the video.
NECROTISING FASCIITIS- the flesh eating infection
#surgicaleducator #necrotisingfasciitis #surgicaltutor #babysurgeon #usmle
· Dear Viewers
· Greetings from “Surgical Educator”
· Today in this episode I have discussed about Necrotising Fasciitis- the flesh eating infection
· It is common in immunocompromised patients even after trivial trauma.
· I have discussed about the overview,etiology,types,clinical features,complications and treatment of Necrotising Fasciitis
· I hope this video is interesting and also useful to all of you
· You can watch the video in the following links:
· surgicaleducator.blogspot.com youtube.com/c/surgicaleducator
Thank you for watching the video
SIGMOID VOLVULUS- GENERALISED ABDOMINAL PAIN
#surgicaleducator #generalisedabdominalpain #sigmoidvolvuus #usmle #babysurgeon #surgicaltutor
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
• Dear Viewers,
• Greetings from “Surgical Educator”
• Today I have uploaded a video on Sigmoid Volvulus- a didactic lecture.
• It is one of the life-threatening surgical problems you see in surgical wards.
• I have discussed the various causes for Generalised Abdominal Pain, epidemiology, etiology, pathology, clinical features, investigations, and treatment of Sigmoid volvulus.
• I have also included a mind map, diagnostic algorithm and a treatment algorithm for Sigmoid Volvulus.
• I hope the video will be very useful and you will enjoy it.
• You can watch all my surgical teaching videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the video.
Top 5 Deep Learning and AI Stories - October 6, 2017NVIDIA
Read this week's top 5 news updates in deep learning and AI: Gartner predicts top 10 strategic technology trends for 2018; Oracle adds GPU Accelerated Computing to Oracle Cloud Infrastructure; chemistry and physics Nobel Prizes are awarded to teams supported by GPUs; MIT uses deep learning to help guide decisions in ICU; and portfolio management firms are using AI to seek alpha.
Introduction
Definition
Pathway of odontogenic infection
Classification
Maxillary space infection
Mandibular space infection
Ludwigs angina
Cavernous sinus thrombophlebitis
Occurrence of infectious disease is determined by interaction of host , the microorganism and the environment
In healthy state there is balance among these factors and when the balance is lost disease occurs
Most odontogenic infections arise as a sequel of pulp necrosis caused by caries, trauma, periodontitis
Definition : the fascial spaces are the potential spaces between the various layers of fascia normally filled with loose connective tissue and bounded by anatomical barriers , usually of bone , muscle or fascial layers.
(Moore – 1975)
Invasion of dental pulp by bacteria after decay of a tooth
inflammation edema and lack of blood supply
Venous congestion ,pulpal tissue death
Reservoir for bacterial growth
Periodic egress of bacteria into surrounding alveolar Acute stage
in acute stage ,infection spreading in the soft tissues can take the following forms of in the clinical situation
Abscess
Cellulitis
Fulminating infections
this presentation includes anatomy physiology function of peritoneum ,also includes cause of peritonitis its severity ,various scoring system investigation and treatment.It includes the recent advancement and latest articles from latest books of surgery.
Appendicitis refers to acute inflammation of the appendix, and is the most common cause of acute abdomen requiring emergency surgery. It typically presents with periumbilical pain, which migrates to the right lower quadrant (RLQ), associated with fever, vomiting, anorexia, and malaise.
DETAILED DISCUSSION OF NECROTIZING FASCIITIS.
A SOFT TISSUE INFECTION. USUALLY CALLED AS FLESH EATING BACTERIAL INFECTION. CAUSED BY BACTERIA. AFFECTS THE SOFT SKIN TISSUES
tutorials in surgery, surgery training curriculum, residency in surgery, surgical education, principles of surgery, operative surgery, surgical anatomy, pathology and radiology, research methodology, surgery mcqs, surgery essay writing, part 1 exams, part 2 fellowship exams.
resident doctors. medical officers and house officers
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!
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.
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.
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
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
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
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
FOURNIER'S GANGRENE
1. FOURNIER’S
GANGRENE
DR BASHIR YUNUS
SURGERY RESIDENT
AKTH
bbinyunus2002@gmail.com 11/29/2014 1
2. DEFINITION
Fournier’s gangrene is a synergistic polymicrobial necrotizing fasciitis of the
perineum and genitalia.
bbinyunus2002@gmail.com 11/29/2014 2
3. ANATOMY
The five fascial
planes that can be
affected are:
Colles’fascia,
dartos fascia,
Buck’s fascia,
Scarpa’s fascia,
and Camper’s
fascia.
bbinyunus2002@gmail.com 11/29/2014 3
4. ANATOMY
Colles’ fascia is the fascia of the anterior
triangle of the perineum.
It prevents the spread of infection in a
posterior or lateral direction, but provides no
resistance to spread in an anterosuperior
direction towards the abdominal wall.
Posterior spread to the anal region will be
limited by the termination of Colles’ fascia in
the posterior edge of the perineal membrane
Dartos fascia is the continuation of Colles’
fascia over the scrotum and penis.
Buck’s fascia lies deep to the dartos fascia,
covering the penile corpora.
Camper’s fascia is the loose areolar fascial
layer deep to the skin of the abdominal wall,
but superficial to
Scarpa’s fascia. Together with Scarpa’s fascia
it is continuous with Colles’ fascia
inferomedially.
bbinyunus2002@gmail.com 11/29/2014 4
5. ANATOMY
• Urogenital causes of Fournier’s gangrene
lead to initial involvement of the anterior
triangle, whereas anorectal causes primarily
involve the posterior triangle.
• Blood supply to the testis, bladder, and
rectum originates directly from the aorta
and not from the perineal vasculature, and
for this reason they are rarely affected in
Fournier’s gangrene.
bbinyunus2002@gmail.com 11/29/2014 5
8. CAUSES
UROGENITAL
•Urethral stricture
•Indwelling transurethral catheter
•Prolonged or neglected use of condom catheter
•Urethral calculi
•Urethritis
•Transurethral surgery
•Infection of periurethral glands and paraurethral abscess
•Urogenital tuberculosis
•Urethral cancer
•Prostate biopsy
•Prostatic massage
•Prostate abscess
•Insertion of penile prosthesis
•Constriction ring device for management of ED
bbinyunus2002@gmail.com 11/29/2014 8
9. CAUSES
ANORECTAL
Ischiorectal or perianal or
intersphincteric abscess
Rectal mucosal biopsy
Banding of hemorrhoids
Anal dilatation
Cancer of sigmoid or
rectum
Diverticulitis
Rectal perforation by
foreign body
Ischemic colitis
Anal stenosis
bbinyunus2002@gmail.com 11/29/2014 9
16. PATHOGENESIS
• The pathogenesis of Fournier’s gangrene is
characterized by polymicrobial infection with
subsequent vascular thrombosis and tissue necrosis,
aggravated by poor host defense due to one or
more underlying systemic disorders.
bbinyunus2002@gmail.com 11/29/2014 16
17. PATHOGENESIS
• Aerobic organisms cause intravascular coagulation
by inducing platelet aggregation and complement
fixation, while anaerobes produce heparinase.
bbinyunus2002@gmail.com 11/29/2014 17
18. PATHOGENESIS
• Hypoxic tissue leads to the formation of oxygen free
radicals (superoxide anions, hydrogen peroxide,
hydroxyl radicals)
• This lead to cell membrane disruption, decreased
ATP production, and DNA damage, which leads to
decreased protein production
bbinyunus2002@gmail.com 11/29/2014 18
19. PATHOGENESIS
• Anaerobic organisms secrete various enzymes and
toxins. Lecithinase, collagenase, and hyaluronidase
cause digestion of the fascial planes.
• They produce insoluble hydrogen and nitrogen,
leading to the formation of gas in the subcutaneous
tissues, clinically palpable as crepitus.
bbinyunus2002@gmail.com 11/29/2014 19
20. PATHOGENESIS
• Endotoxins are released from the cell walls of Gram
negative bacteria.
• Macrophage activation and subsequent
complement activation ensues with release of pro-inflammatory
cytokines and eventual development
of septic shock
bbinyunus2002@gmail.com 11/29/2014 20
21. CLINICAL
PRESENTATION
1-Prodromal
symptoms of
fever and
lethargy,
which may be
present for 2-7
days
2-Intense
genital pain
and
tenderness
that is usually
associated
with edema of
the overlying
skin
3-Increasing
genital pain
and
tenderness
with
progressive
erythema of
the overlying
skin.
4-Dusky
appearance of
the overlying
skin;
subcutaneous
crepitation
5-Obvious
gangrene of a
portion of the
genitalia;
purulent
drainage from
wounds
bbinyunus2002@gmail.com 11/29/2014 21
22. CLINICAL
PRESENTATION
• Fournier’s gangrene shows vast heterogeneity in
clinical presentation,
o from insidious onset and slow progression to
o rapid onset and fulminant course,
• the latter being the more common presentation.
• the
• disease tends to present more in elderly men(6-7th
decade) and also has been reported in women
and children
bbinyunus2002@gmail.com 11/29/2014 22
23. INVESTIGATION
Laboratory Studies
full blood count, clotting profile, urea, creatinine and
electrolytes, liver function tests, blood glucose, blood
gases, group and screen, HIV and VDRL.
Abnormal findings include anemia, thrombocytopenia,
coagulopathy, hyponatremia, and raised urea
and creatinine. Hypocalcaemia may occur in some
cases, subsequent to the chelation of ionized calcium by
triglycerides liberated by bacterial lipases.
bbinyunus2002@gmail.com 11/29/2014 23
24. • Imaging Studies
o Radiography
o Ultrasonography
o CT scanning
o MRI
bbinyunus2002@gmail.com 11/29/2014 24
25. TREATMENT
• Medical
o Aggressive resuscitation
o Antibiotics with broad-spectrum coverage
• Surgical
o Emergent surgical excision of all necrotic tissue
o The skin should be wide opened
o Re-debridement
o Fecal diversion
o Urinary diversion
o Orchiectomy?
bbinyunus2002@gmail.com 11/29/2014 25
26. TREATMENT
• Reconstruction
o Primary closure of the skin, if possible.
o Local skin flap coverage.
o Split-thickness skin grafts.
o Muscular flaps, which are used to fill a cavity.
bbinyunus2002@gmail.com 11/29/2014 26
27. COMPLICATION
• Unresolved sepsis
• Unrecognized cause of the infection
o (perforated peptic ulcer disease, appendicitis, diverticulitis) or extension
of the necrotizing process outside the obvious wound.
• Complication of severe acute illness.
o (bacterial endocarditis, pneumonia)
• The plethora of comorbid conditions.
o (acute myocardial infarction, respiratory failure, pressure ulcerations,
delirium) or the bed-rest conditions imposed on patients who are acutely
ill (pulmonary embolus, deep venous thrombosis, atelectasis, pneumonia)
bbinyunus2002@gmail.com 11/29/2014 27
29. PROGNOSIS
• In the pre-antibiotic era, Fournier’s gangrene was
commonly fatal; even today, it poses a significant
risk of morbidity and mortality.
• Despite aggressive therapy, the mortality rate for
patients with Fournier’s gangrene is nearly 50%
because of the aggressive nature of the infection
and the presence of underlying comorbidities.
bbinyunus2002@gmail.com 11/29/2014 29
30. PROGNOSIS
• Delays in diagnosis or treatment increase the mortality
rate.
o A 24-hour delay in radical debridement increases the mortality rate by 11.5%;
o A 6-day delay is associated with a mortality rate of 76%.
• Additional factors associated with high mortality include:
o Anorectal origin
o Advanced age.
o Extensive disease
o Shock
o Sepsis at presentation,
o Renal failure
o Hepatic dysfunction.
• Multiorgan system failure secondary to gram-negative
sepsis is the most common cause of death
bbinyunus2002@gmail.com 11/29/2014 30
Editor's Notes
A prominent feature of patients with Fournier’s gangrene is that most of themhave an underlying systemic disorder causing vascular disease or suppressed immunity, which increases their susceptibility to polymicrobial infection.