1. This document provides guidance on performing a patient examination, including taking a medical history and conducting a physical examination of a swelling.
2. It details the key components of a patient's medical history to cover, such as their personal history, present complaint, past medical history, and family history.
3. The document also describes how to physically examine a swelling, including inspecting it, palpating it, performing percussion and auscultation, and discussing different types of sutures used in surgery.
Recent Advances In The Management Of Juvenile Idiopathic ArthritisNaveen Kumar Cheri
The term “rheumatologicaldisorders” refers to diseases that affect the major connective tissues of the body (e.g. skin, bone, blood vessels, cartilage and basement membrane).
Juvenile Idiopathic Arthritis (JIA) is the most common pediatric rheumatologic disease. It is associated with significant long term morbidity.
It was previously called as, Juvenile Rheumatoid Arthritis (by ACR –American College of Rheumatology) or Juvenile Chronic Arthritis (by ELAR –European League Against Rheumatism).
Recent Advances In The Management Of Juvenile Idiopathic ArthritisNaveen Kumar Cheri
The term “rheumatologicaldisorders” refers to diseases that affect the major connective tissues of the body (e.g. skin, bone, blood vessels, cartilage and basement membrane).
Juvenile Idiopathic Arthritis (JIA) is the most common pediatric rheumatologic disease. It is associated with significant long term morbidity.
It was previously called as, Juvenile Rheumatoid Arthritis (by ACR –American College of Rheumatology) or Juvenile Chronic Arthritis (by ELAR –European League Against Rheumatism).
Medical college of wasit
Department of medicine
Case sheet history
Thing to remember :-
1) Stand on the right side of the patient with good confidence .
2) Introduce yourself as a medical student not as a doctor . ( you may face difficult question ).
3) Talk the patient gently with clear comprehensible words .
4) Remember don’t hurt the patient in your speak & touch .
This simplified lecture gives an account of how to approach a patient with a neck mass. Moreover, it shows hoe master thyroid gland history taking and examination and general examination.
Additionally, the lecture is supported by many real-life scenarios to cover the topics from a clinical point of view.
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.
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
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
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.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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.
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!
- 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
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
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Gsur 302
1. GENERAL
SURGERY
- 302 -
SUMMARY PREPARED
BY
SABRI KHALIL SHAMALI
College of medicine
2011
2nd version
bîuìÛìäØnÛaë@âìÜÈÜÛ@‹—ß@òÈßbu@‡vß@ÝibÔß@M@oíýnŽ@òjnØß@À@bèã뇤@
2. Start by putting the patient at ease: ( )
• Greet the patient by name: "Good morning, Mrs Jones"
• Introduce yourself and explain that you are a medical student.
• Shake the patient's hand, or if they are unwell rest your hand on theirs.
• Ensure that the patient is comfortable.
You should always begin the physician-centered phase of the interview with "WH"
questions (where? what? when?) directed at the chief complaint(s). Build on the
information the patient has already given you. Flesh out areas of the story you don't
fully understand. Try to quantify whenever possible (pain on a scale of 1 to 10,
number of days instead of "a while," etc.). Be as specific as possible and try to record
what the patient says accurately, without interpretation
A.Personal history:
1- Name:
Medical registration
To be familiar with patient
2-Age: Why we ask about age: "age related diseases as:
"
Infant (0-2 yrs) --- congenital diseases
Childhood (2-12 yrs) --- Parasitic infection mumps
Adolescence (12-20 yrs) --- Trauma, TB
Adulthood (20-40yrs)--- Hernia )
Middle age (40-60yrs) --- Gall bladder diseases, Atherosclerosis
Old age (above 60rs --) --- Malignancy, vascular disease)
3. Sex: Why sex: "sex related diseases"
emale
Breast cancer
Gall bladder stones
Femoral Hernia
Goiter
SLE "Systemic Lupus Erythematosis"
ale
Hypertension
Inguinal hernia
Peptic ulcer
Gastric and bladder carcinoma
4- Residence: íÚ^Î÷]<á^ÓÚ
Farmer ---- Malnutrition and parasitic infection "bilharziasis"
Endemic diseases: Oases ---goitre
Bilharziasis---Egypt
stomach cancer Japan
Burkett's lymphoma central Africa, esophageal cancer china
1
3. 5. occupation :ﺍﻟﻤﻬﻨﺔ
Porter --- ﺍﻟﻌﺘﺎﻝhernia
teachersurgeon ﺟﺮﺍﺡbarber --- ﺣﻼﻕVaricose vein
Vibration --- vascular diseases
Radiation --- Bone marrow depression
6. Marital status:
Single, married, divorced or widow, offspring. the age of the youngest
7. Menstrual History:
regularity of menstruation, age of menarchemenopause
8. Special Habits:
Smoking:"number of cigarette and period of smoking"
Lung cancer, Lip cancer , Urinary bladder cancer
Atherosclerosis
Respiratory tract infection
Emphysema, chronic bronchitis
Alcohol Abuse:
Peptic ulcer
Liver cirrhosis
Drug Abuse and addiction.--- injection lead to hepatitis and AIDS
B. Complaint:
1-Written in patient words "only translation without medical terms"
2- only one complaint the most sever and recent"(distressing one)
3- in brief
4-Duration of complaint
5-Complaint may be swelling , pain or disturbed function
6- one complain one system
C. present History:
1-history of pain:
If the history of the presenting complaint includes pain, ask about it using the
mnemonic SOCRATES
Site - where exactly is this pain?
Onset - when did the pain start, did it start suddenly or gradually?
• sudden "trauma > hematoma" ( MCQ )
• gradual "neoplasia"
• acute "inflammation , infection"
• Accidental "discovered by patient"
2
4. Character – describe the pain - sharp? knife-like? gripping? burning?
crushing?
• Colic pain
• Throbbing pain - infection with pus
• dragging "heaviness" – varicose vein
• Radiation - "Referred pain " extension-of pain to another site"
does the pain spread anywhere? To the arm, jaw, groin etc?
Renal pain back pain ,radiate to inguinal region and testicular
o Gall bladder pain mid-epigastrium and tip of right scapula
o appendicitis pain around the umbilicus
• Associated symptoms - is the pain accompanied by any other features?
o like oedema, hemoptysis , vomiting
• Timing duration - does the pain vary in intensity during the day?
( )
o Short "inflammation"
o Long "benign lesion"
• Exacerbating
srotcaf gniveiler dna - does anything make the pain better or worse?
• Severity - does the pain interfere with daily activities or with sleep?
o Mild
o Moderate
o Sever " life stopping"
2-History of swelling :
( ) ﺍﻭﻝ٦ ﻧﻘﺎﻁ ﻟﻠﺘﻮﺿﻴﺢ-ﺗﺘﺤﺪﺙ ﻋﻦ ﻃﺮﻳﻘﺔ ﺳﺆﺍﻝ ﺍﻟﻤﺮﻳﺾ
Some key questions to be asked regarding a swelling (generally)
1. When do you first notice the lump?
REMEMBER, first noticed the lump 3 months ago is not the same as first appeared 3
months ago.
2. How do you notice it?
Below are the 3 commonest answers :
a) It's painful b) I noticed it accidentally c) Others told me about it
Generally, if the lump is painful, the commonest aetiology is inflammation.
Most of the patients thought that only painful lumps are cancerous.
3. How does the lump disturbs you?
Basically, the question is asking about the associated symptoms.
It can be pain, discharge, dysphagia, dyspnoea, cosmetically disfiguring, fear of
malignancy, etc.
4. Any changes to the lump since you first notice it?
The commonest change is the size.
Whether the lump has increased or decreased in size, or it's size fluctuates.
5. Has the lump ever dissapears before?
Does the lump dissapears when the patient is lying down supine?
or any other activities
6. Do you ever had any other lumps before this?
Asking for multiplicity
3
5. 1. Onset:
o Sudden "trauma hematoma" _MCQ_
o Gradual "neoplasia"
o Acute "inflammation, infection"
o Accidental "discovered by patient or others"
2. Course:
o Progressive rapid "malignant lesion" or slow
"Benign lesion"
o Regressive acute infection
o Stationary cysts or benign lesion
o Intermittent jaundice due to obstruction
3. Duration:
o Short "inflammation
o Long "benign lesion"
4. Relation to pain:
o Swelling then pain --malignancy
o Pain then swelling- inflammation
5. Relation of onset to constitutional manifestation:
o Fever , redness, headache, malaise
6. effect on body function and nearby structures
7. possible cause (aetiology):
o Carrying Heavy object -- hernia
o Trauma -› hematoma
8. Special character:
o Move up and down with deglutition thyroid swelling
o increase size with food pharyngeal diverticulum
o Pulsations aneurysms or vascular swelling
o Impulse on cough and reduce on laying down hernia
D.past history:
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The past medical history is essentially background information related to the
patient's health and well being. A brief past medical (and social) history often
includes these elements
General question:
• Have you suffered from any previous illness?
1. Allergies and Reactions to Drugs (What happened?)
2. Current Medications (Including "Over-the-Counter")
3. Medical/Psychiatric Illnesses (Diabetes, Hypertension, Depression, etc.)
4. Surgeries/Injuries/Hospitalizations (Appendectomy, Car Accident, etc.)
5. Immunizations
6. smocking/Alcohol
4
6. 7. Reproductive Status for Females
o Last Menstrual Period
o Last Pelvic Exam/Pap Smear
o Pregnancies/Births/Contraception
8. Birth History/Developmental Milestones for Children
9. Exposures
:lufpleh DAERHT cinomenm eht dnif yam uoY
• Tuberculosis
• Hypertension (myocardial infarction and strokes)
• Rheumatic fever
• Epilepsy
• Asthma, anxiety and arthritis
• Diabetes and depression
E. Family History:
• Are your father, mother, brothers, sisters alive? - If they have died, at what
age did he/she/they die? What did he/she/they die of?
• Do they have any current illnesses?
• Do any illnesses run in your family?
Similar cases in family "hereditary disease
Consanguinity ا رب
relevant - cancer breast and hemolytic anemia
goiter , varicose veins
irrelevant-hernia
5
7. Local examination of
swelling
a- inspection: <ì‚â^Ž¹^e<
o 1- solitary or multiple
o 2- site (anatomical)
o 3- Size ( in cm)
o 4- Shape (rounded, oval, etc.)
o 5. Surface:
• - Smooth
• - Irregular :
granular (<0.5 cm), nodular (1-2 cm), lobulated (>2 cm)
o 6. Surrounding structures:
( relation & effect of swelling in the surrounding structures ):
Relation to muscle:
(ask the patient to contract the muscle and see if the swellings):
- decrease in size --> deep to muscle
- Increase in size - superficial to muscle
-No change- muscular swelling
Relation to surrounding structures as arteries and veins
o 7-Other Swelling: draining lymph nodes
o 8-Special sings:
• Move up and down with deglutition > thyroid swelling
• increase size with food > pharyngeal diverticulum
• Pulsations > aneurysms or vascular swelling
• Impulse on cough and reduce on laying down > hernia
o 9.skin overlying:
• Normal
• Sings of inflammation (redness, dilated veins)
• Sings of malignancy (skin retraction , dilated veins)
• Scars
6
8. B) palpation ‚éÖ^e<Œ^Šu÷]<
1-tenderness اﻻﻟﻢ ﻋﻨﺪ اﻟﻠﻤﺲ
2-Temperature- by dorsum of hand which is more dry
3-consistency :
solid :
• Hard like bone
• Firm like tip of nose
• Soft like lobule of ear
Systic : fluctuant "presences of fluid" (MCQ )
Can be detected by:
• fluctuation test : -
- cross fluctuation test
- Bipolar fluctuation test- for swelling have 2 place
NB . fluctuation test uses > 2 cm
Pagets test uses < 2 cm
4-Edge:
well defined edges or ill defined edges
remember . comment on edge by palpation ( MCQ )
C) Percussion:
• Resonant: gaseous swellings
• Dull: cyst and solid swellings
D) Auscultation:
• Systolic murmurs in aneurysm
• Contentious murmurs in A/V fistula
• Venous hum in portal hypertention
• Intestinal sounds in hernias
7
9. - Sutures -
Def: Surgical suture is a medical device used to hold body tissues
together after an injury or surgery.
Uses: wound closure (Wound healing) :
1ry intention
2ry intention – granulation tissue/leave scar and doesn't look nice
3ry intention – infection wound sutured after wound healing
Type of sutures:
1-absorbable:
o Not for skin
o For abdominal layer
o Intestine , stab knife
(NB. We can use non-absorbable but prone to infection)
2- non-absorbable:
For skin suture : / multifilament
fix drain (natural)
prolene (polyprolene) suture/ (synthetic) ( mcQ)
BN . Prolene {inert} the body doesn't react against it
Uses:
1- for suture tough structure, we suture linea alba , rectus sheath at midline
with prolene
2- repair of hernia: protrusion of a sac
Sac = -omentum – intestine
Prolene mesh non absorbable for treatment of hernia
:erutus elbabrosba fo epyT
(every thread has tensile strength)
A) chromic catgut (natural)
• induce very severe immune reaction
• has tensile strength remain 90 days (loss of tensile strength after 3
weeks)
B) synthetic vicryl :
• not much severe immune reaction at natural
• monofilament (monocryl) mcq
• multifilament (vicryl) : mcq
o More tensile
o More liability to infection
o Absorbed after 70 days
8
10. :Chromic Catgut suture:
is an absorbable, sterile, surgical suture composed of highly purified connective
tissue (mostly collagen) derived from either beef or sheep intestines
Application: General Closure , Urology , Plastic Surgery
: Silk Suture
Natural Non-absorbable Suture (braided)
Indications: Eye and lip skin surgery , Intraoral surgery
Advantages: Best handling and tying of any Suture Material
Disadvantages: - Least tensile strength of any Suture Material
- High tissue reactivity (similar to CatgutSuture)
- Increases risk of infection due to high capillarity
:esoohc ot woH
ﻛﻞ ﻣﺎ ﺍﺯﺩﺍﺩ ﺭﻗﻢ ﺍﻟﺨﻴﻂ ﻛﻠﻤﺎ ﻗﻠﺖ ﺳﻤﺎﻛﺘﻪ
Example :
Face : 0.4 and late
Scalp : 1
Vascular non absorbable – prolene : 6.0
BN . Cartilage (not sutured) lead to ISCHEMIA
Precaution to ensure increase intention healing :
A) approximate not strangulate
cut of blood supply of edges no wound healing
B) don t increase number of sutures more than needed
(wound 5 cm need 4 sutures)
Every needle in for out lead to trauma
Every suture will contain foreign body / bacteria
BN . If there is skin loss ; leave to heal natural –skin graft
C) no tension on wound
D) suture memory
♦ ability of suture material to regain its normal shape
9
11. complication of suturing a wound
1- infection :
♦ tools not clean
♦ disease transmission (as AIDS)
♦ inflammation ( auto immune Reaction)
2- scar
♦ wound healing but leave mark
♦ not raised / not elevated
♦ respect edges of wound
3- , keloid (occur more with natural)
♦ spread out of wound edges
♦ itching
♦ raised
4- improper healing (opened the wound)
BN .(radiotherapy) : ( endarteitis obliteranis )
i.e small vessels are blocked lead to impair healing
BN . Human glue ( skin stripsskin dips)
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<www.facebook.com/dr.alshamali
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