This document provides an overview of hernia examination. It defines a hernia and describes the types, predisposing factors, and basic features. It focuses on inguinal hernia, covering the applied anatomy, differences between direct and indirect types, and how to examine an inguinal hernia. The examination involves inspection, palpation including checking for a cough impulse, attempting reduction, and assessing for bowel sounds or tenderness. Differential diagnoses are also listed. The goal is to understand hernia examination principles and be able to demonstrate proper inguinal hernia evaluation.
Simple notes on definition of abdominal hernias in general, as well as clinical features and management of inguinal hernias.
Brief explanation of hernia repair methods (laparoscopic, open surgery)
Simple notes on definition of abdominal hernias in general, as well as clinical features and management of inguinal hernias.
Brief explanation of hernia repair methods (laparoscopic, open surgery)
Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
EPIDIDYMAL CYST
VARICOCELE
Describes the concept of a surgical abdomen, acute abdominal pain, emergency intervention and approach to management, including the controversial use of analgesic and antibiotics in emergency room.
pelvic inflammatory disease: case presentation & disease overview farah al souheil
pelvic inflammatory disease is a very common type of Sexually transmitted disease among young sexually active females. in this presentation we discuss a case suffering from PID and then we evaluate the plan of discharge based on disease and treatment overview
Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
EPIDIDYMAL CYST
VARICOCELE
Describes the concept of a surgical abdomen, acute abdominal pain, emergency intervention and approach to management, including the controversial use of analgesic and antibiotics in emergency room.
pelvic inflammatory disease: case presentation & disease overview farah al souheil
pelvic inflammatory disease is a very common type of Sexually transmitted disease among young sexually active females. in this presentation we discuss a case suffering from PID and then we evaluate the plan of discharge based on disease and treatment overview
Varicose Veins is dilatation of superficial veins due to high pressure in the vein i.e. because standing and walking upright increases the pressure in the veins of lower body. It affects as many as 10% of the population.
For many people, varicose veins could be a cosmetic concern. For others, it causes unsightly bulges in the legs, present with swelling of the leg, pain, Eczema, heaviness and fatigue. These veins do not perform any effective function and their removal or closure only helps the blood to flow through the normal deeper veins.
Varicose veins may also signal a higher risk of other circulatory problems. Treatment may involve self-care measures or procedures by your doctor to close or remove veins. These varicose veins should be treated before they produce complications, which are often irreversible.
To know more, read on Varicose Veins by our Consultant Cardiothoracic and Vascular Surgeon, Dr. C. Anand Somaya.
Varicose veins:A never ending problem if mistreated!KETAN VAGHOLKAR
Varicose veins is one of the most distressing disorders affecting the lower limbs. It is commonly seen in individuals who stand for prolonged hours thus causing immense pain and discomfort. These days it is also found in individuals who sit for prolonged periods as seen in computer professionals. Proper treatment based on good understanding of the pathophysiology underlying the disease is pivitol for a successful outcome. the presentation outlines the approach to the problem for practitioners
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From: UCD PAEDS <ucdpaeds@gmail.com>
Date: 2009/2/12
Subject: Fwd: Bambury Tutorial on Head and Neck
To: ucdgrad09@gmail.com
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From: Henning L. Stokmo <helangen@gmail.com>
Date: Wed, Feb 11, 2009 at 7:07 PM
Subject: Bambury Tutorial on Head and Neck
To: ucdpaeds@gmail.com
Examination of Respiratory System PPT -- By Prof.Dr.R.R.deshpande
In this PPT Prof.Dr.Deshpande is explaining following points -- Importance of Respiratory system Examination , How to perform examination of Upper Respiratory system ? How to perform Inspection of Chest ,with following points – Size & Shape of chest ,Type of Respiration, Chest expansion with deep breathing ,Position of Trachea, Apex beat ,Accessory muscles etc How to perform Palpation Examination with following points – Measurement of chest with tape & card board ,Expansion of chest by measuring circumference of chest ,Palpation of chest expansion ,Position of Trachea by Palpation ,TVF. Then there is explanation of Percussion & Auscultation of chest .
Mobile – 922 68 10630
Also visit – www.ayurvedicfriend.com
Inguinal and femoral hernia:
A hernia is a protusion of a viscus or a part of viscus through and abnormal opening in the walls of its containing cavity. Details of inguinal hernia and few slides on other types of hernia.
Hernias (as an inguinal hernia, umbilical hernia, or spigelian hernia) in which an anatomical part (as a section of the intestine) protrudes through an opening, tear, or weakness in the abdominal wall musculature.
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
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!
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.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
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.
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.
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
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
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
2. Outline
• Definition
• Types
• Predisposing factors
• Basic features of a hernia
• Inguinal hernia
• Applied anatomy
• Examination of inguinal hernia
• Differences b/t direct and indirect inguinal hernia
• Some definitions
• Video click for inguinal hernia examination
4/21/2015 2
3. Learning out come
• To understand the basic principle for examination of hernia.
• To know the various types of herniae.
• Able to understand the applied anatomy for the inguinal region.
• Able to demonstrate the examination of inguinal hernia.
• Comprehend the differences between direct and indirect inguinal
hernia.
• To appreciate the some confused definitions.
• To be able to develop the skill for the examination of a herniae
4/21/2015 3
5. Hernia – protrusion of a viscous or part of
viscous through an abnormal opening in the
walls of its containing activity.
4/21/2015 5
25th edition,Bailey`s & Love`s Short practice of surgery
8. Composition of hernia
Sac
• Sac is a
diverticulum of
peritoneum
• Consist of
mouth,neck,
body and
fundus
Covering
• Derived
from the
layers of
abd wall
through
which the
sac passes
Contents
• Omentum- omentocele
• Intestine- enterocoele
• Portion of circumference of
intestine- Richter’s Hernia
• Portion of bladder (or a
diverticulum)
• Ovary with or w/o
corresponding Fallopian
tube
• Meckel’s diverticulum-
Littre’s hernia
• Fluid
4/21/2015 8
10. Reducible Hernia-
contents can be
returned to abdomen
Irrreducible Hernia-
contents cannot be
returned to the
abdomen but there is
no other complication
Obstructed Hernia-
irreducible hernia
containing intestine
that is obstructed with
good blood supply
Strangulated Hernia-
blood supply is
obstructed
Inflammed Hernia-
contents of the sac
become inflammed
4/21/2015 10
11. Basic features of hernia???
• Occur at weak point (Congenital or acquired)
• Reducible on lying down or with direct pressure
• Have an expansile cough impulse
(Visible & palpable)
4/21/2015 11
Note: last 2 signs may be absent if constricted at
the neck
12. Causes of abdominal Herniae
Anatomical weakness
• Structures passing through
the abdominal wall
• Muscle fail to develop
• Scar tissue
Acquired weakness
• Trauma
• High intra-abdominal
pressure
• Coughing
• Straining
• Abdominal distension
4/21/2015 12
13. Various types of Herniae?(common)
• Inguinal
• Umblical
• Incisional
• Femoral
• Epigastric
4/21/2015 13
21. Examination of the hernia
• Ask permission
• Exposure
• Position
• Third party
• Privacy
• Manner
4/21/2015 21
22. Ask the patient to stand up
• Lying position …..why not?
Not possible to see the true size.
proper examination even not detect at all.
• If suspect since early,start with standing position
• If found during routine abdominal exam, complete
abd exam first and ask the patient to stand up to
examine properly.
NOTE: examine both inguinal regions
4/21/2015 22
23. Look at the swelling from the front
• Exact size and shape
• Visible expansile cough impulse
• Distinguish from femoral hernia
• Extend of lump…down into the scrotum ??
• Other scrotal swelling ….
• Any other swelling on the “normal side”
4/21/2015 23
24. Feel from the front
• Exam the scrotum and content
• First whether inguino-scrotal or true scrotal by
getting above the upper edge ( get above )
• Don’t exam the external ring or canal as it is
painful
4/21/2015 24
25. Feel from the side
• Having exam the scrotal content & can’t get above the lump –
assuming the inguinal hernia – proceed to examination of the
lump…….??? Inguinal Hernia examination
• Stand at the side of the patient –same side of hernia
• Place on hand at the back of to support the patient
• Examinating hand and fingers parallel to the inguinal ligament.
4/21/2015 25
26. Expansile cough impulse
• Firmly compress the lump with fingers
• Ask the patient to turn head toward to opposite side &
to cough
• If Tense and expansile = cough impulse (+)
Note:
• Localized swelling in the spermatic cord and undescended testis
come out during cough but not bigger nor tense .
• (+) is diagnostic for hernia
• (-) can not exclude diagnosis (e.g adhesion …)
4/21/2015 26
27. Is the swelling is reducible?
• Position????
• Can control at internal ring =indirect
• Can not control = direct
Note:
• Reduction point to pubic tubercle
• above and medial … inguinal
• Below and lateral …….femoral
Only for reducible one
4/21/2015 27
28. Remove the finger and watch the
reappearance
• Direction and the way reappearance help to deduct the
origin of hernia
• Obliquely downward = indirect
• Directly project forward = direct
NOTE:
Difficult in obese patient
4/21/2015 28
30. Feel the other side
• Move the other side and exam the inguinal region
• Commonly bilateral particularly in direct inguinal hernia
• Ask the patient to cough to make obvious small bulge
4/21/2015 30
31. Examine the abdomen
• Any possible increased intra-abdominal
pressure
e.g ..????
4/21/2015 31
34. Indirect inguinal hernia Direct inguinal hernia
Any age but common in young Elderly
Via deep inguinal ring and long the
inguinal canal
Via transversalis fascia (hasselbach’s
triangle)
Patent or reopen processus vaginalis Weak abdominal wall/muscle
Unilateral in 2/3 case (right side more
common)
Bilateral in > ½ case
Enter scrotum (complete) Does not enter scrotum (incomplete)
Reduced by patient/doctor (manually) Reduced on lying down (automatically)
Narrow neck- more liable to strangulate Broad neck
Zieman technique- impulse on index
finger
Impulse on middle finger
Deep ring occlusion test- control Bulge out
Little finger invagination test- impulse on
finger tip
Impulse on pulp
4/21/2015 34
35. Clinical features
Indirect inguinal hernia
- sudden pain at the groin
- swelling in inguinal canal which
may extend into scrotum
- become visible when patient
stand or cough
- dragging/ discomfort
- passes above and medial to
pubic tubercle
- palpable cough impulse
- audible bowel sound +/-
Direct inguinal hernia
- seen protruding directly forward
- usually readily reducible
- gradual onset
- Severe pain is rare If there is no
complication such as incarceration or
strangulation
4/21/2015 35
36. D/Dx of inguinal hernia???
• Femoral hernia
• Vaginal hydrocele
• Hydrocele of cord or canal of nuck
• Undescended testis
• Lipoma of cord
4/21/2015 36