Historia de la Cirugia Endoscopica Transvaginal por Orificios Naturales
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The document discusses the history and evolution of transvaginal endoscopic surgery through natural orifices, beginning with early descriptions of pelvic anatomy in the 18th century. It outlines key milestones and innovations in culdoscopy and notescopic techniques over the 20th century, including the introduction of ventroscopy in 1901, colpolaparoscopy in 1937 using an angled lens, and descriptions of culdoscopy in 1944. More recent advancements incorporated flexible instruments, 3D imaging, and hybrid NOTES procedures combining laparoscopic assistance. Transvaginal endoscopic procedures such as cholecystectomy, appendectomy, nephrectomy and sigmoidectomy were performed in humans as the field continued
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Laparoscopy is a minimally invasive surgical technique used in gynecology. The two main types are laparoscopy and hysteroscopy. Laparoscopy allows surgeons to examine the abdominal cavity and perform surgery using small incisions and long thin instruments inserted through the abdominal wall. It has advantages over open surgery like less pain, shorter hospital stays, and quicker recovery times. Complications can include bleeding, infection, and injury to nearby organs. Laparoscopy has a long history dating back to the early 19th century and has increasingly replaced open surgery for many gynecological conditions since the 1960s as techniques have advanced.
Laparoscopic Transperitoneal Ureterolithotomy- An Alternative to Open Surgery
Laparoscopic Transperitoneal Ureterolithotomy- An Alternative to Open Surgery SSR Institute of International Journal of Life Sciences
ABSTRACT- Urinary tracts stone diseases are one of the most common afflictions of modern society and it has
witnessed much advancement in its management. Keeping in view various aspects of management we carried out a
comparatively newer study called Transperitoneal Ureterolithotomy. This study was carried out to evaluate Laparoscopic
Transperitoneal Ureterolithotomy (TPUL) as a viable option to open surgical ureterolithotomy, Laparoscopic
Retroperitoneal Ureterolithotomy (RPUL) & endoscopic urology and to assess its place in the spectrum of various surgical
interventions for ureteric calculi in a tertiary care center. This study was conducted on 25 selected patients of a single large
impacted calculus of size more than 10mm in upper and middle ureter. It was observed that conversion to open
ureterolithotomy was observed in 4 cases and excessive bleeding in one case. No major perioperative complications were
seen. The procedure has definitely shown decreased post-operative discomfort, decreased requirement of post-operative
analgesia, better cosmesis, early return to work and less morbidity.
Key-words- Transperitoneal ureterolithotomy (TPUL), Retroperitoneal ureterolithotomy (RPUL), Extracorporeal
shockwave lithotripsy (ESWL), Open surgical ureterolithotomy
Usg 4 surgeons
Ultrasound can be used widely by surgeons during operations. It has several uses including acquiring new diagnostic information, confirming completion of operations, and guiding surgical procedures. Intraoperative ultrasound is performed using contact, probe-standoff, or compression scanning techniques. It is useful for examining organs like the liver and bile ducts. Laparoscopic ultrasound overcomes some disadvantages of laparoscopy and can also be used to guide procedures. Focused assessment with sonography for trauma (FAST) allows rapid identification of free fluid in trauma patients.
914.full.pdf
This review article summarizes the history and outcomes of treating Hirschsprung's disease. It describes how the cause was discovered in 1948 and the original Swenson procedure was developed. Over time, modifications like the Duhamel and Soave procedures were introduced. The article reviews diagnostic techniques, operative mortality rates, complications, and long-term outcomes for different surgical approaches. It finds that while modifications aimed to improve on the original Swenson procedure, they were associated with higher complication and reoperation rates compared to the original approach.
Ostomytalk10 12
This document summarizes bladder cancer epidemiology, diagnosis, staging, treatment options including radical cystectomy, and the history and evolution of radical cystectomy and urinary diversion techniques. It discusses how radical cystectomy was first performed in the late 19th century but had high mortality rates until antibiotics were introduced. It outlines key developments like the ileal conduit procedure in the 1950s and robotic cystectomy in the 2000s. The future may involve tissue engineered bladder replacements.
Laparoscopy
This document provides information about laparoscopy and hysteroscopy procedures. It begins with the basics of laparoscopy, including a definition, brief history, and descriptions of the instruments used. Advantages include reduced postoperative pain and recovery time compared to open surgery. Risks include potential injuries. Hysteroscopy allows direct visualization of the uterine cavity using a small telescope inserted through the cervix. Various devices and distension media options are described. Common indications for both procedures include diagnostic evaluation and treatment of conditions like endometriosis, cysts, and fibroids. Overall the document outlines the key elements of minimally invasive laparoscopic and hysteroscopic surgeries.
Endoscopy skills 2 2-2015
Laparoscopy is a minimally invasive surgical technique that allows visualization of the abdominal organs through small incisions. It has many applications in gynecological endoscopy including diagnostic laparoscopy to investigate causes of infertility, ovarian cysts, ectopic pregnancy, and endometriosis. Key steps in the laparoscopy procedure are pneumoperitoneum creation, trocar insertion, visualization of organs, and completion with gas evacuation. It provides diagnostic and therapeutic benefits over laparotomy with less pain and faster recovery.
Tips & Tricks in Laparoscopic Adhesiolysis
This document summarizes a study on laparoscopic adhesiolysis for small bowel obstruction. Key points include:
- Laparoscopic adhesiolysis has advantages over open surgery like less pain, quicker recovery, and fewer adhesions.
- Patient selection is important, and factors like bowel diameter >4cm or distal complete obstruction increase risk of conversion.
- The open technique for initial trocar insertion is recommended to avoid injury to adherent bowel.
- Adhesiolysis requires careful sharp dissection and avoidance of cautery to prevent new adhesions.
- Findings like perforated bowel or dense adhesions often require conversion to open surgery.
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International Journal of Pharmaceutical Science Invention (IJPSI)
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In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
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GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. ENVIRONMENTAL SANITATION in community setting
“Environmental sanitation means the art and science of applying sanitary, biological and physical science principles and knowledge to improve and control the environment therein for the protection of the health and welfare of the public”.The overall importance of sanitation are to provide a healthy living environment for everyone, to protect the natural resources (such as surface water, groundwater, soil ), and to provide safety, security and dignity for people when they defecate or urinate .Sanitation refers to public health conditions such as drinking clean water, sewage treatment, etc. All the effective tools and actions that help in keeping the environment clean come under sanitation. Sanitation refers to public health conditions such as drinking clean water, sewage treatment. All the effective tools and actions that help in keeping the environment clean and promotes public health is the necessary in todays life.
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Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
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2nd-generation Antihistaminic Part I.pptx
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
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Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- 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
Storyboard on Skin- Innovative Learning (M-pharm) 2nd sem. (Cosmetics)
Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
Maintaining skin health is crucial for overall well-being, involving proper hygiene, hydration, protection from sun exposure, and avoiding harmful substances. Skin conditions and diseases range from minor irritations to chronic disorders, emphasizing the importance of regular care and medical attention when needed.
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PGx Analysis in VarSeq: A User’s Perspective
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Historia de la Cirugia Endoscopica Transvaginal por Orificios Naturales
- 1. Historia de la Cirugia Endoscopica Transvaginal por Orificios Naturales www.culdoscopy.com
- 5. Dr. Ott’s Publication of Ventroscopia
- 9. Topic Two
- 17. Culdolaparoscopic Cholecystectomy (1999) Culdolaparoscopic Cholecystectomy During Vaginal Hysterectomy . Tsin DA, Sequeira J, Giannikas G. JSLS 2003;7:171-172.
- 19. And then came NOTES
- 23. Then around the world
- 27. More Flexible Endoscopes The Eagle Claw [Olympus, Center Valley, Pennsylvania] suturing device with a semi-circular needle. Transdouglas Endoscopic Device
- 28. Flexible Instruments Novare Covidien Ethicon Endosurgical
- 30. Magnets Dr. Guillermo Dominguez, Poza Rica, Mexico (2008)
- 31. Dr. Fausto Davila Poza Rica, Mexico (2008) Rein and Hook
- 35. Experimental Secured Independent Tools Micro robotics
- 36. Thank you for your attention www.culdoscopy.com For more information visit:
Editor's Notes
- Tsin DA, Castro-Perez R, Davila MR, Davila F.