latest knowledge practical points short presentation
It will serve as guideline for Covid-19 corona virus
it will help in preparing ICU as well as policy making
institutions should device their own strategy
Pulmonary hypertension and its anesthetic managementprateek gupta
pulmonary hypertension and it pathophysiology. pre operative, intraoperative and post operative complications and anesthetic management.
drugs that can be used in anesthetic management of pulmonary hypertensiom
Pulmonary hypertension and its anesthetic managementprateek gupta
pulmonary hypertension and it pathophysiology. pre operative, intraoperative and post operative complications and anesthetic management.
drugs that can be used in anesthetic management of pulmonary hypertensiom
Corna virus detail And corona virus in pakistanEmaan Uppal
The 2019–20 coronavirus pandemic is a pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified in Wuhan, Hubei, China in December 2019Avoiding close contact with sick individuals; frequently washing hands with soap and water; not touching the eyes, nose, or mouth with unwashed hands; and practicing good respiratory hygiene.
Corna virus detail And corona virus in pakistanEmaan Uppal
The 2019–20 coronavirus pandemic is a pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified in Wuhan, Hubei, China in December 2019Avoiding close contact with sick individuals; frequently washing hands with soap and water; not touching the eyes, nose, or mouth with unwashed hands; and practicing good respiratory hygiene.
PREVENTION OF CORONA VIRUS INFECTION AMONG HEALTH WORKERS & PATIENTSSANJAY SIR
This presentation is for health care workers & patients to limit the transmission of corona virus infections. it also helps educator of medical, nursing & paramedics to teach their students about control & prevention strategies. it also create awareness among HCWs & common people.
This document provides interim guidance for healthcare facilities (e.g., hospitals, long-term care and outpatient facilities, and other settings where healthcare is provided) and will be updated as needed.
Hospital care in Department define as Covid-free: A proposal for a safe hospi...Valentina Corona
Hospital care in Department define as Covid-free: A proposal for a safe hospitalization protecting helathcare professionals and patients not affect by Covid-19
How to ventilate COPD and ARDS in Intensive care unit. safe lung ventilation. PEEP, Tidal volume, mode of ventilation. limits of ventilation. ventilator alarms
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
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.
Follow us on: Pinterest
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
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
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
2. Summary
• Pandemics and epidemics are unique challenges
for ICU preparedness. In a highly mobile,
globalized world, infectious disease is no longer
confined to fixed geographic regions. The risks of
pandemic disease to clinical staff requires that
institutions have mechanisms to protect their
pandemic disease to clinical staff requires that
institutions have mechanisms to protect their
personnel while also providing adequate care to
affected patients. Engagement of community
partners is necessary to permit adequate data
collection, to develop ethical standards for
resource allocation, and to manage anxiety and
expectations among the public
3. “stuff, staff, and space”
• Besides Covid-19 ICUs may be burdened with
other disasters like hurricanes, wars and
earthquakes (non infectious)
• In infectious pandemic HCWs are at risk due to• In infectious pandemic HCWs are at risk due to
their actual work and measures have to be
taken to protect them from infection as well
as prevent absenteeism
4. “Stuff”: Supply Requirements for
Pandemic Preparedness
• ICU should be prepared of caring the patients
for 96 hours without outside supplies
• In cases of disaster this rule should be
complied as well.complied as well.
• We should expect at least double the load as
compared to usual routine work in ICU
5. “Stuff”: Supply Requirements for
Pandemic Preparedness
• Disposable items (masks, gowns, suction
catheters) pharmaceuticals (and particularly
antimicrobial drugs)
• Mechanical ventilators
• When additional supplies are not available,• When additional supplies are not available,
alternative methods to provide respiratory
support may need to be considered, such as
– the use of anesthesia ventilators,
– high-flow nasal cannula oxygenation,
– noninvasive positive pressure ventilation for selected
patients
6. “Stuff”: Supply Requirements for
Pandemic Preparedness
• Oseltamivir and peramivir for influenza, plus
appropriate antimicrobial drugs for secondary
bacterial infections
– intravenous fluids,
– agents for rapid-sequence intubation,– agents for rapid-sequence intubation,
– analgesics and sedatives for intubated patients,
– vasopressors,
– venous thromboembolism prophylaxis,
– neuromuscular blockade agents for patients with
severe hypoxemic respiratory failure
7. “Stuff”: Supply Requirements for
Pandemic Preparedness
• Laboratory equipment and kits
• Waste disposal equipment
8. “Staff”: Increasing the Safety of
Trained Personnel
• Trained personnel.
• In case of shortage: trained critical care
personnel supervise staff experienced in acute
care (eg, hospitalists, medical/surgical nurses,care (eg, hospitalists, medical/surgical nurses,
general inpatient pharmacists)
– (Trained staff intervening directly for highly
complex patients as well as for emergencies and
procedures)
9. “Staff”: Increasing the Safety of
Trained Personnel
• Protect your “Staff”
– Careful infection prevention practices,
– the use of personal protective equipment (PPE),
– Sadly no vaccine available– Sadly no vaccine available
– Flu vaccine for all staff
– N-95 for laboratory workers and ICU workers in
direct contact with secretions
– Closed circuit suction in ventilated patients
10. “Staff”: Increasing the Safety of
Trained Personnel
• Staff may get sick (and they really can)
• They must avoid coming to work and must
seek medical advice
• This will lower the risk of spreading infection• This will lower the risk of spreading infection
in HCWs
11. “Space”: Critical Care Without an
Intensive Care Unit
• Separate rooms are desirable but not always
practical
• Cohorting confirmed cases of Covid-19 may be
necessary to avoid spread of infectionnecessary to avoid spread of infection
12. “Space”: Critical Care Without an
Intensive Care Unit
• Moving less sick patients from ICU to
accommodate more sick patients lying in ED
or medical floor
– patients not requiring mechanical ventilation,– patients not requiring mechanical ventilation,
vasopressor support, or intensive
neuromonitoring
I take it as a golden opportunity with support of the
ministry and police to move unnecessary staying
patients in ICU
13. Temporary ICU building
• Postanesthesia care unit (PACU) or a
monitored step-down unit
– (Cancellation of elective surgical procedures may
open up the PACU and same-day surgical units asopen up the PACU and same-day surgical units as
auxiliary ICUs and step-down units, for example.)
14. Planning for pandemics
1. Triage and resource allocation
– Scarce resources, such as ECMO or access to an
ICU, will require allocation in a manner that is
open, consistent, and based on broadly acceptedopen, consistent, and based on broadly accepted
ethical principles
– reasonable chances of survival
– critically ill patients denied ICU admission in a
disaster must receive appropriate and
compassionate palliative care.
15. Planning for pandemics
2. Optimization of staffing
– The hospitals prepared with Ebola Treatment
unit capability – regular refresher training
– staff training on infection prevention practices– staff training on infection prevention practices
for pandemic threats
– Training donning and doffing of PPE and PAPR
use, should be routine for institutions
17. Planning for pandemics
3. Equipment, supplies, and space
– The Joint Commission-mandated 96-hour supply
requirement (including food, water, consumables,
and medications)and medications)
– Coordination with nearby hospitals,
pharmaceutical vendors, and regional and
national health authorities, including via the
Strategic National Stockpile
18. Planning for pandemics
5. Public Health
– Hospitals and ICUs must have plans to coordinate
with public health authorities for
1. identification of cases,
2. access to diagnostics,2. access to diagnostics,
3. and tracking of potentially contagious individuals as
part of outbreak investigations.
4. Systematic data collection, either through
government, academic, or combined networks, is
similarly crucial to test interventions to end an
epidemic
19. Planning for pandemics
5. Public affairs
– Transparency
– Confidentiality
– Ethical consideration for allocation of ventilator– Ethical consideration for allocation of ventilator
– Media interaction (regularly)
– Collaboration with public health authorities
–
20. This article is prepared using following link
• https://sccm.org/Disaster/COVID-19-ICU-
Preparedness-
Checklist?_zs=X7asi1&_zl=7MSb6
21. This article is prepared using following link
• https://www.sciencedirect.com/science/articl
e/pii/S0749070419300405?via%3Dihub#bib10
22. Worth reading
• https://jamanetwork.com/journals/jama/fullarticle/2762996
published on 11-March-2020
• Don’t use NIV and HFNC
https://www.thelancet.com/action/showPdf?pii=S2213-
2600%2820%2930110-7
• Ebola's Message: Public Health and Medicine in the Twenty-First
Century edited by Nicholas G. Evans, Tara C. Smith, Maimuna S.Century edited by Nicholas G. Evans, Tara C. Smith, Maimuna S.
Majumder
• Use of Air Powered respirators
https://reader.elsevier.com/reader/sd/pii/S0166354213002246?tok
en=84374D61DD2B8C14ED93ABE4FCB3FED8DBDB109D3962F722D
21D0F457A345B1CED50B429BFA1DAA8FBAE2713A05BE3D5
• https://netec.org/