Internal hernia
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This document discusses internal hernias, which occur when an organ or part of an organ protrudes through the wall that normally contains it. It provides details on different types of internal hernias like paraduodenal, pericecal, foramen of Winslow hernias. It also discusses causes, symptoms, diagnosis through imaging like CT scans, and management through surgery to reduce the hernia and repair any damage. Risk factors include congenital defects and surgeries like liver transplant or Roux-en-Y gastric bypass. Early diagnosis and treatment are important to prevent complications.
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Intussusceptions
Intussusception is the prolapse of one part of the intestine into the lumen of the immediately adjoining part. It is most common in infants and children under 3 years old. Clinical diagnosis is based on symptoms like abdominal pain and vomiting. Ultrasound is very accurate for diagnosis and shows the pathognomonic "target" or "doughnut sign". Initial treatment is usually non-surgical reduction with hydrostatic or pneumatic enema under fluoroscopy or ultrasound guidance. Surgical reduction or resection is needed if non-surgical reduction fails or if there are signs of perforation or peritonitis.
P tin appedectomy& hernia
This document discusses physiotherapy approaches for various abdominal surgeries including appendicectomy, hernia repair, nephrectomy, and operations on the small and large intestine. It outlines common indications, surgical procedures, complications, and post-operative physiotherapy protocols for mobilization and rehabilitation. The physiotherapy aims to safely progress exercises away from the incision site and address any postoperative problems like pain, reduced lung function, or risk of blood clots through techniques like chest physiotherapy, positioning, early mobilization, and pain relief measures.
Esophageal cancer
The document describes the anatomy and pathophysiology of the esophagus. It discusses:
- The esophagus is a 25 cm muscular tube that extends from the cricopharyngeus to the gastroesophageal junction.
- There are four layers of the esophageal wall and four regions of the esophagus.
- Esophageal cancer is most commonly squamous cell carcinoma or adenocarcinoma. Risk factors include smoking, alcohol, obesity, and Barrett's esophagus.
- Staging of esophageal cancer involves evaluating the primary tumor, lymph nodes, and distant metastases. Treatment depends on the cancer stage but may include surgery, chemotherapy, or radiation therapy.
Liver abscess 1
This document discusses liver abscesses, including their classification, presentation, risk factors, and management. There are three main types of liver abscess - pyogenic (polymicrobial), amoebic (caused by Entamoeba histolytica), and fungal. Common symptoms include fever, right upper quadrant pain, and tender hepatomegaly. Risk factors vary depending on the type but include diabetes, cancer, travel to endemic areas, and alcohol use. Treatment involves drainage of pus via percutaneous or surgical methods along with antibiotics. Factors determining the need for drainage versus medical management alone depend on the size and characteristics of the abscess.
abdominoperinealresection-230308170906-3b30e42b (1).pptx
This document provides an overview of the abdominoperineal resection (APR) procedure for rectal cancer. It discusses the historical background, indications for APR, preoperative planning including imaging and marking of the stoma site. The document describes the surgical techniques for both the abdominal and perineal components of APR. It also reviews postoperative care, management of complications, and reported outcomes of APR.
Jm tubiana p taourel mdct in upper gastrointestinal obstruction jfim hanoi 2015
Jm tubiana p taourel mdct in upper gastrointestinal obstruction jfim hanoi 2015JFIM - Journées Francophones d'Imagerie Médicale
MDCT in upper gastrointestinal obstruction: A pictorial review summarizes the causes, epidemiology, pathophysiology, and key MDCT findings of gastro-duodenal obstruction. Intrinsic causes include gallstones, tumors, ulcers, and hematomas. Extrinsic causes include pancreatitis, gastric volvulus, surgical complications, hiatal hernias, mesenteric artery syndrome, and external masses. MDCT is useful for differentiating mechanical from functional obstruction and identifying lesions, complications, and the level of obstruction to guide management. The document reviews anatomy and illustrates various pathologies through case examples.DOC-20230219-WA0087.diseaes_esofags.pdf
This document provides an overview of the anatomy, physiology, and common diseases of the esophagus. It begins with the learning objectives which are to understand the anatomy/physiology and clinical features of benign and malignant esophageal diseases. It then covers topics such as surgical anatomy, physiology, symptoms, investigations, congenital anomalies, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, motility disorders, and diverticula.
esofagus.pdf
This document provides an overview of the anatomy, physiology, and common diseases of the esophagus. It begins with the learning objectives which are to understand the anatomy/physiology and clinical features of benign and malignant esophageal diseases. It then covers topics such as surgical anatomy, physiology, symptoms, investigations, congenital anomalies, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, motility disorders, and diverticula.
diseasesofoesophagus-141014153402-conversion-gate01.pdf
This document provides an overview of the anatomy, physiology, and common diseases of the esophagus. It begins with the learning objectives which are to understand the anatomy/physiology and clinical features of benign and malignant esophageal diseases. It then covers topics such as surgical anatomy, physiology, symptoms, investigations, congenital anomalies, foreign bodies, perforations, gastroesophageal reflux disease, hiatal hernia, motility disorders, and diverticula.
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abdominoperinealresection-230308170906-3b30e42b (1).pptx
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Jm tubiana p taourel mdct in upper gastrointestinal obstruction jfim hanoi 2015
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More from Asif Ansari
Appendicitis
This document discusses the approach and management of appendicitis. It begins by describing the pathophysiology of appendicitis, caused by obstruction of the appendix lumen leading to ischemia and necrosis. Clinical presentation includes migratory right lower quadrant pain. Diagnosis involves blood tests, imaging like CT or ultrasound, and clinical scoring systems. Treatment of uncomplicated appendicitis is appendectomy, while complicated or perforated cases may involve initial antibiotic treatment and drainage before surgery. Long-term antibiotic treatment can avoid surgery for some patients with perforated appendicitis.
Bowel anastomosis
This document discusses intestinal anastomosis, which involves creating a connection between intestinal loops or ends. Intestinal anastomosis is commonly performed for elective and emergency cases involving conditions like cancer, infections, or obstructions. The key factors for a successful anastomosis are minimal contamination, good blood supply, and tension-free apposition of the intestinal ends. The document compares hand-sewn and stapled techniques, noting that while staplers are faster, studies have found no difference in outcomes between the two methods. Proper patient factors and surgical technique are more important than the specific method used.
Ot & protocols
Dr. K.S. Dhillon moderated a presentation by Dr. Asif Mian Ansari on operating theater design and protocols. Key points included that operating theaters should have unidirectional airflow, segregated zones for sterile, clean and disposal areas, and meet standards for dimensions, airflow, temperature and humidity. Proper attire, aseptic techniques and regular sterilization are necessary to control infection transmission in the operating theater.
Sterilisation & disinfection
The document discusses sterilization and disinfection methods used in hospitals. It begins by defining key terms like sterilization, disinfection, cleaning, and antisepsis. It then describes various chemical and physical methods used for disinfection and sterilization of medical equipment, including steam, ethylene oxide, hydrogen peroxide gas plasma, and peracetic acid. Factors that can affect sterilization effectiveness, like cleaning and device design, are also covered. The document emphasizes that proper cleaning is required before disinfection or sterilization and that instrument classification guides appropriate processing method.
Antimicrobials in surgical patients
This document discusses antibiotic prophylaxis and treatment in surgical patients. It begins by defining different types of antibiotics, including their mechanisms and spectra of activity. It then provides guidelines for antibiotic prophylaxis based on the surgical procedure and patient risk factors. Specific procedures are listed with their recommended antibiotic regimens as well as alternatives for penicillin-allergic patients. Common antibiotic side effects and considerations for special situations like beta-lactam allergies are also reviewed.
Perioperative nutrition
Dr. Asif Mian Ansari presented on nutritional requirements for surgical patients. Major points included:
1) Malnutrition can complicate surgical outcomes as nutritional needs are increased during stress and recovery requires an anabolic state.
2) Formulas to calculate basal metabolic rate and increased needs during stress or infection were provided.
3) Guidelines for caloric and protein intake for normal and surgical patients depending on stress level were outlined.
4) Enteral nutrition is preferred over parenteral nutrition when possible due to lower risk of complications.
Wound healing
The document discusses the stages of wound healing including hemostasis, inflammation, proliferation, and remodeling, and describes factors that can influence wound healing such as wound type, location, and patient health issues. It also covers types of scar formation including hypertrophic, atrophic, and keloid scars, as well as treatments that can be used for problematic scars.
Wound healing
The document discusses the stages of wound healing including hemostasis, inflammation, proliferation, and remodeling, and the factors that influence wound healing such as wound type, patient health, and environmental conditions. It also covers abnormal wound healing which can result in hypertrophic or keloid scarring, and treatments for scarring including pressure therapy, steroid injections, and surgery.
Mirizzi syndrome
This document discusses Mirizzi syndrome, which is defined as extrinsic compression of the common hepatic duct by an impacted gallstone in the cystic duct or gallbladder. It presents the different classifications of Mirizzi syndrome, including the original 2 types described by McSherry in 1982 and the expanded 4 types described by Csendes in 1989. It details the clinical presentation, diagnostic imaging tools including ultrasound, CT, MRCP and ERCP, as well as the surgical approaches recommended for each type of Mirizzi syndrome.
Acute mesenteric ischemia
This document discusses acute mesenteric ischemia (AMI), a rare but life-threatening condition caused by sudden interruption of blood supply to the intestine. It can be caused by arterial embolism, thrombosis, or venous thrombosis. Clinical features include severe abdominal pain, nausea, vomiting, and bloody stools. Early diagnosis via CT angiography and prompt resuscitation, antibiotics, anticoagulation, and surgery are important, as delayed treatment can lead to bowel necrosis and death. Surgical management focuses on reestablishing blood flow and resecting non-viable bowel. Outcomes depend on how quickly treatment is initiated.
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Recently uploaded
The debris of the ‘last major merger’ is dynamically young
The Milky Way’s (MW) inner stellar halo contains an [Fe/H]-rich component with highly eccentric orbits, often referred to as the
‘last major merger.’ Hypotheses for the origin of this component include Gaia-Sausage/Enceladus (GSE), where the progenitor
collided with the MW proto-disc 8–11 Gyr ago, and the Virgo Radial Merger (VRM), where the progenitor collided with the
MW disc within the last 3 Gyr. These two scenarios make different predictions about observable structure in local phase space,
because the morphology of debris depends on how long it has had to phase mix. The recently identified phase-space folds in Gaia
DR3 have positive caustic velocities, making them fundamentally different than the phase-mixed chevrons found in simulations
at late times. Roughly 20 per cent of the stars in the prograde local stellar halo are associated with the observed caustics. Based
on a simple phase-mixing model, the observed number of caustics are consistent with a merger that occurred 1–2 Gyr ago.
We also compare the observed phase-space distribution to FIRE-2 Latte simulations of GSE-like mergers, using a quantitative
measurement of phase mixing (2D causticality). The observed local phase-space distribution best matches the simulated data
1–2 Gyr after collision, and certainly not later than 3 Gyr. This is further evidence that the progenitor of the ‘last major merger’
did not collide with the MW proto-disc at early times, as is thought for the GSE, but instead collided with the MW disc within
the last few Gyr, consistent with the body of work surrounding the VRM.
Sharlene Leurig - Enabling Onsite Water Use with Net Zero Water
Sharlene Leurig - Enabling Onsite Water Use with Net Zero WaterTexas Alliance of Groundwater Districts
Presented at June 6-7 Texas Alliance of Groundwater Districts Business Meetingwaterlessdyeingtechnolgyusing carbon dioxide chemicalspdf
The technology uses reclaimed CO₂ as the dyeing medium in a closed loop process. When pressurized, CO₂ becomes supercritical (SC-CO₂). In this state CO₂ has a very high solvent power, allowing the dye to dissolve easily.
SAR of Medicinal Chemistry 1st by dk.pdf
In this presentation include the prototype drug SAR on thus or with their examples .
Syllabus of Second Year B. Pharmacy
2019 PATTERN.
Shallowest Oil Discovery of Turkiye.pptx
The Petroleum System of the Çukurova Field - the Shallowest Oil Discovery of Türkiye, Adana
The binding of cosmological structures by massless topological defects
Assuming spherical symmetry and weak field, it is shown that if one solves the Poisson equation or the Einstein field
equations sourced by a topological defect, i.e. a singularity of a very specific form, the result is a localized gravitational
field capable of driving flat rotation (i.e. Keplerian circular orbits at a constant speed for all radii) of test masses on a thin
spherical shell without any underlying mass. Moreover, a large-scale structure which exploits this solution by assembling
concentrically a number of such topological defects can establish a flat stellar or galactic rotation curve, and can also deflect
light in the same manner as an equipotential (isothermal) sphere. Thus, the need for dark matter or modified gravity theory is
mitigated, at least in part.
20240520 Planning a Circuit Simulator in JavaScript.pptx
Evaporation step counter work. I have done a physical experiment.
(Work in progress.)
Applied Science: Thermodynamics, Laws & Methodology.pdf
When I was asked to give a companion lecture in support of ‘The Philosophy of Science’ (https://shorturl.at/4pUXz) I decided not to walk through the detail of the many methodologies in order of use. Instead, I chose to employ a long standing, and ongoing, scientific development as an exemplar. And so, I chose the ever evolving story of Thermodynamics as a scientific investigation at its best.
Conducted over a period of >200 years, Thermodynamics R&D, and application, benefitted from the highest levels of professionalism, collaboration, and technical thoroughness. New layers of application, methodology, and practice were made possible by the progressive advance of technology. In turn, this has seen measurement and modelling accuracy continually improved at a micro and macro level.
Perhaps most importantly, Thermodynamics rapidly became a primary tool in the advance of applied science/engineering/technology, spanning micro-tech, to aerospace and cosmology. I can think of no better a story to illustrate the breadth of scientific methodologies and applications at their best.
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
Context. With a mass exceeding several 104 M⊙ and a rich and dense population of massive stars, supermassive young star clusters
represent the most massive star-forming environment that is dominated by the feedback from massive stars and gravitational interactions
among stars.
Aims. In this paper we present the Extended Westerlund 1 and 2 Open Clusters Survey (EWOCS) project, which aims to investigate
the influence of the starburst environment on the formation of stars and planets, and on the evolution of both low and high mass stars.
The primary targets of this project are Westerlund 1 and 2, the closest supermassive star clusters to the Sun.
Methods. The project is based primarily on recent observations conducted with the Chandra and JWST observatories. Specifically,
the Chandra survey of Westerlund 1 consists of 36 new ACIS-I observations, nearly co-pointed, for a total exposure time of 1 Msec.
Additionally, we included 8 archival Chandra/ACIS-S observations. This paper presents the resulting catalog of X-ray sources within
and around Westerlund 1. Sources were detected by combining various existing methods, and photon extraction and source validation
were carried out using the ACIS-Extract software.
Results. The EWOCS X-ray catalog comprises 5963 validated sources out of the 9420 initially provided to ACIS-Extract, reaching a
photon flux threshold of approximately 2 × 10−8 photons cm−2
s
−1
. The X-ray sources exhibit a highly concentrated spatial distribution,
with 1075 sources located within the central 1 arcmin. We have successfully detected X-ray emissions from 126 out of the 166 known
massive stars of the cluster, and we have collected over 71 000 photons from the magnetar CXO J164710.20-455217.
THEMATIC APPERCEPTION TEST(TAT) cognitive abilities, creativity, and critic...
THEMATIC APPERCEPTION TEST(TAT) cognitive abilities, creativity, and critic...Abdul Wali Khan University Mardan,kP,Pakistan
hematic appreciation test is a psychological assessment tool used to measure an individual's appreciation and understanding of specific themes or topics. This test helps to evaluate an individual's ability to connect different ideas and concepts within a given theme, as well as their overall comprehension and interpretation skills. The results of the test can provide valuable insights into an individual's cognitive abilities, creativity, and critical thinking skillsBob Reedy - Nitrate in Texas Groundwater.pdf
Presented at June 6-7 Texas Alliance of Groundwater Districts Business Meeting
Randomised Optimisation Algorithms in DAPHNE
Slides from talk:
Aleš Zamuda: Randomised Optimisation Algorithms in DAPHNE .
Austrian-Slovenian HPC Meeting 2024 – ASHPC24, Seeblickhotel Grundlsee in Austria, 10–13 June 2024
https://ashpc.eu/
Micronuclei test.M.sc.zoology.fisheries.
Current Ms word generated power point presentation covers major details about the micronuclei test. It's significance and assays to conduct it. It is used to detect the micronuclei formation inside the cells of nearly every multicellular organism. It's formation takes place during chromosomal sepration at metaphase.
快速办理(UAM毕业证书)马德里自治大学毕业证学位证一模一样
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本公司拥有海外各大学样板无数，能完美还原。
1:1完美还原海外各大学毕业材料上的工艺：水印，阴影底纹，钢印LOGO烫金烫银，LOGO烫金烫银复合重叠。文字图案浮雕、激光镭射、紫外荧光、温感、复印防伪等防伪工艺。材料咨询办理、认证咨询办理请加学历顾问Q/微741003700
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2:同时对留学生所学专业登记给予评定
3:国家专业人才认证中心颁发入库证书
4:这个认证书并且可以归档倒地方
5:凡事获得留信网入网的信息将会逐步更新到个人身份内，将在公安局网内查询个人身份证信息后，同步读取人才网入库信息
6:个人职称评审加20分
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8:在国家人才网主办的国家网络招聘大会中纳入资料，供国家高端企业选择人才
ESA/ACT Science Coffee: Diego Blas - Gravitational wave detection with orbita...
ESA/ACT Science Coffee: Diego Blas - Gravitational wave detection with orbita...Advanced-Concepts-Team
Presentation in the Science Coffee of the Advanced Concepts Team of the European Space Agency on the 07.06.2024.
Speaker: Diego Blas (IFAE/ICREA)
Title: Gravitational wave detection with orbital motion of Moon and artificial
Abstract:
In this talk I will describe some recent ideas to find gravitational waves from supermassive black holes or of primordial origin by studying their secular effect on the orbital motion of the Moon or satellites that are laser ranged.ESR spectroscopy in liquid food and beverages.pptx
With increasing population, people need to rely on packaged food stuffs. Packaging of food materials requires the preservation of food. There are various methods for the treatment of food to preserve them and irradiation treatment of food is one of them. It is the most common and the most harmless method for the food preservation as it does not alter the necessary micronutrients of food materials. Although irradiated food doesn’t cause any harm to the human health but still the quality assessment of food is required to provide consumers with necessary information about the food. ESR spectroscopy is the most sophisticated way to investigate the quality of the food and the free radicals induced during the processing of the food. ESR spin trapping technique is useful for the detection of highly unstable radicals in the food. The antioxidant capability of liquid food and beverages in mainly performed by spin trapping technique.
Recently uploaded (20)
The debris of the ‘last major merger’ is dynamically young
The debris of the ‘last major merger’ is dynamically young
aziz sancar nobel prize winner: from mardin to nobel
aziz sancar nobel prize winner: from mardin to nobel
Sharlene Leurig - Enabling Onsite Water Use with Net Zero Water
Sharlene Leurig - Enabling Onsite Water Use with Net Zero Water
waterlessdyeingtechnolgyusing carbon dioxide chemicalspdf
waterlessdyeingtechnolgyusing carbon dioxide chemicalspdf
The binding of cosmological structures by massless topological defects
The binding of cosmological structures by massless topological defects
20240520 Planning a Circuit Simulator in JavaScript.pptx
20240520 Planning a Circuit Simulator in JavaScript.pptx
Applied Science: Thermodynamics, Laws & Methodology.pdf
Applied Science: Thermodynamics, Laws & Methodology.pdf
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...
THEMATIC APPERCEPTION TEST(TAT) cognitive abilities, creativity, and critic...
THEMATIC APPERCEPTION TEST(TAT) cognitive abilities, creativity, and critic...
ESA/ACT Science Coffee: Diego Blas - Gravitational wave detection with orbita...
ESA/ACT Science Coffee: Diego Blas - Gravitational wave detection with orbita...
mô tả các thí nghiệm về đánh giá tác động dòng khí hóa sau đốt
mô tả các thí nghiệm về đánh giá tác động dòng khí hóa sau đốt
ESR spectroscopy in liquid food and beverages.pptx
ESR spectroscopy in liquid food and beverages.pptx
Internal hernia
- 1. Dr. Asif Mian Ansari DNB resident Dept. of General Surgery Max hospital, Mohali
- 2. Hernia Protrusion of an organ/part of organ Through it’s containing wall
- 3. Source of chronic/intermittent abdominal pain 33% internal hernias present as SBO 40% present as strangulation Mild digestive symptoms to acute obstructive features Difficult preop diagnosis If reducible silent Incidence increased from last decade as more liver transplant & RYGB surgeries
- 4. Protrusion of viscera into a compartment Through the peritoneum or mesentery, which may be: Pre existing anatomical structure Recess or fossa Acquired openings Predisposing factors Congenital Acquired
- 5. Paraduodenal 53% Pericecal 13% Foramen of Winslow 8% Transmesenteric 8% Intersigmoid 6% Supravesical/pelvic 6% Retroanastomotic 5% Transomental 4%
- 6. LEFT PD HERNIA 40% of all (most common) Congenital fossa of Landzert (2%) at DJ junction behind the IMV Chronic postprandial pain RIGHT PD HERNIA 13 % Congenital fossa of Waldayer (<1%) behind the SMA Chronic postprandial pain
- 9. LEFT PD HERNIA Encapsulated cluster of jejunum in LUQ- barium study RIGHT PD HERNIA Encapsulated cluster of bowel loops lateral & inferior to descending duodenum- barium study
- 10. LEFT PD HERNIA CT:loops between stomach & pancreas, behind pancreas or between transverse colon & left adrenal gland RIGHT PD HERNIA CT: loops lateral & inferior to descending duodenum
- 11. Management : In lines of acute intestinal obstruction Naso-gastric drainage Fluid & electrolytes management Parenteral antibiotics Early laparotomy Aim of surgery: reduction & incarcerated bowel, resection of non viable bowel & closure of defect
- 13. RLQ pain, may mimic acute appendicitis Radiology: small bowel loops in Right paracolic gutter
- 15. Small bowel (2/3rd), caecum, ascending colon, gall bladder, transverse colon & omentum Usually Proximal bowel obstruction features Radiology: circumscribed loops medial & posterior to stomach
- 16. CT findings: bowel loops between IVC and liver hilum into the lesser sac
- 17. 3 types: difficult to differentiate radiologically Intersigmoidcongenital Transmesosigmoidacquired Intramesosigmoidacquired
- 18. Children most common (35%) type congenital defects in mesentery Adults acquired
- 19. Herniation through un natural opening post surgical: RYGB Liver transplant Trauma infections
- 20. Gastric pouch formation Proximal end of Roux limb is attached to gastric pouch Distally jejunao-jejunal ananstomosis is done
- 21. Abdominal pain within 3 months of surgery, one should always suggest the possibility of internal hernia Incidence is approximately 3%
- 22. Mesocolic space: through an iatrogenic opening in the mesocolon). Peterson hernia: behind Roux (alimentary) limb Distal mesenteric space: between the 2 leaves of mesentery at the distal anastomosis
- 24. Early diagnosis & prompt management is important to prevent strangulation Acquired internal hernias can be prevented