Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
esophageal varices are the second most common cause of upper GI bleed after PUD.These are actually the dilated veins which occur secondary to increase in the pressure in the portal circulation called as Portal Hypertension..
esophageal varices are the second most common cause of upper GI bleed after PUD.These are actually the dilated veins which occur secondary to increase in the pressure in the portal circulation called as Portal Hypertension..
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
Seminar presentation by 5th-year medical students under the supervision of in house lecturer. He was previously working as a consultant surgeon in Syria. Reference as mentioned in the slides.
Intestinal obstruction by Nadia SarwarNadia Sarwar
Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating, and not passing gas.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
3. CLASSIFICATION
DYNAMIC : where peristalsis is working against a mechanical obstruction.
ADYNAMIC: it may occur in two forms
1. 1st where peristalsis may be absent (paralytic ileus,)occurring secondarily to
neuromuscular failure in the mesentery.
2. 2nd where peristalsis may be present in nonpropulsive form.(pseudo-obstruction)
3
5. ONTHE BASIS OF NATURE IT IS
CLASSIFIED INTO
ACUTE
CHRONIC
ACUTE ON CHRONIC
SUBACUTE
6. ACUTE OBSTRUCTION :
IT USUALLY OCCUR IN SMALL BOWEL OBSTRUCTION WITH
SUDDEN ONSET OF SEVERE COLICKY CENTRAL ABDOMINAL PAIN,
DISTENTION AND EARLYVOMITING AND CONSTIPATION.
7. CHRONIC OBSTRUCTION :
USUALLY SEEN IN LARGE BOWEL OBSTRUCTION WITH LOWER
ABDOMINAL COLIC AND ABSOLUTE CONSTIPATION,FOLLOWED BY
DISTENTION
8. ACUTE ON CHRONIC OBSTRUCTION :
IT STARTS IN LARGE BOWEL BUT GRADUALLY INVOLVES THE SMALL
INTESTINE.
EARLY SYMPTOMS ARE PAIN AND CONSTIPATION BUTWHEN SMALL
INTESTINE IS INVOLVED IT IS CHARACTERIZED BYVOMITING AND
GENERAL DISTENTION.
9.
10.
11. COMMON CAUSES OF MECHANICAL
SMALL BOWEL OBSTRUCTION:
1. Adhesions and bands following abdominal surgery
2. External hernia
3. Intussusceptions
4. Volvulus
5. Neoplasm (benign or malignant).
6. Obstruction : worms
1
1
12. COMMON CAUSES OF MECHANICAL
LARGE BOWEL OBSTRUCTION
1
2
1. Large bowel cancer.
2. Sigmoid diverticular disease.
3. Sigmoid volvulus.
16. COMMON CAUSES OF NON-MECHANICAL
SMALL-BOWEL OBSTRUCTION
1– Paralytic ileus after abdominal surgery
2– Localized intra abdominal abscess or generalized
peritonitis
3– Mesenteric embolism or thrombosis with small
bowel infarction
4– Intestinal pseudo-obstruction
10
17. COMMON CAUSE OF NON-MECHANICAL
LARGE BOWEL OBSTRUCTION:
11
1 – Retroperitoneal hematoma following lumber
fracture or lumber surgery
2 – Idiopathic
22. 2 - CLOSED LOOP OBSTRUCTION
Bowel obstructed at both proximal & distal
points
There is rapid increase in the intra luminal
tension, Gangrene or perforation can occur
more quickly, peritonitis.
Example: Colonic obstruction with
competent ileocaecal valve
23. 3 . STRANGULATION
This is the end result a closed loop
obstruction when major arterial supply to the
affected bowel has been occluded , causing
gangrene over a considerable area.
24. MECHANICAL OBSTRUCTION
Following questions must be answered:
1 – Is it obstruction and if so at what level ?
2 – Is strangulation present ?
3 – Is dehydration present ?
4 – What is the cause ?
5 - What is the treatment ?
25. 1 – IS IT OBSTRUCTION,AND IF SO,
ATWHAT LEVEL ?
1
9
The question is answered by considering the
clinical features.
Symptoms
Signs
27. PAIN
Sudden, severe
Colicky in nature
Central , around umbilicus in small bowel
obstruction
Lower abdomen in large bowel obstruction
Continuous if perforation or strangulation is present
Absent in paralytic ileus.
21
28. VOMITING
2
2
Early in high small bowel obstruction,
Late in low small bowel obstruction ,
Delayed or absent in large bowel obstruction.
Character : initially clear ,becomes discolored
, and finally feculent (dark and foul smiling).
30. Local signs in the abdomen are:
Inspection:
Scar
Distension, central in small bowel obstruction and peripheral
in large bowel obstruction
Visible peristalsis
SIGNS
2
5
31. Palpation:
Abdominal mass may suggest carcinoma or
strangulated bowel.
Rigidity and rebound tenderness , indicates ischemia
& peritoneal irritation.
2
6
32. Percussion:
Resonance because of gas filled bowel
Tenderness on percussion indicates the presence of
peritonitis.
2
7
33. Auscultation:
Bowel sounds
Tympani
Metallic clicks as pressure is raised if much gas is
present in the bowel.
Gurgling borborygmi if gas and fluid are present in
the bowel.
Silence if generalized peritonitis or paralytic ileus is
present.
2
8
34. On rectal examination:
Impacted feces
Rectal cancer
Blood on finger which maybe present with mesenteric
artery occlusions, intussusception or Volvulus.
2
9
37. 4 - WHAT ISTHE CAUSE?
3
2
1 - Previous abdominal surgery and features of small
bowel obstructions suggest adhesions, The attacks may
have been recurrent
2 - Large bowel obstruction and history of constipation
with intermittent mucous or bloody diarrhea suggest
carcinoma of the colon
3 – No previous operations and symptoms of small bowel
obstruction suggest obstructed hernia or an
uncommon cause such as congenital band, internal
hernia or mesenteric occlusion.
41. 5 – MANAGEMENT
3
6
Non operative :
• In case of Simple obstruction without strangulation .
• Gastrointestinal decompression: NG tube
• IV fluid
• Antibiotics
Operative:
• Usually surgery
• Replace fluid before surgery