Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.
Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.
nursing intervention for patients with musculoskeletal system disorders by Mulugeta Emiru (MSc in Adult health Nursing): Mizan Tepi university. 2017/2018.
meniscus injury explained with treatment and videos to help understand the use of MRI to help understand injury to meniscus and help diagnose meniscal tear
Definition.
Purpose Of Counseling.
Types Of Counseling.
Qualities Of Counselor.
Guidelines Of Effective Counseling.
Skills Of Counselor.
Phases Of Counseling.
GATHER Approach.
Counseling VS Health Education.
Conclusion.
INTRODUCTION
ETIOLOGY
RISK FACTORS
PATHOPHYSIOLOGY
CLASSIFICATION
CLINICAL FEATURES
DIAGNOSTIC MEASURES
MANAGEMENT
Medical
Surgical
Nursing
CONCLUSION
BIBLIOGRAPHY
POST TEST
Gross Anatomy & Physiology of Eye
Introduction to cataract
Epidemiology of cataract
The etiological factors
Pathophysiology
Clinical manifestations
Types
Diagnostic measures
Surgical measures
Pre and post operative nursing management
Complications after surgery.
Summary
INTRODUCTION
HISTORY OF CANNABIS
EPIDEMIOLOGY
RISK FACTORS
CAUSES
HIGH RISK GROUP
PATHOPHYSIOLOGY
D/D
PREPARATION OF CANNABIS
METHOD OF USE
CLINICAL PICTURES
CANNABIS INDUCED DISORDER
COMPLICATION
MANAGEMENT
BRAIN STORMING
REFERENCES
INTRODUCTION OF VACCINE & VACCINATION.
HISTORY.
TYPRE OF VACCINE
CONTRAINDICATION.
CLASSIFICATION ACCORDING TO PATHOGEN.
PRECAUTION BEFORE TO VACCINE.
DRUGS ADMINISTRATION -: ROUTES & DOSE
SUMMARY.
REFERENCES.
ASSESSMENT QUESTIONS
INTRODUCTION
HISTORY
CLASSIFICATION OF ANTICHYCOTIC DRUGS
INDICATION
PHARMACOKINETICS
MECHANISM OF ACTION
CONTRAINDICATION
SIDE EFFECTS & NURSING IMPLICATION
FAMILY TEACHING
INTRODUCTION
HISTORY
MECHANISM OF ACTION
INDICATION OF ECT
TYPES OF ECT
ELECTRIC STIMULUS
DURATION OF THERAPY
PRE TREATMENT EVALUATION
CONTRAINDICATION
SIDE EFFECT
ELECTROD REPLACEMENT
ROLE OF NURSES
DOCUMENTATION
SUMMARY
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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!
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.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
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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
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.
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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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
3. RELEVENT ANATOMY
- The Knee Joint is the largest & complex joint in the body .
- It consists of 3 Joints:
1) Medial Condylar Joint : Between the medial condyle “of
the femur” & the medial condyle “of the tibia” .
2) Latral Condylar Joint : Between the lateral condyle “of the
femur” & the lateral condyle “of the tibia” .
3) Patellofemoral Joint : Between the patella & the patellar
surface of the femur.
- The fibula is NOT directly involved in the joint .
5. INTRODUCTION
Amputation is the surgical removal of a limb or
part of a limb by cutting through the shaft of the
bone.
Through the knee amputations – the removal of
the lower leg and knee joint. The remaining
stump is still able to bear weight as the whole
femur is retained
6. EPIDEMIOLOGY OF DISABILITY
In 2011, the prevalence of persons with disabilities
in Nepal was 1.9% of the total population.
This figure comes from the question asked in the
census, "Do you or any other of your family members
have a disability?"
The National Population and Housing Census 2011
indicated that physical disabilities represented a third
of the total population of persons with disabilities in
Nepal.
7. Levels of Amputation
Through Knee
Amputation
85%
Below Knee Amputation
87%
Above Knee Amputation
93%
Source : Lower Extremity Amputations Around the Knee Joint: A Functional Outcome Study
: Nitesh K Karn1,2, MBBS, (FCPS); at all, BBMed, 2019, 3:39-46
LEVEL OF KNEE AMPUTATION
8. TYPES OF KNEE AMPUTATION
Below knee amputations-BKA (transtibial) – an
amputation of the leg below the knee that retains the
use of the knee joint.
Through the knee amputations – the removal of
the lower leg and knee joint. The remaining
stump is still able to bear weight as the whole
femur is retained
Above knee amputation-AKA (transfemoral) - an
amputation of the leg above the knee joint.
9. INDICATIONS
Dead (or Dying)
Gangrene
PeripheralVascular disease Atherosclerosis
Embolism
SevereTrauma Burns
Frost bite
Bone setters gangrene
Dangerous limb
Malignant tumours:Osteosarcoma, Marjolins ulcer
Potentially lethal sepsis
Crush Injury
Damn Nuisance
Pain
Gross malformation
Recurrent Sepsis
Severe loss of function
Madura foot
Elephantiasis
Colloquially 3 D’s
Dead (or Dying)
Dangerous limb
Damn Nuisance
10. LEVEL OF AMPUTATION
Determined by :
a) Disease process
b)Viability of tissues and
c) Prosthesis available.
Determination of adequate blood
flow:
Clinical :i.) lowest palpable pulse
ii.) skin colour and temperature
iii.)bleeding at surgery
Others:
Doppler ultrasonography
11. LEVEL OF AMPUTATION Contd.
Transcutaneous oxygen measurement >40mmHg.
Skin perfusion pressure measurement
by infrared thermography or laser
doppler flowmetry.
Tooshort a stump may tend to slip out of
prosthesis.Too long a stump may have
12. IDEAL STUMP
It Should have
1. Sufficient length to bear prosthesis.
• Below knee 7.5 - 12.5 cm from tibial tuberosity
• Above Knee - 23 cm from greater trochanter
2. Conical and Rounded
3. Tenderness Free
4. Adequate joint movement, blood supply.
5. Heal adequately by 1st intention
6. Scar - thin, placed where it is not exposed to
pressure, freely mobile over underlying tissues - not
interfere with prosthetic function
7. Skin should not be infolded and no redundant soft
tissue.
8. Adequate muscle padding - adequate movement
13. EVALUATION OF PATIENT WHO NEED AMPUTATION
• Check for anemia - correct by blood or packed cells
transfusion
• Infection - control using antibiotic and proper dressing
• Decision of which limb to be amputated
• Decision of level of amputation by :
– Skin temperature
– Arterial doppler
• Informed consent should be taken
• Psychological counselling
• Plan for prosthesis & rehabilitation by physiotherapist &
rehabilitation team.
14. AMPUTATION IN KNEE
ABOVE KNEE (AK) AMPUTATION
• Equal anterior and posterior flaps
• Ideal femur stump should be 25 cms long.
• Minimum stump should be 10cms long.
• It is technically easy, healing chances are
better and faster.
• Cosmetic results poor, prosthesis fitting isnot
• proper, pt limps while walking and need
support
15. B E LO W K N E E A M P U TAT I O N ( B U R G E S S ’ )
• Min. Stump L e n gt h :
• 8 C m From Tibial Tuberosity
(14-17 C m Is Good)
• Long Posterior Flap
• S ca r Anteriorly
AMPUTATION IN KNEE
16. PREVENTION
Diagnosis and management of diabetes
Thorough foot exam once per year
Drive safely:
Wear your seatbelt
Drive the speed limit
Safety at work if using heavy equipment, saws,
explosives, or flammable substances
17. COMPLICATIONS
• Early
Hemorrhage, Hematoma,
Infection
Gas gangrene
Wound dehiscene
Gangrene of flaps
DVT → Pulm. Embolism
• Later
• Pain
• Infection, bone spur,scar adherent
to bone, amputation neuroma
• Phantom limb
• Phantom pain
• Ulceration of the stump
• pressure effects of the
prosthesis/↑ ischemia.
Early Complications
Late Complications
18. NURSING DIAGNOSIS
Acute pain r/t surgical amputation
Risk for infection r/t a site for organism
invasion 2o to surgical amputation
Impaired skin integrity r/t surgical amputation
Risk for disturbed sensory perception:
phantom limb pain r/t surgical amputation
Disturbed body image r/t amputation of a body
part
Disturbed self-concept r/t loss of a body part
Risk for anticipatory grieving r/t loss of a body
part
Risk for dysfunctional grieving r/t loss of a
body part
Impaired physical mobility r/t loss of extremity
Self-care deficit: feeding, bathing, hygiene,
dressing, grooming, or toileting r/t loss of
extremity
Risk for falls r/t loss of lower extremity
Fear r/t surgery, coping with the loss of limb
after surgery
Ineffective coping r/t failure to accept loss of a
body part
19. NURSING MANAGEMENT
PREOPERATIVE CARE
Assessment and resuscitation
Investigate & address co-morbid conditions in consultation with
physicians, Anaesthetists & Physiotherapist(multidisciplinary).
FBC,FBS, Se/u/c, urinalysis, chest x-ray,ECG, serum albumin(>3.5g/dl).
Informed consent –pathology, inevitability of amputation, complications,
availability of prosthesis
Determine the level of amputation.
a)Find a place where healing is mostly to be complete.
b)Tohave an ideal stump for prosthesis fitting.
20. ANAESTHESIA : GA/Spinal
POSITION : Supine
Psychological support is most important to maintain cardiac hemostasis also.
PREINCISION : prophylactic antibiotics,exsanguinate, tourniquet, skin
prep & draping.
Irrigation with N/S, Removal of tourniquet to meticulously secure
haemostasis.
Assist in close skin with interrupted non absorbable sutures.
Wound dressing- soft or rigid
Oxygen saturation vital monitoring assessment.
Assess for bleeding and urine output during operation time.
If more blood loss infused blood volume.
INTRA-OPERATIVE CARE
21. POST OPERATIVE CARE
General care: Control of pain, prevention oedema, prevention of
infection, DVT prevention, care of concurrent medical conditions.,
Suture removal.
Physiotherapy: Muscles exercised, joints keptmobile, patients
taught how to use crutches & prosthesis.
NUTRITION: high protein,fiber containing
diet,calcium,phosphorous etc.
Stump dressing
1. Soft dressing: gauze, cotton wool,bandage, Teachpatient or r
elative stump bandaging.
2. Rigid dressing: POP cast can be used with stump socks &
padding.
Cast changed every 5-7 days for skin care.Within 3-4 wks rigid
dressing can be changed to a removable temporary prosthesis.
22. PROSTHESIS
Is the substitution of a part of the body to achieve optimum
function .
The term "prosthesis" refers to an external assistive
device applied to replace an absent limb.
23.
24. REFERENCES
• Surgeryencyclopedia: https://www.surgeryencyclopedia.com/A-
Ce/Amputation.html
• Text book of Medical Surgical Nursing, 6th Edition By GN Mandal, Makalu
Publication,
• American Academy of Orthopaedic Surgeons. 6300 North River Road,
Rosemont, Illinois 60018-4262. Phone (847) 823-7186. http://www.aaos.org .
• Amputation; Stump. (2009). Mosby’s dictionary of medicine, nursing, and health
professions (8th ed.). St. Louis, MO: Mosby Elsevier.
Read more: https://www.surgeryencyclopedia.com/A-
Ce/Amputation.html#ixzz6QDgKeLZu
• Medscape: https://emedicine.medscape.com/article/1232102-overview#a13
• Bailey & Love's Short Practice of Surgery, 27th Edition: International Student's Edition.
Pg 1144.
• Manipal Manual of Surgery 4th Edition; K Rajgopal, Anitha Shenoy.Pg 700-704
• www.google.com
• www.slideshare.com
• www.slidesgo.com
25. POST TEST
{1} Types of amputation includes…..
a. Below knee amputation
b above knee amputation
c. Both of above
d. None of above
{2} Indications of amputation belongs to
a. 3D b.4D c. 5D d. 6D
{3} Complication of amputation…………
a. Hemorrhage
b. Hematoma
c. Pain
d. all
{4} Amputation means……….