Mini-Gastric BypassShown to be an excellent operation
But Many New Surgeons Do Not Know the Critical Factors to Do the MGB Correctly
One Critical Success Factor:
LONG Gastric Pouch
Mini-Gastroplasty: Most Surgeons Do Not Understand the MGB
The MSG is simple and successful in Less Severely Obese patients. The Mini-Sleeve Gastroplasty avoids the foreign body of a band and unlike the Sleeve Gastrectomy is less likely to cause reflux easily reversible.
This describes the performance of the Non-resectional "Mini" Sleeve Gastroplasty and confirms previous work showing that the results of the MG are similar to the Band and the Excisional (irreversible) Sleeve Gastrectomy.
Mini-Gastric Bypass Done Right: A Description of the Surgical TechniqueDr. Robert Rutledge
Mini-Gastric Bypass Done Right:
A Description of the Surgical Technique
Authors: Dr.Rutledge, Dr.K.S.Kular and Dr.Manchanda.
This chapter discusses the technique of Mini-Gastric Bypass (MGB). The title of the chapter is Mini-Gastric Bypass Done Right.The surgical technique is selected to indicate our opinion that many surgeons and physicians have been and remain confused about the performance of the MGB as created and taught be Dr Rutledge.
Explicitly, the Mini-Gastric Bypass(MGB) which will be discussed in this article is NOT a so called Single Anastomosis Bypass, its not the Omega Loop Bypass nor the SAGB nor the SADI and especially it is definitely not the Old Mason Loop Gastric Bypass. These misnomers and other surgeon and patient misunderstandings and confusion has led to problems with this otherwise it is a simple procedure.
The Mini-Gastric Bypass is reported and described as a simple technique yet as the following examples will show it can be both tragic and occasionally deadly when used by surgeons with inadequate understanding of the procedure and its technique.
The Mini-Gastric Bypass is an analogue of two routine straightforward general surgical principles, the Collis Gastroplasty and the Antrectomy and Billroth II. Although the foundational principles of the MGB are relatively simple and straightforward it has been shown that many surgeons are confused about the details of the procedure, leading in some cases to tragic and deadly results in the wrong hands.
Knee Replacement has a versatile treatments which were being provided by multispeciality hospitals located at kharghar Navi Mumbai localitiy with all the advance technologies and experienced doctors and surgeons
Mini-Gastroplasty: Most Surgeons Do Not Understand the MGB
The MSG is simple and successful in Less Severely Obese patients. The Mini-Sleeve Gastroplasty avoids the foreign body of a band and unlike the Sleeve Gastrectomy is less likely to cause reflux easily reversible.
This describes the performance of the Non-resectional "Mini" Sleeve Gastroplasty and confirms previous work showing that the results of the MG are similar to the Band and the Excisional (irreversible) Sleeve Gastrectomy.
Mini-Gastric Bypass Done Right: A Description of the Surgical TechniqueDr. Robert Rutledge
Mini-Gastric Bypass Done Right:
A Description of the Surgical Technique
Authors: Dr.Rutledge, Dr.K.S.Kular and Dr.Manchanda.
This chapter discusses the technique of Mini-Gastric Bypass (MGB). The title of the chapter is Mini-Gastric Bypass Done Right.The surgical technique is selected to indicate our opinion that many surgeons and physicians have been and remain confused about the performance of the MGB as created and taught be Dr Rutledge.
Explicitly, the Mini-Gastric Bypass(MGB) which will be discussed in this article is NOT a so called Single Anastomosis Bypass, its not the Omega Loop Bypass nor the SAGB nor the SADI and especially it is definitely not the Old Mason Loop Gastric Bypass. These misnomers and other surgeon and patient misunderstandings and confusion has led to problems with this otherwise it is a simple procedure.
The Mini-Gastric Bypass is reported and described as a simple technique yet as the following examples will show it can be both tragic and occasionally deadly when used by surgeons with inadequate understanding of the procedure and its technique.
The Mini-Gastric Bypass is an analogue of two routine straightforward general surgical principles, the Collis Gastroplasty and the Antrectomy and Billroth II. Although the foundational principles of the MGB are relatively simple and straightforward it has been shown that many surgeons are confused about the details of the procedure, leading in some cases to tragic and deadly results in the wrong hands.
Knee Replacement has a versatile treatments which were being provided by multispeciality hospitals located at kharghar Navi Mumbai localitiy with all the advance technologies and experienced doctors and surgeons
Prof. Anisuddin Bhatti gave lectures to residents & Junior consultants on PostPolio Residual Paralysis part2 lower limb Reconstructive surgery on 17.04.202. Acknowledged for text and figures as such in reference list.
Aortic and carotid arterial wall thickness in term small-for-gestational-age newborns and relationship with prenatal signs of severity
I. Stergiotou, F. Crispi, B. Valenzuela-Alcaraz, M. Cruz-Lemini, B. Bijnens, E. Gratacos
Volume 43, Issue 6, Date: June 2014, pages 625-631
http://onlinelibrary.wiley.com/doi/10.1002/uog.13245/abstract
JOURNAL CLUB ON CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH ...Shilpa Shiv
CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH A CONNECTIVE TISSUE GRAFT TO TREAT MILLER'S CLASS I GINGIVAL RECESSION, JCP 2014;41(4):387-395.
The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass
The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass
Fear of Cancer, General Surgeons Use the Billroth II, Bariatric Surgeons FE...Dr. Robert Rutledge
Irrational Fears of CancerGeneral Surgeons Use the Billroth IIBariatric Surgeons FEAR the Billroth II (Mini-Bypass)
Irrational Fear of Gastric Cancer:CHOOSING THE BEST WEIGHT LOSS SURGERY, R Rutledge MD, www.CLOS.net, Email: DrR@clos.net. http://www.slideshare.net/DrRRMD/fear-g-ca-02-0214v2
GASTRIC VS. COMBINED GASTRO-INTESTINAL PROCEDURES FOR CONTROL OF OBESITYDr. Robert Rutledge
GASTRIC VS. COMBINED GASTRO-INTESTINAL PROCEDURES FOR CONTROL OF OBESITY
1. Bariatric surgery history is replete with failed Primary Gastric Procedures for obesity,
2. Physiologically it is easy to see how an excess of 2, 000 calories a day can be ingested as liquid/soft calories (Coke and Cake) thus “Beating” the operations’ “gastric restriction” Band/Sleeve.
3. Studies in Gastric Cancer patients show that Combined Gastro-Intestinal Procedures outperform Primary Gastric Procedures
4. Primary Gastric Procedures can be predicted to fail even following initial success (see Lap Band(r))
Fear & Confusion about the Risk of Cancer after Bariatric SurgeryDr. Robert Rutledge
Esophageal Cancer from
Fear & Confusion about the Risk of Cancer after Bariatric Surgery
Sleeve & Band vs Risk of Gastric Cancer after Mini-Gastric Bypass
Dr Rutledge
The Centers for Laparoscopic Obesity Surgery, www.CLOS.net www.MiniBypass.net Email: DrR@clos.net
Sleeve Gastrectomy and Lap band Appear likely to Lead to Esophageal CancerDr. Robert Rutledge
It appears that Sleeve and Band surgeons Should warn their patients of the Long term risk of GERD and Increased Risk of Esophageal cancer and Institute appropriate follow up planning.
Prof. Anisuddin Bhatti gave lectures to residents & Junior consultants on PostPolio Residual Paralysis part2 lower limb Reconstructive surgery on 17.04.202. Acknowledged for text and figures as such in reference list.
Aortic and carotid arterial wall thickness in term small-for-gestational-age newborns and relationship with prenatal signs of severity
I. Stergiotou, F. Crispi, B. Valenzuela-Alcaraz, M. Cruz-Lemini, B. Bijnens, E. Gratacos
Volume 43, Issue 6, Date: June 2014, pages 625-631
http://onlinelibrary.wiley.com/doi/10.1002/uog.13245/abstract
JOURNAL CLUB ON CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH ...Shilpa Shiv
CORONALLY ADVANCED FLAP vs THE POUCH TECHNIQUE COMBINED WITH A CONNECTIVE TISSUE GRAFT TO TREAT MILLER'S CLASS I GINGIVAL RECESSION, JCP 2014;41(4):387-395.
The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass
The contribution of malabsorption to the reduction in net energy absorption after long-limb Roux-en-Y gastric bypass
Fear of Cancer, General Surgeons Use the Billroth II, Bariatric Surgeons FE...Dr. Robert Rutledge
Irrational Fears of CancerGeneral Surgeons Use the Billroth IIBariatric Surgeons FEAR the Billroth II (Mini-Bypass)
Irrational Fear of Gastric Cancer:CHOOSING THE BEST WEIGHT LOSS SURGERY, R Rutledge MD, www.CLOS.net, Email: DrR@clos.net. http://www.slideshare.net/DrRRMD/fear-g-ca-02-0214v2
GASTRIC VS. COMBINED GASTRO-INTESTINAL PROCEDURES FOR CONTROL OF OBESITYDr. Robert Rutledge
GASTRIC VS. COMBINED GASTRO-INTESTINAL PROCEDURES FOR CONTROL OF OBESITY
1. Bariatric surgery history is replete with failed Primary Gastric Procedures for obesity,
2. Physiologically it is easy to see how an excess of 2, 000 calories a day can be ingested as liquid/soft calories (Coke and Cake) thus “Beating” the operations’ “gastric restriction” Band/Sleeve.
3. Studies in Gastric Cancer patients show that Combined Gastro-Intestinal Procedures outperform Primary Gastric Procedures
4. Primary Gastric Procedures can be predicted to fail even following initial success (see Lap Band(r))
Fear & Confusion about the Risk of Cancer after Bariatric SurgeryDr. Robert Rutledge
Esophageal Cancer from
Fear & Confusion about the Risk of Cancer after Bariatric Surgery
Sleeve & Band vs Risk of Gastric Cancer after Mini-Gastric Bypass
Dr Rutledge
The Centers for Laparoscopic Obesity Surgery, www.CLOS.net www.MiniBypass.net Email: DrR@clos.net
Sleeve Gastrectomy and Lap band Appear likely to Lead to Esophageal CancerDr. Robert Rutledge
It appears that Sleeve and Band surgeons Should warn their patients of the Long term risk of GERD and Increased Risk of Esophageal cancer and Institute appropriate follow up planning.
Mini Gastric Bypass: initial Experience
British Obesity Metabolic Surgery Society
4 th Annual Scientific Meeting
Jan 23-25, 2013 Glasgow
SPIRE Hospital Southampton
Department of Bariatric Surgery
M Van den Bossche, I Bailey, J Kelly
J Byrne, R Sutherland*
Five Year Outcome Sleeve Gastrectomy Mini-Gastric Bypass From a Community Hos...Dr. Robert Rutledge
Five Year Outcome Sleeve Gastrectomy Mini-Gastric Bypass From a Community Hospital in Punjab, India
Dr K S Kular
Kular Medical Education & Research Society
Kular Group of Institutes
drkskular@gmail.com
www.kularhospital.com
Sleeve
MGB
Kular Hospital
Sleeve v MGB (Hint: MGB Better)
Weight Loss Raw Data, Weight Loss Excluding SG Revisions v Age Wt matched MGBs, Resolution of Co-Morbidities, Patient Satisfaction, Dyspepsia/Bile Reflux
Conclusions
The Mini-Gastric BypassDr Rutledge, DrR@CLOS.netFour Stories for Four Radical Ideas
20 minutes, 4 topics
5 minutes each
1. (Mis)Understanding the MGB Mechanism of action
2. MGB Paradox (Good MGB/Bad MGB)
3. MGB: BP Limb Length
4. MGB-OT to the new MGB2i
Mini-Gastric Bypass Technical Errors, Tips & Pointers
The Mistake of the
Twisted PouchAnterior Gastro-Jejunostomy
(No it is Not A Good Idea!)
Twisted PouchCommon Error in “New” Inexperienced MGB Surgeons
Common in RNY surgeons
Low Port sites => Twisted pouch because of poor positioning of First Staple Firing => Beginning Twist
2nd Common Error is short posterior pouch wall vs long anterior wall
These two errors => Twist so that anterior pouch surface twists 180 degrees
=> Makes an Anterior GJ seem like a good idea; Wrong!
The Mystery of Bile or No Bile:“Elementary My Dear Watson!”
Why the two opposite studies of the MGB
1. Minimal Bile Reflux
2. Common Bile Reflux
Answer: 1. Skill and knowledge of the Surgeons & 2. Propper care and education of post op patients
Conclusion: Don't Do the MGB! If You Don't Know What You are Doing
Rx Lifestyle & Diet Plan
Simple Diet & Lifestyle Changes: Rx gut microbiome: Plain Yogurt / Curd / Fermented Dairy:1-2 tsps 3-6 x / Day.
Stop smoking, NSAIDs, Iron, “Supplements”, Vitamins & Medications
Before Meals, Stay upright after eating, Small meals, Limit fatty foods,
Avoid problem (junk) foods: soda, candy, fried foods, caffeinated and carbonated drinks, chocolate, citrus juices, vinegar dressings & mint, etc.
Limit or avoid alcohol, Eat slowly, small amounts, chew thoroughly and rest between bites,
Keep head up for 30-90 minutes post meals, relax for 30-90 minutes after meals.
Mini-Gastric Bypass Technical Errors, Tips & Pointers
The Mistake of the
Twisted PouchAnterior Gastro-Jejunostomy
(No it is Not A Good Idea!)
Doing the MGB WrongThe Twisted Gastric Pouch
The Neo-Gastric Pouch Should not be twisted
That should be obvious
The lesser curve should lie at 9 o'clock, medially
The Neo-Greater curvature should lie at 3 o'clock, laterally
Twisted (Wrong) pouch makes the anterior GJ “look” like a good choice
Twisted Gastric Pouch Syndrome:
Post op
Nausea and vomiting
CTScan, Endoscopy all negative
“INVISIBLE ILLNESS”
Rx: Revision
Prevention: Simple, Do Not Twist the Pouch & Never Anterior Anastomosis
Understanding Weight Loss After Bariatric SurgeryUnderstanding the Bilio-Pancreatic Limb Length
Statistics, Random Distribution and Too Little or Too Much of a Good Thing
The Billroth II is a good safe operation
Routinely used daily by General, Trauma and Cancer Surgeons Around the world
Studies show surgeons who are more fearful of Billroth II and cancer are the least knowledgeable about the scientific data on the Billroth II and Gastric Cancer
Prediction of Weight Loss Following The Mini-Gastric Bypass: Multivariate Regression Modeling
Robert Rutledge, K Kular, N. Manchanda CLOS Center For Laparoscopic Obesity Surgery, MGB Review Corp
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!
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
- 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
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. Mini-Gastric Bypass
• Anyone can do a “singleAnyone can do a “single
anastomosis gastric bypass”anastomosis gastric bypass”
• That Does Not mean theyThat Does Not mean they
can/are doing the truecan/are doing the true
“Mini-Gastric Bypass” (MGB)“Mini-Gastric Bypass” (MGB)
• See the Following Example...See the Following Example...
3. No No No
This is NOT an Mini-Gastric BypassThis is NOT an Mini-Gastric Bypass
4. Edward E. Mason, MD, PhD
NOT Mini-Gastric BypassNOT Mini-Gastric Bypass
NOTNOT
Mini-GastricMini-Gastric
BypassBypass
10. Surgeons Need to Understand
Basic General Surgery
• Misunderstanding BasicsMisunderstanding Basics
of General Surgeryof General Surgery
• Difference betweenDifference between
Total/Subtotal GastrectomyTotal/Subtotal Gastrectomy
Vs.Vs.
Distal Gastrectomy/AntrectomyDistal Gastrectomy/Antrectomy
15. Total/Subtotal Gastrectomy
Basic General Surgery:Basic General Surgery:
Total/Subtotal GastrectomyTotal/Subtotal Gastrectomy
Never Reconstruct with Loop Billroth IINever Reconstruct with Loop Billroth II
Only RNYOnly RNY
16. Mason Loop
Violation of Basic General Surgery
• Basic General SurgeryBasic General Surgery
• Total/Subtotal GastrectomyTotal/Subtotal Gastrectomy
NEVER Reconstruct wNEVER Reconstruct w
Loop!Loop!
• Mason Loop BypassMason Loop Bypass
Reconstruct w LoopReconstruct w Loop
• Thus Mason Loop =>Thus Mason Loop =>
FailureFailure
• Violation of Basic GeneralViolation of Basic General
Surgical PrinciplesSurgical Principles
17. Mason Loop
Violation of Basic General Surgery
• Mason Loop BypassMason Loop Bypass
Reconstruct w LoopReconstruct w Loop
• Thus Mason LoopThus Mason Loop
=> Failure=> Failure
• Violation of BasicViolation of Basic
General SurgicalGeneral Surgical
PrinciplesPrinciples
18. Total/Subtotal Gastrectomy
• Basic General SurgeryBasic General Surgery
• NEVER ReconstructNEVER Reconstruct
w Billroth IIw Billroth II
• NEVER ReconstructNEVER Reconstruct
w Billroth IIw Billroth II
• NEVER ReconstructNEVER Reconstruct
w Billroth IIw Billroth II
• NEVER ReconstructNEVER Reconstruct
w Billroth IIw Billroth II
19. MGB Gastric Pouch
• Mini-Gastric BypassMini-Gastric Bypass
Shown to be an excellentShown to be an excellent
operationoperation
• But Many New Surgeons DoBut Many New Surgeons Do
Not Know the Critical FactorsNot Know the Critical Factors
to Do the MGB Correctlyto Do the MGB Correctly
• One Critical Success Factor:One Critical Success Factor:
• LONG Gastric PouchLONG Gastric Pouch
20. What should be ideal length of pouch?
• This question shows theThis question shows the
surgeon has not understandsurgeon has not understand
the teachings of Generalthe teachings of General
Surgery HistorySurgery History
• The Answer to Creation of theThe Answer to Creation of the
pouch is Simple...pouch is Simple...
21. MGB Gastric Pouch
• General Surgery:General Surgery:
• Acceptable:Acceptable:
Antrectomy/Distal GastrectomyAntrectomy/Distal Gastrectomy
+ Billroth II Loop+ Billroth II Loop
• Never Acceptable:Never Acceptable:
Total/Subtotal GastrectomyTotal/Subtotal Gastrectomy
+ Billroth II Loop+ Billroth II Loop
22. MGB Gastric Pouch
• General Surgery:General Surgery:
• Acceptable:Acceptable:
Antrectomy/Distal GastrectomyAntrectomy/Distal Gastrectomy
+ Billroth II Loop+ Billroth II Loop
• NEVER Acceptable!!!NEVER Acceptable!!!
Total/Subtotal GastrectomyTotal/Subtotal Gastrectomy
+ Billroth II Loop+ Billroth II Loop
23. MGB Gastric Pouch
• Acceptable:Acceptable:
Antrectomy/DistalAntrectomy/Distal
GastrectomyGastrectomy
+ Billroth II Loop+ Billroth II Loop
• Not AcceptableNot Acceptable
Total/SubtotalTotal/Subtotal
GastrectomyGastrectomy
+ Billroth II Loop+ Billroth II Loop
24. MGB Pouch
• EG JunctionEG Junction
• Pouch fromPouch from
EGJ to AntrumEGJ to Antrum
• Crow's FootCrow's Foot
• AntrumAntrum
25. MGB Pouch
• EG JunctionEG Junction
• Pouch fromPouch from
EGJ to AntrumEGJ to Antrum
• Crow's FootCrow's Foot
• AntrumAntrum
26. MGB Pouch
• EG JunctionEG Junction
• Pouch fromPouch from
EGJ to AntrumEGJ to Antrum
• Crow's FootCrow's Foot
• AntrumAntrum
27. MGB Pouch
• EG JunctionEG Junction
• Pouch fromPouch from
EGJ to AntrumEGJ to Antrum
• Crow's FootCrow's Foot
• AntrumAntrum
28. MGB Gastric Pouch Length
• How Long is the MGBHow Long is the MGB
Pouch?Pouch?
• Wrong AnswerWrong Answer
Not in CentimetersNot in Centimeters
• Answer: FromAnswer: From
EG JunctionEG Junction to Beyondto Beyond
thethe Crow's FootCrow's Foot into theinto the
AntrumAntrum
• The MGB Gastro-The MGB Gastro-
Jejunostomy should lieJejunostomy should lie
at the level of theat the level of the
Transverse ColonTransverse Colon
29. Creation of the MGB Pouch
• Details atDetails at
https://mgbguidelines.wordpress.com/gastric-pouch-creation/https://mgbguidelines.wordpress.com/gastric-pouch-creation/
• Creation of the Gastric PouchCreation of the Gastric Pouch
(Band/Sleeve/RNY)(Band/Sleeve/RNY)
• Bougie of size 28 to 36 F can be used toBougie of size 28 to 36 F can be used to
fashion the pouchfashion the pouch
• Understanding MGB Anatomy & PhysiologyUnderstanding MGB Anatomy & Physiology
• MGB NOT ObstructiveMGB NOT Obstructive
• No Tight Pouch (The MGB is not a Sleeve)No Tight Pouch (The MGB is not a Sleeve)
• Pouch Diameter and Length are Not CriticalPouch Diameter and Length are Not Critical
• MGB Pouch Size:MGB Pouch Size:
• Pouch Diameter = Esophagus;Pouch Diameter = Esophagus;
30. Creation of the MGB Pouch
• Details atDetails at
https://mgbguidelines.wordpress.com/gastric-pouch-creation/https://mgbguidelines.wordpress.com/gastric-pouch-creation/
• Pouch Length = Allow GJ at the greater curve of thePouch Length = Allow GJ at the greater curve of the
stomachstomach
• Start the Gastric Pouch (Long Pouch) at or beyondStart the Gastric Pouch (Long Pouch) at or beyond
Crow’s Foot (junction of body and antrum of theCrow’s Foot (junction of body and antrum of the
stomach.stomach.
• Beware a Twist in the Pouch)Beware a Twist in the Pouch)
• Avoid Bleeding Along Staple Line; (Very SlowAvoid Bleeding Along Staple Line; (Very Slow
Application of Stapler, use compression)Application of Stapler, use compression)
• Management of EG junction; MGB vs Sleeve (DOManagement of EG junction; MGB vs Sleeve (DO
NOT go near the EG junction)NOT go near the EG junction)
• Management of the gastric fundus; (Leaving someManagement of the gastric fundus; (Leaving some
fundus is acceptable)fundus is acceptable)
• Never dissect the EG junctionNever dissect the EG junction
31. Creation of the MGB Pouch
• Details atDetails at
https://mgbguidelines.wordpress.com/gastric-pouch-creation/https://mgbguidelines.wordpress.com/gastric-pouch-creation/
• Never dissect the EG junctionNever dissect the EG junction
• Never attempt to visualize the diaphragmatic curaNever attempt to visualize the diaphragmatic cura
• Always stay lateral to the EG junctionAlways stay lateral to the EG junction
• Leaving some of the fundus behind in the MGB isLeaving some of the fundus behind in the MGB is
always acceptablealways acceptable
• Reminder: The MGB is NOT a Sleeve, The MGB isReminder: The MGB is NOT a Sleeve, The MGB is
NOT a RNYNOT a RNY
• Complete division of the stomach in NOT critical inComplete division of the stomach in NOT critical in
the MGBthe MGB
32. MGB Part 1:
Creation of the Gastric Pouch
• Youtube.com VideosYoutube.com Videos
• http://www.youtube.com/watchhttp://www.youtube.com/watch
?v=1B45TUAimJE?v=1B45TUAimJE
• Technique of Mini-GastricTechnique of Mini-Gastric
Bypass; Tips and TricksBypass; Tips and Tricks
33. Conclusions
• Mini-Gastric BypassMini-Gastric Bypass
Shown to be an excellentShown to be an excellent
operationoperation
• But Many New Surgeons DoBut Many New Surgeons Do
Not Know the Critical FactorsNot Know the Critical Factors
to Do the MGB Correctlyto Do the MGB Correctly
• One Critical Success Factor:One Critical Success Factor:
• LONG Gastric PouchLONG Gastric Pouch