Platelet-rich plasma (PRP) involves concentrating the platelets from a patient's own blood, which contain growth factors that promote healing. PRP is being used increasingly in various medical fields as a non-operative treatment. In obstetrics, studies have found PRP may help seal tears in the amniotic membrane in cases of premature rupture of membranes. It may also accelerate wound healing after cesarean sections and episiotomies. The PRP preparation process involves drawing and centrifuging blood to separate out platelets, which are then injected into the target site to stimulate healing. More research is still needed but PRP represents a promising regenerative approach with few risks.
Obstetric emergency which can kill instantly !! - PPH presenting to ED, so what is the role of Emergency Dept ? The most basic presentation of Obstetric emergency and how to tackle it? Being an emergency physician, obstetrics is always challenging! Keep yourself updated with Obstetric emergency.
Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life.
Obstetric emergency which can kill instantly !! - PPH presenting to ED, so what is the role of Emergency Dept ? The most basic presentation of Obstetric emergency and how to tackle it? Being an emergency physician, obstetrics is always challenging! Keep yourself updated with Obstetric emergency.
Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life.
Platelet Rich Plasma ( PRP ) is very popular in the treatment of musculo skeletal pathologies. This ppt gives a brief introduction to platelets and in sights into developing a PRP kit.
Haven’t been able to witness the joy of becoming a mother even after all the strenuous attempts? Lost all hopes due to recurrent unsuccessful IVF and Implantation? Or have seen the face of failure or cancellation every time you’re prepared for Transfers due to unready endometrium? Have all these failed attempts made you wondered why? No it’s nothing close to a curse, just a medical uncertainty that can be looked after.
Platelet-rich plasma (PRP) has become popular as a non operative treatment option for a broad spectrum of medical disorders. There are reasonable amount of data which warrant continued research in PRP but currently its role in clinical practice is not completely defined. Prior to its use, special consent is required after an honest and open discussion with the patient as well controlled human studies are lacking
VCare Trichology hair care clinic in Chennai and Bangalore offers world class hair growth treatments and hair transplantation therapies with a team of expert hair doctors, Trichologists and surgeons at a state of art facility clinic
Platelet Rich Fibrin (PRF) in Dentistry, What is PRF ? , What are the difference between PRP,PRGF and PRF ?, Preparation of PRF , shapes of PRF, Role of PRF in wound healing, APPLICATIONS OF PRF, Applications of PRF In Oral and Maxillofacial Surgery, Applications of PRF In Periodontics, Applications of PRF In Endodontics, Applications of PRF In Tissue Engineering
Platelet function and constituents of platelet rich plasma.Angad Malhotra
Int J Sports Med. 2013 Jan;34(1):74-80. doi: 10.1055/s-0032-1316319. Epub 2012 Aug 14.
Platelet function and constituents of platelet rich plasma.
Pelletier MH, Malhotra A, Brighton T, Walsh WR, Lindeman R.
Intra caesarean loop (device or system ) insertion
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
2. Introduction
• Regenerative biomedicine continues to progressively
emerge at the forefront of healthcare in a number of
medical disciplines
• Platelet-rich plasma (PRP) is becoming more popular as
a nonoperative treatment option for a broad spectrum
of medical disorders.
• PRP is widely used in orthopedic and sports medicine to
relieve pain through the natural promotion of healing in
musculoskeletal diseases such as tendonitis, arthritis,
ligament sprains, and tears.
• These growth factors have been found to promote
natural healing responses by researchers across
multiple specialties, such as dentistry, dermatology,
urology, and gynecology
3. What is Platelet Rich Plasma (PRP)?
• It’s a autologous ( means patient’s own blood)
concentration of platelets in a small volume of
plasma usually 5 to 10 fold the normal level of
the whole blood.
• Since the platelets is so concentrated, so do all
the growth factors also will be 5 to 10 folds
higher.
4. FDA approval
• PRP does not require FDA approval
• Since
• It is not a medicine or a device.
• PRP comes from patient own body.
• Patient own blood is drawn and sterilely
processed in a highly specialized FDA
approved collection kit and centrifuge to
concentrate the platelets 6 times their natural
values in pure plasma without any red cells.
5. Short history
• 1905 : German surgeon August Bier discovered that, injected with their own blood, patients with bone
fractures heal faster.
• 1935 – 1980:before antibiotics, autohemotherapy (intramuscular injection of a small amount of blood
taken from the same individual) and autoserotherapy (treatment with blood from the patient’s blood) were
among the most popular secondary treatments.
• 1980 : maxillofacial surgeon Robert E. Marx was the first to use blood plasma as a gel; the discovery that
platelets contain protein factors (PRP factors) that stimulate cellular regeneration opened the way for the
autologous plasma gel production technology; this was developed mainly for use in stomatology (the
Harvest company, USA).
• 2003 : the Russian scientists Renat R. Akhmerov (Professor, Doctor of Medicine, plastic surgeon and
maxillofacial surgeon, oncodermatologist) and Roman F. Zarudy (Doctor of Medicine, maxillofacial surgeon,
implantologist) were the first in the world to use platelet-rich autologous plasma to treat inflammatory and
atrophic diseases, in the postoperative period; the technology was named Plasmolifting™.
• 2004 : Plasmolifting ™ clinical trials were carried out on the two Russian scientists and on volunteers, to
treat photodermatosis, hair loss and acne, with good results (in addition to the therapeutic effects, the
patients’ skin was rejuvenated); Roman F. Zarudy explained that the new injecting form of plasma opened
up new possibilities for them, as maxillofacial surgeons (especially for tissue regeneration), and the method
revolutionized this sphere of surgical practice; at first, their colleagues were skeptical of his new
technology’s success, but – with time – the Plasmolifting™ method began to be applied in various fields of
medicine.
• 2011 : with the support of doctors Akhmerov and Zarudy, the Plasmolifting Company was set up; it
exclusively produces and distributes the equipment necessary for the Plasmolifting™ method, wishing to
offer everyone this natural healing method; today, the Plasmolifting Company has created a vast
distribution network in Europe, develops and distributes the Plasmolifting™ tubes and organizes specialty
courses; the aim of the company is to convert autologous plasma injections into a routine biological
stimulation method.
6. PRP composition and activation
• Platelets contain high concentrations of cytokines and growth
factors stored within α-granules. These growth factors include
platelet-derived growth factor, insulin-like growth factor, vascular
endothelial growth factor, platelet-derived angiogenic factor,
transforming growth factor beta, fibroblast growth factor,
epidermal growth factor, connective tissue growth factor, and
interleukin-8. In addition to growth factors, platelets contain other
substances, such as fibronectin, vitronectin, and sphingosine 1-
phosphate, that initiate wound healing
• Platelet activation triggers the release of these growth factors by a
variety of substances or stimuli such as thrombin, calcium
chloride, and collagen. Each method influences both the physical
form of PRP and the amount of growth factors released, as well as
the kinetics of release. No evidence has been found regarding the
ideal concentration of activator required to trigger the optimal
release of growth factors during the activation process of PRP, and
different concentrations may therefore lead to different results
7. The theory underlying this treatment
modality
• It was derived from natural healing processes,
as the body's first response to tissue injury is to
deliver platelets to the injured area.
• Platelets promote healing and attract stem cells
to the site of the injury.
• Moving from basic science to clinical practice,
• PRP injections have been applied to diseased
ligaments, tendons, and joints, with superb
outcomes in terms of repair
8. Growth Factors In Platelets
• Platelets is part of the cell in our blood that help in the clotting
mechanisms. It’s a very tiny cells but inside the contain a lot of
important growth factors such as:-
• Platelet Derived Growth Factors (PDGF)
• Vascular Endothelial Growth Factors (VEGF)
• Insulin Like Growth Factors ( IGF 1& 2)
• Transforming Growth Factors beta( TGF-b)
• Fibroblast Growth Factors ( FGF)
• Epidermal Growth Factors ( EGF )
• Connective Tissue Growth Factors (CTGF)
• Interleukin 8 (IL 8)
• All these growth factors are very important for healing,
formation of new vessels, collagen production and regeneration!
9. The science of PRP
• PRP preparation
• The preparation of PRP is an outpatient procedure that involves a blood draw, preparation of the PRP,
and the injection of PRP into the diseased area.
• Multiple methods have been developed for PRP preparation, with variation in the speed and timing of
centrifugation
• The following steps present a representative method of preparing PRP:
• (1) venous blood (15–50 mL) is drawn from the patient's arm in anticoagulant-containing tubes;
• (2) the recommended temperature during processing is 21℃–24℃ to prevent platelet activation during
centrifugation of the blood;
• (3) the blood is centrifuged at 1,200 rpm for 12 minutes;
• (4) the blood separates into three layers: an upper layer that contains platelets and white blood cells, an
intermediate thin layer (the buffy coat) that is rich in white blood cells, and a bottom layer that contains
red blood cells;
• (5) the upper and intermediate buffy layers are transferred to an empty sterile tube. The plasma is
centrifuged again at 3,300 rpm for 7 minutes to help with the formation of soft pellets (erythrocytes and
platelets) at the bottom of the tube;
• (6) the upper two-thirds of the plasma is discarded because it is platelet-poor plasma;
• (7) pellets are homogenized in the lower third (5 mL) of the plasma to create the PRP;
• (8) the PRP is now ready for injection. Approximately 30 mL of venous blood yields 3–5 mL of PRP;
• (9) the affected area is disinfected before the PRP injection;
• (10) providing assurance to the patient and discussing the procedure make the injection easier and less
painful;
• (11) PRP stimulates a series of biological responses, and the injection site may become swollen and
painful for roughly 3 days.
11. Premature rupture of membranes
• (PROM) occurs due to damage and tears in the fetal
membrane leading to congenital infections and poor
neonatal outcomes.
• The PRP plug was stable and attached firmly to
amnion tear
• a PRP plug persists for nearly 2 months in an amniotic
fluid environment.
• It also provides waterproof sealing of iatrogenic
defects in amnion and chorion.
• Moreover PRP stimulates cell growth and proliferation
and may thereby enhance a membrane healing
response.
12. Effect of Autologous Platelet-rich
Plasma in Uterine Wound niche
• the efficacy of intramyometrial injection of
autologus platelet rich plasma on uterine wound
healing after primary cesarean section
• it will be injected into uterus after closing uterine
incision .
• Injection sites will be selected near the incision at
evenly 20 different sites
• Decrease cesarean scar defect(niche) ---- 6 weeks
after CS no any defect in the anterior
myometrium related to scar site
14. During And/Or After Surgery
• Like any surgical procedure, postoperative healing and pain
are major concerns for both the patient and their physician.
• Platelet Rich Plasma (PRP), if applied during and/or after
surgery, will help to accelerate the body’s healing processes
and significantly reduce the amount of recovery time
needed.
• Procedures that fall into this statistic include:
• C-sections
• Vaginal hysterectomy
• Abdominal hysterectomy
• Laparoscopic procedures
• Urogynecologic procedures
15. Wound Healing
• It has been proven that usage of PRP will
accelerate the healing of any surgical wound and
reduce the duration of hospital stay even in high
risk patient such as patient with Diabetes Mellitus
.
• The wound was also underrun with 1ml of
plasma directly applied to the surgical site at the
level of the deep dermis
• The wound was injected with aliquots of 0.2ml of
PRP using multiple punctures.
• The need for painkillers is also reduced
16. How long does the entire process take?
• The injection takes less than 5 minutes,
• but an hour is scheduled to provide ample
time for patient
• to meet with the doctor to ensure that there
are no contraindications, review pre and post
procedure expectations, draw blood,
centrifuge the blood and prepare the
treatment in a relaxed, comfortable
environment.
17. What prep is given for local
anesthesia?
• After counseling, patient will empty her bladder and
• move to the treatment table where patient will undress
from the waist down, and cover with a sheet.
• doctors find that an extra injection of local pain control
often hurts more than the shot itself.
• Therefore, doctors use 20 – 30 minutes of a topical
numbing cream (Benzocaine, Lidocaine, Tetracaine).
• This is applied to the clitoral and vaginal areas, with a piece
of plastic wrap placed over the cream by the patient and the
medical assistant just before the blood draw.
• Patient MUST tell doctor BEFOREHAND if patient have any
allergic reactions to any of these medications, so doctors
can make arrangements.
18. Contraindications to PRP Therapy
• Acute infectious diseases.
• Viral hepatitis B and C.
• Systemic diseases.
• Allergic reactions to anticoagulants.
• Immunosuppressive conditions.
• Blood-clotting disorder.
• Pregnancy and lactation.
• Mental disorders.
• With a personal history of oncology.
• Age under 18 years.
19. Are there side effects?
• Be assured the treatment rarely has side effects.
• Even patients that have drug allergies can safely
opt for the procedure and enjoy significant
improvement within a few weeks following the
treatment.
• Occasionally there is a small amount of bruising
or tingling in the injected areas.
• There are no infections or cancers or other
adverse side effects known.
20. Recommended course of PRP Therapy
• A course of 1 to 4 procedures is recommended,
• depending on the intensity of changes,
• the time between injections being 1 month.
• doctors recommend 1 treatment to start and see
how patient response is.
• Your provider may recommend more depending
on a multitude of patient-specific factors.
• Re-evaluate after 12-18 months
21. What if it doesn't work?
• A majority of women experience definite improvement
in their symptoms.
• If patient have followed every instruction properly,
• doctors will review a full assessment of the potential
reasons for the sub-optimal results.
• The main issue is usually not the preparation or
performance of the injection, but a woman’s own
particular body’s ability to heal, using its own blood
components, and her following the pre and post
procedure instructions precisely.
• doctors will consider performing a second injection only
after 6 months of healing and a full assessment.
22. Benefits of PRP Therapy
• The PRP Therapy uses patient’s own blood,
therefore, this method has the minimum number
of contraindications, and the risk of allergy,
rejection and other “side effects” is completely
excluded, which ensures complete
biocompatibility of the administered preparation.
• The PRP Therapy does not require special
training and, under certain conditions, can be
performed immediately at the doctor’s office.
The whole procedure takes no more than 30
minutes. After the autoplasma injection, the
patient can continue her daily routine at once.
23. Recommendations after PRP Therapy
• For 3 days after the administration, it is
recommended to abstain from:
Sexual activity.
Taking steam baths.
Visiting saunas and taking baths.
• Use cotton underwear for 5 days after the PRP
Therapy.
• In order to avoid hyperpigmentation at the
injection site, it is not recommended to use a
tanning bed/booth and undergo prolonged
24. The success of this technique
• entirely depends on
• the speed of blood collection and transfer to
the centrifuge.
• In fact, without anticoagulant, the blood
sample starts to coagulate almost immediately
upon contact with the tube glass, and it does
take a minium of few minutes of
centrifugation to concentrate fibrinogen in the
middle and upper part of the tube.
• Quick handling is the only way to obtain a
25. Conclusion
• PRP is an innovative therapeutic modality,
• as it is affordable,
• simple,
• cheap,
• easily performed, and
• effective.
• It is also a noninvasive modality with promising
results and
• no side effects.
• In the field of gynecology, the few studies that
have been conducted are pilot studies, case
series, and case reports.
• The risks of PRP therapy as infection, bleeding,
and nerve damage, appear to be minimal.