* Fluid resuscitation is mandatory in shock from traumatic haemorrhage * Massive use of resuscitative fluids following injury is now being disputed * Adequate resuscitation is no longer judged by presence of normal vital signs * Normalcy of organ and tissue specific measured values are to be achieved * Search for a single endpoint that works for all trauma patients, is unrealistic * Resuscitate with appropriate fluid, in appropriate amount, at appropriate time
THYROIDECTOMY- Operative Surgery
Dear viewers,
Greetings from “Surgical Educator”
Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries. I have already uploaded two videos on open and Laparoscopic Appendicectomy. In this video today, I have discussed Thyroidectomy Surgery. However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery. Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful. This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
Surgicaleducator.blogspot.com
Youtube.com/c/surgicaleducator
Thank you for watching the videos.
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
* Fluid resuscitation is mandatory in shock from traumatic haemorrhage * Massive use of resuscitative fluids following injury is now being disputed * Adequate resuscitation is no longer judged by presence of normal vital signs * Normalcy of organ and tissue specific measured values are to be achieved * Search for a single endpoint that works for all trauma patients, is unrealistic * Resuscitate with appropriate fluid, in appropriate amount, at appropriate time
THYROIDECTOMY- Operative Surgery
Dear viewers,
Greetings from “Surgical Educator”
Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries. I have already uploaded two videos on open and Laparoscopic Appendicectomy. In this video today, I have discussed Thyroidectomy Surgery. However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery. Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful. This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
Surgicaleducator.blogspot.com
Youtube.com/c/surgicaleducator
Thank you for watching the videos.
URETHRAL INJURY- Trauma Surgery
#surgicaleducator #babysurgeon
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on URETHRAL INJURY- one more in Trauma Surgery. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about anatomy, classification, etio-pathogenesis, symptoms, signs, investigations, grading, treatment, complications, treatment algorithm and case vignettes of urethral injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of urethral injury and should also be able to institute immediate treatment to the patients if there is a need. The definitive urethroplasty should be done by a Urologist. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
Types of Urethral injury, Mechanism of Urethral injury, Classification of Urethral injury, Symptoms of Urethral injury, Signs of Urethral injury,
Investigations for Urethral injury, Grading of Urethral Injury, Treatment for Urethral injury, Complications of Urethral Injury
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
Fever and Hyperthermia and Pyrexia of unknown origin by Dr Mohammad Hussien for Medical Student .
Ass.Lecturer of Hepatogastroentrology at Kafrelsheikh University.
this i take from i cant remember the website. i find it interesting and easy to understand and i upload it, so that i can read it anytime i want without losing it..... lets us together read.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
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.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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2. Febrile Surgical Patient
• Common
• Long list of differential diagnosis
• Understandable to equate fever with
infection
• Workup and therapy should be
individualized
3. What constitutes a fever?
•
•
•
•
Arbitrary
Temperature that raises concern
> 38oC
Increased metabolic rate 7% -15% / oC
– little morbidity aside of discomfort and
increased insensible fluid loss
• But risk of neurological injury if > 41 oC
4. Noninfectious Causes of
Fever
• Nosocomial infection unlikely in the first 48
hours after operation
• The most common cause of postoperative
fever is ATELECTASIS
5. Causes of post-op fever
• Non-infectious
• Infectious
– Device-related
– Not related to devices
7. Drug fever
•
•
•
•
•
Only 2 - 3% of all post-op fever
Usually due to hypersensitivity
Antibiotics most common
Diagnosed by exclusion
Fever often subsides after removal of
drugs
• Malignant hyperthermia
• Neuroleptic malignant syndrome
8. Haematological Fever
• Transfusion reaction
– passenger leukocytes leads to
alloimmunization to leukocyte-specific
antigens in the recipient
• Deep venous thrombosis
• Haematoma
9. Infectious Causes of Fever
• If operation is performed for control of an
infection, the fever is expected to settle
within 72 hrs
• New or persistent fever more than 3 days
after surgery should raise a strong
suspicion of persistent sepsis or a new
complication
10. Device-related infection
• Nosocomial infection often arise in
association with indwelling devices:
– IV drips
– ET-tube, tracheostomy tube, NG tube
– Urinary catheters
– Drains
11. Nosocomial Chest infection
• After 3rd day
• Risk factors:
– prolonged mechanical ventilation
– cardiothoracic, neurosurgical,
trauma operation
– major H&N or GI surgery
• purulent sputum, fever, high
WCC, and abnormal CXR
12. Urinary tract infection
• Seldom destabilizing
• Upper tract rare
• Most important risk factor
– duration of catheterization
• Indication of cath should be reviewed daily
• Remove at the earliest opportunity
13. Infection of vascular Access
• Central or peripheral lines
• Percutaneously placed catheter should
be removed
• Surgically placed catheter (e.g. Hickman
line) may be salvaged by antibiotics
(successful if Gram positive infection, not
likely if infected by pseudomonas or
fungus)
14. Nosocomial Infection not
related to Devices
• Wound infection
• Necrotizing fasciitis
• Pseudomembranous colitis
• Acalculus cholecystitis
15. Approach to Post-op Fever
• An individual approach is essential
• Unlikely diagnoses should not be pursued
until more common causes have been
excluded
• Important to differentiate whether the fever
is due to infection or just an inflammatory
response only
17. Day 1
• Most common: atelectasis
• Persistent sepsis if OT was done for
control of infection
• Rare causes:
•
•
•
•
thyroid crisis
transfusion reaction
drug fever
malignant hyperthermia / NMS
18. Day 2 - Day 3
• Infection related to indwelling device
– Drip site infection
– Chest infection / Sinusitis
– Bacterial cystitis
• Haematoma
• Tissue necrosis (e.g. flap)
• Gout / pseudogout
20. Day 6 - Day 7
• All of the above and,
• Deep venous thrombosis
• Pulmonary embolism
21. Approach to Post-op Fever
• Careful review of history
– Premorbid condition
– Indication of surgery
– Nature of operation
• Physical examination
– Chart of vital signs
– Possible source of infection
• Consider culture of blood, sputum and urine
• CXR, +/- USG abdomen +/- CT scan
• Empiric antibiotics if necessary