This document provides guidelines for conducting a preoperative health status evaluation. It outlines topics to cover in the patient's medical history including biographic data, chief complaints, past medical issues, medications, and health habits. It also describes a review of systems and physical examination. Common health conditions that should be asked about are listed. The document then provides guidance for managing patients with specific medical conditions such as cardiovascular diseases, pulmonary diseases, diabetes, and pregnancy during dental procedures.
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
DR. SWARNEET KAKPURE (DEPT OF CONSERVATIVE DENTISTRY AND ENDODONTICS)
THE TOPIC PRESENTED IN SEMINAR COVERS ALMOST ALL THE ASPECTS OF COMPLEX AMALGAM RESTORATIONS INCLUDING PIN RETAINED,SLOT RETAINED AMALGAM RESTORATIONS,CEMENTED,FRICTION LOCKED & SELF THREADING PINS, TMS SYSTEM,AMALGAM FOUNDATIONS ALONG WITH TECHNIQUES OF INSERTION AND MATRIX PLACEMENT.
Fixed prosthodontic treatment can offer exceptional satisfaction for both patient and the dentist. Fixed Prosthodontics can transform an unhealthy, unattractive dentition with poor function into a comfortable, healthy occlusion capable of giving years of further service while greatly enhancing esthetics.
Nothing is more important in the construction of fixed partial dentures than an adequate diagnosis and a well-devised treatment plan. Although these two subjects are usually considered together. Astute dentists must recognize their subtle differences. Diagnosis is an evaluation of the condition of the patient when he presents for treatment. Treatment planning concerns the treatment procedures by which the dentist will restore the patient to an optimum state of dental health.
DR. SWARNEET KAKPURE (DEPT OF CONSERVATIVE DENTISTRY AND ENDODONTICS)
THE TOPIC PRESENTED IN SEMINAR COVERS ALMOST ALL THE ASPECTS OF COMPLEX AMALGAM RESTORATIONS INCLUDING PIN RETAINED,SLOT RETAINED AMALGAM RESTORATIONS,CEMENTED,FRICTION LOCKED & SELF THREADING PINS, TMS SYSTEM,AMALGAM FOUNDATIONS ALONG WITH TECHNIQUES OF INSERTION AND MATRIX PLACEMENT.
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
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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.
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
3. Medical history
1. Biographic data
2. Chief complaint and its history
3. Medical history
4. Social and family medical histories
5. Review of systems
6. Physical examination
7. Laboratory and imaging results
5. Medical history
1. Past hospitalizations, operations, traumatic injuries, and serious illnesses
2. Recent minor illnesses or symptoms
3. Medications currently or recently in use and allergies (particularly drug
allergies)
4. Description of health-related habits or addictions, such as the use of
ethanol, tobacco, and illicit drugs; and the amount and type of daily
exercise
5. Date and result of last medical checkup or physician visit
6.
7. Common Health Conditions to Inquire About Verbally
or on a Health Questionnaire
•Allergies to antibiotics or local anesthetics
•Angina
•Anticoagulant use
•Asthma
•Bleeding disorders
•Breastfeeding
•Corticosteroid use
•Diabetes
•Heart murmurs
Others
8. Review of Systems
•Constitutional: Fever, chills, sweats, weight loss, fatigue, malaise, loss of
appetite
•Head: Headache, dizziness, fainting, insomnia
•Ears: Decreased hearing, tinnitus (ringing), pain
•Eyes: Blurring, double vision, excessive tearing, dryness, pain
•Nose and sinuses: Rhinorrhea, epistaxis, problems breathing through nose,
pain, change in sense of smell
•Temporomandibular joint area: Pain, noise, limited jaw motion, locking
•Oral: Dental pain or sensitivity, lip or mucosal sores, problems chewing,
problems speaking, bad breath, loose restorations, sore throat, loud snoring
•Neck: Difficulty swallowing, change in voice, pain, stiffness
12. Management of Patients With
Compromising Medical Conditions
Cardiovascular Problems
Angina Pectoris
1. Consult the patient’s physician.
2. Use an anxiety-reduction protocol
3. Have nitroglycerin tablets or spray readily available. Use
nitroglycerin premedication, if indicated
4. Ensure profoundlocalanesthesia before starting surgery
5. Consider the use of nitrous oxide sedation
6. Monitor vital signs closely
7. Consider possible limitation of amount of epinephrine used (0.04 mg maximum
8. Maintain verbal contact with patient throughout the procedure to monitor status.
14. Cerebrovascular Accident (Stroke)
Patients who have had a cerebrovascular accident (CVA) are always susceptible to further
neurovascular accidents. These patients are often prescribed anticoagulants or antiplatelet
medication depending on the cause of the CVA; if they are hypertensive, they are given
blood pressure–lowering agents. CVAs are typically a result of an embolus from a history of
atrial fibrillation, a thrombus due to a hypercoagulable state, or stenotic vessels. In the case
of a patient having an embolic or thrombotic stroke, the patient is likely taking an
anticoagulant as opposed to an ischemic stroke secondary to stenotic vessels, in which case
the patient would be taking an antiplatelet medication. If such a patient requires surgery,
clearance by the patient’s physician is desirable, as is a delay until significant hypertensive
tendencies have been controlled. The patient’s baseline neurologic status should be
assessed and documented preoperatively. The patient should be treated by a
nonpharmacologic anxietyreduction protocol and have vital signs carefully monitored
during surgery. If pharmacologic sedation is necessary, low concentrations of nitrous oxide
can be used. Techniques to manage patients taking anticoagulants
15. Dysrhythmias
these patients may have been prescribed anticoagulants or may have a
permanent cardiac pacemaker. Pacemakers pose no contraindications to
oral surgery, and no evidence exists that shows the need for antibiotic
prophylaxis in patients with pacemakers. Electrical equipment, such as
electrocautery and microwaves, should not be used near the patient. As
with other medically compromised patients, vital signs should be carefully
monitored, and all other comorbid conditions should be considered
16. Heart Abnormalities That Predispose to
Infective Endocarditis
The internal cardiac surface, or endocardium, can be predisposed to
infection when abnormalities of its surface allow pathologic bacteria to
attach and multiply.
17. Congestive Heart Failure (Hypertrophic
Cardiomyopathy)
1. Defer treatment until heart function has been medically improved and
the patient’s physician believestreatment is possible.
2. Use an anxiety-reduction protocol
3. Consider possible administration of supplemental oxygen
4. Avoid using the supine position
5. Consider referral to an oral-maxillofacial surgeon
18. Asthma
1. Defer dental treatment until the asthma is well controlled and the patient has no
signs of a respiratory tract infection
2. Listen to the chest with a stethoscope to detect any wheezing before major oral
surgical procedures or sedation.
3. Use an anxiety-reduction protocol, including nitrous oxide, but avoid the use of
respiratory depressants
4. Consult the patient’s physician about possible preoperative use of
cromolyn sodium
5. If the patient is or has been chronically taking
corticosteroids, provide prophylaxis for adrenal insufficiency
6. Keep a bronchodilator-containing inhaler easily accessible
7. Avoid the use of nonsteroidal antiinflammatory drugs in
susceptible patients
20. Renal Failure
1. Avoid the use of drugs thatdepend on renal metabolism or
excretion. Modify the dose if such drugs are necessary. Do not use an
atrioventricular shunt for giving drugs or for taking blood specimens
2. Avoid the use of nephrotoxic drugs such as nonsteroidal
antiinflammatorydrugs.
3. Defer dental care until the day after dialysis has been given.
4. Consult the patient’sphysician about the use of prophylactic
antibiotics
5. Monitor blood pressure and heart rate
6. Look for signs of secondary hyperparathyroidism
7. Consider screening for hepatitisB virus before dental
treatment. Take the necessary precautions if unable to screen for
hepatitis.
21. Renal Transplantation and
Transplantation of Other Organs
1. Defer treatment until the patient’sprimary carephysician or
transplant surgeon clears the patient for dental care
2. Avoid the use of nephrotoxic drugs
3. Consider the use of supplemental corticosteroids.
4. Monitor blood pressure
5. Consider screening for hepatitisB virus before dental care.
Take necessary precautions if unable to screen for hepatitis
6. Watch for presence of cyclosporine-A–induced gingival
hyperplasia. Emphasize the importance of oral hygiene.
7. Consider use of prophylactic antibiotics, particularly in patients taking
immunosuppressive agents
23. Hepatic Disorders
1. Attempt to learn the cause of the liver problem; if
the cause is hepatitis B, take usual precautions.
2. Avoid drugs requiring hepatic metabolism or excretion; if
their use is necessary, modify the dose.
3. Screen patients with severe liver disease for bleeding disorders by using
tests for determining platelet count, prothrombin time, partial
thromboplastin time, and bleeding time
4. Attempt to avoid situations in which the patient might
swallowlarge amounts of blood.
26. Hyperthyroidism
1. Defer surgery until the thyroid gland dysfunction is well controlled
2. Monitor pulse and blood pressure before, during, and after surgery
3. Limit the amount of epinephrine used
27. Hypothyroidism
The dentist can play a role in the initial recognition of hypothyroidism.
Early symptoms of hypothyroidism include fatigue, constipation, weight
gain, hoarseness, headaches, arthralgia, menstrual disturbances, edema,
dry skin, and brittle hair and fingernails. If the symptoms of
hypothyroidism are mild, no modification of dental therapy is required
30. Seizure Disorders
1. Defer surgery until the seizures are well controlled
2. Consider having serum levels of antiseizure medications measured if
patient compliance is questionable
3. Use an anxiety-reduction protocol
4. Take measures to avoid hypoglycemia andfatigue in the
patient
31. Ethanolism (Alcoholism)
Patients requiring oral surgery who exhibit signs of severe alcoholic liver
disease or signs of ethanol withdrawal should be treated in the hospital
setting. Liver function tests, a coagulation profile, and medical consultation
before surgery are desirable. In patients who can be treated on an
outpatient basis, the dose of drugs metabolized in the liver should be
altered, and the patients should be monitored closely for signs of
oversedation
32. Management of Patients During and
After Pregnancy
1. Defer elective surgery until after delivery, if possible
2. Consult the patient’s obstetrician if surgery cannot be delayed
3. Avoid dental radiographs unless information about tooth roots
or bone is necessary for proper dental care. If radiographs
must be taken, use proper lead shielding
4. Avoid the use of drugs withteratogenic potential. Use local
anesthetics when anesthesia is necessary.
5. Use at least 50%oxygen if nitrous oxide sedation is used,
but avoid use during the first trimester
6. Avoid keeping the patient in the supine position for longperiods
to prevent vena caval compression
7. Allow the patient to taketripsto the restroom as often as
needed