Esophageal Atresia (EA) and Tracheo Esophageal Fistula (TEF)puji123456
Esophageal atresia (EA) is the
congenital malformation that
represent the failure of the esophagus
to develop a continuous passage upto
the stomach
Tracheo esophageal fistula (TEF) is
the congenital malformation where the
trachea and esophagus fails to separate
into distinct structures and a passage is
created between the two.
Esophageal Atresia (EA) and Tracheo Esophageal Fistula (TEF)puji123456
Esophageal atresia (EA) is the
congenital malformation that
represent the failure of the esophagus
to develop a continuous passage upto
the stomach
Tracheo esophageal fistula (TEF) is
the congenital malformation where the
trachea and esophagus fails to separate
into distinct structures and a passage is
created between the two.
This set of ppt displays a short description about IVH and Pulmonary hemorrhage its causes, grades, pathophysiology related to it, management and the prognosis in paediatric population.
A developmental anomaly is a broad term used to define conditions which are present at conception or occur before the end of pregnancy. In the case of cerebral palsy, a small number also occur after birth. this is also a birth defect.
A Tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the Oesophagus and the trachea. TEF is a common congenital abnormality.
Oesophageal atresia is failure of oesophagus to form a continuous passage from the pharynx to the stomach
TEF is an abnormal connection between the trachea and the oesophagus
This set of ppt displays a short description about IVH and Pulmonary hemorrhage its causes, grades, pathophysiology related to it, management and the prognosis in paediatric population.
A developmental anomaly is a broad term used to define conditions which are present at conception or occur before the end of pregnancy. In the case of cerebral palsy, a small number also occur after birth. this is also a birth defect.
A Tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the Oesophagus and the trachea. TEF is a common congenital abnormality.
Oesophageal atresia is failure of oesophagus to form a continuous passage from the pharynx to the stomach
TEF is an abnormal connection between the trachea and the oesophagus
Tracheo oesophageal atresia and fistula A-Z for medical students
This powerpoint covers everything you need to know about tracheoesophageal fistula and atresia as a medical student.It is not intended for patients. Covers anatomy, embryology,types ,classification and treatment of tracheo-oesophageal fistula and atresia.
A Tracheoesophageal fistula is a congenital disease. It is a acquired communication between the trachea and esophagus. Most of the patient with TEF are diagnosed immediately following after birth.TEF are often associated with life threatening complications.
ANESTHETIC MANAGEMENT OF TRACHEOESOPHAGEAL FISTULA by Dr.Sravani VishnubhatlaDrSravaniVishnubhatl
Learning Objectives:
Review the clinical presentation of a patient with tracheoesophageal fistula (TEF)
Understand the prevalence of TEF, types, and associated syndrome
Discuss the diagnosis of TEF
Describe the medical and surgical management of TEF
Understand the anesthetic-related implications and develop an anesthetic plan
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
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
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!
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.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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.
2. Overview-
A fistula is an abnormal communication between two
epithelial-lined surfaces.
An atresia refers to complete obliteration or absence of
an orifice of a hollow organ.
A stenosis is change in diameter of a hollow organ to
become narrower. It can also be called stricture.
4. Introduction-
Esophageal atresia(EA) and tracheoesophageal fistula(TEF)
are the most common congenital anomalies of oesophagus.
It is a acquired communication between the trachea and
esophagus. Most of the patient with TEF are diagnosed
immediately following after birth.
TEF are often associated with life threatening complications
5. Definition-
Esophageal Atresia(EA)- defined as the complete absence of
continuity of oesophagus to stomach.
Tracheoesophageal Fistula (TEF)- defined as the congenital
abnormal connection between proximal or distal oesophagus
and the trachea.
A tracheoesophageal fistula, as the name implies, is an abnormal
communication between the trachea and esophagus.
7. Incidence-
EA with or without TEF is the most common oesophageal
malformation, occurring in approximately 1 in 3500 live
births. The vulnerable groups are- premature and low birth
weight (LBW) infants and mothers with polyhydramnios.
Often associated with other GI and cardiac anomalies.
8. Embryology-
The median pharyngeal groove (primitive digestive tube) develops in
the ventral aspect of foregut at day 22 of gestation, which develops
into the respiratory and digestive tubes.
These two tubes are separated by the mesenchyme.
The development of an abnormal epithelial-lined connection between
the two tubes results in the creation of the TEF. Excess mesenchymal
growth can stretch and disrupt the oesophagus, creating EA.
13. Classification- (Gross
classification)-5 types- EA with or
without TEF:-
- both distal
and proximal part of esophagus is blind and no
fistula is developed between esophagus and
trachea. Atresia/ Blind
pouch
14. Continuation.
- the proximal and distal part of esophagus is
connected to trachea by a fistula and the distal part of
esophagus is blind.
Fistula
Atresia
15. the proximal part of esophagus is
blind and distal part is connected by a
fistula to trachea.
Atresia
Fistula
16. both proximal and distal parts of esophagus are
connected to trachea by two separate fistula.
17. there is no presence of atresia in the
esophagus but is attached with trachea by a
single fistula.
18. Etiology-
The exact cause is unknown.
Some factors-
Heritable genetic factors- A 2% risk is present when one of the
sibling is affected; occasional association is with trisomies of 21, 13
and 18 chromosomes.
Maternal alcohol and smoking
Exogenous sex hormones
Exposure to methimazole
Prolonged mechanical ventilation via endoctracheal tube
Maternal polyhydamnios
Diabetes Mellitus during the first trimester of pregnancy.
19. Pathophysiology-
Upper part of esophagus is developed
from retropharyngeal segment and the
lower part of the first part of primitive gut.
At 4-5 weeks of gestation the laryngeal-
tracheal groove is formed.
Two longitudinal furrows develop and
separate the respiratory tract permordium
from oesophagus.
Deviation cellular growth of the septum
results in formation of fistula between
esophagus and trachea
22. Intermittent unexplained cyanosis and laryngospasm.
Poor feeding
Seal- bark cough
Violent response after first or second swallow of feeding
such as infant cough and chokes fluid through nose and
mouth.
23. Diagnosis-
Ultrasound scanning- prenatal diagnosis may reveal the size of
gastric bubble , polyhydramnios and other associated anomalies
Plain X-ray of abdomen
Chest X-ray using air contrast in the proximal pouch. If distal TEF is
present, air in the stomach will be seen on X-ray.
Passing of radiopaque catheter through oesophagus- the catheter
does not reach to the desired length.
Tracheo-brochoscopy- to examine the tracheobronchiolar tree. It helps in
detection of associated tracheobronchial anomalies.
ECG- for infants with clinical signs of cardiovascular disease.
27. Management-
Immediate management-
-Infant is managed with head elevated at a position of 30degree to
reduce the risk of gastric secretion entering into lungs.
-Nasogastric aspiration of secretions for every 5-10mins. Blind
pouch should be washed with normal saline to prevent blocking of
tube with thick mucus.
-IV fluid administration.
-Airway clearance with oxygen therapy.
-Nothing per mouth
28. Supportive management-
-Maintenance of nutritional requirements and warmth.
-Infection prevention
-Antibiotic therapy
-Respiratory support
-Chest physiotherapy and postural drainage
29. Medical management-
In healthy infants without pulmonary complications, primary repair is
done along with parenteral nutrition and upper pouch suction.
Pre-0peratively, a cuffed endotracheal tube is place distal to the fistula
site in order to prevent the reflux of gastric contents to the lungs.
30. Surgical management-
Done by end-to-end anastomosis with excision of the fistula by right
postolateral thoracotomy with internal chest drainage.
It is done with infants more than 2kg body weight with no pneumonia,
thereby emphasising clinically stable conditions.
32. •Intially gastrostomy is performed, followed by esophageal
anastomosis or colonic transplant after one year. This is done mainly
for premature and very sick infants with congenital anomalies.
•Circular oesophagotomy- performed on proximal pouch to gain
length and allow for primary anastomosis at initial surgery.
•Cervical oesophagotomy/ Esophagocoloplasty- When
oesophagus ends are too widely separated oesophageal replacement
with the segments of intestine (colonic reposition).
It is done at the age of 18 to 24 months.
• After surgical methods, IV fluid therapy is given for the first 48 hours
followed by gastrostomy feeding.
33. Nursing management-
A mother who is carrying the foetus may have polyhydramnios, which occurs
in approximately in 33% cases and virtually 100% of mothers with foetuses with
oesophageal atresia without fistula.
VACTERL (vertebral defects, anorectal malformations, cardiovascular
defects, tracheoesophageal defects, renal anomalies, and limb deformities) refers
a set of associated anomalies that should be readily apparent upon physical
examination.
The presence of the others must be assessed.
34. a. Preoperative-
related to abnormal communication between
trachea and oesophagus as evidenced by excessive secretions, respiratory
distress.
elated to feeding
difficulties as evidenced by regurgitation of feed.
related to obstruction secondary to anatomical defect as
evidenced by drooling of saliva.
elated to abnormal communication between oesophagus
and trachea.
related to inadequate oral intake.
elated to neonatal surgical emergency.
related to physical defect and hospitalization.
35. b.Postoperative-
related to surgical interventions as evidenced by
assessment.
related to inadequate oral intake
as evidenced assessment and observation.
related to surgical interventions as evidenced by facial grimancing and cry
of the infant.
related to surgical wound as evidenced by assessment of
the surgical site incision.
related to the hospital procedures.
related to complex surgery.
related to prolonged illness.
related to home- based long term care.
36. a. Preoperative-
•Preventions of aspirations by positioning, suctioning and NPO.
•Assessment of respiratory status.
•Administration of oxygen.
•Prevention of dehydration by IV fluid, intake and output chart, monitoring of vital
signs and general health.
•Perform oropharyngeal suctioning to remove accumulations of secretions.
•Placement of suction catheter in proximal pouch for every 10-15mins.
•Watch for any choking and cyanosis during feeding.
•Prevention of infections by infection control measures.
•Teach family about gastrostomy feeding techniques.
•Reducing parental anxiety by explaining the outcomes of the impending surgery
and by emotional support.
37. b.Postoperative-
•Maintaining of clear airway.
•Providing adequate feeding by IV fluid and gastrostomy feeding.
•Pain management-
•By tactile stimulations
•Administering of analgesics (if necessary)
•Provision of comfortable position with comfort devices.
•Periodic inspection and assessment of the surgical site.
•Maintaining of chest tube drainage with necessary precautions.
•Monitoring of child’s condition and detection of problems early.
•Prevention of infections by careful handling of the baby.
•Stimulating parent-child bondage by parental participation of child care.
•Improving knowledge by necessary health education, encouraging questions
and explaining answers.
38. Complications-
a. Recurrent pneumonia
b. Acute lung injury
c. Acute respiratory distress syndrome, lung abscess
d. Poor nutrition
e. Bronchiectasis from recurrent aspiration
f. Respiratory failure
g. Hiatal hernia
h. GERD
i. Anastomotic leak
j. Tracheomalacia
k. The major postoperative complications are-
tracheal stenosis and recurrent fistula.