its a basic introduction about Seldinger technique and Intervetional radiology.In interventional radiology, procedures generally start with the Seldinger technique to access the vasculature, using a needle through which a guidewire is inserted, followed by navigation of catheters within the vessels.
An overview of Doppler Effect in Ultrasonography - the medical imaging of the body using Ultrasound.
Includes Colour Doppler, Power Doppler, Spectral Doppler, Continuous Wave Doppler, Pulsed Wave Doppler, and comparisons with other Radiographic imaging modalities.
This presentation include biliary anatomy ,indication, contraindication post op care of percutaneus transhepatic biliary drainage with important technique. and advantage and disadvantage of different technique. This is important for radiologist, radiographers, intervention radiologist radiology resident. Thanks
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
An overview of Doppler Effect in Ultrasonography - the medical imaging of the body using Ultrasound.
Includes Colour Doppler, Power Doppler, Spectral Doppler, Continuous Wave Doppler, Pulsed Wave Doppler, and comparisons with other Radiographic imaging modalities.
This presentation include biliary anatomy ,indication, contraindication post op care of percutaneus transhepatic biliary drainage with important technique. and advantage and disadvantage of different technique. This is important for radiologist, radiographers, intervention radiologist radiology resident. Thanks
This presentation provides sufficient material for anyone who wants is interested in interventional radiology. Here we will discuss the available facilities, mechanisms and equipments.
In my opinion this presentation will prove a footstep in interventional radiology
Starting with the Definition, Coverage of field, Seldinger technique, Instruments used in IR we move forward into the embolization Techniques and applications, IR procedures in hepatobiliary system, Portal hypertension, Varicose veins
and lastly RFA for bone tumors like ostoid osteoma
Basics of laproscopic surgery..
by dr navdeep s kamboj presented at sgrdumsar amritsar.
topics covered--
1 basics of laparoscopy
2 lap cholecystectomy
3 lap appendixcectomy
pneumoperitonem
merits and demerits of laproscopy
ligasure
endoscopy,
laparoscopic instruments
Radiological placement is consistently more reliable than surgical placement. There are fewer placement complications and fewer catheter infections overall.
It is convenient for the patient, quick, time saving, and cost effective
Interventional radiologists
placement and
management
research and development of hemodialysis catheters
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
SELDINGER TECHNIQUE & INTERVENTIONAL RADIOLOGY
1. M K RIYAS Dip RT,BMIT ,PGDHM
MEDICAL IMAGING TECH.
AIMS
2. What is Seldinger
technique?
Seldinger technique is the medical procedure to obtain
safe access to the blood vessel and other hollow
organs……
3. HISTORY……..
IN 1953, SVEN IVAR SELDINGER PUBLISHED A METHOD
FOR PERCUTANEOUS ARTERIAL CATHETERISTION THAT
OPENED THE DOORS TO THE FIELD OF ANGIOGRAPHY
& INTERVENTIONAL RADIOLOGY
4. Seldinger technique for introducing
catheters
This technique allows entry into an area without a
cut down and because small gauge needles are used .
There is minimal trauma to surrounding tissues.
Less pain and faster recovery
7. Stabilize needle.
Stabilize needle with the other hand
to prevent it from dislodging .
Advance wire into vessel
8. Remove needle and wire cover.
The guide wire needs to be securely held during the
procedure to limit further advancement into the
vessel.
9. cont……
Advanced dilator over the wire 1 to 1 half inches into
the insertion point and rotate back and forth . Remove
dilator.
Advanced sheath/ catheter over the guide wire into the
vessel
Remove guide wire . Flush and secure catheter to skin
with sutures..
Wrap to provide additional stabilization
10. *Seldinger needle
Mostly used 18 gauge angiographic needle
Guide wire is introduced directly through the needle
11. *Guide wire
It’s a long and flexible ,fine metal wire.
They are the stainless steel metallic structures that
guides the catheter through the blood vessels for
placements.
Guide wires are used for interventional procedures
Tips at the end of GW
Straight
J- tipped -prevents subintimal dissection of
artery.
Covered by a coating- teflon , heparin and recently
hydrophilic polymers(glide wires) are used
12.
13. *Catheter
Catheter is a tubular, thin ,flexible instrument
It can be inserted into a body cavity, duct or vessel.
Functionally ,they allow drainage , administration
of fluid or gases, access by surgical instruments
diameter is given in French(Fr)—3Fr=1mm
14. types
Straight- end hole only—
smaller vessels/minimal
contrast.
Pigtail- circular tip with
multiple side holes —larger
vessels/ more contrast.
H1 or Head hunter tip– used
for femoral approach to
brachiocephalic vessels.
15. Simmons catheter is highly curved ---
for sharply angled vessels--cerebral
and visceral angiography.
C2 or Cobra catheter has angled tip
joined to a gentle curve—celiac, renal
& mesenteric arteries.
Judkins catheters
Right(lesser curve) & left(greater
curve) for right & left coronary
arteries.
Amplatz catheters
Right & left coronary arteries
17. Catheterization method of
percutaneous femoral
Puncturing of femoral artery is the
most common catheterization
approach.
It is easily accessible and is Fairly large
The Seldinger technique is used for
catheterization of the vessel.
The best entry level is at the apex of
the femoral arch.
Introducing the needle above the arch
result in missing the artery..
18. Cont….
The femoral approach is indicated in studies of
pathologic conditions are
Lower extremities
Pelvic area
Thoracic aorta and coronary
Abdominal aorta and branches
Head and neck angiography
19. Other sites…
Brachial approach
Artery is punctured just above the elbow
reducing the risk of damaging the brachial plexus
Radial approach
Arterial point at the point of maximum
pulsation, near the styloid process
20. Risks/ Complications
Bleeding at puncture site
Thrombus formation
Embolus formation –plaque dislodged from vessel wall
by catheter
Dissection of vessel
Puncture site infection ( contaminated sterile field)
Contrast reaction
21.
22. What is interventional procedures
In medicine, an intervention is usually undertaken to
help treat or cure a condition
23. INTERVENTIONAL RADIOLOGY (IR)
Also known as Vascular and Interventional Radiology
(VIR) or Surgical Radiology
A subspecialty which provide minimally invasive
techniques with the help of imaging modalities to
diagnose or treat a condition
26. ANGIOGRAM
Imaging the blood vessels to look for abnormalities
with the various contrast media
HISTORY
The first angiogram was performed only months after
Roentgen's discovery of X rays.
Two physicians injected mercury salts into an amputated
hand and created an image of the arteries
Post mortem injection of mercury salts in
Jan,1896.
27. ANGIOPLASTY
Opening of narrow or blood
vessels using a balloon, may
include placement of metallic
stents as well
28. ABLATION
Radiofrequency ablation
(RF/RFA)
localized destruction of
tissue (e.g., tumours ) by
heating
Cryoablation
localized destruction of
tissue by freezing
Microwave ablation
localized destruction of
tissue by heating
29. ANEURISM
Aneurism is a localized , blood filled balloon like bulge
in the wall of blood vessels. Aneurism can occur in any
blood vessels
Minimally invasive techniques have been developed
for many types of aneurism.
30. BIOPSY
Taking a tissue sample from the area of interest for
pathological examination from a percutaneous
approach
31. CHOLECYSTOSTOMY
Placement of a tube into the gallbladder to remove
infected bile in patients with cholecystitis: an
inflammation of gallbladder , who are too frail or too
sick to undergo surgery
32. DRAIN INSERTIONS
Placements of tubes into different parts of the body to
drain fluids (e.g. abscess drain to remove pus, pleural
drains)
33. EMBOLISATION
Embolisation is a way of blocking abnormal blood
vessels(to stop the extra function).
Various substances can be used to block the blood
vessels, including medical glue, medical putty, tiny
metal coils or plastic beads.
41. IR SUIT
Specifically designed to accommodate the
quantity of equipment needed & the large
number of people involved in the
procedure.
Personnel in the IR room
Interventional Radiologist ( or other specialist)
Radiologic Technologists
Nurse
Sometimes Anesthesiologist depending on the
procedure
42. Prepare Room/ consent forms
Provide radiographic positioning /Dr
assistance
Knowledge of exam, anatomy, pathology
Prepare sterile tray, prep patient
Knowledge of catheters and guide wires
Know sterile technique/ safe clean up
Monitor ECG + pressure
Patient care skills and pharmacology
44. Melvin P. Judkins M.D. (1922-1985)
A pioneer Radiologist
whose techniques are
still used today in
coronary Angiography
45. Charles T. Dotter M.D. (1920-1985)
Interventional Radiologist
Pioneer in the Field of
Minimally Invasive
Procedures (Catheterization)
Developed Continuous X-Ray
Angio-Cardiography
Performed First Angioplasty
(PTCA) Procedure in 1964.
46. “If a plumber
can do it to
pipes, we can
do it to blood
vessels.”
Charles T. Dotter M.D.
Editor's Notes
The key hole of the interventional procedure…..
He was born on 19th April 1921 in Sweden. Specialized in radiology .
Less pain ,faster recovery ,less complication ,better out comes
Prepare the puncture site shave, drape the site ,local anesthesia (Site cleaned, area draped, local given
) ..30 -45 degree needle angulations…18 G needle
Intervetional procedures ,that are int radio,uro,cardio
Femoral artery is generally most frequent… Axillary area also choose to introduce catheter.
The left brachial artery approach is primarily employed in the study of the left vertebral artery. The basilar artery and the posterior fosse
The right brachial approach is the most useful examination of the right vertebral artery, the basilar artery.
*Fluoroscopy and ct use ionizing radiation ..adv its more fast and geometrically accurate
*Ultrasound is frequently used to guide needles during vascular access and drainage..its offer real-time feedback and inexpensive. Difficult to see some areas and limited penetration power
*MRI provides superior tissue contrast but cost of being expensive and requiring specialized equipments…that z…
including iodinated contrast, gadolinium based agent, CO2
Ablation is removal of a body part or tissue
Transjugular approach
Chemoembolization : delivering cancer treatment directly to a tumour through its blood supply
Radioembolization : embolization of tumour with radio active microspheres of glass or plastic , to kill tumous while minimizing expossure to healthy cells
Usually done in lumbar vertebrae
Should be take consent prior the procedure…
*reduce the radiation dose