1. The document discusses snake bites in Indonesia, which remain a neglected tropical disease. It notes that venomous snakes are found widely across different habitats in Indonesia.
2. Data on snake bites in Indonesia is dispersed across different hospitals and health centers and has not been fully collected into a centralized database. Preliminary data from one region of East Java from 2015-2016 showed 148 snake bite cases.
3. Effective treatment of snake bites requires proper first aid, transportation to medical facilities, management at health centers and hospitals, increased public awareness, physical and mental recovery support, and government support. Collaboration between doctors and herpetologists is important for snake identification and antivenom selection.
Dokumen tersebut membahas update manajemen gigitan ular di Indonesia, mencakup biodiversitas ular di Indonesia, data insiden gigitan ular, pengertian tentang ular, habitat ular, jenis ular berbisa dan tidak berbisa di Indonesia, gejala dan penatalaksanaan gigitan ular, serta racun-racun lain seperti racun ikan dan hymenoptera."
FAST (Focused Assessment with Sonography for Trauma) adalah pemeriksaan USG serial untuk mendeteksi cairan atau udara di area anatomis tertentu seperti perikardium, ruang pleura, dan kantung Morisson untuk mendiagnosis keadaan pasien trauma. Lokasi yang diperiksa meliputi subkostal, kanan atas kuadran, kiri atas kuadran, suprapubik, dan dada kanan-kiri. Temuan abnormal seperti efusi pericardium, hemoperitoneum, dan hemothoraks
This document provides guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care that are current until October 2020. After this date, an updated document should be requested from the listed organization. It also contains information on diagnosing and treating tachycardia, including appropriate doses of medications like adenosine and cardioversion procedures. Recommendations are provided for evaluating and managing stable or unstable rhythms based on factors like heart rate, blood pressure, pulse, and mental status.
This document provides an overview of snake bites in tropical countries. It discusses the types of snakes that cause bites, including cobras, kraits, sea snakes, and various pit vipers. It describes the local and systemic effects of snake venom, which can include bleeding, swelling, pain, nausea, paralysis, kidney injury, and cardiac arrest. Treatment involves identifying the snake species, examining the patient, providing antivenom immunotherapy, and managing complications. Laboratory tests and grading scales help determine antivenom dosage and monitor treatment progress.
Dokumen tersebut membahas update manajemen gigitan ular di Indonesia, mencakup biodiversitas ular di Indonesia, data insiden gigitan ular, pengertian tentang ular, habitat ular, jenis ular berbisa dan tidak berbisa di Indonesia, gejala dan penatalaksanaan gigitan ular, serta racun-racun lain seperti racun ikan dan hymenoptera."
FAST (Focused Assessment with Sonography for Trauma) adalah pemeriksaan USG serial untuk mendeteksi cairan atau udara di area anatomis tertentu seperti perikardium, ruang pleura, dan kantung Morisson untuk mendiagnosis keadaan pasien trauma. Lokasi yang diperiksa meliputi subkostal, kanan atas kuadran, kiri atas kuadran, suprapubik, dan dada kanan-kiri. Temuan abnormal seperti efusi pericardium, hemoperitoneum, dan hemothoraks
This document provides guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care that are current until October 2020. After this date, an updated document should be requested from the listed organization. It also contains information on diagnosing and treating tachycardia, including appropriate doses of medications like adenosine and cardioversion procedures. Recommendations are provided for evaluating and managing stable or unstable rhythms based on factors like heart rate, blood pressure, pulse, and mental status.
This document provides an overview of snake bites in tropical countries. It discusses the types of snakes that cause bites, including cobras, kraits, sea snakes, and various pit vipers. It describes the local and systemic effects of snake venom, which can include bleeding, swelling, pain, nausea, paralysis, kidney injury, and cardiac arrest. Treatment involves identifying the snake species, examining the patient, providing antivenom immunotherapy, and managing complications. Laboratory tests and grading scales help determine antivenom dosage and monitor treatment progress.
Dokumen tersebut membahas tentang krisis hipertensi atau hipertensi emergensi, yaitu peningkatan tekanan darah yang mendadak pada penderita hipertensi yang membutuhkan penanganan segera. Dokumen tersebut menjelaskan klasifikasi, gejala, faktor risiko, pendekatan awal, diagnosis, dan penatalaksanaan krisis hipertensi secara singkat.
Resusitasi cairan dan elektrolit membahas tentang resusitasi cairan pada pasien perdarahan akut dan dehidrasi, termasuk pilihan cairan, algoritme resusitasi, dan penilaian status volume darah."
Hernia adalah kelainan dimana organ atau jaringan menonjol melalui celah pada dinding yang mengelilinginya. Hernia paling sering terjadi pada dinding perut, terutama di area inggu, paha, dan pusar. Hernia dibagi berdasarkan etiologi, penampakan, lokasi anatomi, sifat, dan klinis. Pemeriksaan hernia meliputi inspeksi, palpasi, dan manuver-manuver seperti Valsalva. Tatalaksana hernia mel
Kolitis adalah peradangan kolon yang ditandai dengan diare berdarah, nyeri perut, dan demam. Diagnosis didasarkan pada riwayat medis, pemeriksaan fisik, dan tes radiologi seperti foto colon in loop yang menunjukkan penyempitan kolon. Penyakit ini tidak dapat disembuhkan dan pengobatannya meliputi sulfasalazine, kortikosteroid, dan imunosupresan.
Laporan ini memberikan ringkasan hasil tutorial modul 1 tentang luka/trauma yang dilakukan oleh kelompok 8. Laporan tersebut menjelaskan deskripsi luka akibat tembakan yang ditemukan pada pasien, patomekanisme terjadinya luka tembak, serta pendekatan proximus morbus untuk mengungkap penyebab luka.
Bab 3 membahas anatomi dasar yang terlihat dalam gambar radiologi seperti thoraks yang menampilkan paru-paru, jantung, tulang rusuk, trakea, dan aorta."
Tatalaksana Gagal Jantung Akut ( Acute Heart Failure Update)Isman Firdaus
Dr. Isman Firdaus memiliki berbagai spesialisasi kardiologi dan pengalaman kerja sebagai konsultan kardiologi intensif di beberapa rumah sakit. Dokumen ini membahas tentang gagal jantung akut, meliputi definisi, patofisiologi, faktor pemicu, gejala klinis, penilaian profil hemodinamik, dan algoritme penatalaksanaan cepat.
ugas Radiologi
Dibuat oleh : Fransiska Lumempouw
Stase Kepaniteraan Klinik Radiologi
Universitas Kristen Indonesia
untuk bahan bacaan dan referensi tugas
Hipoglikemi merupakan salah satu komplikasi dari DM, hal ini perlu diwaspadai oleh setiap orang khususnya penderita DM. Perlu kita ketahui dan pahami bagaimana untuk menanganinya supaya tidak sampai menyebabkan kematian.
Snakebite is a major public health issue, causing over 100,000 deaths worldwide each year. India accounts for nearly half of snakebite deaths globally, with the highest numbers occurring in rural areas. The "Big Four" venomous snakes that cause the majority of bites in India are the common krait, Indian cobra, Russell's viper, and saw-scaled viper. Proper first aid and timely administration of antivenom are critical to reducing mortality. Symptoms of envenoming depend on the snake species and amount of venom injected, and may include local tissue damage, bleeding disorders, organ dysfunction and systemic effects. Diagnosis involves examining the bite site and signs/symptoms, and lab tests can
- Poisoning is an important cause of morbidity and mortality in India, though exact estimates are not available. Hospital studies show up to 10% of admissions are due to poisoning.
- Common poisons in India include organophosphates and carbamates (50% of poisonings) as well as other compounds like medications and industrial chemicals.
- Accurate history regarding type and amount of poison ingested is important for proper management, which generally involves decontamination, supportive care, and antidotes when available. Prevention focuses on education and addressing social factors contributing to suicidal attempts.
Dokumen tersebut membahas tentang krisis hipertensi atau hipertensi emergensi, yaitu peningkatan tekanan darah yang mendadak pada penderita hipertensi yang membutuhkan penanganan segera. Dokumen tersebut menjelaskan klasifikasi, gejala, faktor risiko, pendekatan awal, diagnosis, dan penatalaksanaan krisis hipertensi secara singkat.
Resusitasi cairan dan elektrolit membahas tentang resusitasi cairan pada pasien perdarahan akut dan dehidrasi, termasuk pilihan cairan, algoritme resusitasi, dan penilaian status volume darah."
Hernia adalah kelainan dimana organ atau jaringan menonjol melalui celah pada dinding yang mengelilinginya. Hernia paling sering terjadi pada dinding perut, terutama di area inggu, paha, dan pusar. Hernia dibagi berdasarkan etiologi, penampakan, lokasi anatomi, sifat, dan klinis. Pemeriksaan hernia meliputi inspeksi, palpasi, dan manuver-manuver seperti Valsalva. Tatalaksana hernia mel
Kolitis adalah peradangan kolon yang ditandai dengan diare berdarah, nyeri perut, dan demam. Diagnosis didasarkan pada riwayat medis, pemeriksaan fisik, dan tes radiologi seperti foto colon in loop yang menunjukkan penyempitan kolon. Penyakit ini tidak dapat disembuhkan dan pengobatannya meliputi sulfasalazine, kortikosteroid, dan imunosupresan.
Laporan ini memberikan ringkasan hasil tutorial modul 1 tentang luka/trauma yang dilakukan oleh kelompok 8. Laporan tersebut menjelaskan deskripsi luka akibat tembakan yang ditemukan pada pasien, patomekanisme terjadinya luka tembak, serta pendekatan proximus morbus untuk mengungkap penyebab luka.
Bab 3 membahas anatomi dasar yang terlihat dalam gambar radiologi seperti thoraks yang menampilkan paru-paru, jantung, tulang rusuk, trakea, dan aorta."
Tatalaksana Gagal Jantung Akut ( Acute Heart Failure Update)Isman Firdaus
Dr. Isman Firdaus memiliki berbagai spesialisasi kardiologi dan pengalaman kerja sebagai konsultan kardiologi intensif di beberapa rumah sakit. Dokumen ini membahas tentang gagal jantung akut, meliputi definisi, patofisiologi, faktor pemicu, gejala klinis, penilaian profil hemodinamik, dan algoritme penatalaksanaan cepat.
ugas Radiologi
Dibuat oleh : Fransiska Lumempouw
Stase Kepaniteraan Klinik Radiologi
Universitas Kristen Indonesia
untuk bahan bacaan dan referensi tugas
Hipoglikemi merupakan salah satu komplikasi dari DM, hal ini perlu diwaspadai oleh setiap orang khususnya penderita DM. Perlu kita ketahui dan pahami bagaimana untuk menanganinya supaya tidak sampai menyebabkan kematian.
Snakebite is a major public health issue, causing over 100,000 deaths worldwide each year. India accounts for nearly half of snakebite deaths globally, with the highest numbers occurring in rural areas. The "Big Four" venomous snakes that cause the majority of bites in India are the common krait, Indian cobra, Russell's viper, and saw-scaled viper. Proper first aid and timely administration of antivenom are critical to reducing mortality. Symptoms of envenoming depend on the snake species and amount of venom injected, and may include local tissue damage, bleeding disorders, organ dysfunction and systemic effects. Diagnosis involves examining the bite site and signs/symptoms, and lab tests can
- Poisoning is an important cause of morbidity and mortality in India, though exact estimates are not available. Hospital studies show up to 10% of admissions are due to poisoning.
- Common poisons in India include organophosphates and carbamates (50% of poisonings) as well as other compounds like medications and industrial chemicals.
- Accurate history regarding type and amount of poison ingested is important for proper management, which generally involves decontamination, supportive care, and antidotes when available. Prevention focuses on education and addressing social factors contributing to suicidal attempts.
This document provides information on snake bites in India. It discusses the epidemiology of snake bites, classification of venomous and non-venomous snakes, common venomous snakes in India, clinical features of envenomation, grading of severity, first aid, diagnosis, investigations, treatment with anti-snake venom, and management of anti-snake venom reactions. Key points include that the most common sites of snake bites are the lower limbs, the clinical effects depend on whether the snake is neurotoxic like cobras or haemotoxic like vipers, and treatment involves administration of anti-snake venom according to clinical criteria and symptoms.
This document presents a case study of a 7-year-old boy who was bitten by a snake on his left foot. He experienced swelling and pain that progressed up his left leg. He was initially treated with IV fluids, analgesics, and antivenom at a local hospital before being referred for possible antivenom allergy.
On examination, he had swelling up to his knee with tenderness and blebs. Investigations showed elevated white blood cell count. He developed worsening swelling and pus, and was diagnosed with necrotizing fasciitis. He underwent wound debridement and antibiotics were changed. Cultures grew Klebsiella pneumoniae. He was treated surgically and with antibiotics.
It has been prepared according to national guideline on snake bite management in Bangladesh. It would be very much helpful for health care professionals working in Bangladesh
This document discusses snake venom poisoning and its management. It begins by classifying snakes and identifying the 5 families that contain venomous species. It then describes the differences between poisonous and non-poisonous snakes. The document outlines the components of snake venom and their effects. Signs and symptoms of envenomation are provided for different snake families. Diagnosis involves identifying the snake species based on symptoms, circumstances, or antigen detection. Treatment primarily involves administering antivenom, with dosages varying based on severity of symptoms. Adjuvant treatments like neostigmine may also be used depending on the neurotoxin involved.
Scrub typhus is a bacterial infection caused by Orientia tsutsugamushi that is transmitted by chigger bites. It is estimated to cause one million cases and 10% fatalities annually, mainly in Asia and northern Australia. Common symptoms include abrupt high fever with headache and rash. Complications can include meningitis, pneumonia, renal failure and multi-organ dysfunction. Diagnosis is by serology, PCR or culture. Doxycycline or azithromycin are effective treatments. Prevention focuses on controlling rodents, insecticide spraying, and avoiding chigger bites by protective clothing and tick checks. No vaccine currently exists but research is being done on protein subunit candidates. Scrub typhus remains underreported globally
4.Management of IHPS and Intussusception.pptxmekuriatadesse
This document discusses two pediatric surgical conditions: hypertrophic pyloric stenosis and intussusception.
For hypertrophic pyloric stenosis, it provides details on the etiology, risk factors, diagnosis using ultrasound, and surgical treatment via pyloromyotomy. Intussusception is described as the invagination of the bowel where the proximal bowel telescopes into the distal bowel. It discusses the pathophysiology involving compression of blood vessels which can lead to ischemia if not treated. Types of intussusception and treatment involving surgery or enema are also outlined.
This document summarizes information about snake bites in Malaysia. It presents 3 case studies of patients who were bitten by snakes and describes their symptoms, treatment, and outcomes. It also identifies the 5 genera of venomous snakes in Malaysia, describes their physical characteristics and venom effects. The pathological effects of different snake venoms are explained. Guidelines are provided for first aid treatment, grading of envenomation severity, anti-venom dosage, and supportive hospital care for snake bite patients.
This document provides information on experimental pharmacology and the use of laboratory animals. It discusses several common laboratory animal species - mice, rats, guinea pigs, and rabbits - including their characteristics, housing, feeding, and experimental uses. Methods of euthanasia are also covered, outlining both chemical and physical approaches. The key points are that experimental pharmacology involves testing drugs on laboratory animals while ensuring humane treatment, and that the choice of euthanasia method depends on providing a painless and reliable death.
This document provides information about rabies, including:
- Rabies is a fatal viral disease transmitted through the bites or scratches of infected animals. It affects over 150 countries worldwide.
- Dogs are responsible for transmitting rabies to humans in 99% of cases. India has the highest rabies burden with 20,000 deaths annually.
- Post-exposure prophylaxis including wound cleansing, rabies immunoglobulin, and vaccination is highly effective in preventing rabies if administered promptly after exposure. Pre-exposure vaccination is recommended for at-risk groups. Rabies remains virtually 100% fatal if left untreated.
This document summarizes information about snake bites in India. It notes that there are 216 snake species in India, 52 of which are poisonous, belonging to 4 families. It then describes the clinical features and symptoms of bites from different snake families, including local effects, systemic effects on organs like the heart and kidneys, and unusual late manifestations. The document outlines evaluation and management of snake bites, including first aid, antivenom therapy, and monitoring for signs of envenomation.
Snakes and scorpions can inject venom through bites or stings that is dangerous and sometimes fatal. There are over 50,000 deaths from snake bites worldwide each year. Venoms vary and can be neurotoxic, vasculotoxic, or myotoxic. Immediate medical help is needed for bites. Scorpion venom can also be neurotoxic or haemolytic, causing local or systemic effects like paralysis, cardiac issues, or death in severe cases. Treatment involves immobilization, antivenom, supportive care, and monitoring for complications.
Snake bites are a major public health issue in rural India, with over 100,000 envenomations reported annually. The most common poisonous snakes in India include cobras, kraits, Russell's vipers, saw-scaled vipers, and hump-nosed vipers. Effective first aid and treatment involves immobilizing the bitten area, seeking prompt medical care, diagnosing envenomation symptoms, and administering antivenom as needed to counteract the effects of snake venom.
This document provides information on various pediatric medical instruments and procedures. It describes the indications, contraindications, complications and steps for performing lumbar punctures, bone marrow aspirations, liver biopsies, nasogastric/feeding tubes, suction tubes, scalp vein needles, Ambu bags, bag valve masks, Guedel airways, and laryngoscopes. Key details are provided for each instrument/procedure including appropriate sizes, positioning, sterile technique, and monitoring for complications.
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
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
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).
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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.
2. • WHO 2010 kasus negleted ,2016 masih tetap negleted
Ular berbisa tersebar sangat luas mulai dari laut, darat (dataran
rendah sampai dataran tinggi). Luasnya daerah distribusinya membuta
ular teradaptasi dengan sempurna pada habitatnya.
Variasi habitat, pakan dan persebaran geografi memperlihatkan
perbedaan komposisi racun mereka.
Setiap ular berbisa memiliki karakter bisa yang khas, sehingga antibisa
ular yang digunakanpun juga harus khusus.
4. Indonesia mempunyai kasus yang sangat banyak untuk gigitan ular berbisa.
Namun demikian data tersebut tersebar diseluarh rumah sakit dan puskesmas di seluruh
Indonesia.
Data keseluruhan belum terkumpul didalam satu sitem data base.
Data yang terkumpul (Maret 2015 – Agustus 2016) di Kabupaten Bondowoso (Jawa
Timur) saja adalah 148 kasus mulai kasus gigitan,
terdiri dari kasus gigitan Ular viper pohon Trimeresurus insularis (85 kasus),Ular weling
Bungarus candidus (5 kasus), Ular kobra Naja sputatrix (15 kasus). Ular tanah
Colleselasma rhodostoma (2 kasus), 5 kasus gigitan oleh ular tak berbisa (non venomous
snake: ular kopi Coelognathus flavolineatus dan Ular air Xenochrophis trianguligera),
dan 36 kasus gigitan yang tidak dapat diidentifikasi jenis ularnya. Selain itu, terdapat
juga 5 kejadian venom Ophthalmia (mata tersembur oleh bisa Ular kobra Naja
sputatrix) (Maharani,2016)
5.
6. • 1.lingkungan:kebun,sawah,tambang,hutan gunung,rawa
• Carana memakai APD(sandal,sepatu boot,sepattu
berlampu,lampu sener kepala,senter,tongkat,celana panjang
• 2.rumah:rumah kotor sarang tikus,katak,kandang
ayam,membersihkan tumpukan kayu,gundukan rayap,lubang di
dinding kayu,bambu ,menaa anaman bambu,perdu
• 3.pekerjaan:petani,nelayan,penari ular,snake handler,pawwang
ular,restoan menu ular,penyamak kulit ular
7.
8. WHO review 2016
Kolaborasi dokter dan herpetologi sudah
dimulai RECSINDONESIA sejak tahun
2013 sampai sekarang dalam hal
identifikasi ular
34. 1.Bengkak dan memar disebabkan karena venom yg menyebabkan
peningkatan permeabilitas vascular dan ischemia disebabkan karena trombosis
pada first aids yang salah berupa torniquet.
2.Hipotensi dan shock disebabkan hipovolemia leakage plasma dan darah
,vasodilatasi dan kerusakan myocardial
3.Oligopeptida dan vasodilatasii autocoid menyebabkan transient hipotensii
dini
4.Procoagulasi enzyym menyebabkan defibrinogenesis,DIC,coagulopathi
5.Phospolipase adalah anti coagulan
6.Platelet aktiasi atau inhibisi dan sequestrasi menebabkan trombositopeni
7.Perdarahan sistemik spontan disebabkan oleh enzym N metaloprotease
haemorrhagins
8.Complemen akivasi platelet koagulasi darah dan mediator humoral
Patofisiologi venom (WHO
review 2016)
38. Di rumah sakit
Ada antibisa ular yang siap diberikan
Kapan PBI dipakai
Jarak jauh
Ular tidak diketahui jenisnya
Neurotoksin kuat (bungarus dan sea snake)
39.
40. LOCAL
• Swelling > half bitten
limb/48 hours
• Toes especially fingers
• Rapid extension within a few
hours
• Enlarged tender lymphnode
draining the affected area
SYSTEMIC
• Haemostatic abnormality
• Neurotoxic signs
• Cardiovascular abnormalities
• Acute kidney injury
• Myoglobinuria/generalised
rhabdomyolysis/haemolysis
• Supporting lab evidence of
systemic envenoming
(A. Khaldun, 2015)
41. • HOME
• DO NOT PANIC
• DO NOT GIVE CONSTRICTING BAND (TORNIQUET), SUCKING, or OTHER
TRADITIONAL TREATMENT
• IMMOBILIZE BITTEN AREA (will be discussed)
• SEND TO PRIMARY HEALTH CARE OR EMERGENCY DEPARTMENT
• BRING DEAD OR ALIVE SPECIMENT OR SNAKE PHOTO INTO
EMERGENCY TO BE IDENTIFIED TO GIVE A SUITABLE ANTIVENOM
• PRIMARY HEALTH CARE
• DO GENERAL EXAMINATION, MAKE IT STABLE !
• EVALUATE THE IMMOBILIZATION
• GIVE IMMOBILIZATION IF NO IMMOBILIZATION BEFORE
• GIVE ANALGESIA WHEN NEEDED
• MARK THE EDEMA BY USING RPP TEST (will be discussed)
• DO NOT DO CROSS INCISION !!!!
• BRING THE PATIENT TO THE EMERGENCY DEPARTMENT
42.
43.
44.
45. • 20 minutes Whole Blood Clotting Test (20’WBCT)
• Rate Proximal Progression (RPP) Test
• Electrocardiography
• Laboratory check
• Haemoglobin
• White blood cells
• Platelet count
• Liver function test
• Renal function test
• PT
• APTT
• INR
46. • Aim : to make sure hemotoxin or not by knowing from the
coagulation.
• How to do?
• Take a glass bottle, DO NOT USE PLASTIC BOTTLE
• Take 2 ml of blood
• Then take that blood into the glass bottle
• Wait for about 20 minutes
• Repeat that test 2 times minimal
• Result :
• After waiting about 20 minutes:
• Clotting (+) : no coagulation disorder (NonHemotoxin)
• Clotting (-) : coagulation disorder (HEMOTOXIN)
47.
48. • Aim : to evaluate the edema progression to make a
best next medical treatment.
• How to do?
• Take a tape as a mark to measure the edema
• Make sure the proximal margin of the edema, then take the
distal margin of the tape into the proximal margin of the
edema.
• Note the time when the tape was given (date and time)
• Repeat the evaluation of the edema every 2 hours
• Result : cm/hour
• Example : 10/10/15 ; 09.00 – 11.00 = 4 cm. So we have
evaluated that the edema increase about 2 cm per hour.
50. Keep the Airway Breathing and Circulation stable
• Airway
• 02 Non Re-Breathing Mask 12 lpm
• Laryngeal Mask Airway and Endotracheal Tube (if needed)
• Suction if gargling (+), Head tilt and chin lift if snoring (+)
• Breathing
• Evaluate the respiratory rate
• Circulation
• Make iv access, give Normal Saline 0.9% (don’t forget to take some
blood for laboratory checking)
• Blood pressure
• Pulse
• Oxygen saturation by using pulse oxymetri
• Blood or Fresh Frozen Plasma as indicated
51. • Immobilize bitten area by using Pressure Bandaging
Immobilization
• Antivenom : DRUG OF CHOICE
• If the snake that bite the patient include in 3 snakes which are covered by
the SABU, we can give SABU quickly
• 2 vials SABU + 100 ml Normal Saline 0.9% dripped 60-80 drop per
minute
• Repeated every 6-8 hours. BE AWARE TO RE-ENVENOMATION SIGN!!!
• Symptomatic
• Analgesia : morphine (PS≥7) and paracetamol infusion or oral (PS<7)
• Antibiotic
• When indicated, example : leucocytosis
52. • Anticholinesterase drugs
• Especially for neurotoxin envenoming
• Should give atropine before giving the drugs to prevent physostigmine
intoxication.
• Physostigmine dose
• Adult (>12 yo) : 1.0-2.0 mg
• Children ≤ 12 yo : 0.02 mg/kg/dose (max single dose 0.5 mg)
• Should be given slowly 3-5 minutes by IV push
53. Presinaptik : Phosolipase A2 merusak vesikel sinaptik release
Postsinaptik:polipeptide toxin yang mengeblock acetylcholin reseptor pada
muscle end plate
Dendrotoxin:K+ channel oksin menstimulasi sehingga terjadi over release
neurotransmitter
Asciculins:anicholinesterase mengeblok normal breakdown dan recycling
neurorasmiier release
Neuromuscular
junction snake toxin
68. Any questions after this meeting? Feel free to reach Dr. dr. Tri Maharani, M.Si, Sp. EM
by phone or whatsapp 085334030409 (Telkomsel) or 08973665684 (Tri)
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