Mr. Enep, a 57-year-old male, was admitted on December 21st for grade III Patel-Joag tetanus and a puncture wound on his left plantar foot. His treatment plan includes wound cleaning and irrigation, antibiotics including ampicillin sulbactam and metronidazole, and tetanus immunoglobulin injections. He is also receiving supportive care including oxygen, IV fluids, analgesics, and monitoring of his wound healing over time.
1. The patient is a 13 day old baby boy referred for imperforate anus. Physical exam found anal dimple but no anus, undescended left testis, and greenish black urine.
2. Initial management included warm care, IV fluids, OGT and urethral catheter placement, and plans for urgent colostomy. Laboratory results were largely normal.
3. The patient underwent successful colostomy. Post-op diagnosis was anal malformation with rectourethral fistula and undescended left testis. Management continues with antibiotics and pain medications.
Laparoscopic hernia repair has become the preferred technique for bilateral hernias, femoral hernias, and recurrent hernias after open surgery. It provides benefits like less pain, faster return to normal activities, and fewer wound complications compared to open repair. However, it requires a longer operating time and has risks of visceral and vascular injuries. While recurrence rates are similar, laparoscopic repair is better for quality of life outcomes. TEP and TAPP are both effective techniques but TAPP has higher risks of complications. Mesh fixation may not be needed for inguinal hernia repair by laparoscopy. Overall, laparoscopic hernia repair is recommended for select cases by guidelines but an open approach remains appropriate
Clinical-Meeting-Microbiology: a presentation in health sciencesssuser38e71a
This document presents two case studies of patients with hydatid cysts. The first case is a 65-year-old male who presented with irregular stool habits and was found to have a large cyst in his liver on imaging. He underwent laparoscopy and drainage of the cyst. Microscopy found hooklets characteristic of Echinococcus granulosus. The second case is a 35-year-old female with a history of previous hydatid cyst surgery who presented with pain and was found to have a recurrent cyst on imaging. Both patients underwent drainage and treatment with antihelminthics. Hydatid cyst is discussed as a neglected tropical disease caused by E. granulosus that commonly involves the liver and can recur
Scoliosis surgery can lead to several respiratory, visual, bleeding, and positioning related complications under anesthesia. This document discusses prevention strategies for these complications. It recommends preoperative breathing exercises, lung protective ventilation, fluid management, and normothermia to prevent respiratory complications. Proper positioning, blood pressure control, and fluid therapy can help prevent postoperative visual loss. The use of antifibrinolytics and careful positioning can reduce bleeding risks. Monitoring of vital signs and padding pressure points can help prevent organ injuries and neural injuries from the prone position.
This document discusses the treatment of various motility disorders of the esophagus, including achalasia cardia, diffuse esophageal spasm, nutcracker esophagus, and hypertensive LES. For achalasia cardia, the standard treatment is modified Heller's cardiomyotomy with partial fundoplication to address reflux. Endoscopic pneumatic balloon dilation and Botox injections provide minor and temporary relief. For diffuse esophageal spasm, first line treatments include calcium channel blockers and nitrates, with long esophageal myotomy or POEM as surgical options. Nutcracker esophagus is typically treated medically while hypertensive LES may be treated with Botox or balloon
COVID -19 with Multiorgan dysfunction syndrome.pptxrambhoopal1
This document summarizes the medical history and treatment of a 26-year-old male patient who presented with fever, cough and breathing difficulties and was eventually admitted to the ICU. Over the course of 42 days in the hospital, the patient developed complications including severe COVID pneumonia, cellulitis, suspected neuroleptic malignant syndrome, sepsis, organ dysfunction, pancytopenia and ventilator-associated pneumonia. Despite aggressive treatment including ventilation, antibiotics and consultations with multiple specialists, the patient's condition deteriorated and he was declared dead on June 22nd.
This document discusses the importance of the anesthesiologist in ophthalmology. It outlines the monitoring standards that should be followed during eye surgery under local anesthesia, including monitoring of vital signs, oxygenation, and ventilation. It notes the risks of eye injury during anesthesia for eye surgery, such as from patient movement or complications related to the eye block. It also lists contraindications for local/regional anesthesia techniques.
1. The patient is a 13 day old baby boy referred for imperforate anus. Physical exam found anal dimple but no anus, undescended left testis, and greenish black urine.
2. Initial management included warm care, IV fluids, OGT and urethral catheter placement, and plans for urgent colostomy. Laboratory results were largely normal.
3. The patient underwent successful colostomy. Post-op diagnosis was anal malformation with rectourethral fistula and undescended left testis. Management continues with antibiotics and pain medications.
Laparoscopic hernia repair has become the preferred technique for bilateral hernias, femoral hernias, and recurrent hernias after open surgery. It provides benefits like less pain, faster return to normal activities, and fewer wound complications compared to open repair. However, it requires a longer operating time and has risks of visceral and vascular injuries. While recurrence rates are similar, laparoscopic repair is better for quality of life outcomes. TEP and TAPP are both effective techniques but TAPP has higher risks of complications. Mesh fixation may not be needed for inguinal hernia repair by laparoscopy. Overall, laparoscopic hernia repair is recommended for select cases by guidelines but an open approach remains appropriate
Clinical-Meeting-Microbiology: a presentation in health sciencesssuser38e71a
This document presents two case studies of patients with hydatid cysts. The first case is a 65-year-old male who presented with irregular stool habits and was found to have a large cyst in his liver on imaging. He underwent laparoscopy and drainage of the cyst. Microscopy found hooklets characteristic of Echinococcus granulosus. The second case is a 35-year-old female with a history of previous hydatid cyst surgery who presented with pain and was found to have a recurrent cyst on imaging. Both patients underwent drainage and treatment with antihelminthics. Hydatid cyst is discussed as a neglected tropical disease caused by E. granulosus that commonly involves the liver and can recur
Scoliosis surgery can lead to several respiratory, visual, bleeding, and positioning related complications under anesthesia. This document discusses prevention strategies for these complications. It recommends preoperative breathing exercises, lung protective ventilation, fluid management, and normothermia to prevent respiratory complications. Proper positioning, blood pressure control, and fluid therapy can help prevent postoperative visual loss. The use of antifibrinolytics and careful positioning can reduce bleeding risks. Monitoring of vital signs and padding pressure points can help prevent organ injuries and neural injuries from the prone position.
This document discusses the treatment of various motility disorders of the esophagus, including achalasia cardia, diffuse esophageal spasm, nutcracker esophagus, and hypertensive LES. For achalasia cardia, the standard treatment is modified Heller's cardiomyotomy with partial fundoplication to address reflux. Endoscopic pneumatic balloon dilation and Botox injections provide minor and temporary relief. For diffuse esophageal spasm, first line treatments include calcium channel blockers and nitrates, with long esophageal myotomy or POEM as surgical options. Nutcracker esophagus is typically treated medically while hypertensive LES may be treated with Botox or balloon
COVID -19 with Multiorgan dysfunction syndrome.pptxrambhoopal1
This document summarizes the medical history and treatment of a 26-year-old male patient who presented with fever, cough and breathing difficulties and was eventually admitted to the ICU. Over the course of 42 days in the hospital, the patient developed complications including severe COVID pneumonia, cellulitis, suspected neuroleptic malignant syndrome, sepsis, organ dysfunction, pancytopenia and ventilator-associated pneumonia. Despite aggressive treatment including ventilation, antibiotics and consultations with multiple specialists, the patient's condition deteriorated and he was declared dead on June 22nd.
This document discusses the importance of the anesthesiologist in ophthalmology. It outlines the monitoring standards that should be followed during eye surgery under local anesthesia, including monitoring of vital signs, oxygenation, and ventilation. It notes the risks of eye injury during anesthesia for eye surgery, such as from patient movement or complications related to the eye block. It also lists contraindications for local/regional anesthesia techniques.
Sedation in ophtalmology,Part presented to a Ophtalmic course in Lecce,Italy,2011.There is at the end an annotated bibliography on points of interest in ophtalmology,cataract surgery in particular.
Colonoscopy is one of the most common procedures in medicine today. This lectures covers the complications associated with colonoscopy, including the risk factors and management.
- Total ER cases were 134 with the most common being RTA (80 cases) and abdominal cases (37 cases)
- 9 operative cases were reported including exploratory laparotomy, herniorrhaphy, appendectomy, embolectomy, and amputation
- 2 cases were managed conservatively including a case of gallstone pancreatitis and a pelvic fracture
Dr. Biswajit Deka presented on endoluminal treatments for GERD. He discussed the pathophysiology of GERD and how endoluminal procedures aim to increase LES tone and length to prevent reflux. The main endoluminal procedures covered were EsophyX which creates an incisionless fundoplication, Stretta which uses RF to remodel the LES, MUSE which creates a partial fundoplication with staples, and injections or mucosal excision techniques. Complications were generally minor but include bleeding, perforation, and pain. Endoluminal GERD treatments are promising but still developing compared to anti-reflux
A 35-year-old male presented with a left inguinal hernia. Examination and imaging confirmed a left inguinal hernia with omental fat as the content. The patient underwent a left hernioplasty surgery under spinal anesthesia. Post-operatively, the patient was treated with antibiotics and analgesics. By post-operative day 3, the patient had no complaints and was discharged on medications including antibiotics and supplements.
This document discusses regeneration in endodontics, including regeneration in animals and mythology, as well as regenerative endodontic procedures. Regenerative endodontics aims to replace missing or diseased pulp through the creation and delivery of new tissues. The key steps in regenerative endodontic procedures are accessing and cleaning the root canal, placing an intracanal medicament like calcium hydroxide or triple antibiotic paste, and intentionally inducing bleeding in the canal to form a blood clot and begin regeneration. Several case studies demonstrate positive outcomes from regenerative endodontic procedures, with teeth responding positively to cold tests and showing continued root development. However, challenges remain in ensuring sufficient microbiological control and avoiding uncontrolled regeneration.
This document discusses various types of dialysis for children including acute peritoneal dialysis, chronic peritoneal dialysis (CAPD and CCPD), hemodialysis, and CAVH-CVVH. It provides details on procedures, complications, nursing care, training programs, and prevention of infections for pediatric dialysis patients. The goal of home dialysis programs is to allow children to receive treatment at home while maintaining a normal lifestyle with minimal hospitalizations. Strict adherence to infection control measures is important to prevent the spread of endemic infections.
- A 6-year-old female patient presented with headache after a traffic accident where her head hit the pavement. On examination, she had a 3cm cephalhematoma and 2x1cm wound on her left parietal region.
- Imaging showed an epidural hematoma and depressed skull fracture in the left parietal region. Her GCS was 15/15.
- The working diagnosis was mild head injury, left parietal epidural hematoma, and depressed skull fracture. The plan was for craniotomy for hematoma evacuation and reconstruction of the depressed fracture.
The document discusses enhanced recovery after surgery (ERAS) programs. It describes how ERAS utilizes a multimodal approach involving surgeons, nurses, dietitians and others to optimize patient care and recovery through measures like preoperative counseling and nutrition, minimal invasive surgery when possible, reduced use of tubes/drains, early mobilization and feeding, and well-managed postoperative pain control. The goal is to reduce length of stay without increasing complications through evidence-based practices compared to traditional postoperative care methods. Studies show ERAS programs can achieve these outcomes safely and cost-effectively across several surgery types.
This document discusses septic arthritis, including:
- It is an infection and inflammation of the synovial joint cavity that can be caused by bacterial infection entering through the bloodstream.
- Common sites are the knee and hip. Staphylococcus aureus is a common cause.
- Presentation includes acute pain, swelling and restricted movement of the infected joint. Blood tests may show elevated inflammatory markers.
- Diagnosis involves synovial fluid analysis which in septic arthritis will show purulent fluid with a high white blood cell count on microscopy.
- Treatment involves antibiotics along with surgical drainage if needed. Prognosis depends on early diagnosis and treatment to prevent joint damage.
1. Septic arthritis, or bacterial infection of a joint, can occur when bacteria enters the synovial joint space, causing inflammation and purulent effusion. Common causes include Staphylococcus aureus and streptococcal infections.
2. Risk factors include advanced age, diabetes, prosthetic joints or recent joint surgery, and immunocompromised states. Presentation involves acute joint pain, swelling, warmth, and restricted movement. Diagnosis is confirmed by synovial fluid analysis showing purulent fluid with over 50,000 WBCs/mm3.
3. Treatment involves intravenous antibiotics for 2-4 weeks based on causative organism, along with surgical drainage if needed. Outcomes depend on
The weekly report summarizes the emergency patients received from February 23rd to March 8th 2022, including the date, attending doctor, new patients, and consultations. A total of 31 patients were seen over the two week period, with doctors dr. Siska, dr. Ida Ayu Ary Pramita, and dr. Ni Made Ayu Surasmiati seeing the most new patients. The report provides details of each patient's symptoms, examination findings, treatment plan and follow up care.
Therapeutic endoscopy is used in GI surgery to directly examine and treat problems in the digestive tract. It allows diagnosis and treatment without invasive surgery. Common therapeutic endoscopic procedures described include hemostasis for bleeding ulcers or varices, polypectomy, stricture dilation, stent placement, and debridement for conditions like achalasia. New techniques under development include natural orifice transluminal endoscopic surgery (NOTES) to perform surgical procedures without external incisions by entering through natural openings. Therapeutic endoscopy provides minimally invasive options for many GI conditions.
This document discusses emerging technologies in wound care, focusing on hyperbaric oxygen therapy, advanced cell-based therapies using mesenchymal stem cells and bioengineered skin substitutes, and intermittent pneumatic compression devices. It reviews evidence that hyperbaric oxygen therapy significantly increases wound healing rates compared to placebo treatment. New cell-based therapies utilize fibroblasts, keratinocytes, and mesenchymal stem cells from sources like bone marrow and amniotic membrane to reduce inflammation and promote proliferation, angiogenesis, and collagen deposition. Intermittent pneumatic compression enhances lymphatic return, arterial perfusion, and oxygen delivery to wounds.
This document summarizes a case presentation of a 74-year-old Thai female patient undergoing peritoneal dialysis who presented with increasing fatigue. Her peritoneal dialysis prescription was adjusted and tests revealed a left pleural effusion. Further imaging with nuclear scintigraphy confirmed omental wrapping around the peritoneal catheter. The patient was temporarily switched to hemodialysis and underwent catheter revision surgery. The importance of proper peritoneal catheter placement and design is discussed to reduce complications.
A 25 year old female presented with a burst abdomen 14 days post-LSCS. Predisposing factors for burst abdomen include wound infection and early stitch removal. Treatment options include immediate re-suture with deep retention sutures and broad spectrum antibiotics to address any infection, leaving the skin open if severe sepsis is present.
- A young male patient presented with mild blurring of vision and redness in the right eye, which was initially suspected to be glaucoma. However, further examination revealed proptosis, dilated episcleral vessels, and a bruit heard on auscultation of the orbit, leading to a provisional diagnosis of carotid cavernous fistula. Imaging including MRI/MRA and cerebral angiography confirmed the diagnosis. The patient was treated with endovascular embolization, which resolved his symptoms and signs including the intractable glaucoma. Carotid cavernous fistulas are rare but can be misdiagnosed if not considered, so a high index of suspicion is needed for
a presentation on few patients with gynaecological malignancy. presented on September 2022. This presentation contains with diagnosis ,investigation, management (both surgical & medical ).
This document discusses laparoscopic appendectomy techniques and results from United Family Intermed Hospital and Gurvan Gal Hospital. It begins with a brief introduction of laparoscopic appendectomy history and the key steps of the procedure. It then summarizes results from 101 patients, noting common appendicitis types, low complication rates, and short hospital stays. It concludes with a literature review comparing laparoscopic and open appendectomy outcomes, risks for obese patients, and emerging minimally invasive techniques.
A Review on Recent Advances of Packaging in Food IndustryPriyankaKilaniya
Effective food packaging provides number of purposes. It functions as a container to hold and transport the food product, as well as a barrier to protect the food from outside contamination such as water, light, odours, bacteria, dust, and mechanical damage by maintaining the food quality. The package may also include barriers to keep the product's moisture content or gas composition consistent. Furthermore, convenience is vital role in packaging, and the desire for quick opening, dispensing, and resealing packages that maintain product quality until fully consumed is increasing. To facilitate trading, encourage sales, and inform on content and nutritional attributes, the packaging must be communicative. For storage of food there is huge scope for modified atmosphere packaging, intelligent packaging, active packaging, and controlled atmosphere packaging. Active packaging has a variety of uses, including carbon dioxide absorbers and emitters, oxygen scavengers, antimicrobials, and moisture control agents. Smart packaging is another term for intelligent packaging. Edible packaging, self-cooling and self-heating packaging, micro packaging, and water-soluble packaging are some of the advancements in package material.
Smoking as a preservation and processing method for food, Food preservation, food processing, smoking, meat and meat products, methods of food smoking, application, cold smoking, hot smoking, warm smoking, liquid smoking, food industry and business, offset smokers, upright drum smokers, Vertical water smokers, Propane smokers, Electrical smokers and related health concerns.
Sedation in ophtalmology,Part presented to a Ophtalmic course in Lecce,Italy,2011.There is at the end an annotated bibliography on points of interest in ophtalmology,cataract surgery in particular.
Colonoscopy is one of the most common procedures in medicine today. This lectures covers the complications associated with colonoscopy, including the risk factors and management.
- Total ER cases were 134 with the most common being RTA (80 cases) and abdominal cases (37 cases)
- 9 operative cases were reported including exploratory laparotomy, herniorrhaphy, appendectomy, embolectomy, and amputation
- 2 cases were managed conservatively including a case of gallstone pancreatitis and a pelvic fracture
Dr. Biswajit Deka presented on endoluminal treatments for GERD. He discussed the pathophysiology of GERD and how endoluminal procedures aim to increase LES tone and length to prevent reflux. The main endoluminal procedures covered were EsophyX which creates an incisionless fundoplication, Stretta which uses RF to remodel the LES, MUSE which creates a partial fundoplication with staples, and injections or mucosal excision techniques. Complications were generally minor but include bleeding, perforation, and pain. Endoluminal GERD treatments are promising but still developing compared to anti-reflux
A 35-year-old male presented with a left inguinal hernia. Examination and imaging confirmed a left inguinal hernia with omental fat as the content. The patient underwent a left hernioplasty surgery under spinal anesthesia. Post-operatively, the patient was treated with antibiotics and analgesics. By post-operative day 3, the patient had no complaints and was discharged on medications including antibiotics and supplements.
This document discusses regeneration in endodontics, including regeneration in animals and mythology, as well as regenerative endodontic procedures. Regenerative endodontics aims to replace missing or diseased pulp through the creation and delivery of new tissues. The key steps in regenerative endodontic procedures are accessing and cleaning the root canal, placing an intracanal medicament like calcium hydroxide or triple antibiotic paste, and intentionally inducing bleeding in the canal to form a blood clot and begin regeneration. Several case studies demonstrate positive outcomes from regenerative endodontic procedures, with teeth responding positively to cold tests and showing continued root development. However, challenges remain in ensuring sufficient microbiological control and avoiding uncontrolled regeneration.
This document discusses various types of dialysis for children including acute peritoneal dialysis, chronic peritoneal dialysis (CAPD and CCPD), hemodialysis, and CAVH-CVVH. It provides details on procedures, complications, nursing care, training programs, and prevention of infections for pediatric dialysis patients. The goal of home dialysis programs is to allow children to receive treatment at home while maintaining a normal lifestyle with minimal hospitalizations. Strict adherence to infection control measures is important to prevent the spread of endemic infections.
- A 6-year-old female patient presented with headache after a traffic accident where her head hit the pavement. On examination, she had a 3cm cephalhematoma and 2x1cm wound on her left parietal region.
- Imaging showed an epidural hematoma and depressed skull fracture in the left parietal region. Her GCS was 15/15.
- The working diagnosis was mild head injury, left parietal epidural hematoma, and depressed skull fracture. The plan was for craniotomy for hematoma evacuation and reconstruction of the depressed fracture.
The document discusses enhanced recovery after surgery (ERAS) programs. It describes how ERAS utilizes a multimodal approach involving surgeons, nurses, dietitians and others to optimize patient care and recovery through measures like preoperative counseling and nutrition, minimal invasive surgery when possible, reduced use of tubes/drains, early mobilization and feeding, and well-managed postoperative pain control. The goal is to reduce length of stay without increasing complications through evidence-based practices compared to traditional postoperative care methods. Studies show ERAS programs can achieve these outcomes safely and cost-effectively across several surgery types.
This document discusses septic arthritis, including:
- It is an infection and inflammation of the synovial joint cavity that can be caused by bacterial infection entering through the bloodstream.
- Common sites are the knee and hip. Staphylococcus aureus is a common cause.
- Presentation includes acute pain, swelling and restricted movement of the infected joint. Blood tests may show elevated inflammatory markers.
- Diagnosis involves synovial fluid analysis which in septic arthritis will show purulent fluid with a high white blood cell count on microscopy.
- Treatment involves antibiotics along with surgical drainage if needed. Prognosis depends on early diagnosis and treatment to prevent joint damage.
1. Septic arthritis, or bacterial infection of a joint, can occur when bacteria enters the synovial joint space, causing inflammation and purulent effusion. Common causes include Staphylococcus aureus and streptococcal infections.
2. Risk factors include advanced age, diabetes, prosthetic joints or recent joint surgery, and immunocompromised states. Presentation involves acute joint pain, swelling, warmth, and restricted movement. Diagnosis is confirmed by synovial fluid analysis showing purulent fluid with over 50,000 WBCs/mm3.
3. Treatment involves intravenous antibiotics for 2-4 weeks based on causative organism, along with surgical drainage if needed. Outcomes depend on
The weekly report summarizes the emergency patients received from February 23rd to March 8th 2022, including the date, attending doctor, new patients, and consultations. A total of 31 patients were seen over the two week period, with doctors dr. Siska, dr. Ida Ayu Ary Pramita, and dr. Ni Made Ayu Surasmiati seeing the most new patients. The report provides details of each patient's symptoms, examination findings, treatment plan and follow up care.
Therapeutic endoscopy is used in GI surgery to directly examine and treat problems in the digestive tract. It allows diagnosis and treatment without invasive surgery. Common therapeutic endoscopic procedures described include hemostasis for bleeding ulcers or varices, polypectomy, stricture dilation, stent placement, and debridement for conditions like achalasia. New techniques under development include natural orifice transluminal endoscopic surgery (NOTES) to perform surgical procedures without external incisions by entering through natural openings. Therapeutic endoscopy provides minimally invasive options for many GI conditions.
This document discusses emerging technologies in wound care, focusing on hyperbaric oxygen therapy, advanced cell-based therapies using mesenchymal stem cells and bioengineered skin substitutes, and intermittent pneumatic compression devices. It reviews evidence that hyperbaric oxygen therapy significantly increases wound healing rates compared to placebo treatment. New cell-based therapies utilize fibroblasts, keratinocytes, and mesenchymal stem cells from sources like bone marrow and amniotic membrane to reduce inflammation and promote proliferation, angiogenesis, and collagen deposition. Intermittent pneumatic compression enhances lymphatic return, arterial perfusion, and oxygen delivery to wounds.
This document summarizes a case presentation of a 74-year-old Thai female patient undergoing peritoneal dialysis who presented with increasing fatigue. Her peritoneal dialysis prescription was adjusted and tests revealed a left pleural effusion. Further imaging with nuclear scintigraphy confirmed omental wrapping around the peritoneal catheter. The patient was temporarily switched to hemodialysis and underwent catheter revision surgery. The importance of proper peritoneal catheter placement and design is discussed to reduce complications.
A 25 year old female presented with a burst abdomen 14 days post-LSCS. Predisposing factors for burst abdomen include wound infection and early stitch removal. Treatment options include immediate re-suture with deep retention sutures and broad spectrum antibiotics to address any infection, leaving the skin open if severe sepsis is present.
- A young male patient presented with mild blurring of vision and redness in the right eye, which was initially suspected to be glaucoma. However, further examination revealed proptosis, dilated episcleral vessels, and a bruit heard on auscultation of the orbit, leading to a provisional diagnosis of carotid cavernous fistula. Imaging including MRI/MRA and cerebral angiography confirmed the diagnosis. The patient was treated with endovascular embolization, which resolved his symptoms and signs including the intractable glaucoma. Carotid cavernous fistulas are rare but can be misdiagnosed if not considered, so a high index of suspicion is needed for
a presentation on few patients with gynaecological malignancy. presented on September 2022. This presentation contains with diagnosis ,investigation, management (both surgical & medical ).
This document discusses laparoscopic appendectomy techniques and results from United Family Intermed Hospital and Gurvan Gal Hospital. It begins with a brief introduction of laparoscopic appendectomy history and the key steps of the procedure. It then summarizes results from 101 patients, noting common appendicitis types, low complication rates, and short hospital stays. It concludes with a literature review comparing laparoscopic and open appendectomy outcomes, risks for obese patients, and emerging minimally invasive techniques.
A Review on Recent Advances of Packaging in Food IndustryPriyankaKilaniya
Effective food packaging provides number of purposes. It functions as a container to hold and transport the food product, as well as a barrier to protect the food from outside contamination such as water, light, odours, bacteria, dust, and mechanical damage by maintaining the food quality. The package may also include barriers to keep the product's moisture content or gas composition consistent. Furthermore, convenience is vital role in packaging, and the desire for quick opening, dispensing, and resealing packages that maintain product quality until fully consumed is increasing. To facilitate trading, encourage sales, and inform on content and nutritional attributes, the packaging must be communicative. For storage of food there is huge scope for modified atmosphere packaging, intelligent packaging, active packaging, and controlled atmosphere packaging. Active packaging has a variety of uses, including carbon dioxide absorbers and emitters, oxygen scavengers, antimicrobials, and moisture control agents. Smart packaging is another term for intelligent packaging. Edible packaging, self-cooling and self-heating packaging, micro packaging, and water-soluble packaging are some of the advancements in package material.
Smoking as a preservation and processing method for food, Food preservation, food processing, smoking, meat and meat products, methods of food smoking, application, cold smoking, hot smoking, warm smoking, liquid smoking, food industry and business, offset smokers, upright drum smokers, Vertical water smokers, Propane smokers, Electrical smokers and related health concerns.
Cacao, the main component used in the creation of chocolate and other cacao-b...AdelinePdelaCruz
Cacao, the main component used in the creation of chocolate and other cacao-based products is cacao beans, which are produced by the cacao tree in pods. The Maya and Aztecs, two of the earliest Mesoamerican civilizations, valued cacao as a sacred plant and used it in religious rituals, social gatherings, and medical treatments. It has a long and rich cultural history.
Science Text Book characteristics and libraryJerslin Muller
This ppt contains qualities of a good Science Text Book, need for text book, importance of text book, criteria of a science text book, text book analysis, content analysis, Hunter's score card, library, utilization of library.
Discover the Magic 7 Fruits for Weight Loss You Need to Know About!.pdfRapidLeaks
Fruits, a.k.a, nature’s candy are beneficial for tons of reasons. They’re filled with vitamins and nutrients that are not just healthy but delicious too. And, some have officially been identified as fruits for weight loss, which makes them ideal for any and every kind of diet you are currently experimenting with.
Also read: https://rapidleaks.com/lifestyle/food-drink/fruits-weight-loss/
Panchkula offers a wide array of dining experiences. From traditional North Indian flavors to global cuisine, the city’s restaurants cater to every taste bud. Let’s dive into some of the best restaurants in Panchkula
FOOD PSYCHOLOGY CHARLA EN INGLES SOBRE PSICOLOGIA NUTRICIONALNataliaLedezma6
Our decisions about what to put on our plate are far more intricate than simply following hunger cues. Food psychology delves into the fascinating world of why we choose the foods we do, revealing a complex interplay of emotions, stress, and even disorders.
Agriculture Market : Global Trends and Forecast Analysis (2023-2032)PriyanshiSingh187645
The global agriculture market is anticipated to grow at a substantial CAGR of 9.60% in the upcoming years. The global agriculture industry was estimated to be worth USD 13.5 billion in 2022 and was expected to be worth USD 25.6 billion by 2030.
What is a typical meal for a person on a Mediterranean diet?Krill Arctic Foods
Curious about what a typical Mediterranean diet dinner entails? Dive into our collection of delectable Mediterranean diet recipes for dinner that are both nutritious and satisfying. From savory grilled chicken with Greek-inspired flavors to vibrant vegetable pasta dishes, we've curated a menu that captures the essence of Mediterranean cooking. Explore the world of Mediterranean flavors and elevate your dinner table with our inspired recipes that celebrate health and taste in every bite
Exploring_Karnali_Region_of_Nepal_(Food, Culture and People).pptxLincoln University
Largest province in Nepal, Mountain landscape with 47% of an area located above 4000 masl, Characterized by its unique cultural heritage, diverse geography, and traditional farming practices
Traditional Agriculture: Subsistence farming on terraced fields (rice, wheat, millet, bean, potato and barley)
Fruits: Apple, walnut, orange, etc.
Livestock Rearing: Transhumance system of animal husbandry (goats, sheep, and cattle)
Dietary Staples: Rice, lentils, vegetables, and dairy products
Food Preparation: Often prepared using locally grown ingredients with traditional cooking methods
Religious Practices: Hinduism and Buddhism
Social Customs: Strong community bonds, traditional attire and customs are upheld during festivals
Environmental Connection: Respect for nature and reverence for sacred sites
Historical Context: Farming techniques shaped by the region's rugged terrain, climate, and historical interactions
Cultural Influence: Food preferences, agricultural rituals, and farming practices have been influenced by a blend of indigenous traditions, Hindu and Buddhist beliefs, and trade routes
Enhancing Agricultural Practices: Introducing modern farming techniques without compromising traditional values
Access to Education and Resources: Investing in education and providing access to agricultural inputs
Promoting Sustainable Tourism: Leveraging the region's cultural richness and natural beauty
Intersection of culture, agriculture, and tradition
Embracing sustainable development practices and honoring cultural heritage
Enhance the lives of its people while safeguarding their unique way of life
2. Mr. Enep, M, 57 y.o (05/07/1965)
BPJS/0002099940
Consultant dr. Betha Egih Riestiano, Sp.BP-RE
Admission 21/12/22, Consulted 21/12/22 – Azalea (2.3)
Resident in charge : Ribka - Manefo
Diagnosis
Plastic Reconstructive and Aesthetic Surgery
• General Tetanus grade III Patel-Joag
• Vulnus punctum a.r Left plantar pedis
Plan
Plastic Reconstructive and Aesthetic Surgery
• Wound toilette with NaCl 0.9% and chlorhexidine, cross incision and irigasion with H2O2 and povidone iodine. Wound toilette with
povidone iodine, hypafix. GV everyday
• Keep the skin area around the wound cean and moist
• Swab Culture
• Ampicillin sulbactam 4 x 1.5 gr IV and metronidazole 3 x 500 mg IV, tetagam 1 amp IM-
• Consult:TS BM dan THT-KL focal infection
Neurology
• Bed rest
• O2 nasal kanul 3 lpm
• IVFD NaCl 0.9% 1500cc/24 jam
• - Diazepam 8 amp/24jam
• - Ceftriaxone 2x1 gr IV
• - Metronidazole 4x500 mg IV
• - Tetagam 1x500 IU IM
• - Paracetamol 3x500 mg
• - Omeprazole 2x40 mg IV
• - EKG- Ro. Thorax
3. ``
Mr. Enep, M, 57 y.o (05/07/1965)
BPJS/0002099940
Consultant dr. Betha Egih Riestiano, Sp.BP-RE
Admission 21/12/22, Consulted 21/12/22 – Azalea (2.3)
Resident in charge : Ribka-Manefo
Clinical Picture,
21/12/2022
Lower Extremities
4. ``
Mr. Enep, M, 57 y.o (05/07/1965)
BPJS/0002099940
Consultant dr. Betha Egih Riestiano, Sp.BP-RE
Admission 21/12/22, Consulted 21/12/22 – Azalea (2.3)
Resident in charge : Ribka - Manefo
Left Foot Region
H4 (25/12/22)
H0 (21/12/22)
5. ``
Mr. Enep, M, 57 y.o (05/07/1965)
BPJS/0002099940
Consultant dr. Betha Egih Riestiano, Sp.BP-RE
Admission 21/12/22, Consulted 21/12/22 – Azalea (2.3)
Resident in charge : Ribka - Manefo
Left Foot Region H7 (28/12/22)
H7 (28/12/22)
Editor's Notes
1
KU: luka pada punggung dan paha
RPS: Luka awalnya berupa bintik kemerahan berisi cairan seperti nanah sejak 1 bulan lalu, kemudian pecah sendiri dan menjadi luka dengan dasar kemerahan. Luka dirawat dengan larutan betadine, namun dikatakan tidak kunjung menutup dan malah makin dalam.Pasien datang ke RSHS dengan keluhan kejang berulang sejak 13 jam SMRS. Kejang dikatakan seluruh tubuh, kepala menengok ke kanan, tangan dan kaki kaku. Durasi kejang setiap kejang 2-3 menit. Setelah kejang pasien sadar. Keluhan disertai dengan demam sejak 6 Jam SMRS. Keluhan mual, muntah, BAB cair tidak ada. Keluhan batuk pilek sesak napas tidak ada. Pasien tidak merasa ada penurunan berat badan.Sebelumnya pasien dirawat di RSHS selama 3 hari (pulang tanggal 1 Desember 2022) untuk tata laksana BMP evaluasi. Sebelumnya pada pertengahan November pasien dirawat dengan keluhan muntah dan BAB cair, serta kejang. Saat dirawat, pasien dikesankan Syok Sepsis (Teratasi > 24jam) + Acute Lymphoblastic Leukemia High Risk + Diare Akut ec Disentri Amoeba dengan Dehidrasi Berat (Teratasi) + Acute Kidney Injury Fase Failure + Elektrolit Imbalans (Hiponatremia, Hipokalemia, Hipokalsemia) + Elevated Liver Enzyme. Pasien terdiagnosis ALL-HR pada bulan Agustus 2022 di RSHS. Pasien telah mendapatkan kemoterapi sebanyak 7 siklus. Pasien juga mendapatkan terapi obat prednisone sejak pertama kali berobat dan sejak itu pasien tampak bengkak dan tubuh membesar, kulit juga tampak muncul garis-garis kemerahan. Pasien sudah dilakukan BMP evaluasi pada bulan November 2022 dengan hasil ALL remisi komplit.
RPD: Pasien merupakan anak ke 1, dari ibu P3A0, lahir spontan di bidan, lahir langsung menangis, BBL 3000 gram. Riwayat imunisasi dasar lengkap. Tumbuh kembang sesuai usia.
RPK: riwayat penyakit yang sama di keluarga -O/Kes: GCS 11 (E3M5V3)TD: 140/100 mmHgHR: 110 x/menit RR: 24 x/menit S: 36.8 C SpO2 : 95% on room airBB: 44 kg TB: 154 cm
Status Generalis
Kepala : konjungtiva anemis -/-, edema palpebra (-), moon face (+)
Leher: KGB tidak teraba membesar
Toraks: bentuk gerak simetris, retraksi (-) Cor: S1 S2, murmur tidak terdengar.
Pulmo: VBS kanan=kiri, slem -/-, crackles -/-
Abdomen: cembung, lembut, BU (+), hepar tidak teraba membesarLien schuffner II
Ekstremitas: akral hangat, CRT<2 detik, Striae (+)
Status neurologis
rangsang meninges: Kaku kuduk (-), Brudzinski I/II/III: -/-/-CN II/III: pupil isokor, diameter 3 mm ODS, refleks cahaya (+/+)CN III, IV, VI: gerak bola mata ke segala arahCN VII: kesan paresis (-)
Motorik: kesan paresis (-)
Refleks fisiologis: APR +/+, KPR +/+ N
Refleks patologis: babinski +/+, gordon +/+, oppenheim +/+, chaddock +/+
Status lokalisa.r. trunkus posterior:I: multiple striae +, terdapat luka tunggal ukuran 1 x 1 x 0.5 cm, tepi ireguler, dasar jaringan granulasi dan subkutis, eksudat + minimal, pus -, slough -, nekrotik -, edema -, hiperemis di sekitarnya -, epitelialisasi -P: NT +, fluktuasi -a.r. femur sinistra:
I: multiple striae +, terdapat luka tunggal ukuran 2.5 x 2 x 0.5 cm, tepi ireguler, dasar jaringan granulasi dan subkutis, eksudat + minimal, pus -, slough -, nekrotik -, edema -, hiperemis di sekitarnya -, epitelialisasi -P: NT +, fluktuasi -
KU: luka pada punggung dan paha
RPS: Luka awalnya berupa bintik kemerahan berisi cairan seperti nanah sejak 1 bulan lalu, kemudian pecah sendiri dan menjadi luka dengan dasar kemerahan. Luka dirawat dengan larutan betadine, namun dikatakan tidak kunjung menutup dan malah makin dalam.Pasien datang ke RSHS dengan keluhan kejang berulang sejak 13 jam SMRS. Kejang dikatakan seluruh tubuh, kepala menengok ke kanan, tangan dan kaki kaku. Durasi kejang setiap kejang 2-3 menit. Setelah kejang pasien sadar. Keluhan disertai dengan demam sejak 6 Jam SMRS. Keluhan mual, muntah, BAB cair tidak ada. Keluhan batuk pilek sesak napas tidak ada. Pasien tidak merasa ada penurunan berat badan.Sebelumnya pasien dirawat di RSHS selama 3 hari (pulang tanggal 1 Desember 2022) untuk tata laksana BMP evaluasi. Sebelumnya pada pertengahan November pasien dirawat dengan keluhan muntah dan BAB cair, serta kejang. Saat dirawat, pasien dikesankan Syok Sepsis (Teratasi > 24jam) + Acute Lymphoblastic Leukemia High Risk + Diare Akut ec Disentri Amoeba dengan Dehidrasi Berat (Teratasi) + Acute Kidney Injury Fase Failure + Elektrolit Imbalans (Hiponatremia, Hipokalemia, Hipokalsemia) + Elevated Liver Enzyme. Pasien terdiagnosis ALL-HR pada bulan Agustus 2022 di RSHS. Pasien telah mendapatkan kemoterapi sebanyak 7 siklus. Pasien juga mendapatkan terapi obat prednisone sejak pertama kali berobat dan sejak itu pasien tampak bengkak dan tubuh membesar, kulit juga tampak muncul garis-garis kemerahan. Pasien sudah dilakukan BMP evaluasi pada bulan November 2022 dengan hasil ALL remisi komplit.
RPD: Pasien merupakan anak ke 1, dari ibu P3A0, lahir spontan di bidan, lahir langsung menangis, BBL 3000 gram. Riwayat imunisasi dasar lengkap. Tumbuh kembang sesuai usia.
RPK: riwayat penyakit yang sama di keluarga -O/Kes: GCS 11 (E3M5V3)TD: 140/100 mmHgHR: 110 x/menit RR: 24 x/menit S: 36.8 C SpO2 : 95% on room airBB: 44 kg TB: 154 cm
Status Generalis
Kepala : konjungtiva anemis -/-, edema palpebra (-), moon face (+)
Leher: KGB tidak teraba membesar
Toraks: bentuk gerak simetris, retraksi (-) Cor: S1 S2, murmur tidak terdengar.
Pulmo: VBS kanan=kiri, slem -/-, crackles -/-
Abdomen: cembung, lembut, BU (+), hepar tidak teraba membesarLien schuffner II
Ekstremitas: akral hangat, CRT<2 detik, Striae (+)
Status neurologis
rangsang meninges: Kaku kuduk (-), Brudzinski I/II/III: -/-/-CN II/III: pupil isokor, diameter 3 mm ODS, refleks cahaya (+/+)CN III, IV, VI: gerak bola mata ke segala arahCN VII: kesan paresis (-)
Motorik: kesan paresis (-)
Refleks fisiologis: APR +/+, KPR +/+ N
Refleks patologis: babinski +/+, gordon +/+, oppenheim +/+, chaddock +/+
Status lokalisa.r. trunkus posterior:I: multiple striae +, terdapat luka tunggal ukuran 1 x 1 x 0.5 cm, tepi ireguler, dasar jaringan granulasi dan subkutis, eksudat + minimal, pus -, slough -, nekrotik -, edema -, hiperemis di sekitarnya -, epitelialisasi -P: NT +, fluktuasi -a.r. femur sinistra:
I: multiple striae +, terdapat luka tunggal ukuran 2.5 x 2 x 0.5 cm, tepi ireguler, dasar jaringan granulasi dan subkutis, eksudat + minimal, pus -, slough -, nekrotik -, edema -, hiperemis di sekitarnya -, epitelialisasi -P: NT +, fluktuasi -
KU: luka pada punggung dan paha
RPS: Luka awalnya berupa bintik kemerahan berisi cairan seperti nanah sejak 1 bulan lalu, kemudian pecah sendiri dan menjadi luka dengan dasar kemerahan. Luka dirawat dengan larutan betadine, namun dikatakan tidak kunjung menutup dan malah makin dalam.Pasien datang ke RSHS dengan keluhan kejang berulang sejak 13 jam SMRS. Kejang dikatakan seluruh tubuh, kepala menengok ke kanan, tangan dan kaki kaku. Durasi kejang setiap kejang 2-3 menit. Setelah kejang pasien sadar. Keluhan disertai dengan demam sejak 6 Jam SMRS. Keluhan mual, muntah, BAB cair tidak ada. Keluhan batuk pilek sesak napas tidak ada. Pasien tidak merasa ada penurunan berat badan.Sebelumnya pasien dirawat di RSHS selama 3 hari (pulang tanggal 1 Desember 2022) untuk tata laksana BMP evaluasi. Sebelumnya pada pertengahan November pasien dirawat dengan keluhan muntah dan BAB cair, serta kejang. Saat dirawat, pasien dikesankan Syok Sepsis (Teratasi > 24jam) + Acute Lymphoblastic Leukemia High Risk + Diare Akut ec Disentri Amoeba dengan Dehidrasi Berat (Teratasi) + Acute Kidney Injury Fase Failure + Elektrolit Imbalans (Hiponatremia, Hipokalemia, Hipokalsemia) + Elevated Liver Enzyme. Pasien terdiagnosis ALL-HR pada bulan Agustus 2022 di RSHS. Pasien telah mendapatkan kemoterapi sebanyak 7 siklus. Pasien juga mendapatkan terapi obat prednisone sejak pertama kali berobat dan sejak itu pasien tampak bengkak dan tubuh membesar, kulit juga tampak muncul garis-garis kemerahan. Pasien sudah dilakukan BMP evaluasi pada bulan November 2022 dengan hasil ALL remisi komplit.
RPD: Pasien merupakan anak ke 1, dari ibu P3A0, lahir spontan di bidan, lahir langsung menangis, BBL 3000 gram. Riwayat imunisasi dasar lengkap. Tumbuh kembang sesuai usia.
RPK: riwayat penyakit yang sama di keluarga -O/Kes: GCS 11 (E3M5V3)TD: 140/100 mmHgHR: 110 x/menit RR: 24 x/menit S: 36.8 C SpO2 : 95% on room airBB: 44 kg TB: 154 cm
Status Generalis
Kepala : konjungtiva anemis -/-, edema palpebra (-), moon face (+)
Leher: KGB tidak teraba membesar
Toraks: bentuk gerak simetris, retraksi (-) Cor: S1 S2, murmur tidak terdengar.
Pulmo: VBS kanan=kiri, slem -/-, crackles -/-
Abdomen: cembung, lembut, BU (+), hepar tidak teraba membesarLien schuffner II
Ekstremitas: akral hangat, CRT<2 detik, Striae (+)
Status neurologis
rangsang meninges: Kaku kuduk (-), Brudzinski I/II/III: -/-/-CN II/III: pupil isokor, diameter 3 mm ODS, refleks cahaya (+/+)CN III, IV, VI: gerak bola mata ke segala arahCN VII: kesan paresis (-)
Motorik: kesan paresis (-)
Refleks fisiologis: APR +/+, KPR +/+ N
Refleks patologis: babinski +/+, gordon +/+, oppenheim +/+, chaddock +/+
Status lokalisa.r. trunkus posterior:I: multiple striae +, terdapat luka tunggal ukuran 1 x 1 x 0.5 cm, tepi ireguler, dasar jaringan granulasi dan subkutis, eksudat + minimal, pus -, slough -, nekrotik -, edema -, hiperemis di sekitarnya -, epitelialisasi -P: NT +, fluktuasi -a.r. femur sinistra:
I: multiple striae +, terdapat luka tunggal ukuran 2.5 x 2 x 0.5 cm, tepi ireguler, dasar jaringan granulasi dan subkutis, eksudat + minimal, pus -, slough -, nekrotik -, edema -, hiperemis di sekitarnya -, epitelialisasi -P: NT +, fluktuasi -