An ostomy is a surgically created opening in the intestine that allows for waste to exit the body into an external bag. There are two main types - an ileostomy, which is created from the small intestine, and a colostomy, which is created from the large intestine. An ostomy may be temporary or permanent and is usually required due to conditions like cancer, IBD, or injury. Attaching the external bag securely is important to prevent complications. Diet and lifestyle adjustments are also needed after an ostomy is created.
SIGMOID VOLVULUS- GENERALISED ABDOMINAL PAIN
#surgicaleducator #generalisedabdominalpain #sigmoidvolvuus #usmle #babysurgeon #surgicaltutor
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
• Dear Viewers,
• Greetings from “Surgical Educator”
• Today I have uploaded a video on Sigmoid Volvulus- a didactic lecture.
• It is one of the life-threatening surgical problems you see in surgical wards.
• I have discussed the various causes for Generalised Abdominal Pain, epidemiology, etiology, pathology, clinical features, investigations, and treatment of Sigmoid volvulus.
• I have also included a mind map, diagnostic algorithm and a treatment algorithm for Sigmoid Volvulus.
• I hope the video will be very useful and you will enjoy it.
• You can watch all my surgical teaching videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the video.
SIGMOID VOLVULUS- GENERALISED ABDOMINAL PAIN
#surgicaleducator #generalisedabdominalpain #sigmoidvolvuus #usmle #babysurgeon #surgicaltutor
Subscription Link: http://youtube.com/c/surgicaleducator...
Surgical Educator Android App link: https://play.google.com/store/apps/de...
• Dear Viewers,
• Greetings from “Surgical Educator”
• Today I have uploaded a video on Sigmoid Volvulus- a didactic lecture.
• It is one of the life-threatening surgical problems you see in surgical wards.
• I have discussed the various causes for Generalised Abdominal Pain, epidemiology, etiology, pathology, clinical features, investigations, and treatment of Sigmoid volvulus.
• I have also included a mind map, diagnostic algorithm and a treatment algorithm for Sigmoid Volvulus.
• I hope the video will be very useful and you will enjoy it.
• You can watch all my surgical teaching videos in the following link:
• youtube.com/c/surgicaleducator
• Thank you for watching the video.
OPEN INGUINAL HERNIA REPAIR- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #openinguinalherniarepair #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and open and
Laparoscopic Cholecystectomy
• In this video today, I have discussed Open Inguinal Hernia Repair.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
• Thank you for watching the videos.
LAPAROSCOPIC CHOLECYSTECTOMY- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #laparoscopiccholecystectomy #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and Open Cholecystectomy.
• In this video today, I have discussed Laparoscopic Cholecystectomy- the flagship procedure for laparoscopic surgeries.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and the links are:
• https://www.youtube.com/watch?v=VStEzI1jL8Y
• https://www.youtube.com/watch?v=O8j4kwpzd24
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
Types, Investigation, complication and treatment of Incisional herniaimraxid
It is herniation through a weak abdominal scar (scar of previous surgery).
It is common in old age and obese individuals.
Predisposing Factors:
..> Vertical scar, midline scar, lower abdominal scar— may injure the nerves of the abdominal muscles.
...> Scar of major surgeries (biliary, pancreatic).
...> Scar of emergency surgeries (peritonitis, acute abdomen).
For Health Tips: http://MedicoPk.com/
OPEN INGUINAL HERNIA REPAIR- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #openinguinalherniarepair #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and open and
Laparoscopic Cholecystectomy
• In this video today, I have discussed Open Inguinal Hernia Repair.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and I will give a link for each surgery in the end of the video as end-cards, which I think will be very useful.
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
• Thank you for watching the videos.
LAPAROSCOPIC CHOLECYSTECTOMY- OPERATIVE SURGERY
#surgicaleducator #operativesurgery #laparoscopiccholecystectomy #usmle #babysurgeon #surgicaltutor
Dear viewers,
• Greetings from “Surgical Educator”
• Because of the popular demand by viewers of the YouTube channel “Surgical Educator”, I have decided to create and upload videos on common surgeries.
• I have already uploaded videos on open and Laparoscopic Appendicectomy, Thyroidectomy, Modified Radical Mastectomy and Open Cholecystectomy.
• In this video today, I have discussed Laparoscopic Cholecystectomy- the flagship procedure for laparoscopic surgeries.
• However, these videos are not real surgeries but the theoretical aspect of operative surgery like going through an atlas of operative surgery.
• Along with these videos, I recommend you to watch real operative surgery videos as well and the links are:
• https://www.youtube.com/watch?v=VStEzI1jL8Y
• https://www.youtube.com/watch?v=O8j4kwpzd24
• This will give a very good opportunity for the surgical trainees to mentally rehearse various surgical steps in a sequential manner prior to actual surgery. You can watch the video in the following links:
• surgicaleducator.blogspot.com
• youtube.com/c/surgicaleducator
Types, Investigation, complication and treatment of Incisional herniaimraxid
It is herniation through a weak abdominal scar (scar of previous surgery).
It is common in old age and obese individuals.
Predisposing Factors:
..> Vertical scar, midline scar, lower abdominal scar— may injure the nerves of the abdominal muscles.
...> Scar of major surgeries (biliary, pancreatic).
...> Scar of emergency surgeries (peritonitis, acute abdomen).
For Health Tips: http://MedicoPk.com/
A stoma (or ostomy, these 2 words mean the same thing) is a surgically created opening on the abdomen which allows stool or urine to exit the body. There are 3 main types of stoma – colostomy, ileostomy and urostomy.
Stoma care,child,
Helps both UG and PG nursing students
Helps in knowing how to care for a stomal site
daily activities with stoma.
Dietary guidelines for a child with stoma
Colostomy power point is very important for studentstembotisa26
This topic will help health worker to know what colostomy is and it will help them to have knowledge on the management of the patient with this condition
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Contents
• What is an ostomy
• Types of ostomy
• Attachment of stoma appliance
• Ileostomy vs colostomy
• Loop ileostomy (total procto-colostomy)
• Double baral stoma
• Complications
• Diet
• Colostomy irrigation
JMJ 2
3. What is an ostomy?
• An opening,
• In the small intestine or large intestine,
• Created as an outlet through the anterior abdominal wall,
• In order to pass fecal matter into a bag
• STOMA = part of intestine we use to create this outlet
JMJ 3
4. Purpose of stoma
• It reduces pain and discomfort
• Allows systematic defication
• May help relieve symptoms of intestinal disease
JMJ 4
5. Disease conditions where you might
need stoma
• Inflammatory bowel disease
• Ulcers
• Polyps
• Cancers
• Disorders of bowel function – Hurschprung’s disease
• Accidental injury
• Congenital deformities of anus and rectum
JMJ 5
6. Type of ostomy
Ostomy
Ileostomy Colostomy
JMJ 6
Stoma of the terminal
part of small intestine
An artificial opening
made in the large bowel
to divert feceas and
flatus to external
environment, where it
can be collected into an
external appliance
8. Type of ostomy
Stoma
Temporary Permanent
JMJ 8
Stoma of the terminal
part of small intestine
An artificial opening
made in the large bowel
to divert feceas and
flatus to external
environment, where it
can be collected into an
external appliance
11. Attachment of the stoma appliance
JMJ 11
1. Remove the colostomy
bag carefully
12. Attachment of the stoma appliance
JMJ 12
2. Check the stoma for the
colour
If it is black- consult your
doctor
Stoma has to be pink, red
in colour
Clean the stoma well
Let it dry
13. Attachment of the stoma appliance
JMJ 13
3. Try using a skin barrier,
such as stoma powder.
Sprinkle stoma powder
around the stoma.
Be careful not to put the
powder on the stoma itself.
Carefully dust it around
using a dry wipe, and let
the area dry for about 60
seconds.
14. Attachment of the stoma appliance
JMJ 14
4. Place the transparent
stoma template over your
stoma, to assess the
diameter
Opening should match the
diameter – skin irritation
16. Attachment of the stoma appliance
JMJ 16
5. Remove the sticker of
the wafer and fix it
carefully
17. Attachment of the stoma appliance
JMJ 17
6. Fix the pouch to the
wafer
Clip the other end
Apply micropore plasters
around the wafer
Wafer may be left in place
for 7 days
19. Colostomy vs ileostomy
Ileostomy Colostomy
Sprout + No sprout / flush
Site Usually in RIF Temporary colostomy – transvers or
right upper quadrant
End colostomy – usually in LIF
Effulent Liquid contain some amount of enzymes
(alkali and proteolytic enzymes)
excoriation of skin + (Autodigestion)
Solid, hard stools compaired to
ileostomy
Watery liquid stools Hard stools
Oddor Oddor + Oddor is more
Frequency of
discharge
Higher Lower
Circular folds on the ileum + no
More likely to develop fluid and electrolyte
problems JMJ 19
23. Artificial pouch
JMJ 23
• After anastomosis
you have to rest the
anastomosis site
• To prevent that –
make a loop
ileostomy in the RIF
to divert feces
• Can reverse after
6/52 when the
anastomosis is
healed
27. Double barrel stoma
• Bowel is surgically severed and 2 ends are
brought out into the abdomen as 2 separate
stomas
• Proximal end – functional stoma
• Distal end – non functioning (mucus fistula)
• Used in temporary diversion – cases where
resection is required due to perforation or
necrosis
JMJ 27
30. Ischemia
• Due to impaired blood flow
• Poor blood supply when stoma is formed
• Too tight stoma bag
• Too tight dresses over storma
• Management
• Close observation during post op period
• A clear plastic appliance should be fitted
• Avoid tight clothing
• Inform your surgeon if you notice any colour change
JMJ 30
31. Bleeding
• Overenthusuastic cleaning
• When using template for measurement
• Bleeding from lumen is more serious
• Portal HPT in cirrhosis
• Recurrence of colonic CA
• Management
• Do not rub your stoma
• Be careful when applying the bag
• Compress with guaze
• Usually resolve without interventions
JMJ 31
32. Retraction
• Recession of the stoma
• away from the skin surface
• due to excess tension of the stoma
• Insufficiant fixation
• Post op weight gain
• Management
• Use and appliance with rigid flange
• Apply stoma adhesive paste before fixing appliance
JMJ 32
34. Excoriation of skin
• Make sure the wafer and the pouch are well fixed
• Control excessive mucus discharge
• Be cautious of the size of the stoma and the wafer
• Use luke warm water and mild soap to clean the peristomal
skin
• Never use alcohol agents, savlon, creams, powder or
chemical agents to clean
• Never use artificial drying methods. Ex: hair driers
JMJ 34
35. Excoriation of skin
• Management
• Educate the patient about appliance change
• Consider a 2 piece appliance to allow healing
• Use stoma adhesive powder or pase
• Do not use antiseptics for cleaning peristomal skin
• Change the base plate as soon as it leaks
• A methyl cellulose skin wafer is helpful
JMJ 35
38. Avoid
• Vegetables – raddish, cabbage, garlic, cucumber, kno-kol
• Are known to result in offensive odour
• Carbanoted beverages, chewing gum and smokinh
• Causes excess gas in stoma appliance
• High and moderate fiber diet
JMJ 38
42. Colostomy irrigation
• Normally done in patients with a
• Permement colostomy
• Who need bowel preparation for special investigations –colonoscopy
• Usually done it after 1 year of stoma creation
• Takes about 45 minutes
JMJ 42
44. Requirement for stoma irrigation
• 1.5 – 2 L of luke warm
water
• Resovior bag
• A tube with a
controller and a funnel
shaped introducer,
which prevents damage
to stoma
• 2 clips to close the bag
• Bag to discard feces
JMJ 44