defination of hernia,epidemiology,etiology,parts of hernia,classification,clinical features,pathophysiology,predisposing factors and surgical management of strangulated hernia,
In this presentation I have shown the etiology, clinical features and treatment for both Phimosis & Paraphimosis. I have also showed various methods of circumcision for both infants and adults.
In this presentation I have shown the etiology, clinical features and treatment for both Phimosis & Paraphimosis. I have also showed various methods of circumcision for both infants and adults.
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
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Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
This presentation gives a fine description about stoma and ostomy. This contains the details regarding types, complications and the advices that you should give to a patient with a stoma.
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
cause,pathogensis,clinical features,treatment,prevention are explained in short .. pls comment if u want anythin to be added .. or if u want to know something more abt typhoid ... i wud consider it as a positive stimulus for me ....
case history in detail including objectives, goals, chief complaint, history of present illness, past dental history, medical history, general examination, extraoral examination intraoral examination further dividing into hard and soft tissue examination, provisional diagnosis, differential diagnosis, investigation, final diagnosis, treatment plan, prognosis
AFP surveillance
reverse cold chain
polio vaccine --> live attenuated
paediatrics
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microbiology
serotype 3
new vaccine schedule
IPV added to go national immunisation schedule d
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Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
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It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
2. DEFINATION
IT IS AN ABNORMAL PROTRUSION OF A VISCOUS
OR A PART OF A VISCOUS THROUGH AN
OPENING ARTIFICIAL OR NATUERAL WITH A
SAC COVERING IT.
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6. •COVERING OF THE SAC ARE THE
LAYERS OF THE ABDOMINAL WALL
THROUGH WHICH THE SAC PASESS
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7. IT IS A DIVERTICULAM OF PERITONEUM WITH
.MOUTH
.NECK
.BODY
.FUNDUS
•NECK IS NARROW IN INDIRECT
BUT WIDE IN DIREC HERNIA
•BODY IS THIN IN INFANTS, CHILDREN AND IN
INDIRECT BUT IS THICK IN DIRECT AND
LONG STADING HERNIA
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8. 1. OMENTUM-OMENTOCELE
2. INTESTINE-ENTEROCELE COMMONLY SMALL BOW
3. PORTTION OF CIRCUMFERENCE OF BOWEL
4. URINARY BLADDER-CYSTOCELE
5. MECKLE,S DIVERTICULAM-LITTRE,S HERNIA
6. OVARY
7. FALLOPIAN TUBE
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14. A HERNIA IN WHICH BLOOD
SUPPLY OF THE HERNIATED
VISCUS IS SO CONSTRICTED
BY SWELLING AND CONG-
-STION AS TO ARREST ITS
CIRCULATION
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15. •STRANGULATION COMMONLY OCCURS
IN SMALL BOWEL AND ALSO OCCURE IN
LARGE BOWEL .
•OCCASIONALLY STRANGULATED
OMENTOCELE CAN ALSO OCCURE WITHOU
ANY INTESTINAL OBSTRUCTION
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16. •STRANGULATION CAN OCCUR IN
•INGUINAL
•FEMORAL
•OBTURATOR
•UMBLICAL
•ANY OTHER HERNIA
25-8-2015 16
17. •BUT INDIRECT INGUINAL HERNIA IS MORE
PRONE FOR STRANGULATION BECAUSE OF
CONSTRICTING AGENTS
1. NECK OF SAC
2. SUP ING RING IN CHILDREN
3. ADHESIONS WITHIN SAC
25-8-2015 17
19. EPIDEMIOLOGY
•INCIDENCE RATE OF STRANGULATED INGUINAL
•HERNIA VARIES BETWEEN 0.29%AND 2.9%
•MORTALITY RATE RANGES BETWEEN 2.6% TO 9%
BUT A DELAY OF 12H INCREASE
CHANCE OF INTESTINAL RESECTION RATE.
•ABOUT 95% OF INGUINAL HERNIA PATIENT PRESENT
•AT CLINICS AND ONLY 5% PRESENT AS AN
•EMERGENCY WITH IRREDUCIBLE HERNIA WHICH
•PROGRESS TO STRANGULATION
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20. MORTALITY RISK IS SEVEN TIME HIGHER
IN CASES AFTER EMERGENCY
STRANGULTED INGUINAL HERNIA
SURGERY AND 20 TIME HIGHER IF BOWEL
RESECTION WAS UNDERTAKEN
DURING INFANCY
INCIDENCE IS 4%
FEMALE TO MALE RATIO IS 5;1
IN FEMALE INFANTS THE CONTENTS MAY BE OVARY
WITH OR WITHOUT FALLOPIAN TUBE25-8-2015 20
21. •STRANGULATED HERNIAS ARE
MORE FREQUENTLY SEEN IN
ELDERLY PATIENTS,AND THEIR
PREVELANCE IN THE 60 YEAR OLD
POPULATION HAS BEEN
REPORTED TO BE 9.8% COMPARED
WITH 1.8% FOR YOUNGER
PATIENTS
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22. OBSTRUCTION VENOUS RETURN IMPAIRED
CONGESTION OF THE BOWEL
FURTHER DILATATION OF THE BOWEL
WHICH BECOMES PURPLE COLOUREDCONT…
25-8-2015 22
23. FLUID COLLECT IN THE SAC
EVEVTUALLY ARTERIAL SUPPLY IS IMPAIRED
BOWEL BECOMES DARK, BROWNISH
BLACK COLOURED WITH FLABBY AND
FRIABLE WALL
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24. BACTERIA MIGRATE TRAN SEROSALLY
AND MULTIPLY IN FLUIDE OF THE SAC
PERFORATION OCCURE AT THE SITE OF
CONSTRICTION RING
PERITONITIS OCCURE25-8-2015 24
30. •SEVERE PAIN INITIALLY AT HERNIAL
SITE THEN BECOME GENERALISED
•PERSISTENT VOMITING
•ABDOMINAL DISTENSION
•CONSTIPATION
•RECENT SUDDEN INC IN SIZE OF LUMP
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32. PERCUSSION AUSCULTATION
NOT POSSIBLE DUE
TO TENDERNESS IF
DONE THEN….
DULL IN CASE OF
OMENTUM
RESONENT IN CASE
OF GUT
GUT SOUNDS MAY
BE AUDIBLE IN
CASE OF
ENTEROCELE
SILENT ABDOMEN
IN CASE OF
PERITONITIS
(PARALYTIC
PARALYSIS)
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33. BLOOD TESTS IMAGING
CBC (TOTAL COUNT
BLOOD SUGAR
SERUM
ELECTROLYTES
BLOOD UREA
SERUM CRITININE
PLAIN XRAY
ABDOMEN IN ERECT
POSITION IN CASE
OF OBS MULTIPLE
AIR FLUIDE LEVELS
U/S ABDOMEN
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35. •OFTEN IN IRREDUCIBLE HERNIA,
REDUCTION OF HERNIA
IS TRIED BY
1.ELEVATION
2.SEDATION
3.TAXIS
25-8-2015 35
36. •IT IS A TRIAL TO REDUCE PARTIALLY
REDUCED OR IRREDUCIBLE HERNIA
WHILE FLEXING AND MEDIALLY
ROTATING THE HIP
•IT IS DANGEROUS IN
OBS AND MAYDLES HERNIA
25-8-2015 36
38. 1. PREOP TREATMENT
•PT ADMITTED
• IV CANULA
•RYLE,S TUBE (NG) ASPIRATION
•IV FLUIDS TO CORRECT
DEHYDRATION AND ELECTROLYTE
IMBALANCE
•ANTIBIOTICS
•CATHETERISATION
•SHIFT PT FOR EMERGENCY SURGERY
25-8-2015 38
39. OPERATION – NO 1.INGUINAL HERNIOTOMY
1.INCISION
•INCISION IS MADE OVER THE MOST
PROMINENT
PART OF THE SWELLING
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40. 2.DELIVERING & OPENING
OF SAC
•SAC IS EXPOSED
•CONSTRICTION RING AND SUP RING IS RELEASED
•DELIVER BODY AND FUNDUS OF SAC WITH
COVERING ONTO SURFACE
•SAC IS OPENED WITHOUT SPILLAGE OF FLUIDE
•FLUID IS SUCKED AND MOPPED
25-8-2015 40
42. 2.IN CASE OF INTESTINE
•BOWEL IS HELD WITH FINGERS SO AS TO PREVENT
IT FROM GETTING REDUCED
•VIABILITY OF THE BOWEL IS CHECKED BY
•COLOUR
•PERISTALSIS
•PULSATION
•BLEEDING
VIABLE INTESTINE IS RETURNED TO PERITONEAL
CAVITY WHEN GANGRENOUS RESECTION AND
ANASTOMOSIS IS DONE AND DRAIN IS PLACED
25-8-2015 42
43. 4.EXCISION OF SAC
1. MODERATE SIZED HERNIAL SAC CAN
BE EXCISED AND CLOSED BY A PURSE
STRING SUTURES
2. LARGE SIZED &ADHERENT HERNIAL SAC
IS CUT ACROSS AND NECK OF SAC IS
TIED AND SUTURED
6.WOUND CLOSER
•WOUND CLOSE LAYER BY LAYER25-8-2015 43
44. NO.2 BASSINI,S REPAIR
•IT IS DONE BY PLACING INTERUPTED NON-
-ABSORBABLE SUTURES
NO.3 LIGHTWEIGHT MESH
•SOME SURGOENS STILL USE A LIGHWEIGHT
SYNTHETIC MESH COVERED BY APPROPRIATE
ANTIBIOTIC
25-8-2015 44
46. 1. BAILEY,S AND LOVE
2. SRB,S MANUAL OF SURGERY
3. ESSENTIALS OF SURGERY BY DR SHAMIM
4. WIKIPEDIA
5. TOPIC UPON HERNIA FROM UNIVERSITY OF
COLORADO HOSPITAL
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