The document provides an overview of basic wound healing sciences. It begins with the history of wound management in ancient Egypt. The rest of the document is summarized in the following points:
1. It defines wounds and classifies them. The normal wound healing process occurs in three phases: inflammatory, proliferative, and remodeling.
2. Factors that affect wound healing and potential complications are discussed. Chronic wounds and types of abnormal scarring like hypertrophic scars and keloids are also covered.
3. The reconstructive ladder is explained as the hierarchical approach used in wound closure, ranging from dressings to skin grafts and flaps. Recent advances in wound care like negative pressure therapy and skin substit
This lecture covers the basics of suturing i.e wound healing, indications and contraindications of suturing, wound assessment, wound aftercare, suture and needle types, suturing techniques, knot types.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
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.
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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.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Wound healing seminar 24 sept 2019 [autosaved]
1. Basic sciences of Wound healing
1This Photo by Unknown Author is licensed under CC BY
Presenter Dr. Shashank
Dr. Saurabh
Moderator Dr Shreesha
2. The ancient Egyptians were the first civilization to have
trained clinicians to treat physical aliments. Medical papyri,
such as the Edwin Smith papyrus (circa 1600 BCE) and the
Ebers papyrus (circa 1534 BCE), provided detailed
information of management of disease, including wound
management with the application of various potions and
grease to assist healing. [1, 2]
History of Wound Management
2
3. Contents:
3
• Wound definition
• Classification of wounds
• Healing
• Types of wound healing
• Stages of wound healing
• Phases of wound healing
• Factors affecting wound healing
• Complication
4. Definition of wound
• A wound is a break in the integrity of
the skin or tissues often which may be associated
disruption of the structure and function
4
5. • Tidy wound – Primary closure of all structures (bone, tendon,
vessel and nerve) may be possible
• Contaminated wound – Require debridement before definitive
repair
5
Rank and Wakefield classification
6. Types of Wounds
Tidy wounds Untidy wounds
Incised Crushed or avulsed
Clean Contaminated
Healthy tissues Devitalized tissues
Seldom tissue loss Often tissue loss
6
7. Normal Wound Healing
• Three phases
• Inflammatory phase
• Begins immediately after wounding, lasts 2-3 days
• Vasoconstriction, thrombus formation
• Platelet aggregation
• Infiltration of inflammatory cells
• Removal of devitalized tissue and microorganisms by macrophages
7
8. Normal Wound Healing
• Proliferative phase
• 3rd day to 3rd week
• Fibroblast activity, with production of collagen and ground substance
• Angioneogenesis
• Reepithelialisation of wound surface
• Remodelling / Maturation phase
• Maturation of collagen
• Type III replaced by type I (1:4)
8
10. The Reconstructive Ladder
• A heirachy of options available for closing a wound
• Systematic, modern and safe approach to reconstruction
▫ Choose least aggressive method initially
▫ Rise-up rungs of the ladder as necessary
▫ More problematic wounds may require higher rungs
10
11. Step 1: Dressings
• Adjunct applied to a wound to promote healing and
prevent further harm
• Allow the wound to heal by secondary intention
• Aim – maintain a moist environment without excess
exudate
11
12. Low Adherence Dressing
Maintain a moist wound bed
• Allow exudate to pass through into a secondary dressing e.g gauze
Semi Permiable Film
Transparent polyurethane sheet coated with hypoallergenic adhesive • Permeable to air and water vapour; impermeable to
fluids and microorganisms • Example - Tegaderm
Foam Dressing
Highly absorbent with a hydrophobic backing to prevent strikethrough
Hydrocolloids
Virtually impermeable
12
13. Alginate
Very absorbent – used only on wound with high exudate
Antimicrobial dressing
Reduce microbial load in colonised or infected wounds • Silver =
most common active ingredient; Iodine also effective
Vaccum Assisted Closure
• Draws excess exudate away from the wound
• Promotes angiogenesis and granulation
• Continuous or intermittent suction
• ▫ 50-70mmHg – chronic wounds/skin grafts
• ▫ ~120mmHg – acute wounds
13
14. Step 2: Primary (or delayed) closure
• Primary closure – appose + secure incised wound edges
• Traumatic/dirty wounds – may require debridement
delayed closure
Step 3: Skin grafting
• Block of tissue transferred without blood supply
• Classified according to tissue of origin:
▫ Autograft ▫ Allograft ▫ Xenograft
14
15. Step 4: Tissue expansion
• Increases surface area of locally available skin
• Expander implant into subcutaneous pocket
serial injection with saline via port over weeks/months
• Expander removed skin advanced
Step 5: Flaps
Flap = “a unit of tissue which maintains its
own blood vessels whilst being transferred
from a donor site to a recipient site”
• 3 broad types –
random pattern, pedicled and free
15
16. Managing The Acute Wound
• Cleansing
• Exploration and diagnosis
• Debridement
• Repair of structures
• Replacement of lost tissues where indicated
• Skin cover if required
• Skin closure without tension
16
17. Factors Influencing Wound Healing
• Site of wound
• Structures involved
• Mechanism of wounding – Incision / Crush / Crush avulsion
• Contamination (Foreign bodies / bacteria)
• Loss of tissue
• Other local factors
• Vascular insufficiency
• Previous radiation
• Pressure
17
18. •Systemic factors
• Malnutrition or vitamin and mineral deficiencies
• Disease (Diabetes)
• Medications (Steroids)
• Immune deficiencies (Chemotherapy, AIDS)
• Smoking
18
19. •Contraction
• Spontaneous closure of full thickness skin wounds or contraction of tubular organs
such as common bile duct or oesophagus after injury
• Active biologic process that decreases the dimension of involved connective tissue
• May be useful for healing of large open full thickness wounds
• May lead to severe functional and asthetically deforming contractures
19
20. •Connective tissue matrix deposition
• Fibroblasts are recruited at site of injury and produse new connective tissue matrix
• Important process in primary wound closure
20
21. Types of Wound Closure
• Primary closure / Healing by first intention
• Immediate closure of wound using sutures, clips, staples and adhesive materials
• Minimal scarring
• Delayed primary closure
• Approximation delayed until several days to prevent infection
• Wounds with significant bacterial contamination, foreign bodies or extensive
tissue trauma
21
22. Types of Wound Closure
• Spontaneous / Secondary wound healing
• Wound left open
• Heals by granulation, contraction and epithelialisation
• Poor scar
22
23. Difference between 1˚ & 2˚ union of
wound
23
FEATURES PRIMARY SECONDARY
CLEANLINESS CLEAN NOT CLEAN
INFECTION NOT INFECTED INFECTED
MARGINS SURGICALLY CLEAN IRREGULAR
SUTURES USED NOT USED
HEALING SMALL GRANULATION
TISSUE
LARGE GRANULATION
TISSUE
OUT COME LINEAR SCAR IRREGULAR WOUND
COMPLICATION NOT FREQUENT FREQUENT
29. Type of scar
• Normal scar
: normal wound healing process
• Abnormal scar
: Multiple disturbance in wound healing process
: Excessive collagen production
: Reduce collagen degradation
29
30. What is a Keloid?
• Non-cancerous fibrous proliferations that occur in the dermis after
trauma or injury to the skin
• Keloids grow beyond the boundaries of the original wound site (vs.
hypertrophic scar)
• Etiological factors that determine how a scar becomes a keloid
remain unknown
30
31. Who and Why?
• Individuals with darker-pigmented skin or who freckle are more
predisposed
• Seen largely in Africans, African-Americans, Hispanics, and Asians
• Can be a familial/genetic predisposition
• Can be due to immunological causes
• Bottom line… No one knows!
31
32. How? (Pathophysiology)
• A result of an overactive inflammatory response and fibroblast
proliferation
• A result of an abnormal collagen deposition in healing skin wounds
• Skin wound tension is a contributing factor in keloid formation
• Individuals with an inflammatory or infectious element are at a
predisposition for keloids
32
39. Hypertrophic scar
• Linear, red, raised firm scar
• Confined to the original injury site
• Pruritic, but not pain or hyperesthesia
• Common affect under constant pressure and stretching area
• Usually arise within 1 month of injury
39
42. Hypertrophic Scar / Keloid
42
Hypertrophic scar Keloid
Can regress Does not regress
Oriented collagen Random eosinophilic
collagen
Confined to wound Not confined
Scant mucin Mucinous stroma
No myofibroblasts Myofibroblasts
43. • In this stage alkaline phosphatase plays an important
role in mineralization.
• Several growth factors identified as a key components in
the production of osseous tissue are:
a. TGF- ß
b. BMP
c. PDGF
d. FGF
e. IGF
43
44. Growth Factors
• Growth Factors and Biologic Wound Products
• • Biologic wound products aims to accelerate healing by
augmenting or modulating inflammatory mediators
• • Prostaglandin E1
• • Cytokines-Chemokines , lymphokines, monokines, interleukins,
colony-stimulating factors, and interferons.
•
• • Becaplermin(Regranex)rhPDGF & EGF-FDAapproved products
in the growth factor family
44
45. COMPLICATION:
45
1. Deficient scar formation:
a) Wound dehiscence
b) Ulceration
2. Excessive formation of the repair components:
a) Aberrations of growth: -hypertrophic scar
-keloid
b) Excessive amount of granulation tissue
formation
46. c) Exuberant proliferation of fibroblasts and other
connective tissue elements: Desmoids or Aggressive
fibromatoses
46
3. Formation of contractures
48. 48
Silver Sulfadiazine and Nitrate
• Higher rate of resistance
Nanocrystalline Silver Dressing
• Impaired reepithelialization
• Pseudoeschar formation
• Bone marrow toxicity from the propylene glycol
• High enough initial concentration (3176mg/L and 3025mg/L, resp. but have little to no
residual activity
49. 49
•Nanocrystalline Silver Dressing
Two layers of high-density polyethylene net sandwiching a layer of
rayon/polyester gauze
• Outer layer is coated with a nanocrystalline (<20nm), noncharged
form of silver (Ag0), and the inner layer helps maintain a moist
environment for wound healing