Color Doppler Ultra sound Imaging Course
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Enhance your medical skills with our Doppler Ultrasound Course! Master blood flow assessment and vascular diagnosis with expert-led training, hands-on practice, and cutting-edge techniques. Enroll now to advance your career.
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Definition: - It is defined as suspending a part of the body or whole body with the supported slings and pulleys. That is given to the patients to increase ROM, increase muscle power, and support body part. Suspension free the body from friction of material upon the body components may be resting and it permits free movements without resistance. Late Mrs. Guthrie Smith invented the suspension apparatus.
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Friction.
Pendulum.
Eliminating gravity.
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Easy to lift the limbs.
Active movement can be performed easily with minimum friction.
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Suspension instruments: -
Suspension frame.
Supporting ropes.
Pulleys.
Slings.
S-hook and dog clips.
Wooden cleat.
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---
II. Peptic Ulcer Disease (PUD)
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Etiology and Risk Factors
Helicobacter pylori infection – Present in ~90% of duodenal and 70% of gastric ulcers.
NSAIDs – Inhibit prostaglandin synthesis, compromising mucosal defense.
Smoking – Impairs mucosal healing.
Stress (critical illness) – Leads to stress ulcers.
Zollinger-Ellison Syndrome – Gastrinoma with excess acid secretion.
Corticosteroids, alcohol, and genetic predisposition are other contributors.
Pathophysiology
The balance between aggressive factors (acid, pepsin, H. pylori, NSAIDs) and defensive mechanisms (mucus, bicarbonate, blood flow, prostaglandins) determines mucosal integrity.
H. pylori causes chronic inflammation and epithelial damage. NSAIDs decrease prostaglandins, reducing mucosal blood flow and bicarbonate production.
---
III. Clinical Features of Peptic Ulcer
Epigastric pain: Most common symptom; burning or gnawing in nature.
Duodenal ulcers: Pain relieved by food, occurs 2–3 hours after meals.
Gastric ulcers: Pain worsens with food intake.
Nausea, bloating, early satiety
Complications:
Bleeding: Hematemesis, melena.
Perforation: Sudden severe abdominal pain.
Gastric outlet obstruction
Penetration into adjacent organs (e.g., pancreas)
---
IV. Diagnosis of Peptic Ulcer
Endoscopy: Gold standard for diagnosis and biopsy to rule out malignancy.
Rapid urease test, histology, urea breath test, stool antigen – for H. pylori.
Serologic testing (less preferred).
Barium study
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TYPES
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CLINICAL MANIFESTATION
painless leakage of fluid from vagina
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decrease uterine size
abdominal pain and back pain
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DIAGNOSTIC EVALUATION
History collection (steady loss of small amount of fluid from vagina)
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Pooling test: During a speculum examination, healthcare providers look for amniotic fluid accumulating in the posterior vaginal fornix (the area at the back of the vagina).
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Induction of labor reduces the time of delivery and the rates of chorioamnionitis and endometritis and admission to the neonatal intensive care unit.
If the patient does not go into spontaneous labor on her own then labor induction should be performed with oxytocin. So, use oxytocin or prostaglandins as indicated Otherwise, perform cesarean delivery.
COMPLICATIONS
IF FETUS REMAIN IN UTERO
Neonatal conditions
Infection and sepsis
Deformations
Umbilical cord compression
Pulmonary hypoplasia
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Main Components of an Anesthesia Machine:
Gas Supply:
Oxygen (O₂), nitrous oxide (N₂O), and medical air are commonly used.
Can come from cylinders or a hospital’s central gas supply.
Flow Meters:
Control the flow rate of gases going to the patient.
Measured in liters per minute (L/min).
Vaporizers:
Convert liquid anesthetic agents (like isoflurane, sevoflurane) into gas form.
Allows precise control of anesthetic concentration.
Breathing Circuit:
Connects the machine to the patient via a face mask or endotracheal tube.
Includes inspiratory and expiratory pathways.
Ventilator:
Provides controlled or assisted breathing to the patient.
Works in different modes like volume-controlled or pressure-controlled ventilation.
Scavenging System:
Removes excess anesthetic gases to prevent leakage into the operating room.
Ensures safety for healthcare providers.
Carbon Dioxide Absorber:
Uses soda lime or another absorbent to remove CO₂ from exhaled air in a closed circuit.
Safety Features:
Alarms for oxygen failure, low pressure, or high airway pressure.
Oxygen flush system for emergencies.
Hypoxic guard to prevent delivery of pure nitrous oxide (ensuring oxygen is always mixed i
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💡 Key Topics Covered:
✔ History and Evolution of Pharmacoeconomics
✔ Goals and Objectives of Pharmacoeconomic Studies
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✔ Different Pharmacoeconomic Methodologies (Cost-Minimization, Cost-Effectiveness, Cost-Utility, Cost-Benefit)
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Introduction
Lipid autocoids, also known as eicosanoids and related lipid mediators, are bioactive molecules derived from polyunsaturated fatty acids (PUFAs). These molecules play crucial roles in inflammation, immunity, hemostasis, cardiovascular function, and various physiological and pathological processes. Unlike classical hormones, lipid autocoids act locally, exerting their effects at or near their site of synthesis.
This document provides an in-depth analysis of lipid autocoids, covering their biosynthesis, classification, physiological roles, and clinical significance.
Classification of Lipid Autocoids
Lipid autocoids are broadly classified into the following categories:
1. Eicosanoids (Derived from Arachidonic Acid)
Prostaglandins (PGs)
Thromboxanes (TXs)
Leukotrienes (LTs)
Lipoxins (LXs)
2. Specialized Pro-resolving Mediators (SPMs)
Resolvins
Protectins
Maresins
3. Endocannabinoids
Anandamide (AEA)
2-Arachidonoylglycerol (2-AG)
4. Platelet-Activating Factor (PAF)
5. Sphingolipid-Derived Mediators
Sphingosine-1-Phosphate (S1P)
Ceramides
Biosynthesis of Lipid Autocoids
Lipid autocoids are derived from membrane phospholipids through enzymatic pathways:
1. Phospholipase A2 (PLA2) Activation:
PLA2 catalyzes the release of arachidonic acid (AA) from membrane phospholipids.
2. Cyclooxygenase (COX) Pathway:
Converts AA into prostaglandins and thromboxanes.
COX-1: Constitutive enzyme (housekeeping functions).
COX-2: Inducible enzyme (inflammation and pain response).
3. Lipoxygenase (LOX) Pathway:
Converts AA into leukotrienes and lipoxins.
5-LOX: Leads to leukotrienes (inflammation, bronchoconstriction).
12-LOX & 15-LOX: Lead to lipoxins (anti-inflammatory action).
4. Cytochrome P450 (CYP) Pathway:
Converts AA into epoxyeicosatrienoic acids (EETs), which regulate vascular tone.
5. Endocannabinoid Biosynthesis:
Derived from membrane phospholipids via enzymatic reactions.
Degraded by fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MAGL).
Physiological Roles of Lipid Autocoids
1. Inflammation and Immune Response
Prostaglandins (e.g., PGE2) modulate fever and pain.
Leukotrienes mediate allergic responses and asthma.
Lipoxins and resolvins promote resolution of inflammation.
2. Cardiovascular System
Thromboxanes (TXA2) induce platelet aggregation and vasoconstriction.
Prostacyclin (PGI2) inhibits platelet aggregation and promotes vasodilation.
EETs regulate blood pressure and vascular homeostasis.
3. Pulmonary Function
Leukotrienes (LTC4, LTD4, LTE4) are potent bronchoconstrictors.
PGE2 has bronchodilatory effects.
4. Renal Function
Prostaglandins regulate glomerular filtration rate and sodium excretion.
EETs contribute to natriuresis.
5. Neurotransmission and Pain
Endocannabinoids modulate pain perception and neuroprotection.
Prostaglandins contribute to central pain sensitization.
6. Reproductive System
P
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. Introduction to Suspension therapy.pptxDr. Prashant Kaushik Contents: -Definition, Principle, Advantages, Suspension instruments, Procedure, Types of suspension, Techniques.
Definition: - It is defined as suspending a part of the body or whole body with the supported slings and pulleys. That is given to the patients to increase ROM, increase muscle power, and support body part. Suspension free the body from friction of material upon the body components may be resting and it permits free movements without resistance. Late Mrs. Guthrie Smith invented the suspension apparatus.
Principle: - It is working under three principle: -
Friction.
Pendulum.
Eliminating gravity.
(a) Friction: - It occurs during a particular surface move on another. It is the force, which restrict the movement of an object. If the surface are more smooth and slippery will have less friction, in that surface the movement will be more and will cause slippery. If the surface is hard or rough results in more friction and the movements are opposed by the friction force.
The same principle is used in the suspension which has less friction causes smooth and easy movements.
(b) Pendulum: - Pendulum is heavy material suspended by the weightless thread. The force is applied on the pendulum it results in to and fro movement.
One complete swing is called as Oscillation. The arc of movement of the pendulum forms a segment of base of the cone. In the human body the pendular motion occurs mainly in the shoulder joint and the hip joint, forward leg movement and the arm swing movement while walking. The simple muscular contraction is necessary to initiate the oscillation. The same mechanism is used in the suspension therapy to maintain the muscle property, increase the range of movement and strengthening the muscles.
(c) Eliminating Gravity Movement: - If the person has the muscle power 2 (gravity eliminated movement), can go for the suspension exercises.
The patients should have minimal muscle power of 2 to under go for suspension therapy exercise. If the muscle power is above 3, the patient can go for against the gravity exercise instead of suspension therapy exercise.
Advantages: - It reduces the burden for the therapist.
Easy to lift the limbs.
Active movement can be performed easily with minimum friction.
Easier to maintain the position of limbs with slings and pulleys in the required position.
Suspension instruments: -
Suspension frame.
Supporting ropes.
Pulleys.
Slings.
S-hook and dog clips.
Wooden cleat.
(a) Suspension Frame: - It is made up of stainless steel or plastic-coated steels. In the top and head end side presents the 5-centimeter metal mesh, and the remaining sides are kept open. The measurement of the frame is 1m or 2m width X 2m length X 2m height. In the middle of the frame 2m length X 1m width X 1m height couch is placed for the patient's accommodation.
(b)Supporting Ropes: - It is 1.5 meters length, and 3 ply hemp ropes are used for the suspension to avoid slipping.
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While PUD typically involves mucosal erosion in the stomach or proximal duodenum due to Helicobacter pylori infection or NSAID use, GERD arises from the reflux of gastric contents into the esophagus due to incompetent lower esophageal sphincter tone. Both conditions necessitate a thorough understanding of their etiopathogenesis for rational therapy and long-term management. This document explores the latest, evidence-based treatment paradigms, structured with clarity and clinical relevance.
---
II. Peptic Ulcer Disease (PUD)
Definition and Epidemiology
Peptic ulcers are breaks in the mucosal lining of the stomach or duodenum that penetrate the muscularis mucosa. Gastric ulcers typically occur on the lesser curvature of the stomach, while duodenal ulcers are found in the first part of the duodenum.
Globally, the prevalence of PUD has declined, largely due to H. pylori eradication, yet NSAID-related ulcers persist, especially among the elderly.
Etiology and Risk Factors
Helicobacter pylori infection – Present in ~90% of duodenal and 70% of gastric ulcers.
NSAIDs – Inhibit prostaglandin synthesis, compromising mucosal defense.
Smoking – Impairs mucosal healing.
Stress (critical illness) – Leads to stress ulcers.
Zollinger-Ellison Syndrome – Gastrinoma with excess acid secretion.
Corticosteroids, alcohol, and genetic predisposition are other contributors.
Pathophysiology
The balance between aggressive factors (acid, pepsin, H. pylori, NSAIDs) and defensive mechanisms (mucus, bicarbonate, blood flow, prostaglandins) determines mucosal integrity.
H. pylori causes chronic inflammation and epithelial damage. NSAIDs decrease prostaglandins, reducing mucosal blood flow and bicarbonate production.
---
III. Clinical Features of Peptic Ulcer
Epigastric pain: Most common symptom; burning or gnawing in nature.
Duodenal ulcers: Pain relieved by food, occurs 2–3 hours after meals.
Gastric ulcers: Pain worsens with food intake.
Nausea, bloating, early satiety
Complications:
Bleeding: Hematemesis, melena.
Perforation: Sudden severe abdominal pain.
Gastric outlet obstruction
Penetration into adjacent organs (e.g., pancreas)
---
IV. Diagnosis of Peptic Ulcer
Endoscopy: Gold standard for diagnosis and biopsy to rule out malignancy.
Rapid urease test, histology, urea breath test, stool antigen – for H. pylori.
Serologic testing (less preferred).
Barium study
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Artificial Intelligence, Data and Competition – SCHREPEL – June 2024 OECD dis...OECD Directorate for Financial and Enterprise Affairs
Color Doppler Ultra sound Imaging Course
- 1. Mediflick Yourfavourite online courses at anytime from anywhere!
- 2. About Mediifflliick Mediflick is an online radiology house, the idea behind the foundation of Mediflick.com was to keep updating the medical professionals regarding new advances in the field of medical education along with making basics strong.
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