This document discusses current concepts in managing the difficult airway. It summarizes several alternative airway devices and techniques including lighted stylets, video laryngoscopes, rigid and flexible fiber-optic laryngoscopes, supraglottic airway devices, awake intubation techniques using topical anesthesia, flexible fiber-optic intubation, retrograde intubation, transtracheal jet ventilation, cricothyrotomy, and tracheostomy. It provides tables describing many new airway devices and concludes that clinical experience is crucial for applying these techniques and devices to solve most airway problems.
Management Outcomes of Post-Thyroidectomy Bilateral Recurrent Laryngeal Nerve Paralysis at National Hospital Abuja by Olusesi Abiodun Daud in Experiments in Rhinology & Otolaryngology
Bilateral recurrent laryngeal paralysis is an uncommon complication of total or subtotal thyroidectomy, observed in approximately 0.4 per cent of cases. This paralysis could be temporary or permanent. An audit of 5 cases referred to the ENT Department of National Hospital Abuja, between January 2010 and July 2017 is presented. All cases were referred already on tracheostomy tubes and were females aged 11 to 59 years. 4 of the cases had external arytenoidectomy, bilateral in 2 cases, and unilateral in 2 cases. 4 out of the 5 cases were successfully decannulated. The preferred approach to cases of post-thyroidectomy bilateral recurrent laryngeal nerve paralysis referred to ENT Specialists in resource-poor economy like ours is not very clear from existing literature and we discuss our adopted protocol for management of such cases in this case series.
https://crimsonpublishers.com/ero/fulltext/ERO.000511.php
Management Outcomes of Post-Thyroidectomy Bilateral Recurrent Laryngeal Nerve Paralysis at National Hospital Abuja by Olusesi Abiodun Daud in Experiments in Rhinology & Otolaryngology
Bilateral recurrent laryngeal paralysis is an uncommon complication of total or subtotal thyroidectomy, observed in approximately 0.4 per cent of cases. This paralysis could be temporary or permanent. An audit of 5 cases referred to the ENT Department of National Hospital Abuja, between January 2010 and July 2017 is presented. All cases were referred already on tracheostomy tubes and were females aged 11 to 59 years. 4 of the cases had external arytenoidectomy, bilateral in 2 cases, and unilateral in 2 cases. 4 out of the 5 cases were successfully decannulated. The preferred approach to cases of post-thyroidectomy bilateral recurrent laryngeal nerve paralysis referred to ENT Specialists in resource-poor economy like ours is not very clear from existing literature and we discuss our adopted protocol for management of such cases in this case series.
https://crimsonpublishers.com/ero/fulltext/ERO.000511.php
Dr Pawan Sharma1*, Dr D K Verma2, Dr Raj Kumar3
1General Surgeon Incharge, Civil Hospital Rohru, Shimla (HP), India
2Professor of Surgery, IGMC Shimla (HP), India
3General Surgeon Incharge, Distt Hospital Bilaspur (HP), India
*Address for Correspondence: Dr. Pawan Sharma, General Surgeon Incharge, Department of Surgery, Civil Hospital,
Rohru, Shimla, HP, India
Received: 17 September 2016/Revised: 11 October 2016/Accepted: 25 October 2016
ABSTRACT- This study was carried out to evaluate laparoscopic retroperitoneal ureterolithotomy (RPUL) as a viable
option to open surgical ureterolithotomy, laparoscopic transperitoneal ureterolithotomy (TPUL) & endoscopic urology and
to assess its place in the spectrum of alternatives for the surgical treatment of ureteric calculi in a tertiary care centre. This
study was conducted on 20 selected patients of single large impacted calculus of size more than 8mm in upper & middle
ureter. It was observed that excessive bleeding was present in only one (5%) of the patients, while need for conversion to
open ureterolithotomy was seen in 8 (40%) cases. No major peri-operative complications were encountered. From our
experience, it can be concluded that this procedure has definitely shown decreased post-operative discomfort, decreased
requirement of post-operative analgesia, better cosmesis, early return to work and less morbidity. RPUL can be considered
as another well-established armamentarium in the armour of laparoscopic surgeons and is recommended as an effective
minimally invasive primary treatment in large, impacted difficult stones in the upper & mid ureter.
Key-words- Retroperitoneal ureterolithotomy (RPUL), Transperitoneal ureterolithotomy (TPUL), Extracorporeal
shockwave lithotripsy (ESWL)
neck trauma
for emergency medicine resident training
penetrating neck trauma
blunt neck trauma
strangulation neck trauma
airway management
how to deal
three zone
no zone strategy
Cardiac Interventions in Pediatric Cardiology: The FutureApollo Hospitals
Pediatric Cardiac interventions have come a long way from the initial intervention in the 1950's. Balloon angioplasty
has been accepted as the procedure of choice in several congenital anomalies. Apart from balloon angioplasties/
valvuloplasties, Atrial Septal Defect, Ventricular Septal Defect (muscular) device closure have been FDA approved
with adequate world wide clinical experience and long-term follow-up. In addition, newer procedures are under
clinical trial for perimembranous VSD device closure in the catheterization lab; per operative closed heart procedure
in the operation theatre or as a hybrid procedure. Palliative procedures like flow restriction to lungs with devices to
equate with surgical pulmonary artery banding; stenting of the patent ductus arteriosus in duct dependent cyanotic
heart disease in the newborn or a combination of these form transcatheter Norwood stage I in the cath lab.
Experience and technology will also help make transcatheter Fontan operation possible and that does not seem too far. The emphasis in pediatric cardiac interventions shall always remain that the decision, procedure, and management of their complications is a joint effort of the surgeon and the interventionalist.
Dr Pawan Sharma1*, Dr D K Verma2, Dr Raj Kumar3
1General Surgeon Incharge, Civil Hospital Rohru, Shimla (HP), India
2Professor of Surgery, IGMC Shimla (HP), India
3General Surgeon Incharge, Distt Hospital Bilaspur (HP), India
*Address for Correspondence: Dr. Pawan Sharma, General Surgeon Incharge, Department of Surgery, Civil Hospital,
Rohru, Shimla, HP, India
Received: 17 September 2016/Revised: 11 October 2016/Accepted: 25 October 2016
ABSTRACT- This study was carried out to evaluate laparoscopic retroperitoneal ureterolithotomy (RPUL) as a viable
option to open surgical ureterolithotomy, laparoscopic transperitoneal ureterolithotomy (TPUL) & endoscopic urology and
to assess its place in the spectrum of alternatives for the surgical treatment of ureteric calculi in a tertiary care centre. This
study was conducted on 20 selected patients of single large impacted calculus of size more than 8mm in upper & middle
ureter. It was observed that excessive bleeding was present in only one (5%) of the patients, while need for conversion to
open ureterolithotomy was seen in 8 (40%) cases. No major peri-operative complications were encountered. From our
experience, it can be concluded that this procedure has definitely shown decreased post-operative discomfort, decreased
requirement of post-operative analgesia, better cosmesis, early return to work and less morbidity. RPUL can be considered
as another well-established armamentarium in the armour of laparoscopic surgeons and is recommended as an effective
minimally invasive primary treatment in large, impacted difficult stones in the upper & mid ureter.
Key-words- Retroperitoneal ureterolithotomy (RPUL), Transperitoneal ureterolithotomy (TPUL), Extracorporeal
shockwave lithotripsy (ESWL)
neck trauma
for emergency medicine resident training
penetrating neck trauma
blunt neck trauma
strangulation neck trauma
airway management
how to deal
three zone
no zone strategy
Cardiac Interventions in Pediatric Cardiology: The FutureApollo Hospitals
Pediatric Cardiac interventions have come a long way from the initial intervention in the 1950's. Balloon angioplasty
has been accepted as the procedure of choice in several congenital anomalies. Apart from balloon angioplasties/
valvuloplasties, Atrial Septal Defect, Ventricular Septal Defect (muscular) device closure have been FDA approved
with adequate world wide clinical experience and long-term follow-up. In addition, newer procedures are under
clinical trial for perimembranous VSD device closure in the catheterization lab; per operative closed heart procedure
in the operation theatre or as a hybrid procedure. Palliative procedures like flow restriction to lungs with devices to
equate with surgical pulmonary artery banding; stenting of the patent ductus arteriosus in duct dependent cyanotic
heart disease in the newborn or a combination of these form transcatheter Norwood stage I in the cath lab.
Experience and technology will also help make transcatheter Fontan operation possible and that does not seem too far. The emphasis in pediatric cardiac interventions shall always remain that the decision, procedure, and management of their complications is a joint effort of the surgeon and the interventionalist.
Google programmes and internships for studentsAndrii Gorbenko
Information of main programmes and internships available for students throughout EMEA.
Language of presentation: Russian.
Translated version will be available pretty soon.
This documentation have all the details about school management system, even in this document have DFD,ERD,FDD digram that are useful to create database. to get more details about this product plz mail me on (aki_string@yahoo.co.in) thanks.....
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Introduction of the Portex Tracheal TubeMediNeeds2
In conditions of critical care, efficient control of the airway is essential for ensuring that patients receive the appropriate amount of ventilation and oxygenation. The Portex Tracheal Tube is a groundbreaking device that was created to improve the safety and effectiveness of endotracheal intubation. This device is one of the most significant advancements in this sector. In this article, we examine the characteristics, advantages, and practical applications of the Portex Tracheal Tube, bringing attention to the vital role it plays in contemporary medical practise.
FOR MORE INFO - https://www.jeenee.net/read-blog/136846_the-introduction-of-the-portex-tracheal-tube.html
Advancements in modern imaging techniques such as ultrasound, magnetic resonance imaging, computer tomography and other radiological procedures have improved the diagnosis of gynecological conditions to a great extent. However, the establishment of a final diagnosis and the initiation of appropriate treatment requires direct viewing of the uterine cavity as in hysteroscopy. In many cases, the patient can be treated during the initial hysteroscopy.
Bilateral vocal fold paralysis is a rare condition. The commonest cause identified is mostly iatrogenic. It can be extremely debilitating for the patient who usually suffers from severe breathlessness on slightest exertion. Many of them requires a tracheostomy to maintain airway. The treatment of bilateral vocal cord palsy is a balance between phonation, airway and swallowing. Several surgical modalities have been described for cases which doesn't improve with conservative management. However transoral CO2 laser endoscopic arytenoidectomy has become the standard of management today for this condition. CO2 laser is arguably the most appropriate tool for cordectomy with the advantage of increased precision, better hemostasis and minimal tissue handling. We describe the procedure of posterior cordectomy with partial arytenoidectomy using transoral CO2 laser in two patients who were successfully managed for this condition in our centre.
Background: Septoplasty is a common surgical
procedure performed by otolaryngologists for the correction of
deviated nasal septum. This surgery may be associated with
numerous complications. To minimize these complications,
otolaryngologists frequently pack both nasal cavities with
different types of nasal packing. Despite all its advantages,
nasal packing is also associated with some disadvantages. To
avoid these issues, many surgeons use suturing techniques to
obviate the need for packing after surgery.
Objective: To determine the efficacy and safety of trans-septal
suture technique in preventing complications and decreasing
morbidity after septoplasty in comparison with nasal packing.
Patients and methods: Prospective comparative study. This
study was conducted in the department of Otolaryngology -
Head and Neck Surgery, Rizgary Teaching Hospital - Erbil,
from the 6th of May 2014 to the 30th of November 2014.
A total of 60 patients aged 18-45 years, undergoing septoplasty,
were included in the study. Before surgery, patients were
randomly divided into two equal groups. Group (A) with transseptal
suture technique was compared with group (B) in which
nasal packing with Merocel was done. Postoperative morbidity
in terms of pain, bleeding, postnasal drip, sleep disturbance,
dysphagia, headache and epiphora along with postoperative
complications including septal hematoma, septal perforation,
crustation and synechiae formation were assessed over a follow
up period of four weeks.
Results: Out of 60 patients, 37 patients were males (61.7%)
and 23 patients were females (38.3%). Patients with nasal
packing had significantly more postoperative pain (P<0.05)><0.05). There was no significant difference between
the two groups with respect to nasal bleeding, septal
hematoma, septal perforation, crustation and synechiae
formation.
Conclusion: Septoplasty can be safely performed using transseptal
suturing technique without nasal packing.
airway management by comparative study beyween Airtraq and McGrath Videolaryngoscope and Classical Macintosh in neutral neck position (stimulated cervical injury scenarios)
Management of iatrogenic bilateral vocal cord paralysis by endoscopic transor...Apollo Hospitals
Bilateral vocal fold paralysis is a rare condition. The commonest cause identified is mostly iatrogenic. It can be extremely debilitating for the patient who usually suffers from severe breathlessness on slightest exertion. Many of them requires a tracheostomy to maintain airway. The treatment of bilateral vocal cord palsy is a balance between phonation, airway and swallowing. Several surgical modalities have been described for cases which doesn’t improve with conservative management. However transoral CO2 laser endoscopic aryte-noidectomy has become the standard of management today for this condition. CO2 laser is arguably the most appropriate tool for cordectomy with the advantage of increased pre-cision, better hemostasis and minimal tissue handling. We describe the procedure of posterior cordectomy with partial arytenoidectomy using transoral CO2 laser in two pa-
tients who were successfully managed for this condition in our centre.