ultrasonographyOver the last 10 years, ultrasound has developed into an indispensible tool in anaesthesia and intensive care. Ultrasound is not new to medicine but its use in anaesthesia is. Ultrasound technology is emerging rapidly and the field of anaesthesia is not untouched by its widespread applications. Uses of ultrasound in anaesthesia: Establishing vascular access Regional anaesthesia for nerve blocks Trans-oesophageal echocardiography tool for cardiac imaging Lung imaging Viewing blood flows to rule out deep vein thrombosis and peripheral vascular disease Assessing depth of epidural space in cases of difficult anatomy Role of ultrasound in airway assessment Basic physics: Sound is produced when mechanical energy travels
The index finger can pass though the transverse sinus, which helps surgeons to identify the blood vessels of the heart during coronary artery bypass surgery. Oblique sinus is formed by reflection of the pericardial membranes onto the pulmonary veins. It is bounded by the inferior vena cava and by the right pulmonary veins on one side and the left pulmonary veins on the other. Functions of the Pericardium The pericardium is known to have some specific functions: • Tethering: pericardium holds the heart in place within the cardiac
(ii) Horizontally, it stretches out from the horizontal fringe of the sternum to the midaxillary line. Profound Relations: The profound surface of the bosom is identified with the accompanying structures in a specific order. 1. The bosom lies on the profound sash (pectoral belt) coating the pectoralis major. 2.
Abstract: Ocular lymphomas are rare malignancies that display a myriad of clinical manifestations; therefore the diagnosis can be a challenging task. Almost all intraocular lymphomas are B cell non-Hodgkin’s lymphomas. Although the orbit is an extranodal site where lymphocytes are not found under normal conditions, lymphoid tumors are the third most common cause of proptosis in the adults. Ocular lymphomas are most challenging cases seen by ophthalmologists and are more serious eye conditions, leading possibly to blindness and death. We describe a series of 4 cases which presented as ocular adnexal masses and a view on clinicopathological details.
Inferior vena cava, extra-parenchymal portal vein and the gall bladder were excluded from the outline. Hepatic veins and intra-parenchymal portal venous system and the fissures that did not open into the abdominal cavity were included in the outlining . Volume was determined in milliliters using the automatic volumetry software of Intellispace Portal (Philips Healthcare, Best, The
If the total urogenital mobilization proves not be enough to repair the malformation, then the operation must be completed through a laparotomy. The separation of the rectum from the vagina is not difficult in very high malformations since it is similar to what is described in the separation of the rectum from the bladder neck in male patients. On the other hand, the separation of the vagina from the urinary tract in a case of a cloaca with a long common channel is a very delicate maneuver that requires expertise and finesse. Once the vagina has been completely separated, which is a maneuver that may take several hours, the surgeon then has to make important decisions considering the way to repair the vagina. The separation of the vagina from the urinary tract should be performed with the bladder open in the midline and with ureteral catheters.
The thoracic oesophagus is situated a little to the left in the superior mediastinum between the trachea and the vertebral column. It passes behind and to the right of the aortic arch to descend in the posterior mediastinum along the right side of the descending thoracic aorta. Below, as it inclines left, it crosses anterior to the aorta and enters the abdomen through the diaphragm at the level of the tenth thoracic vertebra. From above downwards, the trachea, right pulmonary artery, left main bronchus, pericardium (separating it from the left atrium) and the diaphragm are anterior. The vertebral column, longus colli, right posterior intercostal arteries, thoracic duct, azygos vein and the terminal parts of the hemiazygos and accessory hemiazygos
CT scan of the patient revealed a lobulated, well-circumscribed, intensely enhancing soft-tissue mass filling the left nasal cavity. Epicentre of the lesion was seen to be in the nasal cavity and it was closely attached to the middle turbinate with no erosion or remodelling of underlying bones. A diagnosis of haemangioma or angiofibroma was made. (Figure 1 & 2) Diagnostic nasal endoscopy was done, which revealed a polypoidal mass attached to the middle turbinate. Endoscopy assisted mass excision was planned.
These patients were subjected to anthropometric measurements namely waist hip ratio, weight height, skin fold thickness and Lipid profile was done. Results: Both the groups were matched for age, sex and risk factors other than the one studied, namely smoking, alcoholism, diabetes, hypertension, family H/o. There is no statistical difference is noted between the two groups in age, sex, smoking, alcoholism, Hypertension, Diabetes, Family H/o. In all these parameters compared between these groups the P value is more than 0.05 which is statistically insignificant. Conclusion: BMI does not properly define obesity and the risk of cardiovascular events.
3.3 Methods 3.3.1 Dissecting protocol Ethical consent was sought and approved by the University Ethics Committee of the University Putra Malaysia (UPM) under the code: UPM/TNCPI/184.108.40.206 (JKEUPM) F2. 220.127.116.11 Position and orientation The cadavers were placed in supine position and both arms were abducted at an angle of ninety degree, 90°. The following anatomical land marks were located before started dissection. 1. Jugular notch - the superior border of the manubrium 2.
Pulmonary Artery Pressure Monitoring This monitors the pressures in the right side of the heart and indirectly measures the left side of the heart. This is the most invasive catheter used in critical care, and routine use of the pulmonary artery (PA) catheter is controversial; it can assess many hemodynamic parameters such as PA systolic and diastolic, pulmonary MAP, pulmonary artery wedge pressure (PAWP), and cardiac output. Cardiac output is used to calculate other parameters such as cardiac index, systemic vascular resistance (SVR), and pulmonary vascular resistance (PVR). PAWP is also known as pulmonary artery occlusive pressure or pulmonary capillary wedge pressure. The traditional PA catheter is known as a Swan-Ganz catheter after its inventors, and the thermodilution catheter after the principle behind its operation.
Several detailed laboratory investigations are performed to exclude systemic causes, malignancy, or any other ongoing process that must be excluded prior to repair. In our study most of the septal perforations were caused following septal surgery as mentioned above. Tomography of the paranasal sinuses is indicated to evaluate the nasal septum and the presence of concomitant paranasal sinus disease9. We assessed the size of perforations and the size of the flap available preoperatively using Plain CT-scan of Nose and Paranasal sinuses with a combination of axial and coronal sections. This gave us a clear picture of the defect in the nasal septum along with accurate information of the availability of nasoseptal flap.
Prescribed drug policies entailed varying detail regarding specific drugs or groups of drugs, including ' over the counter ' medications as well as prescription only drugs. In many cases, they recommended or required that advice be sought from a company medical practitioner or from an approved aviation medical examiner (William E. Thomas 43). Screening policies Eighteen airlines indicated that they had an alcohol and/or drugs screening program for aircrew. Unfortunately, variable amounts of detail were provided, and in two cases no information was provided at all. Two airlines referred only to conducting medical examinations; in one case on a 'frequent ' basis, and in the other case on a 'random ' basis prior to flying duties.
M., Pickett, A. M., Van Blarcum, G. S., Mack, A. W., & Newman, M. T. (2015). The use of intravenous tranexamic acid in patients undergoing total hip or knee arthroplasty: A retrospective analysis at a single military Institution. Military Medicine, 180(10), 1087-1090. doi:10.7205/MILMED-D-14-00657 The research design for this reference is a retrospective review of a single case-controlled study. Referencing the Table 1 level of evidence, this study would be categorized as level 2. The study reviewed all total hip arthroplasty (THA) and TKR surgeries that administered TXA intraoperatively from February 2012 to April 2014 (Formby, Pickett, & Van Blarcum et al., 2015).
In critically ill patients, several scoring systems have been developed. The Acute Physiology and Chronic Health Evaluation (APACHE) and the Simplified Acute Physiology Score (SAPS) are the most common scoring systems used in the intensive care unit (ICU).  They are used for risk stratification and prediction of mortality.  The scoring systems should be easy, quick,cheap and predict something clinically important over a wide range of clinical situations.  While it seems that scores using a larger number of data inputs are the best scoring systems, simpler scores are better than complex scores.