Category Archives: Clinical

Minimally invasive surgeries: Greatest innovation to overcome the pain in traditional surgeries

1The word minimally invasive surgeries or laparoscopic surgeries have become predominant nowadays since it offers the patients with smaller incisions, faster recovery times, reduced pains and the scarring. The probability of accuracy was also high in the case of the minimally invasive surgery when compared to the traditional open surgery.

Laparoscopy has got its name from the instrument which it uses called the laparoscope, a slender tool that has a tiny video camera and light on the end. Whenever a surgeon inserts it through a small cut, they can look through the video monitoring and see what is happening inside. If this technique had not been present, they require the larger cutting which would have been more painful. At the starting stages minimally invasive surgeries have been used for the gynecological surgeries and now its use has become predominant in all the cases of surgery.

Key benefits of having this kind of surgery is that we have smaller scars, shorter hospital stays and less pain.

When a robot helps?

In robotics assisted version of laparoscopic surgery, the surgeons first cut through the skin and inserts the camera as usual and later they use the robot’s mechanical arms to perform the surgery. Most of the surgeons think robotics assisted surgery is helpful in treating the people who weigh a lot, and for the gynecological and the urological surgery. The robotic surgery, the monitor gives the surgeon 3-D, high-resolution, magnified images inside the body. While they are watching the screen, they use the hands to control the robot and the surgical instruments. This helps the surgeon to be more successful and it causes the less discomfort to the body after the operation and has the very less bleeding.

The next level of advancement in the case of surgery is the gaming technology and the virtual augmentation in surgeries.

Ways hospitals can improve surgical training through technology: Nurturing the fields of surgery and surgical instrumentation

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Improving the standard of surgery to be performed has became one of the key roles for the growing and developed hospitals and here are the some of the steps carried are adopted by them to improve the fields of surgery. The first and foremost thing to be monitored is quality. Generally outcomes are partly measured with the quality of care surgery patients receive throughout their hospital stays. Importantly technical quality of surgical procedures is also the major factor for the positive outcomes. Advances in technology and analytics have created opportunities for evaluating surgeons techniques.

 Digital trail:
The digital trail includes real-time information on a patient’s history, vital signs, imaging and other parameters. It’s also increasingly feasible to collect and synthesize information from surgical instruments and clinical workflows to drive surgical performance. Through analyzing such data, surgeons can find the root causes for the complications that put a patient and hospital at risk.

 Interactions among the surgeons:
Surgical units where other healthcare professionals have clearly defined roles within the team in delivering surgical care. We need to build on interactions and work with these colleagues to learn from these examples and encourage this recent trend in the field of surgery to develop.

 Data Analysis of the surgical results:
Data analysis at all levels could improve our understanding of surgical results and help develop ways to improve surgical techniques outcomes. Outcomes should be as simple as possible, so that it could have the wide range of understanding and take necessary steps to overcome the negative analysis.

 Virtual Imaging techniques: Big view through the small window:
In any situation with unexpected anatomy this virtual reality techniques will be very helpful for both the pediatric and the adult patient care. Virtual reality augmented surgical procedures will help to achieve better results in the field of surgery than the normal conventional procedures.

Women’s polycystic ovary disorder may cause increased hazard of autism in newborns

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Autism, Extreme introvertedness, or extraordinary introvertedness run clutter, insinuates to a extend of conditions characterized by challenges with social aptitudes, repetitive behaviours, talk and nonverbal communication, as well as by one of a kind qualities and contrasts. We now know that there’s not one autism but numerous sorts, caused by diverse combinations of genetic and natural impacts2

PCOS could be a condition caused by excess release of testosterone which comes about in postponed onset of adolescence, irregular menstrual cycles, and overabundance substantial hair. Children born to women with polycystic ovary disorder (PCOS) may be more likely to create extreme introvertedness, agreeing to a consider. PCOS may be a condition caused by tall testosterone which comes about in postponed onset of adolescence, unpredictable menstrual cycles, and abundance real hair. Past considers had showed up that extremely introverted children have lifted levels of “sex steroid” hormones counting testosterone which “masculinise” the baby’s body and brain. Debating on the increase level of hormones, the gather found that one conceivable source may be the mother.

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In case the mother had higher levels of testosterone than regular, as is the case in ladies with PCOS, at that point a few of the hormone might cross the placenta amid pregnancy, uncovering her unborn child to more of this hormone, and changing the baby’s brain improvement, the discoveries appeared.

New investigate is making a differentiating us to understand the impacts of testosterone on the creating fetal brain, and on the child’s afterward conduct and intellect.

In any case, these hormonal impacts are not fundamentally free of hereditary components, as a mother or her child may have higher levels of the hormone for hereditary reasons, and testosterone can influence how genes work.

Other Factors which causes Autism in few cases:

  • Rubella (German measles) in the pregnant mother
  • Tuberous sclerosis (a rare genetic disorder that causes benign tumors to grow in the brain as well as in other vital organs)
  • Fragile X syndrome (the most common inherited form of intellectual disability)
  • Encephalitis (brain inflammation)
  • Untreated phenylketonuria (PKU) – when the body lacks an enzyme needed for normal metabolism.
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Does cannabis improve breathlessness during exercise in patients with advanced COPD?

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Inhaled vaporized cannabis does not appear to improve or worsen exercise performance and activity-related breathlessness in patients with advanced chronic obstructive pulmonary disease (COPD), according to a randomized controlled trial.

A researcher reported that the trial did not find a difference between vaporized cannabis and placebo on lung volumes or heart rate at rest or during exercise. Nor did the study find that cannabis affected cognitive function, mood or psycho-activity. The burden of breathlessness in patients with COPD is high. Even when on optimal medication for their lung disease, many patients with COPD continue to suffer from disabling breathlessness at rest and while performing basic activities of daily living.

Earlier, controlled studies reported that smoking cannabis opened the airways of adults with and without asthma. More recently, a large observational study found a positive association between cannabis use and forced expiratory volume (the amount of air that can be forcefully exhaled in one second) and forced vital capacity (the total amount of air that can be exhaled after taking a deep breath) in the field of pharmacology.

In the current crossover study of 16 patients with advanced COPD, all the patients were taking optimal medication for their lung disease; dual or triple inhalation therapy (long-acting muscarinic antagonist and long-acting beta2-agonist bronchodilator with or without an inhaled corticosteroid).

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Participants in pharmaceutical practices were randomly selected to inhale a single dose of vaporized cannabis or a placebo before exercising on a stationary bike. Participants then “crossed over” to the other arm of the trial. Neither the researchers nor the patients knew when they were receiving the vaporized cannabis or the placebo.

Although the clinical study did not find a meaningful negative or positive effect of vaporized cannabis on breathlessness during exercise or on exercise performance, the researchers noted variability in responsiveness to the cannabis. After inhaling vaporized cannabis, breathlessness during exercise improved in 4 of the 16 patients. In the remaining 12 patients, breathlessness during exercise did not change, or worsened.

Senior researchers said that trial results may not be generalizable because the number of participants was small and represented a relatively homogenous group of patients with stable, but advanced, COPD.

In addition to the fact that all the participants were on optimal COPD therapy, researchers suggested a number of factors that may have limited the therapeutic benefit of cannabis in the study, including the dose of cannabis used, that it was inhaled rather than taken orally and that it was administered only once and not repeated.

ARBD- Alcohol-related brain damage diagnosis and What are the Links between Alcohol and Dementia?

Alcohol related Brain Damage is a mind issue caused by consistently drinking excessively liquor more than quite a long while. A few people routinely drink significantly more elevated amounts than the suggested furthest reaches of liquor. The second way that liquor abuse prompts ARBD is by causing thiamine insufficiency. Liquor related mind harm can’t be dependably analyzed except if the individual has quit drinking liquor for a little while, to empower the indications of liquor inebriationand withdrawal to determine. A man’s evaluation for suspected ARBD takes after comprehensively an indistinguishable stride from for dementia. The specialist will do a full physical examination and take a definite history from the individual and somebody who knows them well if conceivable. A mind output may likewise be required. This may preclude other conceivable reasons for side effects (eg stroke, drain, tumor).

Dementia

ARBD and Alzheimer’s illness have comparative side effects since they both influence the cholinergic framework, which assumes a critical part in memory. While analysts presently comprehend that Alzheimer’s, Disease isn’t caused by ARBD, the two prompt comparative impacts by lessening the mind in certain comparative ways. Individuals who have a type of dementia, regardless of whether caused by liquor utilize scatter or not, are probably going to endure more genuine memory misfortune on the off chance that they devour liquor. To a limited extent, this is caused by responses between dementia prescriptions, different drugs for different sicknesses, and liquor. It can likewise be caused by liquor itself, particularly in the later phases of dementia. Senior natives who knocked back the firewater two times every month were 147 percent will probably encounter subjective decrease and 146 percent more prone to have more memory issues contrasted with the individuals who did not drink.  ARBD should be diagnosed if the individual has disabled memory, considering or thinking which is sufficiently terrible to influence everyday life, together with an ongoing history of quite a loDementia Conference - 2018ng while of liquor abuse. If their condition keeps on exacerbating, they might be determined to have a type of dementia, for example, Alzheimer’s ailment. As indicated by the side effects, the specialist may analyze Wernicke-Korsakoff disorder, Korsakoff’s alcoholic psychosis, alcoholic dementia, liquor amnestic disorder, incessant alcoholic mind disorder or another condition.

Seizures may harm learning limit of rat brains

Madhu sai

Seizures from the get-go in life render mind circuits unequipped for supporting picking up amid basic periods being developed, as indicated by another mouse study1. The discoveries add to a collection of proof that recommends early-life seizures worsen highlights of a mental imbalance.

Treating the mice with a concoction that squares neuronal flagging mitigates the seizures’ belongings. This finding further backings the hypothesis — and furthermore offers any desire for a treatment.

“The cool thing is that while there is the message that seizures aggravate neuro developmental scatters, it would seem that this could be reversible,” says co-lead specialist Frances Jensen, teacher of neurology at the University of Pennsylvania.

The analysts concentrated on signals coming into the sound-related cortex, a cerebrum locale that procedures sounds, yet the discoveries may stretch out to any mind circuit those progressions with encounter.

“I think the work adds to the writing that neonatal seizures are not kindhearted and ought to be dealt with rapidly, as they will adjust mental health,” says Peyman Golshani, relate teacher of neurology at the University of California, Los Angeles, who was not associated with the work.

Restricted learning:

Learning happens when certain neurotransmitters — associations between neurons — fortify in light of involvement. What’s more, these times of learning are basic for mental health.

The new investigation recommends that seizures initiate neural connections rashly. Accordingly, all associations are similarly responsive; none of them can create devoted reactions to specific sounds or other jolts.

The analysts synthetically prompted seizures in a subset of the mice for three days beginning on day 9 after birth. On day 12, the beginning of a basic sound-related learning period, they uncovered a portion of these mice and a few controls to 7-kilohertz sounds, which the two mice and individuals can hear.

In cerebrum cuts from similar mice, they at that point utilized electrical streams to empower the parts of the thalamus, the mind locale that signs to the sound-related cortex, that react to 7-kilohertz sounds.

The cuts from mice that heard for the most part 7-kilohertz tones amid the basic time frame demonstrated a more prominent reaction to the incitement than those from mice that didn’t hear these tones. Cuts from mice that had encountered seizures before the introduction to sound did not demonstrate a similar lift accordingly.

The specialists likewise took a gander at electrical action in the mind cuts. Cuts from mice that had encountered seizures have a bizarrely high number of dynamic neurotransmitters.

Great planning: Neurotransmitters end up initiated when neurons transport a receptor called AMPA to the intersection. The outcomes propose that blocking AMPA receptors may save the mice’s capacity to learn.

The group set out to test that hypothesis. They gave mice a medication that squares AMPA receptors one hour after every seizure. The treated mice did not demonstrate the overabundance of enacted neurotransmitters and could adjust to sound in their second seven day stretch of life. The outcomes showed up in May in Cell Reports.

“It’s an energizing finding,” says Matthew Anderson, relate teacher of neuropathology at Beth Israel Deaconess Medical Center in Boston, who was not associated with the examination. “This could affect a significant expansive extent of mentally unbalanced people.”

Numerous individuals with extreme introvertedness have seizures, and the outcome is verification, on a fundamental level, that a comparable approach may regulate the impacts of seizures in those individuals.

Be that as it may, the compound utilized as a part of the examination isn’t itself a decent clinical competitor since it acts like a heavy hammer, hushing cerebrum signals, says Takao Hensch, co-lead specialist and educator of atomic and cell science and neurology at Harvard University. A favored strategy may be to keep AMPA receptors from entering neural connections after a seizure.

High-Risk HPV More than Doubles Pregnant Women’s Preeclampsia Risk

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Approximately 45% of women ages 20 – 24 are infected with high-risk human papillomavirus (HPV).  About 30% of women between the ages of 25 and 40 have high-risk HPV, with the percentage slightly declining among women in their forties.  For sure, high-risk HPV is an extremely normal illness – particularly among ladies in their child bearing years. Ladies infected with high-risk HPV right on time in pregnancy are more than twice as prone to develop preeclampsia.

An investigation demonstrates a relationship between high-chance human papillomavirus and preeclampsia, which is steady with the affiliation that was already observed between high-chance HPV and cardiovascular ailment.

Utilizing information on the populace predominance of high-chance HPV disease, the scientists evaluated that if all ladies got the quadrivalent immunization (which avoids around 66% of such contaminations); the rate of preeclampsia would tumble from 5,189 to 5,020 cases for every 100,000 ladies. Preeclampsia is a serious condition characterized by a rapid rise in blood pressure, leakage of protein in the urine and swelling of the legs after the 20th week of pregnancy.  While the exact cause of preeclampsia is still not fully understood.

HPV’s Effects on Pregnancy

The high-risk HPV has been previously implicated in both adverse pregnancy outcomes and adverse cardiovascular outcomes.  “This association between HPV and cardiovascular disease is relevant in pregnancy, as preeclampsia and cardiovascular disease share a similar pathophysiology,” including endothelial dysfunction and inflammation, as well as vascular risk factors such as obesity, hypertension, diabetes, and dyslipidemia. High-risk HPV causes changes in the placenta that accelerate unfavourable vascular changes.  “So it is believed that there is a biologic plausibility to support a role of high-risk HPV and preeclampsia.

In a study it is stated that the, women infected with high-risk HPV had a higher rate of preeclampsia than their non- infected one and also tended to have a higher rate of severe preeclampsia.

After adjustment for age, nulliparity, blood pressure at entry to care, and smoking, the difference corresponded to a more than doubling of the odds of preeclampsia for the high-risk HPV group, according to data reported.  The ladies with high-chance HPV likewise were essentially more prone to have an unconstrained preterm birth before 37 weeks, any preterm birth before 35 weeks, and unconstrained preterm birth before 35 weeks.

Preeclampsia Complications

Preeclampsia is the second leading cause of death during pregnancy.  The condition can harm veins and, if untreated, increment the danger of creating eclampsia, which can bring about risky seizures, stroke and numerous organ failures.  Preeclampsia can likewise cut off blood supply to the fetus and result in untimely birth or even death.

Given the serious complications associated with preeclampsia. It is basic for doctors to know about whether their pregnant patients have HPV.  Since high risk HPV more than doubles the risk of developing preeclampsia, patients with high-risk HPV should be monitored very closely for the condition so that if preeclampsia occurs, treatment can be promptly initiated.

Improving quality of Life with Intestinal Rehabilitation

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Intestinal rehabilitation is the process of slowly restoring the intestine’s ability to digest food and absorb nutrients. This is usually done through medicines, Diet and Surgery other than organ (intestine) transplant.

Who should try intestinal rehabilitation?

Intestinal rehabilitation is required if:

  • They are on total parenteral nutrition (TPN) because of intestinal failure.
  • They were able to stop TPN, but they still have trouble digesting and absorbing nutrients because of intestinal failure.

TPN is a complete form of nutrition given into the blood through a vein (intravenously) by a central line placed in the child’s chest, neck or groin.

A child may be on TPN if they have an intricate digestive condition that does not allow them to get all their nutrition by mouth or feeding tube. This includes children with short bowel syndrome, motility disorders, absorptive disorders or other conditions that can cause intestinal failure.

Some children on TPN get part of their nutrition by mouth or feeding tube; some take TPN only.

Why is intestinal rehabilitation used?

TPN is a lifesaver for patients who cannot absorb enough nutrition through their small intestine. But if TPN is used long-term, it can result in liver failure and life-threatening infections.

Our goals with intestinal rehabilitation are to:

  • End or reduce the need for TPN.
  • Children should start eating by mouth.
  • Prevent the need for intestine transplant if possible.

If intestinal rehabilitation does not work or is not an option for the children, intestine transplant may be the next step.

What does the Intestinal Rehabilitation Program do?

The specialists first look at:

  • Children’s intestinal and liver health.
  • Whether the children may be able to switch from TPN to eating by mouth or feeding tube. This can depend on factors like why the children have intestinal failure and how much of their intestine remains if part was removed by surgery.

If we find that the children will benefit from intestinal rehabilitation, the children will take part in an intensive program over several months. The intestinal rehabilitation team will:

  • Evaluate the children’s intestinal function in detail.
  • Take steps to reduce the risk of central-line infections while the children are on TPN.
  • Create an individualized nutrition plan to find the diet that works best for the children body.
  • Manage overgrowth of bacteria in the intestines.
  • Perform nontransplant surgery, such as intestine lengthening or tapering where needed.
  • Teach the children and family about how to care for the central line, how to manage day-to-day nutrition and what to expect.
  • Depending on the children needs, the children may stay in the hospital for the first phase of intestinal rehabilitation. This will be followed by regular clinic visits.

What happens after intestinal rehabilitation?

Once the child is able to eat by mouth and is off TPN, the specialists will keep seeing them in the Intestinal Rehabilitation Clinic for follow-up visits. Our focus at these clinic visits is to monitor the child’s growth; go over nutrition and feeding plans; and watch for anaemia, bacteria growth or other problems that can sometimes happen. On-going care from intestinal rehabilitation experts is important to keeping the children healthy.

Drowning, Swimming, and Summer Sun Care: Pediatrics Meet 2018

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Summer is a time when water safety becomes a top priority. News scope is far reaching about swimming pool security, water quality with our shorelines and sun mind. The Pinellas County Department of Health shared the accompanying web joins for references on the water nature of open pools, open water parks, and neighborhood shorelines.

The leading Departments of Health recommends following these simple steps for a healthy and safe swim experience:

  • Use a high SPF sunscreen to protect yourself and your family from harmful UV rays that cause sunburn and skin cancer and reapply after swimming
  • Wear insect repellent to prevent mosquito bites and the spread of mosquito-borne illnesses
  • Shower with soap before you get in the water
  • Limit the amount of fresh water going up your nose when swimming can help prevent the infection from the ameba Naegleria fowleri. The amoeba that causes the rare infection of the brain called primary amebic meningoencephalitis (PAM) is often fatal and dangerous.
  • Don’t swallow the water you swim in
  • Stay out of the water if you have diarrhea, don’t swim until you are diarrhea-free for two weeks
  • Parents should take children on bathroom breaks every 60 minutes
  • Avoid contact with algae blooms
  • Wash your hands after visiting the bathroom or changing diapers
  • Visit your local hardware or pool-supply store and purchase pool test strips to check the chlorine and pH levels before getting into the water.
  • Parents should also be aware that the use of swim diapers and swim pants doesn’t necessarily keep fecal bacteria out of the water, and some germs can survive days even in properly chlorinated pools.

Swimming safety is another area of safety for those in the heat of summer. Knowing about water safety and how to prevent drownings is important for all Floridian’s, including how to prevent drowning, barriers that are available, safe swimming, swimming lessons and supervision. The following web sites help to guide residents to swim lessons located throughout the county.

CATARACT SURGERY: PRESERVE YOUR REJUVENATED VISION AFTER CATARACT SURGERY

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Nowadays the people who have crossed their 50’s are found to have the cataract surgery and it has become more common and many doesn’t know what is meant by the cataract. Most of the elderly person when goes to the hospital we could clearly hear the doctor saying you have the cataract. A cataract can be simply defined as the mass covering the entire lens inside the eye, that sometimes cannot be rectified by contact lenses, corneal refractive surgery. The thing what the modern Cataract surgery provides to the individual is that they can reduce the need for the glasses. Cataract is found to be prevalent in all the developed and developing countries and the modernized cataract surgery is found to be the potential solution to it. In the modern cataract surgery procedure, the lens that was found to be cloudy is usually replaced with the artificial lens. In most of the modern cataract surgery the clouded lens inside the eyes are gently found to be broken up by ultrasound waves and the broken pieces of lenses are generally removed from the eyes with suction. These so-called lasers have gained their approval for the following reasons,

  • For creating the corneal incision and to allow the surgeons to access the lens.
  • And, for removing the anterior capsule of the lens.
  • For the fragmentation of cataract.
  • Peripheral Corneal incision can be done to reduce the astigmatism.

Laser Cataract surgery has become easier but the only disadvantages with them is that they are found to be very expensive. The reason is since they may cost more than $300,000 to $500,00 for a surgeon to purchase and they are also found to have more maintenance cost. In most of the cases the causes for the cataract surgery may include excessive ultraviolet exposure, ionizing radiation, diabetes, smoking and many others. There are commonly three types of cataract they may commonly include nuclear sclerotic, cortical and posterior subcapsular cataract. Healthy life styles especially the diet rich in anti-oxidants and the omega 3 fatty acids can generally avoid the cataract at the older ages. The most beneficial thing of this cataract surgery is that they do not require the hospital stays and they have become the same day surgery even. The scientist are also involved in finding the eye drops for the purpose of dissolving the cataract without undergoing the surgery.