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Follow-up after Cardiovascular Surgery - ECAB by O P Yadava Pdf
Follow-up of patients after surgery is of utmost importance as results of the surgery heavily depend on the treatment of patient in the follow-up period. A good follow-up and proper treatment also provides protection to the patient from various complications and recurrence of the disease. Therapeutic guidelines and algorithms for treatment of the patients after discharge from the hospitals exist for a number of cardiovascular disorders. Still, follow-up and postdischarge treatment is very often found to be inappropriate and incomplete. This results in many avoidable complications for both the patient as well as the treating clinician. This book is designed to update the readers on follow-up regimens for some of the important cardiovascular surgical procedures. Typical supportive case scenarios are included to exemplify and highlight the various points discussed. Thus it provides an excellent opportunity to widen one’s perspective in this area.
Coronary Artery Disease - ECAB by R R Kasliwal Pdf
Coronary artery disease or CAD is the end result of the process of accumulation of atheromatous plaques within the walls of the arteries supplying the myocardium. Atherosclerosis is a chronic systemic disease process, affecting all the vascular beds in body and many factors responsible for its evolution have been identified. A rising incidence of this disease among people of Indian origin and an emerging role of genetic factors leading to atherosclerosis necessitates modifications in ourstrategies to handle it. The importance of the risk factors in causation of the disease need to be emphasized even more and masses need to be educated about the role of lifestyle modifications in its management. Further, early detection of preclinical or sub-clinical disease would add another dimension to the overall preventive strategy for this condition. This book is designed to update the readers on the evergrowing list of risk factors for CAD and the increasing significance of lifestyle modifications in prevention of the disease. Besides these, the therapeutic approach towards this chronic disease and methods of early detection has also been discussed. Typical supportive case scenarios are also included to exemplify and highlight the various points discussed. Thus, it provides an excellent opportunity to widen one’s perspective in this area.
Patients born with cardiac defects need to be identified early and the severity of symptoms also needs to be identified. In children with larger defects or with more symptoms, early institution of treatment is warranted, since in absence of treatment, the disease progresses to pulmonary hypertension and a simple pathology gets complicated. Presence of congestive cardiac failure in infancy or of pulmonary artery hypertension is indication for early surgical treatment (prior to 6 months of age). Untreated ASD may at times allow the child to grow and reach adulthood, but can cause complications in adulthood also. These issues related to understanding of natural history of the shunts and its implications in management decisions need to be addressed in clear terms. Also the role and timing of surgical therapy need to be emphasized. This book is designed to address such questions with supportive clinical scenarios. Thus, it provides an excellent opportunity to widen one’s perspective in this area.
Dilated cardiomyopathy (DCM) is traditionally referred to as idiopathic dilated cardiomyopathy (IDC), which includes genetic forms of DCM. The patients present with a wide range of symptoms like dyspnea, orthopnea, paroxysmal nocturnal dyspnea, arrhythmias or complications associated with DCM. The diagnosis is based on exclusion of the various identifiable causes of systolic left ventricular dysfunction, such as ischemic cardiomyopathy, hypertensive cardiomyopathy, alcoholic cardiomyopathy, myocarditis secondary to viral or other causes, peripartum cardiomyopathy and cardiomyopathies secondary to amyloidosis, hemochromatosis, sarcoidosis, and due to drug toxicity. The sophisticated and expensive diagnostic tests might not be feasible for a typical Indian patient. This prompts us to emphasize the need for corroborating the clinical clues with the available affordable investigative tests that also offer reasonably valid results. The medical management of congestive heart failure is vital to the management protocol of DCM. The roles of heart transplant, cardiomyoplasty and surgical devices have to be weighed from patient to patient with a clear understanding of the etiology of the disease. The recent improvement in the prognosis of DCM presents an encouraging picture to the researchers and practitioners dedicated to the development of drugs and devices to improve the life expectancy of patients of DCM. This clinical update module has been formulated to update the readers on the existing and emerging treatment strategies widely followed and recommended by practitioners of international repute. The essential features of the medical and surgical management have been discussed in detail. Moreover, a comprehensive discussion on the occurrence and management of DCM in pediatric patients has also been incorporated in this book. The book is an honest attempt to provide the medical practitioner with a wide knowledge platform about DCM and its clinical implications.
Acute Coronary Syndrome - ECAB by R R Kasliwal Pdf
Acute coronary syndrome (ACS) is the term for the clinical signs and symptoms of myocardial ischemia: unstable angina, non–ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). Unstable angina and NSTEMI normally result from a partially or intermittently occluded coronary artery, whereas STEMI results from a fully occluded coronary artery. The patients present with a wide arena of signs and symptoms like chest pain, nausea/vomiting, exertional pain, palpitation, shortness of breath, fatigue, etc. Angina, or chest pain, continues to be recognized as the classic symptom of ACS. In unstable angina, chest pain normally occurs either at rest or with exertion and results in limited activity. Chest pain associated with NSTEMI is usually longer in duration and more severe than chest pain associated with unstable angina. The diagnosis of ACS is based on triad of clinical presentation, electrocardiography and cardiac biomarkers. Electrocardiography is the most important initial diagnostic procedure when doctors suspect an acute coronary syndrome. Findings on a 12-lead ECG help the practitioner to differentiate between myocardial ischemia, injury, and infarction, locate the affected area and assess related conduction abnormalities. But at the same front, the definition of unstable angina, NSTEMI and STEMI is based on the levels of cardiac biomarkers too. Acute coronary syndromes are medical emergencies that need prompt action. Half of deaths due to a heart attack occur in the first 3–4 hours after symptoms begin. The sooner treatment begins, the better the chances of survival. Anyone having symptoms that might indicate an acute coronary syndrome should obtain prompt medical attention. Management of ACS involves a spectrum of interventions. It encompasses cardiac monitoring, thrombolysis, antiplatelet therapy, anticoagulant therapy, reperfusion therapy and invasive investigation and revascularization therapy. Reperfusion therapy (percutaneous coronary intervention) mainly holds for the ST-elevation myocardial infarction. Prognosis of the ACS patients depends on the post-myocardial risk stratification. The main highlights of risk stratification are risk stratification scores, assessment of cardiac function and stress testing, and management.
Pulmonary Hypertension - ECAB by Sheila Glennis Haworth,R Krishna Kumar Pdf
Pulmonary hypertension is defined as a mean pulmonary artery pressure (mPAP) ≥25 mmHg, with Pulmonary Capillary Wedge Pressure ≤ 15 mmHg, measured by cardiac catheterization. The etiology of PH has a varied spectrum extending right from Drugs, toxins and portal hypertension to HIV, Collagen Vascular Diseases and Persistent Pulmonary Hypertension of Newborn, etc. The estimation of disease prevalence has been nearly impossible owing to the geographic distribution and economic diversity, along with significant regional variations in human development and healthcare infrastructure. A large number of patients with PH never reach the health centers capable of diagnosing the disease condition correctly. Advance pulmonary vascular disease as a result of uncorrected CHD is a major health challenge in the developing world. PH exists as a major component of many forms of cardiac and pulmonary disease. While breathlessness is the most common feature of PH, patients often also present with chest pain, syncope, fatigue, weakness and abdominal distension. The precordial signs include a right ventricular lift, accentuated pulmonary component of S2, a pansystolic murmur of Tricuspid regurgitation, a diastolic murmur of pulmonary regurgitation and a right ventricular S3. The standard diagnostic workup in developed countries includes a series of investigations to rule out the secondary causes. Additional tests are required to estimate the disease severity and plan the appropriate treatment. These include the cardiac catheterization, selective pulmonary angiography by direct injection of pulmonary arteries, high resolution CT scan, cardiac magnetic resonance, ABGs, nocturnal O2 saturation, etc. While most of the basic management is feasible in the Indian conditions, most of the newly introduced drugs are either not available or are available at costs that far exceed the paying capacity of an average citizen of a developing economy. An underdeveloped health insurance system adds further to the financial burden of the treatment. Measures like formulation of guidelines for diagnosis and treatment of PAH, educating clinicians and scientists and making medications affordable to poor patients might ensue a breakthrough in the overall management of pulmonary hypertension.
Healing across Boundaries by Makarand R. Paranjape Pdf
This unique volume initiates a dialogue between bio-medicine and alternative therapeutics. Undertaking a multidisciplinary exploration of the science and spirituality of healing and wellness, it offers varied perspectives from doctors, medical researchers, Ayurvedic practitioners, philosophers, psychologists, sociologists, and cultural critics. It expands the horizons of health sciences in engaging with diverse traditions — bio-medicine, Ayurveda, Siddha, and Jaina bio-ethics. The book will interest scholars and researchers in social and community medicine, biological sciences, sociology and social anthropology, as well as cultural studies.
Author : Centers of Disease Control Publisher : World Health Organization Page : 204 pages File Size : 54,7 Mb Release : 2013 Category : Medical ISBN : UGA:32108054359529
Hospitals and Borders by Centers of Disease Control Pdf
This volume examines why hospitals collaborate with each other and with other health care actors across borders in Europe. Cross-border hospital collaboration is not a new phenomenon but began to receive increased attention in the first decade of the 21st century in the context of European debates on patient mobility, the impact of European Union (EU) integration on national health systems and the particular situation of border regions. In this context, the role of health care providers stands out: while physically anchored in the health system that funds and regulates them, hospitals in border regions often witness or initiate cross-border movements of patients and health professionals.
Cerebral Palsy by Freeman Miller,Steven J. Bachrach Pdf
When a child has a health problem, parents want answers. But when a child has cerebral palsy, the answers don't come quickly. A diagnosis of this complex group of chronic conditions affecting movement and coordination is difficult to make and is typically delayed until the child is eighteen months old. Although the condition may be mild or severe, even general predictions about long-term prognosis seldom come before the child's second birthday. Written by a team of experts associated with the Cerebral Palsy Program at the Alfred I. duPont Hospital for Children, this authoritative resource provides parents and families with vital information that can help them cope with uncertainty. Thoroughly updated and revised to incorporate the latest medical advances, the second edition is a comprehensive guide to cerebral palsy. The book is organized into three parts. In the first, the authors describe specific patterns of involvement (hemiplegia, diplegia, quadriplegia), explain the medical and psychosocial implications of these conditions, and tell parents how to be effective advocates for their child. In the second part, the authors provide a wealth of practical advice about caregiving from nutrition to mobility. Part three features an extensive alphabetically arranged encyclopedia that defines and describes medical terms and diagnoses, medical and surgical procedures, and orthopedic and other assistive devices. Also included are lists of resources and recommended reading.
Author : Jonathan H. Mackay,Joseph E. Arrowsmith Publisher : Cambridge University Press Page : 0 pages File Size : 49,8 Mb Release : 2012-03-15 Category : Medical ISBN : 052119685X
Core Topics in Cardiac Anesthesia by Jonathan H. Mackay,Joseph E. Arrowsmith Pdf
Since the publication of the first edition of Core Topics in Cardiac Anaesthesia, the clinical landscape has undergone significant change. Recent developments include the increased use of electrophysiology, the resurgence of primary percutaneous intervention in acute coronary syndromes, the use of percutaneous devices in patients previously considered inoperable, and the withdrawal of aprotinin. Against this landscape, this invaluable resource has been fully updated. New chapters are dedicated to right heart valves, pulmonary vascular disease, cardiac tumours and cardiac trauma. All other chapters have been updated according to the latest international guidelines. Written and edited by an international author team with a wealth of expertise in all aspects of the perioperative care of cardiac patients, topics are presented in an easy to digest and a readily accessible manner. Core Topics in Cardiac Anaesthesia, Second Edition is essential reading for residents and fellows in anaesthesia and cardiac surgery and clinical perfusionists.
Wrist and Elbow Arthroscopy with Selected Open Procedures by William B. Geissler Pdf
Now in its revised and significantly expanded third edition, this comprehensive, authoritative text reinforces its standing as the gold standard on arthroscopic techniques for the wrist and elbow, now including selected open surgical techniques as well. Fundamental topics, such as anatomy, operative set-up, assessment, and lasers and electrothermal devices open the book. Generously illustrated with intraoperative photographs and full-color figures, chapters covering arthroscopic techniques are full-length and in detail. Topics include the management of TFCC tears, joint instability, arthritis, fractures and nonunions, dorsal and volar ganglions, and many more conditions and injuries of the wrist and elbow. While chapters on open techniques could present an extensive history and background of the subject as compared to the arthroscopic chapters, they will be focused approaches discussing why the author thinks it is the best open technique, including tips, tricks, pearls and how to perform the operation. Open management of ulnar impaction, scapholunate instability, total wrist arthroplasty, and elbow contractures are discussed, among others. Selected chapters include video supplements for additional, real-world demonstrations of techniques. Bringing together a truly international cross-section of experts and thought leaders in orthopedics and hand surgery, Wrist and Elbow Arthroscopy with Selected Open Procedures, Third Edition remains the premier resource for all clinicians working in this field.
Unconventional Organ Damage in Diabetes - ECAB by Samar Banerjee Pdf
Cell health depends on a steady supply of fuel from glucose and free fatty acids. Both these major fuels are regulated by insulin. Cells in the muscle, liver, and fat need insulin to receive glucose, and hence do not become exposed to high blood glucose levels when the blood sugars are high and insulin levels are low. The lack of insulin slows the movement of glucose into these cells, and probably spares them from damage when blood sugars are high. However, other cells such as those in the brain, nervous system, heart, blood vessels and kidneys pick up glucose directly from the blood without using insulin. These cells, except the brain, are more prone to damage from high blood sugars because they become exposed to high internal levels of glucose. This to quite an extent explains why damage tends to occur in specific organs such as in nerve and kidney cells, and in small blood vessels like those in the eyes. This project on the organ damage in diabetes is an attempt to elaborate on the various factors to be considered in managing these patients, the pointers for early diagnosis and prevention of the same.
