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Laparoscopic Cholecystectomy

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Nausea is a sensation of unease and discomfort in upper stomach with an involuntary urge to vomit. It may precede vomiting, but a person can have nausea without vomiting. Some common causes of nausea are motion sickness, dizziness, migraine, fainting, gastroenteritis, food poisoning, side effect of many medications or as non-specific sequel of disorders like type of surgery, raised intracranial pressure, ionizing radiation, or postoperative. Nausea and vomiting in the postoperative period occurs in 20% to 30% of patients.[1] depending on surgical and patients factors. PONV can be such an unpleasant experience that patients often rate it worse than postoperative pain.[2]10 PONV may delay a patient’s discharge from postanesthesia …show more content…

The etiology of PONV is multifactorial during laparoscopic cholecystectomy, therefore, combination of different classes of anti-emetics are preferred to control PONV, [6] [7] [205,206] including anticholinergics, antihistamines, butyrophenones, benzamide, dexamethasone and 5-HT3 antagonists. Ondansetron, 5- hydroxytryptamine type 3 (5-HT3) receptor antagonist, blocks receptors in the CTZ as well as vagal nerve terminals. Dexamethasone has been used as an anti-emetic for a long time with limited adverse effect. The exact anti-emetic mechanism of dexamethasone is unknown, but it is thought to enhance the anti-emetic effect of 5-HT3 receptor antagonists [8] [208] that is central/peripheral inhibition of production of 5-HT, central inhibition of synthesis of prostaglandins, changes in permeability of the blood brain barrier to plasma proteins, or by releasing endorphins.[9]

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Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.

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Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance.

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“Electroconvulsive Therapy: The Second Most Controversial Medical Procedure,” by Charles H. Kellner, MD, briefly compares the electroconvulsive therapy debate, also called ECT or shock therapy, to abortion. Kellner discusses the argument supporting shock therapy and how the opposing argument is often invalid. Both are highly controversial with opposers who attempt discrediting practitioners and the practices themselves. Also, methods of performing abortions and shock therapy are slightly touched on or not taught in medical schools. Most are aware of abortion, but many, including some psychiatrists, are surprised ECT is still used in medicine.

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4.1. Vasovagal Causes. 4.2. Orthostatic hypotension. 4.3.

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Also use of narcotic analgesics must be retreated for acute episodes to minimize the potential for dependence (Grantham, 1992) 11.130. When conservative measures fail, surgical interventions ranging from cyst aspiration and sclerosing agents to laparoscopic or surgical cyst fenestration can be considered. Laparoscopy can be carried out only on dialysis-dependent patients as it eliminates any remaining renal function, essentially decreasing GFR to zero (Lee et al., 2003)

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- People taking the drug are usually stricken with nausea. (afflicted or overwhelmed by or as if by disease, misfortune, or sorrow/ made incapable or unfit {Merriam Webster}/afflicted/ affected/ struck down/ troubled/ tormented/ wracked/ traumatized/ suffering/ infected/ struck/ incapacitated/ hit/ set upon/ come down with) ~ I was stricken with flu. -My mother’s dead, and her assailant is now gone.

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Vomiting is treated by anti-emetics and any bacterial infection will be immediately treated with antibiotics. Intestinal bacteria is especially common with this disease, as the virus primarily attacks the digestive system. In severe cases, blood or plasma transfusions may be

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Gallstones Introduction Gallstones are pieces of solid material that form in the gallbladder. These stones develop because cholesterol and pigments in bile sometimes form hard particles. Gallstones form in the gallbladder a small organ located under the liver. The gallbladder aids in the digestive process by storing bile and secreting it into the small intestine when food enters. Bile is a fluid produced by the liver and is made up of several substances, including cholesterol, bilirubin and bile salts (WebMD.

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Method: The organ bath file was opened and we examined tissue type and Agonist and Antagonists of different drugs which were available. Guinea pig ileum was selected as tissue type and Acetyl choline as agonists. Then different amount of acetylcholine were added to the organ bath which produced different results and finally, a log – dose response curve for acetyl- choline was constructed with the X axis corresponding to drug dose (Drug concentration) and the Y axis corresponding to response (gms).

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You have a fever. You have not been able to have a bowel movement, and you are in pain and vomiting.

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Laparoscopic CRC Surgery Advanced variety of tools and treatment options are available to cure colorectal cancer, or at least enable CRC patients to cope with its complications and improve their life quality.1 Depending on the CRC stage, the patient situation, and the oncologist experience, the treatment choice is determined.1 Oncologists prefer surgical options with the premature CRC stages.1 Surgery is also preferred with metastasis unless the cancer has metastasized to more than one position of the body.2 Surgical options comprise laparoscopic surgery, robotic surgery and open surgery.3 Laparoscopic surgery and robotic surgery are highly advanced and the preferable ones since they are associated with minimal rates of morbidity and mortality.3,4

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Could their abdominal pain be from gastritis, or could it turn to a terrifying scene of bleeding esophageal varices? The exposure to some of the rare clinical scenarios and complex cases honed my clinical acumen, making me better equipped to provide quality care for my patients in the future. Additionally, as an international graduate, I was faced with a myriad of medical and social complexities that taught me that illness is universal, regardless of cultural differences, and I have come to appreciate the unique challenges and perspectives that each patient brings to the table. What made me more interested in GI is that it is a field where people who

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At moments, he knows that the nausea is rising in him but does not do anything until it is there. It is not something from the outside, it is within him. He cannot explain it. He wants to avert it but cannot. It is something that possesses him at moments, and in those moments, he feels like an outlaw.

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10 Tips On Surviving A Home Reno Big decisions like home renovation projects require big planning. A home reno will cause upheaval to your finances, your lifestyle, and your relationships. However, if done right, they will be totally worth it. Follow these tips on surviving a home reno and you will have a much smoother ride through the madness of your home renovation journey. 1) Find A Safe Place Demolition can be unsettling and even dangerous.

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Introduction Gallbladder is an organ in the body and it is part of the biliary system. It is a pear-shaped muscular sac that is located on the ventral surface of the liver and on the right side of the abdomen. Moreover, it has 3 layers; an outer serous peritoneal layer, a middle smooth muscle layer and the last layer is an inner mucosal layer which is connected to the lining of the bile duct. The main function of the gallbladder is to store and concentrate bile which helps the body to break down and digest fats.

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