DEBx Medical ’s Post

I feel priveleged to have the opportunity to work with Andy and his team on these intiatives. The truth is, Perspective Shifting is about making differences in many areas - sometimes for many people. What Healthcare Evolution Group is doing is EVOLVING healthcare in a way that benefits everyone. They're a change making organization that shows the power of perspective shifting. Health and Wellness is only one facet of life, it requires awareness, strategy, and perspective. All of which seem to be something that is controversial in today's world. What's interesting is that there is a universal moral code that anthropologists have found around the world. Two of these moral values around collaboration in societies, is helping family and helping your group. Why I find this interesting is that we all believe that helping others is important... and since we all believe that helping others is important, many of the arguments around the healthcare space are really, simply arguments where through seeing a different perspective we can come to common ground on. Andy and his team are doing just that. Finding the common ground, and working to elevate everyone. Sometimes, that comes from simple questions around challenges that other people just think is the status quo. Why is that status quo? How can it be better? How can we make this work for everyone? Want to bring HEG services and offerings to your physicians, clients, or groups? Reach out to me and I'll get you connected. #perspectiveshifting #healthcare #evolving

📗New review: Povidone Iodine vs Chlorhexidine Gluconate for Preoperative Skin Antisepsis📗 Surgical site infection (SSI) remains a challenge in healthcare, contributing to prolonged hospital stays, increased healthcare costs, and adverse patient outcomes, including mortality. Effective preoperative skin disinfection interventions, such as povidone-iodine (PVI) and chlorhexidine (CHG), are widely used but their efficacy remains debated. To address this gap, authors from the University of São Paulo, Universidade Federal de Minas Gerais, Universidade Federal do Estado do Rio de Janeiro, Universidade Federal do Maranhão (Brazil) and the Fatima Memorial Hospital College of Medicine & Dentistry (Pakistan) performed a meta-analysis aims to evaluate the efficacy of PVI and CHG. Their fingings suggested that PVI as preoperative skin antisepsis demonstrated a non-significant reduction in deep SSI compared to CHG but was associated with an increased risk of overall and superficial SSI. Despite these findings, PVI remains an effective option, especially in resource-limited settings. 📗Read the full article here: https://ow.ly/PTv250Tz7Zg

Case Overview A 37-year-old male patient visited our clinic in July 2024 with complaints of pain in the lower left tooth region, specifically related to the area around his wisdom tooth (tooth 38). After examination, we diagnosed him with **pericoronitis**, an inflammation of the gum tissue surrounding a partially erupted wisdom tooth. At that time, we advised him of several treatment options, including: 1. **Irrigation and scaling** around tooth 38 to manage the infection. 2. **Operculectomy**, a surgical removal of the gum flap covering the wisdom tooth. 3. **Wisdom tooth extraction** to resolve the issue long-term. The patient opted for irrigation and scaling along with medication, but didn’t return for further treatment. Four days ago, he called us and expressed interest in **laser gum removal**. Upon visiting our clinic Dr. Gul's Dental Clinic, he mentioned that he had been in pain during a trip after the first visit and couldn’t enjoy his time. Over the last five days, the pain had intensified. We performed the laser gum removal (operculectomy) quickly, and the procedure was completed painlessly within 5-10 minutes. **What is Pericoronitis?** Pericoronitis is an infection or inflammation of the gum tissue surrounding a partially erupted tooth, most commonly a wisdom tooth. The flap of gum (operculum) can trap food particles and bacteria, leading to swelling, discomfort, and even infection. If left untreated, it can cause severe pain and spread the infection to other parts of the mouth. **Treatment Options for Pericoronitis:** 1. **Irrigation and Scaling**: Cleaning the area to remove trapped debris and bacteria to reduce inflammation and pain. 2. **Operculectomy**: A procedure to remove the gum flap covering the tooth. This allows for better cleaning and prevents further trapping of food and bacteria. 3. **Wisdom Tooth Extraction**: Removing the wisdom tooth entirely to prevent future infections or complications if the tooth is unlikely to fully erupt. **Advantages of Laser Treatment for Pericoronitis:** - **Minimally Invasive**: Laser treatment is quick, requiring less time than traditional surgery. - **Painless**: Patients often report little to no discomfort during and after the procedure. - **Reduced Bleeding**: Lasers promote clotting, leading to less bleeding during the procedure. - **Faster Healing**: Lasers cause less trauma to the tissue, resulting in quicker recovery and healing. - **Precise**: The laser targets only the inflamed or infected tissue, preserving healthy gum tissue. #pericoronitis #operculectomy #laser #gumsurgery

You have Sara, a 34-year-old patient who comes into your office looking completely miserable. She's congested, can barely breathe through her nose, and has been dealing with thick green/yellow nasal drainage for months now. "Doc, I've tried all the antibiotics and nasal sprays, but nothing is working! My face hurts, I can't smell anything, and I'm just so sick of this sinus issues!" she exasperatedly explains. As you go through Sara's history and perform an exam - noting nasal polyps, tenderness over the sinuses, and that telltale thick drainage - it becomes clear she is suffering from chronic rhinosinusitis or CRS. This is an inflammatory sinus condition that has been persisting for over 12 weeks despite treatment attempts so far. So what do we do for Sara to get her some relief? Chronic sinus issues can really take a toll on a person's quality of life when they become this difficult to manage. First off, we need to get a CT scan of Sara's sinuses to better evaluate what we're dealing with. The CT will allow us to see if there is mucosal thickening, sinus opacification, an obstructed ostiomeatal complex, or evidence of nasal polyps that could be contributing. Assuming the CT confirms chronic rhinosinusitis, we'll want to hit this hard with maximal medical therapy: 1) Mometasone nasal spray - I'll have you use 2 sprays in each nostril daily. This topical steroid helps reduce the inflammation. 2) Twice daily nasal saline rinses or irrigations to flush out mucus and irritants. 3) A course of oral steroids like methylprednisolone 20mg daily for 2 weeks to get that inflammation under better control. We'll also counsel you on lifestyle modifications - no smoking, using a humidifier at home, and avoiding any irritants that could exacerbate the inflammation. If Sara doesn't see significant improvement after 4-6 weeks of this aggressive medical regimen, we may need to consider bringing in the ENT surgeons for a functional endoscopic sinus surgery or FESS. During a FESS, they can go in with a small endoscope and remove any nasal polyps, open up obstructed outflow pathways like the ostiomeatal complex, and renovate the sinus cavities to allow for better drainage. The key teaching point here is that we need to take a comprehensive approach with chronic rhinosinusitis. We'll use medications to maximize medical management first, but there's also a time where sinus surgery may be warranted for those who don't respond adequately. Consistent use of the nasal sprays, rinses and lifestyle modifications will be essential even after disease improvement.

what is the #complication of tooth #extraction? Dental extractions, much like any surgical procedure, are not without risk. These risks must be discussed with the patient before the procedure. Frequently occurring risks after dental extraction includes pain, bleeding, bruising, swelling, and infection. Damage to the adjacent structures, like neighboring teeth, should always be mentioned, especially when adjacent teeth have restorations. Site-specific risks such as oroantral communication and inferior dental nerve injury must be mentioned if appropriate. Pain Pain after a dental extraction is a commonly occurring postoperative risk. This is usually managed sufficiently with over-the-counter analgesics such as paracetamol and ibuprofen] These two medications can be taken in combination to good effect .However, some patients may not find these medications sufficient and may return with a primary complaint of post-operative pain. A thorough pain history and clinical examination should be taken in this scenario. If the clinician is satisfied that there is no other diagnosis for the patient's pain, then conservative management would be advisable. Reassurance should be given to the patient that post-operative pain can take 3 to 7 days to settle. [50] Additional analgesia can be prescribed in this circumstance, such as opioids or corticosteroids. Another common reason for patients returning with post-operative pain is alveolar osteitis, known as dry socket. Alveolar osteitis occurs due to the breakdown of the blood clot in a socket before wound organization has occurred.[52] Patients with alveolar osteitis present with post-operative pain initially resolving and then increasing 1 to 3 days following the extraction. The patient may report they saw a clot being lost when spitting out, or on clinical examination, the loss of the clot will be evident. The patient may also report noticing a bad taste in their mouth or halitosis. Alveolar osteitis is usually treated with irrigation with saline along with the placement of a medicated dressing in the socket. Alvogyl is a commonly used dressing that acts as a local analgesic, an antibacterial, and an obtundent. Patients may also complain of pain associated with the temporomandibular joint following an extraction. This pain is usually myofascial in nature and can be resolved with conservative management advice and time. Bleeding Post-operative bleeding is a normal occurrence after tooth extraction. Any medical factors in the patient's history predisposing them to prolonged post-operative bleeding should be identified early and managed according to the relevant guidelines. If a patient does continue to bleed after a prolonged period of pressure is placed on the area, then local hemostatic agents should be used to arrest bleeding. If these are unsuccessful, localized use of tranexamic acid can also be considered. #linkedinbyalkhansa #dentistry_local_anesthesia_oral_surgery #الخنساء_لقدافي

This case study presents the successful retreatment of a maxillary left tooth (#14) following persistent pain reported by the patient. the tooth was effectively managed, alleviating the patient's discomfort. Case Description: A 19-year-old patient presented with complaints of persistent pain in the upper left quadrant, specifically associated with tooth #14. The patient reported a history of root canal treatment performed on the tooth several years ago. Clinical examination revealed localized tenderness to percussion and palpation in the region of tooth #14. Clinical Findings: 1. Tooth #14 exhibited tenderness to percussion and palpation, suggestive of periapical inflammation. 2. Radiographic examination revealed inadequate obturation of the root canal system with evidence of periapical radiolucency, indicating persistent infection. 3. Clinical history indicated previous endodontic treatment on tooth #14. Treatment Plan: 1. Removal of existing root canal filling material and thorough cleaning and disinfection of the root canal system. 2. Shaping and obturation of the root canal system using contemporary endodontic techniques and materials. 3. Evaluation of the tooth's structural integrity and restoration as necessary to ensure long-term stability. Treatment Procedure: 1. Gutta-percha and sealer from the previous root canal treatment were meticulously removed using rotary instrumentation and solvent-based techniques. 2. The root canal system was thoroughly cleaned and shaped using nickel-titanium rotary files and irrigation with sodium hypochlorite solution. 3. Intra-canal medicaments were used to disinfect and promote healing within the root canal system. 4. The root canal system was obturated using thermoplasticized gutta-percha and a biocompatible sealer to ensure three-dimensional sealing. Post-Operative Care: 1. Follow-up appointments were scheduled to monitor healing, assess the resolution of symptoms, and evaluate the integrity of the Restoration The patient reported immediate relief from pain following the retreatment procedure. Radiographic evaluation at follow-up appointments demonstrated complete resolution of periapical radiolucency, indicating successful elimination of infection. The tooth remained asymptomatic, and the patient expressed satisfaction with the outcome of the retreatment. This case underscores the significance of thorough assessment, precise execution, and contemporary techniques in achieving successful endodontic retreatment outcomes. By addressing the underlying cause of pain and infection, tooth #14 was effectively managed, highlighting the importance of retreatment as a viable option for salvaging compromised teeth. #dental #DentalExcellence #Endodontics #DentalToolsMastery #dentistry #doctor #BUE هذا من فضل ربي 🙏🏽♥️

Got Blepharitis $1.00 Treatment cost Blepharitis Protocols  We have been utilizing the povidone iodine protocol since 2015 for blepharitis. How I treated my blepharitis in less than 7 days. **Note: As a Doctor consider the treatment based on your experience. Make a clinical decision to proceed with Povidone Iodine. We cannot intervene in a clinician's decision. However, we are sharing this information for your review. Protocol #1: Blepharitis - Home Treatment with Povidone Iodine Swabs Rinse the eyes and face with water five times before bedtime and first thing in the morning. Recommended WEYE foam facial wash. Apply povidone iodine every morning and night for seven nights. (attached image: Betadine Treatment Blepharitis Arnold Flores Steps) Protocol #2: In-Office Steps to Consider Administer a drop of anesthetic in each eye. Hold the eyelids open with a speculum or fingers. Apply 5% povidone iodine in the same manner as done in cataract surgery, allowing it to rest on the ocular surface for 10-30 seconds. (1,2) Rinse with Adipaq (Sterile saline solution). In office can be combined with IPL, MiBoFlo and LLLT IPL Follow with 8 minutes of MiBoFlo per eye to bring comfort after Ivermectin treatment Blue and red Low-Level Light Therapy (LLLT) at 70% power. 1. https://lnkd.in/g-sP9rab 2. https://lnkd.in/g-BWBDJ3 **Povidone Iodine 5% for Blepharitis: 100 patients ages 4 to 12 years of age Lid Hygiene with Betadine Lid hygiene with povidone iodine 5% w/v, a new and effective 7 day therapy, in the treatment of blepharitis Purpose: To evaluate the efficacy of povidone iodine 5%w/v(PI5%), as an effective lid scrub in the treatment of blepharitis. SETTING: The study was conducted at Chacha Nehru Bal Chikitsalaya, New Delhi, India, in a Pediatric Population. METHODS: Lid hygiene was performed 2 times a day with a Q-tip or a sterile cotton stub dipped in PI5% solution. 100 patients (in a pediatric set-up with ages 4-12 years) with acute and chronic blepharitis were followed up for 7 days. Slit lamp examinations were performed on Day 1, Day 4 and Day 7. Patients with hypersensitivity to surface applicants, severe ulcerative blepharitis, cutaneous and systemic disorders were excluded. RESULTS: The parameters monitored were crusting and scaling, lid margin erythema and edema and discharge. The severity was given a scale of 1 (Minimal),2 (Moderate),3 (Severe) signs. On day 4 scales in 87%, erythema and edema in 85% and discharge in 71% of the patients had been reduced. On day 7 scales in 98%, erythema and edema in 93.4% and discharge in 92.7% of the patients had been reduced. CONCLUSIONS: PI 5% is documented safe for ocular use and was well tolerated. PI 5% has not yet been used for blepharitis, this is the first study ever. It is more effective than shampoo and lid scrubs for blepharitis. Finally, especially important for use in developing areas, it is not expensive.

The ureters are anatomically divided into three segments: Abdominal ureter: The portion of the ureter that runs from the renal pelvis to the pelvic brim Pelvic ureter: The portion of the ureter that runs from the pelvic brim to the bladder Intravesical or intramural ureter: The portion of the ureter that runs within the bladder wall The ureters are narrow tubes that carry urine from the kidneys to the bladder. They are about 25–30 cm long in adults and follow an "S" shaped curve as they travel from the kidney to the bladder. The ureters have a one-way valve system in the pelvic ureter to prevent urine from flowing back up into the kidneys ICD-10 codes related to the ureters: N28.89: Other specified disorders of the kidney and ureter N28.81: Hypertrophy of the kidney N28.82: Megaloureter N28.83: Nephroptosis N28.84: Pyelitis cystica N28.85: Pyeloureteritis cystica N28.86: Ureteritis cystica Q62.61: Deviation of the ureter N20.1: Calculus of the ureter N20.2: Calculus of the kidney with calculus of the ureter The ureters are two tubes that carry urine from the kidneys to the bladder. A blockage in the ureters can prevent urine from flowing into the bladder. Symptoms of a ureteral obstruction include: abdominal pain on one or both sides, repeated urinary tract infections, leg swelling, and difficulty urinating CPT codes related to the ureters: 52354: A medical procedural code for a transurethral surgical procedure on the ureter or pelvis 50760: A CPT code for a repair procedure on the ureter, such as an anastomosis of a mid ureteral avulsion 50684: A CPT code for an introduction procedure on the ureter, such as ureterography 50810: A CPT code for a procedure where a bladder structure is created from an excised part of the sigmoid colon, and the ureters are inserted into it 50750: A CPT code for a repair procedure on the ureter 52356: A CPT code for a transurethral surgical procedure on the ureter or pelvis, such as stone procedures 52344: A CPT code for a ureteral dilation with a scope

#INSERTION OF A NG-TUBE. PURPOSE: Decompression of stomach ( to remove fluids and gas). To prevent or relieve nausea and vomiting after surgery or traumatic events by decompressing the stomach. To determine the amount of pressure and motor activity of GI tract. To give gastric lavage. To obtain specimen for laboratory studies. To administer medications. To give gastric gavage. ARTICLES: 2 kidney trays Mackintosh and towel Cotton tipped applicators Saline Levine's tube or Ryles tube size 8-12 fr. Water soluble lubricant such as glycerin or liquid paraffin. Adhesive plaster and scissors Gauze pieces Clean syringe, size 10-20 ml Measuring cup or Marked drinking cup. Clamp for occluding the NG tube Suction apparatus Pen light/flash light Tongue blade Glass of water. PROCEDURE: Nursing action (rationale) _Identify your patient (Helps in determining the appropriate size of the NG-tube). _ Check the physician's orders for any precautions such as for positioning or movement. _Ascertain the level of consciousness and ability to follow instructions. (Avoid the risk of aspiration of fluid). _Ascertain the ability of the patient to maintain desired position during insertion. ( Facilitates insertion of the tube. _Review the patients medical history for any nasal lesions, bleeding polyps or deviated nasal septum. (May require change in the route of nutritional support. eg, orogastric insertion) _Wash hands and done gloves ( to prevent infection) _Explain procedure to the patient. (Reduces anxiety and helps patients to assist in insertion of the tube. to be contd.....

𝐇𝐨𝐰 𝐒𝐭𝐢𝐭𝐜𝐡𝐞𝐬 𝐖𝐨𝐫𝐤? Stitches, also known as sutures, are a fundamental part of medical procedures, especially in surgeries and wound closures. They work by bringing together the edges of a wound or an incision, promoting healing and reducing the risk of infection. The process of stitching involves several steps and considerations to ensure optimal healing and minimal scarring. When a wound occurs, the body initiates a complex healing process. Stitches aid this process by physically closing the wound edges, which promotes the alignment of tissues, reduces bleeding, and prevents the entry of harmful bacteria. This closure allows the body's natural healing mechanisms to work efficiently, leading to better #tissue regeneration and reduced scarring. 𝐂𝐥𝐢𝐜𝐤 𝐇𝐞𝐫𝐞 𝐭𝐨 𝐆𝐞𝐭 𝐅𝐫𝐞𝐞 𝐏𝐃𝐅 𝐁𝐫𝐨𝐜𝐡𝐮𝐫𝐞: https://lnkd.in/gTkTssMN Surgical sutures come in various materials, each offering unique properties suited to different types of wounds and surgical procedures. Common materials include absorbable and non-absorbable sutures. Absorbable sutures are designed to break down and be absorbed by the body over time, eliminating the need for removal. They are often used for internal closures or in areas where removal would be difficult. Non-absorbable sutures, on the other hand, remain in place indefinitely and need to be removed manually after the wound has healed. The choice of suture material depends on factors such as the location and type of wound, the patient's medical history, and the surgeon's preference. Sutures also come in various sizes and shapes, allowing for customization based on the specific requirements of the wound. During the stitching process, surgeons carefully select the appropriate suture material and technique to achieve optimal wound closure. This may involve using different types of stitches, such as simple interrupted, continuous, or mattress #stitches, depending on the characteristics of the wound and the desired outcome. Proper technique and precision are crucial when applying stitches to ensure effective wound closure and minimize the risk of complications such as infection or tissue damage. Additionally, post-operative care, including wound management and monitoring, plays a vital role in the healing process. Stitches function by bringing together #wound edges to facilitate healing and minimize scarring. Surgical sutures, available in various materials and types, are essential tools in the hands of medical professionals, enabling them to perform precise wound closures and promote optimal patient outcomes. #surgical #sutures #future #innovation #health #medical