Dear Colleagues,
Assalamon-Alaikum, ( May ALLAH Keep You Safe )

Department of Plastic Surgery,Services Institute of Medical Sciences/Servcices Hospital,Lahore , Department of Microbiology, University of Health Sciences,Lahore, School of biological Sciences and Honey Bees Research Institute, Punjab University,Lahore invite You to the second international conference on “ Medicinal Uses of Honey” from Nov.10-12,2008.
The idea behind the conference is to share and exchange Knowledge, Research and experience and to promote use of Honey in a wide spectrum of diseases. Following topics will be discussed by internationally renowned speakers.

Honey, The Natural Healer and The best medicine
Past, Present and Future of Honey in modern medical Science
Can Honey reduce Insulin Resistance, Obesity and Diabetes Mellitus?
Honey Dressings in Burn Patients
Use of Honey in Diabetic Foot
Antibacterial properties of Honey
Are we losing fight against multi-drug resistant microbes?
Honey as probiotics and prebiotics
Antioxidant properties of Honey
Comparison of different floral Honeys with regard to MIC values against common pathogens
Bees and Bee’s Products
Bee Flora and its Biodiversity
Use of Honey and Transfer Factors in Cancer and Degenerative Diseases
Honey use as Cough Suppressant
Honey Use for Restorative Sleep
Honey Use for Cognitive performance and Memory
Honey as adjuvant to Chemotherapy

Honey is a natural product, produced by Honey Bees from nectar and pollen of flowers prevalent in that particular area. So the honey’s color, taste and smell vary in different parts of the world. So far more than 300 types of Honey have been found.
Honey is produced by bees as food for themselves but the major use is by the humans. Honey is one of the healthy food product having readily assimilable sugars, as these have already been digested by the Bee’s intestinal enzymes.

Honey has been used as food sweetener, for its nutritive and medicinal properties. Honey has been used for times immemorial as traditional remedy for many ailments. However may researchers and scientists now have carried out enormous number of clinical trials, proving the benefits of honey as an effective therapeutic agent. Honey is being used extensively to augment immune responses in patients on chemotherapy, to promote restorative sleep, reducing insulin resistance, control of diabetes mellitus & obesity, as cough suppressant, help in cognitive performance and memory, in delayed/non healing wounds, infected wounds, diabetic foot, gastric ulcers, sore throat, radiation mucositis ad ocular infections. Honey is being used by many ENT Surgeons, Dento-maxillo- facial surgeons and also by the dermatologists for many many ailments.
The first International Conference on Medicinal Uses of Honey was held at Kota Bharu, Kelantan, Malaysia, under the patronage of University Sains Malaysia from Aug.26-28, 2006.This Conference was the first sincere effort to break the hard frozen ice about use of Honey in human ailments. There was a real variety of speakers from all around the globe, to discuss and share their experience about the medicinal uses of honey.

At the concluding ceremony, it was decided unanimously that the next conference will be held at Lahore-Pakistan in 2008.We are trying our level best to organize this event by requesting and attracting a galaxy of international speakers. The emphasis is to develop and provide a platform for western and eastern scientists so as to promote the use of honey on real scientific grounds in different diseases.
Please visit the official website “www.honeyconference .com” It will provide all information about the conference events, abstract submission, Travel arrangements, Registration fees, social program, city tour and accommodation/ hotel arrangements.
Please pass on this information to all colleagues interested in honey use in human diseases. We are anxiously waiting for your guidance and suggestions

With Warm Greetings from Lahore, Pakistan

Ghulam Qadir Fayyaz

Secretary Organizing Committee
Associate Professor Plastic surgery
Services Institute of Medical Sciences/
Services Hospital, Lahore, Pakistan
Email:- gqfayyaz@hotmail. com
Mobile:- 0092+321+4430561
Fax:- 0092+42+5164932

A Airway maintenance with C-spine control
B Breathing and ventilation.
C Circulation (pulses, hemorrhage control).
D Disability (neurological status).
EExposure (complete) and Environment (Temperature control).
Restart ABCDE if patient deteriorates.
Always deal with A & B first as they may kill the patient now not C.
Airway:
1.  Immobilize cervical spine with collar or sand bags. In Trauma case ONLY.

To the examiner/ nurse “A Collar or sand bags please to immobilize the C-spine.”

2.  Airway assessment: Assess ability to breath and speak.
If patient is already responded appropriately to you so far, indicates patent airway & ability to breath is normal.
“Mr./Ms.., Where are you now?…What day of the week is today?”

To the examiner “Patient is alert, oriented, speaking, no noisy breathing, airway is patent.”

3.  Airway management:

GO TO BREATHING if airway is patent.
OR Â To the examiner “Patient is…., an indication for endotracheal tube.”
2- Definitive airway management:
-Â Endotracheal intubation (ETT):
Find out them at the ebook ” A Step By Step Guide To Mastering The OSCEs”
Breathing:
1- LOOK: for:
1. Mental status: anxiety, agitation.
2. Color: cyanosis / pallor.
3. Chest movements.
4. Respiratory rate & effort.
5. JVP. (if collar on don’t remove it. If sand bags, do it.)
To the examiner “Patient is not agitated, no cyanosis or pallor. Normal symmetrical chest movements, Normal respiratory effort & rate at…bpm, JVP is….”
2- FEEL: for:
1. Airflow.
2. Tracheal shift. (if collar on don’t remove it. If sand bags, do it.)
3. Chest wall for crepitus.
4. Flail segments & sucking chest wounds.
5. Subcutaneous emphysema.
 “Mr/Ms…, I’m going to uncover and feel your neck and chest, Okay.”
 “Any pain?”
To the examiner “There is no tracheal shift, crepitus, flail segments, sucking wounds or subcutaneous emphysema.”
3- LISTEN: Â Â Â Â Â 1. Sounds of obstruction (Stridor) & Air escaping.
2. Breath sound & symmetry of air entry. Both sides: apex, lower, & sides.
3. Heart sounds. If muffled with high JVP: Temponade: pericardiocenthesis.
 “Mr/Ms…, I’m going to listen your chest.”
To the examiner “Breath sounds are normal, symmetrical, no stridor, normal heart sounds / ….   diminished air entry on the left…..”
4- Assess Respiratory Function:

   Ventilation modalities:

Circulation:
1. Ask for Vital signs:

To the examiner/nurse “What are his/her vitals, please?”
Carefully listen to what the examiner says and comment: e.g. “Normal/ so, he has fever/tachycardia/ tachypnea….”.

- Blood pressure: If conscious mobile patient, take it on:
“Mr/Ms.., I’m going to check your blood pressure in both your arms then your leg, (if no collar) and I’ll recheck your arm while sitting/standing for a minute?.”
Note: Usually the examiner will stop you and give you the results, but start doing it until he/she stops you.
Measure BP in unconscious yourself on one arm.

To the examiner “Blood pressure is …. mmHg lying and …. mmHg standing. No postural hypotension, No significant upper/lower extremities difference. (aortic dissection)”

To the nurse “Put him on cardiac monitor & pulse oxymeter. Repeat vitals every (5-15) minutes & inform me.”

2. IV lines & Investigations:

To the nurse
1) “I want 2 wide pore gauge 14-16 IV lines established, please.
2) Start Normal Saline/ Ringer Lactate, one liter on each at 125-1000 ml/h each (choose).
3) Take a blood sample and send for:
- Blood group, Rh & cross-match,
- CBC, Lytes, (ABGs, CK-MB, Tropinin) if respiratory/ cardiac case
- Liver function test (ALT, AST, ALP, & amylase),
- Renal function tests (BUN, Cr),
- Coagulation profile (INR/PTT),
- Rapid bedside Blood sugar,
- Toxicology screen (if indicated).
4)Â Also send for:Â 12- lead ECG, CXR, Head CT (if comatose),
C-Spine & pelvic X-rays (if trauma)”
5)Â Foley’s catheter / Nasogastric tube (if needed).
“Mr/Ms .., I’ll put a bee tube inside in order to monitor your urine output, okay..?”
Note: If blood seen from meatus: NO FOLEY’S (? Urethral injury)

Assess Respiratory Function:
Change to assisted ventilation or ETT if needed.
 If BP low:

 If Comatose:

3. Rule out shock:

Go to Detailed Secondary Survey

FFFÂ Go to management below.

Management of hemorrhagic shock:

1 – Ask for vitals again: “What are his/her vitals, please?”
Carefully listen to what the examiner says and comment: e.g. “Normal/ so, he has fever/tachycardia/ tachypnea….”.
2 – Secure airway and O2: Already done but check the mask and O2 level.
3 – Control bleeding by:
Find out them at the ebook ” A Step By Step Guide To Mastering The OSCEs”
4 – Replace lost blood:
5 – Vasopressors:
- Not during bleeding.
- Used if hypotension persists despite appropriate volume administration. Also for septic and anaphylactic shocks.

* If Patient is stable now: Proceed to Disability.
If not: Repeat ABC until becomes stable.

Then you have to go into D, E and then detailed survey.

____________ _________ _________ _________ _________ _________ _________ _________ _____

2) Today’s OSCE Exam preparation tips:

We also asked you to prepare steps for every emergency management of common emergencies like:
** IF Diabetic Emergencies:

To the nurse “Run the Normal Saline at 1000cc/h each;
Give 5 (-10) IU Insulin IV bolus, then another 5 (-10)/h by IV infusion”
“When Blood glucose reaches 15 mMol/L change the fluid to two third 5% dextrose water (D5W) and one third Normal Saline. Then add 20 mEq/L KCL to the fluid.”
“Send for urine glucose and ketones.”