Journal de chirurgie et d'anesthésie

Abstrait

Update on Ghanem's New Scientific Discoveries In Physics, Physiology and Medicine

Ahmed N. Ghanem

Introduction and objective: To report the new scientific discoveries in physics, physiology and medicine by one author.

Materials and methods: Results of my research are summarized. It is based on 2 clinical studies one prospective and the second case series on Hyponatraemia (HN) of The Transurethral Resection of the Prostate (TURP) syndrome. A physics study on porous orifice (G) tube proves Starling’s law is wrong. I reported prospective study on nephroptosis revealing its link with the Loin Pain Haematuria Syndrome (LPHS) and curative surgery for it.

Results: Two physics and two physiological discoveries are reported. Acute HN presents as shock during surgery. It is induced by massive gain of sodium-free fluid recognized as Volumetric Overload Shock (VOS). Features of the multiple organ dysfunction syndrome occur, include ARDS, Acute Renal Failure (ARF) and Coma. The prospective study demonstrated volumetric overload is the most significant in patho-aetiology. The case series demonstrated mistaking VOS for a known shock and treating it with further volume expansion cause death. Correct diagnoses as VOS and treating it with hypertonic sodium are lifesaving. The physics study on the G tube demonstrated that proximal, akin to arterial, pressure induces suction not filtration producing the hydrodynamic phenomenon that replaces Starling’s law. The link of LPHS with nephroptosis is demonstrated by the IVU 7 sign. The curative surgery for LPHS is renal sympathetic denervation and nephropexy.

Conclusion: Dilution HN presents as shock that is mistaken for known shocks and treated with volume expansion causing death or ARDS. Manifestations include shock, ARDS, ARF and Coma. The correct treatment is hypertonic sodium. Starling s law has proved wrong. The correct replacement is the hydrodynamics of G tube. The puzzle of LPHS was also resolved.