Neural tube defects are the most common congenital abnormality in India which can be easily prevented with due information and better nursing practices. Neural Tube Defects can be prevented with intake of folic acid.
Pediatrics. trisomy 21. Meiotic non-disjunction of chromosome 21. clinical features and associated abnormalities of down syndrome. screening test for down syndrome. counseling for parents in down syndrome.
These are cardiac anomalies arising as a result of a defect in the structure or function of the heart and great vessels which is present at birth
These lesions either obstruct blood flow in the heart or vessels near it, or alter the pathway of blood circulating through the heart
Neural tube defects are the most common congenital abnormality in India which can be easily prevented with due information and better nursing practices. Neural Tube Defects can be prevented with intake of folic acid.
Pediatrics. trisomy 21. Meiotic non-disjunction of chromosome 21. clinical features and associated abnormalities of down syndrome. screening test for down syndrome. counseling for parents in down syndrome.
These are cardiac anomalies arising as a result of a defect in the structure or function of the heart and great vessels which is present at birth
These lesions either obstruct blood flow in the heart or vessels near it, or alter the pathway of blood circulating through the heart
EATING DISORDERS (Psychiatry-7)by dr Shivam sharma.pptxShivam Sharma
For any queries ,contact shvmshrm@outlook.com
---
## Introduction to Eating Disorders
Welcome to this comprehensive presentation on Eating Disorders, a critical and often misunderstood area of mental health. This presentation is designed to provide in-depth knowledge and insights into the various aspects of eating disorders, making it valuable for both postgraduate medical aspirants preparing for the INI-CET and the general public seeking to understand these complex conditions.
### Objectives:
1. **Understanding Eating Disorders**: Gain a clear understanding of what eating disorders are, their types, and their distinguishing characteristics.
2. **Etiology and Risk Factors**: Explore the underlying causes and risk factors that contribute to the development of eating disorders.
3. **Clinical Features and Diagnosis**: Learn about the clinical features, diagnostic criteria, and the importance of early detection.
4. **Management and Treatment**: Review the current approaches to managing and treating eating disorders, including medical, psychological, and nutritional interventions.
5. **Prevention and Awareness**: Discuss strategies for prevention, early intervention, and increasing awareness about eating disorders.
This presentation aims to bridge the gap between academic knowledge and practical understanding, providing you with the tools to recognize, diagnose, and effectively manage eating disorders. Whether you are preparing for a medical exam or seeking to educate yourself or others about these serious conditions, this presentation will equip you with essential information and practical insights.
Let's begin our journey into understanding eating disorders and the significant impact they have on individuals and society.
---
For any queries ,contact shvmshrm@outlook.com
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. History
• Named after a physician, “John Langdon
Down” in 18th century.
• Described as Mongoloid child of
European parentage-”Mongolism”
• In 1959 a French doctor, named
“Jerome Lejeune”, discovered it was
caused by the inheritance of an extra
chromosome 21.
• Also known as “trisomy 21”
4/28/2014 2
3. Incidence
• Incidence classified according
to 3 major ethnic groups
•Malay - 1 in 981
•Chinese - 1 in 940
•Indians - 1 in 860
4/28/2014 3
4. Introduction
• Down syndrome is an autosomal
disorder because it affects
chromosome 21, which is an
autosome.
• Down syndrome is neither a dominant
nor recessive trait because it is just
an error in the “translation” process
of chromosome 21.
4/28/2014 4
5. Genetics of DS
• It is believed that the „amyloid precursor
protein gene (App)‟ is the cause of „Down
syndrome‟, and it is located on chromosome 21.
• A mutation in this gene usually results in
Alzheimer‟s disease . Similarly three copies of
this gene has a huge effect on the brain &
other tissues of body.
• Scientists believe that excess „App‟ gene is
causing the cells to die (apoptosis), because it
interfere with the normal cell division (mitosis).
• Therefore people with down syndrome tend to
develop the brain with signs of Alzheimer‟s and
abnormalities other parts of the body.4/28/2014 5
6. 92% -94% Trisomy 21
- nondisjunction during
fertilisation
2-4% Mosaicism
- error in cell division
after fertilisation
3-4% Translocation of
chromosome 21
- breaking and
attaching to other
chromosomes (14)
during cell division
4/28/2014 6
7. Down Syndrome & Maternal Age
A study done in Mysore,
India - paternal age and
maternal grandmother‟s
age influences Down
Syndrome in neonates.
Age Incidence of Down
Syndrome
< 30
30
35
36
37
38
39
40
42
44
46
48
49
Less than 1 in 1000
1 in 900
1 in 400
1 in 300
1 in 230
1 in 180
1 in 135
1 in 105
1 in 60
1 in 35
1 in 20
1 in 16
1 in 12
4/28/2014 7
9. Risk factors
• Advancing maternal age – usually
women of age 35 and above
• Mothers who already have one
child with Down syndrome –
increased risk for subsequent
pregnancies
• Parents who are carriers of the
genetic translocation for Down
syndrome4/28/2014 9
10. Clinical features
• Life expectancy : 55 years
(National Down Syndrome
Society)
• Physical appearances
– flat facial profile and an upward
slant to the eye
– short neck
– abnormally shaped ears
– white spots on the iris of the eye
(called Brushfield spots)
– single, deep transverse crease on
the palm of the hand.
4/28/2014 10
11. - relatively late development of
deciduous and permanent teeth as
compared with other children
- Teeth could appear in a different
sequence and positions
- Teeth are often are rounded, pointed
or cone-shaped. Smaller with gaps
- Fewer teeth.
- Maxilla is narrow, the tongue appears
too big for the mouth and the teeth
may be pushed out of place, as the
child grows older.
- Habit of breathing through the mouth
- Mental retardation varied from mild to
moderate – some even have special
abilities after training
and early interventions
4/28/2014 11
12. Neonatal features
• Flat facial profile
• Poor Moro reflex
• Excessive skin at
the nape of neck
• Slanted palpebral
fissures
• Hypotonia
• Hyper flexibility
of joints
• Dysplasia of pelvis
• Anomalous ears
• Dysplasia of
midphalanx of
fifth finger
• Transverse palmer
crease(simian)
4/28/2014 12
16. – Sleep problems
• Sleep apnoea, other sleep disturbance
– Skeletal problems
• Flat foot, atlantoaxial subluxation
– Visual problems
• Refractive disorder, squint, nystagmus
– Hearing problems
• Hearing loss, conductive hearing loss, chronic otitis media
- Obesity and nutrient deficiency
- Malabsorption (probably linked with celiac disease) due to intestinal
damage
- Some has lack of vitamin B12, folic acid and zinc
- Need for antioxidants i.e. vitamin E
4/28/2014 16
17. Mental Retardation
• Almost all DS babies have MR.
• Mildly to moderately retarded .
• Starts in the first year of life.
• Average age of sitting(11 mon), and
walking (26 mon) is twice the typical age.
• First words at 18 months.
• IQ declines through the first 10 years of
age, reaching a plateau in adolescence that
continues into adulthood.
4/28/2014 17
18. Heart Disease
• 50 % of Down Syndrome pts have heart
disease
• Endocardiac cushion defects
• VSD
• Secundum ASD
• PDA
• Tetrology of Fallot
• Mitral valve prolapse
• AR, MR
4/28/2014 18
19. GI abnormalities
• 5% of cases
• Duodenal atresia or stenosis, sometimes
assoc with annular pancreas in 2.5 % of
cases
• Imperforate anus
• Esophageal atresia with TE fistula is less
common
• Hirschsprung‟s disease
• Strong assoc with celiac disease between
5 – 16 % ,4/28/2014 19
20. Growth
• Weight, length and HC are less in DS
• Reduced growth rate
• Prevalence of „obesity‟ is greater in
DS
• Weight is less than expected for
length in „infants‟ with DS, and then
increases disproportionally so that
they are obese by age 3-4 yrs
4/28/2014 20
21. Eye problems
Most common disorders are
Refractory error – 35 to 76 %
Strabismus – 25 to 57 percent
Nystagmus – 18 to 22 percent
Cataract occur in 5 % of newborns,
Frequency increases with age.
4/28/2014 21
23. Hearing loss
• Unilateral or bilateral
• Conductive, sensorineural or
mixed
• Otitis media is a frequent
problem
4/28/2014 23
24. Hematologic disorders
• The risk of leukemia is 1 to 1.5 percent.
• 65% of newborn have polycythemia
resulting in hypoglycemia.
• Risk of AML and ALL is also much higher
than the general population.
• Transient leukemia – exclusively affects
NB.
- It is asymptomatic with spontaneous
resolution in 2-3 months.
4/28/2014 24
25. Endocrine disorder
• Thyroid disease –
Hypothyroidism occurs more
frequently than hyperthyroidism.
• Diabetes –
The risk of type 1 diabetes is
three times greater than that of
the general population.
4/28/2014 25
26. Reproduction
• Women with DS are fertile and may
become pregnant.
• Nearly all males with DS are
infertile. Due to impaired
„spermatogenesis‟.
4/28/2014 26
27. Skeletal abnormalities
• Excessive mobility of atlas (C1) and the
axis (C2), may lead to subluxation of
the cervical spine. (Atlantoaxial
instability )
• Diagnosis made by lateral neck
radiograph.
• flat foot, dysgenesis of middle phalax
in little finger, narrow maxilla,
clindactyly.
4/28/2014 27
29. Diagnosis
• Prenatal screening
• If no screening – It can be recognized
by the characteristic phenotypic
features.
• Confirmed by genetic Karyotyping.4/28/2014 29
30. Management
1. Growth – Measurements should be plotted
on the appropriate growth chart for children
with DS.
• This will help in prevention of obesity and
early diagnosis of celiac disease and
hypothyroidism.
2. Cardiac disease – All newborns should be
evaluated by cardiac ECHO for CHD in
consultation with pediatric cardiologist.
3. Hearing – Screening to be done in the
newborn period, every 6 months until 3 yrs
of age and then annually.4/28/2014 30
31. Management (cont.)
4. Eye disorders - An eye exam should be
performed in the newborn period or at least
before 6 months of age to detect
strabismus, nystagmus, and cataracts.
5. Thyroid Function – Should be done in
newborn period and should be repeated at
six and 12 months, and then annually.
6. Celiac Disease – Screening should begin
at 2 yrs. Repeat screening if signs develop.
4/28/2014 31
32. Management ( cont)
7. Hematology – CBC with DLC at birth to
evaluate for polycythemia as well as
leukemia.
8. Atlanto-axial instability – X ray for
evidence of AAI or sub-luxation at 3 to 5
years of age.
9. Alzheimer’s disease – Adult with a Down
Syndrome has earlier onset of symptoms.
When diagnosis is considered, thyroid
disease and possible depression should be
excluded.
10.Rehabilitation4/28/2014 32
34. Counseling
• May begin when a prenatal diagnosis is
made.
• Discuss the wide range of variability in
manifestation and prognosis.
• Medical and educational treatments and
interventions should be discussed.
• Initial referrals for early intervention,
and „rehabilitation‟.
4/28/2014 34
35. Mortality
Avarage life span is 25yrs. To 50 yrs.
Most likely cause of death is CHD,
AAI, Hypothyroidism and Leukemia.
Improved survival is because of
increased placements of infants in
„rehabilitation homes‟ and changes in
treatment for common causes of death.
Survival is better for males
4/28/2014 35