Biliary atresia is a progressive disease of the bile ducts that affects infants. It causes bile buildup in the liver due to obstruction of bile flow from the liver to the small intestine. This buildup damages liver tissue and can lead to cirrhosis. There are three types: isolated biliary atresia, biliary atresia associated with laterality defects, and biliary atresia associated with other birth defects. The causes are unclear but may involve genetic, viral, toxic, or immune factors. Clinical features include jaundice, acholic stools, dark urine, and an enlarged firm liver occurring in the first few months of life. Prenatal ultrasound may also detect liver abnormalities.
Cholemia is a condition caused by the presence of excess bile in the blood. Its symptoms can include somnolence (drowsiness), yellow tinge to skin and whites of eyes, fatigue, nausea and, in extreme cases, coma. It is often an early sign of liver disease.
Gallstones are hardened deposits of digestive fluid that can form in the gallbladder. The gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath the liver. The gallbladder holds a digestive fluid called bile that's released into the small intestine.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Cholemia is a condition caused by the presence of excess bile in the blood. Its symptoms can include somnolence (drowsiness), yellow tinge to skin and whites of eyes, fatigue, nausea and, in extreme cases, coma. It is often an early sign of liver disease.
Gallstones are hardened deposits of digestive fluid that can form in the gallbladder. The gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath the liver. The gallbladder holds a digestive fluid called bile that's released into the small intestine.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
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3. Introduction
• Biliary atresia (BA) is a progressive, idiopathic, fibro-obliterative
disease of the extrahepatic biliary tree that presents with biliary
obstruction in the neonatal period.
• Bile flow obstruction into the intestine causes the bile to build up in
the liver and damage it. This damage leads to scaring of the liver
tissue and loss of liver functionality and eventually cirrhosis
4. TYPES OF BILIARY ATRESIA
1. Biliary atresia without any other anomalies or malformations
• Happens when children are born without jaundice, but within the first two
months of life, jaundice develops and stools become progressively acholic
2. Biliary atresia in association with laterality malformations
• Include situs inversus, asplenia or polysplenia, malrotation, interrupted inferior
vena cava, and cardiac anomalies
• Poorer outcomes due to the associated cardiac abnormalities
3. Biliary atresia in association with other congenital malformations
• Associated congenital malformations include intestinal atresia, imperforate anus,
kidney anomalies, and/or cardiac malformations
5. PATHOGENESIS
• The causes of BA are not well established and are probably
multifactorial; genetic factors may play a permissive role in some
cases.
• Several mechanisms may contribute to the development of BA:
1. Viral etiologies : including cytomegalovirus, reovirus, and group C rotavirus
2. Toxic etiologies: toxin-mediated inflammatory response
3. Genetic etiologies: Mutations in the CFC1 gene, Exome sequencing in 67
4. Immunologic etiologies: Immune dysregulation
6. CLINICAL FEATURES
• Prenatal findings
• Prenatal ultrasound identifies an abnormality suggesting BA, including a cyst
in the liver hilum or heterotaxy syndrome
7. CLINICAL FEATURES
• Signs and symptoms
• Jaundice: first sign and occurs any time from birth up to eight weeks of age
• Acholic stools
• Dark urine
• Firm, enlarged liver and splenomegaly