This document discusses different types of non-suppurative otitis media, including otitis media with effusion (OME), adhesive otitis media, tympanosclerosis, and barotraumatic otitis media. It describes the symptoms, signs, and treatments for OME, which is the presence of fluid in the middle ear without infection. Causes of OME include Eustachian tube dysfunction due to obstruction, infection, or functional issues. Treatments discussed include antibiotics, nasal decongestants, myringotomy with grommet insertion, and devices to aid Eustachian tube drainage. Complications of chronic OME include tympanosclerosis, adhesive otit
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT)Dr Krishna Koirala
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT) is an important topic for MBBS and MS ENt students. Dr Krishna Koirala will be explaining this topic in a simplified way.
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT)Dr Krishna Koirala
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT) is an important topic for MBBS and MS ENt students. Dr Krishna Koirala will be explaining this topic in a simplified way.
Vertigo is a subtype of dizziness in which a patient inappropriately experiences the perception of motion (usually a spinning motion) due to dysfunction of the vestibular system.
inflammation of the ear, usually distinguished as otitis externa (of the passage of the outer ear), otitis media (of the middle ear), and otitis interna (of the inner ear; labyrinthitis).
Otitis media with effusion in children Augustine raj
Otitis media with effusion, also called glue ear, serous otitis media is a very common problem encounterd in children . most of the times it is missed leading to deafness , social adjustment disorders, poor scholastic performance of kids. this slideshare is to create an awareness amonf general physicians and ENT specialists
Presence of serous or mucoid fluid in the middle ear cleft without frank pus
Synonyms
Glue ear
Serous otitis media
Secretory otitis media
Seromucinous otitis media
Exudative otitis media
Catarrhal otitis media
Etiology
1. Eustachian tube dysfunction
Vacuum in middle ear extravasation of fluid
Lack of drainage of middle ear secretions
2. Upper respiratory tract allergy / viral infection
Increase middle ear secretions
3. Low grade middle ear infection
Inadequate treatment of ASOM
Symptoms
Decreased hearing in a young child that increases during U.R.T.I.
Mild earache
Blocking sensation in ear/ aural fullness
Delayed & defective speech due to deafness
OME is defined as presence of serous or mucoid fluid in the middle ear cleft without frank pus
Synonyms are:
Glue ear
Serous otitis media
Secretory otitis media
Seromucinous otitis media
Exudative otitis media
Catarrhal otitis media
Symptoms of OME:
Decreased hearing in a young child that increases during U.R.T.I.
Mild earache
Blocking sensation in ear/ aural fullness
Delayed & defective speech due to deafness
Signs of OME:
1. Otoscopy : Dull /pinkish/blue eardrum with restricted mobility
Retraction of T.M. in early stage
Bulging of T.M. in later stages
Fluid level and air bubbles seen behind the T.M.
2. Tuning Fork Tests
Conductive deafness
Medical Treatment:
Antibiotic (Co - amoxyclav) for 2-4 weeks
Nasal decongestants (systemic + topical)
H1 anti-histamines
Auto-inflation of the Eustachian tube by Valsalva maneuver
Analgesic for acute earache
Low dose topical steroids and steroid sprays
Surgical Treatment: Myringotomy (Tympanocentesis) + grommet (Pressure Equalization / Ventilation tube) Insertion
Radial incision made in antero-inferior quadrant
For thick fluid, 2 incisions made in antero-inferior quadrant and antero-superior quadrant (Beer can principle)
Cortical mastoidectomy for refractory cases with loculated fluid in mastoid
Treatment for predisposing factors like adeno-tonsillectomy ,antral wash ,polypectomy
otitis media is the inflammation of the ear drum or tympanic membrane this topic include its definition , etiology, pathophysiology, clinical manifestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from otitis media and for learning for their examination and knowledge purpose
and care of the child with acute otitis media and chronic otitis media and make their family aware about the complication of the otitis media like hearing loss meningitis
Nasal Polyps are defined as pale, polypoidal, pedunculated , prolapsed sinus mucosa into the nose.
They cause nasal obstruction. Nasal allergy and infecions are proposed to be the most common etiological factors for nasal polyps.
This presentation explains in detail about every aspect of nasal polyps.
Allergic rhinitis is a very much prevalent condition in the community. This presentation hopes to spread a ray of hope in treating allergic and intrinsic rhinitis.
CSOM may lead to different complications. Although less common in developed countries, CSOM is common in developing and underdeveloped countries.
This presentation explains the complications of CSOM in details.
Facial nerve is the nerve of facial expression. Facial nerve disorders can lead to ugly face. This presentation explains the facial nerve disorders in details.
CSOM AA might present with both intracranial and extracranial complications. Extracranial complications might again be divided into Intratemporal and extratemporal extracranial.
This presentation explains you about different complications of CSOM in details.
Multiple choice Questions in Otorhinolaryngology with explanations module 2 ...Dr Krishna Koirala
In our part of world, final university examination in otorhinolaryngology carries 80 marks in theory. Out of that there shall be 30 MCQ questions each carrying 1 mark.
So I request you all to go through this presentation.
Audiometry for Undergraduate and postgraduate ENT students Dr Krishna Koirala
Audiometry is one of the essential topic in MBBS.
This presentation helps students to learn about basic audiometry for MBBS level and shall equally be useful for postgraduate ENT students, too.
Vestibular function tests are essential tests in otorhinolaryngology examination, especially examination of ear.
This presentation explains about all the important vestibular function tests.
Presentation prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal, for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal, for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal, for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Tonsils and adenoids
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal, for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
Non suppurative otitis media
1. Non - suppurative
Otitis Media
Dr. Krishna
Koirala, MS
Associate
Professor
Dept. of ENT- HNS2016-04-26
2. Types
1. Otitis Media with effusion (O.M.E.)
2. Adhesive otitis media
3. Tympanosclerosis
4. Barotraumatic otitis media
3. Otitis Media with
Effusion
• Presence of serous or mucoid fluid in
the middle ear cleft without frank pus
• Synonyms
– Glue ear
– Serous otitis media
– Seromucinous otitis media
– Secretory otitis media
– Exudative otitis media
– Catarrhal otitis media
4. Etiology
1. Eustachian tube dysfunction
– Vacuum in middle ear→ extravasation
of fluid
– Lack of drainage of middle ear
secretions
2. Upper respiratory tract allergy / viral
infection
– Increase middle ear secretions
6. Symptoms
• Mild deafness in a young child that
increases during U.R.T.I.
• Mild otalgia
• Blocking sensation in ear
• Delayed & defective speech due to
7. Signs
1. Otoscopy
− Dull /pinkish/blue eardrum with
restricted mobility
− Retraction of T.M. in early stage
− Bulging of T.M. in later stages
− Fluid level and air bubbles seen behind
the T.M.
16. Politzerization
• Rubber tube attached
to Politzer bag is put
into one nostril & both
nostrils pinched
• Pt is asked to swallow
repeatedly & Politzer
bag is squeezed
simultaneously
18. • Balloon is inflated by blowing air out of
nose
• When fully inflated, balloon neck is
pinched off and nasal occluder is
inserted into one nostril
• Child is instructed to swallow as balloon
is deflated into the nasal cavity
• Portion of air from balloon enters
Eustachian tube & ventilates middle ear
20. • Based on Politzer Maneuver, Ear Popper
Device delivers a safe, constant,
regulated stream of air into nasal cavity
• During swallowing, air is diverted to
Eustachian tube clearing and ventilating
middle ear
22. EARDOC generates and transmits special
vibration waves which travel through
temporal bone to reach the middle ear &
Eustachian tube → the waves ease middle
ear pressure and drain trapped fluids →
edema & pain are reduced
23. Surgical treatment
1. Myringotomy (Tympanocentesis) +
grommet (Pressure Equalization /
Ventilation tube) Insertion
– Radial incision made in antero-inferior
quadrant
– For thick fluid, 2 incisions made in
24. 2. Cortical mastoidectomy for refractory
cases with loculated fluid in mastoid
3. Treatment for predisposing factors like
adeno-tonsillectomy ,antral wash
,polypectomy
38. Adhesive Otitis Media
• Pathology
– TM atrophy + atelectasis (due to
dissolution of fibrous layer) +
adhesions in middle ear cavity,
following chronic O.M.E.
• Clinical Features
– Conductive deafness
39. Treatment:
1. Hearing Aid
2. Surgery (long term results are poor)
a. Tympanotomy + release of adhesions
+ put silastic sheet b/w promontory &
TM
b. Grommet insertion
40. Tympanosclerosis
Deposition of hyaline
(acellular and avascular
collagen) and calcium
deposits in submucosal
tissue of T.M. & M.E.
cavity following long-
standing otitis media
during healing process
43. Role of Esutachian tube
• E.T. has collapsible cartilaginous and rigid
bony portion
• Allows expulsion of air from middle ear
into E.T. but not suction of air into middle
ear via ET
44. Etiology
• Failure of Eustachian tube to equalize
rapid increase in pressure difference b/w
middle ear & atmosphere, over a long
period
• During ascent
– Middle ear pressure > Atmospheric
Pressure → no barotrauma in normal
middle ear
• During descent
45. Pressure
Differen
ce
Pathology in
normal Middle
Ear
Symptom
s
- 60 mm
Hg
Hyperemia , edema ,
exudation , T.M.
retraction
Otalgia,
deafness,
tinnitus
- 90 mm
Hg
Locking of ET
(collapse of lumen),
microscopic
hemorrhage
Severe
otalgia
- 100 to
400 mm
Hg
T.M. rupture Frank
blood
otorrhea
47. Prevention
1. Avoid air travel during cold / nasal
allergy
2. During descent while flying
– Do repeated swallows (lozenges /
chewing gum)
– Do intermittent Valsalva maneuvre
– Avoid sleeping (as swallowing is
