This document discusses eye disorders in children. It covers the types of eye conditions infants and children are susceptible to, the importance of early detection and treatment, and priorities for care which include promoting healthy development and maximizing vision. It provides recommendations for pediatric eye screening and examinations at different ages. Details are given on components of the eye exam, conditions that warrant referral, and education on prevention.
Pediatric Cortical Visual Impairment: Congenital or acquired brain-based visual impairment with onset in childhood, unexplained by an ocular disorder, and associated with unique visual and behavioral characteristics. (PCVI Society). Presentation made to Illinois College of Optometry NORA and COVD students, faculty and residents.
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
2. OVERVIEW
•Infants and children and particularly
susceptible to permanent central visual loss,
opacities, refractive errors not associated with
amblyopia, strabismus, and other conditions
that interfere with visual acuity (Woo, 2020).
•Early detection and correction of these
conditions may prevent permanent loss in the
mature central visual system of the older child
or adult (Woo, 2020).
•When care for children with eye problems,
priorities include promoting optimizing growth
and development of the ocular structures and
maximizing visual acuity (Woo, 2020).
•Nurse practitioners should seek to promote
good vision and health, detect abnormalities,
and treat conditions that fall within their scope
of practice (Woo, 2020).
•Nurse practitioners should also refer patients
with conditions requiring an ophthalmologist’s
attention, as well as provide education and
3. HISTORY AND CLINICAL
FINDINGS
•The U.S. Department of Health and
Human Services (HHS) Healthy
People 2020 propose to:
• Increase the proportion of
preschool children (<5 years of
age)
• Reduce blindness and visual
impairment in children and
adolescents (<17 years of age)
• Reduce uncorrected visual
impairment due to refractive
errors
• Increase the use of personal
protective eyewear in
recreational activities and
hazardous situations around the
home
•The U.S. Preventive Services Task
Force (USPSTF) recommends vision
screening for children 6 months to
5 years of age (Woo, 2020).
4. RECOMMENDED AGES AND
METHODS FOR PEDIATRIC EYE
EVALUATION SCREENING
Recommended Age Method for Evaluation
Newborn to 3 months old Ocular history
Red reflex
Inspection
3-6 months old Ocular history
Fix and follow
Red reflex
Inspection
6-12 months old and until child is able to cooperate for verbal visual
acuity
Ocular history
Fix and follow with each eye
Alternate occlusion
Corneal light reflex
Red reflex
Inspection
Photoscreening
3 years of age and older and every 1-2 years after 5 years of age Ocular history
Visual acuity
Corneal light reflex/cover-uncover reflex
Red reflex
Inspection
Photoscreening or autorefraction
Attempt ophthalmoscopy
5. PHYSICAL
EXAMINATION
• With a penlight, gross inspection should be made of the
external structures including the lids, bulbar and
palpebral conjunctiva, cornea, lacrimal structures, the
size, symmetry, and reactivity of the pupils, orbits, eye
muscle balance, and mobility (Woo, 2020).
• The red reflex is tested in all ages. It must be assessed
for color, intensity, and clarity (opacities or white spots)
(Woo, 2020). A rule a thumb is that if the examiner
cannot see into the eye, the patient cannot see out (Woo,
2020).
• In children beginning at age 5 years, funduscopic
examination may allow for visualization of the retina,
choroid, fovea, macula, optic disc and cup, and entry and
exit or the vessels and nerves (Woo, 2020).
• Examination of the conjunctiva and sclera is sometimes
facilitated by using a cotton-tipped applicator the evert
the eyelid (Woo, 2020).
• Growth parameters (especially head growth and shape)
and the head and neck or other structures should be
examined if a systemic condition is suspected (Woo,
2020).
6. PHYSICAL
EXAMINATION:
RED REFLEX
• The red reflex should be
tested at every well
examination, including the
initial newborn examination.
• The red reflex test is also
called the Bruckner test and
allows the clinician to detect
the presence of asymmetric
refractive errors, strabismic
deviations, and abnormalities
in the ocular media such as
cataracts, corneal
abnormalities, and
retinoblastoma (Woo, 2020).
• Disease processes involving
the cornea, lens, vitreous, or
retina block the light from
entering or exiting the pupil
and result in an abnormal red
reflex (Woo, 2020).
7. COLOR VISION
TESTING
•The human retina contains
6 million red and green
cones and approximately 1
million blue cones (Woo,
2020).
•Alterations in color vision
occur when the normal
photopigments in the
photoreceptor cones are
replaced by different ones
(Woo, 2020).
•Color ranges are then
interpreted or perceived
differently (Woo, 2020).
• Red-green color
deficiency
• Blue-yellow deficiency
8. ASSESSMENT OF
VISUAL LOSS
If significant visual disturbance is suspected, the
following functional vision assessments should be
performed, and the child referred immediately to an
ophthalmologist:
Shine a penlight into the eye from a lateral
position and turn the light off and on several times
to assess light perception. If the child can identify
when the light is on or off, vision is described as
“LP” (light perception) (Woo, 2020).
Move a hand back and forth with periodic
cessation 12 inches from the child’s face.
Indication of search and recognition is
documented as “H/M at 1 ft” (hand motion) (Woo,
2020).
Ask the child to count the number of fingers (C/F)
seen when one, two, or three fingers are held up
12 inches from the child’s face. If the child is
correct, document the vision as “C/F at 1 ft” (Woo,
This Photo by Unknown Author is licensed under CC BY-NC
This Photo by Unknown Author is licensed under CC BY-NC
9. INDICATIONS FOR A COMPREHENSIVE PEDIATRIC
EYE EVALUATION
TABLE 35.4
PAGE 621
Risk Factors
Prematurity, Retinopathy of prematurity,
Intrauterine growth retardation, Neurologic
disorders, Thyroid disease, Cleft palate, Suspected
child abuse
Family History of eye problems
Retinoblastoma, Childhood cataract, Childhood
glaucoma, Retinal degeneration, Strabismus,
Amblyopia, Eyeglasses in early childhood, Sickle
cell anemia
Signs or Symptoms of eye problems
Defective ocular fixation, Abnormal light reflex,
Irregular pupils, Drooping eyelids, Lumps/Swelling
around eyes, Nystagmus, Squinting, Persistent
head tilt This Photo by Unknown Author is licensed under CC BY-NC-ND
10. SPECIAL
CONSIDERATIONS
FOR EYE
EXAMINATIONS
Infants and Toddlers (newborn-2 years
of age)
Better to preform examination early in
the morning or after an infant nap.
Preschool Children (3 years-5 years of
age)
At this age children have expressive
language skills, but testing
modifications are often needed to
gather information. Begin exam with
procedures that appear less
threatening.
School-Age Children (6-18 years of
age) This Photo by Unknown Author is licensed under CC BY-SA
11. DIAGNOSTIC STUDIES
•PHOTOSCREENING AND
AUTOREFRACTORS
• Used to screen for optical
and physical abnormalities
of the eyes and at
preventive visits in the
pediatric office.
•LABORATORY AND
IMAGING STUDIES
• Cultures and gram staining
of eye discharge
• Ultrasound
• CT
• MRI
•FLUORESCEIN STAINING
This Photo by Unknown Author is licensed under CC BY-NC
12. PATIENT AND
FAMILY
EDUCATION AND
PREVENTION
•Prevent Blindness 2018
recommends specific prevention
steps which include the following:
• Using safety gates and
cushions/pads at sharp corners,
storing sharp utensils/tools out
of reach of children, and storing
chemicals securely
• Restraining children properly in
the car, not allowing children
under 12 years of age to sit in
the front seat
• Limiting/supervising the use of
laser pointers, BB guns, air
rifles, paintball devices, darts
and fireworks
13. MANAGEMENT/REFERRAL/
FOLLOW-UP
Eye pathology is referred to an ophthalmologist or
optometrists depending on the severity of the eye
disorder.
Management includes:
Occlusion - by patching, optical or pharmacologic
penalization, or occlusive contact lens.
Corrective lens – contact lenses or eyeglasses.
The American Academy of Ophthalmology (AAO)
discourages LASIK surgery in children younger than
18 years of age and provides strict guidelines for
candidates for the procedure.
This Photo by Unknown Author is licensed under CC BY-SA-NC
14. REFERENCES
Woo, T. M. (2020). Eye disorders. Burns’ Pediatric
Primary Care.
American Optometric Association. (2017).
Comprehensive pediatric eye and vision examination.
Retrieved from https://www.aoa.org/news/clinical-
eye-care/health-and-wellness/aoa-releases-new-
evidence-based-guideline-for-pediatric-eye-
care?sso=y
Editor's Notes
Hello, today ms KeScharnae Drakeford and myself, Melissa collins will be presenting eye disorders in the pediatric population.
The recommended technique follow: darken the examination room, as it is easier to detect more subtle asymmetries between the red reflexes. Stand an arm’s length away from the infant or child with the ophthalmoscope’s light set at 0 or +1 to illuminate the face. NOTE: In children with fair skin pigmentation, the red reflex is bright red-orange; in those with darker pigmentation, the red reflex is dark-brown or pale yellow. The red reflexes should be symmetric; any asymmetry, dark or white spots, opacities, or leukocoria (white pupillary reflex) requires prompt referral to an ophthalmologist.
Red-green color deficiency is an X-linked inherited disorder or may indicate optic nerve disease. Inherited (X-linked) color deficiencies are more common in males, affecting less than 5% of females. Color vision deficiency may also be acquired. A patient with acquired color deficiency may have had normal color vision and then experienced color changes and losses. Diabetes, infections, optic neuritis, and toxins are systemic conditions that can lead to such losses. Blue-yellow deficiency is the most common type of acquired color deficiency. A significant color vision deficiency can affect school performance, have safety implications if the child is unable to distinguish traffic or vehicle brake lights, and affect career choices. Color vision is tested by using the Richmond pseudoisochromatic plates or Ishihara plates. Children 3 to 4 years of age are usually able to comply with testing directions, but the test is not routinely administered. Parents may request testing when their child is young and makes errors when asked to identify colors.
Photoscreeners assess the red light reflex and high refractive error and screen for amblyopia and strabismus. Autorefractors may be used to determine the refractive error of each eye. Medial opacities and refractive errors can be discerned using instrument-based screening in preverbal or developmentally delayed children. Instrument-based vision screening is a valid and reliable alternative method for visual screening in children under 5 years of age or who are not able to use vision charts.
Cultures and gram staining of eye discharge are done if identification of infection or particular organisms would be helpful in guiding managements. Ultrasound (not to be used in cases of suspected ruptured globe), computed tomography (CT), or magnetic resonance imaging (MRI) is sometimes useful in determining a diagnosis of orbital cellulitis, trauma, or tumor or in substantiating a concern about the central nervous system (CNS). An MRI should not be used in the case of a suspected intraocular metal foreign body.
Fluorescein staining may be used to determine the extent of damage the corneal or conjunctival epithelium as a result of trauma, infection, or exposure to a foreign body. After applying the fluorescein, examine the cornea with a cobalt blue filter light in a darkened room; any injury will take up the fluorescein stain and appear as a greenish area. Too much of the stain will cloud the entire cornea.