Talks about Neuromuscular transmission in NMJ. It explains how Acetylcholine at a pre synaptic terminal transmits an impulse to the post synaptic terminal
Acetylcholine -
Acetylcholine is an organic chemical that functions in the brain and body of many types of animals as a neurotransmitter—a chemical message released by nerve cells to send signals to other cells, such as neurons, muscle cells and gland cells.
All about Neuromuscular junction...Structure,Steps involved,Drugs acting at neuromuscular junction , Clinical aspects (Myasthenia gravis and lambert eaton syndrome)
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.
Acetylcholine -
Acetylcholine is an organic chemical that functions in the brain and body of many types of animals as a neurotransmitter—a chemical message released by nerve cells to send signals to other cells, such as neurons, muscle cells and gland cells.
All about Neuromuscular junction...Structure,Steps involved,Drugs acting at neuromuscular junction , Clinical aspects (Myasthenia gravis and lambert eaton syndrome)
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
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
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
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
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
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.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
2. Objectives
The general mechanism of skeletal
muscle contraction.
02
The physiologic anatomy of the skeletal
muscle and NM junction.
01
Motor End Plate potential and how
action potential and
excitation-contraction coupling are
generated in skeletal muscle.
03
The molecular mechanism of skeletal
muscle contraction & relaxation.
04
Sliding filament mechanism.
05
Drugs/ diseases affecting the
neuromuscular transmission.
06
Know and describe the following:
3. Transmission between motor neurons
and muscle cells.
An axon terminal (synaptic knob) can
meet another cell, a neuron, muscle
fiber, or gland cell.
One neuron will transmit info to a
muscle or another neuron or gland
cell by releasing chemicals called
neurotransmitters.
In neuromuscular transmission, the
neurotransmitter is acetylcholine.
Neuromuscular transmission
Site: Synapse
If transmission is between neuron
and muscle cell it’s called a
neuromuscular junction.
In the synaptic knob, the process
of “conversion of electrical signal
into a chemical signal” is called
transduction.
4. Neuromuscular Junction (NMJ)
In the case of neuron to neuron transmission
A neuromuscular junction, is a chemical
synapse formed by the contact between
a motor neuron and a muscle fiber. It is
part of a motor unit.
A motor unit is made up of a motor
neuron and the skeletal muscle fibers it
innervates.
5. Physiologic Anatomy of the
Neuromuscular Junction
(Presynaptic terminal)
terminal
Motor end plate
Synaptic trough/gutter
Subneural cleft
(Increases surface area)
Synaptic
vesicles
Acetylcholine (Ach)
Acetylcholinesterase
Acetylcholine receptor/
ligand gated channel
Ca2+
Voltage gated
calcium channel
Axon of motor neuron
ECF
axon terminal
(presynaptic terminal)
(Nerve+Muscle)
Test yourself
6. 02
Synaptic cleft
03
Synaptic gutter/
synaptic trough
01
Axon terminal
The Neuromuscular junction
consists of
Contains around 300,000
vesicles which contain the
neurotransmitter acetylcholine
(Ach).
It is the muscle cell membrane
which is in contact with the nerve
(axon) terminal.
It has many folds called Subneural
Clefts , which:
1: greatly increase the surface area
2: allow for accommodation of large
numbers of Ach receptors .
Ach receptors are located here .
20 – 30 nm ( nanometer ) space
between the axon terminal &
the muscle cell membrane.
It contains the enzyme
acetylcholinesterase which can
destroy Ach .
● The entire structure of axon terminal , synaptic cleft and synaptic gutter is called “ Motor End-Plate ”
7. Acetylcholine
Ach is synthesized
locally in the
cytoplasm of the
nerve terminal , from
active acetate
(acetyl coenzyme A)
and choline.
Then it is rapidly
absorbed into the
synaptic vesicles
and stored there.
The synaptic
vesicles themselves
are made by the
Golgi Apparatus in
the nerve soma (
cell-body).
Then they are
carried by
Axoplasmic
Transport to the
nerve terminal ,
which contains
around 300,000
vesicles
● Each vesicle is then filled with around 10,000 Ach molecules
8. 01
02
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03
Transduction in NMJ
04
05
06
When a nerve impulse (action
potential) reaches the nerve
terminal ,it opens calcium
channels (they are voltage gated)
Calcium diffuses from the
ECF into the axon terminal.
Ca++ releases Ach from
vesicles by a process of
EXOCYTOSIS
(Release from vesicles into synaptic cleft)
Ach combines with its receptors
in the subneural clefts. This
opens sodium channels.
(Ligand gated channel)
sodium diffuses into the muscle
causing a local,non- propagated
potential called the “ End-Plate
Potential (EPP)” in the motor
end plate
If there is sufficient Na influx, this
EPP triggers a muscle AP which
spreads down/ propagat
inside the muscle (sarcolemma) to
make it contract.
In this step, the AP spreads down the sarcolemma and opens more Na voltage gated
channels. Na is diffused into muscle cell, generating a stronger AP = contraction.
AP = Action potential.
EPP = End-plate potential.
NMJ=Neuromuscular Junction.
EPP is weaker than AP.
*One nerve impulse can releases 125 Ach vesicles.
*The quantity of ACh released by one nerve impulse is more
than enough to produce one EPP.
9. Destruction of
Acetylcholine
● After ACh acts on the receptors , it is hydrolyzed by the enzyme
Acetylcholinesterase (cholinesterase ) into Acetate & Choline .
● The Choline is actively reabsorbed into the nerve terminal to be used
again to form ACh.
● This whole process of Ach release, action & destruction takes about 5-10
ms .
Ach
Acetylcholinesterase
Acetate
Choline
(reabsorbed)
(enzyme)
ms= milliseconds
10. End-Plate Potential Action Potential
In motor end plate In sarcolemma
Graded Non graded
Does not spread rapidly Spreads rapid (propagates)
Can be summated (added) Cannot be summated
Does NOT obey all-or-none law Obeys all-or-none law
Doesn’t need to reach threshold
(is about -40) .any small stimuli
will produce response.
Doesn’t produce respond until it
reach threshold point
Found only on the postsynaptic
membrane of the muscle cell
In neurons and muscle cells
Caused by the ligand-gated
acetylcholine receptor channels
Maintained by voltage-gated Na
and K channels
11. 2- stimulate NMJ by inactivating Acetylcholinesterase:
e.x:
A- Neostigmine, Physostigmine.
(inactivate Ach-estrase for hours)
B- diisopropyl fluorophosphate “nerve gas poison”:
(inactivate Ach-estrase for weeks and can cause death by
respiratory muscle spasm)
Curare & Curariform like-drugs:
- Prevent passage of impulses from the nerve ending
into the muscle by blocking the action of Ach on its
receptors.
- act by competitive inhibition to Ach at its receptors &
can not cause Depolarization.
Botulinum toxin:
Bacterial poison that decreases the quantity of Ach release
by the nerve terminals.
drug stimulates by
2 ways:
blocking drugs
1- stimulate muscle fiber by Ach-like action:
e.x: Methacholine, Carbachol, and Nicotine.
● act for minutes or hours.
● NOT destructed by cholinestrase.
Drugs That stimulate or Block Transmission
at the Neuromuscular Junction
12. - It’s an Autoimmune disorder.
- patients develop antibodies which block or destroy
their own Ach receptors.
- decreasing the EPP , or even preventing its formation.
- weakness or paralysis of muscles.
- patient may die because of paralysis of respiratory
muscles.
- Occurs in about 1 in every 20,000 persons.
01
signs of Myasthenia Gravis:
- Presents with ptosis, dysarthria, dysphagia, and proximal
limb weakness in hands & feet.
-in adult females affects eyelid, extra ocular bulbar and
proximal limb muscles.
02
Treatment:
- Administration of anticholinesterase drugs such as
Neostigmine which allows larger than normal amounts of
Ach to accumulate in the synaptic space.
- Corticosteroids and Immunosuppressant drugs to inhibit the
immune system, limiting antibody production.
03
Myasthenia Gravis
ﺑﯾطﻠﻊ ﻟﻠﻲ ﻣﻧﺎن دﻛﺗورة ﻟﻣﺣﺎﺿرات اﻷدوﯾﺔ ﻣﻠﺧص
Shatha Aldhohair,Med439 ♥
13. S
U
M
M
A
R
Y
Action potential
reaches terminal
axon
when there is sufficient Na
influx, EPP triggers a
muscle AP which
propagate inside the
muscle to make it contract.
sodium diffuses
causing a local,
non- propagated
potential called EPP
Ach links with the
receptor and open
Ligand gated channel
Calcium voltage
channels in synaptic
knob open
Calcium diffuses in axon
terminal and moves
synaptic vesicle closer to
presynaptic terminal
Exocytosis of ACh in
neuromuscular
junction
ACh reaches post
synaptic terminal
which is the motor
end plate
1 2
3
4
5
6
7
8
14. Q1: mention two features of EPP and two
features of AP ?
Q2: what does NMJ means and what is the
site?
SAQ
answer
key
:
1)
slide
10
2)
NMJ
is
transmission
is
between
neuron
and
muscle
cell
site:
synaps
SAQ
MCQs
key
answer
:
1)
D
2)
B
3)
A
4)
C
5)
A
6)
D
Q1: process of the conversion of an electrical signal into a chemical signal?
A) NMJ B) neurotransmitters C) synaptic knob D) transduction
Q2 : what is the function of Subneural cleft?
A) Increases Voltage gated
calcium channel
B) Increases surface area C) decrease surface area D) Increases
neurotransmitters action
Q3 : The synaptic vesicles are made by?
A) Golgi apparatus B) mitochondria C) sarcoplasm D) nerve cytoplasm
Q4 : Ach combines with its receptors in the subneural clefts, This opens?
A) muscle AP B) calcium channels C) Ligand gated channel D) potassium channels
MCQs
QUIZ!
Q5 : After ACh acts on the receptors , it is hydrolyzed by the enzyme Acetylcholinesterase into?
A) Acetate & Choline B) ester & Choline C) Acetate & ester D) Acetate & Cholinesterase
Q6 : An axon terminal can meet another cell, a neuron, muscle fiber, or gland cell called?
A) NMJ B) presynaptic terminal C) Synaptic vesicles D) synaptic knob
اﻟﺳﺎﺑﻌﺔ اﻟطﺑﻌﺔ ،ﻟﻠﺗدرﯾب ﻟﮭﺎ ارﺟﻌوا ٥٣ ﺻﻔﺣﺔ ﻣن ﻟﯾﻧدا ﺑﻛﺗﺎب ﻣﻣﺗﺎزة أﺳﺋﻠﺔ ﻓﯾﮫ
15. Abdulrahman Alswat Haya Alanazi
▷ Mishal Althuanyan
▷ Basel Fakeeha
▷ Mohammad Beyari
▷ Abdulaziz Alsuhaim
▷ Mohammad Alsalman
▷ Abdulrahman Addweesh
▷ Morshed Alharbi
▷ Ahmad Alkhayatt
▷ Abdulaziz Alguligah
▷ Omar Alhalabi
TEAM MEMBERS
▷ Sumo Alzeer
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▷ Renad Alhomaidi
▷ Yasmin Alqarni
▷ Lama Alahmadi
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▷ Hind Almotywea
▷ Sarah Alqahtani
▷ Duaa Alhumoudi
Question bank
TEAM LEADERS
THANK
YOU
REVIEWED BY
Meshal Alhamed Ghada Alothman