This document discusses abdominal wall defects that occur during embryonic development, including exomphalos and gastroschisis. It describes the normal embryological development of the abdominal wall and how failures during development can result in defects. It provides details on the characteristics, contents, and management of exomphalos and gastroschisis. The document also discusses extrophy of the bladder, including the anatomical defects, problems with management, and staged surgical approach.
HYSTEROSALPINGOGRAPHY - It is the radiological procedure in which the contrast is injected into the uterus to study the uterine tube and fallopian tube
HYSTEROSALPINGOGRAPHY - It is the radiological procedure in which the contrast is injected into the uterus to study the uterine tube and fallopian tube
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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
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.
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
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
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
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.
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2. EmbryologyEmbryology
Normal 2wk embryo is a flat disc that containsNormal 2wk embryo is a flat disc that contains
ectoderm, endoderm & mesodermectoderm, endoderm & mesoderm
Intraembryonic coelom divides mesoderm intoIntraembryonic coelom divides mesoderm into
sphlancnoplueric & somatoplueric mesodermsphlancnoplueric & somatoplueric mesoderm
4 folds appear4 folds appear
Cephalic fold: thoracic & epigastric wallCephalic fold: thoracic & epigastric wall
Caudal fold: hindgut, bladder & hypogastricCaudal fold: hindgut, bladder & hypogastric
wallwall
Lateral folds: lateral abdominal wall.Lateral folds: lateral abdominal wall.
Four folds meet to form the umbilical ring byFour folds meet to form the umbilical ring by
4rth week4rth week
3.
4. Physiological herniation of gut during the 6Physiological herniation of gut during the 6
– 10th week.– 10th week.
Small defects at umbilicus: probablySmall defects at umbilicus: probably
failure of intestine to return into thefailure of intestine to return into the
peritoneal cavityperitoneal cavity
Large defects: Failure of development ofLarge defects: Failure of development of
body wall.body wall.
ExomphalosExomphalos
GastroschisisGastroschisis
Extrophy bladderExtrophy bladder
5. ExomphalosExomphalos
Central defect at the site of the umbilicalCentral defect at the site of the umbilical
ringring
Eviscerated contents are covered by a sacEviscerated contents are covered by a sac
formed by peritoneum, whartons jelly &formed by peritoneum, whartons jelly &
amnionamnion
6. Size 4 – 12cmsSize 4 – 12cms
Umbilical cord is inserted onto the sacUmbilical cord is inserted onto the sac
Contents: Usually small & large bowel,Contents: Usually small & large bowel,
sometimes stomach & liversometimes stomach & liver
Abdominal muscles are well developed,Abdominal muscles are well developed,
coelom not well developedcoelom not well developed
7. Congenital hernia of the cord:Congenital hernia of the cord:
Less than 4 cms diameterLess than 4 cms diameter
Contain few loops of intestineContain few loops of intestine
May be missed at birthMay be missed at birth
Careless clamping may result in injuryCareless clamping may result in injury
Giant omphalocoeles:Giant omphalocoeles:
Massive sac containing most of theMassive sac containing most of the
abdominal viscera including liver,abdominal viscera including liver,
spleen, gall bladder, gonads,spleen, gall bladder, gonads,
intestines.intestines.
8. GastroschisisGastroschisis::
Smooth edged defect locatedSmooth edged defect located
adjacent to a normal umbilical cord.adjacent to a normal umbilical cord.
Ocassionaly separated from theOcassionaly separated from the
cord by a strip of skin.cord by a strip of skin.
Almost always to the right of theAlmost always to the right of the
umbilicusumbilicus
Size 2-5 cms, often dangerouslySize 2-5 cms, often dangerously
small compared to the size of thesmall compared to the size of the
eviscerated organs.eviscerated organs.
9. Stomach, small & large intestine areStomach, small & large intestine are
commonly herniated.commonly herniated.
There is no sac, hence exposed toThere is no sac, hence exposed to
amniotic fluid.amniotic fluid.
Exposed bowel often foreshortened,Exposed bowel often foreshortened,
edematous, covered by thickedematous, covered by thick
exudates. May be ischemic.exudates. May be ischemic.
10.
11. Associated anomalies:Associated anomalies:
Pentalogy of CantrellPentalogy of Cantrell
( defect of cephalic fold)( defect of cephalic fold)
OmphalocoeleOmphalocoele
Anterior diaphragmaticAnterior diaphragmatic
herniahernia
Sternal cleftSternal cleft
Ectopia cordisEctopia cordis
Cardiac anomaliesCardiac anomalies
Lower midline defect:Lower midline defect:
Bladder / cloacalBladder / cloacal
extrophyextrophy
ARMARM
MMCMMC
Sacral vertebralSacral vertebral
anomaliesanomalies
Major congenital anomalies are often seen
12. ManagementManagement
Immediate post natal :Immediate post natal :
NG aspirationNG aspiration
IV Fluid managementIV Fluid management
CatheterisationCatheterisation
Maintain body temperatureMaintain body temperature
DressingDressing
13. Surgical managementSurgical management
Could be in single / multiple stagesCould be in single / multiple stages
Exomphalos:Exomphalos:
Excise the sacExcise the sac
Put the contents back into thePut the contents back into the
abdomen after inspectionabdomen after inspection
Measure abdominal pressureMeasure abdominal pressure
14. If pressure lower than 20cms of HIf pressure lower than 20cms of H2200
proceed with primary repair of theproceed with primary repair of the
defectdefect
If pressure is high, close only theIf pressure is high, close only the
skin to make a ventral hernia forskin to make a ventral hernia for
repair laterrepair later
If peritoneal cavity is small & notIf peritoneal cavity is small & not
accepting contents, apply prostheticaccepting contents, apply prosthetic
closureclosure
15. Single running suture is applied at theSingle running suture is applied at the
top of the sac. Suture reapplied everydaytop of the sac. Suture reapplied everyday
and contents are gradually reduced overand contents are gradually reduced over
a period of 8 – 10 days. Then defect isa period of 8 – 10 days. Then defect is
repairedrepaired..
Dacron reinforcedDacron reinforced
silastic sheet is used as asilastic sheet is used as a
prosthetic sac.prosthetic sac.
It is sutured to theIt is sutured to the
fascia around thefascia around the
circumference of thecircumference of the
defect.defect.
16. Extrophy – Epispadias ComplexExtrophy – Epispadias Complex
Abnormal over-development of cloacalAbnormal over-development of cloacal
membrane preventing migration ofmembrane preventing migration of
mesenchymal tissue and development ofmesenchymal tissue and development of
lower abdominal wall.lower abdominal wall.
Incidence: 1 in 20,000 live births.Incidence: 1 in 20,000 live births.
17. AnatomyAnatomy
Musculoskeletal defect:Musculoskeletal defect:
Outward rotation of iliac bonesOutward rotation of iliac bones
results in wide pubic diastasis. Pelvicresults in wide pubic diastasis. Pelvic
diaphragm is open (divergent) anddiaphragm is open (divergent) and
incompetent. High incidence of rectalincompetent. High incidence of rectal
prolapseprolapse
18. Urinary defectsUrinary defects
Anterior wall of bladder absentAnterior wall of bladder absent
Mucosa of posterior wall , trigone, uretericMucosa of posterior wall , trigone, ureteric
orifices & bladder neck exposedorifices & bladder neck exposed
Bladder plate may be large & elastic orBladder plate may be large & elastic or
small, fibrosed & unelastic.small, fibrosed & unelastic.
Mucosa may be normal, polypoid or undergoMucosa may be normal, polypoid or undergo
squamous metaplasia.squamous metaplasia.
Upper tracts & kidneys are usually normal.Upper tracts & kidneys are usually normal.
19. Anorectal:Anorectal:
Perineum is short & broad. Anus displacedPerineum is short & broad. Anus displaced
anteriorlyanteriorly
Male genital defect:Male genital defect:
Severe - EpispadiasSevere - Epispadias
Phallus is foreshortened because of widePhallus is foreshortened because of wide
separation of crural attachmentseparation of crural attachment
Prominent dorsal chordeeProminent dorsal chordee
20. Short urethral grooveShort urethral groove
External sphincter deficientExternal sphincter deficient
Female genital defectFemale genital defect
Short vagina. Stenosis commonShort vagina. Stenosis common
Clitoris is bifid and labia divergentClitoris is bifid and labia divergent
21.
22. Problems in managementProblems in management
Bladder plate may be inadequateBladder plate may be inadequate
Large fascial defect on bladder closure. DifficultLarge fascial defect on bladder closure. Difficult
to repair inspite of osteotomiesto repair inspite of osteotomies
Chances of continence after surgery is poorChances of continence after surgery is poor
Extremely difficult to attain cosmeticallyExtremely difficult to attain cosmetically
satisfying reconstruction of genitaliasatisfying reconstruction of genitalia
Fertility poor.Fertility poor.
23. ManagementManagement
Staged repairStaged repair
Stg 1: Bladder closure atStg 1: Bladder closure at
presentationpresentation
Stg 2: Epispadias repair at 6 – 12Stg 2: Epispadias repair at 6 – 12
monthsmonths
Stg 3: Bladder neck repair at 4 yrsStg 3: Bladder neck repair at 4 yrs