- A 9-year-old boy presented with fatigue, fever, ankle pain, and nosebleeds over the past month and a half. Examination found lymphadenopathy, petechiae, pale appearance, and swollen ankles. Blood tests found anemia, low platelets, and 34% blast cells in bone marrow.
- The doctor's diagnosis was acute lymphoblastic leukemia (ALL), the most common childhood cancer. Treatment involves induction, consolidation, intensification, and maintenance chemotherapy phases over 2-3 years to eliminate cancer cells and prevent relapse. Prognosis depends on factors like age, white blood cell count at diagnosis, and response to treatment.
This presentation will surely help the general physicians and paediatricians to understand the symptoms of cystic fibrosis and will educate regarding various diagnostic modalities in cystic fibrosis
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.
This presentation will surely help the general physicians and paediatricians to understand the symptoms of cystic fibrosis and will educate regarding various diagnostic modalities in cystic fibrosis
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.
- 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
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
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
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
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.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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
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.
1. By: Dr. Shah Abdar Khan
2nd Year PGR pediatrics LRH
Date: 28th March 2023
2. • 9 Years old school going child named XYZ from Swabi
presented to our OD with the complaint of ;
• Fatigability 45 days
• Fever 45 days
• Pain in both ankles 30days
• 4 episodes of epistaxis in last 5 days
3. o According to the mother of the child, this otherwise
healthy child experienced tiredness while doing minimal
routine activity like going to school, carrying his bag, and
while climbing on stairs which he previously used to do
with any comlaint.
• Cont….
4. In addition to this she told that
the boy has fever since last 45
days which is non documented,
episodic and nocturnal in
nature, relieves with
paracetamol, and is not
associated with rigors, chills,
sweating or weight lose.
5. • The mother further added to the history that along with
above mentioned complaints, the child experiences pain
in both lower limbs, are tender to touch, were not swelled
in the beginning but swelled with the passage of time and
has disturbed his sleep on several occasions due to
increase in its severity at night..
6. • There was no history of trauma, lumping, migration of
pain to other joints, hematuria, hotness of joints, rash ,
alopecia , photophobia , abdominal distention or any
changes in nails color.
7. • The child recently had 4 episodes of nasal bleeding in
previous 5 days that stopped by applying pressure at
home. No history of blood in urine, stools, vomits and any
heavy bleed with minor traumas or circumcision.
•
8. • Upon inquiry the mother told that there are several bluish
patches on his body more on his legs and back. She also
confirmed that his color became paler and paler over the
previous month although change in the color of his eyes,
stools and urine has not ben noted.
9. Systemic review Unremarkable
Vaccination was up to date
No significant past medical or surgical hx was resent
Consanguinity negative
No worth mentioning issue in antenatal, post natal or natal
hx.
11. • Examination
• Upon examination the child had fever of 102 F , was ale
looking, with pulse rate of 80/minute and BP of 110 mm
Hg , has anterior cervical and inguinal lymphadenopathy.
The nodes were about v.5cmm, hard and mobile.
Petichea were present on both shins, buttocks and back.
Rest of the examination was unremarkable.
12. • On lower limb examination both the shins just superior to
ankle joints were noted to be mildly swelled with no
redness or increase warmth and intact range of motion.
No abnormality in the gait of the child was noted.
15. • On peripheral smear lymphocytosis with few predominant
blast cells having increased Nuclear to cytoplasmic ratio
were noted along with normochromic/ normocytic red
blood cells and decreased number of platelets.
16. • The bone marrow report showed 34% of blast cells with
suppressed erythropoiesis and mrgakaryopoiesis .
17. • For further investigations to know the sub type and do the
treatment accordingly the attendants were advised to
consult pediatric oncology at Lahore Children Hospital as
they had no affordability to bear the cost here by
themselves.
18.
19. • ALL is the most common malignancy of childhood
accounting for % of all the cancers in this age group.
• It a
• I a heterogeneous group of malignancies result from
distinctive genetical abnormalities with varying clinical
manifestation.
• Fortunately it is the first disseminated cancer shown to be
curable
20. • All most commonly effect the pediatric population with
peak at the age of 2 to 3 years with male predominance
• 85 % of ALL are B ALL , 15% T ALL and 1% are derived
from mature B cells( Burkett lymphoma
• Th disease has close association with certain
chromosomal abnormalities , such as Bloom syndrome,
Down's syndrome, Ataxia telangiectasia and fanconi
anemia.
• The risk of ALL in identical twin to develop ALL is at least
twice as that of other population.
21. • Symptoms
• Anorexia malaise irritability
• Intermittent , non specific , low grade fever
• Bones and often joints pain and joints swelling
• Pallor, fatigue, bruising , oral mucosa bleeding and
epistaxis.
22. • Pallor
petechial skin lesions
• Lymphadenopathy
• Splenomegaly
• Hepatomegaly less often
• Signs of increased IC and CNS nerves palsies in case of
CNS dissemination
23. • The differentials of ALL differs on the basis of signs and
symptoms the patient present with.
• If pancytopenia is the only presentation then the main
differentials are aplastic anemia, myelofibrosis, familial
HLH.
• The differentials of fever range from various bacterial and
viral infections to autoimmune and connective tissue
diseases.
• If there is joints involvement then JIA, SLE, psoriatic
arthritis and septic arthritis must be excluded.
25. • The treatment options varies in correspondence to
several factors like age of the patient, age of diagnosis,
type of ALL, WBC count at diagnosis and response of
patient to initial chemo.
• As a general role the treatment has following stages
• Remission induction
• Consolidation
• Interim Maintenance phase
• Delayed Intensification phase
• Maintenance
• Treatment of relapse
26. • In this phase chemo is given foe 4 weeks aimed to
achieve remission , which is defined as less than 5%
blast cells in marrow.
• Ideally on 29th day bone marrow test is performed which
is called Minimal Residual Disease (MRD ) test to know
the effectiveness of treatment and progression of disease
27. Various chemotheraputic options are availed but the most
common for ALL is
Inj vincristine weekly
A corticosteroids
Single dose of pegylated asparaginase
High risk patients also receives daunomycin at weekly
intervals
28. • After eradication of blasts from the patients blood and
marrow the patient take rest from chemo for a week and
the another phase of chemo starts called consolidation.
• This phase lasts for 4 to 8 weeks
• In this phase the patient receives intravenous as well as
intrathecal chemo which aims to prevent CNS relapse.
• Methotrexate, cytarabine, vincristine,cyclohoshamide and
mercatapurins are the prominent drugs used in this hase.
29. • These are the relatively non toxic phases of
chemotherapy , each lasting for 8 weeks and aim to
eradicate residual malignant cells if any.
• The same drugs as mentioned in previous slides are the
options to be used in these phases.
30. • The final phase in treatment of ALL is the maintenance
hae , the failure of completing this phase is the most
common cause of treatment's failure.
• This duration of this phase is 2 years for girls and 3 years
for boys.
• In this phase the patient take most of his her medications
at home and comes to hospital for iv vincristine and
course of steroids every 4 weekly, cbc monthly an
intrathecal chemo once in 3 months.
31. • Relapse occurs in bone marrow in 15 % cases, in CNS in
5% cases and in testis in about 25 cases.
• It predicts poorer prognosis and then needs more
aggressive course of chemo.
32. • The prognosis of ALL varies from patient to patient
• It depends upon several factors like
• Age and gender of the patient
• Time of diagnosis
• Chromosomal makeup of the patient
• CNS involvement at the time of diagnosis
• WBC count at the time of diagnosis
33. • Male ender, age less than 1 year or greater than 1 years,
initial WBC count of greater than 50,000, CNS
involvement at the time of diagnosis, philadelphia
chromosomes and failure to induce remission are the
common factors that indicates poorer prognostic factors.