This document provides an overview of critical thinking, evidence-based medicine, and how to practice evidence-based medicine. It defines critical thinking as the process of conceptualizing and evaluating information to guide beliefs and actions. Evidence-based medicine is defined as integrating the best research evidence with clinical expertise and patient values/circumstances. The history of evidence-based medicine is discussed, from Cochrane's work in the 1970s highlighting gaps between research and practice, to Guyatt coining the term "evidence-based medicine" in 1991 and Sackett explaining the combination of research, expertise, and patient factors in 1996. The five steps to practice evidence-based medicine are described as developing questions, finding evidence, appraising evidence, integrating
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
Evidence based nursing practice is one of most important for perfect and accurate in terms of saving a life.this presentation covers almost all aspect of EBD
Is the ability to access, assess and apply the best evidence from systematic research information to daily clinical problems after integrating them with the physician's experience and patient's value.
evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
This ppt will help dentists in taking Evidence Based decision in daily practice and will also help researchers to categorized result of research on the basis of hierarchy of Evidence Based Dentistry
This topic is very essential for Pharm.D students. It includes application, benefits, limitations of EBM. It also includes EBM history and background which helps you for examinations. EBM is very important topic in Pharmacotherapeutics-III so you may find this needful.
All the best!!!
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
EBM is the practice of integrating individual clinical expertise with the best available clinical evidence from systematic research to maximize the quality and quantity of life for individual patients.
Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.
Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values.
The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
This ppt will help dentists in taking Evidence Based decision in daily practice and will also help researchers to categorized result of research on the basis of hierarchy of Evidence Based Dentistry
This topic is very essential for Pharm.D students. It includes application, benefits, limitations of EBM. It also includes EBM history and background which helps you for examinations. EBM is very important topic in Pharmacotherapeutics-III so you may find this needful.
All the best!!!
evidence based practice is best for the people working with patients
ebp should be used by the heath care provider.
ebp based upon clinical experties
best research evidence
patient preference and values
EBM is the practice of integrating individual clinical expertise with the best available clinical evidence from systematic research to maximize the quality and quantity of life for individual patients.
Evidence Based Practice is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care.
Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values.
The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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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
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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
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Adult health.pptx
1. Critical Thinking and Evidence
Based Medicine
for Adult Health Nursing Msc
Students
Dr.Beka A.(GP)
2. Critical Thinking
Critical thinking is the intellectually disciplined process of actively and
skillfully conceptualizing, applying, analyzing, synthesizing, and/or
evaluating information gathered from, or generated by, observation,
experience, reflection, reasoning, or communication, as a guide to
belief and action.
3.
4. What is Evidence-based medicine
• Evidence-based medicine(EBM) requires the integration of the best
research evidence with our clinical expertise and our patient's unique
values and circumstances.
5.
6. What is Evidence-based medicine
• By best research evidence, we mean clinically relevant
research, sometimes from the basic sciences of
medicine,
By clinical expertise, we mean the ability to use our
clinical skills and past experience to rapidly identify
each patient's unique health state and diagnosis
By patient values, we mean the unique preferences,
concerns, and expectations that each patient brings to a
clinical encounter
7. History of Evidence Based Medicine
• In 1972, Professor Archie Cochrane, a medical doctor and researcher
in the UK, highlighted the fact that most treatment related decisions
were not based on a systematic review of clinical evidence. He
proposed that researchers should collaborate internationally to
systematically review all the best clinical trials specialty by
specialty. This highlighted gaps that existed between research and
clinical practice and started to convince practitioners of the benefits
of an evidence-based approach.
8. History of Evidence Based Medicine
• The term ‘evidence-based medicine’ was introduced by Gordon
Guyatt and his team in 1991 to shift the emphasis in clinical decision-
making from ‘intuition, unsystematic clinical experience, and
pathophysiologic rationale’ to scientific, clinically relevant research.
9. History of Evidence Based Medicine
• In 1996, D. L. Sackett, a Canadian-American doctor and founder of the
first department of clinical epidemiology at McMaster University in
Ontario, explained that evidence-based clinical decision-making is a
combination of not only research evidence but also clinical expertise,
as well as the unique values and circumstances of individual patients.
11. How to Practice EBM
• Step 1—converting the need for information (about
prevention, diagnosis, prognosis, therapy, causation,
etc.) into an answerable question by asking two types of question
Background questions
Ask for general knowledge about a condition, test, or treatment
Foreground questions
Ask for specific knowledge to inform clinical decisions or actions
12. How to Practice EBM
Step 2—tracking down the best evidence with which
to answer that question
• Always look for the best evidence
13. How to Practice EBM
Step 3—critically appraising that evidence for its
validity, impact and applicability
• Validity: Internal and external validity ; Construct validity, criteria
validity and Content validity
• Impact: size of the effect
• Applicability: Usefulness in our clinical practice
14. How to Practice EBM
• Step 4—integrating the critical appraisal(the process of carefully and
systematically examining research to judge its trustworthiness, and its
value and relevance in a particular context) with our
clinical expertise and with our patient's unique biology,
values, and circumstances
15. How to Practice EBM
•Step 5—evaluating our effectiveness and efficiency in
executing steps 1 to 4 and seeking ways to improve
them both for next time
16. What are the limitations of EBM?
Discussion about the practice of EBM naturally engenders negative and
positive reactions from clinicians. Some of the criticisms focus on
misunderstandings and misperceptions of EBM, such as the concerns
that it ignores patient values and preferences and promotes a
“cookbook” approach
Relegation of clinical judgment and mechanistic reasoning, and over-
reliance on the reliability of clinical trials and systematic reviews