by post graduates from Maratha Mandal's NathajiRao Halgekar Institute of Dental Sciences, Belgavi.
A step wise presentation of Amylodosis covering,
INTRODUCTION
DEFINITION
HISTORY
PHYSICAL NATURE
CHEMICAL NATURE
CLASSIFICATION
PATHOGENESIS
STAINING CHARACTERISTICS
DIAGNOSTIC TESTS
MORPHOLOGY
CLINICAL FEATURES
TREATMENT
PROGNOSIS
A Powerpoint presentation on the epidemiology, etiology, pathogenesis, clinical features, diagnostic work up and treatment of the common types of amyloid.
by post graduates from Maratha Mandal's NathajiRao Halgekar Institute of Dental Sciences, Belgavi.
A step wise presentation of Amylodosis covering,
INTRODUCTION
DEFINITION
HISTORY
PHYSICAL NATURE
CHEMICAL NATURE
CLASSIFICATION
PATHOGENESIS
STAINING CHARACTERISTICS
DIAGNOSTIC TESTS
MORPHOLOGY
CLINICAL FEATURES
TREATMENT
PROGNOSIS
A Powerpoint presentation on the epidemiology, etiology, pathogenesis, clinical features, diagnostic work up and treatment of the common types of amyloid.
Autoimmune hemolytic anemia (AIHA) is a type of normochromic normocytic anemia that is caused by autoantibodies that are produced in the patient against his/her own blood cells, particularly against RBCs. As a result hemolysis occurs leading to anemia.
Autoantibodies are produced secondary to autoimmune diseases, lymphoproliferative disorder (LPDs), certain infections or immunodeficiency syndromes.
In this presentation AIHA is under consideration on a broader scale, with only basic information and concepts.
amyloidosis(including history,physical and chemical properties, classification, variants, staining characteristics, lab diagnosis,morphological patterns according to organ involved ,), basically for undergraduates and residents in pathology
Autoimmune hemolytic anemia (AIHA) is a type of normochromic normocytic anemia that is caused by autoantibodies that are produced in the patient against his/her own blood cells, particularly against RBCs. As a result hemolysis occurs leading to anemia.
Autoantibodies are produced secondary to autoimmune diseases, lymphoproliferative disorder (LPDs), certain infections or immunodeficiency syndromes.
In this presentation AIHA is under consideration on a broader scale, with only basic information and concepts.
amyloidosis(including history,physical and chemical properties, classification, variants, staining characteristics, lab diagnosis,morphological patterns according to organ involved ,), basically for undergraduates and residents in pathology
Amyloidosis is a condition associated with a number of inherited and inflammatory disorders in which extracellular deposits of fibrillar proteins are responsible for tissue damange and functional compromise. (Robbins Basic Pathology, 9th Edition)
The following slideshow deals with the classification of Amyloidosis:
MBBS PPT - AMYLOIDOSIS types diagnostic approach and staining characteristic...DrDivitasaxena1
Amyloidosis is caused by extracellular deposition of fibrillar proteins which leads to tissue damage and functional compromise
Abnormal fibrils are produced by aggregation of misfolded proteins
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Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
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How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Chapter 3 - Islamic Banking Products and Services.pptx
Amyloidosis 1
1.
2. Amyloidosis refers to an abnormal deposit of insoluble fibrillar
protein in extracellular spaces of various tissues and organs.
The insoluble fibrills are formed by the misfolded proteins which
are usually soluble in their normal folded configuration.
It is associated with a number of clinical conditions like multiple
myeloma, familial Mediterranean fever, rheumatoid arthritis,
tuberculosis, brocheactasis etc.
3. All amyloid have same morphological and staining property but
amyloidosis is not a single disease.it is a group of disease having in
common, the deposition of similar appearing proteins in which
biochemical structure and mechanism of formation are different.
4. On electron microscopy
All types of amyloid are composed of fibrills
that are continuous, non branching, , rigid,
insoluble ,linear and measures about 7-10nm
in diameter.
On X-ray crystallography
Amyloid fibrills shows beta – pleated sheet
configuration which produces periodicity that
gives the characteristic staining properties of
amyloid with Congo red and apple green
birefringence under polarizing microscopy.
5. Fibrillar proteins bind with variety of substances
About 95% of the amyloid material consists of fibril
protein.
Remaining 5% consist of serum amyloid P,
proteoglycans, glycosaminoglycan, etc.
7. AL(amyloid light chain) protein-
Consist of complete immunoglobulin light chains or the amino terminal fragments of
light chain or both.
Produced by plasma cells and associated with some monoclonal b-cell proliferation
like in case of plasma cell tumors.
AA(amyloid associated) protein-
Derived from a larger precursor in the serum called SAA(serum amyloid associated)
protein synthesized by liver.
Associated with chronic inflammation in which there is increased synthesis of SAAP
under the influence of cytokines released during inflammation.
8. TRANSTHYRETIN(TTR)-
It is a normal serum protein which transports thyroxin and retinol.
Mutation in the gene encoding TTR alters its structure
misfolding of protein.
Found in - familial amyloid polyneuropatheis, senile systemic amyloidosis.
A BETA-2 MICROGLOBULIN-
Seen in cases of long term haemodialysis (10-12) years.
It is a small protein which is a normal component of MHC class 1
It cannot be filtered by the haemodialysis membrane hence its serum concentration
increases leading to its deposition in bones and joints.
AMYLOID BETA PEPTIDE-
It is derived from amyloid beta precursor protein.
It is deposited in cerebral amyloid angiopathy and neurofibrillary tangles in Alzheimer's
disease.
9.
10.
11.
12. Clinical manifestations initially may be non-specific like weakness, weight
loss. Specific symptoms appear later and are related to cardiac, renal and
gastrointestinal involvement.
Renal involvement- it gives rise to proteinuria which may lead to nephrotic
syndrome. In advanced cases, the obliteration of glomeruli causes renal
failure and uraemia.
Cardiac amyloidosis- it may present as congestive cardiac failure ,
conduction disturbances and arrhythmias.
Gastrointestinal amyloidosis-it may be present as malabsorbtion, diarrhoea
and digestive disturbances.
13.
14. CONGO RED STAIN-
›It is a special stain used for the
diagnosis of amyloidosis.
›Amyloid stain pink or red with
Congo red stain under ordinary light.
›But under polarizing microscope it
gives APPLE GREEN BIREFRINGENCE.
›It is due to the cross beta
configuration of amyloidosis.
IMMUNOHISTOCHEMISTRY
›It can distinguish AL, AA, ATTR types of amyloid.
›Antibody stain is used against specific amyloid which acts as antigen here.
›E.g.- anti-AA, anti-lambda, anti kappa, transthyretin antibody stains etc.
15. METACHROMATIC STAINS-
Methyl violet and cresyl violet is used.
The dye reacts with the amyloid and produces color change.
It imparts rose pink color to the amyloid deposits.
FLOURESCENT STAINS-
Dye THIOFLAVIN-T binds to the amyloid and imparts yellow color under uv light.
H AND E STAIN-
Amyloid with H and E stain appears as extracellular, homogenous, structure less,
and eosinophilic hyaline material.
STAIN ON GROSS-
LUGOL’S IODINE imparts mahogany brown color to the amyloid containing area
which on addition of sulphuric acid turns blue.
16. Amyloid deposition in
heart
H and E Stain
Amyloid deposition on
kidney
Congo red stain
19. KIDNEY
GROSS-
Cut surface is pale, waxy and translucent.
it appears to be shrunken due to ischemia, caused
by vascular narrowing induced by the amyloid
deposit within arteriolar walls.
MICROSCOPY-
GLOMERULI-main site of amyloid deposition.
First focal deposits occurs within mesangial matrix,
accompanied by nodular thickening of glomerular
basement membrane.
Progressive accumulation of amyloid causes capillary
narrowing thereby showing obliteration of capillary
lumen.
Glomerulus shows broad ribbons of amyloid.
20. SPLEEN
GROSS- it may show one of two pattern
of deposition.
Sago spleen- amyloid deposits are limited to the splenic
follicles which grossly appear like sago granule hence
known as sago spleen. Microscopically, the amyloid is
deposited into the wall of the wall of arterioles in the
white pulp.
Lardaceous Spleen- The amyloid is deposited into walls
of the splenic sinuses and connective tissue framework
into the red pulp. This may result in moderate to marked
enlargement of spleen. Fusion of early deposits give rise
to large, map like area of reddish color on cut surface.
This resemble pig fat and hence called as lardaceous
spleen. Microscopically, it shows amyloid deposits in the
wall of the sinuses.
Light microscopy-This deposits appear homogeneous
pink which when stained with Congo red and viewed
under polarizing microscope give rise to characteristic
green birefringence.
21. LIVER
Gross-It may cause moderate to
marked enlargement .it appear
pale ,grey ,waxy.
MICROSCOPY
• Amyloid first deposits in the space
of disse and then progressively
encroaches on adjacent hepatic
parenchymal cells and sinusoids.
progressive accumulation leads to
deformity, pressure atrophy and
disappearance of liver cells.
22. HEART
It may be involved in systemic
amyloidosis(AL) type or may be
the major organ involved in
SENILE SYSTEMIC
AMYLOIDOSIS.
GROSS-heart may be enlarged
and firm. subendocardial deposits
may appear as gray pink like dew
drops.
MICROSCOPY-amyloid is
deposited between the muscle
fibers of myocardium and their
progressive accumulation causes
pressure atrophy of myocardial
fibers.
23. Tissue biopsy provides definitive diagnosis
Fat pad biopsy. Fat, aspirated from the abdominal wall is the most easily accessible tissue and biopsy is
positive in >80% of patients with systemic amyloidosis.
Staining of the tissue specimen with congo red reveals an apple green birefringence when viewed by
polarised light microscopy.
Peripheral blood film- Howell Jolly bodies seen in hyposplenism.
BNP, pro-BNP, Troponin- increased in cardiac amyloidosis.
ECG- low voltage QRS complex, conduction block.
Echocardiography- speckled pattern is seen.
Urine analysis- proteinuria in renal amyloidosis.
Serum/urine protein electrophoresis- presence of monoclonal light chains in AL amyloidosis
Bone marrow biopsy- identification of dominant plasma cell in AL amyloidosis
24. It varies with the type of amyloidosis.
AL amyloidosis carries the worst prognosis if left untreated with median survival
of two years.
Outcomes in patients with AA amyloidosis depends on the underlying disease
and symptoms may improve if the underlying condition is treated.
People with ATTR have the best prognosis and may survive over a decade.
Cause of death in most cases of amyloidosis is cardiac failure or sudden death
from a fatal arrhythmias.
25. Liver transplant in ATTR amyloidosis.
Use of PO doxycycline (100 mg OD) in amyloid
arthropathy