The document discusses different types of anemias classified based on morphology, etiology, and pathophysiology. It describes macrocytic anemias like megaloblastic anemia caused by vitamin B12 or folate deficiency. Microcytic anemias discussed include iron deficiency anemia and sickle cell anemia. Normocytic anemias can result from blood loss, hemolysis, or bone marrow failure. Etiologies include deficiencies, impaired bone marrow function, or peripheral causes like bleeding or hemolysis. Diagnosis and treatment of various anemias like iron deficiency, vitamin B12 deficiency, and folate deficiency anemia are also summarized.
Anemia Causes, Types, Symptoms, Diet, and Treatment Dr Medical
https://userupload.net/0gv9ijneu7hf
Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen.
Hinduja Hospital’s specialist doctor suggests on abnormal blood counts and management of Anemia. Anemia is a can be a cause of a serious illness, so it is important to have it assessed and get the appropriate treatment.
Anemia Causes, Types, Symptoms, Diet, and Treatment Dr Medical
https://userupload.net/0gv9ijneu7hf
Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen.
Hinduja Hospital’s specialist doctor suggests on abnormal blood counts and management of Anemia. Anemia is a can be a cause of a serious illness, so it is important to have it assessed and get the appropriate treatment.
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
Megaloblastic anaemia is a type of anaemia characterized by the formation of unusually large, abnormal and immature red blood cells called as megaloblasts by the bone marrow, which are released into the blood. To know more visit here: www.lazoi.com
Anemia - Types, Pathophysiology, Clinical Manifestations, Etiology, TreatmentMd Altamash Ahmad
Anaemia can be defined as a reduction from normal of the quantity of haemoglobin in the blood.
It is not one disease, but a condition that results from a number of different pathologies.
The World Health Organisation defines anaemia in adults as haemoglobin levels less than 13g/dL for males and less than 12g/dL for females.
The low haemoglobin level results in a corresponding decrease in the oxygen-carrying capacity of the blood.
Anaemia is possibly one of the most common conditions in the world and results in significant morbidity and mortality, particularly in the developing world.
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
Megaloblastic anaemia is a type of anaemia characterized by the formation of unusually large, abnormal and immature red blood cells called as megaloblasts by the bone marrow, which are released into the blood. To know more visit here: www.lazoi.com
Anemia is one of the most commonly seen condition predominantly in women due to various causes such as some chronic infection conditions and all. There are different types of anemias are there here we discuss mainly about Iron deficiency and sickle cell anemia.
causes of macrocytic anemia pathopysiology, sign and symptoms and the difference between macrocytic anemia megaloblastIc anemia. causes of hypersegmented neutrophils and its association between them. investigation and medical management plus pictures illustration.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
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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
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
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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Anemias are a group of diseases characterized by a decrease in haemoglobin or
RBCs, resulting in decreased oxygen carrying capacity of blood.
The decrease may result from blood loss, increased destruction of RBCs
(hemolysis), or decreased production of RBCs.
Anemia, like a fever, is a sign that requires investigation to determine the
underlying etiology.
The most serious complications of severe anemia arise from tissue hypoxia. Shock,
hypotension, or coronary and pulmonary insufficiency can occur. This is more
common in older individuals with underlying pulmonary and cardiovascular
disease.
3. BASED ON MORPHOLOGY
BASED ON ETIOLOGY
BASED ON PATHOPHYSIOLOGY
4. A)BASED ON MORPHOLOGY
1) Macrocytic anemias
Where cells are larger than normal.
Mean corpuscular volume(MCV) >100 fL
Megaloblastic anemia
Cells are larger than normal in size because of impaired DNA synthesis.
Vitamin B12 deficiency
Folate deficiency
Can be caused by inadequate dietary intake, decreased absorption and inadequate
utilization.
Deficiency of intrinsic factor can cause a decrease in absorption of vitamin B12 in the
GIT which is caused by alcohol dependence, pernicious anemia etc.
Folate deficiency can be caused due to hyper utilization during pregnancy, hemolytic
anemia, myelofibrosis, malignancy, chronic inflammatory disorders, long-term dialysis or
growth spurt .
Drugs can cause anemia by reducing absorption of folate (eg. phenytoin) or by interfering
with corresponding metabolic pathways(eg. methotrexate).
5. 2) Microcytic anemia
RBCs are lesser in size than normal.
MCV <80fL
MCHC <32 g/dL
Iron deficiency anemia
Iron deficiency anemia develops when body stores of iron drop too low to support
normal red blood cell (RBC) production.
Inadequate dietary iron, impaired iron absorption, bleeding, or loss of body iron in
the urine may be the cause.
Sickle-cell anemia
RBCs become sickle shaped.
Presence of abnormal hemoglobin called hemoglobin S in RBC.
Genetic causes; abnormal genes which are inherited from parents.
Present from birth.
Most infants do not present any symptoms until they are 5-6 months age.
Causes painful swelling of the hands and feet called dactylitis, fatigue and jaundice
in children.
Some complications are: Acute pain(sickle-cell or vaso-occlusive crisis), acute chest
syndrome, stroke, pulmonary hypertension, liver complications etc.
7. Thalassemia
Inherited blood disorders that can result in abnormal formation of hemoglobin.
2 types: Alpha-thalassemia and Beta-thalassemia.
Hemoglobin consists of 4 globin chains bound to the heme molecule.
There are 4 major types of globins: alpha (α), beta (β), gamma (γ), and delta (δ).
The dominant hemoglobin in adults (hemoglobin A) is composed of 2 alpha and 2
beta chains.
Two minor forms of hemoglobin constitute a small percentage of normal blood:
hemoglobin F , composed of 2 alpha chains and 2 gamma chains, and hemoglobin
A2, composed of 2 alpha chains and 2 delta chains.
A very tightly controlled globin chain production process keeps the ratio of alpha
chains to non-alpha chains at 1.00 (± 0.05).
In thalassemia , this ratio is disrupted.
Alpha thalassemias involve HBA1 and HBA2 genes.
Beta thalassemias are due to mutations in HBB gene.
Patients are always at risk of severe anemia and require lifelong transfusions.
Iron overload: Patients have excessive iron levels in the body either from the
disease or continuous transfusions. Iron gets accumulated in tissues and causes
damage to heart, liver and endocrine system.
Iron chelation therapy is required to manage iron overload.
8.
9. 3)Normocytic anemia
Common form of anemia that occurs with older age.
Manifests with a decrease in haemoglobin and hematocrit but not MCV or MCH or
MCHC.
Causes include:
Recent blood loss
Hemolysis
Bone marrow failure
Anemias of chronic disease
Renal failure
Endocrine disorders
Myelodysplastic anemias(Blood cancer)
Anemias of chronic disease is a hypoproliferative anemia associated with chronic
infectious or inflammatory processes, tissue injury, or conditions that release
proinflammatory cytokines.
The pathogenesis is based on shortened RBC survival, impaired bone marrow
response, and disturbance of iron metabolism.
10. 1)Deficiency
Iron
Vitamin B12
Folic acid
Pyridoxine
2)Central-caused by impaired bone marrow function
Anemia of chronic disease
Anemia of the elderly(normocytic anemia)
Malignant bone marrow disorders
Myelodysplastic syndrome, leukaemia, aplastic anemia, multiple myeloma,
PNH(Paroxysmal nocturnal hemoglobinuria).
3)Peripheral
Bleeding (hemorrhage)
Hemolysis(Hemolytic anemia)
11. Hemolytic anemia
A condition in which there is premature destruction of RBCs before their life span
of 120 days is completed and the bone marrow is not able to compensate for the
RBC loss.
Mild anemia is asymptomatic but severe anemia can be life threatening and can
cause angina and cardiopulmonary decompensation.
Hereditary disorders may cause hemolysis as a result of erythrocyte membrane
abnormalities, enzymatic defects, and hemoglobin abnormalities. Hereditary
disorders include the following:
Glucose-6-phospate dehydrogenase deficiency
Sickle cell disease
Hereditary spherocytosis
Acquired causes of hemolysis include the following:
Immune disorders
Toxic chemicals and drugs
Antiviral agents (eg, ribavirin )
Physical damage
Infections [18]
13. Excessive sequestration in the spleen
Heredity
Disorders of hemoglobin synthesis
4)Inadequate production of mature RBCs
Deficiency of nutrients(B12, folic acid, iron, protein)
Deficiency of erythroblasts
Aplastic anemia
Isolated(often transient) erythroblastopenia
Folic acid antagonists
Antibodies
5)Conditions with infiltration of bone marrow
Lymphoma
Leukaemia
Myelofibrosis
Carcinoma
14. 7)Endocrine abnormalities
Hypothyroidism
Adrenal insufficiency
Pituitary insufficiency
8)Chronic renal disease
9)Chronic inflammatory disease
Granulomatous diseases
Collagen vascular diseases
10)Hepatic diseases
Paleness of skin due to iron deficient anemia
15. Aplastic anemia is a syndrome of bone marrow failure characterized by peripheral
pancytopenia and marrow hypoplasia.
Although often normocytic, mild macrocytosis can also be observed in association
with stress erythropoiesis and elevated fetal hemoglobin levels.
Occurs primarily due to bone marrow failure.
On morphologic evaluation, the hematopoietic elements in the bone marrow are
less than 25%, and they are largely replaced with fat cells.
Symptoms:
Fatigue
Dyspnea
Paleness
Tachycardia
Frequent infections
Mostly genetic cause
16. Signs and symptoms depend upon the onset and cause of the anemia, and on the
individual.
Acute-onset anemia:
Tachycardia
Light headedness
Breathlessness
Chronic anemia:
Weakness
Fatigue
Vertigo
Faintness
Cold sensitivity
Pallor
Loss of skin tone
19. Rapid diagnosis is essential because it anemia is often a sign of underlying
pathology.
Signs and symptoms
Complete Blood count
Reticulocyte index
Peripheral blood smear report
Stool examination
Serum iron for Iron-deficiency anemia
TIBC(Total Iron Binding Capacity)
Macrocytic anemias-Raised MCV(80-110 FL)
Hypersegmented polymorphonuclear leukocytes for macrocytic anemia
20. Iron deficiency anemia:
Oral iron therapy containing soluble ferrous iron salts which are not enteric coated and not
slow or sustained release is recommended at a daily dosage of 200 mg in two or 3 divided
doses.
In case of dietary absorption iron is best absorbed from meat, fish and poultry and poorly
from vegetables, grain products, diary products and eggs.
Parenteral iron is required in cases where there is malabsorption of iron from diet ,
intolerance of oral iron or non compliance. Parenteral administration however does not
hasten the hematologic process.
SALT ELEMENTAL IRON(%) ELEMENTAL IRON
PROVIDED
Ferrous sulphate 20 60-65mg/324-325 mg tab
18 mg iron/5 ml syrup
44mg iron/5 ml elixir
15 mg iron/0.6 ml drop
Ferrous sulphate(exsiccated) 30 65 mg/200 mg tablet
60 mg/187 mg tab
50 mg/160 mg tab
21. SALT ELEMANTAL IRON(%) ELEMENTAL IRON
PROVIDED
Ferrous gluconate 12 36 mg/325 mg tablet
27 mg/240 mg tab
Ferrous fumarate 33 33 mg/ 100 mg tab
63-66mg/200 mg tab
106 mg/324-325 mg tab
33 mg/5 ml suspension
Polysaccharide iron
complex
100 150 mg cap
50 mg tab
100 mg /5 ml elixir
Carbonyl iron 100 50 mg caplet
22.
23. Vitamin B12 Deficiency anemia:
Oral vitamin B12 supplementation is as effective as parenteral therapy.
Oral cobalamin is initiated at 1-2 mg daily for 1-2 weeks followed by 1 mg daily.
Parenteral therapy is more rapid acting than oral therapy and should be given if
neurologic symptoms are present.
An intranasal gel formulation can be advantageous for patients who are homebound, have
cognitive impairment, or experience dysphagia.
A widely used regimen is cyanocobalamin 1000 µg daily for a week, then weekly for a
month, and then monthly. When symptoms resolve, daily oral administration can be
initiated.
Folate-deficiency anemia:
Oral folate 1 mg daily for 4 months is usually sufficient, unless the underlying etiology
cannot be corrected..
If malabsorption is present, the daily dose should be increased to 5 mg.
Anemia of chronic disease:
Treatment must focus on correcting reversible causes.
Iron therapy is not effective when inflammation is present.
Epoetin alfa is a human erythropoietin produced in cell culture using recombinant DNA
technology which stimulates erythropoiesis and facilitates formation of new RBCs.
24. It is used in cases of anemia associated with chronic renal failure and chemotherapy.
In case of renal failure associated anemia it is to be used only if hemoglobin levels go
<10 g/dl.
Initial dosage is 50-100 units/kg thrice weekly.
If no increase in hemoglobin after 6-8 weeks of administration then increase to 150
units/kg thrice weekly or in patients with AIDS to 300 units/kg weekly.
Hemolytic Anemia:
Management consists of administration of folic acid supplements.
Corticosteroids such as prednisone prevents phagocytosis of antibody covered RBCs and
thus is useful in autoimmune hemolytic anemia.
Iron supplements are contraindicated in hemolytic anemia.
Thalassemia:
Management includes administration of folic acid supplements and iron chelation
therapy.
Iron chelating agents- Deferoxamine mesylate & Deferasirox.
Approximately 8mg of iron is bound by 100 mg of deferoxamine from ferritin and
hemosiderin but not from transferrin and it gets excreted in urine and bile.
Given via IM inj, SC bolus, slow infusion or continuous infusion.
Deferasirox is available as tablet for oral suspension and it binds to iron with affinity ratio
of 2:1