This document discusses the management of diarrhea through rehydration and drug therapy. It defines diarrhea and describes oral rehydration solutions for acute diarrhea treatment. Loperamide is recommended for acute diarrhea while opioids like codeine, diphenoxylate, and tincture of opium can be used for chronic diarrhea. Antimicrobial agents may be given if an infectious cause is known. Other drugs discussed for chronic diarrhea include clonidine, octreotide, cholestyramine, bulk forming agents, and certain plant alkaloids, calcium channel blockers, and chloride channel blockers.
Presentation on Antacids and antiulcer drugs. Introduction to ulcers, classification of antiulcer drugs, their pharmacological actions, uses and adverse effects.
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Lecture slides for undergraduate MBBS class in Pharmacology on " Drugs for Diarrhoea" . It includes various treatment modalities which are used in the management of Diarrhoea. Basic source of information for preparing this slides is" Essentials of Pharmacology by KD tripathi, 7th Edition". Images are searched with the help of google images.
Autacoids - pharmacological actions and drugs related to them. SIVASWAROOP YARASI
Autacoids or "autocoids" are biological factors which act like local hormones, have a brief duration, and act near the site of synthesis. The word autacoids comes from the Greek "autos" (self) and "acos" (relief, i.e. drug).
Presentation on Antacids and antiulcer drugs. Introduction to ulcers, classification of antiulcer drugs, their pharmacological actions, uses and adverse effects.
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Lecture slides for undergraduate MBBS class in Pharmacology on " Drugs for Diarrhoea" . It includes various treatment modalities which are used in the management of Diarrhoea. Basic source of information for preparing this slides is" Essentials of Pharmacology by KD tripathi, 7th Edition". Images are searched with the help of google images.
Autacoids - pharmacological actions and drugs related to them. SIVASWAROOP YARASI
Autacoids or "autocoids" are biological factors which act like local hormones, have a brief duration, and act near the site of synthesis. The word autacoids comes from the Greek "autos" (self) and "acos" (relief, i.e. drug).
Generic Imodium is generic medicine used to treat diarrhea. Know the great information how and when one should take generic Imodium. Mentioned are the usage and direction of the diarrhea pill.
Diarrhea & Constipation are two common symptoms that occur everyday in any country. They may indicate simple to chronic cases in the beginning. However, right treatment that carried out may help patient solve it, detect any abnormalities and prevent serious further problems later.
As this herbicide poisoning is frequent with poor outcomes so its management needs to be discussed and awareness should be raised among farmers about its use and pre-hospital treatments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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.
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
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.
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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.
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
2. Diarrhea: defined as 3 or more loose or watery stools in a
24 hour period.
In other words it is due to passage of excess water in
faeces which may be due to
1.Decreased water and electrolyte absorption
2.Increased secretion by intestinal mucosa
3.Increased luminal osmotic load
4.Inflammation of mucosa and exudation into lumen
Most patients with sudden onset of diarrhea have a
benign self-limited illness requiring no treatment or
evaluation.
3.
4. Principles of management
• Treatment of fluid depletion, shock and
acidosis
• Maintainence of nutrition
• Drug therapy
• Based upon severity and nature of diarrhea
management is carried on
5. Intravenous rehydration
• When fluid loss is severe
• Components:
NaCl
KCl
NaHCO3
Ringer lactate commonly recommended iv
fluid
6. Acute diarrhea
Oral rehydration solution is the cornerstone for patients
with acute illnesses resulting in significant diarrhea
Rehydration. WHO ORS:
1.Sodium chloride: 3.5g
2.Sodium bicarbonate: 2.5g
Or
Trisodium citrate: 2.9g
3.Potassium chloride 1.5g
4.Glucose: 20g
5.Potable water: 1 liter
Rice based physiological solutions.
Rationale of ORS
8. Home solution:
½ tsp salt (3.5g)
1 tsp baking soda (2.5g NaHCO3)
8 tsp sugar (40g)
8 oz orange juice (1.5g KCl)
1 L water
9. Antidiarrheal drugs: treat only symptoms!
– Diarrhea is usually caused by infection (Salmonella,
shigella, campylobacter,clostridium, E. coli), toxins,
anxiety, drugs…
– In healthy adults mostly discomfort and
inconvenience
– In children (particularly mal-nourished) a principal
cause of death is due to excessive loss of water and
minerals.
10. Drug therapy
• Specific antimicrobial agents
No value
Only on severity basis
On regular basis
• Probiotics
• Drugs of IBD
• Non-specific agents
11. Antimotility agents:
– Muscarinic receptor antagonists (not useful due to side
effects) and opiates:
• Diphenoxylate
•Difenoxin
•Loperamide
– All have CNS effects – to be use carefully in treatment
of diarrhea!
12. Antimotility agents & anti-secretory agents:
Opiods continue to be used widely
Mechanism of action:
1. Intestinal motility--µ receptors
2. Intestinal secretion-- δ receptors
3. Intestinal absorption--- µ & δ receptors
All the commonly used opioids act principally via
peripheral µ receptors and are preferred over opioids
that penetrate central nervous system
13. Loperamide:
•40-50 times more potent than morphine as an anti-
diarrheal agent
•Increases small intestinal and mouth to cecum transit
time.
•Increases anal sphincter tone
•Anti-secretory activity against cholera toxin and some
forms of E.coli toxin
14. Loperamide:
Half- life 11 hours
Dose: 4mg initially followed by 2mg after each subsequent
stool, up to 16mg/day.
If clinical improvement does does not occur in acute
diarrhea within 48 hours, DISCONTINUE loperamide
Not recommended in children <2 years.
15. Loperamide:
•Effective in travellers diarrhea
•Used alone or in combination with antimicrobial agents
(trimethorim with or without sulfamethoxazole)
•Adjunctive treatment in almost all forms of chronic
diarrheal diseases.
•Lacks significant abuse potential
•Overdose: CNS depression, paralytic ileus, toxic
megacolon.
16. Difenoxin-
Active metabolite of diphenoxylate
Both combined with 25 mcg of atropine to prevent abuse.
Excess dose: CNS effects, anticholinergic effects,
constipation, toxic megacolon
Other opioids:
1. Paregoric: 2mg morphine/5mL.
2. Deodorized tincture of opium.
17. DO not use loperamide in:
1. Patients with bloody diarrhea
2. High fever
3. Systemic toxicity
4. Worsening diarrhea despite treatment
19. Bismuth subsalicylate:
Trivalent bismuth suspended in a mixture of magnesium
aluminium silicate clay.
In stomach: Combines with HCl→ Bismuth oxychloride
+ Salicylic acid
20. Bismuth subsalicylate
2 tab or 30mL up to 8 times daily
•Anti-inflammatory
•Anti-bacterial
•Anti- secretoty
•Also decreases vomiting
21. Diphenoxylate and atropine contraindicated in acute
diarrhea because of rare precipitation of toxic megacolon.
GIVE APPROPRIATE ANTIBIOTICS, IF CAUSATIVE
ORGANISM IS KNOWN
22. Rifaximin: Non absorbed oral antibiotic . 200mgtid x 3
days
Ciprofloxacin 500mg
Ofloxacin 400mg X 5 to 7 days
Norfloxacin 400mg bd
Levofloxacin 500mg od
Cortrimoxazole DS bd
Doxycycline 100mg bd
23. Liquid paraffin - No longer recommended
- more ADR
Malabsorption of fat soluble vitamins
It foreign body reactions in small bowel
(paraffinoma
fecal leak at anal canal & pruritus ani
24. Treatment of Chronic diarrhea
A number of antidiarrheal agents may be used in certain
patients with chronic diarrheal conditions.
Opioids are safe in most patients with chronic, stable
symptoms.
Loperamide: 4mg initially ,then 2 mg after each loose
stool ( maximum: 16 mg/d).
Diphenoxylate with atropine: One tablet three or four
times daily as needed.
25. Treatment of Chronic diarrhea
Codeine and tincture of opium: Chronic, intractable
diarrhea.
Codeine 15-60 mg every 4 hours
Tincture of opium: 10-25 drops every 6 hours
27. Octreotide: Somatostatin analog
•Stimulates intestinal fluid and electrolyte absorption
•Inhibits intestinal fluid secretion
•Inhibits release of gastrointestinal peptides.
Given for: secretory diarrheas due to tumors--- VIPomas,
Carcinoid, AIDS related diarrhea
Dose: 50-250mcg subcutaneously three times daily.
29. Cholestyramine:
Bile salt binding resin
Used in:
•Bile salt induced diarrhea
•Intestinal resection
•Ileal disease
Dose: 4g once to three times daily
30. Bulk forming and hydroscopic agents:
Carboxymethylcellulose & Calcium polycarbophil– absorb
water and stool bulk.
Useful in mild chronic diarrhea in patients with irritable
bowel syndrome
Mechanism of action: Works as a gel to modify stool
texture & viscosity to produce perception of decreased
stool fluidity.
31. Others:
Clays such as kaolin and other silicates like attapulgite
( magnesium aluminium disilicate) bind water avidly.
Kaolin and pectin: useful in mild diarrhea.
Calcium channel blockers like verapamil and nifedipine:
decrease gut motility, promote intestinal water absorption.
32. Berberine:
Plant alkaloid. It has:
•Antimicrobial activity
•Inhibits smooth muscle contraction
•Delays intestinal transit by antagonizing effects of
acetylcholine.
Chloride channel blockers:
Antisecretory agents.
Calmodulin inhibitors including chlorpromazine and
ZALDARINE MALEATE
