Obesity is defined as excess body fat and is measured using body mass index (BMI). Anti-obesity drugs work by decreasing fat absorption, increasing satiety hormones, or altering brain pathways regulating appetite. Common anti-obesity drugs include Orlistat, Sibutramine, Lorcaserin, Qsymia, Contrave, and Liraglutide. These drugs work through various mechanisms like inhibiting lipase, reuptake of serotonin/norepinephrine, activating serotonin receptors, or being GLP-1 receptor agonists. All have potential adverse effects ranging from gastrointestinal issues to psychiatric problems. Bariatric surgery remains the most effective long-term treatment for obesity but also carries postoperative risks.
this was the first lecture which i delivered as a doctor. it was about dyslipidemia. i hope you will find information valuable to you here. please read. let me know about your ideas. comment.
Prokinetics are the type of drugs which enhances gastrointestinal motility/transit by
increasing the frequency or strength of contractions.
They speed up gastric emptying by enhancing coordinated propulsive motility.
Treat Gastrointestinal symptoms : Abdominal discomfort, Bloating, constipation,
Heart burn, nausea and vomiting. And few gastrointestinal disorders : irritable bowel
Syndrome, gastritis, gastroparesis and functional dyspepsia.
Increases gastric emptying
Relief of gastric stasis
Decreases reflux esophagitis/heart burn
Decreases regurgitation of gastric contents & emesis
this was the first lecture which i delivered as a doctor. it was about dyslipidemia. i hope you will find information valuable to you here. please read. let me know about your ideas. comment.
Prokinetics are the type of drugs which enhances gastrointestinal motility/transit by
increasing the frequency or strength of contractions.
They speed up gastric emptying by enhancing coordinated propulsive motility.
Treat Gastrointestinal symptoms : Abdominal discomfort, Bloating, constipation,
Heart burn, nausea and vomiting. And few gastrointestinal disorders : irritable bowel
Syndrome, gastritis, gastroparesis and functional dyspepsia.
Increases gastric emptying
Relief of gastric stasis
Decreases reflux esophagitis/heart burn
Decreases regurgitation of gastric contents & emesis
Obesity in Adolescent- Right Time to InterveneSujoy Dasgupta
Invited lecture by Dr Sujoy Dasgupta in a Webinar by Food, Drugs and Medicosurgical Equipment Committee of FOGSI (Federation of Obstetric and Gynaecological Societies of India) on “Adolescent Nutrition: Challenges and Way Forward” held in November, 2021.
obesity or over weight is biggest problem nowadays so in this presentation solution and suggestion about weight loss and causes of weight gain prevention on weight gain is given so it help to stay fit and healthy in life
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!
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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.
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
4. OBESITY
• Defined as an excess of body fat.
• Surrogate marker for body fat content Body Mass Index.
• BMI= Weight (in kg)
Height (in m2)
• BMI not a direct estimate of adiposity; large muscle mass.
5. OBESITY
• Can also be defined as,
• 25% or greater total body fat- men
• 35% or greater- women
• Estimation of % of total body fat:
• Measurement of skin fold thickness
• Bioelectrical impedance
• Underwater weighing
6. BODY MASS INDEX
BODY MASS INDEX VALUES(kg/m2)
NORMAL 18.5- 24.9
OVERWEIGHT 25-29.9
CLASS I OBESITY 30-34.9
CLASS II OBESITY 35-39.9
CLASS III OBESITY (EXTREME) > 40
According to National Institute of Health:
7.
8. EPIDEMIOLOGY
• Obesity “Killer lifestyle disease”
• According to WHO,
• 1.2 billion people classified overweight worldwide
• 3% of Indian population- obese
• Lancet India is just behind US and China among top 10
countries with highest number of obese.
9. OBESITY
• Obesity results from greater energy intake than energy
expenditure.
• 9.3 Cal 1gm fat is stored.
• Fat adipocytes SC tissue; IP cavity; liver & other tissues.
10.
11. OBESITY
• Infancy; childhood hyperplastic obesity number of
adipocytes
• Adults Hypertrophic obesity size of adipocytes
• Extremely obese size and number of adipocytes contains
double amount of lipids as a lean person
16. OBESITY AND GENETICS
• 20-25%
• How genes contribute to obesity???
• One/ more abnormality of pathway regulating feeding center
• Abnormality of energy expenditure and fat storage
18. • Neural centers regulating appetite, feeding, behavior and
energy status: Hypothalamus; the amygdala; nucleus tractus
solitarius (NTS).
• Lateral nuclei hypothalamus feeding center
• Ventromedial nuclei satiety center
19. • Arcuate nucleus floor of 3rd ventricle in hypothalamus
key site.
• These centers possess high density receptors for
neurotransmitters and hormones.
36. SIBUTRAMINE- MOA
• Inhibits reuptake of serotonin; norepinephrine at
hypothalamic sites
• Increases levels of these substances- enhances satiety
• Reduction in waist circumference
• Decrease in plasma TG and VLDL
• Increase in HDL
• Dose- 5-15 mg/day
38. RIMONABANT
• Cannabinoid type-1 receptor antagonist
• Developed for smoking cessation; facilitate weight loss
• Initially used in pts with BMI> 30kg/m2
• Frequent adverse effects most notably severe
depression risk of suicide this drug is no longer used
clinically
39. LORCASERIN
• Serotonin 2C receptor agonist
• Selectively activates serotonin 2C receptors in brain
promotes satiety
• Indicated as an adjunct to low calorie diet and increased
physical activity
• BMI> 27 kg/m2 associated with weight-related comorbid
condition or BMI >30kg/m2
44. CONTRAVE- MOA
• Effect on 2 separate areas of brain
• Hypothalamus
• Mesolimbic dopamine circuit
• Exact neurochemical effects not known
45. CONTRAVE- ADR
• Nausea, vomiting
• Headache, dizziness, insomnia
• Dry mouth
• Constipation
• Has potential to cause suicidal thoughts & behaviors.
46. LIRAGLUTIDE
• Glucagon like peptide 1 receptor agonist.
• A physiological regulator of appetite; calorie intake
• GLP-1 receptor- present in several areas of brain regulating
appetite.
• Dose- 3mg subcutaneously
49. BARIATRIC SURGERY
• Most effective long-term treatment for obesity
• Several approaches used- performed laproscopically
• Goal- disrupting release of ghrelin and other peptides
enhancing satiety
These methods are rarely used in clinical practice; Hence BMI is the only method to assess obesity.
Abdominal circumference >102cm in men and >88 in women
Waist hip ratio >1 in men and >0.85 in women obesity
The Western Pacific Region Office of WHO recommends that, amongst Asians, BMI > 23.0 is overweight and > 25.0 is obese.
Obesity important cause of preventable death worldwide
A study published in the noted medical journal Lancet says India is just behind US and china in this global hazard list of top 10 countries with highest number of obese people.
Metabolic syndrome is a disorder of energy utilization and storage, diagnosed by a co-occurrence of three out of five of the following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL) levels
Once a person is obese and attains a stable weight energy intake = energy expenditure. For weight loss, energy intake should be less than energy expenditure.
Sensation of hunger- craving for food; rhythmic contractions of stomach; restlessness; Sensation of appetite- desire for food; helps to choose quality of food to be eaten. Both these feelings are influenced by hypothalamus.
Satiety centre- gives sense of nutritional satisfaction- inhibits feeding centre; In case of complete satiety- even in presence of highly appetizing food, the person refuses it.
Also, the paraventricular nucleus, dorsomedial nucleus and arcuate nucleus play an important role in feeding regulation.
Hormones and neurotransmitters are released from GIT and adipose tissue in stimulation to food intake. These converge into the arcuate nucleus
Arcuate nucleus 2 types of neurons to control appetite & energy expenditure 1) anorexigenic POMC & CART; 2) orexigenic NPY/AGRP
POMC release MSH acts on melanocortin receptors in PVN (MCR 3 and 4) activation of MCR decreased food intake and increased energy expenditure. This is mediated by activation of neuronal pathways projecting from PVN to nucleus tractus solitaries
Defective signaling of this pathway is associated with obesity. Mutations of MCR-4 is the main cause for obesity and accounts for 5-6% of early onset obesity in children.
AGRP inhibits MSH natural antagonist of MCR 3 and 4 increases food intake
When energy stores deplete activation of orexigenic neurons release of NPY stimulates appetite.
2 major clinical trial sustained weight loss of 9-10% over 2 years
Increases the levels of these substances in the synaptic cleft and enhances satiety
Phentermine- a sympathomimetic; topiramate- antiepileptic
Indicated in adjunct to low calorie diet and increased physical activity. BMI > 27 and if associated with other comorbidity. BMI> 30
Naltrexone- an opioid antagonist
Bupropion- an inhibitor of neuronal reuptake of dopamine and norepinephrine
Indications same as previous drugs
Indications same as other drugs
After 12 weeks study, sustained progressive dose dependent weight loss of up to 11 kg from baseline
Reduced hunger; food intake. Reduced total, LDL, Tg and increased HDL levels
Vertical banded gastroplasty- Also known as stomach stapling; A small stomach pouch 15-30 ML capacity is created using bands/staples. At the bottom of the pouch is a small hole through which contents flow into the remainder of stomach and GIT
Roux-en-Y gastric bypass- Stomach is divided into 2 pouches and small intestine is rearranged to connect to both.
