Edema is characterized by swelling caused by excess fluid in the interstitial tissue. It can be localized or generalized. Common causes include cardiac, renal, or hepatic disease which decrease plasma oncotic pressure allowing fluid shift from vessels into tissue. A thorough history, physical exam, and lab tests are needed to determine the underlying cause and guide treatment such as diuretics, dietary changes, or treating the primary disease.
A 7 years old boy had increasing lethargy for a week. On physical examination, he had periorbital and pitting edema at the ankles, but is normotensive and afebrile. Laboratory studies smarked albuminuria. He was given a thiazide diuretic and his urine output increases and his edema resolves
Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine. Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood.
Nephrotic syndrome may be caused by primary (idiopathic) renal disease or by a variety of secondary causes. Patients present with marked edema, proteinuria, hypoalbuminemia, and often hyperlipidemia.
Nephrotic syndrome is a primary glomerular disease characterized by the following:
Marked increase in protein in the urine (proteinuria)
Decrease in albumin in the blood (hypoalbuminemia)
Edema (The swelling (edema), can be most noticeable on the face, around the eyes, around the feet and ankles, and in the belly area (or the abdomen).
High serum cholesterol and low-density lipoproteins (hyperlipidemia)
Nephrotic syndrome is a clinical disorder characterized by marked increase of protein in the urine ( proteinuria ), decrease in albumin in the blood (hypoalbuminemia ),edema, & excess lipids in the blood ( hyperlipidemia )
Pathophysiology
Nephrotic syndrome can occur with almost any intrinsic renal disease or systemic disease that affects the glomerulus.
Although generally considered a disorder of childhood, nephrotic syndrome does occur in adults, including the elderly. Causes include:
Chronic glomerulonephritis
Diabetes mellitus with intercapillary glomerulosclerosis
Amyloidosis of the kidney
Systemic lupus erythematosus
Multiple myeloma and renal vein thrombosis.
NSAIDs
Pre eclampsia
Nephrotic syndrome happens when damage to your kidneys causes these organs to release too much protein into your urine.
Nephrotic syndrome isn’t itself a disease. Diseases that damage blood vessels in your kidneys cause this syndrome.
Nephrotic syndrome is characterized by the following:
A high amount of protein present in the urine (proteinuria)
high cholesterol and triglyceride levels in the blood (hyperlipidemia)
Low levels of a protein called albumin in the blood (hypoalbuminemia)
Swelling (edema), particularly in your ankles and feet, and around your eyes.
Chronic renal failure or chronic kidney disease management, pharmacist role, medical management objectives, goals of the therapy .
What are the risk factors of chronic renal failure, clinical manifestations of chronic renal failure, renal failure complications, pathophysiology of chronic renal failure.
Glomerulonephritis is inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine.
kindly check this slide for nephrotic syndrome. in this slide i covered all the points regarding this topic.
if any suggestion give comment on this topic
Bile or liver problem causing yellowness
• A yellow discoloration of the skin, mucous membranes, or sclera of the eyes, jaundice indicates excessive levels of conjugated or unconjugated bilirubin in the blood.
• In fair-skinned patients, it’s most noticeable on the face, trunk, and sclera; in dark-skinned patients, on the hard palate, sclera, and conjunctiva.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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!
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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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.
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
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.
Evaluation of antidepressant activity of clitoris ternatea in animals
Approach to child with generalized body swelling
1.
2. Edema is a clinical condition characterized
by an increase in interstitial fluid volume and
tissue swelling that can be either localized or
generalized. Severe generalized edema is
known as anasarca. More localized interstitial
fluid collections include ascites and pleural
effusions.
3. Generalized edema is typically chronic and
progressive It may result from
cardiac, renal, endocrine, or hepatic disorders
as well as from severe burns, malnutrition, or
the effects of certain drugs and treatments
Common factors responsible for edema are
hypoalbuminemia and excess sodium
ingestion or retention, both of which
influence plasma osmotic pressure
7. Medical history questions documenting swelling
in detail may include the following
Time pattern
o When did you first notice this?
o Is it present all the time?
o Does it come and go?
Quality
o How much swelling is there?
o When you poke the area with a finger, does the
dent remain?
Location
o Is it overall or in a specific area (localized ?
o If swelling is in a specific area, what is that
area?
8. Others
o What seems to make the swelling better?
o What seems to make the swelling worse?
o Is the edema worse in the morning or at the
end of the day?
o Is it affected by position changes?
o Is it accompanied by shortness of breath or
pain in the arms or legs?
o Find out how much weight the patient has
gained
o Has his urine output changed in quantity or
quality?
o What other symptoms are also present?
9. Next, ask about previous burns or
cardiac, renal, hepatic, endocrine, or GI
disorders. Ask the patient to describe his
diet so you can determine whether he
suffers from protein malnutrition. Explore
his drug history, and note recent I.V.
therapy.
10. Begin the physical examination by
comparing the patient’s arms and legs for
symmetrical edema. Also, note
ecchymosis, rash and cyanosis. Assess the
back, sacrum, and hips of the bedridden
patient for dependent edema. Assess the
abdomen for ascites and scrotum. Palpate
peripheral pulses, noting whether hands and
feet feel cold, and measure the blood
pressure. Finally, perform a complete
cardiac, respiratory and abdominal
11. Skin Disorders
• Cellulitis, exfoliative dermatitis, and
burns can cause increase in capillary
permeability and edema.
• History and physical exam are
diagnostic.
12. Allergic Reaction
• Release of histamine and other vasoactive
mediators can produce localized or generalized
edema.
• Drugs, chemical exposure by inhalation, foods)
especially milk, eggs, chocolate, nuts(, and bee
stings are common causes of allergic reactions.
• Lips, eyelids, and face are frequently
involved, and urticaria also may occur.
• Wheezing, laryngospasm, and hypotension
may be seen with anaphylactic reactions.
• History and physical exam are usually
diagnostic.
13. Vasculitis
Common causes of vasculitis causing
edema include Kawasaki disease and
collagen vascular disease.
Septicemia
Severe bacterial or rickettsial infections
can cause increase in capillary permeability
and edema.
14. Vitamin E Deficiency
• Uncommon since addition of vitamin E
to infant formulas.
• Preterm infants 4–6 weeks of age
without normal intake of vitamin E may
develop generalized edema, hemolytic
anemia, and thrombocytosis.
• Serum concentration of vitamin E is low.
15. Angioedema
Recurrent attacks of
acute, painless, nonpitting edema involving
the skin and mucous membranes — especially
those of the respiratory
tract, face, neck, lips, larynx, hands, feet, geni
talia, or viscera — may be the result of a food
or drug allergy or emotional stress; they may
also be hereditary. Abdominal
pain, nausea, vomiting, and diarrhea
accompany visceral edema; dyspnea and
stridor accompany life-threatening laryngeal
edema. .
• Diagnosis is confirmed by measurement of
16. Increased Hydrostatic Pressure
Increased BloodVolume
• Administration of excessive amounts of
sodium or fluid can produce volume
overload and edema.
• In cardiac failure, diminished renal blood
flow leads to decrease in glomerular
filtration rate (GFR) and edema.
• Renal disease e.g., (glomerulonephritis)
or any cause of renal failure also may lead
to decrease in GFR and edema.
17. Severe, generalized pitting edema — occasionally
anasarca — may follow leg edema late in a patient
with heart failure. The edema may improve with
exercise or elevation of the limbs and tends to be
worse at the end of the day. Other classic late
findings include hemoptysis, cyanosis, marked
hepatomegaly, clubbing, crackles, and a ventricular
gallop. Typically, the patient also experiences
tachypnea, palpitations, hypotension, weight gain
despite anorexia, nausea, slowed mental
response, diaphoresis, and pallor.
Dyspnea, orthopnea, tachycardia, and fatigue
signal left-sided heart failure; jugular vein
distention, enlarged liver, and peripheral edema
18. IncreasedVenous Pressure
• Increased venous pressure from deep
venous thrombosis, constrictive
pericarditis, portal hypertension, or
impaired venous drainage from tumor may
produce edema.
• Deep venous thrombosis in thigh or calf
produces pain and swelling of leg distal to
thrombus. U/S is usually diagnostic.
19. , generalized
pitting edema may be most prominent in
the arms and legs. It may be accompanied
by chest
pain, dyspnea, orthopnea, nonproductive
cough, pericardial friction rub, jugular vein
distention, dysphagia, and fever
20. Increased Lymph Pressure
• Lymphedema is excessive accumulation
of lymph in interstitial space and is
principal cause of increased lymph
pressure.
• Can be congenital or acquired, sporadic
or familial, and may appear at birth or in
childhood or adolescence.
• Abnormal development or dysfunction
of lymphatic vessels, lymph node
obstruction, and venous stasis are
common mechanisms producing
lymphedema.
21. • Common presentation is
unilateral, painless edema of leg;
however, pain may occur with massive
edema or cellulitis.
• U/S and MRI are useful in detection of
lymphatic malformations and obstructive
lesions.
Disorders with Proteinuria
• Any renal disorder causing severe
proteinuria may produce edema.
Nephrotic syndrome and acute
glomerulonephritis are common examples.
22. is characterized by
generalized pitting edema, the edema is
initially localized around the eyes. With
severe cases, anasarca develops, increasing
body weight by up to 50%. Other common
signs and symptoms are
ascites, anorexia, fatigue, malaise, depression
, and pallor.
UG confirms presence of proteinuria.
23. Generalized pitting edema occurs as a late
sign of acute renal failure. With chronic renal
failure, edema is less likely to become
generalized; its severity depends on the
degree of fluid overload. Both forms of renal
failure cause oliguria, anorexia, nausea and
vomiting, drowsiness, confusion, hypertensi
on, dyspnea, crackles, dizziness, and pallor.
24. Disorders without Proteinuria
Acute and Chronic Liver Disease
• Decrease in synthesis of albumin in liver
produces hypoalbuminemia.
• Serum albumin of <2.5 g/dL causes
decrease in plasma oncotic pressure and
edema.
edema is a late sign of
cirrhosis, a chronic disease. Accompanying
signs and symptoms include abdominal
pain, anorexia, nausea and
vomiting, hepatomegaly, ascites, jaundice, p
ruritus, bleeding tendencies, musty
breath, lethargy, mental changes, and
asterixis.
25. Gastrointestinal Disease
• Loss of serum albumin in GI tract leads to
decreased plasma oncotic pressure and
edema.
• Screening test for protein loss in stool is
measurement of alpha1-antitrypsin in spot
stool sample.
26. Protein-Calorie Malnutrition
• Severe protein-calorie malnutrition can
produce edema because of decrease in
serum albumin.
• Growth failure, decreased muscle
mass, diarrhea, hepatomegaly, anemia, pi
gment changes of hair and
skin, fatigue, and apathy are other
findings.
• Edema resolves with adequate calorie
and protein intake.
27. Congenital Albumin Deficiency
• Severe edema occurs with congenital
albumin deficiency, which is rare.
• Very low or undetectable serum albumin
concentration in absence of other causes
of hypoalbuminemia confirms diagnosis.
Hydrops Fetalis: Immune and Nonimmune
Hydrops fetalis is term used to describe
severe generalized edema in fetus or
newborn, Because of use of anti-D
immune globulin for Rh isoimmunization;
most cases of Hydrops are nonimmune
type
28. • UG screens for proteinuria and renal disease.
• In absence of significant proteinuria or
cardiac failure, serum albumin should be
measured. Fluid overload and allergic reactions
are common causes of edema with normal
serum albumin. Decreased serum albumin
without proteinuria suggests liver
disease, protein-losing enteropathy, or protein-
caloric malnutrition.
• Electrolytes, B.urea and S.creatinine
• CXR, ECG, ECHO and others
29. • Jaundice, hepatomegaly, and abnormal
liver function tests are manifestations of liver
disease.
• Elevated fecal alpha1-antitrypsin level
indicates increased protein loss in stool and
is seen with various causes of protein-losing
enteropathy.
• Protein-calorie malnutrition can be
assessed by plotting weight and height on
growth charts
30. Treatments for edema are focused on
reversing the underlying cause, if there is one
present treat accordingly.
Bed rest, dietary and lifestyle
modifications, such as limiting sodium
chloride (salt) intakes, are recommended.
many physicians implement diuretic
therapies. Diuretics are used to decrease the
amount of water in the body by increasing
the flow of urine.
31. Avoid I.V. saline solution infusions and enteral
feedings may cause sodium and fluid
overload, resulting in generalized
edema, especially in patients with cardiac or
renal disease
Monitor intake and output and daily weight.
Also monitor serum electrolyte levels —
especially sodium and albumin.
Renal failure in children commonly causes
generalized edema. Monitor fluid balance
closely. Remember that fever and diaphoresis
can lead to fluid loss, so promote fluid intake.