The urinary system consists of the kidneys, ureters, urinary bladder, and urethra. The kidneys filter waste from the blood to produce urine, which travels through the ureters to the bladder. The bladder stores urine and empties through the urethra upon urination. The detrusor muscle within the bladder wall contracts and relaxes to facilitate filling and emptying. Various receptors including muscarinic and beta adrenergic receptors regulate bladder function. The prostate gland surrounds the urethra in males and secretes fluid. Common urinary disorders include overactive bladder, urinary incontinence, and benign prostatic hyperplasia.
Urinary incontinence simply means involuntary leaking of urine.
Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.
Social and hygienic problem.
The urinary system's function is to filter blood and create urine as a waste by-product. The organs of the urinary system include the kidneys, renal pelvis, ureters, bladder and urethra. The body takes nutrients from food and converts them to energy.
After ingesting food and fluids, our body eliminates waste products through the urinary system and the gastrointestinal system. Nurses provide care for patients with commonly occuring elimination alterations, including urinary tract infections, urinary incontinence, urinary retention, constipation, diarrhea, and bowel incontinence. This chapter will provide an overview of these alterations and the associated nursing care.
describes its definition, causes, clinical manifestations, diagnosis and rx.
feedback and inquiries; gufuabdikadir96@gmail.com
Urinary incontinence affects millions of people.Urinary incontinence is leakage of urine you can’t control. Also referred to as loss of bladder control. No matter what you call it, if you have it, you may feel like you’re the only one because people don’t really talk about it. But you’re not alone.
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
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.
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Urinary incontinence simply means involuntary leaking of urine.
Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.
Social and hygienic problem.
The urinary system's function is to filter blood and create urine as a waste by-product. The organs of the urinary system include the kidneys, renal pelvis, ureters, bladder and urethra. The body takes nutrients from food and converts them to energy.
After ingesting food and fluids, our body eliminates waste products through the urinary system and the gastrointestinal system. Nurses provide care for patients with commonly occuring elimination alterations, including urinary tract infections, urinary incontinence, urinary retention, constipation, diarrhea, and bowel incontinence. This chapter will provide an overview of these alterations and the associated nursing care.
describes its definition, causes, clinical manifestations, diagnosis and rx.
feedback and inquiries; gufuabdikadir96@gmail.com
Urinary incontinence affects millions of people.Urinary incontinence is leakage of urine you can’t control. Also referred to as loss of bladder control. No matter what you call it, if you have it, you may feel like you’re the only one because people don’t really talk about it. But you’re not alone.
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
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.
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
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. Urinary System
The urinary system or urinary tract (also
called the excretory system) is the organ
system that produces, stores, and
eliminates urine.
In humans it includes -
Two kidneys
Two ureters
A Urinary bladder
A urethra
3. Kidney:
• The kidneys are bean‐shaped organs that
lie in the abdomen.
• The main role of kidney is to filter water
soluble waste products from the blood.
Ureters:
• Ureters are a tube-like organ which is
made of smooth muscle
• Ureters carries urine from the kidney to
urinary bladder
Physiology of urinary system
Urinary Bladder
• A hollow muscular, and distensible (or
elastic) organ, which sits on the pelvic floor
• Collects urine excreted by the kidneys prior
to disposal by urination
• The urinary bladder usually holds 300‐350
mL of urine; a full adult bladder holds
about 500 mL of urine.
Urethra
• It is also a tube-like organ which is made of
smooth muscle
• Urine comes out the body through urethra
4. • In anatomy, the urinary bladder is the organ
that collects urine excreted by the kidneys
prior to disposal by urination.
• A hollow muscular, and distensible (or
elastic) organ, the bladder sits on the pelvic
floor.
• Urine enters the bladder via the ureters and
exits via the urethra.
• The urinary bladder usually holds 300-350
mL of urine; a full adult bladder holds about
500 mL of urine.
Urinary Bladder
5. The urinary bladder is composed of
four layers of muscles:
•The serosa
•The detrusor muscle
•A submucosal coat of connective
tissue, and
•The mucosa, which contains a layer of
epithelial cells, and connective tissue
that facilitate its contractility and allow
storage of urine at low pressure
Muscles of Urinary Bladder
6. • The detrusor muscle is a layer of the urinary bladder wall made of smooth muscle
fibers arranged in spiral, longitudinal, and circular bundles.
• Detrusor is innervated by sympathetic nervous system fibers from the lumbar
spinal cord and parasympathetic fibers from the sacral spinal cord.
• When the bladder is stretched, this signals the parasympathetic nervous system
to contract the detrusor muscle. This encourages the bladder to expel urine
through the urethra.
• For the urine to exit the bladder, both the autonomically controlled internal
sphincter and the voluntarily controlled external sphincter must be opened.
Problems with these muscles can lead to incontinence.
• If the amount of urine reaches 100% of the urinary bladder's capacity, the
voluntary sphincter becomes involuntary and the urine will be ejected instantly.
• The desire to urinate usually starts when the bladder reaches around 25% of its
working volume.
Detrusor Muscle
8. Bladder Filling & Emptying Cycle
The cycle of
bladder filling
and emptying
1. Bladder fills
2. First desire to
urinate (bladder
half full)
Urination 3. Urination
voluntarily inhibited
until time and place
are right
Detrusor
muscle
contracts
Detrusor muscle relaxes
Urethral
sphincter
contracts
Urethral sphincter relaxes
9. Muscarinic receptors are acetylcholine receptors found in the plasma
membranes of certain neurons and other cells. They play several roles,
including acting as the main end-receptor stimulated by acetylcholine
released from postganglionic fibers in the parasympathetic nervous
system.
Distribution of Muscarinic Receptors:
M1: Brain, salivary glands, sympathetic ganglia
M2: Heart, hindbrain, smooth muscle (urinary bladder)
M3: Urinary bladder, smooth muscles, salivary glands, brain
M4: Brain
M5: Brain, eye
Receptors in Bladder-
Muscarinic Receptors
10. β receptors have the subtypes β1, β2 and β3.
Distribution of β Receptors in Bladder:
β1 : only 1.5% expression in the total bladder
β2 : only 1.4% expression in the total bladder
β3 : More than 97% expression in the total bladder
Receptors in Bladder-
β Adrenergic Receptors
11. Prostate Gland
Prostate Gland
Walnut‐shaped gland that forms part of the male
reproductive system.
Location
Prostate gland is located at the bladder neck surrounding
the urethra.
Functions
Secretes semen which carries sperm
During orgasm, prostate muscles contract and propel
ejaculate out of the penis
Structure
The mean weight of the "normal" prostate in adult males
is about 11 grams, usually ranging between 7 and 16
grams.
12. Zones of Prostate Gland
The prostate gland anatomy is divided into four
zones:
• Peripheral: The outermost part which
consists of 70% of the normal prostate.
• Central: Nearly 25% of the normal prostate
gland.
• Transition: Accounts for 5% of prostate
volume and this region is responsible for the
prostate enlargement problems.
• Periurethral or anterior fibro‐muscular zone
13. Cells of Prostate Gland
The prostate gland comprises of three types of
cell:
Stroma
Epithelium
Ductal lumina
In a normal sized prostate, the ratio of stroma
and epithelium tissue is 2:1. But, in case of BPH
or in an enlarged prostate the ratio of stroma
and epithelium rises to 5:1
14. • The α1 adrenergic receptor is a G
protein‐coupled receptor
• There are three subtypes including
α1A, α1B, and α1D
• Norepinephrine and epinephrine
signal through the α1‐adrenergic
receptor in the central and peripheral
nervous systems
Receptors in Prostate-
Alpha‐1 adrenergic receptor
15. Location of α1A & α1D
adrenoceptors are as follows:
• α1A: Bladder neck &
• α1D: Detrusor muscle
Localization of α1‐adrenergic receptors
17. • Urinary incontinence is the involuntary leakage of urine. It is the inability to
hold urine in the bladder because voluntary control over the urinary sphincter
is either lost or weakened.
Urinary Incontinence
Symptoms
• Leakage of urine.
• Pain whenever your bladder fills or when you're urinating.
• Progressive weakness of your urine stream, down to "dribbling,"
• The feeling that you've not completely emptied your bladder.
• Increased rate of urination.
• Waking up often with the need to urinate.
• Bed-wetting or leaking urine in your sleep.
• Inability to urinate or straining to empty the bladder.
• Frequent urinary tract and bladder infections.
18.
19. • Urge incontinence
Urge incontinence symptoms involve the sudden and uncontrollable need to
urinate i.e. the urge and can't make it to the bathroom in time.
• Stress incontinence
Stress incontinence involves urine leakage when physical stress places pressure on
the bladder i.e. leak when cough or sneeze, also might leak if laugh, lift heavy
weights, or take part in physical activity like running, jogging, or aerobic dance. This
type of urinary incontinence can be caused by damage to the muscles that control
the bladder.
• Mixed incontinence
Mixed incontinence, if a patient experiences both stress and urge incontinence
he/she has mixed incontinence.
Classification of Urinary Incontinence
20. • The term “Overactive Bladder” is used
to describe involuntary contractions of
the detrusor muscle.
• The International Continence Society
defines overactive bladder (OAB) as a
syndrome characterized by urgency
with or without urge incontinence,
and usually with frequency and
nocturia.
• Overactive bladder is a common
bladder condition (1 in 6 adults). It is
not a normal sign of aging. It can occur
at any age.
Overactive Bladder
21. The symptoms associated with Overactive Bladder are
• Urge urinary incontinence
• Urinary urgency and
• Urinary frequency
Clinically Overactive Bladder can present as
• Urgency: Frequently experiencing a strong, sudden and unpredictable
desire to urinate.
• Frequency: More than 8 micturitions in a 24 hour period.
• Urge Incontinence: Episodes of involuntary urine loss associated with a
sudden, strong desire to void.
• Nocturia: Waking up 2 or more times per night to urinate.
Symptoms of OAB
22. Benign Prostatic Hyperplasia (BPH)
• Benign prostatic hyperplasia is a non-
cancerous enlargement of the prostate.
• It is a progressive disease.
• It involves hyperplasia of prostatic
stromal and epithelial cells, resulting in
the formation of large prostate.
• The enlarged prostate cause partial or
sometimes complete obstruction of the
urethra, which interferes with the
normal flow of urine.
23. Pathophysiology of BPH
• Multifactorial
• Most experts consider Dihydrotestosterone (DHT), a metabolite of
testosterone, is a critical mediator of prostatic growth.
• DHT is synthesized in the prostate from circulating testosterone by the
action of the enzyme 5α‐reductase (5-AR). This enzyme is localized
principally in the stromal cells.
• An estimated 50% of men have BPH by age 50 years and 75% by age 80
years
• In 40–50% of these men, BPH becomes clinically significant.
24. Clinical Sign & Symptoms of BPH
Storage Symptoms
• Daytime urinary frequency
• Nocturia (Night time frequency)
• Urgency
• Dysuria (Painful Urination)
25. Clinical Sign & Symptoms of BPH
Voiding Symptoms
• Slow stream
• Splitting or spraying
• Intermittency
• Hesitancy
• Straining
• Terminal dribble (leak urine after
Urination has ceased)