Law is a demanding field, and attorneys demand even more of themselves. Attorneys often turn to substances to escape from daily problems and cope with their enormous workload. In this webinar, we will explore addiction in the legal profession. Why lawyers suffer at significantly greater rates than the general public and what the profession should be doing to address the problem.
Law is a demanding field, and attorneys demand even more of themselves. Attorneys often turn to substances to escape from daily problems and cope with their enormous workload. In this webinar, we will explore addiction in the legal profession. Why lawyers suffer at significantly greater rates than the general public and what the profession should be doing to address the problem.
Healthcare providers are increasingly breaking the secure supply chain and endangering patients. Learn about counterfeit drugs and most recent incidents involving providers.
Also learn about how you can be a part of the solution by working with the Partnership for Safe Medicines.
Special Challenges in Clinical Trials: Case Study: the Dying child and the ...Michael Swit
A review of a case study involving whether it would be proper to authorize the use of a drug whose approval had been withdrawn when it is believed to be the only hope for a dying child.
Healthcare providers are increasingly breaking the secure supply chain and endangering patients. Learn about counterfeit drugs and most recent incidents involving providers.
Also learn about how you can be a part of the solution by working with the Partnership for Safe Medicines.
Special Challenges in Clinical Trials: Case Study: the Dying child and the ...Michael Swit
A review of a case study involving whether it would be proper to authorize the use of a drug whose approval had been withdrawn when it is believed to be the only hope for a dying child.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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
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
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. 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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Business ethics
1. Page 1 Out of 1
AEREN FOUNDATION’S Maharashtra Govt. Reg. No.: F-11724
NAME :
(NAME TO APPEAR ON THE CERTIFICATE)
REF NO :
COURSE :
SUBJECT:
AN ISO 9001 : 2008 CERTIFIED INTERNATIONAL B-SCHOOL
BUSINESS ETHICS
2. Page 1 Out of 1
Case : 1 WORKING FOR ELI LILLY & COMPANY (Marks 20)
Eli Lilly, the discoverer of Erythromycin, Darvon, Ceclor, and Prozac, is a major
pharmaceutical company that sold $6.8 billion of drugs all over the world in 1995, giving it profits of
$2.3 billion. Headquartered in Indianpolis, Minnesota, the company also provides food, housing, and
compensation to numerous homeless alcoholics who perform short-term work for the company. The
work these street people perform, however, is a bit unusual.
Before approving the sale of a newly discovered drug, the U.S. Food and Drug Administration
requires that the drug be put through three phases of tests after being tested on animals. In phase I,
the drug is taken by healthy human individuals to determine whether it has any dangerous side
effects. In Phase II, the drug is given to a small number of sick patients to determine dosage levels.
In Phase III, the drug is given to large numbers of sick patients by doctors and hospitals to determine
its efficacy.
Phase I testing is often the most difficult to carry out because most healthy individuals are
reluctant to take a new and untested medication that is not intended to cure them of anything and that
may have potentially crippling or deadly side effects. To secure test subjects, companies must
advertise widely and offer to pay them as such as $250 a day. Eli Lilly, however, does not advertise
as widely and pays its volunteers only $85 a day plus free from and board, the lowest in the industry.
One of the reasons that Lily’s rates are so low is because, as a long time nurse at the Lily Clinic is
reported to have indicated, “ the majority of its subjects are homeless alcoholics” recruited through
word of mouth that is spread in soup kitchens, shelters, and prisons all over the United States.
Because they are alcoholics, they are fairly desperate for money. Because they alcoholics, they are
fairly desperate for money. Because phase I testes can run several months, test subjects can make as
$4500 – an enormous sum to people who are otherwise unemployable and surviving on handouts.
Interviews with several homeless men who have participated in Lily’s drug tests and who describe
themselves as alcoholics who drink daily suggest that they are, by and large, quite happy to
participate in an arrangement that provides them with “easy money”. When asked, one homeless
drinker hired to participate in a Phase I trail said he had no idea what kind of drug was being tested
on him even though he had signed an informed – consent form. An advantage for Lilly is that this
kind of test subject is less likely to sue if severely injured by the drug. The tests run on the homeless
men, moreover, provide enormous benefits for society. It has been suggested, in fact, that in light of
the difficulty of securing test subjects, some tests might be delayed or not performed at all if it were
not for the large pool of homeless men willing and eager to participate in the tests.
The Federal Drug Administration requires that people who agree to participate in Phase I tests must
give their “ informed consent” and must take a “ truly voluntary and a uncoerced decision.” Some
have questioned whether the desperate circumstances of alcoholic and homeless men allow them to
make a truly voluntary and uncoerced decision when they agree to take an untested potentially
dangerous drug for $ 85 a day. Some doctors claim that alcoholics run a higher risk because they
may carry diseases that are undetectable by standard blood screening and that make them vulnerable
to being severely named by certain drugs. One former test subject indicated in an interview that the
drug he had been given in a test several years before had arrested his heart and “ they had to put
things on my chest to start my heart up again.” The same thing happened to another subject in the
same test. Another man indicated that the drug he was given had made him unconscious for 2 days
while others told of excruciating headaches.
3. Page 1 Out of 1
In earlier years, drug companies used prisoners to test drugs in Phase I tests. During the
1970s, drug companies stopped using prisoners when critics complained that their poverty and the
promise of early parole in effect were coercing the prisoners into “Volunteering”. When Lilly first
turned to using homeless people during the 1980s, a doctor at the company is quoted as saying, “ We
were constantly talking about whether we were exploiting the homeless. But there were a lot of them
who were willing to stay in the hospital for four weeks.” Moreover, he adds. “Providing them with
a nice warm bed and good medical care and sending them out drug – and alcohol – free was a
positive thing to do.”
A homeless alcoholic indicated in an interview that when the test he was participating in was
completed, he would rent a cheap motel room where I’ll get a case of Miller and an escort girl have
sex. The girl will cost me $ 200 an hour.” He estimated that it would take him about two weeks to
spend the $ 4650 Lily would pay him for his services. The manager at another cheap motel said that
when test subjects completed their stints at Lily, they generally arrived at his motel with about $ 2500
in cash : “ The guinea pigs go to the lounge next door, get drunk and buy the house a round. The
idea is, they can party for a couple of weeks and go back to Lily and do the next one.”
Questions :
1.Discuss this case from the perspective of utilitarianism, rights, justice and caring. What
insight does virtue theory shed on the ethics of the events described in this case ?
2. “ In a free enterprise society all adults should be allowed to make their own decisions
about how they choose to earn their living.” Discuss the statement in light of the Lily
case.
3. In your judgment, is the policy of using homeless alcoholics for test subjects morally
appropriate ? Explain the reasons for your judgment. What does your judgment imply about
the moral legitimacy of a free market in labor ?
4. How should the managers of Lily handle this issue ?