Carbohydrate is an organic compound that consists only of carbon (C), hydrogen & oxygen. The primary function of carbohydrates is to provide energy for the body.
Simple carbohydrates have one or two sugar molecules.
Complex carbohydrates have three or more sugar molecules, such as legumes, bread, rice, pasta.
This Slide share includes Carbohydrate and its Nutrition. It includes introduction, classification, digestion and absorption, sources, RDA and effects of excess and limited use of carbs and fibre and its health effects.
A complete review of carbohydrates. definition, source of carbohydrates. Importance, function of carbohydrates. translocation of carbohydrates in plants.
Carbohydrates are generally classified into monosaccharides (simple sugars), oligosaccharides (containing few sugar units) and polysaccharides (containing many sugar units).
Monosaccharides are sugar molecules containing short chain of carbon atoms, one aldehydic or ketonic group and hydroxyl groups attached to remaining Carbon atoms.
Oligosaccharides are formed by polymerisation of monosaccharide molecules by elimination of water molecules.
Polysaccharides are high molecular weight substances composed of large number of moosaccharide units combined to form one large polymer molecule. They may be straight chain or branched chain polymers.
This Slide share includes Carbohydrate and its Nutrition. It includes introduction, classification, digestion and absorption, sources, RDA and effects of excess and limited use of carbs and fibre and its health effects.
A complete review of carbohydrates. definition, source of carbohydrates. Importance, function of carbohydrates. translocation of carbohydrates in plants.
Carbohydrates are generally classified into monosaccharides (simple sugars), oligosaccharides (containing few sugar units) and polysaccharides (containing many sugar units).
Monosaccharides are sugar molecules containing short chain of carbon atoms, one aldehydic or ketonic group and hydroxyl groups attached to remaining Carbon atoms.
Oligosaccharides are formed by polymerisation of monosaccharide molecules by elimination of water molecules.
Polysaccharides are high molecular weight substances composed of large number of moosaccharide units combined to form one large polymer molecule. They may be straight chain or branched chain polymers.
Subject : Nutrition, Unit- VI
This topic provides brief knowledge about lipid metabolism and it is prepared according to INC syllabus for first year BSc Nursing Students.
Introduction to carbohydrate, Classification of carbohydrate, Monosaccharide's, Disaccharides, Oligosaccharides, Polysaccharide, Functions of Carbohydrate, Sources of Carbohydrate, RDA of Carbohydrate, Deficiency and Excess of Carbohydrate
History
Introduction
Functions
Classification – Monosaccharides
Disaccharides
Oligosaccharides
Polysaccharides
Digestion of carbohydrates
Absorption of carbohydrates
Dietary guidelines
Carbohydrates and oral health
Nutritional health programs in India
Public health significance
Subject : Nutrition, Unit- VI
This topic provides brief knowledge about lipid metabolism and it is prepared according to INC syllabus for first year BSc Nursing Students.
Introduction to carbohydrate, Classification of carbohydrate, Monosaccharide's, Disaccharides, Oligosaccharides, Polysaccharide, Functions of Carbohydrate, Sources of Carbohydrate, RDA of Carbohydrate, Deficiency and Excess of Carbohydrate
History
Introduction
Functions
Classification – Monosaccharides
Disaccharides
Oligosaccharides
Polysaccharides
Digestion of carbohydrates
Absorption of carbohydrates
Dietary guidelines
Carbohydrates and oral health
Nutritional health programs in India
Public health significance
Metabolism is the chemical reactions in the body's cells that change food into energy.
Our bodies need this energy to do everything from moving to thinking to growing.
1. Introduction to biochemistry: Cell and its biochemical organization, transport process across the cell membranes. Energy rich compounds: ATP, Cyclic AMP and their biological significance.
2. Biological oxidation: Coenzyme system involved in Biological oxidation. Electron transport chain (its mechanism in energy capture: regulation and inhibition): Uncouplers of ETC: Oxidative phosphorylation.
3. Enzymes: Definition: Nomenclature, IUB classification, Factor affecting enzyme activity, Enzyme action, enzyme inhibition. Isoenzymes and their therapeutic and diagnostic applications, Coenzymes and their biochemical role and deficiency diseases.
4. Carbohydrate metabolism: Glycolysis, Citric acid cycle (TCA cycle), HMP shunt, Glycogenolysis, gluconeogenesis, glycogenesis. Metabolic disorders of carbohydrate metabolism (diabetes mellitus and glycogen storage diseases): Glucose, Galactose tolerance test and their significance, hormonal regulation of carbohydrate metabolism.
5. Lipid metabolism: Oxidation of saturated (-oxidation): Ketogenesis and ketolysis, biosynthesis of fatty acids, lipids, metabolism of cholesterol, Hormonal regulation of lipid metabolism. Defective metabolism of lipids (Atherosclerosis, fatty liver, hypercholesterolemia).
6. Protein and amino acid metabolism: protein turn over, nitrogen balance, Catabolism of Amino acids (Transamination, deamination & decarboxylation).Urea cycle and its metabolic disorders, production of bile pigments, hyperbilirubinemia, porphoria, jaundice. Metabolic disorder of Amino acids.
7. Nucleic acid metabolism: Metabolism of purine and pyrimidine nucleotides, Protein synthesis, inhibition of protein synthesis
8. Introduction to clinical chemistry:
a) Urine analysis (macroscopic and physical examination, quantitative and
semi quantitative tests).
b) Test for NPN constituents. (Creatinine /urea clearance, determination of
blood and urine creatinine, urea and uric acid).
c) Test for hepatic dysfunction-Bile pigments metabolism.
d) Test for hepatic function: test- Serum bilirubin, urine bilirubin and urine
urobilinogen.
e) Lipid profile tests: Lipoproteins, composition, functions. Determination of
serum lipids, total cholesterol, HDL cholesterol, LDL cholesterol and
triglycerides.
All living cells require energy to carry out various cellular activities.
This energy is stored in organic molecules (e.g. carbohydrates, fats, proteins) that we eat as food.
These organic molecules are broken down into smaller units: proteins into amino acids, polysaccharides into simple sugars, and fats into fatty acids and glycerol by enzymatic reactions in cells to generate energy in the form of adenosine triphosphate (ATP).
The ATP generated by these pathways in cells is used to drive fundamental cellular processes.
Glucose is utilized as a source of energy, & stored as glycogen to release glucose as & when the need arises.
The multiple forms of an enzyme catalyzing the same chemical reaction are called isoenzmyes. They, however, differ in their physical and chemical properties.
Examples: Isozymes of numerous dehydrogenases, and several oxidases, transaminases, phosphatases, transphosphorylases, proteolytic enzymes, aldolases.
The principle sources of protein are pulses, cereals, peas, beans and nuts and principle animal sources are milk and its products, meat, fish, liver, eggs etc.
Primarily proteins are hydrolyzed from polypeptides to dipeptides and then finally they are converted in amino acids and absorbed in gut.
Digestion of proteins begins in stomach and happens at different levels in GI tract by help of different digestive enzymes.
Fatty acids are obtained from the hydrolysis of fats.
Fatty acids that occur in natural fats usually contain an even number of carbon atoms (due to synthesis from 2-carbon units) and are straight chain derivatives.
The chain may be saturated (containing no double bonds) or unsaturated (containing one or more double bonds).
Intestinal obstruction is the mechanical impairment which is partial or complete blockage of the bowel that results in the failure of the passage of intestinal content through the intestine.
Parotitis is the inflammation of the parotid glands. It is the most common inflammatory condition of the salivary glands, although inflammation can occur in the other salivary glands as well.
Body maintains a balance between the amount of fluid taken in and amount excreted.
Fluid balance is the balance between water coming into the body, from drinks, food and water leaving the body, mainly in the form of urine.
A peptic ulcer is the erosion in the mucosal wall of the stomach or the first part of the small intestine, an area called the duodenum. An ulcer occurs when the lining of these organs is surrounded by the acidic digestive juices which are secreted by the stomach cells.
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.
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
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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
2. CARBOHYDRATES
Carbohydrate is an organic compound that
consists only of carbon (C), hydrogen & oxygen.
The primary function of carbohydrates is to
provide energy for the body.
Simple carbohydrates have one or two sugar
molecules.
Complex carbohydrates have three or more sugar
molecules, such as legumes, bread, rice, pasta.
4. 1. MONOSACCHARIDES
Monosaccharides are simple sugars which cannot be
hydrolyzed into a simpler form. Common
monosaccharides have functional group, i.e. aldoses
and ketoses.
Aldoses: Monosaccharide having an aldehyde group.
(CHO) as the functional group. For example,
glyceraldehyde, glucose, galactose, etc.
Ketoses: Monosaccharides having keto group (C=O) as
the functional group. For example, ribulose, fructose
etc.
5. 2. DISACCHARIDES
Disaccharides are carbohydrates that can be
hydrolyzed into two units of monosaccharides.
e.g. Maltose, Lactose & sucrose
6. 3. OLIGOSACCHARIDES
•They yield 2 to 10 monosaccharides molecules on
hydrolysis.
- An example is ABO blood type specificity. Fructose,
Mannose & Glucose residues attached on RBC cell
surface contribute to the antigenticity of ABO blood
groups.
7. 4. POLYSACCHARIDES
•They consist of repeated units of monosaccharides or
their derivatives held together by glycosidic bond.
They are of two types:
1. Monopolysaccharides: These are made-up of
same type of monosaccharides. E.g. starch,
cellulose etc.
2. Heteropolysaccharides: These are made-up of
different type of monosaccharides. E.g. hyaluronic
acid, heparin.
8. FUNCTIONS OF CARBOHYDRATES
•Carbohydrates are the main source of energy in the
body. When carbohydrates are oxidized, are they
liberate CO₂, water and energy.
•They serve as storage form of energy (glycogen).
•Certain carbohydrates are the starting materials for
the biological synthesis of fatty acids and amino
acids.
•Certain products of carbohydrate metabolism acts as
catalyst to promote oxidation of food stuffs.
9. FUNCTIONS OF CARBOHYDRATES
•Carbohydrates like glycoproteins and glycolipids
participate in the structure of cell membrane.
•Carbohydrates are the structural components of
many organisms. Example, cellulose of plants, cell
wall of microorganisms.
•Carbohydrates save proteins from being used in
the production of energy.
10. DIGESTION OF CARBOHYDRATES
•Digestion is the process of breakdown of large
and complex organic molecules into simpler
forms.
•Digestion of carbohydrates is mainly of three
types i.e. polysaccharides (starch and glycogen),
disaccharides (sucrose, lactose, maltose) and
monosaccharides (glucose and fructose).
11. Contd…
•The monosaccharide is absorbed without any
change while polysaccharides and disaccharides
need digestion process to be converted into
monosaccharide.
•Digestion happens at different levels in gastro-
intestinal tract by help of different digestive
enzymes which convert carbohydrates into
simpler forms.
12. DIGESTION OF CARBOHYDRATES
In mouth, salivary amylase converts polysaccharides
into simpler carbohydrates
Then, moves on to stomach and no such carbohydrate
digestion occurs there.
Further, pancreatic amylase converts complex
carbohydrates into simpler carbohydrates for digestion.
14. ABSORPTION OF CARBOHYDRATES
Simplest form of carbohydrates, monosaccharide i.e.
glucose, fructose and mannose are absorbed at jejunum.
Fructose is absorbed more slowly then glucose and
galactose. The monosaccharide is absorbed through
following two mechanisms:
1. Facilitative transport (with the concentration
gradient): Generally, all the monosaccharide i.e. fructose,
glucose and galactose are absorbed by the diffusion with
concentration gradient by means of sodium-dependent
facilitative transporter.
15. Contd…
•Active transportation (against concentration
gradient): When concentration fall and not
favourable then, absorption of glucose is done by
active transportation. The active transportation
happen by the help of sodium linked glucose
transporter (SLGT-1). This transporter binds both
glucose and sodium at separate sites and transport
across plasma membrane and needs energy which is
provided from hydrolysis of ATPs.
16. METABOLISM OF CARBOHYDRATES
•Digestion process converts all carbohydrates like
polysaccharides and disaccharides to
monosaccharides into gut. Then these
monosaccharides are converted to glucose in the
liver. So liver is first filter of carbohydrates and
has major role in storage and distribution. There
are numerous metabolic pathways from
beginning to the end.
17. METABOLISM OF CARBOHYDRATES
•Carbohydrates are not only obtained from food but
are also produced in body. Amino acids, glycerol, etc.
are the different components from which synthesis of
carbohydrates takes place.
•The chemical reactions which occurs in the body are
mainly divided into three pathways:
a. Catabolic pathways: Catabolic pathways are those
which result in breaking down of compounds:
-Glycolysis
-Glycogenolysis
18. METABOLISM OF CARBOHYDRATES
b. Anabolic pathways: Anabolic pathways are
those which build compounds or synthesize
substances for the body:
-Gluconeogenesis
-Glycogenesis
c. Amphibolic pathway: It has a dual role: both
catabolic and anabolic.
- TCA cycle
19. GLYCOLYSIS
Glycolysis means breakdown of glucose or sugar. It is a
set of reactions in which one glucose molecule
produces two pyruvic acid molecules, 2 molecules of
ATP, 2 molecules of NADH (Nicotinamide adenine
dinucleotide) and 2 molecules of water. In the
glycolysis pathway, the breakdown of six-carbon
glucose (C₆H₁₂O₆) into two molecules of three-carbon
compound pyruvate (C₃H₆O₃) takes place.
Site: It occurs in the cytosol of the cell.
20. GLYCOLYSIS
Importance:
•It provides fuel in the form of ATP and
intermediates for metabolic pathways.
•It can operate both in aerobic and anaerobic
conditions forming different end products.
•It is the fastest pathway for supplying energy.
22. Reactions of Aerobic Glycolysis or glucose
1. In the first step, the glucose is irreversibly activated to glucose-6-phosphate in the
cell. This step is catalyzed by hexokinase enzyme. This requires Mg2+ and ATP.
In liver, glucokinase is the specific enzyme which also catalyzes this reaction at
higher concentration of glucose. Glucose-6 phosphate is impermeable to the cell
membrane. It is a central molecule with a variety of metabolic fates, such as
glycolysis, cogenesis, gluconeogenesis and HMP shunt.
2. Next the glucose-6-phosphate is isomerized to fructose-6-phosphate by
phosphohexose isomerase enzyme.
3. Fructose-6-phosphate is then irreversibly phosphorylated by phosphofructokinase
enzyme to fructose 1,6-bisphosphate. Fructose 1,6-bisphosphate contains two
phosphoric acid groups at C1 and C6 via phosphate ester bond.
4. Later, fructose 1, 6-bisphosphate molecule (six carbon sugar) is cleaved by
aldolase enzyme to yield glyceraldehyde-3-phosphate and dihydroxy acetone
phosphate (2, 3-carbon sugars-trioses).
5. Dihydroxyacetone phosphate formed in the above step is converted back
glyceraldehyde 3-phosphate by phosphotriose isomerase enzyme.
23. Reactions of Aerobic Glycolysis or glucose
6. Now we have two molecules of glyceraldehyde-3-phosphate
molecules, which get oxidized to 1,3-bisphosphoglycerate by the action
of gluteraldehyde 3-phosphate dehydrogenase enzyme. This step utilizes
glyceraldehyde to convert glyceraldehyde 3-phosphate into 1, 3 bis
phosphoglycerate to convert inorganic phosphoglycerate.
In 1, 3-bisphosphoglycerate the phosphate group 3-bisphosphoglycerate.
at carbon atom number 1 is high-energy group. Iodoacetate and arsenite
inhibit the enzyme glyceraldehyde 3-phosphate dehydrogenase. During
oxidation of glyceraldehyde-3-phosphate the reducing equivalents are
transferred to the acceptor NAD (nicotinamide adenine dinucleotide)
enters into mitochondria and The (reduced) NADH under aerobic
conditions enters & produces three molecules of ATP through its passage
into electron transport or respiratory chain. This type of formation of
energy currency ATP chain or through respiratory chain is called as
oxidative phosphorylation.
24. Reactions of Aerobic Glycolysis or glucose
7. In the next step, the high-energy compound 1,3-bisphosphoglycerate
transfers its high-energy to ADP to form ATP resulting in the formation of 3-
phosphoglycerate. This reaction is catalyzed by phosphoglycerate kinase
enzyme. This type of formation of energy from ATP by high-energy substrate is
called as substrate level phosphorylation.
8. 3-phosphoglycerate is then isomerized to 2-phosphoglycerate by
phosphoglycerate mutase enzyme.
9. 2-phosphoglycerate is then converted to one more high-energy compound
called phosphoenolpyruvate. This reaction is catalyzed by enolase enzyme.
The activity of this enzyme is completely inhibited by fluoride. Hence, fluoride
is used during blood collection for glucose estimation. This prevents the
utilization of glucose by red blood cell (RBC).
10. Later phosphoenolpyruvate is converted to pyruvate by pyruvate kinase
enzyme. In this step one molecule of ATP is formed by substrate level
phosphorylation
25. Reactions of Aerobic Glycolysis
Under aerobic conditions pyruvate is the end
product of glycolysis. Hence, pyruvate is then
converted into acetyl-CoA or oxaloacetate in the
mitochondria.
26. Anaerobic glycolysis
Under anaerobic condition pyruvate is reduced to lactate by
lactate dehydrogenase enzyme. This step utilizes the reducing
equivalent from NADH (Nicotinamide adenine dinucleotide) formed
in the earlier step and regenerates NAD+. Thus, the number of
ATP produced will be less in anaerobic condition.
Lactate accumulation in muscle leads to muscle cramps and
fatigue. In thiamine deficient alcoholics, pyruvate is rapidly
converted to lactate resulting in lactic acidosis.
27. Energetics of Glycolysis
1. Anaerobic glycolysis:
Energy spent/molecule of glucose =
i. Hexokinase 1 ATP
ii. PFK 1 ATP
Total = 2 ATP
Energy generated/molecule of glucose =
i. Phosphoglycerate kinase 1 ATP × 2 = 2 ATP
ii. Pyruvate kinase 1 ATP x2 = 2 ATP
Total = 4 ATP
Therefore NET GAIN OF ATP= 4-2 = 2 ATP
28. Energetics of Glycolysis
2. Aerobic glycolysis
Energy spent/molecule of glucose =
i. Hexokinase 1 ATP
ii. PFK 1 ATP
Total = 2 ATP
Energy generated/molecule of glucose =
i. Glyceraldehyde 3-Ph DH 1 x NADH x 2 = 3x2 = 6 ATP
ii. Phosphoglycerate kinase 1 ATP x 2 = 2 ATP
iii. Pyruvate kinase 1 ATP x 2 = 2 ATP
Total = 10 ATP
Therefore NET GAIN = 10-2 = 8 ATP
29. TRICARBOXYLIC ACID CYCLE (KREB'S
CYCLE OR CITRIC ACID CYCLE)
Significance:
Tricarboxylic acid (TCA) is a final common pathway for
oxidation of carbohydrates, fats and proteins. It provides
abundant ATP for the body and also provides substrates
for respiratory chain. It is amphibolic in nature showing
both catabolic and anabolic features. Since final common
oxidation takes place in this cycle, it is called catabolic.
TCA cycle provides substrates for synthesis of heme,
nonessential amino acids, fats, glucose, etc., and hence
called anabolic.
30. TRICARBOXYLIC ACID CYCLE (KREB'S
CYCLE OR CITRIC ACID CYCLE)
Features:
TCA cycle oxidizes acetyl-CoA to CO₂, and H₂O with
liberation of energy. It is strictly aerobic and purely
mitochondrial.
Sources of Acetyl-CoA:
• Fatty acid
• Pyruvate
• Glucose
• Ketogenic amino acids
36. GLUCONEOGENESIS
Gluconeogenesis is the synthesis of glucose
from noncarbohydrate precursors. Substrates
for gluconeogenesis are lactate, pyruvate,
glucogenic amino acids as major substrates
and to a lesser extent propionate and
glycerol.
39. Physiological significance of gluconeogenesis
•Maintenance of blood glucose level especially under
conditions of starvation.
•Brain has a minimum need of 120 grams of glucose
per day. The body stores of glycogen are depleted
within first 12-18 hours of fasting.
•On prolonged starvation, gluconeogenesis is speeded
up.
40.
41. Cori’s Cycle or Lactic Acid Cycle
Lactic acid is the major end product in muscle in
anaerobic glycolysis. Muscle tissue is incapable of
resynthesizing glucose from lactate. The conversion
takes place entirely in the liver. Muscle lactate is
transported to the liver by the blood. In the liver, it is
converted to glucose and glycogen by the enzymes
concerned in gluconeogenesis.
Liver glycogen is converted to glucose which is carried
back to muscle by blood. This conversion of muscle
lactate to glucose in liver and its re-entry into muscle is
called "Cori's Cycle.
42. GLYCOGEN METABOLISM
•Glycogen is stored in liver and muscle in cytoplasm as
granules. Liver glycogen is concerned with export of
glucose for circulation to maintain blood sugar and
muscle glycogen provides glucose for glycolysis within
the muscle itself providing energy during exercise.
Metabolism of glycogen:
a. Synthesis (glycogenesis)
b. Breakdown (glycogenolysis)
43. Glycogenesis (Synthesis of
Glycogen)
Glycogenesis occurs in liver and muscle
when plenty of glucose is available. It is a
cytosolic pathway requiring ATP and UDP
glucose.
Glycogenesis is the formation of glycogen
from glucose.
46. Glycogenesis (Synthesis of Glycogen)
3. Formation of branches:
•It involves "branching enzyme” (glycosyl alpha 4-6
transferase)
•It transfers a linear chain of 6-8 glucose residues to
another chain of glucose, forming a- 1,6 linkage,
thus branching takes place.
•To the newly formed branch, glycogen synthase
again adds glucose units by a, 1-4 linkages with
further branching and elongation to form glycogen.
47. Glycogenesis (Synthesis of Glycogen)
•Then, this glucose is transferred to a
glycogen primer (glycogenin) molecule
which is the acceptor of glycosyl unit.
•Then, glucose unit is added to the outer
(non-reducing) end of glycogen primer to
form alpha 1,4 glycosidic linkage or glycogen
and UDP is liberated.
51. Glycogenolysis
•Debranching enzyme has two activities:
i. Glucan transferase activity: It transfers a block of 3
glucose residues to another chain. Now branch point
is exposed.
ii. α, 1-6 glucosidase activity: It hydrolyses α, 1-6 linkage
at branch point, releasing free glucose.
52. BLOOD GLUCOSE AND ITS REGULATION
•Blood sugar regulation is the process by which the
levels of blood sugar, primarily glucose are
maintained by the body. The maintenance of
glucose level in blood within narrow limits is a
finely And efficiently regulated system. This is
important because it is essential to have
continuous supply compound, glucose to the
brain. Mechanisms of Blood Sugar Regulation:
53. BLOOD GLUCOSE AND ITS REGULATION
•Blood sugar levels are regulated by negative feedback
in order to keep the body in homeostasis. Levels of
glucose in the blood are monitored by the cells in the
pancreas's Islets of Langerhans.
•The blood glucose level falls to dangerous levels (as
in very heavy exercise or lack of food), the Alpha cells
of the pancreas release glucagon, a hormone whose
effects on cells act to increase blood glucose levels.
•They convert glycogen into glucose (this process is
called glycogenolysis). The glucose is released into
the bloodstream, increasing blood sugar levels.
54. BLOOD GLUCOSE AND ITS REGULATION
•When levels of blood sugar rise, whether as a
result of glycogen conversion, or from digestion of
a meal, a different hormone is released from beta
cells found in the Islets of Langerhans in
pancreas.
•This hormone, insulin, causes the liver to convert
more glucose into glycogen (this process is called
glycogenesis), and to force about 2/3 of body cells
(primarily muscle and fat cells) to take-up glucose
from the blood through the GLUT4 transporter,
thus decreasing blood sugar.
55. BLOOD GLUCOSE AND ITS REGULATION
•When insulin binds to the receptors on the cell surface,
vesicles containing the GLUT4 transporters come to the
plasma membrane and fuse together by the process of
exocytosis, thus enabling a facilitated diffusion of
glucose into the cell.
•As soon as the glucose enters the cell, it is
phosphorylated into Glucose-6-Phosphate in order to
preserve the concentration gradient so glucose will
continue to enter the cell.
•Insulin also provides signals to several other body
systems, and is the chief regulatory metabolic control in
humans.
56. BLOOD GLUCOSE AND ITS REGULATION
•There are also several other causes for an increase in
blood sugar levels. Among them are the 'stress'
hormones such as epinephrine (also known as
adrenaline), several of the steroids, infections, trauma,
and of course, the ingestion of food.
57. HYPOGLYCEMIA
•Hypoglycemia is a condition that occurs when
blood sugar (glucose) is too low. Blood sugar
below 70 mg/dl is considered low and termed as
Hypoglycemia.
58. Causes and Risk Factors of Hypoglycemia
•Taking insulin or diabetes medicine at the wrong time
•Taking too much insulin or diabetes medicine by
mistake
•Not eating enough during meals or snacks after taken
insulin or diabetes medicine
•Skipping meals
•Waiting to eat meals after insulin
•Exercising more or at a different time than usual
•Drinking alcohol
59. Symptoms of Hypoglycemia
•Double vision or blurred vision
•Fast heartbeat
•Feeling or acting aggressive
•Feeling nervous
•Headache
•Hunger
•Shaking
•Trouble in Sleeping
60. Symptoms of Hypoglycemia
•Sweating
•Tingling or numbness of the skin
•Tiredness or weakness
•Unclear thinking.
Sometimes blood sugar may be too low, even without
having symptoms. If blood sugar gets too low, patient
may:
•Faint
•Have a seizure or Go into a coma.
62. Treatment of Hypoglycemia
•Treatment primarily depends on the cause.
•If blood sugar is low (70 mg/dL), treat it right away.
•Give about 15 grams of carbohydrates. Examples are: A
1/2 cup (4 ounces) of fruit juice or regular, non-diet
soda, 5 or 6 hard candies, 1 tablespoon sugar, plain or
dissolved in water, 1 tablespoon honey or syrup. Wait
about 15 minutes before giving anything else. Be
careful not to over-treat by eating too much. This can
cause high blood sugar and weight gain.
63. Treatment of Hypoglycemia
•Check blood sugar again: If person does not feel
better in 15 minutes and blood sugar is still low
(less than 70 mg/dL), eat something that has 15
grams of carbohydrates again.
•Person may need to eat a snack that has
carbohydrates and protein if blood sugar is in a
safer range (over 70 mg/dL) and next meal is
more than an hour away. If these steps for raising
your blood sugar do not work, plan to administer
5% dextrose Intravenously.
64. GLUCOSE TOLERANCE TEST (GTT)
•The glucose tolerance test is a laboratory method
to check how the body breaks down (metabolizes)
sugar. The glucose tolerance test is aid to
diagnosis in diabetes mellitus. If the glucose level
peak at Higher than normal level at 1 and 2 hours
after injection or ingestion of glucose and are
slower than normal to return to fasting levels, then
diabetes mellitus is confirmed. The most common
glucose tolerance test is:
65. GLUCOSE TOLERANCE TEST (GTT)
•The oral glucose tolerance test (OGTT):
Person cannot eat or drink anything for at
least 8 hours before the test For the test,
after taking a fasting blood sample of patient,
he/she is asked to drink a liquid containing a
certain amount of glucose (usually 75 grams).
Then blood samples are taken every 30 to 60
minutes after drinking the glucose solution.
The test takes up to 3 hours.
66. GLUCOSE TOLERANCE TEST (GTT)
• The intravenous glucose tolerance test (IGT): It is rarely used, and is
never used to diagnose diabetes. In this test, glucose is injected into
vein. Blood glucose levels are measured before the injection, and again
at 1, 2 and 3 hours after the injection. However, the timing may vary.
• Indications of GTT:
• Glucose tolerance tests are one of the tools used to diagnose diabetes.
• Diabetic patients with untreated diabetes have high blood glucose
levels.
• The oral glucose tolerance test is used to screen pregnant women for
gestational diabetes tors between 24 and 28 weeks of pregnancy.
• It may also be used when the diabetes is suspected, even though the
fasting blood glucose level normal.
67. GLUCOSE TOLERANCE TEST (GTT)
•Preparation for the Test:
•Make sure that patient eat normally for several days
before the test.
•Ensure that patient has not consumed anything for 8
hours before the test and patient do not eat during test
also.
•Certain medicines also may be discontinued which may
affect the test results such as steroids, morning dose of
insulin or oral hypoglycemic medicines, etc.
68. GLUCOSE TOLERANCE TEST (GTT)
•Interpretations of GTT:
•Blood values for a 75-gram oral glucose tolerance test
used to check for type 2 diabetes:
•Fasting: 60 and 100 mg/dL
•1 hour: less than 200 mg/dL
•Between 140 and 200 mg/dL is considered impaired
glucose tolerance or prediabetes. A glucose level of 200
mg/dl. or higher is a sign of diabetes.
•Normal blood values for a 100-gram oral glucose
tolerance test used to screen for gestational diabetes:
•Fasting: less than 95 mg/dL
69. GLUCOSE TOLERANCE TEST (GTT)
• 1 hour: less than 180 mg/dL
• 2 hour: less than 155 mg/dL
• 3 hour: less than 140 mg/dL
• Nursing Considerations:
• Instruct the patient to eat a high-carbohydrate (200-300 g) diet for 3 days
before the test.
• Instruct the patient to avoid alcohol, coffee and smoking for 36 hours before
test.
• Instruct the patient to fast for 8 to10 hours before test.
• Instruct the patient to avoid strenuous exercise for 8 hours before test and
after the test.
• Instruct the patient with diabetes mellitus to withhold morning insulin or oral
hypoglycemia medications.
• Instruct the patient that the test may take 3 to 5 hours requires IV or oral
administration of glucose and multiple blood samples.