Case history.ppt
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This document outlines the key components and procedures involved in performing a case history and external eye exam as the initial steps of an optometric examination. It discusses the importance of the case history for determining the appropriate tests and leading to an accurate diagnosis. The case history should gather information on the chief complaint, medical history, visual/ocular history, and family history. The external eye exam uses the slit lamp biomicroscope to examine the lids/lashes, conjunctiva, iris, and crystalline lens through specific illumination and magnification settings while instructing the patient to move their eyes in different positions.
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Presbyopia is a normal condition associated with aging where the eye's ability to accommodate starts to decline, making it difficult to focus on close objects. The decline is caused by a stiffening lens and weakening ciliary muscle. Aphakia is the absence of the crystalline lens, usually due to congenital conditions, trauma, or surgery. Pseudophakia refers to an eye with an artificial intraocular lens implant. Accommodation is the eye's ability to change focus by altering the shape of the crystalline lens. It allows viewing of near objects. The mechanisms involves contraction of the ciliary muscle and relaxation of the suspensory ligaments to make the lens more convex. Hypermetropia is caused by
contact_lenses_(1)_continued.pptx
Modern contact lenses are classified as either hard or soft. Hard contact lenses include PMMA and RGP lenses. PMMA lenses were the first rigid lens material patented in 1934 and have good optical properties but extremely low oxygen permeability. RGP lenses allow oxygen to pass through and are more durable than soft lenses, though initially less comfortable. Soft contact lenses are made of polymers that absorb water, such as poly HEMA, which increases their oxygen permeability and makes them more comfortable and pliable than hard lenses.
Accommodation_&_convergence.pptx
This document discusses accommodation and convergence in the eye. It defines accommodation as the ability of the eye to focus on near objects and convergence as the inward movement of the eyes. It describes how accommodation and convergence are measured in diopters and meters respectively. The document also explains that accommodation and convergence are linked (accommodative convergence) and how the ratio between the two (AC/A ratio) is important for diagnosing certain eye conditions.
normal and abnormal field (1).pptx
Visual field testing should be performed if a patient has symptoms of central vision loss, glaucoma or risk factors for glaucoma, symptoms of a neurological disease, symptoms or signs of a retinal disease, an abnormal repeatable screening, or if they are at risk for developing drug-related retinopathy such as from hydroxychloroquine use.
Dispensing BSc (3) (1).pptx
The document discusses best form lenses and meniscus lenses. Meniscus lenses minimize two types of optical aberrations. Standard meniscus lenses have a base surface, usually +6.0D, +9.0D or +12.0D, and a combining surface ground to the prescription. Transposition changes a lens prescription from plus to minus cylinder form by algebraically summing the sphere and cylinder, changing the cylinder sign, and adjusting the axis 90 degrees.
null-2.ppt
Biometry is the measurement and analysis of people's physical and behavioral characteristics. It is used in identification and access control, including fingerprint, face, iris, and voice recognition. Biometric technologies compare a person's characteristics to templates stored in a database to verify or determine identity.
contact_lens_solutions.pptx
This document discusses contact lens solutions and accessories. It explains that various solutions and proper patient education are required to fit, wear, and maintain contact lenses safely and avoid ocular damage. Specifically, it outlines the importance of tonicity, pH, viscosity, preservatives, and shelf life of solutions. It also describes different types of solutions for hard and soft lenses as well as accessory solutions for irrigation and staining.
Dispensing BSc (2).pptx
This document discusses key optical properties and measurements of lenses, including:
- Vertex power and surface power measurements for thick and thin lenses. Spectacle lenses are considered thin lenses.
- Equivalent power is measured from either focus to the principal point and is equal from both sides, though principal points cannot be physically located.
- Combining multiple lenses uses algebraic summation of their powers.
- Spectacle correction aims to provide a sharp retinal image, though magnification from non-matching lenses between eyes can impact vision.
- Back vertex distance and lens power, shape, and thickness determine a lens's effective power and magnification. Plus lenses magnify and minus lenses minify.
Contact_lenses
This document discusses different types of contact lenses, including corneal (rigid) contact lenses and hydrogel contact lenses. Corneal contact lenses are made of materials like PMMA and silicone and have advantages like excellent visual acuity and ability to correct corneal astigmatism. However, they are less comfortable than soft lenses and have a longer adaption period. Hydrogel lenses are soft and flexible and made of materials like HEMA. They are comfortable, easy to fit, and correct astigmatism up to 1.00D, but have shorter lifespan and require more complex care. The document also covers manufacturing methods for contact lenses.
Contact lens
This document discusses contact lenses, including their history, advantages over eyeglasses, ideal properties, and materials. Contact lenses are small medical devices that are placed directly on the cornea to correct refractive errors. Some key advantages over eyeglasses are a wider field of view, avoidance of prismatic effects and reflections, and better cosmetic appearance. The ideal contact lens material would provide sufficient oxygen to the cornea, be optically transparent, dimensionally stable, and biocompatible while requiring minimal care. Modern materials include plastics that are easy to manufacture and polish.
Dispensing BSc (1).pptx
This document defines key terms related to dispensing spectacles, including that dispensing involves making and fitting corrective lenses and frames. It describes the job of opticians is to transform prescriptions into comfortable, attractive glasses that provide the prescribed visual improvement. Corrective lenses, including glasses, contacts, and IOLs, are used to treat various vision conditions by bending light before it reaches the eye.
Applied_physiology.pptx
The document discusses the physiological effects of contact lens wear on the cornea. It states that contact lenses occlude the cornea from its normal oxygenated environment. This can lead to hypoxia (reduced oxygen supply) and hypercapnia (carbon dioxide accumulation) in the cornea. Prolonged hypoxia can decrease corneal sensitivity and make the epithelium more fragile. When the eye is closed during sleep or extended wear, the cornea experiences increased temperature, hypotonic tears, lowered pH, and even less oxygen. These changes can impact the cornea's structure and function over time.
Management of tropia by prisms.pptx
Hetrotropia is a condition where one or both eyes are not directed at the fixation point. There are different types of strabismus classified by direction of deviation and constancy. Prisms can be used to relieve diplopia by placing the base over the weak eye to redirect the image. The Krimsky or corneal light reflex test assesses ocular alignment by observing symmetry of the light reflexes. An asymmetrical reflex indicates an imbalance like esotropia or exotropia.
Fixation_disparity.pptx
Panum's area allows for slight vergence errors when binocularly fixating and fusing a contour. Fixation disparity (FD) refers to a small misalignment of the visual axis under binocular conditions and is smaller than a squint. While strabismus prevents binocular single vision, FD maintains it but may reduce stereopsis. The Mallett unit is used to measure and neutralize FD by detecting horizontal or vertical misalignments and introducing prism corrections. FD increases under stress and its presence indicates a decompensated phoria requiring further testing.
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Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
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Nano-gold for Cancer Therapy chemistry investigatory project
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The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
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Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
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Patellar Instability: Diagnosis Management
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
RESPIRATORY DISEASES by bhavya kelavadiya
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
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- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
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Case history.ppt
- 1. Case history
- 2. Case history ◉ Is the cornerstone of an optometric examination. ◉ Role and significance: ◉ To determine which specific tests or procedures should be performed during the examination and, after interpretation and analysis, ultimately will lead to a definitive diagnosis and management plan.
- 3. ◉ Essentials questions: I. Does the patient have a problem ?. II. What is the specific problem ? III. What is or will be the effect of the problem on the patient performance? Cont :
- 4. ◉ Case history elements: ◉ Chief complaint: What is the problem? What is the reason for this visit? What brings you to day? Cont :-
- 5. ◉ Medical history: ◉ Are you in good general health? ◉ Do you have any health problem? ◉ Do you have any health problems such as high blood pressure or diabetes? Cont :-
- 6. ◉ Visual and ocular history: ◉ When was you last eye examination? ◉ How long have you wearing glasses? ◉ Have you ever had an eye diseases ,injuries , or surgery? Cont :-
- 7. ◉ Family ocular history: ◉ Has any one in your family had an eye disease such as cataract, or glaucoma? ◉ Family medical history: ◉ Does any one in your family have any systemic health problems such as high blood pressure or diabetes? Cont :-
- 10. Lids and lashes Use diffuse illumination with the illumination arm set approximately 30 from the straight ahead position. Set the magnification on a low setting (6x or 10x). Instruct the patient to close his eyes. Starting at the temporal canthus , scan across the upper lid and lashes Instruct the patient to open his eyes . Scan from nasal to temporal across the lower lid and lashes
- 12. dit
- 14. conjunctiva Narrow beam to a wide parallelepiped, with the illumination arm set approximately 30 degree from the straight ahead position Keep the magnification on a low setting Instruct the patient to open his eyes and look up. Inform the patient that you are going to touch his lower lid. Place your index finger close to the patient lower lash margin and evert the lower lid . Scan the inferior palpebral and bulbar conjunctiva
- 15. conjunctiva You should be scanning from temporal to nasal. Instruct the patient to look down. Inform the patient that you are going to touch his upper lid .place your thumb close to upper lash margin and elevate the lid .scan across the superior bulbar conjunctiva . Instruct the patient to look first to the left and then to the right ,while you scan the nasal and temporal bulbar conjunctiva. If indicated ,evert the upper lid at this time
- 20. Iris Increase the slit width to a wide parallelepiped 3mm. Keep the magnification at medium setting. Instruct the patient to look straight ahead. Scan across the iris surface looking for irregularities Note the pupillary light reflex.
- 21. Crystalline lens Narrow the angle of illumination arm to about 10-20 degree. Magnification at medium setting. Reduce the slit beam to a narrow parallelepiped Slowly move the slit lamp closer to the patient until the light is direct through the pupil and becomes sharply focus on the anterior surface of the lens Then move the biomicroscope closer to the patient to examine the deeper layers of the lens.
- 23. THANK YOU