Centrally acting muscle relaxants work in the central nervous system to reduce muscle tone without affecting consciousness. They selectively depress polysynaptic reflexes in the spinal cord and brain that are involved in regulating muscle tone. They also depress pathways in the brainstem that maintain wakefulness, but to a lesser degree. Common classes of centrally acting muscle relaxants include mephenesin congeners, benzodiazepines, GABA mimetics, and central α2 agonists. Examples are carisoprodol, diazepam, baclofen, and tizanidine. These drugs are used to treat muscle spasms, spasticity, and pain conditions involving muscle spasms.
Sedative-hypnotics are a class of drugs that cause a dose-dependent depression of the CNS function, inducing sedation, sleep, and unconsciousness with increasing dose. Agents in this class of drugs include benzodiazepines and Z-drugs, barbiturates, and melatonin agonists. Most of the sedative-hypnotic drugs affect GABAergic transmission, increasing the inhibition of neuronal excitability, with the exception of melatonin agonists, which act on hypothalamic melatonin receptors. Sedative-hypnotic drugs are used as anxiolytics, sedatives, muscle relaxants, anesthetics, and anticonvulsants. Common side effects result from excessive CNS depression and include confusion, drowsiness, somnolence, and respiratory depression. Long-term use of sedative-hypnotics is associated with a risk of dependence.
Sedatives & Hypnotics
Sedatives
➢ It is a drug that reduces excitement and calms the person
➢ A drug that reduces excitement, calms the patient (without inducing sleep)
➢ Sedatives in therapeutic doses are anxiolytic agents
➢ Most sedatives in larger doses produce hypnosis (trans like state in which
subject becomes passive and highly suggestible)
Impact of drug therapy on various neurological conditions and its effects on rehabilitation; conditions like stroke, parkinson's disease,vertigo and also its effects on various impairments like spasticity, sensory impairments, cognition
Respiratory stimulants: types, complete discussion on indications, contraindications, assessment, patient notes and examples of stimulants both central and respiratory
Expectorants and Antitussives: types, complete discussion on indications, contraindications, assessment, patient notes and examples of expectorants and antitussives
Complete pharmacology of Non steroidal Anti inflammatory Drugs, classification, Mechanism of action, Pharmacological actions, Indications, Contraindications, Adverse effects
Pharmacology laboratory experiment, both invivo and invitro includes interpolation, matching , bracketing, three point, four point bioassays with a note on hypoglycemic activity, acute skin irritation, acute eye irritaiton, pyrogen test, gastrointestinal motility test, physiological salt solutions
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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
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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.
2. • These are drugs which reduce skeletal muscle tone by a
selective action in the cerebrospinal axis, without altering
consciousness.
• They selectively depress spinal and supraspinal polysynaptic
reflexes involved in the regulation of muscle tone without
significantly affecting monosynaptically mediated stretch
reflex.
• Polysynaptic path ways in the ascending reticular formation
which are involved in the maintenance of wakefulness are also
depressed, though to a lesser extent.
3. • All centrally acting muscle relaxants do have some sedative
property.
• They have no effect on neuromuscular transmission and on
muscle fibres, but reduce decerebrate rigidity, upper motor
neurone spasticity and hyperreflexia.
9. 1. Mephenesin
• It was the first drug found to cause muscle relaxation in animals without
producing unconsciousness and was called internuncial neurone blocking
agent because its primary site of action is the spinal internuncial neurone
hitch modulates reflexes maintaining muscle tone.
• It is not used clinically because orally it causes marked gastric irritation,
and injected i.v., it causes thrombophlebitis, haemolysis and fall in BP.
• It has been included in counterirritant ointments (MEDICREME,
RELAXYL) where its irritant rather than muscle relaxant property could be
affording relief.
10. 2. Carisoprodol
• It has a favourable muscle relaxant: sedative
activity ratio with weak analgesic, antipyretic and
anticholinergic properties.
• It is used in musculoskeletal disorders associated with
muscle spasm.
11. 3. Chlorzoxazone
• It is pharmacologically similar to Mephenesin, but
has a longer duration of action and is better tolerated
orally.
12. 4. Chlormezanone
• It has antianxiety and hypnotic actions as well, and
has been used for tension states associated with
increased muscle tone.
13. 5. Methocarbamol
• It is less sedative and longer acting than Mephenesin.
• Orally it has been used in reflex muscle spasms and chronic
neurological diseases.
• It can be injected i.v. Without producing thrombophlebitis and
haemolysis— used for orthopaedic procedures and tetanus.
14. 6. Diazepam
• It is the prototype of benzodiazepines (BZDs) which act in the brain on
specific receptors enhancing GABAergic transmission.
• Muscle tone is reduced by supraspinal rather than spinal action; muscle
relaxant : sedative activity ratio is low.
• No gastric irritation occurs and it is very well tolerated, though sedation
limits the dose which can be used for reducing muscle tone.
• It is particularly valuable in spinal injuries and tetanus. Combined with
analgesics, it is popular for rheumatic disorders associated with muscle
spasm.
• Dose: 5 mg TDS orally, 10–40 mg i.v. (in tetanus).
15. 7. Baclofen
• This analogue of the inhibitory transmitter GABA acts as a
selective GABAB receptor agonist.
• The GABA receptors have been divided into:
1. GABAA receptor Intrinsic ion channel receptor
• which increases Cl¯ conductance; blocked by
bicuculline; facilitated by BZDs.
2. GABAB receptor G-protein coupled receptor;
• hyperpolarizes neurones by increasing K+
conductance and altering Ca2+ flux; bicuculline
insensitive, but blocked by saclofen.
16. Uses
1. Acute muscle spasms Over stretching of a muscle, sprain,
tearing of ligaments and tendons, dislocation, fibrositis,
bursitis, rheumatic disorders, etc. cause painful spasm of
muscles.
2. Torticollis, lumbago, backache, neuralgias These are other
conditions in which painful spasm of certain muscles is a
prominent feature; respond in the same way as acute muscle
spasms.
17. 3. Anxiety and tension Increased tone of muscles often attends these states.
Diazepam group of drugs and Chlormezanone benefit by their antianxiety
as well as muscle relaxant actions.
• Spastic neurological diseases Impairment of descending pathways in the
cerebrospinal axis and withdrawal of inhibitory influence over the stretch
reflex causes chronic increase in muscle tone or spasticity.
• Hemiplegic, paraplegia, spinal injuries, multiple sclerosis, ALS and
cerebral palsy fall in this category.
• These conditions are benefited by Baclofen, diazepam, tizanidine and
dantrolene but not by Mephenesin group of drugs.
18. 5. Tetanus Most commonly diazepam is infused i.v. and the
dose is titrated by the response.
6. Electroconvulsive therapy Diazepam decreases the
intensity of convulsions resulting from ECT, without
diminishing its therapeutic effect.
7. Orthopaedic manipulations These procedures may be
performed under the influence of diazepam or
Methocarbamol given i.v.