The document summarizes the changes to the respiratory system during pregnancy. Key changes include increased chest diameter and elevation of the diaphragm. Lung volumes like functional residual capacity decrease while tidal volume increases, leading to higher minute ventilation. This causes a respiratory alkalosis with lower PaCO2 and bicarbonate. Dyspnea is common due to the higher work of breathing but is usually benign.
Detailed account of the various changes that occur in maternal anatomy, physiology, and metabolism of pregnant women. These physiological changes are often very precise, and deviations of physiological responses can be a prelude to possible disease/infectious states. In this second part of Labor, we will examine the various systems of the human body,its altered states during pregnancy, and how those changes affect the woman preparing for delivery. Special care is imperative in properly determining the needs of an expecting mother, so developing an intimate, trusting relationship between the mother and fully understanding her physiological output will lead to the best chances of a successful delivery.
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients.
Differences between Paediatric and Adult airway gourav_singh
These slides contain a brief discussion about what all common differences between pediatric and adult airway can be found if you are in an ENT OPD or during Anesthesia.
Just a brief discussion.
Detailed account of the various changes that occur in maternal anatomy, physiology, and metabolism of pregnant women. These physiological changes are often very precise, and deviations of physiological responses can be a prelude to possible disease/infectious states. In this second part of Labor, we will examine the various systems of the human body,its altered states during pregnancy, and how those changes affect the woman preparing for delivery. Special care is imperative in properly determining the needs of an expecting mother, so developing an intimate, trusting relationship between the mother and fully understanding her physiological output will lead to the best chances of a successful delivery.
Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients.
Differences between Paediatric and Adult airway gourav_singh
These slides contain a brief discussion about what all common differences between pediatric and adult airway can be found if you are in an ENT OPD or during Anesthesia.
Just a brief discussion.
obstetric and gyneacology; Changes in pregnancy, cardiovascular changes, respiratory changes, endocrine changes, gastrointestinal changes, related organ changes in pregnancy. hormonal changes during pregnancy.
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
Changes in Respiratory System with Various Physiological ConditionsAnand Bansal
Topics - High-Altitude Physiology, Deep Sea Diving And Effects Of Increased Barometric Pressure, Changes In Respiratory System During Pregnancy, Physiological Changes Of Repiratory System With Exercise, Physiological Changes Of Respiratory System With Aging
Has it been awhile since the birth of your baby?
Have you tried all of the popular core exercises you know and still that stubborn belly just won't go away?
Does your tummy pooch feel like a wet noodle while you are walking around?
Has your "innie" belly button become and "outtie" without your permission?
Is your lower back giving you problems?
Is the pain persistent?
If you are experiencing most or ALL of these symptoms on a regular basis, then you may be suffering from “Diastasis Recti”, also known as Rectus Diastasis.
, on 7 January, Chinese authorities confirmed that they had identified a new virus. The new virus is a coronavirus, which is a family of viruses that include the common cold, and viruses such as SARS and MERS.
This new virus was temporarily named “2019-nCoV
Bacterial flora in sputum and antibiotic sensitivity in exacerbations of bron...Dr.Aslam calicut
http://jmscr.igmpublication.org/home/index.php/current-issue/5487-bacterial-flora-in-sputum-and-antibiotic-sensitivity-in-exacerbations-of-bronchiectasis
http://jmscr.igmpublication.org/v6-i8/65%20jmscr.pdf
Muhammed Aslam et al JMSCR Volume 06 Issue 08 August 2018
Obstructive Sleep Apnoea and the Metabolic SyndromeDr.Aslam calicut
Introduction
OSA and the Metabolic Syndrome
OSA and Obesity
OSA and Hypertension
OSA and Insulin Resistance
OSA and Dyslipidemia
Pathogenesis
Effect of Treatment
Conclusion
Napcon 2014 presentation abstract Page 14 - Presentation28
High Dose Rate Endobronchial Brachytherapy for Palliative Treatment of Lung Cancer – A Case Report Muhammed Aslam N K , Rajeev Ram , Achuthan V , Manoj D K ,Rajani M Pariyaram medical colleg , kannur
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
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
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
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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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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
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.
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
2. INTRODUCTION
• The anatomic and physiological changes of pregnancy
have major pulmonary and cardiovascular
consequences throughout the gravid period.
• Physiological values and requirements, as well as
normal laboratory assessment parameters, dynamically
changes.
• An appreciation of these changes is essential to
understanding the clinical cardiopulmonary
manifestations of both pre existing diseases during
pregnancy and cardiopulmonary diseases that may be
unique to pregnancy
3. ANATOMIC CHANGES OF NORMAL
PREGNANCY
Upper Airways
• Hyperemia, friability, mucosal edema, and
hypersecretion of the airway mucosa -- most
pronounced in the upper airways, especially during the
third trimester
• Nasal obstruction, epistaxis, sneezing episodes, and
vocal changes may occur, and these may worsen when
the individual lies down.
• Nasal and sinusoidal polyposis is often seen and tends
to recur in women with each pregnancy
4. • Recurrent or chronic “head colds,”
• Nasal obstruction may contribute to upper airway
obstruction during sleep, leading to snoring and even
obstructive sleep apnea.
5. Clinical consequences of the anatomic
changes of the upper airway
• Preferential mouth breathing and intolerance of nasal
cannula delivery of oxygen.
• Nasopharyngeal obstruction may make the pregnant
individual poorly tolerant of the introduction of
nasogastric tubes, nasal airways, or nasotracheal tubes
• Small endotracheal tubes, 6.0 mm or less, may be
advised
6. Lower airways
• Mucosal changes that affect the upper airwaysmay also
occur in the central portion of the airway, such as the
larynx and trachea.
• Nonspecific complaints of airway irritation, such as
irritant cough or sputum production
7. • The physiological causes of nasal mucosal changes
appear to be predominantly mediated by estrogens.
• Estrogens increase tissue hydration and edema. They
also cause capillary congestion and hyperplastic and
hypersecretory mucous glands.
8. RespiratoryMuscles and the Thoracic Cage
• The enlarging uterus produces upward displacement of
the diaphragm → increase in the anteroposterior and
transverse diameters of the thoracic cage
• Diaphragm may be elevated up to 4 cm cephalad, but
diaphragmatic function is not impaired
• Thoracic cage increase by 5-7 cm in circumferance
• Diaphragmatic excursion during breathing may be
greater in pregnancy than during the puerperium
,suggesting that breathing may be more diaphragmatic
than costal during pregnancy
9. • Progressive relaxation of the ligamentous attachments of
the ribs broadens the subcostal angle by approximately
50 percent (from68 to 103 degrees).Consequently, there
is a 5- to 7-cm increase in chest circumference.
• The shortening and widening of the thoracic cavity
results in upward and lateral displacement of the cardiac
apex on chest radiography.
10. PHYSIOLOGICAL CHANGES
• Enlarging uterus cause serial changes in lung volumes
• Expiratory reserve volume decreases by 8 to 40 percent
• Residual volume decreases by 7 to 22 percent
• 10 to 25 percent decrease in functional residual capacity
after the fifth or sixth month of pregnancy (more
pronounced in the supine position)
• Inspiratory capacity increases (due to the
counterbalancing effects of widening of the lower rib
cage, attenuation of the abdominal musculature, and
unimpaired diaphragmatic movement)
• Vital capacity preserved
11. • Total lung capacity minimally decrease in the third
trimester
• Residual volume to total lung capacity ratio is low in the
third trimester.
• In late pregnancy, airway closure may occur at a lung
volume close to or greater than functional residual
capacity (more significant in the supine position)
12. Increased gastric and esophageal pressure occurring in
late pregnancy
Decrease in transpulmonary pressure
Peripheral airway collapse
13. • Tidal volume increases 30 to 35 ( increased ventilatory
drive )
Increase in minute ventilation
• Respiratory rate either does not change appreciably or
increases slightly.
• Maximum voluntary ventilation does not change greatly
14. • FEV1 -- not significantly different.
• Progressive increases of airway conductance occur
between 6 months of pregnancy and term with a
decrease in airway resistance.
• Total pulmonary resistance is reduced by 50 percent.
• Lung compliance does not change significantly.
• Compliance of the thoracic cage decreases
15. Lung volume changes associated with pregnancy
Although total lung capacity, residual volume, and expiratory reserve volume
diminish, vital capacity is preserved in values similar to nonpregnant women
16. • In early pregnancy Diffusing capacity is either
unchanged or slightly increased
• Rest of pregnancy, the diffusing capacity decreases.
• Carbon dioxide production and oxygen consumption
increase (increase in basal metabolic rate, coupled with
growth in the mass of fetal and maternal tissue and a
small increase in cardiac and respiratory work)
17. • Since the increase in minute ventilation is approximately
two times greater than the increase in oxygen
consumption, without significant change in respiratory
exchange ratio, the increased respiratory drive of
pregnancy results in alveolar hyperventilation.
• Progesterone levels increase gradually during
pregnancy from 25 ng/ml at 6 weeks to 150 ng/ml at 37
weeks
18. • The increase in minute ventilation results in a respiratory
alkalosis with compensatory renal excretion of
bicarbonate
• PCO2 falls to levels of 28 to 32 mmHg.
• Arterial pH is maintained in the range of 7.40 to 7.45
• Bicarbonate decreases to 18 to 21 mEq/L
19. • The increase in ventilatory drive and the decrease in
functional residual capacity accelerate induction and
recovery from inhalational anesthesia.
20. • The decrease in functional residual capacity, the
increase in closing volumes, and the increase in oxygen
consumption lead to a more precipitous decline in
arterial PO2 in pregnant patients who are apneic or
hypoventilating
21. During parturition
• Respiratory responses during parturition are greatly
affected by stage of labor and the response to pain and
anxiety.
• During labor, tidal volumes ranges from 350 to 2250 ml
and minute ventilations from 7 to 90 L/min
22. Physiologic Dyspnea of Pregnancy
• The increase in minute ventilation that accompanies
pregnancy is often perceived as shortness of breath.
• Shortness of breath at rest or with mild exertion is so
common that it is often referred to as „„physiologic
dyspnea.‟‟
• The increase in minute ventilation and the load imposed
by the enlarging uterus cause an increase in the work of
breathing.
• Other factors contribute to the sensation of dyspnea
include increased pulmonary blood volume, anemia, and
nasal congestion
23. • Differentiate the normal dyspnea of pregnancy from that
due to disease pathology.
• Pathologic dyspnea : increased respiratory rate greater
than 20 breaths per minute, arterial PCO2 less than 30
or greater than 35, hypoxemia or abnormal measures on
forced expiratory spirometry, or cardiac
echocardiography
• Abrupt or paroxysmal episodes of dyspnea suggest an
abnormal condition