This document provides an overview of prostaglandins, leukotrienes, and thromboxanes. It discusses their introduction, classification, chemical structures, biosynthesis, regulation, mechanisms of action, functions, and applications. Specifically, it notes that prostaglandins are derived from arachidonic acid and have diverse hormone-like effects. Leukotrienes are inflammatory mediators produced from arachidonic acid oxidation. They are involved in inflammation and hypersensitivity reactions. Thromboxanes are involved in blood clotting and are derived from arachidonic acid through the action of thromboxane-A-synthase.
Chemistry of Prostaglandins, leukotrienes and thromboxanes(Advance medicinal ...Rohit kaushiK.
1st discovered in human serum in 1930, were found to be stimulate uterine contraction and reduce pressure.
Presumed to be synthesized by prostate gland hence the name.
Later found that synthesized in all tissue except erythrocytes.
It have a cyclopentane ring (formed from 8 to 12 carbon atoms) and two side chains, with carboxyl group on one side.
They differ In their structure due to substituent group double bond on cyclopentane ring.
Prostaglandins are structurally resemble with prostanoic acid, 20-carbon fatty acid.
Abbreviated as PG, with the class designated by a capital letter A,B,D,E,F,G,H and I, followed by a number.
PGE and PGF; 1st isolated from the biological fluids.
The letters refer to the different ring structure, except in PGG and PGH: same ring structure (cyclo endohydroperoxide).
In the same series, depending upon double bonds on the side chains designated as PGE1, PGE2, PGE3..etc
The number of double bonds varies from 1-3.
PROSTAGLANDINS RECEPTORS
They function close to the site of synthesis and are deactivated to inactive metabolites before moving into the circuation.
Act locally in very low concentration, and acts on GPCR receptors.
INHIBITION OF PROSTAGLANDINS
Corticosteroids (e.g. cortisol) prevent the formation of arachidonic acid by inhibiting the enzyme phospholipase A2.
Anti inflammatory drugs inhibits the synthesis of prostaglandins.
They block the action of cyclooxygenase.
Aspirin irreversibly inhibits cyclooxygenase.
DEGRADATION OF PROSTAGLANDINS
All eicosanoids are metabolized rapidly.
Degradation mainly occurs in liver and lung.
Two enzymes, namely 15-α-hydroxy PG dehydrogenase & 13-PG reductase, convert hydroxyl group at C15 to keto group & then to C13 and C14 dihydroderivative.
BIOCHEMICAL ACTION OF PROSTAGLANDINS
The Prostaglandins (PGE, PGA, & PGI2) are vasodilator in nature. So they decreases blood pressure.
PGE1 & PGE2 induce the symptoms of inflammation (redness, swelling, edema etc.) due to arteriolar vasodilator, and cause rheumatoid arthritis, psoriasis etc. so Corticosteroids are used to treat these conditions.
PGE2 & PGF2 are used for the medical termination of pregnancy and induction of labor.
Pyrogens (fever causing) promote PG synthesis leading to the formation of PGE2.
Migraine is also due to PGE2.
PGE2 along with histamine and bradykinin causes pain.
PGI2 inhibit platelet aggregation.
They are used in the treatment of gastric ulcers, hyoertention, thrombosis, asthma etc.
Prostaglandins are also employed in the medical termination of pregnancy, prevention of conception, induction of labor etc.
Leukotrienes are synthesized by leucocytes, mast cells, lung, heart, spleen etc. by lipoxygenase pathway of arachidonic acid.
Leukotrienes are 20- Carbon polyenoic fatty acids having a number of substituents.
Depending upon the substitutions, they are divided into LTA, LTB, LTD, and LTE.
Each type is divided into sub-groups depending upon the number of double bonds which vary from 3-5.
Leukotrienes possess
Here is a short an detailed explanation on nomenclature of steroids for pharmacy students. It includes all the points necessary for the topic along with an example for better understanding
Chemistry of Prostaglandins, leukotrienes and thromboxanes(Advance medicinal ...Rohit kaushiK.
1st discovered in human serum in 1930, were found to be stimulate uterine contraction and reduce pressure.
Presumed to be synthesized by prostate gland hence the name.
Later found that synthesized in all tissue except erythrocytes.
It have a cyclopentane ring (formed from 8 to 12 carbon atoms) and two side chains, with carboxyl group on one side.
They differ In their structure due to substituent group double bond on cyclopentane ring.
Prostaglandins are structurally resemble with prostanoic acid, 20-carbon fatty acid.
Abbreviated as PG, with the class designated by a capital letter A,B,D,E,F,G,H and I, followed by a number.
PGE and PGF; 1st isolated from the biological fluids.
The letters refer to the different ring structure, except in PGG and PGH: same ring structure (cyclo endohydroperoxide).
In the same series, depending upon double bonds on the side chains designated as PGE1, PGE2, PGE3..etc
The number of double bonds varies from 1-3.
PROSTAGLANDINS RECEPTORS
They function close to the site of synthesis and are deactivated to inactive metabolites before moving into the circuation.
Act locally in very low concentration, and acts on GPCR receptors.
INHIBITION OF PROSTAGLANDINS
Corticosteroids (e.g. cortisol) prevent the formation of arachidonic acid by inhibiting the enzyme phospholipase A2.
Anti inflammatory drugs inhibits the synthesis of prostaglandins.
They block the action of cyclooxygenase.
Aspirin irreversibly inhibits cyclooxygenase.
DEGRADATION OF PROSTAGLANDINS
All eicosanoids are metabolized rapidly.
Degradation mainly occurs in liver and lung.
Two enzymes, namely 15-α-hydroxy PG dehydrogenase & 13-PG reductase, convert hydroxyl group at C15 to keto group & then to C13 and C14 dihydroderivative.
BIOCHEMICAL ACTION OF PROSTAGLANDINS
The Prostaglandins (PGE, PGA, & PGI2) are vasodilator in nature. So they decreases blood pressure.
PGE1 & PGE2 induce the symptoms of inflammation (redness, swelling, edema etc.) due to arteriolar vasodilator, and cause rheumatoid arthritis, psoriasis etc. so Corticosteroids are used to treat these conditions.
PGE2 & PGF2 are used for the medical termination of pregnancy and induction of labor.
Pyrogens (fever causing) promote PG synthesis leading to the formation of PGE2.
Migraine is also due to PGE2.
PGE2 along with histamine and bradykinin causes pain.
PGI2 inhibit platelet aggregation.
They are used in the treatment of gastric ulcers, hyoertention, thrombosis, asthma etc.
Prostaglandins are also employed in the medical termination of pregnancy, prevention of conception, induction of labor etc.
Leukotrienes are synthesized by leucocytes, mast cells, lung, heart, spleen etc. by lipoxygenase pathway of arachidonic acid.
Leukotrienes are 20- Carbon polyenoic fatty acids having a number of substituents.
Depending upon the substitutions, they are divided into LTA, LTB, LTD, and LTE.
Each type is divided into sub-groups depending upon the number of double bonds which vary from 3-5.
Leukotrienes possess
Here is a short an detailed explanation on nomenclature of steroids for pharmacy students. It includes all the points necessary for the topic along with an example for better understanding
Biosynthesis and catabolism of acetylcholine. Cholinergic receptors (Muscarinic & Nicotinic) and their distribution.
Parasympathomimetic agents: SAR of Parasympathomimetic agents
What is Psychosis? Types of Psychosis, Chemical Classification of Antipsychotic drugs, SAR of Phenothiazenes and Butyrophenones, Chemistry, IUPAC nomenclature, MOA and uses of antipsychotic drugs.
MORPHINE AS A LEAD DRUG MOLECULE COMPOUNDShikha Popali
THE ADDICTED DRUG MORPHINE AN ALKALOID USED TO TREAT SOME DISEASE , HERE WE HAVE ATTEMPT ALL DATA ITS STURECTURE MECHANISM OF ACTION, SAR AND APPLICATIONS.
Introduction
Classification
Therapeutic values of peptidomimetics
Design of peptidomimetics by manipulation of amino acids
Modification of peptide backbone
Chemistry of prostaglandins, leukotrienes and thromboxanes
Stereochemistry is the ‘chemistry of space’ , that is stereochemistry deals with the spatial arrangements of atoms and groups in a molecule.
Stereochemistry can trace its roots to the year 1842 when the French chemist Louis Pasteur made an observation that the salts of tartaric acid collected from a wine production vessel have the ability to rotate plane-polarized light, whereas the same salts from different sources did not have this ability.
Isomers are compounds that contain exactly the same number of atoms, i.e., they have exactly the same empirical formula, but differ from each other by the way in which the atoms are arranged.
Constitutional isomers, also known as structural isomers, are specific types of isomers that share the same molecular formula but have different bonding atomic organization and bonding patterns.
Stereoisomers are molecules having the same molecular formula and the atomic arrangement, but differ in their spatial arrangement.
Geometric isomers are two or more coordination compounds which contain the same number and types of atoms, and bonds (i.e., the connectivity between atoms is the same), but which have different spatial arrangements of the atoms.
There are 2 types of geometric isomers, ‘cis’ and ‘trans’.-cis isomers: when similar groups are present on the same side of the double bonds, then they are termed as cis.- trans isomers: when similar groups are present on the opposite sides of the double bonds then they are called trans isomers.
cis-diethylstilbestrol has only 7% of the estrogenic activity of trans-diethylstilbesterol.
Cisplatin have anticancer activity where ae trans platin is an inactive compound.
In chemistry, a molecule or ion is called chiral if it cannot be superposed on its mirror image by any combination of rotations, translations, and some conformational changes.
Chirality is the property of being non identical to ones mirror image.
Chiral center is defined as the atom bearing 4 different atoms or group of atoms.
Molecules that form nonsuperimposable mirror images, and thus exist as enantiomers, are said to be chiral molecules.
For a molecule to be chiral, it cannot contain a plane of symmetry.
The term enantioselectivity refers to the efficiency with which the reaction produces one enantiomer.
Enantiomers are stereoisomers that are non-superimposable mirror images.
Have identical properties.
Similar shapes
Diastereomers are stereoisomers that are non superimposable and are not mirror images.
Have distinct physical properties.
Have different molecular shapes.
Enantiomers consist of a pair of molecules that are mirror images of each other and are not superimposable.
When a molecule contains only one chiral centre , the two stereoisomers are known as enantiomers.
These may be referred to or labelled using the configurational descriptors as either:
R(rectus meaning right handed) or S(sinister meaning left handed),
D(dextrorotatory)or L (laevorotatory)
E-Entgegen or Z- Zusamen
Presented by Dhanashree Kavhale. M. Pharm.(Pharmaceutical Chemistry) 1st year.
Various organic named reactions are there in Advanced Organic Chemistry I, as some of them are explained along with their mechanism.
synthesis of hetero-cyclic drugs which act as anti-malarial drugs where you get all information about synthesis, preparation, properties, uses of drugs.
Biosynthesis and catabolism of acetylcholine. Cholinergic receptors (Muscarinic & Nicotinic) and their distribution.
Parasympathomimetic agents: SAR of Parasympathomimetic agents
What is Psychosis? Types of Psychosis, Chemical Classification of Antipsychotic drugs, SAR of Phenothiazenes and Butyrophenones, Chemistry, IUPAC nomenclature, MOA and uses of antipsychotic drugs.
MORPHINE AS A LEAD DRUG MOLECULE COMPOUNDShikha Popali
THE ADDICTED DRUG MORPHINE AN ALKALOID USED TO TREAT SOME DISEASE , HERE WE HAVE ATTEMPT ALL DATA ITS STURECTURE MECHANISM OF ACTION, SAR AND APPLICATIONS.
Introduction
Classification
Therapeutic values of peptidomimetics
Design of peptidomimetics by manipulation of amino acids
Modification of peptide backbone
Chemistry of prostaglandins, leukotrienes and thromboxanes
Stereochemistry is the ‘chemistry of space’ , that is stereochemistry deals with the spatial arrangements of atoms and groups in a molecule.
Stereochemistry can trace its roots to the year 1842 when the French chemist Louis Pasteur made an observation that the salts of tartaric acid collected from a wine production vessel have the ability to rotate plane-polarized light, whereas the same salts from different sources did not have this ability.
Isomers are compounds that contain exactly the same number of atoms, i.e., they have exactly the same empirical formula, but differ from each other by the way in which the atoms are arranged.
Constitutional isomers, also known as structural isomers, are specific types of isomers that share the same molecular formula but have different bonding atomic organization and bonding patterns.
Stereoisomers are molecules having the same molecular formula and the atomic arrangement, but differ in their spatial arrangement.
Geometric isomers are two or more coordination compounds which contain the same number and types of atoms, and bonds (i.e., the connectivity between atoms is the same), but which have different spatial arrangements of the atoms.
There are 2 types of geometric isomers, ‘cis’ and ‘trans’.-cis isomers: when similar groups are present on the same side of the double bonds, then they are termed as cis.- trans isomers: when similar groups are present on the opposite sides of the double bonds then they are called trans isomers.
cis-diethylstilbestrol has only 7% of the estrogenic activity of trans-diethylstilbesterol.
Cisplatin have anticancer activity where ae trans platin is an inactive compound.
In chemistry, a molecule or ion is called chiral if it cannot be superposed on its mirror image by any combination of rotations, translations, and some conformational changes.
Chirality is the property of being non identical to ones mirror image.
Chiral center is defined as the atom bearing 4 different atoms or group of atoms.
Molecules that form nonsuperimposable mirror images, and thus exist as enantiomers, are said to be chiral molecules.
For a molecule to be chiral, it cannot contain a plane of symmetry.
The term enantioselectivity refers to the efficiency with which the reaction produces one enantiomer.
Enantiomers are stereoisomers that are non-superimposable mirror images.
Have identical properties.
Similar shapes
Diastereomers are stereoisomers that are non superimposable and are not mirror images.
Have distinct physical properties.
Have different molecular shapes.
Enantiomers consist of a pair of molecules that are mirror images of each other and are not superimposable.
When a molecule contains only one chiral centre , the two stereoisomers are known as enantiomers.
These may be referred to or labelled using the configurational descriptors as either:
R(rectus meaning right handed) or S(sinister meaning left handed),
D(dextrorotatory)or L (laevorotatory)
E-Entgegen or Z- Zusamen
Presented by Dhanashree Kavhale. M. Pharm.(Pharmaceutical Chemistry) 1st year.
Various organic named reactions are there in Advanced Organic Chemistry I, as some of them are explained along with their mechanism.
synthesis of hetero-cyclic drugs which act as anti-malarial drugs where you get all information about synthesis, preparation, properties, uses of drugs.
The principal eicosanoids of biological significance to humans are a group of molecules derived from the 20:4 (20 carbons: 4 sites of unsaturation) fatty acid, arachidonic acid.
Eicosanoids is the class of lipids derived from arachidonic acid. Eicosanoids play an important role in the growth and development, cellular signalling, drug response, platelet action and maintenance of body homeostasis.
Dr. Jibachha Sah,M.V.Sc( Veterinary pharmacology, TU,Nepal),posted lecturer notes on AUTONOMIC AND SYSTEMIC PHARMACOLOGY for B.V.Sc & A.H. 6 th semester veterinary students of College of veterinary science,Nepal Polytechnique Institute, Bharatpur, Bhojard, Chitwan, Nepal.I hope this lecture notes may be beneficial for other Nepalese veterinary students. Please send your comment and suggestion .Email:jibachhashah@gmail.com,moble,00977-9845024121
e-content of Stereochemistry for Pharmacy and Chemistry students.
contents includes Isomerism, Chirality, Stereoisomers, Enantiomer, Diastereomer, Cis And Trans Configuration ,L And D Configuration ,R And S Configuration and Importance of the chirality in drugs ,Intravenous anaesthetics , etc.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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
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
- 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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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.
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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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
2. CONTENTS :-
Eicosanoids
1. Prostaglandins
Introduction
Classification
Chemical structure
Biosynthesis of Prostaglandin
Regulation of Prostaglandin
Mechanism of action
Theraupeutic uses
2. Leukotrienes
Introduction
Biosynthesis of Leukotrienes
Mechanism of action
Function of Leukotrienes
3. Thromboxanes
Introduction
Biosynthesis of Thromboxanes
Function of Thromboxanes
Application
3. Eicosanoids
INTRODUCTION
Eicosanoids are oxidised derivatives of 20-carbon
polyunsaturated fatty acids (PUFAs) formed by the
cyclooxygenase (COX), lipoxygenase (LOX) and cytochrome .
Eicosanoids are Classified as
1. Prostanoids
• Prostaglandins
• Prostacyclins
• Thromboxanes
2. Leukotrienes
• Leukotrienes A4
• Leukotrienes B4
• Leukotrienes C4
• LeukotrienesD4
• Leukotrienes E4
4. 3. Lipoxins
• Lipoxins A4
• Lipoxins B4
All Eicosanoids contain 20 carbon atom
Eicosanoids are considred as Locally acting hormone with wide
range of biochemical Function
And also Arachidonic acid is Precursor of eicosanoids in human
beings.
6. The prostaglandins (PG) are a group
of physiologically active lipid compounds
called eicosanoids having diverse hormone-like effects in
animals. Prostaglandins have been found in almost every tissue in
humans and other animals. They are derived enzymatically from
the fatty acid that is arachidonic acid
Prostaglandin are derivative from hypothetical 20 carbon fatty
acid which is called as prostanoic acid and hence the name is
prostanoid.
7. The prostanoid has a 5 carbon cyclopentane ring which is form by
carbon 8 to carbon 12 and it has 2 side chain 1 chain of 7 carbons
these lied above plane of ring and other chain has below the ring.
Each of the biological active prostaglandin it has a hydroxyl
group at carbon number 15.
8. Classification of Prostaglandins
There is 9 classes of Prostaglandins that are
Prostaglandin A, Prostaglandin B, Prostaglandin C, Prostaglandin
D, Prostaglandin E, Prostaglandin F, Prostaglandin G,
Prostaglandin H, Prostaglandin I
Prostaglandin are classified into three series.
1 series which consist 1 double bond from linoleic acid
Prostaglandin E1.
2 series which consist 2 double bond from Arachidonic acid
Prostaglandin E2.
3 series which consist 3 double bond from Eicosapentaenoic acid
Prostaglandin E3.
9. OH
CH3
O
O
H
O OH
Prostaglandin E2
And double bond between carbon 13 and 14 various
substituent at the cyclopentane ring.
And also these structure has keto group at carbon 9 and
hydroxyl group at carbon 11.
Chemical structures
10. OH
CH3
O
H
O OH
O
H
Prostaglandin F2
These is the structure of Prostaglandine F2.
It has hydroxyl group at carbon number 9 and 11.
As other biologically active prostaglandin it has hydroxyl
group at carbon number 15.
double bond between 13 and 14.
11. Chemical structure of prostacyclins
Prostacyclins contain additional ring formed by cyclization of
side chain by linkage of carbon 6 to carbon 9 through oxygen
atom on that why it is called as Prostacyclins.
13. Thromboxane had derivatives of oxane ring and it is a six memebered
ring intrepted by oxygen atom. these is interupted by oxygen ring and
also they are synthesized from arachidonic acid.
And also it synthesize in human body and it has additional oxygen
atom joined with carbon 9 and 11.
Prostaglandin are derivative of prostanoic acid which is 20 carbon
fatty acid and they are most potent biologically substances.
It produced in almost tissue except erythrocytes.
Thromboxane
14. Prostaglandin are different from true hormone in human body
Prostaglandins are thought to be local hormone secrete by prostate
hormone.
And also prostaglandin were first isolated from prostate gland
secreation hence it named as prostaglandin.
15. Sweedish scientist Ulf van euler got nobel prize in 1970 for
discovery of prostaglandin.
Prostaglandin actually derived from fatty acid called as Arachidonic
acid which is 20 Carbon fatty acid.
16. Biosynthesis of Prostaglandin
At cellular level where are the prostaglandins produced and also
prostaglandin are very unstable compound and there half life
around 30 seconds.
Prostaglandin synthesis is take place from the membrane
phospholipids.
From the memebrane phospholipid it is cleaved by phospholipid
A2 It release precurser for prostaglandin synthesis which is
arachidonic acid.
From that arachidonic acid in sequential enzymatic step
prostaglandin would be produced.
17. This crucial step whenever it is required synthesize phospholipid
A2 releases arachidonic acid from membrane phospholipid there
by prostaglandin synthesis takes place.
Now key enzyme for prostaglandin synthesis pathway is
Prostaglandin H synthase.
Prostaglandin H synthase has 2 kind of activity one
cyclooxygenase activity and peroxidase activity.
Cyclooxygenase activity forms prostaglandin G2 from
arachidonic acid.
And also peroxidase activity that reduces prostaglandin G2 to
prostaglandin H2.
18.
19.
20. Regulation of Prostaglandin production
The prostaglandin the key raw material of prostaglandin
production is arachidonic acid derived from cell membrane.
And it is triggered by a enzyme which is phospholipase A2.
Now modulating phospholipase A2 activity the prostaglandin
production from arachidonic acid derived from cell membrane.
And it is triggered by a enzyme which is phospholipase A2
activity the prostaglandin production can be regulated.
It turns out epinephrine Thrombin, Angiotensin ll , Bradykinin,
vasopressin are positively regulate phospholiphase A2 and that
leads to production of prostaglandin.
21. Steroid kind of inhibit prostaglandin A2 activity and there by
prevent production of prostaglandin.
Prostaglandin H synthase its activity triggered by cathecolamines.
Where as it inhibit by compound like methyl salysilate and similar
compound like aspirin and others.
22.
23. Mechanism of Action
Prostaglandin found to be working G protein couple receptor
signalling pathway.
An often prostaglandin stimulation leads to increase in cyclic
Amp and protein kinase.
A activation followed by several nuclear changes in terms of
chin expression.
Several Prostaglandin has several effect on different level
example prostaglandin I2 leads to vascular dilation.
24. Whereas thromboxanes which is secreated or prevently present in
thrombocyte they induce vasoconstriction.
And also these two has opposite function.
Now prostaglandin I2 which is known as prostacyclin prevent
platelet aggregation.
Where as thromboxanes promote platelet aggregation.
In which prostaglandin F2 are stimulates uterine muscle
contraction sometimes used to terminate pregnancy.
Now Prostaglandin E and Prostaglandin F has opposing role in
terms of broncho constriction and broncho dilation.
25. Prostaglandin F leads bronchial smooth muscle constriction
where PGE leads to dilation of the bronchials.
Prostaglandin E2 and Prostaglandin D2 increase capillary
permeability enabling neutrophill and other imune cell to be
extravated from particular blood capillary near by the tissue and
it also implicate in terms of inflamation.
So that Prostaglandin E2 and prostaglandin D2 are involved in
inflammatory responses.
Now overall prostaglandin prevent are decrease gastric
secreation and increase intestinal mobility.
26. THERAUPEUTIC USES
Abortion : PGs have a place in midterm abortion, missed
abortion. Methotrexate alongwith misoprostol is also highly
successful for inducing abortion in the first few weeks of
pregnancy. Pretreatment with mifepristone improves the efficacy
of PGE2 as abortifacient.
Cervical priming : Applied Intravaginally or in the cervical
canal, low doses of PGE2 which do not affect uterine motility,
make the cervix soft and compliant.
27. Glaucoma : Topical PGF2a analogues like lanatoprost, bimatoprost
that are receptor agonists are the first choice drugs in wide angle
glaucoma.
Peptic ulcer : PGEI (misoprostol) is occasionally used for healing
peptic ulcer.
Avoid Platelet damage : PGI2 (Epoprostenol) can be used to
prevent platelet aggregation and damage during haemodialysis.
28. Leukotrienes
INTRODUCTION
Leukotrienes is kind of similar leukocytes. It kind of
associated with Leukocytes.
Trienes are tell us some features of chemical.
There are 3 consecutive double bond.
Now we understand leukotrienes as kind of chemical
molecules which might have chemical features 3
consecutive double bond found in leukocytes.
So these leukotrienes are actually a family of eicosanoids
(arachidonic acid derivatives).
29. Leukotrienes are inflammatory mediators just like other
arachidonic derivative such as prostaglandin.
Leukotrienes are a family of eicosanoid inflammatory
mediators produced in leukocytes by the oxidation of arachidonic
acid (AA) and the essential fatty acid eicosapentaenoic acid (EPA)
by the enzyme arachidonate 5-lipoxygenase.
Leukotrienes use lipid signaling to convey information to either the
cell producing them (autocrine signaling) or neighboring cells
(paracrine signaling) in order to regulate immune responses.
The production of leukotrienes is usually accompanied by the
production of histamine and prostaglandins, which also act as
inflammatory mediators.
30.
31. 5-lip-oxygenase act on arachidonic acid to form 5-
hydroperoxyeicosatetraenoic acid .
Acts and associate with 5-lox activating protein.
The 5HPETE later converted into leukotriene A4 also it is unstable
and rapidly hydrolyse by the action of enzyme by leukotriene A4
hydrolase to form leukotriene B4 in neutrophils and monocytes.
The LTB4 is one of the most potent inflammation mediating lipids.
And LTA4 (Leukotriene A4) which forms leukotriene C4 which
incorporate with glutathion and with action of LTC4 synthase it
forms leukotrienes C4.
Biosynthesis of Leukotrienes
32. This forms in mast cells and eosinophills.
Later Leukotriene C4 release glutamate to forms leukotriene D4.
Later leukotriene D4 release glycine it forms leukotriene E4.
33.
34.
35. MECHANISM OF ACTION
Which is usually accompanied with the production of
prostaglandins and histamines which are inflamattory
mediators from arachidonic acid there could be production of
leukotrienes and also in otherside which form prostaglandin
derivatives which also take part in inflammatory response.
Leukotrienes receptors are class of G-Protein couple receptor
so generally work by elevation of cyclic Amp in the cell and
leads to several inflammatory cytokinin genes.
But few leukotrienes receptor also nuclear receptor type.
36. And these receptor generally found in easinophil, endothelial
cells, mast cells.
In endothelial cells and also found in smooth muscles cells
important role in smooth muscle contraction and they form
physiological role incase of disease.
37. Function of Leukotrienes
Major role of leukotrienes (specially, leukotrienes D4) is to trigger
contraction in the smooth muscle lining the bronchioles.
Contraction of branchioles is triggered by leukotriene and these is
the key underline feature rhinitis or asthma like diseases.
Leukotrienes contribute to the pathophysiology of asthma,
especially in patients with aspirin. Exacerbated respiratory disease
whose symptoms are
Airflow obstruction, Increased secretion of mucus, Mucosal
accumulation, Broncho constriction, Infiltration of inflammatory
cells in the airway wall.
39. Excess of leukotriene leads to anaphylactic shock
And also leukotrienes inhibitors could be useful for patients with later
stages of alzheimer disease.
And also improve memory loss
And also Leukotrienes classified as
Leukotrienes A4
Leukotrienes B4
Leukotrienes C4
Leukotrienes D4
Leukotrienes E4
Leukotrienes designated as 4 because 4 double bond in their structures
are
40. Leukotrienes are involved in the inflammation and immediate
hypersensitivity reaction.
Leukotriene B4
Increased chemotaxis of polymorphonuclear leukocytes.
Chemotaxis are directed migration of cell in response to
chemical stimulus such as growth factor.
Release of lysosomal enzymes, adesion of white blood cells.
41. Leukotriene C4 , Leukotriene D4, Leukotriene E4
• Involved in contraction of smooth muscle.
• They cause Bronchoconstriction, and Vasoconstriction.
• They also called as slow reacting substance of anaphylaxis.
• Anaphylaxis is seveir potentially life threatening allergic reaction.
• And this reaction occur within seconds or minutes of exposure to
allergens.
42. Thromboxanes
INTRODUCTION
Thromboxane is named for its role in clot formation.
Thromboxane is a member of the family of lipids known as
eicosanoids and also it is derived from arachidonic acid.
Arachidonic acid get converted into thromboxane A2 and
thromboxane B2.
Key enzyme help in these process is known as
thromboxane-A-synthase.
Both thromboxanes are characterized as 6-membered ether
containing cyclic ring.
43.
44. Biosynthesis of Thromboxanes
o Thromboxanes is synthesized in platelet.
o On the platelet membrane they would be phospholiphase and these
would generate arachidonic acid.
o The arachidonic acid converted initially prostaglandin H2 with the
help of cyclo oxygenase.
o Later prostaglandin H2 is converted into either prostacyclin with the
help of prostacyclin synthase or it can converted into thromboxane
A2 with the help of Thromboxane A synthase.
o These Thromboxane A Synthase enzyme exclusively present in the
platelet membrane. Platelet is the site of thromboxane production.
45. Thromboxane once generated can bind to thromboxane receptor
present in wide variety of cell for example blood vessel.
Thromboxane ultimately leads to G-protein mediating signalling
which elevates calcium level in cytoplasm.
Once calcium level elevated it helps in clot formation or
eventually in vasoconstriction.
46.
47. Function of Thromboxanes
One of the major function of the thromboxane is to perform
vasoconstriction.
Thromboxane and prostacyclin has opposite role.
Prostacyclin has vasodilatory role where as thromboxanes has
vasoconstriction role.
And also vasoconstriction caused by thromboxanes play a role in
prinz metal ’s angina and blocked coronary artery.
Any kind of cardiac inflammatory disease one of the leading role
could be played by thromboxanes.
In immune diet if human body has sufficient omega 3 fatty acid
thromboxane A3 has generated instead of thromboxane A2.
48. While thromboxane A2 is potent vasoconstrictor and thromboxane
A3 is less potent vasoconstrictor.
Vasoconstriction mediated effect is less if diet contain omega 3
fatty acid
In this synthesis of thromboxane by blocking cycloxygenase
specific substance such has aspirin can block production of
thromboxane.
Other than thromboxane synthase inhibitor inhibit thromboxane
A-synthase.
49. APPLICATION OF THROMBOXANES
Thromboxanes exert hormone-like Application.
They interact with G-protein-linked receptors on the cell surface
to activate signal transduction pathways inside the cell.
TXs modify inflammatory responses but are most well-known for
their role in platelet aggregation, vasoconstriction, and smooth
muscle proliferation – they are an essential part of the wound
repair mechanism.
Thromboxane synthesis and thus platelet aggregation is inhibited
by non-steroidal anti-inflammatory drugs like aspirin.