This document discusses cyanosis in children. It defines cyanosis as a bluish discoloration of the skin caused by increased reduced hemoglobin. There are two types: peripheral cyanosis caused by slowed blood flow and central cyanosis caused by low oxygen saturation. Causes of central cyanosis include respiratory disorders like pneumonia, cardiac disorders like congenital heart diseases, and neurological disorders like seizures. Management involves diagnosis of the underlying cause through history, exams, oxygen testing, and imaging like echocardiograms. Treatment depends on the specific condition but may include oxygen, antibiotics for infection, or surgery for heart defects.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
most common congenital cyanotic heart disease.one of the conotruncal family of heart lesions.. It accounts for 7 to 10% of all congenital heart abnormalities.
Congenital heart disease is one or more problems with the heart's structure that exist since birth. Congenital means that you're born with the defect. Congenital heart disease, also called congenital heart defect, can change the way blood flows through your heart. IF YOU LIKE GIVE YOUR LIKES AND FOLLOW THIS LINK
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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
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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.
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.
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.
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. Presented by :
Group C4
5th year medical students
Tripoli university
Pediatric
3. Objectives
Definition of cyanosis
Types of cyanosis
Causes of cyanosis
Complications
Management
4. Cyanosis is derived from the colour ‘cyan’, which comes
from ‘kyanous’, the Greek word for blue .
Definition:
It is Bluish discoloration of skin and mucous membrane
caused by increase concentration of reduced
hemoglobin > 5g/dl
so its not less pronounced if the child is anemic.
6. Peripheral cyanosis (blueness of hands &feet)
Normal systemic arterial oxygen saturation.
The increased extraction of oxygen
results from sluggish movement of blood
through the capillary circulation
Sites
Tip of nose
Ear lobules
Outer aspect of lips,chin,cheek
Tips and nailbeds of fingers,toes
Palms,soles Tongue is spared
8. Central cyanosis
Pathologic condition caused by
reduced arterial oxygen saturation.
due oxygenation defect in lung or admixture of
venous and arterial blood
Involves highly vascularized tissues, through which
blood flow is brisk .
Cardiac output typically is normal, and patients have
warm extremities.
It is evident when O2 saturation falls below 90%
From 90_95% (desaturated)
9. Sites:
Tongue (margins & undersurface)
Inner aspect of lips
Mucous membranes of gums ,soft palate
,cheeks
10.
11. Causes of central cyanosis
1_Respiratory disorders :
upper airway obstruction
Respiratory distress syndrome (RDS)
Meconium aspiration(MAS)
Pneumonia (sepsis)
PPHN_Failure of pulm.vascular resistance to fall after
birth
Pulmonary hypoplasia
Bronchopulmonary dysplasia(mechanical ventilation)
Congenital diaphragmatic hernia
Asthma
12. 2_CNS disorders:
ICH
Birth asphyxia
Seizures
Oversedation (direct or through maternal route)
13. 3_Cardiac disorders:
Cyanotic congenital heart diseases (right to left shunt)
5Ts
Tetralogy of Fallot (TOF)
Transposition of great vessels(TGA)
Total anomalous pulmonary venous return
Truncus arteriosus
Tricuspid atresia
Note: persistant cyanosis in otherwise well infant is nearly
always a sign of CHD
16. Differential Cyanosis
Hands red (less blue) and feet blue seen in PDA with
reversal of shunt (Differential Cyanosis) Requires
pulmonary vascular resistance elevated to a systemic level
and a patent ductus arteriosus
Left to right sunt pulmonary HT reversed shunt
(Rt Lt shunt)
Desaturated blood from the ductus enters the aorta distal
to the left subclavian artery, sparing the brachiocephalic
circulation.
17. Management
Aim:
* Differentiate physiologic from pathologic
cyanosis
* Differentiate cardiac from non- cardiac cause
of cyanosis
* Find causes which needs urgent treatment or
referral
18. Do :
1_complete maternal and newborn history
2_perform a full physical examination
3_ Investigation
19. Investigation
* Pulse oximetry: (normal O2 sat. ≥ 95%)
* ABGs :
PaO2: to confirm central cyanosis
↑ PaCO2: may indicate pulmonary or CNS disorders.
↓ pH: sepsis, circulatory shock, severe hypoxemia
* Hyperoxia test (Is it due cardiac or pulmonary cause?)
placing the infant in 100% oxygen for 10 minutes. If he
remains cyanotic after this period, the cyanosis is said to
be secondary to cyanotic heart diseases(SaO2 not reach
the normal value).
20. * CBC :
↑ or ↓ WBC : sepsis
Hematocrit > 65% : polycythemia
* Methemoglobinemia : ↓ SaO2, normal PaO2, chocolate-brown
blood , HB-M
* Sepsis screening
* ECG: Dx for Tricusped atresia (Lt axis deviation only is seen)
* Echo: Dx for CHD
* Chest x-ray
21. Treatment
* Warming of the affected area: in peripheral cyanosis
* Oxygenation & adequate ventilation
(PaO2 normalizes completely during artificial ventilation
in infant with CNS disorder)
* IV fluids
Children who have difficulty in feeding due to cyanosis
need fluids to be administrated.
* If sepsis is suspected or another specific cause is not
identified, start on broad spectrum antibiotics then obtain
a full septic screening
22. * Drugs: Prostaglandin E1
For ductal dependent CHD
IV Infusion of PGE1 at a dose of (0.05-
to maintain patency 0.1mcg/kg/min)
S/E- hypoventilation, apnea, edema and low grade fever
* Surgery
Newborn cyanotic at birth when transfer from intrauterine to extrauterine life , so need quick warming &dryness
As : physiological Cyanosis soon after birth-normal transition from intrauterine to extrauterine life
History of convulsion & general depression ,shallow, irregular respirations and periods of apnea strongly suggest CNS problem
Pneumonia/ sepsis-
PROM
Foul smelling liquor
Maternal pyrexia
Maternal GBS
TTN –
Birth by cesarean section with or without labor
Male sex
Family history of asthma (especially in mother)
Macrosomia
Maternal diabetes
Polycythemia-
small-for-gestational age
MAS-
Post maturity
Small for gestational age
Placental dysfunction
Fetal distress
Meconium stained liquor
Pneumothorax-
Aggressive resucitation
IPPV
Meconiun aspiration
HMD
Hypoplastic lung
Staph pneumonia
Hyaline membrane disease-
Premature infant
Infant of diabetic mother
Brain abscess becos. Blood from Rt to Lt without pass to lung which has a phagocytic activity (filter bld) so go to the brain & cause abscess if contain organisms