Chronic hepatitis is a group of chronic inflammatory diseases of the liver characterized by hepatocyte inflammation, necrosis and dystrophy while maintaining the lobular structure. More than 70% are asymptomatic. About 350-400 million people have chronic hepatitis B worldwide and around 180 million have hepatitis C. Treatment depends on the etiology and includes antiviral drugs and interferons with the goal of suppressing viral replication.
A progressive inflammatory hepatopathy
Several factors (eg, viral infection, drugs, environmental agents) may trigger an autoimmune response and autoimmune disease.
In a few patients with AIH, illness onset follows acute hepatitis A, hepatitis B, or Epstein-Barr virus infections.
Autoantibodies - in patients with chronic HCV infection, liver-kidney microsomal type 1 (LKM-1) antibody.
HLA status affects treatment outcome
This lecture is about Spectrum of HCV infection presented by Dr. Muhammad Mostafa Abdel Ghaffar, Head of Tropical Medicine Department, Ahmed Maher Teaching Hospital.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
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
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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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
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
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.
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.
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.
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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
1. Mohit Rulaniya
•Chronic hepatitis :-
• Chronic hepatitis is a group of chronic diffuse inflammatory-dystrophic diseases of a liver
characterized by inflammation, dystrophy and necrosis of hepatocytes, while maintaining the
lobular structure of the liver.
Epidemiology :-
More than 70% of chronic hepatitis is clinically asymptomatic. In the world, about 350-400
million people suffer from chronic hepatitis B.
About 180 million people suffer from chronic hepatitis C.
3. Classification of chronic hepatitis
On activity of necroinflammatory process:
• Minimal;
• slight marked;
• moderate marked ;
• severe marked.
Stage of hepatitis (to determine by diffusion of fibrosis and forming of cirrhosis):
F0 – fibrosis is absent;
F1 – mild periportal fibrosis;
F2 – moderate fibrosis with porto-portal septs;
F3 – severe fibrosis with porto-central septs;
F4 – liver cirrhosis.
4. Classification of jaundice
Under jaundice understand the yellow
coloration of the skin, sclera and
mucous membranes as a result of
impregnation of the tissues with bile
pigment bilirubin.
Distinguish the following types of
jaundice:
- superhepatic jaundice - hemolytic
anemia.
- subhepatic jaundice:-
• tumors of large bile ducts;
• cholelithiasis;
• acute and chronic pancreatitis;
• hemoblastosis with liver infiltration.
5. intrahepatic jaundice
- enzymopathy:
a) genetically determined - Gilber's disease and others;
b) toxic - alcohol, medicines;
c) viral - predominantly chronic hepatitis C.
- hepatocellular:
a) acute viral hepatitis;
b) alcoholic hepatitis;
c) drug-induced hepatitis;
d) exacerbation of chronic hepatitis and steatohepatitis;
e) cirrhosis of the liver (including primary and secondary biliary cirrhosis);
f) heart disease (stagnant liver);
j) septic hepatitis.
6. -The routes of HBV
transmission:-
sexual;
- percutaneous (intravenous drug use);
- perinatal;
- horizontal;
- blood transfusion;
- nosocomial (can occur from patient to
patient, from patient to health care
worker);
- organ transplantation.
The routes of HDV transmission:-
• The transmission routes of hepatitis D is
the same as hepatitis B.
8. Pathogenesis of chronic hepatitis
Chronic course and progression of the disease is explained by the
processes:
1) the hepatitis B virus, in contrast to the hepatitis C virus, has no direct
cytopathogenic effect on hepatocytes;
2) persistence of the virus in patients with a weakening immune system;
3) development of autoimmune processes, when under the influence of
various factors hepatocytes themselves acquire antigenic properties;
4) liver cells infected with hepatitis viruses are destroyed by the cellular
immune response.
In patients infected with the hepatitis B virus in 10% develops Chronic hepatitis, and in
patients infected with the hepatitis C virus – Chronic hepatitis develops in 80-95%.
9. Clinical manifestation
• Asthenovegetative syndrome: -weakness, slackness, fatigue, irritability, decrease of activity,
loss of weight;
• Dyspeptic syndrome: loss of appetite, nausea, belching in the mouth, vomiting, epigastric
discomfort, a swelling of a stomach, unstable stool;
• Pain syndrome: pressure, heaviness or dull pain in the right hypochondrium, upper abdominal
discomfort;
• Cholestatic syndrome: icterus sclera and visible mucous membranes, skin, itchy skin, traces of
scratching on the skin, darkening of the color of urine;
• In severe forms of сhronic hepatitis - encephalopathy (memory impairment,
emotional lability, irritability).
10. laboratory research
• General blood test: decrease the level of erythrocytes, leucocytes and platelets;
• Cytolysis syndrome: an increase in the level of aminotransferases (aspartate aminotransferase -3-35 U/L, alanine
aminotransferase – 3-35 U/L, gamma-glutamyl transferase – for men 49 U/L, for women 32 U/L)
• Cholestasis syndrome - alkaline phosphatase -30-35 U/L, bile acids (common-3-17mmol/l) and bilirubin – direct (0-
5,1mmol/l) and indirect (5,1-17 mmol/l).
• Hepatodepressive syndrome: decreased level:
- albumin (the norm of 35-50 g / l)
- prothrombin index (normal 80-110%)
• Mesenchymal-inflammatory syndrome: a rise in the level is determined:
- thymol test (norm 0-7 units);
- sulum sample (norm 1.9 units and more);
- gamma globulin serum (norm 8-17 g / l).
• Alpha Fetoprotein (AFP) - the norm is 8-10 IU / l.
An increase in the level of alpha fetoprotein may indicate the development of hepatocellular carcinoma.
11. Markers of chronic viral hepatitis (B, C, D)
• Chronic hepatitis B: HBsAg, anti HBcore IgM, anti HBcore IgG, anti HBe,
The presence of hepatitis B virus in the blood (HBV DNA- deoxyribonucleic acid) is
determined by the polymerase chain reaction (PCR);
• Chronic hepatitis C: anti HCV IgM, anti HCV IgG;
The presence of the hepatitis C virus in the blood and its level is also determined by the
polymerase chain reaction. The hepatitis C virus has 6 genotypes.
Distinguish:
- phase integration - HCV RNA (ribonucleic acid) - 0,
- the replication phase - HCV RNA is above 0 to hundreds of thousands, million or more.
• Chronic hepatitis D: anti HDV IgM, anti HDV IgG.
The presence of the hepatitis D virus in the blood (HDV RNA) and its level is also
determined by the polymerase chain reaction.
12. Instrumental methods of examination
Ultrasound is the main instrumental method for studying the liver and biliary system. Ultrasound
is determined diffuse and focal changes in the liver, the size of the liver and spleen, the diameter
of the portal and splenic veins.
Computed tomography (CT) in detail determines the position, shape, size and structure of the
liver, gallbladder, large bile ducts, and also their relationship with neighboring organs and tissues.
13. Treatment of chronic viral hepatitis B
• Summary of treatment indications:
All patients with chronic hepatitis should be evaluated for treatment. Indication for treatment depends on the
level of viral replication - HBV DNA >2,000 IU/ml., corresponding to >10,000 copies/ml.
Сurrently use pegylated alpha interferons or highly effective analogues of nucleosides or nucleotides (tablet
forms):
- Pegasys 180 mkg subcutaneously 1 time per week. Duration 6-12 months;
- Entecavir 0,5 - 1 tablet per day. Duration - 1 year and more (long term);
- Tenofovir 300 mg 1 tablet per day. Duration - long term;
- Telbivudine 600 mg 1 tablet per day. Duration – long term;
14. Treatment of chronic viral hepatitis C
• Standard therapy: pegylated interferons + ribavirin (the dose of ribavirin depends on body weight).
• Currently used highly effective tablet preparations of direct antiviral action - polymerase inhibitors, protease
inhibitors.
• The scheme and duration of therapy depends on the genotype of HCV, the level of viremia and the
presence of complications.
• Sofosbuvir 400 mg, ledipasvir 90mg, daclatasvir 60 mg etc.
• With newly diagnosed chronic hepatitis (naive patients), there are short treatment regimens - 8-12 weeks.
Treatment of chronic viral hepatitis D:-
• Hepatitis D only occurs in combination with a replicating hepatitis B infection.
In clinical practice, pegylated interferons are used - pegasys 180 mkg and pegintron 1.5 mkg for 48 weeks or
more.