Chronic heart failure is defined as the inefficiency of the heart as a pump to adequately deliver blood to tissues. It results from any structural or functional cardiac disorder impairing the ventricle's ability to fill or eject blood. There are two main types: heart failure with reduced ejection fraction, where the left ventricle ejects 40% or less of blood, and heart failure with preserved ejection fraction, where the left ventricle ejects 50% or greater but filling is impaired. Treatment goals include modifying risk factors, managing structural heart issues, reducing morbidity/mortality, and blocking compensatory neurohormonal activation caused by reduced cardiac output. Core treatments are diuretics, ACE inhibitors, beta-
Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure). Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction.
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Antihypertensives are a class of drugs that are used to treat hypertension (high blood pressure). Antihypertensive therapy seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction.
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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.
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.
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.
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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.
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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.
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
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
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.
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!
2. Definition
◦ Inefficiency of the heart as a pump where the delivery of blood, and
therefore oxygen and nutrients, becomes inadequate for the needs
of the tissues.
◦ Also is a complex clinical syndrome that result from any functional or
structural cardiac disorder that impairs the ability of the ventricle to fill
with or eject blood.
3. Types of heart failure
◦ Heart failure with reduced(HFrEF)or systolic dysfunction :LVEF of 40% or less
◦ Dilated ventricle(pumping problem)
◦ Two third of cases are attributable to chronic heart disease
◦ One third of cases are attributable to non ischemic cardiomyopathy
◦ i.HTN
◦ ii.Thyroid disease
◦ iii.Obesity
◦ iv.Stress
◦ V. Cardiotoxins
◦ Vi. Myocarditis
◦ vii.Idiopathic
◦ viii.Tachycardia
◦ ix.Peripartum
4. ◦ Heart failure with preserved EF (HFpEF)or diastolic dysfunction
◦ LVEF of 50% or greater ;borderline HFpEF is LVEF 41%–49%
◦ Account for about 30% of patients with HF.
◦ Impaired ventricular relaxation and filling
◦ Most cause is HTN (60%–89%).
5.
6.
7. Stages of HF
◦ Stage I : No symptoms with ordinary physical activity(such as walking or climbing stairs)
◦ Stage II : Slight limitation With dyspnoea on moderate to sever exertion (climbing stairs or
walking uphill.
◦ Stage III : marked limitation of activity, activity causes dyspnea,fatigue or palpitation
◦ Stage IV: sever disability,dyspnea at rest( unable to carry out any physical activity without
discomfort)
8.
9.
10.
11.
12. Goals of treatment
◦ 1.Modify or control risk factors (e.g.,HTN,obesity,DM)
◦ 2.Manage structural heart disease
◦ 3. Reduce morbidity and mortality
◦ 4. Prevent or minimize Na and water retention
◦ 5. Eliminate or minimize HF symptoms
◦ 6. Block compensatory neurohormonal activation caused by reduced cardiac output
◦ 7. Slow progression of worsening cardiac function
15. ACE-I
◦ reducing both the preload and afterload on the heart, thereby increasing cardiac output.
◦ ACE inhibitors act upon the renin–angiotensin–aldosterone system, and they reduce
afterload by reducing the formation of angiotensin II
◦ These drugs also have an indirect effect on sodium and water retention by inhibiting the
release of aldosterone and vasopressin, thereby reducing venous congestion and preload.
◦ The increase in cardiac output leads to an improvement in renal perfusion, which further
helps to alleviate oedema
◦ Monitor Bp , renal function, k level
16. ARBs
◦ Although comparisons of ACE inhibitors and ARBs have shown similar benefits on
morbidity and heart failure mortality, only ACE inhibitors have been shown to have
positive effects on all cause mortality. ARBs should, therefore, not be used instead of ACE
inhibitors, unless the patient experiences intolerable side effects.
17. B- blockers
◦ Carvedilol ,labetolol, metoprolol succinate
◦ Blocks the effect of norepinephrin and other sympathetic neurotransmitters on the heart and
vascular system
◦ 1. Decreases ventricular arrhythmias
◦ 2. Decreases cardiac hypertrophy and cardiac cell death
◦ 3. Decreases vasoconstriction and HR
◦ Start low dose and increase every 2 weeks
◦ Avoid abrupt discontinuation
◦ Monitor Bp, HR, signs of congestion
18. Aldosterone antagonists
◦ Spiranolactone and eplerenone
◦ Blocks effects of aldosterone in the kidneys,heart and vasculature
◦ Decrease fluid and Na retention
◦ Eliminates catecholamine potentiation,decreases BP
◦ Recommended in patients with NYHA class II- IV with an LEVF of 35% or less to reduce
morbidity and mortality.
◦ Monitor k level , renal function
19. Digoxin
◦ Has positive inotropic effect,increase cardiac contractility and COP
◦ digoxin is currently recommended for use as add-on therapy at low doses in patients
with moderate-to-severe heart failure who remain symptomatic despite adequate doses of
ACE inhibitor, β-blocker and diuretic treatment.
◦ lack of effect on mortality
◦ Minimal increase in cardiac contractility
◦ Avoid digitalis toxicity
20.
21. Nitrates/hydralazine
◦ Nitrates cause venodilation, thereby reducing the symptoms of pulmonary congestion.
hydralazine, which reduces the afterload combined with it to achieve a balanced effect on
the venous and arterial circulation.
◦ The combined effects of these two drugs lead to an increase in cardiac output, and a
reduction in mortality in patients with heart failure.
◦ Recommended in addition to ACE inhibitors and β-blockers to reduce morbidity and mortality
for patients self-described as African American with NYHA classIII or IV HFrEF
◦ The combination has mainly been reserved for patients unable to tolerate, or with a
contraindication to, ACE inhibitor therapy.
22. Inotropic agents
◦ particularly the sympathomimetic agents dobutamine and dopamine
◦ These agents have inotrope-vasodilator effects which differ according to their action on α,
β1, β2 and dopamine receptors (β1-agonists increase cardiac contractility, β2-agonists
produce arterial vasodilation, dopamine agonists enhance renal perfusion)
◦ Noradrenaline (norepinephrine) is an α-adrenoreceptor agonist where its vasoconstrictor
action limits its usefulness in severely hypotensive patients such as those in septic shock.
◦ Adrenaline (epinephrine) has β1, β2 and α-adrenoreceptor agonist effects and is used in
patients with low vascular resistance.
23. Other agents
◦ Direct-acting vasodilators such as sodium nitroprusside are rarely used except in the
acute setting when they are given by continuous infusion.
◦ Amlodipine and felodipine have a more selective action on vascular tissue and, therefore,
a less pronounced effect on cardiac contractility than other calcium antagonists and
should be the agents of choice where appropriate.
◦ Sacubitril/valsartan (Entresto) novel drug in 2015, Sacubitrilprodrug metabolized to an active
metabolite that inhibits neprilysin,increaseing levels of natriuretic peptides,decrease
hospitalization ana all cause mortality.
◦ Ivabradine selectively inhibits the I£ current in the sinoatrial node ,providing HR
reduction.reduces HF hospitalizations for patients with symptomatic (NYHA class II and
III),chronic stable HFrEF (LVEF of 35% or less) who are receiving evidence-based
therapies,including B-blocker at maximum tolerated dose, and who are in sinus rhythm with HR
of 70 beats/min or greater at rest.