Varicose veins:A never ending problem if mistreated!KETAN VAGHOLKAR
Varicose veins is one of the most distressing disorders affecting the lower limbs. It is commonly seen in individuals who stand for prolonged hours thus causing immense pain and discomfort. These days it is also found in individuals who sit for prolonged periods as seen in computer professionals. Proper treatment based on good understanding of the pathophysiology underlying the disease is pivitol for a successful outcome. the presentation outlines the approach to the problem for practitioners
ALI is most dreaded emergency presentation of peripheral arterial disease.
Definition, presentation, grading, clinical presentation, diagnostic imaging, and management of acute limb ischemia.
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
This presentation gives a summary of the approach to a patient with nutcracker syndrome. It also gives various treatment modalities available to the treating physician.
This topic comes under the category - Venous Diseases. It is very important for a 3rd year MBBS Student to know about Varicose Veins, which is one of the commonest diseases encountered among out-patients.
Varicose veins:A never ending problem if mistreated!KETAN VAGHOLKAR
Varicose veins is one of the most distressing disorders affecting the lower limbs. It is commonly seen in individuals who stand for prolonged hours thus causing immense pain and discomfort. These days it is also found in individuals who sit for prolonged periods as seen in computer professionals. Proper treatment based on good understanding of the pathophysiology underlying the disease is pivitol for a successful outcome. the presentation outlines the approach to the problem for practitioners
ALI is most dreaded emergency presentation of peripheral arterial disease.
Definition, presentation, grading, clinical presentation, diagnostic imaging, and management of acute limb ischemia.
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
This presentation gives a summary of the approach to a patient with nutcracker syndrome. It also gives various treatment modalities available to the treating physician.
This topic comes under the category - Venous Diseases. It is very important for a 3rd year MBBS Student to know about Varicose Veins, which is one of the commonest diseases encountered among out-patients.
Detailed presentation on Varicose veins, examination and management
Detailed presentation on Deep Vein Thrombosis, categories, staging and scoring systems and management.
Management also includes Endovascular and Surgical techniques.
Short notes made on IVC filters
Endovenous Ablation of Varicose Veins. Treat painful varicose veins by Laser ...Saurabh Joshi
Varicose Veins is a very common medical condition affecting more than 30 % of the population. If left untreated, this can cause painful skin ulceration and a significant loss of quality of life.
Treatment is an office procedure, a small needle prick is all that is needed to position the Laser / RFA fiber within the vein and treat this disease once and for all.
Find out more and contact Dr.Joshi for details.
Made by Ranjith R Thampi. A surgery powerpoint I made during internship for Management of Varicose Veins. Tried to cover as much as possible on the topic. Kindly comment before you download. Thanks!
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!
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
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.
Follow us on: Pinterest
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
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
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.
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.
2. CHRONIC SUPERFICIAL VENOUS INSUFFICIENCY (CSVI)
• occurs when the venous wall and/or valves in the
superficial leg veins are not working effectively,
making it difficult for blood to return to the
heart from the legs.
3. Clinical hallmarks:
Distal venous hypertension, which follows the
development of valvular incompetence, reflux,
and/or venous obstruction.
4. VENOUS SYSTEM
Superficial venous system
1. Saphenous veins
2. Lateral venous
complex
Deep venous system
Perforating veins
Deep femoral v.
Femoral v.
Popliteal v.
Small saphenous v.
Great saphenous v.
Perforating v.
Perforating v.
Image source: Fundamentals of Phlebology: Venous Disease for Clinicians. Illustration by Linda S. Nye. American College of Phlebology 2004.
Deep femoral v.
Perforating v.
5. PERFORATING VEINS AND REFLUX
Maintain one-way flow from superficial to deep veins
Perforator valve failure causes:
• Higher venous pressure
and GSV/branch dilation
• Increasing pressure results
in GSV valve failure
• Additional vein branches
become varicose
• Further GSV incompetence
and dilation
9. CEAP
classification
– an international consensus conference initiated the Clinical-
Etiology-Anatomy-Pathophysiology classification.
C: Clinical
E: Etiology
A: Anatomy
P: Pathophysiology
10. CEAP classification cont.
• C 0 – no evidence of venous disease.
• C 1 – telangiectasias/reticular veins.
• C 2 – varicose veins.
• C 3 – edema associated with vein disease.
• C 4a – pigmentation or eczema.
• C 4b – lipodermatosclerosis.
• C 5 – healed venous ulcer.
• C 6 – active venous ulcer.
11. CEAP classification cont.
• E c – congenital
• E p – primary venous disease.
• E s – secondary venous disorder.
• E n – not specified.
12. CEAP classification cont.
• A s – superficial veins.
• A d – deep veins.
• A p – perforating veins.
• A n – not specified.
• P r – venous reflux.
• P o – venous obstruction.
• P n – not specified.
13. 20+ million 2 to 6 million
Skin Ulcers
500,000
Manifestations of Venous Insufficiency
Superficial venous reflux is progressive and if left
untreated, may worsen over time.
Below are manifestations of the disease.5
Photos courtesy of Rajabrata Sarkar, MD, PhD.
Swollen Legs Skin ChangesVaricose Veins
14. Systemic Reflux in Venous Ulceration
Incompetent perforators found in 63% of
venous ulcer patients
Comprehensive care treats all sources
of refluxPhotos courtesy of Steven A. Kaufman, MD.
Sources of Reflux in
Venous Ulcer Patients8
Superficial Perforating Deep
79% 63% 50%
15. SKIN CHANGES AT CSVI
Gravitational dermatitis
Hyperpigmentation
Lipodermatosclerosis
16. LIPODERMATOSCLEROSIS
There is a proliferation of the dermal capillaries
and fibrosis on subcutaneous tissue
It is a combination of:
• induration
• pigmentation
• inflammation
17. VENOUS ULCER
Clinical Findings:
Inner aspect of the distal third of the leg
(commonly the pressure areas)
Shape - rounded, elongated or very large like a cuff
(so-called gaiter ulcer)
Base - flat, covered with fibrous slough
Margins - sharp or rolled
19. Diagnostic Evaluation
Level 1 : history and clinical examination.
Level 2 : non-invasive vascular laboratory testing
which now routinely include Duplex color scanning.
Level 3 : invasive investigations or more complex
imaging studies including ascending and descending
venography, Varicography, venous pressure
measurements, magnetic resonance imaging.
20.
21.
22. Management of
Venous Stasis Ulcers
• Dressings
-Occlusive dressings
-Low adherent gauze dressings
• Surgical debridement
used to remove devitalized tissue.
• Enzymatic agents
used to break down necrotic tissue (Santyl).
23. MANAGEMENT contd.
• Growth factors
synthesized by many cell types such as platelets,
neutrophils, and epithelial cells (e.g. Regranex).
• Bioengineered tissue
used for a variety of non-healing ulcers
(e.g. Apligraf, Dermagraft).
• Skin grafting
an option for non-healing ulcers.
25. 1. Conservative Treatment
• Avoiding long periods of standing
• While sitting, legs should be above the thigh
• Avoiding crossing legs
• Ideal body weight
• Walking programme
• Compression therapy
• Micronised purified flavonoid fraction
(diosmin+ hesperidin)
28. Alternative techniques
Radiofrequency ablation
Endovenous laser ablation therapy.
Indications
Persistent signs/symptoms of venous disease after a
minimum of 3 months of medical therapy
Documented reflux (e.g. >0.5 seconds of reflux GSV).
29. Radiofrequency ablation
• Radiofrequency devices generate a high
frequency alternating current for which the
energy heats the adjacent vein walls to the
probe which alters the protein structure of
the vein effecting its closure.
30. Endovenous laser ablation therapy
• Lasers emit a single, coherent wavelength of light.
Laser therapy of venous structures is based upon the
concept of photothermolysis. Vein wall injury is
mediated directly by absorption of photon energy by
the vein wall and indirectly by thermal convection from
heated blood.
33. 3. SURGICAL OPTIONS
1. Sapheno-femoral/ sapheno-popliteal flush ligation
2. Venous stripping
3. Multiple phelebectomies
4. Ligation of the perforators
34. SAPHENO-FEMORALFLUSH LIGATION
VENOUS STRIPPING
• SFJ is identified after giving a groin incision lateral
to pubic tubercle.
• LSV tributaries are ligated and divided
• A flush SFJ ligation is then performed
• LSV retrogradely stripped to the knee
• Tributaries of varicocities then avulsed through small
incisions
37. • Graduated compression stockings or bandages are worn day
& night for 7-10days; thereafter they are worn only during day
for one month
• Patient should sit with his feet elevated
• Patient should return to work and driving within 10days of
surgery
• Swimming and cycling are allowed after dressing have been
removed
Post-operative care
38. Venous Ulcer Patient Outcomes
• Treating the underlying cause of venous ulceration
results in improved clinical outcomes
• Treating both the superficial and perforator
hypertension results in:
• Faster ulcer healing time
• Lower ulcer recurrence rate
than with compression therapy alone9,10
40. Prevention
Weight control
Adequate physical exercise
Avoidance of smoking
Avoidance of sedentary activities
Control of hypertension
Modification of profession
41. REFERENCES
1. American Heart Association, SIR, Brand et al. “The Epidemiology of Varicose Veins: The
Framingham Study”
2. US Markets for Varicose Vein Treatment Devices 2006, Millennium Research Group 2005.
3. Coon WW, Willis PW, Keller JB: Venous thromboembolism and other venous disease in the
Tecumseh Community Health Study Circulation 1973; 48:839-846.
4. Barron HC, Ross BA. Varicose Veins: A guide to prevention and treatment. NY, NY: Facts on File, Inc.
[An Infobase Holdings Company]; 1995;vii.
5. White JV, Ryjewski C. Chronic venous insufficiency. Perspect Vasc Surg Endovasc Ther 2005;17:319-
27
6. Dietzek A, Two-Year Follow-Up Data From A Prospective, Multicenter Study Of The Efficacy Of The
ClosureFAST Catheter, 35th Annual Veith Symposium. November 19, 2008. New York.
7. Alameida JI. Lessons Learned After 2000 Endovenous Ablations. 34th Veith Symposium. Nov 14-18,
2007. New York
8. Hanrahn L. et al. Distribution of valvular incompetence in patients with venous stasis ulceration.
JVS 13,6, 805-812 June 1991
9. Jamie R Barwell, Colin E Davies, Comparison of surgery and compression with compression alone
in chronic venous ulceration (ESCHAR study): randomized controlled trial,THE LANCET, Vol 363,
June 04
10. Nelzen O. Fransson I. True long-term healing and recurrence of venous leg ulcers following SEPS
combined with superficial venous surgery: a prospective study. Eur J Vasc Endovasc Surg 34, 605-
612 (2007)