Hernia can be life-threatening. If the neck of the herniated sac is obstructed, blood supply to the distal part would be cut short. This would result in gangrene of the herniated part, which is a surgical emergency.
This is a case study done by me as a part of my in-service education progamme in my institution...hope this may help all nurses who wants to do a case study.
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A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral
A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types of hernia are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).
Fourth Recurrence of Aortic Annular Dehiscence Following AVR for Aortic Regur...Apollo Hospitals
It is a report of an unusual case of recurrent periprosthetic aortic regurgitation which occurred four times in the same patient over a span of 26 years. After pre-operative stabilization, the patient was subjected to a fifth open heart surgery to replace the 4th prosthetic aortic valve by an upsized 5th prosthetic valve. Since endocarditis was excluded by repeated blood culture and paucity of vegetations, a working diagnosis of Behcet's disease was arrived upon. The fifth prosthetic aortic valve was implanted using a special suturing technique as described by Azumo, et al in 2009, which involves a sub-annular reinforcement by a Teflon ring. The patient was discharged after an uneventful recovery and is well on regular follow-up.
Anaesthetic Management of A Rare Case of Hemianomalous Pulmonary Venous Conne...Apollo Hospitals
We present a case report on anaesthetic management of a case of hemianomalous pulmonary venous connection with VSD, ASD for total intracardiac repair. A balanced anaesthetic technique was used with oxygen, isoflurane, fentanyl, midazolam, vecuronium. Patient was successfully operated under cardiopulmonary bypass with hypothermia.
This is a case study done by me as a part of my in-service education progamme in my institution...hope this may help all nurses who wants to do a case study.
Search Results
Featured snippet from the web
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral
A hernia occurs when an organ or fatty tissue squeezes through a weak spot in a surrounding muscle or connective tissue called fascia. The most common types of hernia are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).
Fourth Recurrence of Aortic Annular Dehiscence Following AVR for Aortic Regur...Apollo Hospitals
It is a report of an unusual case of recurrent periprosthetic aortic regurgitation which occurred four times in the same patient over a span of 26 years. After pre-operative stabilization, the patient was subjected to a fifth open heart surgery to replace the 4th prosthetic aortic valve by an upsized 5th prosthetic valve. Since endocarditis was excluded by repeated blood culture and paucity of vegetations, a working diagnosis of Behcet's disease was arrived upon. The fifth prosthetic aortic valve was implanted using a special suturing technique as described by Azumo, et al in 2009, which involves a sub-annular reinforcement by a Teflon ring. The patient was discharged after an uneventful recovery and is well on regular follow-up.
Anaesthetic Management of A Rare Case of Hemianomalous Pulmonary Venous Conne...Apollo Hospitals
We present a case report on anaesthetic management of a case of hemianomalous pulmonary venous connection with VSD, ASD for total intracardiac repair. A balanced anaesthetic technique was used with oxygen, isoflurane, fentanyl, midazolam, vecuronium. Patient was successfully operated under cardiopulmonary bypass with hypothermia.
Sexual dysfunction due to SSRI antidepressants: How to manage?Apollo Hospitals
Selective Serotonin Reuptake Inhibitors (SSRIs) are a group of commonly prescribed antidepressants in clinical practice. Sexual dysfunction is a common side effect of SSRIs, which often goes unrecognized but adversely affects the quality of life of the patient. This review takes a look at the occurrence of sexual dysfunction among patients receiving SSRIs from a clinical viewpoint. The review explores into the possible reasons of such a dysfunction and the differential diagnoses to be entertained while dealing patients receiving SSRIs and experiencing sexual dysfunction. The review discusses the management strategies for addressing such dysfunction due to SSRIs, including cessation or reduction of dose, changing to another antidepressant, augmentation with another antidepressant, additional use of medications for erectile dysfunction and use of other add-on strategies. The choice of a specific strategy should be customized to individual needs of the patient.
An 80-day-old infant referred from the Pediatric Hospital and diagnosed to have Early Congenital Syphilis due to Wimberger's sign and osteochondritis of the long bones diagnosed by Roentgenogram. Wimberger's sign is a characteristic sign of Early Congenital Syphilis. In this there is loss of density in the medial aspect of upper end of tibia. There are marked irregular patches of loss of density in the bones particularly in the metaphyses.
Problem of colorectal cancer in India and issues related to managementApollo Hospitals
Colorectal cancer (CRC) in India ranks amongst the lowest in comparison to most parts of the world. However, the sheer population of the country and increasing urbanization, coupled with greater awareness and scope of detection, has resulted in a gradual increase in numbers to the point that it ranks amongst the commonest cancers in India. This review discusses the relevance of specialization in CRC surgery in India and also important aspects of multidisciplinary care such as advances in chemotherapy and radiotherapy. This article also deals specifically with the problem of rectal cancer in young Indians. Furthermore, the impact of minimal access CRC surgery and cutting edge issues in CRC surgery such as approach to complete responders after neo-adjuvant treatment in rectal cancer, concepts in sphincter preservation, and dealing with metastatic CRC are also addressed. Lastly, modern molecular biology with a clinical relevance and modern surgical approaches such as TEMS and TAMIS are also discussed.
Bone is a living tissue capable of changing its structure as the result of the stress to which it is subjected. It consists of cells, fibers and matrix. Calcification of extra cellular matrix makes it hard. The slight degree of elasticity in the bone is due to the presence of the organic fibers. The main function of the bone is protection of some of the vital organs like brain, spinal cord, heart and lungs. It also acts as a lever which helps in locomotion and movement. It is the main storage house of the calcium salts. The cavity of the bone consists of delicate blood forming bone marrow.1 The two forms of bones are compact and cancellous bone. Compact bone exists as a solid mass however the cancellous bone has a branching network of trabeculae. The arrangement of trabeculae is such that it resists the stress and strain to which the bone is exposed. Entheses is an interface where the tendon meets bone. These are the sites of stress concentration at the hard and soft tissue function where mechanical properties differ. They play a pivotal role in the diagnosis of various types of arthritis. However, not much importance has been given by the anatomists and the clinicians towards the study on entheses. This article aims to provide a brief account on entheses to draw the attention towards the known but ignored entity called entheses.
Critically ill neonates frequently require multiple small volume red blood cell (RBC) transfusions. Red blood cell units assigned to individual infants, used sequentially in small aliquots until the original expiration date, can substantially reduce donor exposures. In 1993, adenine–saline solution (AS-3) was introduced by the Canadian Red Cross as the red cell storage medium to replace the citrate phosphate–dextrose–adenine anticoagulant preservative solution (CPDA-1). We surveyed the safety and efficacy of using AS-3 split packs, stored up to 35 days, for premature infants.
Guidelines for the management of relapsed acute lymphoblastic leukemia in chi...Apollo Hospitals
Considerable progress has been made in the treatment of newly diagnosed childhood acute lymphoblastic leukemia. With the use of intensive, risk-stratified multiagent chemotherapeutic protocols, over 80% of patients can hope to be long-term survivors. However, despite optimal treatment, about 20% of patients relapse. The treatment of these children poses a major challenge. The prognosis of these patients depends on a number of factors including time since diagnosis, the site of relapse and immunophenotype. The choice of postinduction therapy depends on these prognostic factors. Considerable work has been done to identify the subgroups of relapsed patients whose outcomes are significantly altered by allogeneic bone marrow transplant. In our scenario, the limited availability of allogeneic bone marrow transplant due to a host of factors renders the management of these children even more challenging.
Expanding indications for pediatric liver transplantationApollo Hospitals
The successful development of pediatric liver transplantation (LT) over the past four decades has dramatically changed the prognosis for children dying of acute and end-stage liver failure. Over the past two decades survival post transplantation has improved because of better preoperative management, optimal nutritional support, innovative surgical techniques, and improvements in immunosuppressive medications. The ensuing improvement in survival rate has extended the range of indications for LT in children to include transplantation for metabolic liver disease and unresectable hepatic tumors.
Liver transplant (LT) is becoming the need of the hour and often the last ray of hope for many of our cirrhotic patients. The dearth of deceased donors, acceptance of living-related donors, better operative skills, and post transplant outcomes have played an important role is making LT accessable to more and more needy people. However, for best outcome it is important to stick to the established criteria laid down for listing a patient for LT for both best outcomes and better distribution of donor livers.
Klippel–Trenaunay syndrome is an uncommon genetic condition. The main pathology consists of arteriovenous malformations. It is generally asymptomatic but may present as soft tissue or bony hypertrophy. We hereby present a case of Klippel–Trenaunay syndrome of an 18 year old male patient coming with large venous malformations, lymphangiomas and A-V fistula at lower leg along with soft tissue hypertrophy of right foot. Patient was evaluated clinically and radiologically and a diagnosis of Klippel–Trenaunay syndrome was formed. Patient was given compression stockings and asked to followup regularly.
Graft-versus-host disease (GVHD) is a complication seen in allogeneic stem cell transplantation. The incidence and severity is more in T-cell replete allograft (stem cells), donor T-cells being the principal mediators of GVHD. Acute GVHD is seen within 90 days post transplant and chronic GVHD after 90 days. Cyclosporin A (CsA) and methotrexate combination is used in prevention of acute GVHD. Corticosteroids and CsA combination is used in treatment of both acute and chronic GVHD.
Preventive and promotive health initiatives: An experience of a wellness clin...Apollo Hospitals
Wellness clinics play a pivotal role in the transforming health status and help in bringing better outcomes of the employees' of an organization. Having a wellness clinic at workplace is an opportunity for the employees' to understand the concepts of health promotion and prevention, in addition to out-patient department. The article shares the experience of wellness clinic established in one of the multinational organization.
Goldenhar syndrome, a term that is often used synonymously with “Oculo-Auriculo-Vertebral (OAV) spectrum”, is a rare disorder that is apparent at birth (congenital). The disorder is characterized by a wide spectrum of symptoms and physical features that may vary greatly in range and severity from case to case. However, such abnormalities tend to involve the cheekbones, jaws, mouth, ears, eyes and/or bones of the spinal column (vertebrae). Although, in most cases, such malformations affect one side of the body (unilateral), approximately 10–33 per cent of affected individuals have such malformations on both sides of the body (bilateral), with one side typically more affected than the other (asymmetry). In the majority of such cases, the right side is more severely affected than the left.
Out of a variety of Digestive System diseases, Hernia is common and associated with obesity. the presentation gives a brief overview regarding the management of hernias in clinical surgical departments of Hospitals.
Understanding Hernia and Laparoscopic Surgery in Lucknow as Their Solution ( ...DP Bora Hospital
One of the common medical conditions that affects millions of people worldwide is hernia. While they can vary in severity, hernias can cause discomfort, pain, and even complications if left untreated. However, advancements in medical technology have provided more effective and minimally invasive treatment options, such as laparoscopic surgeryin Lucknow. In this blog post, we'll delve into everything you need to know about hernias, including their causes, symptoms, and how laparoscopic surgery can help alleviate them.
Incisional Hernia – Causes and Treatment.pdfMeghaSingh194
An incisional hernia is a bulge or protrusion that occurs at the site of previous abdominal surgery. The bulge consists of abdominal contents, including the intestine and/or omentum, pushing through the weakened area of the abdominal wall. In medical terms, incisional hernias are sometimes also known as ventral hernias. Let's explore more: https://www.southlakegeneralsurgery.com/incisional-hernia-causes-and-treatment/
Inguinal and femoral hernia:
A hernia is a protusion of a viscus or a part of viscus through and abnormal opening in the walls of its containing cavity. Details of inguinal hernia and few slides on other types of hernia.
Ventral hernia is protrusion of peritoneal sac through anterior abdominal wall defects except Groin hernias. In this presentation I have discussed Epigastric, Umbilical, Para umbilical, Incisional, Spigelian and Lumbar hernias.
Malignant Mixed Mullerian Tumor – Case Reports and Review ArticleApollo Hospitals
Malignant mixed mullerian tumors are very rare genital tumors. They are biphasic neoplasms composed of an admixture of malignant epithelial and mesenchymal elements. In descending order of frequency they originate in the uterus, ovaries, fallopian tubes, cervix and vagina. Also they arise denovo from peritoneum. They are highly aggressive and tend to occur in postmenopausal low parity women. Because of rarity, there is as such no treatment guidelines available. Multimodality treatment in the form of radical surgery followed by adjuvant chemotherapy or radiotherapy or combined chemoradiation gives a better prognosis & outcome. Two case reports of such tumors, one from ovary and other from penitoneum are presented along with the review of literature.
Intra-Fetal Laser Ablation of Umbilical Vessels in Acardiac Twin with Success...Apollo Hospitals
To interrupt blood supply to the acardiac twin in a case of TRAP sequence of monochorionic diamniotic multiple pregnancy to allow for continuation of the normal twin.
Breast Cancer in Young Women and its Impact on Reproductive FunctionApollo Hospitals
Breast cancer is the most common cancer in women in developed countries. Chemotherapy for breast cancer is likely to negatively impact on reproductive function. We review current treatment; effects on reproductive function; breastfeeding and management of menopausal symptoms following breast cancer.
Turner syndrome (gonadal dysgenesis) is one of the most common chromosomal abnormalities occuring 1 in 2500 to 1 in 3000 live-born girls. It is an important cause of short stature in girls and primary amenorrhea in young women that is usually caused by loss of part or all of an X chromosome. This review briefly summarises the current knowledge about the syndrome and the management strategies.
Due to pregnancy thyroid economy is affected with changes in iodine metabolism, TBG and development of maternal goiter. The incidence of hypothyroidism in pregnancy is quite common with autoimmune hypothyroidism being the most important cause. Overt as well as subclinical hypothyroidism has a varied impact on maternal and neonatal outcome. After multiple studies also, routine screening in pregnancy for hypothyroidism can still not be recommended. Management mainly comprises of dosage adjustments as soon as pregnancy is diagnosed based on results of thyroid function tests. The aim should be to keep FT4 at the upper end of normal range.
Growth Hormone Deficiency (GHD) can persist from childhood or be newly acquired. Confirmation through stimulation testing is usually required unless there is a proven genetic/structural lesion persistent from childhood. Growth harmone (GH) therapy offers benefits in body composition, exercise capacity, skeletal integrity, and quality of life measures and is most likely to benefit those patients who have more severe GHD. The risks of GH treatment are low. GH dosing regimens should be individualized. The final decision to treat adults with GHD requires thoughtful clinical judgment with a careful evaluation of the benefits and risks specific to the individual.
Advances in the management of thalassemia have led to marked improvements in the life span and quality of life of children and young adults. This poses new challenges for the treating physicians. There is now increasing recognition that thalassemics have impaired bone health which is multifactorial in etiology. This paper aims to highlight the factors that predispose these patients to osteoporosis and suggests measures to minimise the impact on bone health.
Laparoscopic Excision of Foregut Duplication Cyst of StomachApollo Hospitals
Retroperitoneal gastric duplication cysts lined by ciliated columnar epithelium are extremely rare lesions and its presentation during adulthood is a diagnostic challenge for treating clinicians. This entity often resembles cystic pancreatic neoplasm, retroperitoneal cystic lesions and sometimes as an adrenal cystic neoplasm. Correct diagnosis on the basis of radiological investigation is difficult and histopathologic analysis. We report a case of gastric duplication cyst in a 16year old girl that mimicked as a retroperitoneal /pancreatic /adrenal cystic lesion and was successfully managed by laparoscopy.
Occupational Blood Borne Infections: Prevention is Better than CureApollo Hospitals
Viral infections like HIV, hepatitis Band C virus pose a big risk to the contacts of individuals with high risk behaviour as well as to the attending health care workers. Blood, semen, vaginal and other potentially infectious materials can transmit the infection to the susceptible contacts. Universal precautions should be strictly implemented during clinical examination, laboratory work and surgical procedures to prevent transmission to the health care providers. Health care workers should receive vaccination for hepatitis B infection. An inadvertent exposure should be managed with proper first aid and infectivity of the source and severity of exposure should be assessed. Severity of exposure is based on the nature and area of exposed surface, mode of injury and volume of infective material. Post-exposure prophylaxis (PEP) should be started as soon as possible after a proper counseling about the effectiveness of post-exposure prophylaxis, side effects and risk of carrying the infection to his familial contacts and its prevention.
Evaluation of Red Cell Hemolysis in Packed Red Cells During Processing and St...Apollo Hospitals
Storage of red cells causes a progressive increase in hemolysis. Inspite of the use of additive solutions for storage and filters for leucoreduction some amount of hemolysis is still inevitable. The extent of hemolysis however should not exceed the permissible threshold for hemolysis even on the 42nd day of storage.
Efficacy and safety of dexamethasone cyclophosphamide pulse therapy in the tr...Apollo Hospitals
Various drugs used to treat pemphigus can cause remission, but none can provide permanent remission as relapses are common. With the introduction of DCP in pemphigus in 1984, patients started being in prolonged/permanent remission. This study was done to compare the efficacy of DCP to oral corticosteroids and cyclophosphamide in combination.
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)Apollo Hospitals
Severe skin adverse drug reactions can result in death. Toxic epidermal necrolysis (TEN) has the highest mortality (30–35%); Stevens-Johnson syndrome and transitional forms correspond to the same syndrome, but with less extensive skin detachment and a lower mortality (5–15%). Hypersensitivity syndrome, sometimes called Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), has a mortality rate evaluated at about 10%. It is characterised by fever, rash and internal organ involvement. Prompt diagnosis is vital, along with identification and early withdrawal of suspect medicines and avoidance of re-exposure to the responsible agent is essential. Cross-reactivity to structurally-related syndrome caused by Carbamazepine medicines is common, thus first-degree relatives may be predisposed to developing this syndrome. We report a case of DRESS secondary to use of Carbamazepine.
Difficult Laparoscopic Cholecystectomy-When and Where is the Need to Convert?Apollo Hospitals
Laparoscopic cholecystectomy has now become the treatment of choice for the gall bladder stone. With increasing experience, surgeon has started to take more difficult cases which were considered relative contra indications for laparoscopic removal of gall bladder few years back.
We conducted this study at our hospital and included all laparoscopic cholecystectomy done from May'08 to January'10. Total time taken in surgery, conversion rate and complication rate were analysed. Factors making laparoscopic cholecystectomy difficult were also analysed. We defined difficult laparoscopic cholecystectomy when we found -dense fibrotic adhesions in and around Callot's triangle, gangrenous gall bladder, empyma, large stone impacted at gall bladder neck, contracted gall bladder, Mirrizi's syndrome, h/o biliary pancreatitis, CBD stones, acute cholecystitis of <72 hrs duration.
Out of 206 cases done during above period, 56 cases were considered difficult. Only two cases were converted to open.
With growing experience and technical advancement surgery can be completed in most of the difficult cases. This is important because recently it is shown in literature that laparoscopic cholecystectomy is associated with less morbidity than open method irrespective of duration of the surgery.
Deep vein thrombosis prophylaxis in a tertiary care center: An observational ...Apollo Hospitals
Deep vein thrombosis (DVT) is a major health problem with substantial mortality and morbidity in medically ill patients. Prevention of DVT by risk factor stratification and subsequent antithrombotic prophylaxis in moderate- to severe-risk category patients is the most rational means of reducing morbidity and mortality.
The spread of dengue and dengue haemorrhagic fever is increasing, atypical manifestations are also on the rise, although they may be under reported because of lack of awareness. We report two such cases of dengue hemorrhagic fever with hepatitis, intraocular hemorrhage, ARDS and myocarditis.
A 71-year-old male presented in ENT department with dysphagia for last three weeks, more to solids than liquids. He had a hard bony bulge in the posterior pharyngeal wall on palpation and hence was referred for an Orthopaedic opinion. Lateral radiograph of the cervical spine revealed diffuse ossification of the anterior longitudinal ligament. This ossification was extending almost half the width of the cervical body from its anterior body at C1 and C2 vertebra level.
Pediatric Liver Transplant (LT) is now an established procedure for End Stage Liver Disease (ESLD) with biliary atresia being the commonest indication. Intensive pre-transplant evaluation, nutritional buildup and immunization are the fundamental pre-requisites of a successful LT. With improvement in surgical micro-anastomotic techniques and superior immunosuppressive regimens the success rate of pediatric LT is in excess of 90%. Most of the transplants in our country however are Living related, due to which a fairly large number of children expire awaiting a donor liver. There should be a concerted effort to evolve the cadaveric donation program, so that majority of the children are benefitted.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
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
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
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
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
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
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
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.
2. Chronicles of Hernia
“Hernia can be life-threatening”
Hernia is caused by a combination of pressure and an opening in the muscle/connective tissue. The
pressure pushes an organ or tissue through the opening or weak spot, causing it to bulge out. It usually
occurs due to a weakness in the muscular structure of the wall of the abdomen. Hernia can be life
threatening. If the neck of the herniated sac is obstructed, blood supply to the distal part would be cut
short. This would result in gangrene of the herniated part, which is a surgical emergency.
Activities that raise the pressure inside the abdomen, like lifting a heavy weight, straining to have a
bowel movement, sneezing or even coughing makes the hernia more noticeable. The intra-abdominal
pressure could be raised for a longer duration through conditions like chronic cough, pregnancy,
accumulation of fluid in the abdomen and malignancies inside the abdomen. All that bulges against the
abdominal wall is not hernia though; lymph nodes and some tumours of the abdominal wall could also
be guilty.
Hernias are commonly located at the sites prone to medical weakness either because of some muscle
weakness, or due to acquired conditions. Depending on the organs involved in causing the disorder,
there can be many different types of hernia.
The most common site is the groin and a hernia there is called inguinal hernia. The intestine or the
bladder could protrude through the abdominal wall or into the inguinal canal in the groin. Femoral
hernia is a bulge in the upper part of the thigh, just below the groin, where the femoral artery and vein
pass.
There is a hernia that affects newborns too, called umbilical hernia, where part of the small intestine
passes through the abdominal wall near the navel. Another unusual but common type is hiatus hernia,
in which there is no exterior bulge. A portion of stomach protrudes upward into the chest, through an
opening in the diaphragm.
Surgery is the only definitive treatment for hernia, though all hernias do not warrant immediate surgery.
The ones which are large and become irreducible need immediate attention and the patient should see
a surgeon at the earliest. With lesser cutting and equal precision, laparoscopic surgery has practically
replaced conventional hernia surgical techniques over the last few decades. Consult a specialist at Nova
Speciality Hospitals to get any doubtful bulges checked and also to get it removed as part of their Day
Surgery Program.