Menorrhagia: Prolonged (>7 days) and/or heavy (>80 ml) uterine bleeding occurring at regular intervals.
Polymenorrhea: An abnormally short interval (<21>35 days) between menses.
Metrorrhagia: variable amounts of inter-menstrual bleeding occurring at irregular but frequent intervals.
Menorrhagia: Prolonged (>7 days) and/or heavy (>80 ml) uterine bleeding occurring at regular intervals.
Polymenorrhea: An abnormally short interval (<21>35 days) between menses.
Metrorrhagia: variable amounts of inter-menstrual bleeding occurring at irregular but frequent intervals.
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
Polycystic Ovarian Syndrome is heterogeneous, multisystem endocrinopathy in women of reproductive age characterized by chronic anovulation resulting in infertility, irregular bleeding, obesity and hirsutism. Most common, although the least understood, cause of androgen excess. Initially it was described in 1935.Also known as Stein-Leventhal syndrome
The slide includes:
Introduction
Incidence
Pathophysiology
Pathology
Clinical features
Investigation
Treatment
what is endometriosis? Theories in endometriosis, sites of endometriosis. types and clinical presentation. signs and symptoms.
Investigations :TVS, CA125
laparoscopic findings
chocolate cyst and extrapelvic endometriosis.
Classification of endometiosis
Diffential diagnosis
Management :of asymptomatic and symptomatic cases
drugs and minimally invasive surgery
surgey and preventive measures in endometiosis.
Polycystic Ovarian Syndrome is heterogeneous, multisystem endocrinopathy in women of reproductive age characterized by chronic anovulation resulting in infertility, irregular bleeding, obesity and hirsutism. Most common, although the least understood, cause of androgen excess. Initially it was described in 1935.Also known as Stein-Leventhal syndrome
The slide includes:
Introduction
Incidence
Pathophysiology
Pathology
Clinical features
Investigation
Treatment
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
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
4. menarche (puberty)
• sequence of biochemical and
physiologic events (adrenarche
and gonadarche)
result in the growth spurt of adolescence,
development of secondary sex
characteristics, and reproductive capacity
5. • Adrenarche: ↑ secretion of
androgens by the adrenal gland,
(age 5 – 20)
• Gonadarche: the initiation of
production of significant
amount of sex steroids
8. Natural menopause
*end of reproductive life
*the permanent cessation of
menstruation
*loss of ovarian follicular activity
*no pathological cause
9. Dx menopause :
1) No menses > 12 mths
2) 17β-estradiol levels < 74 pmol/L
3) FSH levels > 30 IU/L
(Nik Nasri Ismail, ‘Menopause and HRT
in Malaysia’ in First Consensus
Meeting on Menopause in the East
Asian Region)
13. senium
• Phase of life started from 65 –
70 years upwards
• FSH and LH levels drop again
(age-related involution of the
pituitary gland).
14. Statistics
• Mean age for menopause is 50.7
years (Seng CK, 1986).
• Women’s life expectancy : 68 yrs in
1985 to 74 yrs in 1993 (Arshat H et
al., 1989).
☞ 1/3 life, in a hypoestrogenic
state.
15. Endocrinology of
menopause
Less negative feedback,
↑FSH, ↑LH
Hypothalamo-pituitary tact
↓ovarian follicular
estrogen
↓ circulating estrogen
(estrone) to target tissues
16. Endocrinology of
menopause
• adrenal androgen (by ovarian
stromal)
• in response to elevated LH
levels
• Androgen : estrogen ratio (facial
hair, male pattern baldness)
18. FSH - follicle stimulating
hormone
In Females,
• responsible for the early
growth of ovarian follicles
In Males,
• helps mantain the
spermatogenic epithelium
by stimulating Sertoli cells
19. LH - luteinizing hormone
In Females,
• final maturation of the ovarian
follicles and their estrogen
secretion, for ovulation, the
initial formation of the corpus
luteum and secretion of
progesterone
In Males,
• stimulation of testosterone
production from Leydig cells of
testis
23. Common Clinical
Symptoms
• Vasomotor flushes (hot flushes)
- 95% ☞ within three months,
(85% : symptom > one year)
- sudden sensation of intense
warmth accompanied by a
visible ascending flush of the
thorax, neck, and face, followed
by profuse sweating.
24. • Osteoporosis
-Estrogens,
☺inhibit osteoclast function
☺increase intestinal Ca2+absorption
-Peak bone mass age 30,
with 0.2% loss/year after age 40,
becomes 4%/year at menopause
-bone fragility and fracture
25. • Urogenital atrophy
- atrophic urethritis and cystitis
- Vulva and vagina : ↓ mucuos
production, thin epithelium
26. • Cardiovascular disease
- ↑↑ CHD in postmenopausal ≈ men at
the age 70 (B.Ettinger et al.,1996 and
S.A Samaan et al.,1995) by influencing:
1) lipoprotein level
2) direct action on arterial wall
- Abnormal coagulation system
27.
28. Circulation index (hot flushes, sweats,
palpitations, dizziness) and
Nervosity index (irritability, headache,
depression, insomnia) :
29.
30.
31. Increased Risk factors for
Menopause:
• Environmental influences may
alter the ovarian aging process.
• Smoking and high coffee intake
advances the age of menopause
by about 2 years (Kaufmann DW
et al,1980).
• Familial and genetic factors
• Ovarian surgery, adhesions, and
pelvic endometriosis
32. Selection of patients for HRT:
• 1. Pap smear for those with uterus
• 2. Fasting lipid profile
• 3. Mammography
• 4. Fasting blood sugar
• 5. Others if indicated — endometrial biopsy,
FSH, LH, ultrasound
34. Controversial :
• Important studies :
1) The Heart and
Estrogen/Progestin
Replacement Study (HERS)
2) Women’s Health initiative
study (WHI)(JAMA, 2002)
