This document summarizes the medical case history of a 3-year-old boy named Jubayer who was admitted with generalized swelling for 15 days and scanty urination for 10 days. He had a previous episode of nephrotic syndrome 10 months ago. On examination, he was found to have puffy face, distended abdomen, and moderate pallor. Laboratory tests showed urine protein of 4+ and normal kidney function. The provisional diagnosis was nephrotic syndrome first relapse, most likely minimal change disease. The management plan included supportive care, prednisolone treatment, and counseling.
this is a case study on tonsillitis , this details about the diagnosis, management, treatment, patient counselling & pharmacist interventions , regarding medication etc , and also describes in detail about all aspects of tonsillitis .
please comment if you read this
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this is a case study on tonsillitis , this details about the diagnosis, management, treatment, patient counselling & pharmacist interventions , regarding medication etc , and also describes in detail about all aspects of tonsillitis .
please comment if you read this
thank u
This is a presentation about splanchinc circulation.
Done by year 3 medical students at the University of Science and Technology, Sana'a, Republic of Yemen.
Spring semester of 2010.
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.
Spastic quadriplegia with motor, cognition delay with vision and hearing imp...Shubhra Paul
Clinical Meeting on "Spastic quadriplegia with motor, cognition delay with vision and hearing impairment with microcephaly with Lennox-Gastaut syndrome.
"
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
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 lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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.
3. Dr. Shubhra Prakash Paul
MD (Ped) Part II
Bangladesh Institute of Child Health
4. Particulars of the Patient
Name Jubayer
Medical Case History
Age 3years
Sex Male
Address Panchagar
Date of Adm. 10/04/2012
Date of 12/04/2012
Exam.
5. Presenting Complaints with Duration
Generalized swelling for 15 days
Case History
Scanty Micturition for 10 days
6. History of Present Illness
According to his mother, Jubayer was quite
well 15 days back. Then there developed
generalized swelling starting from face.
Mother complained also of scanty micturition
Case History
for last 10 days. There is no history of sore
throat or skin infection prior to this illness.
There was no chest pain, breathlessness ,
headache during the courses of illness.
7. History of Past Illness
Jubayer suffered from same type of illness
i.e. generalized swelling starting from face,10
months back and diagnosed as a case of
nephrotic syndrome first attack and treated
Case History
accordingly in Rangpur Medical College
Hospital and subsequently at Dhaka Shishu
Hospital with Tab. Cortan and syp. Neotack.
8. History of Past Illness
He was completely relieved from 1st attack
of Nephrotic syndrome and completed the
alternate day steroid for adequate duration.
There was no history of breathlessness,
Case History
chest pain, headache, passage of high color
urine through out his illness. He suffered
from occasional cough and cold.
9. Treatment History
He was treated with optimum dose of Tablet
Prednisolone and Syrup Ranitidine for
optimal duration.
Birth History
Case History
He was delivered at term at home without
any perinatal untoward event. His mother
was on irregular antenatal check-up.
10. Immunization History
He is immunized as per EPI schedule
Feeding History
Case History
He was on exclusive breast feeding up to 6
months of age, after that complementary
food is introduced and tolerated. Now he is
on family diet.
11. Developmental Milestones
His mile stone of development is age
appropriate
Family history
Case History
He is the third issue of his non-
consanguineous parents. Other sibs are
healthy. All of his family members are
healthy.
12. Socioeconomic History
Jubayer belongs to a lower socioeconomic
family; father being a farmer and mother
housewife.
Housing and Sanitation history
Case History
He lives in a kacha house with his family
members and drinks tube well water and
uses sanitary toilet.
13. Physical Examination
General Examination
Appearance Playful but having puffy face
and distended abdomen
Built Average
Nutrition Average
Case History
Co-operation Co-operative
Pallor Moderate
Jaundice Absent
Cyanosis Absent
Clubbing Absent
14. Physical Examination contd.
General Examination contd.
Koilonychia
Leuconychia Absent
Dehydration
Edema Present (bilateral pedal)
Case History
Temperature 990F
Pulse 98 /min.
Resp. rate 24/min
Blood Pressure 95/50 mm of Hg
15. Physical Examination contd.…..
General Examination contd..
Skin BCG mark present, no skin lesion
is present
Sign of Absent
meningeal
Case History
irritation
Lymphnode Accessible nodes are not
s enlarged
18. Physical Examination contd.
General Examination contd.
HEENT Normal
Bed side urine (++++)
albumin
Others IV cannula placed on
Case History
right hand
19. Physical Examination contd.
Anthropometry
Height Cm
Weight 13 Kg
Weight for Age + 2 SD
Case History
Height for Age + 0.8 SD
Weight for SD
height
Body Surface 0.71 m2
area
20. Physical Examination Contd.
Per abdominal Examination
Inspection
Abdomen is distended, flanks are full, umbilicus is
centrally placed and everted with transverse slit.
Penis and both scrotum are normal.
Palpation
Case History
Abdomen is soft and non tender. There was no
organomegaly. Both kidneys are not bimanually
ballotable.
21. Physical Examination Contd.
Per abdominal Examination
Percussion
Percussion note is dull. Shifting dullness present
Auscultation
Bowel sound is present.
No hepatic, renal or aortic bruit is detected
Case History
22. Physical Examination Contd.
Examination of Cardiovascular System
No abnormality detected
Examination of Respiratory System
Case History
No abnormality detected
Examination of Alimentary System
No abnormality detected
23. Timeline of illness
Regular ANC -----No illness----
No drug, -
radiation -----------Immunization--------
NVD at term at home
Complementary
Breast feeding Swelling,
Puffiness of face
untoward event
Scanty micturition
Case History
feeding
No perinatal
6 mo. 3 years
24. Timeline of illness
< 7 days > < 14 days > < 2 mo. > 07/12/11-
01/01/12
Swelling Swelling Swelling Swelling
Tab. Frulac Tab. persist Decreased
Deltasone Tab. Deltasone Tab. Cortan
Syp. Gepin Syp. Gepin Syp. Neotack
and frulac
Case History
Panchagar Rangpur Home DSH
Medical
College
3 years
25. Timeline of illness
22/03/12 26/03/12 < 15 days > 10/04/12
Dose of Swelling Swelling, Admission
Steroid Reappear puffiness
complete ed Scanty
d micturition
Case History
Home Home Home DSH
3 years
26. Salient Features
Jubayer , 3 years old boy, 3rd issue of his non-
consanguineous parents from Panchagar was
admitted with the complains of generalized
oedema for 15 days and scanty micturition for
10 days. He suffered from nephrotic syndrome
1st attack 10 months back and was treated
accordingly with prednisolone at optimal dose
Case History
and duration. There was no history of skin
infection or sore throat prior to this illness. There
is no history of chest pain, breathlessness,
headache, hypertension or passage of high
colour urine.
27. Salient Features
On examination Jubayer was found playful,
oedematous, moderately pale. Vital signs are
found within normal limit i.e. HR- Resp. Rate-
Temp. 0F and blood pressure mm of Hg. Skin
survey revealed presence of BCG mark and
absence of any skin lesion. There is no
Case History
lymphadenopathy. Bed side urine protein was
4+. Systemic examination revealed presence of
ascites without hepatosplenomegaly.
Examination of respiratory , cardiovascular and
other system revealed no abnormality.
28. Provisional Diagnosis
Nephrotic Syndrome
(1st relapse) most
Case History
probably Minimal
change disease
29. Differential Diagnosis
Nephrotic syndrome
other than minimal
Case History
change disease
30. Laboratory Investigations
1. Urine routine and microscopic examination (10/04/12)
Appearance
Color Straw
Albumin +++
Microscopy
Pus cell 1 - 2/HPF
Case History
RBCs Nil
Epithelial cells 1 - 2 /HPF
Spot protein creatinine ratio 3.5
II. Urine culture (10/04/12)
No growth
31. Laboratory Investigations
II. Biochemical Parameters (on 11/02/2012)
Serum Creatinine 33.2 µmol/L
Blood urea 2.2 mmol/L
Serum Albumin 7.5 gm/dL
Serum electrolytes
Sodium 138.9 mmol/L
Potassium 3.3 mmol/L
Case History
Chloride 101.8 mmol/L
SGPT 38 IU/L
Serum calcium 1.79 mmol/L
C- Reactive Protein (CRP) 3.7 mg/L
32. Laboratory Investigations
III. Complete Haemogram (10/04/12)
Hemoglobin 10.1 gm/dL
ESR 125 mm in 1st hour
Total WBC Count 16,400 /cumm
Differential count of WBC
Neutrophil 60 %
Case History
Lymphocytes 35%
Monocytes 02 %
Eosinophil 03 %
33. Final Diagnosis
Nephrotic Syndrome (1st
Case History
relapse)
34. Management
A. General Supportive
• Normal diet
• Daily monitoring of Blood pressure, Weight,
Bedside urine albumin, recording of intake
and output, abdominal girth.
B. Specific
Case History
• Tab. Prednisolone 60 mg/m2/day for 4 - 6
weeks followed by 40 mg/m2 every alternate
day for 4 – 6 weeks.