Coagulation disorders can be congenital or acquired. Congenital disorders include hemophilia A which is a factor VIII deficiency and hemophilia B which is a factor IX deficiency. Von Willebrand disease is the most common inherited bleeding disorder caused by a defect in von Willebrand factor. Acquired coagulation disorders result from vitamin K deficiency, liver disease, or disseminated intravascular coagulation. Screening tests for coagulation disorders include platelet count, prothrombin time, and activated partial thromboplastin time.
Haemorrhagic and Haemolytic of Newborn DiseasesNaqib Bajuri
actually for haemorrhagic newborn diseases, mainly focus of vit K def...the other is for revision n more commonly occur in child n adults....for haemolytic newborn disease, mainly focus on Rh disease n ABO incompatibility.....the other when childhoods
Haemorrhagic and Haemolytic of Newborn DiseasesNaqib Bajuri
actually for haemorrhagic newborn diseases, mainly focus of vit K def...the other is for revision n more commonly occur in child n adults....for haemolytic newborn disease, mainly focus on Rh disease n ABO incompatibility.....the other when childhoods
Bleeding disorders Causes, Types, and DiagnosisDr Medical
https://userupload.net/v3l4i8jsk7wq
Factor II, V, VII, X, or XII deficiencies are bleeding disorders related to blood clotting problems or abnormal bleeding problems. Von Willebrand's disease isthe most common inherited bleeding disorder. It develops when the blood lacks von Willebrand factor, which helps the blood to clot.
This would give an idea of the various bleeding disorders, associated clotting factors and more specifically management in the dental office of the patients with bleeding disorders
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
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.
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.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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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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.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
9. PROTHROMBIN TIME (PT)
•
•
•
•
Measures the activity of certain clotting
factors (Extrinsic pathway)
Monitor patients on blood thinner medicine
like Coumadin
Prolonged:
Liver Diseases
Congenital deficiency of coagulation
factor V, VII, X Prothrombin or
Fibrinogen
Normal Values: 10-14 seconds
10. ACTIVATED PARTIAL PROTHROMBIN
TIME (APPT)
•
•
•
•
Test for intrinsic and common pathways
Dependent on activity of all coagulation
factors, except VII and XIII
Normal Values: 30-40 seconds
Monitors heparin tx & screen for
hemophilia
12. Laboratory test Components
Measured
Normal Values
Bleeding time Platelet function
Vascular Integrity
3-10 Minutes
PT I, II, V, VII, IX, X 10-14 Seconds
PTT I, II, V, VII, IX, X, XI, XII 30-40 Seconds
Thrombin
Time
I, II 12-20 Seconds
13. DISORDER OF COAGULATION
•
•
•
CONGENITAL
Either quantitative or
qualitative defect in single
coagulation factor
Haemophilia A
Haemophilia B
VWD
•
•
•
•
ACQUIRED
Deficiencies of Multiple
coagulation factors
Vit. K Def
Liver Disorders
Fibrinolytic defects
DIC
14. HEMOPHILIA
•
•
•
Bleeder’s disease, disease of Hapsburg,
the disease of kings
Hereditary disorder
Defect carried X chromosome and
transmitted as a gender linked Mendelian
recessive trait
16. HEMOPHILIA A
•
•
•
It is the most common hereditary coagulation disorder with
life threatening bleeding
Occurs in approximately 1:10,000 individuals.
Caused by hereditary deficiency or dysfunction of factor VIII.
17. •
•
•
•
In India about 1300 hemophiliacs are born
every year & currently there are about 50,
000 patients with severe disease.
In heritance of Hemophilia is X-linked
recessive is located on the X chromosome
The disease manifests only in males
because they lack the complementary
normal X chromosome.
Female are carriers but don’t manifest the
disease
18.
19. • Severity of disease is based on the amount
of Factor VIII C activity
20. •
•
•
•
•
CLINICAL FEATURES
Hemarthrosis
Acute excruciating pain in the affected
joint ex. Knee, Elbow or wrist joint.
Prolonged bleeding following trauma, tooth
extraction or surgery
Bleeding from mouth, gums and tongue is
common.
CNS bleeding is the most common serious
complication
21.
22. •
•
•
•
•
Patients present with headache, vomiting,
irritability, confusion and drowsiness.
Wound healing is delayed because of
continued bleeding at the site of injury
Petechiae are characteristically absent
LABORATORY INVESTIGATIONS
Prolonged PTT and a normal PT.
These tests point to on abnormality of the
intrinsic coagulation pathway
23.
24. HEMOPHILIA B
•
•
•
CHRISTMAS DISEASE, FACTOR IX
DEFICIENCY
Severe factor IX deficiency produces a
disorder clinically indistinguishable from
factor VIII deficiency (Hemophilia A)
PTT is prolonged and PT is normal
Treated with infusions of recombinant
factor IX
25. VON WILLEBRAND DISEASE
•
•
•
•
M.C inherited bleeding disorder
Bleeding tendency is mild and often goes
unnoticed until some hemostatic stress,
such as surgery or a dental procedure.
Spontaneous bleeding from mucous
membranes ex. Epistaxis
Excessive bleeding from wounds,
menorrhagia.
26. •
•
•
•
Prolonged bleeding time in the presence of
a normal platelet count
It is usually transmitted as an autosomal
dominant disorder, but rare autosomal
variant have been described.
CLASSIFICATION OF VWD
Type 1 : Characterized by a partial
quantitative decrease of normal vWF and
factor VIII
Type 2: vWD is a variant of the disease with
primarily qualitative defects of vWF. It is
either autosomal dominant or recessive
27. •
•
Type 3: Most severe and rarest form of
vWD, characterized by marked deficiency
of both vWF and factor VIII.
Prevalence rate 0.9-1.3 percent
Many children are asymptomatic and are
diagnosed as a result of positive family
history
Excessive Bleeding
Site : Nose, Skin and Gingiva
30. ACQUIRED
•
•
•
•
•
VITAMIN K DEFICIENCY
Hemorrhagic disease of newborn
Now uncommon due to administration of
vitamin K at birth
Vitamin K fat soluble vitamin
Noticed by Dam in the year 1929
Involved in both intrinsic and extrinsic
pathway
31. •
•
•
•
•
•
ROLE OF VITAMIN K
Necessary for post-translational
carboxylation of glutamic acid
Calcium binding to proteins like
Prothrombin factor II, VII, IX, X
SOURCE
Green leafy vegetables
Liver
Milk
Vegetable oils
35. DISSEMINATED INTRAVASCULAR
COAGULATION
•
•
Is an acute, Subacute or chronic thrombo-
hemorrhagic disorder.
Coagulation and results in the formation of
thrombi throughout the microcirculation.
ETIOLOGY
OBSTETRIC COMPLICATIONS:
Amniotic fluid embolism
Eclampsia
Premature separation of placenta
Retained dead fetus placenta
36.
INFECTIONS:
Meningococcal septicemia
Septic Abortion
Gm –ve sepsis E•Coli and Psedomanas
MALIGNANCIES:
Metastatic Mucus secreting
adenocarcinoma
Lymphoproliferative disorder
Fat Embolism
Vascular Disorder
Massive Tissue injury
Severe burn
Hepatic Failure
Post Surgery Massive Trauma
37.
38. PATHOPHYSIOLOGY
•
•
Two major mechanism trigger DIC
Release of tissue factor or thromboplastic
substances in to the circulation
Wide spread injury to the endothelial cells
41. •
•
•
•
•
•
•
•
•
LABORATORY FINDINGS
Prolonged aPPT, PT
Platelet count less than 50,000 /cu mm
Increase fibrin degradation products
Low level of coagulation inhibitors – AT III, Protein C
Low level of coagulation factors V, VIII, X, XIII
TREATMENT
Supportive therapy
No specific treatments
Anticoagulants (Heparin)
Fresh Frozen plasma
42. LIVER DISEASE
•
•
•
•
Liver plays a major role in clotting process.
Site for the synthesis of clotting factors
and their inhibitors.
Liver disease causes impaired hemostatic
function
Most common finding of liver disease is
thrombocytopenia.