This document summarizes the history and physical examination findings of a 46-year-old man admitted to the hospital with fever, jaundice, abdominal distension, and edema. Notable findings included enlarged liver, ascites, anemia, and coagulopathy. Laboratory tests confirmed chronic liver disease and cirrhosis likely due to alcohol use. The patient was diagnosed with cirrhosis and treated with medications to manage ascites, coagulopathy, infections, and complications while abstaining from alcohol. He was referred to the liver unit for ongoing management.
A chronic, progressive disease characterized by widespread fibrosis(scarring) and nodule formation.
The development of cirrhosis is an insidious, prolonged course, usually after decades of chronic liver disease.
Liver cirrhosis, Clinical Presentation, Complications and Treatment.DrSyedMansoorRashid
Liver cirrhosis and Its Complications.
For Undergraduates to know briefly about Liver Cirrhosis and its complications,
Some of data has been taken from other slides and Davidson book of Medicine, but references are not added to the slides.
Dr Syed Mansoor Rashid (Bukhari)
CASE PRESENTATION ONCIRRHOSIS OF LIVER WITH PORTAL HYPERTENSION, HEPATIC EN...Akhil Joseph
A DETAIL CASE PRESENTATION ON CIRRHOSIS OF LIVER WITH PORTAL HYPERTENSION, HEPATIC ENCEPHALOPATHY AND GRADE II OESOPHAGEAL VARICES WITH CONGESTIVE GASTROPATHY. LIVER CIRRHOSIS AND ALL ITS COMPLICATION IN A PATIENT.
Cirrhosis is a diffuse process characterized by liver necrosis & fibrosis and conversion of normal liver architecture into structurally abnormal nodules that lack normal lobular organization
A chronic, progressive disease characterized by widespread fibrosis(scarring) and nodule formation.
The development of cirrhosis is an insidious, prolonged course, usually after decades of chronic liver disease.
Liver cirrhosis, Clinical Presentation, Complications and Treatment.DrSyedMansoorRashid
Liver cirrhosis and Its Complications.
For Undergraduates to know briefly about Liver Cirrhosis and its complications,
Some of data has been taken from other slides and Davidson book of Medicine, but references are not added to the slides.
Dr Syed Mansoor Rashid (Bukhari)
CASE PRESENTATION ONCIRRHOSIS OF LIVER WITH PORTAL HYPERTENSION, HEPATIC EN...Akhil Joseph
A DETAIL CASE PRESENTATION ON CIRRHOSIS OF LIVER WITH PORTAL HYPERTENSION, HEPATIC ENCEPHALOPATHY AND GRADE II OESOPHAGEAL VARICES WITH CONGESTIVE GASTROPATHY. LIVER CIRRHOSIS AND ALL ITS COMPLICATION IN A PATIENT.
Cirrhosis is a diffuse process characterized by liver necrosis & fibrosis and conversion of normal liver architecture into structurally abnormal nodules that lack normal lobular organization
Ketoacidosis and another commorbid and electorlyte imbalanceSoroy Lardo
DM with complication dan commorbid disases has potential complication become severe condition. Electrolyte imbalance one of point disregulation that inflammation on going
A slide on Chronic kidney disease. At the beginning of the presentation is a case study, a patient admitted and treated for chronic kidney disease. Other parts covered include relevant anatomy and physiology, aetiopathogenesis and pathophysiology of the condition, as well as management and prevention.
Undergraduate level Presentation on Childhood Tuberculosis based on WHO guidelines, local Myanmar guidelines, Nelson Textbook of Paediatrics and WHO training modules.It would be mostly appropriate for countries with high Tuberculosis burden.
Sources specified. The original sources of some photos could not be mentioned due to space limitations. I deeply apologize for that.
Undergraduate level presentation on head injury
Includes:
Physiology & Pathophysiology
Epidemiology
Initial evaluation and management
History
Examination
Classification
Management
Outcomes
regarding head injury.
Undergraduate level presentation on Prevention of Surgical infection covering the topics of:
History
Definition
Classification
Risk factors
Surgical Site Infection (SSI)
Tetanus
Gas gangrene
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.
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.
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.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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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
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
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
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
5. Chief complaint
•Fever off and on x 2 months
•Yellow discoloration of skin & sclera x 2 months
•Abdominal Distension and oedema x one and half month
7. Yellow discolorations of skin & sclera
•Noticed by himself while washing his face
•Duration : 2 months
•Onset : Gradual
•Progression: Progressive
•Urine colour : High colour
•Stool colour : Normal
8. For haemolytic jaundice
•No family history of blood diseases/ blood transfusion
•No associated pallor according to the patient
9. For viral hepatitis
•No prodromal symptoms such as anorexia, nausea, vomiting, distaste, rash, joint
and muscle pain.
•No outbreak of VH - A nearby.
•No risk factors for VH – B/C/D such as
oBlood tansfusion,
ounsterile injection,
otatooing,
oear-piercing
osexual promiscuity
•Vaccination (-)
10. For leptospirosis
•No eyeball tenderness
•No abdominal pain, decreased urine output
•No chest pain
•No cough with sputum, haemoptysis
•No muscle and joint pain
•No occupational risk for getting Leptospira infection
12. History of alcohol drinking
•Type : Whisky
•Duration : 2 years
•Amount : 3 – 4 bottles/day
13. For post hepatic jaundice
•No pruritus
•No history of passing worms
•No risk factors for gall stones such as being age over 50, fat,
female gender, being fertile & flatulence
14. Fever
•Duration : 2 months
•Character : Remittent
•Severity : high fever
•No chill and rigor
•Travelling history (+)
•History of TB contact (-)
•Risk factors associated with HIV infection (-)
•Abdominal pain (-)
15. Abdominal distention and Oedema
•Onset : Gradual
•Duration : one and half month
•Site of 1st appearance : Legs
•Progress and rate : Progressive and Gradual
•Severity : Not associated with breathlessness, orthopnoea
•Amount of urine : Normal
•Aggravating Factors : unknown
•Relieving Factors : Diuretics
21. For spontaneous bacterial peritonitis
•Fever (+)
•Abdominal pain (-)
For hepatorenal syndrome
•Oliguria (-)
22. System Review
•Respiratory : Cough(-), Sputum(-), Haemoptysis(-),
wheeze(-), Stridor(-)
•CVS : Dysnoea on exertion(-), Cyanosis(-)
•Renal : Normal Urine Output, Normal urine colour
•CNS : Fit(-)
23. Past Medical History
•Hepatitis (+)
•No past history of blood disorder requiring transfusion
•Hypertension (-)
•Diabetes Mellitus (-)
•Ischaemic heart disease (-)
•TB (-)
24. • On March 2015, admitted to North Okkalar General Hospital for 5
days for the similar complaints.
• Went to 2 follow up after discharge from NOGH.
• On 2nd May. admitted to Aung Yadanar Polyclinic.
27. Drug History
•No known drug allergy.
• No history of taking drug apart from those prescribed by the
hospital.
•There is no history of taking drugs that can cause haemolysis such as
sulphonamides and dapsone.
•No history of taking hepatotoxic drugs such as INH and rafimpicin,
methotrexate, prolonged used of NSAIDs and chlopromazine, etc
•No history of taking indigenous medicine.
33. Abdominal examination (Inspection)
The shape of the abdomen is distended.
The flanks are full.
Umbilicus is flat.
It moves with respiration.
There is no scar, no dilated veins.
No visible mass and peristalsis.
Hernia orifices are intact.
35. Abdominal examination (Palpation)
Deep Palpation
Liver: size-about 4cm from the right coastal margin,
tenderness(-)
Spleen: is not enlarged
Kidneys are not ballotable.
36. Abdominal examination (Percussion)
Liver dullness is increased up to the right 4th intercostal
space along the mid-clavicular line
Upward enlargement of liver (+)
Splenic dullness is absent
Free fluid: Shifting dullness (+)
40. System Review
CVS system – no cyanosis, no cardiomegaly, no added
sounds
Respiratory system –no apical crepitations, no bilateral
basal crepitations
46. Total & Differential Protein (T & DP)
Total protein 60 g/L (reduced)
Albumin 23 g/L (reduced)
Globulin 37 g/L (raised)
A:G ratio reversed
47. Coagulation tests
PT (Prothrombin time) 35 sec (prolonged)
(normal control is 12.0 sec)
INR (International Normalized Ratio) 2.83
INR =
Patient PT
Normal mean PT
ISI
ISI = International Sensitivity Index of thromboplastin
56. Other tests
ESR 60mm after 1st hour (raised)
HBsAg negative
Anti HCV negative
RBS 131 mg/dl
CXR (PA) cardiomegaly
ECG NAD
OGD scopy planned to do next week
57. Child – Pugh Classification
Serum Bilirubin >50 μmol/L 3
Albumin <28 g/L 3
PT >6 sec longer than normal 3
Ascites mild 2
Encephalopathy none 1
Total Score 12 = Child’s C
1st year survival 42%
5th year survival 20%
Refer to Davidson’s Principles & Practice of Medicine
22nd Ed. Pg. 944 for the full scoring system.
58. Maddrey’s discriminant function (DF)
DF = [ 4.6 x Increase in PT (sec) ] + Bilirubin (mg/dL)
DF = 111
> 32 implies severe liver disease with a poor prognosis.
62. Treatment of Ascites
Bed rest in supine position
Salt, water restriction
PO Spironolactone (Aldactone®) 4 tablets od
IV Furosemide (Lasix®) 40 mg 12 hrly