Complications of sinusitis can be local, such as orbital cellulitis, or distant, like brain abscesses. Orbital complications are most common, with progression from preseptal cellulitis to orbital cellulitis, subperiosteal abscess, and orbital abscess. Intracranial complications include meningitis, epidural abscesses, subdural abscesses, and cerebral or venous sinus abscesses. Treatment involves antibiotics, surgical drainage of abscesses, and in severe cases like cavernous sinus thrombosis, anticoagulation. Prognosis is good with prompt treatment but risks include vision loss, diplopia, and neurological deficits.
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal, for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Complications of rhinosinusitis(Dr ravindra daggupati)Ravindra Daggupati
orbital complications of rhino sinusitis,intra cranial complications of rhino sinusitis,classification of complications,diagnosis and treatment of complications
Cavernous sinus thrombosis (CST) is a rare, life-threatening disorder that can complicate facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis or following traumatic injury or surgery, especially in the setting of a thrombophilic disorder. Early recognition of cavernous sinus thrombosis which, often presents with fever, headache, eye findings such as periorbital swelling, and ophthalmoplegia, is critical for a good outcome. Despite modern treatment with antibiotics and anticoagulation, the risk of long-term sequelae, such as vision, diplopia, and stroke, remains significant. This activity examines when cavernous sinus thrombosis should be considered, how to properly evaluate this condition and the role of the interprofessional team in caring for patients with this condition.
Slides prepared and compiled by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal, for teaching undergraduate and postgraduate ENT students in the field of otorhinolaryngology.
A clear and concise explanation of the basic concepts in the subject matter concerned.
He is the Head of department with a sound knowledge in the field of ENT to teach both undergraduate and postgraduate ENT students
Complications of rhinosinusitis(Dr ravindra daggupati)Ravindra Daggupati
orbital complications of rhino sinusitis,intra cranial complications of rhino sinusitis,classification of complications,diagnosis and treatment of complications
Cavernous sinus thrombosis (CST) is a rare, life-threatening disorder that can complicate facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis or following traumatic injury or surgery, especially in the setting of a thrombophilic disorder. Early recognition of cavernous sinus thrombosis which, often presents with fever, headache, eye findings such as periorbital swelling, and ophthalmoplegia, is critical for a good outcome. Despite modern treatment with antibiotics and anticoagulation, the risk of long-term sequelae, such as vision, diplopia, and stroke, remains significant. This activity examines when cavernous sinus thrombosis should be considered, how to properly evaluate this condition and the role of the interprofessional team in caring for patients with this condition.
Presentations and Management of Intracranial Abscess.pptxCHIZOWA EZEAKU
summary on intracranial abscess with emphasis on aetiology, pathogenesis, pathology, forms of presentations , investigations and treatment options of brain abscess.
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.
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
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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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
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
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.
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.
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!
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. • Sinusitis
• Definition of Complications of sinusitis
• Classification
• Clinical features
• Diagnosis
• Investigations
• Treatment
3. Definition
A complication of rhino-sinusitis may be defined as
any adverse progression of chronic or acute bacterial
infection beyond the paranasal sinuses, or
compromise in function of any part of the body due
to local or distant effects of the condition.
7. Orbital Complications
• Most commonly involved complication site:
Proximity to ethmoid sinuses
Orbital septum is the only soft-tissue barrier
Valveless superior and inferior ophthalmic veins
• Continuum of inflammatory/infectious changes
Direct extension through lamina papyracea
8. Impaired venous drainage from thrombophlebitis
Progression within 2 days
• Children more susceptible
< 7 years – isolated orbital (subperiosteal abscess)
> 7 years – orbital and intracranial complications
• Acute pansinusitis leads to 60 to 80% of orbital
complications
10. Periorbital cellulitis (Chandler class I)
• Most common and least severe
• 70 to 80% of cases
• The edema confined to periorbital eyelid by
the orbital septum
• Mild proptosis
13. Medical treatment
• Parenteral therapy
Surgical management is indicated if:
1. The patient fails to respond to IV therapy and/or
deteriorates clinically despite appropriate antibiotic
therapy
14. 2. Ocular motility/visual acuity deteriorates
3. Cranial neuropathies develop
4. The patient develops an abscess other than a
small, medially located subperiosteal abscess
15. Subperiosteal abscess (Chandler class III)
• Pus between the orbital periosteum and the bony
orbital wall
• Typically between the lamina papyracea and the
medial periorbita
16.
17. • Medial subperiosteal abscess: Endoscopic drainage
combined with an external approach
• Laterally seated subperiosteal abscess:
Decompression and drainage of the orbit through an
external approach
18. Orbital abscess (Chandler class IV)
• Extraconal (between the periosteum and the
extraocular muscles)
• Intraconal (located centrally within the muscle cone)
19.
20. Cavernous sinus thrombosis, or CST (Chandler class V)
• Proptosis (often Bilateral)
• Chemosis
• Progressive opthalmoplegia
• Complete loss of vision
22. Treatment
• Mortality rate up to 30%
• Surgical drainage
• Intravenous antibiotics
High-dose
Cross blood-brain barrier
• Anticoagulant use is controversial
Prevent thrombus propagation
Risk intracranial or intra-orbital bleeding
23. PROGNOSIS
• If prompt treatment is carried out with adequate
monitoring of patients during treatment, the
prognosis for the return of normal vision is excellent.
• However, there is a small, but significant risk of
diplopia following surgery
24. Intracranial
• Pathogenesis: two major mechanisms
• Direct extension
• Retrograde thrombophlebitis via the valveless diploic
veins
26. Clinical features
• Nausea and vomiting, neck stiffness, and altered
mental state.
• Increased ICT, meningeal irritation, and focal
neurologic deficits, including CN III, VI, and VII palsies
42. Surgical and medical therapy
• Drain abscess and remove infected bone
• Intravenous antibiotics for six weeks
• May obliterate frontal sinus to prevent
recurrence
diploeic veins of the frontal and sphenoid bones. Direct extension occurs through congenital bony dehiscences, open suture lines or
foramina, or by erosion through bony barriers (e.g., laminapapyracea)
(a) preseptal inflammation: (b) orbital cellulitis; (c) orbital cellulitis with subperiosteal (extra periosteal) abscess;(d) orbital cellulitis with intraperiosteal abscess. (e) cavernous sinus thrombosis
1.No change in extra-ocular movement or an impairment of vision, Visual problems may be present if the problem is stage three (subperiosteal
abscess) or beyond, and specific enquiries should be made regarding visual acuity and colour vision, problems which might indicate a compromise of optic nerve function.
2.IV broad-spectrum antibiotics and hospital observation ,Warm compresses Facilitate sinus drainage, Nasal decongestants Mucolytics Saline irrigations
1.orbital pain -85 to 89%. Formal assessment colour vision, eye movement, visual acuity should be repeated daily. In cases of increased concern six-hourly monitoring of the full range of eye movements, visual acuity and colour vision should be undertaken in conjunction with regular temp & Pulse. If intracranial complications are found, hourly neurological monitoring is likely to be appropriate.
Sepahdari et al examined the use of diffusion weighted imaging (DWI) MRI in the diagnosis of orbital cellulitis and abscess
1.Diffuse enhancement of the left orbit consistent with cellulitis secondary to sinusitis (coronal T1-weighted MRI)
1.until the patient is afebrile and skin changes such as lid edema and erythema have resolved, typically 3 to 5 days. Facilitate sinus drainage
Nasal decongestants Mucolytics Saline irrigations
1.pushing the orbital contents inferiorly and laterally
1. Axial CT- associated left proptosis, enlargement of the left medial rectus muscle, and left ethmoid opacification
2. With advancing infection, ocular mobility and visual acuity are affected, and chemosis develops. The abscess may penetrate through the periosteum into the orbit or anteriorly into the eyelid.
May be treated medically in 50-67%, Combined treatment 95-100% Meta-analysis cure rate 26-93% (Coenraad 2009). Approaches External ethmoidectomy (Lynch incision) is most preferred Transcaruncular approach
proptosis, a limitation of extraocular movement,and visual loss.
(coronal T1-weighted MRI post- gadolinium) diffuse enhancement of the left orbit (cellulitis) with a low density area (fluid) within the inferolateral orbit consistent with an intraorbital abscess
Animal experiments have demonstrated that visual loss may be irreversible if retinal ischaemic time exceeds 100 minutes. Progress ophalmo-lateral gaze affected first
MRI findings of heterogeneity and increased size
Following surgery, a prolonged course (6 weeks) of culture-directed antibiotic therapy.
1.osteomyelitis and subsequent erosion, If infection reaches the subdural space- spreads convexities of the brain because of the lack of septations. The implantation of the arachnoid granules-barrier
Common signs and symptoms Fever (92%) Headache (85%) Nausea, vomiting (62%) Altered consciousness (31%), seizure
Usually amenable with medical treatment Drain sinuses if no improvement after 48 hours
Symptoms, Crescent-shaped hypodensity on CT. It typically occurs just posterior to the frontal sinus, where free venous communication and loose dura
predispose it to abscess formation between the dura and the cranial vault.
Subdural empyemas (41 to 67%) result from sinusitis. Extradural empyema of (L) planum sphenoidale.
antibiotics for 4-8 weeks; usually vancomycin and 3rd or 4th generation cephalosporin
Hemiparesis Lethargy, coma
Antibiotic 6-8 weeks; typically ceftriaxone, vancomycin or nafcillin, and metronidazole. Corticosteroid use is controversial. Steroids can retard the encapsulation process, increase necrosis, reduce antibiotic penetration
Heparin inpatient, warfarin outpatient
Sir Percivall Pott described Pott's Puffy tumor in 1768 as a local subperiosteal abscess due to frontal bone suppuration resulting from trauma
Headache Fever Neurologic findings Periorbital or frontal swelling