Definition of arrhythmia - background on cardiac physiology including conduction in heart - action potential - pathogensis of arrhythmia - causes and risk factors for arrhythmia- diagnosis of arrhythmia - symptoms of tachyarrhythmias and bradyarrhythmias - investigations for arrhythmia - treatment of arrhythmia - pharmacological and other modalities of therapy for arrhythmia - managment of different types of arrhythmias
What are anti-coagulants?
What are the difference between antiplatelet, anticoagulants and thrombolytics?
Coagulation cascade
Virchows Triad
Classification of anti-coagulants?
Indications of anti-coagulants?
Mechanism and site of action of different anti-coagulants?
Definition of arrhythmia - background on cardiac physiology including conduction in heart - action potential - pathogensis of arrhythmia - causes and risk factors for arrhythmia- diagnosis of arrhythmia - symptoms of tachyarrhythmias and bradyarrhythmias - investigations for arrhythmia - treatment of arrhythmia - pharmacological and other modalities of therapy for arrhythmia - managment of different types of arrhythmias
What are anti-coagulants?
What are the difference between antiplatelet, anticoagulants and thrombolytics?
Coagulation cascade
Virchows Triad
Classification of anti-coagulants?
Indications of anti-coagulants?
Mechanism and site of action of different anti-coagulants?
• Incidence
• Pathophysiology
• Assessment and common findings
PCCM 86
• Management PCCM 86
• Complications
o Vulvular heart disease
o Bacterial endocarditis
• Prevention of RHD PCCM 86
Primary
o Secondary
o Tertiary
o Refer
• Essential health information
Definition: Heart failure is a clinical syndrome characterized
by inadequate systemic perfusion to meet the body's
metabolic demands as a result of abnormalities of cardiac
structure or function.
• This may be further subdivided into:
Systolic heart failure: Reduced cardiac contractility
Diastolic heart failure: Impaired cardiac relaxation and
abnormal ventricular filling
Etiology: Most common cause of CHF - Left
ventricular systolic dysfunction (about 60 - 70%)
1. Decreased contractile function
a) Valvular heart disease
b) Coronary Heart Disease : Myocardial ischemia
c) Myocardial Disease : Cardiomyopathy , Myocarditis
2.Increased after load
a)Acute systemic hypertension
3.Abnormalities in preload
a)Excessive preload
b)Reduced preload
Reduced compliance states:
Constrictive pericarditis
Restrictive cardiomyopathy
Precipitating factors:
o Represented with the mnemonic HEARTFAILES
H- Hypertension (systemic)
E- Endocarditis (infections)
A- Anemia
R- Rheumatic fever and myocarditis
T- Thyrotoxicosis and pregnancy
F- Fever (infections)
A- Arrhythmia
I- infarction (myocardial)
L- Lung infection
E- Embolism (pulmonary)
achycardia and Tachypnea
• Jugular venous distention (JVD)
• Pulsus alternans (alternating weak and strong pulse)
• Lung auscultation -Wheezing or rales may be heard
• Cardiac auscultation - Aortic or mitral valvular abnormality
• Skin may be diaphoretic or cold, gray, and cyanotic
• Lower extremity edema
Physical findings:
hest x-ray :
Cardiomegaly
Pulmonary edema, and
Pleural effusion
Echocardiography : may help identify
Valvular abnormalities
Ventricular dysfunction
Cardiac temponade
Pericardial constriction, and
Pulmonary embolus
Electrocardiogram (ECG) (nonspecific tool)
Concomitant cardiac ischemia,
Prior myocardial infarction (MI),
Cardiac dysrhythmias,
Chronic hypertension, and other causes of left ventricular
hypertrophy.
Other laboratory tests (biomarkers)
Hemoglobin, Urinalysis, BUN, Creatinine
Diagnostic approaches
Principles of CHF management
1. Identify and treat the precipitating factors
2. Control the congestive state
3. Improve myocardial performance
4. Prevention of deterioration of myocardial function
5. Treat the underlying cause
Management of Heart Failure
References
• Kasper L., Braunwald E., Harrison’s principles of Internal medicine,
16th Edition, Heart failure, pages 1367-1377.
• Getachew Tizazu, Tadesse Anteneh, internal medicine Lecture notes
For Health Officers, Heart failure, pages 2010-2017
• Karen Whalen, Richard S. Finkel, Thomas A. Panavelil Wolters Kluwer,
Lippincott Illustrated Reviews: Pharmacology, Sixth Edition,
• Kemp CD, Conte JV. The pathophysiology of heart failure. Cardiovasc
Pathol. 2012 Sep-Oct;21(5):365-71.
• King M, Kingery J, Casey B. Diagnosis and evaluation of heart
failure. Am Fam Physician. 2012 Jun 15;85(12):1161-8. 5/06/2022
• Incidence
• Pathophysiology
• Assessment and common findings
PCCM 86
• Management PCCM 86
• Complications
o Vulvular heart disease
o Bacterial endocarditis
• Prevention of RHD PCCM 86
Primary
o Secondary
o Tertiary
o Refer
• Essential health information
Definition: Heart failure is a clinical syndrome characterized
by inadequate systemic perfusion to meet the body's
metabolic demands as a result of abnormalities of cardiac
structure or function.
• This may be further subdivided into:
Systolic heart failure: Reduced cardiac contractility
Diastolic heart failure: Impaired cardiac relaxation and
abnormal ventricular filling
Etiology: Most common cause of CHF - Left
ventricular systolic dysfunction (about 60 - 70%)
1. Decreased contractile function
a) Valvular heart disease
b) Coronary Heart Disease : Myocardial ischemia
c) Myocardial Disease : Cardiomyopathy , Myocarditis
2.Increased after load
a)Acute systemic hypertension
3.Abnormalities in preload
a)Excessive preload
b)Reduced preload
Reduced compliance states:
Constrictive pericarditis
Restrictive cardiomyopathy
Precipitating factors:
o Represented with the mnemonic HEARTFAILES
H- Hypertension (systemic)
E- Endocarditis (infections)
A- Anemia
R- Rheumatic fever and myocarditis
T- Thyrotoxicosis and pregnancy
F- Fever (infections)
A- Arrhythmia
I- infarction (myocardial)
L- Lung infection
E- Embolism (pulmonary)
achycardia and Tachypnea
• Jugular venous distention (JVD)
• Pulsus alternans (alternating weak and strong pulse)
• Lung auscultation -Wheezing or rales may be heard
• Cardiac auscultation - Aortic or mitral valvular abnormality
• Skin may be diaphoretic or cold, gray, and cyanotic
• Lower extremity edema
Physical findings:
hest x-ray :
Cardiomegaly
Pulmonary edema, and
Pleural effusion
Echocardiography : may help identify
Valvular abnormalities
Ventricular dysfunction
Cardiac temponade
Pericardial constriction, and
Pulmonary embolus
Electrocardiogram (ECG) (nonspecific tool)
Concomitant cardiac ischemia,
Prior myocardial infarction (MI),
Cardiac dysrhythmias,
Chronic hypertension, and other causes of left ventricular
hypertrophy.
Other laboratory tests (biomarkers)
Hemoglobin, Urinalysis, BUN, Creatinine
Diagnostic approaches
Principles of CHF management
1. Identify and treat the precipitating factors
2. Control the congestive state
3. Improve myocardial performance
4. Prevention of deterioration of myocardial function
5. Treat the underlying cause
Management of Heart Failure
References
• Kasper L., Braunwald E., Harrison’s principles of Internal medicine,
16th Edition, Heart failure, pages 1367-1377.
• Getachew Tizazu, Tadesse Anteneh, internal medicine Lecture notes
For Health Officers, Heart failure, pages 2010-2017
• Karen Whalen, Richard S. Finkel, Thomas A. Panavelil Wolters Kluwer,
Lippincott Illustrated Reviews: Pharmacology, Sixth Edition,
• Kemp CD, Conte JV. The pathophysiology of heart failure. Cardiovasc
Pathol. 2012 Sep-Oct;21(5):365-71.
• King M, Kingery J, Casey B. Diagnosis and evaluation of heart
failure. Am Fam Physician. 2012 Jun 15;85(12):1161-8. 5/06/2022
Mubashar A Choudry MD | Effects of statin or usual care on outcomesMubashar A Choudry MD
Here, Dr. Mubashar A Choudry MD is explaining about effects of statin or usual care on outcomes. Dr. Mubashar Choudry is a respected cardiologist in Washington.
Heart Disease & Chest Pain Treatment At NT Cardiovascular Center Georgiamelvillejackson
http://www.ntcardiovascularcenter.com NT Cardiovascular Center providing latest cutting edge and comprehensive technology for heart disease, chest pain treatments, congestive heart failure, coronary artery disease monitoring, or any critical heart condition.
Presentations by Tawfiq Choudhury and Rocco Hadland from the second webinar of the Mastering Cholesterol webinar series on Thursday 11 May 2023, focusing on Statins.
Contains 17 clinical situations of prolonged fever and discussion of various differential diagnosis based on them. Also gives the key points in the diagnosis of a prototype diagnosis and the usefulness of a relevant investigation modality in identifying these conditions. This power point presentaion is based on the chapter in Harrison's Text Book on Internal Medicine chapter on Fever of Unknown Origin
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.
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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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
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!
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.
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
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.
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.
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
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.
23. 123 articles 18 trials 2986 patients 7 (n = 562) of metoprolol, 2 (n = 1509) of carvedilol, 2 (n = 36) of nebivolol, 1 (n= 641) of bisoprolol, 1 (n = 17) of acebutolol & 1 (n = 12) of labetalol Improved LVEF (P < 0.001) (11 trials) Higher rates of bradycardia, hypotension, and dizziness (P < 0.001) (13 trials) A decreased rate of worsening of heart failure (P < 0.001) (13 trials) no difference between β-blockers placebo for maximum exercise duration (9 trials)
24.
25.
26. No difference in deaths 1181 vs 1194 More patients in the digoxin group were hospitalized for digoxin toxicity than in the placebo group (P < 0.001) Subgroup analyses suggested a greater benefit among patients at high risk patients Conclusions Digoxin did not affect mortality but reduced hospitalizations in patients with heart failure and normal sinus rhythm. May need to be cautious in female where overdosing may occur
27.
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29. Main results greater improvement in NYHA class (P < 0.001) did not differ for adverse effects: 82% of patients in the spironolactone group had ≥ 1 event compared with 79% of patients in the placebo group (P = 0.17) “serious hyperkalemia” 1% vs 2% (ns); no comment on mild-moderate men in tx group had higher rate of gynecomastia or breast pain (10% vs 1%, P < 0.001). Conclusion Spironolactone reduced all-cause mortality, death, and hospitalization from cardiac causes and death from CHF and improved NYHA functional class in patients with severe CHF.
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37. Heart Failure & Sudden Cardiac Arrest Framingham Heart study – Heart Failure predicts SCD and overall mortality Reduced Left Ventricular Ejection Fraction & risk for sudden cardiac arrest
38. Sudden cardiac Death SCD-HeFT Trial Implantable Defibrillator ICD significantly reduced mortality at 4 year follow up