The PMS process is focused on the collection and analysis of the data that comes from various sources and is carried out according to a PMS plan to be established for each MD in order to:
Technology Considerations to Enable the Risk-Based Monitoring Methodologywww.datatrak.com
TransCelerate BioPharma Inc developed a methodology based on the notion that shifting monitoring processes from an excessive concentration on source data verification to comprehensive risk-driven monitoring will increase efficiencies and enhance patient
safety and data integrity while maintaining adherence to good clinical practice regulations. This philosophical shift in monitoring processes employs the addition of centralized and off-site mechanisms to monitor important trial parameters holistically, and it uses adaptive on-site monitoring to further support site processes, subject safety, and data quality. The main tenet is to use available data to monitor, assess, and mitigate the overall risk associated with clinical trials. Having the right technology is critical to collect and aggregate data, provide analytical capabilities, and track issues to demonstrate that a thorough quality management framework is in place. This paper lays out the high-level considerations when designing and building an integrated technology solution that will aid in scaling the methodology across an organization’s portfolio.
Risk and benefit profile which study sponsors and investigators can easily gather, assess, and report important information about the risks and benefits of a study to help participants make an informed decision about whether or not to enroll.
Technology Considerations to Enable the Risk-Based Monitoring Methodologywww.datatrak.com
TransCelerate BioPharma Inc developed a methodology based on the notion that shifting monitoring processes from an excessive concentration on source data verification to comprehensive risk-driven monitoring will increase efficiencies and enhance patient
safety and data integrity while maintaining adherence to good clinical practice regulations. This philosophical shift in monitoring processes employs the addition of centralized and off-site mechanisms to monitor important trial parameters holistically, and it uses adaptive on-site monitoring to further support site processes, subject safety, and data quality. The main tenet is to use available data to monitor, assess, and mitigate the overall risk associated with clinical trials. Having the right technology is critical to collect and aggregate data, provide analytical capabilities, and track issues to demonstrate that a thorough quality management framework is in place. This paper lays out the high-level considerations when designing and building an integrated technology solution that will aid in scaling the methodology across an organization’s portfolio.
Risk and benefit profile which study sponsors and investigators can easily gather, assess, and report important information about the risks and benefits of a study to help participants make an informed decision about whether or not to enroll.
Understanding Risk Management & Cyber security Principles in Medical DevicesKeerthi Gunasekaran
The reality is Risk Management is one of the more complex aspects of compliance and product efficacy, as risk comes in so many forms and perceptions, and on top of it risk assessments can be interpreted differently across a sector. Often decisions must be made with not enough data to accurately quantify risks. This course teaches the principles and org mindset needed to manage RM and setup cyber security. An Excerpt from ASQ MN presentation by the author Keerthi Gunasekaran
Accelerating the Development of Medical Devices: The Value of Proactive Risk ...Cognizant
Identifying risks and working to mitigate them during the early stages of product development is critical for medical-device manufacturers worldwide. By focusing on four strategies - risk limitation, risk transfer, risk avoidance and risk acceptance, companies can evaluate risk effectively, take appropriate actions, and reduce the time and costs associated with New Product Development (NPD).
This whitepaper discusses the future path of pharmacovigilance from a safety, regulatory and technological perspective. It argues the need to rethink traditional Pharmacovigilance (PV) strategies and discusses the influential role technology including cloud-based solutions, mobile applications, robotic automation, artificial intelligence (AI) and big data analytics will play in transforming the safety continuum.
A compliant CER should support strong clinical evidence that your device achieves its intended purpose without exposing users and patients to risk. The CER must be based on clinical data, which may include clinical data from existing literature, clinical experience, clinical trials, or any combination of the three.
You are required to prepare and submit a clinical evaluation report with your technical file as part of the CE Marking/conformity assessment process. However, approach the CER as a standalone document.
hello there , During M pharm , I have presented this for seminar purpose named as '' QUALITY RISK MANAGEMENT " Hope it will reach your expectations. thank you.
Clinical evaluation report cer in a more stringent regulatory- Pepgra HealthcarePEPGRA Healthcare
European regulatory framework has established rules that govern the development, manufacturing, and marketing of medical devices in the European market. Both European and non-European medical device manufacturer’s fall under the purview of the regulatory framework, which is established to
provide condence to the clinicians and the patients that the medical devices and the implantable devices used in the region have been validated for their potential benets and certied as safe for usage.
Medical Device Software Development: Key Processes and Critical FactorsDashTechnologiesInc
Medical device software development demands a meticulous approach to ensure the creation of safe, effective, and compliant products. The interplay of regulatory compliance, risk management, and thorough documentation contributes to the success of medical device software in improving patient outcomes and advancing healthcare technology.
Overview of Risk Based Monitoring in Clinical Trial ProcessesEditorIJTSRD1
Risk based monitoring RBM has emerged as a transformative approach in clinical trial processes. This paper provides an overview of RBM and its impact on the field of clinical research. By moving away from traditional on site monitoring and adopting a targeted and efficient approach, RBM has demonstrated numerous benefits in terms of cost effectiveness, data quality, and patient safety. This abstract summarizes the key findings discussed in the conclusion. The proactive identification and management of risks throughout the trial lifecycle have led to improved decision making, increased study participant compliance, and enhanced overall trial success rates. With advancing technology, RBM approaches are expected to evolve further, allowing for greater optimization and streamlining of clinical trial processes. The abstract concludes by emphasizing the potential of risk based monitoring to shape the future of clinical research and contribute to the development of safe and effective therapies for patients worldwide. Kelam Himasri | Sankara Narayanan. K "Overview of Risk-Based Monitoring in Clinical Trial Processes" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-3 , June 2023, URL: https://www.ijtsrd.com.com/papers/ijtsrd58586.pdf Paper URL: https://www.ijtsrd.com.com/pharmacy/pharmacy-practice/58586/overview-of-riskbased-monitoring-in-clinical-trial-processes/kelam-himasri
Software as a Medical Device (SaMD) - IMDRF Definition and Categorisationpi
Following the growing importance of technology in healthcare, Medical Devices have begun to play an increasingly important role in the further development of the life sciences landscape.
One of its more remarkable and fastest growing segments goes under the name Software as a Medical Device. This presentation zooms in on the definition and categorisation, as used by the International Medical Device Regulators Forum.
JOURNAL CLUB PRESENTATION (20L81S0402-PA & QA)
Presented by: K VENKATSAI PRASAD (Department of pharmaceutical analysis and quality assurance).RIPER, anantapur
Defining a Central Monitoring Capability: Sharing the Experience of TransCele...www.datatrak.com
Central monitoring, on-site monitoring, and off-site monitoring provide an integrated approach to clinical trial quality management. TransCelerate distinguishes central monitoring from other types of central data review activities and puts it in the context of an overall monitoring strategy. Any organization seeking to implement central monitoring will need people with the right skills, technology options that support a holistic review of study-related information, and adaptable processes. There are different approaches actively being used to implement central monitoring. This article provides a description of how companies are deploying central monitoring, as well as samples of the workflows that illustrate how some have implemented it. The desired outcomes include earlier, more predictive detection of quality issues. This paper describes the initial implementation steps designed to learn what organizational capabilities are necessary.
Understanding Risk Management & Cyber security Principles in Medical DevicesKeerthi Gunasekaran
The reality is Risk Management is one of the more complex aspects of compliance and product efficacy, as risk comes in so many forms and perceptions, and on top of it risk assessments can be interpreted differently across a sector. Often decisions must be made with not enough data to accurately quantify risks. This course teaches the principles and org mindset needed to manage RM and setup cyber security. An Excerpt from ASQ MN presentation by the author Keerthi Gunasekaran
Accelerating the Development of Medical Devices: The Value of Proactive Risk ...Cognizant
Identifying risks and working to mitigate them during the early stages of product development is critical for medical-device manufacturers worldwide. By focusing on four strategies - risk limitation, risk transfer, risk avoidance and risk acceptance, companies can evaluate risk effectively, take appropriate actions, and reduce the time and costs associated with New Product Development (NPD).
This whitepaper discusses the future path of pharmacovigilance from a safety, regulatory and technological perspective. It argues the need to rethink traditional Pharmacovigilance (PV) strategies and discusses the influential role technology including cloud-based solutions, mobile applications, robotic automation, artificial intelligence (AI) and big data analytics will play in transforming the safety continuum.
A compliant CER should support strong clinical evidence that your device achieves its intended purpose without exposing users and patients to risk. The CER must be based on clinical data, which may include clinical data from existing literature, clinical experience, clinical trials, or any combination of the three.
You are required to prepare and submit a clinical evaluation report with your technical file as part of the CE Marking/conformity assessment process. However, approach the CER as a standalone document.
hello there , During M pharm , I have presented this for seminar purpose named as '' QUALITY RISK MANAGEMENT " Hope it will reach your expectations. thank you.
Clinical evaluation report cer in a more stringent regulatory- Pepgra HealthcarePEPGRA Healthcare
European regulatory framework has established rules that govern the development, manufacturing, and marketing of medical devices in the European market. Both European and non-European medical device manufacturer’s fall under the purview of the regulatory framework, which is established to
provide condence to the clinicians and the patients that the medical devices and the implantable devices used in the region have been validated for their potential benets and certied as safe for usage.
Medical Device Software Development: Key Processes and Critical FactorsDashTechnologiesInc
Medical device software development demands a meticulous approach to ensure the creation of safe, effective, and compliant products. The interplay of regulatory compliance, risk management, and thorough documentation contributes to the success of medical device software in improving patient outcomes and advancing healthcare technology.
Overview of Risk Based Monitoring in Clinical Trial ProcessesEditorIJTSRD1
Risk based monitoring RBM has emerged as a transformative approach in clinical trial processes. This paper provides an overview of RBM and its impact on the field of clinical research. By moving away from traditional on site monitoring and adopting a targeted and efficient approach, RBM has demonstrated numerous benefits in terms of cost effectiveness, data quality, and patient safety. This abstract summarizes the key findings discussed in the conclusion. The proactive identification and management of risks throughout the trial lifecycle have led to improved decision making, increased study participant compliance, and enhanced overall trial success rates. With advancing technology, RBM approaches are expected to evolve further, allowing for greater optimization and streamlining of clinical trial processes. The abstract concludes by emphasizing the potential of risk based monitoring to shape the future of clinical research and contribute to the development of safe and effective therapies for patients worldwide. Kelam Himasri | Sankara Narayanan. K "Overview of Risk-Based Monitoring in Clinical Trial Processes" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-7 | Issue-3 , June 2023, URL: https://www.ijtsrd.com.com/papers/ijtsrd58586.pdf Paper URL: https://www.ijtsrd.com.com/pharmacy/pharmacy-practice/58586/overview-of-riskbased-monitoring-in-clinical-trial-processes/kelam-himasri
Software as a Medical Device (SaMD) - IMDRF Definition and Categorisationpi
Following the growing importance of technology in healthcare, Medical Devices have begun to play an increasingly important role in the further development of the life sciences landscape.
One of its more remarkable and fastest growing segments goes under the name Software as a Medical Device. This presentation zooms in on the definition and categorisation, as used by the International Medical Device Regulators Forum.
JOURNAL CLUB PRESENTATION (20L81S0402-PA & QA)
Presented by: K VENKATSAI PRASAD (Department of pharmaceutical analysis and quality assurance).RIPER, anantapur
Defining a Central Monitoring Capability: Sharing the Experience of TransCele...www.datatrak.com
Central monitoring, on-site monitoring, and off-site monitoring provide an integrated approach to clinical trial quality management. TransCelerate distinguishes central monitoring from other types of central data review activities and puts it in the context of an overall monitoring strategy. Any organization seeking to implement central monitoring will need people with the right skills, technology options that support a holistic review of study-related information, and adaptable processes. There are different approaches actively being used to implement central monitoring. This article provides a description of how companies are deploying central monitoring, as well as samples of the workflows that illustrate how some have implemented it. The desired outcomes include earlier, more predictive detection of quality issues. This paper describes the initial implementation steps designed to learn what organizational capabilities are necessary.
Similar to Copy of Slider post_PR-06_07 Sep (1).pdf (20)
The United States has always been and remains to be the leading place
for the conduct of clinical trials. According to Clinicaltrials.gov, the largest
clinical trials registry, 32% of registered clinical trials were conducted in
the U.S. as of May 2022 (1). Factors such as the availability of qualified
healthcare professionals, high-quality infrastructure and facilities,
cutting-edge research, an efficient regulatory system, and a high
standard of ethics and participant protection make the U.S. the leading
country for clinical trials.
Clinical trials follow extensive preclinical research to test the safety and
efficacy of a new drug, medical device, or biological in humans. They are
usually divided into three phases: phases I, II, and III which are designed
to ascertain safety, pharmacokinetics, efficacy, dosage, and adverse
events. Figure 1 shows the typical route from discovery and preclinical
studies to the post-marketing phase (phase IV).Clinical trials represent the longest and most expensive step in bringing
drugs to the market and have the highest attrition rate, only 10% of drugs
that enter phase I trials are granted marketing approval. Therefore,
clinical trials should be conducted by experts that are
well-versed with all the regulations and guidelines in a particular region to
boost the chances of drug approval.
The United States Food and Drug Administration (US FDA) is the
regulatory body that approves and oversees the conduct of clinical trials
for drugs, medical devices, and biologicals that are intended to be
marketed in the U.S and is touted to have the most stringent standards
for drug approval. The primary role of the FDA is to protect public health
by ensuring that medicinal products and devices are safe and efficacious.
Therefore, it is necessary for sponsors/investigators or contract research
organizations (CRO) that are conducting clinical trials to be familiar with
regulations and guidances that govern the conduct of clinical trials.Conducting a clinical trial in the United States requires a deep understanding of the
regulations and guidelines set by the FDA. It is important to know what is needed for a
successful clinical trial, from selecting an appropriate study site to obtaining informed
consent from participants. Additionally, it is essential to understand the requirements for data
collection and analysis, as well as how to develop an effective protocol. Clinical trial services
in USA can provide guidance on all of these aspects and more, helping you ensure that your
clinical trial meets all necessary standards
Real-World Evidence Studies_ Introduction, Purpose, and Data Collection Strat...ProRelix Research
The first image that comes to mind when one thinks of where safety and
efficacy data for a new treatment is generated is a randomized controlled
trial (RCT) at a central site. Although RCTs remain the gold standard for
evidence generation of new treatments, they are limited in terms of their
applicability to broader patient populations with different demographics
such as age, ethnicity, and comorbidities thus limiting their
generalizability. RCTs are carried out under strict conditions and dosing
schedules which are often not observed in the real world and are
conducted for limited time periods which are usually not sufficient to
capture adverse events, especially in the case of chronic diseases. This
has led to a shift in the thinking of sponsors, drug developers, payers,
and regulators to consider the use of real-world data and
real-world-evidence studies to inform decisions related to the product as
well as to support reimbursement decisions.Real-world evidence (RWE) is the clinical evidence regarding the usage
and potential benefits or risks of a medicinal product obtained from
real-world data (RWD). RWD is regarded as observational data that is
collected outside of a traditional RCT (1). Although the terms RWD and
RWE are used interchangeably they are two distinct concepts. Not all
RWD translates into RWE. RWE is obtained by detailed analyses of data
from different types of trials such as pragmatic trials, observational
studies which can be prospective or retrospective, late-phase trials, or
hybrid trials which are designed to collect data from patients in a
real-world setting. The data that is collected can be in various forms such
as electronic health records (EHRS), claims and billing data, product and
disease registries, prescription data, data collected from routine hospital
and physician visits, patient-reported outcomes (PROs), and mobile and
wearable devices. Recently, data from biobanks and ‘-omics’ data is
becoming a valuable source of RWD. RWE studies are intended to
complement data generated from RCTs by providing a detailed view of
the actual use of the product and effectiveness and safety data that RCTs
are unable to capture.There has been a recent upward trend in the number of RWE trials
conducted. In 2021, the Global Data Clinical Trials Database recorded
194 RWE trials and the Food and Drug Administration (FDA) published
90 examples of the use of RWE to support regulatory decisions (2). Since
2018, the FDA has released several pieces of guidance to support the
use of RWD and RWE for regulatory decision-making for drugs and
medical devices and the type of data to be submitted to support these
applications. The two main drivers for recent interest and uptake of RWE
studies are:
A clinical trial is a culmination of the several stages of a drug or medical
device development program that begins with the discovery of a
candidate molecule followed by preclinical toxicology studies in ex vivo, in
vitro, and animal models. Once the candidate molecule shows promising
results in these stages, the next step involves clinical studies on human
subjects. Drug testing in humans is often the most lengthy and expensive
phase of the drug development timeline, and therefore requires extensive
effort and careful execution to maximize the candidate’s chances of
success. In addition to scientific evaluation, clinical studies require
approval by the United States Food and Drug Administration (US FDA),
the regulatory authority in the United States to administer the
experimental drug in humans as well as ship it across state lines. This
approval comes in the form of an Investigational New Drug (IND FDA)
application that is required to be submitted by sponsors, investigators, or
research institutes to the FDA to commence studies on human
participants. The following figure shows the various stages of the drug
development program (Figure 1) marking IND submission on the timeline.
The US Food and Drug Administration (FDA) has established a comprehensive drug
development strategy for US FDA. This strategy is designed to ensure that the drugs
being developed meet the highest standards of safety and efficacy.The IND is a comprehensive document that contains all the information
gained from preclinical and other studies in an organized format. The
FDA reviews and makes the decision to support further clinical studies
from information in the IND that ultimately forms the basis of marketing
approval. INDs can be submitted at any phase during clinical
development to protect the safety and rights of subjects (Phase I) and to
assure adequate scientific evaluation of the drug’s effectiveness and
safety (Phase II and III). The Code of Federal Regulations CFR Title 21.
Part 312 Investigational New Drug Application contains information on
INDs as well as their content and format and should be reviewed
thoroughly by sponsors or investigators prior to submission of an IND
application.
The IND data requirements are important for the development of new drugs and
medical devices. They provide detailed information about the safety and efficacy of a
drug or device before it can be approved for use by the public
Cancer Clinical Trials_ USA Scenario and Study Designs.pdfProRelix Research
Clinical trials in oncology are vital for the advancement of cancer treatments and
care. The US is at the forefront of these clinical trials, with many different study
designs being used to assess the efficacy and safety of new treatments. This article
will explore the current state of oncology clinical trial services in the US, as well as
discuss different types of study designs that are commonly used. It will provide
insight into how these trials are conducted, what data is collected, and how this
information can be used to improve patient care.
The United States Food and Drug Administration (FDA) has released
several guidance documents over the years through the Oncology Center
of Excellence to support the development of oncologic treatments and
diagnoses. Furthermore, information on the clinical trials for the treatment
of different types of cancer or specific interventions can be found on the
National Cancer Institute (NCI) website and Clinical Trials. Currently,
ClinicalTrials.gov, a website maintained by the National Library of
Medicine (NLM) and the National Institutes of Health (NIH) contains
listings of publicly and privately sponsored trials and includes information
on 91,937 studies related to cancer indicating the high volume of
research being conducted in this field.According to the World Health Organization (WHO), cancer is the leading
cause of death worldwide, with a death rate of one in six in 2020 (1).
Aside from the high mortality rate and morbidity associated with cancer, it
also negatively impacts the quality of life and poses a significant financial
burden on patients and payers making it imperative to develop effective
treatments for the disease. According to Global Cancer Observatory
(GLOBACAN), the United States accounted for 13.3% of all estimated
new cases of cancer in 2020 (2). In 2020, the single leading type of
cancer in the United States was breast cancer (11.1%) followed by lung
cancer (10%), prostrate (9,2%), colorectum (6.8%), and melanoma of the
skin (4.2%). Despite the significant prevalence of cancer and numerous
clinical trials conducted for oncology treatments, data have shown an
almost 95% attrition rate for anticancer drugs from Phase I trials until
marketing authorization. Various factors such as inaccurate preclinical
models, lack of suitable biomarkers in clinical trials, and a disconnect
between industry, academia, and regulators are responsible for the high
attrition rate (3). Therefore, it is vital to develop suitable study designs
and protocols for candidate molecules such that they obtain regulatory
approval and can be marketed. In addition to these challenges, the
development of anti-cancer agents comes at a monumental cost of an
estimated $2.8 billion. Several factors such as the choice of relevant
endpoints, the choice of appropriate biomarkers that are guided by tumor
biology, and careful patient selection are expected to improve the overall
fate of oncologic agents in the clinical trial phase
Benefit-Risk Determination is defined as “the
analysis of all assessments of benefit and risk
of possible relevance for the use of the device
for the intended purpose, when used in
accordance with the intended purpose given
by the manufacturer
Embrace different country strategies for eConsent
Integrate eConsent in trial planning
Optimize informed consent form digitization timelines
Train and communicate
Build a monitor advocacy program
This should be included in site-selection questionnaires,
and checklists should be in place to help identify any
challenges to eConsent adoption concerning experience,
patient population, SOPs, technology, and connectivity.
The EU’s Medical Device Regulation (MDR) is a hot topic in
healthcare since it was officially published on 5th May 2017
and came into effect on 25 May 2017. The MDR replaces the
EU Medical Device Directive (93/42/EEC) and the Directive
on active implantable medical devices (90/385/EEC).
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.
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.
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.
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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
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.
- 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
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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.
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
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
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
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
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. The PMS process is focused on the collection and analysis
of the data that comes from the various sources and is
carried out according to a PMS plan to be established for
each MD in order to:
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Update the benefit-risk determination and
improve the risk management;
Update the design and manufacturing
information, the instructions for use and
the labelling;
Update the clinical evaluation;
Update the summary of safety and clinical
performance;
PMS Plan For Each MD
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Identify the needs for preventive, corrective
or field safety corrective action;
Identify options to improve the usability,
performance and safety of the device;
Contribute to the post-market surveillance of
other devices;
Detection and reporting of trends.
Risk management requirements for post-
market surveillance for medical devices.
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With PMS becoming a duty for medical device
manufacturers, the effective risk management system
becomes a priority as well as one of the three basic
elements that ensure compliance and safety, alongside with
PMS and clinical evaluation
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According to the MDR, manufacturers are expected to provide
evidence of a risk management plan created for the whole
lifecycle of products. Such plans should be used for tracking
and reducing any potential hazards and ensuring the safety
of the devices.