Patients suffering from COVID-19 displayed hypocalcemia, vitamin D deficiency, and are often immobilized due to the disease, which will contribute to bone demineralization.
Moreover, the patients regularly present with joint and muscle pain. These symptoms resemble early aging characteristics observed during the development of OA.
Although no viral presence in the joint could be observed, early aging environmental changes could contribute to the development of this early OA-like phenotype.
Drugs that target the renin-angiotensin and immune system were explored as a treatment option for COVID-related musculoskeletal alterations.
This includes RAS modulating therapy, circadian clock modulators, immunomodulators, and chronotherapy
We believe that SARS-CoV-2 contributes to early aging perturbations, such as endothelial and adipose tissue dysfunction, the most frequent long-lasting symptoms of SARS-CoV-2 infection as the result of this accelerated aging process.
The coronavirus infection coronavirus disease 2019 (COVID-19) first presented as an outbreak of atypical pneumonia in Wuhan, China, on December 12, 2019.1,2 Since then, it has spread globally to infect >1 963 943 individuals and killed >123 635 in >200 countries as of April 14, 2020. This infection has affected health and the economy worldwide on an unprecedented scale.
all details explain about corona virus
corona virus slide
covid19 pandemic
epidemiology
pathogenesis
oral pathology
medicine
history
introduction
outbreak
prevent
drugs
test
steps taken by govt
COVID-19:
Introduction
immunosenescence, ARDS,
Hyperinflammation and mortality
Cytokine storm , Inflammatory storm,
Treatment of COVID-19,
Acalabrunitib, Tocilizumab, Anakinra and Itolizumab,
Roleof itolizumab in suppressing the cytokine storm.
Approval status of Itolizumab.
Treatment with the anti-CD6 MAb Itolizumab.
Current status of itolizumab in the treatment of COVID-19,
Common side effects of itolizumab.
Expert opinion
The coronavirus infection coronavirus disease 2019 (COVID-19) first presented as an outbreak of atypical pneumonia in Wuhan, China, on December 12, 2019.1,2 Since then, it has spread globally to infect >1 963 943 individuals and killed >123 635 in >200 countries as of April 14, 2020. This infection has affected health and the economy worldwide on an unprecedented scale.
all details explain about corona virus
corona virus slide
covid19 pandemic
epidemiology
pathogenesis
oral pathology
medicine
history
introduction
outbreak
prevent
drugs
test
steps taken by govt
COVID-19:
Introduction
immunosenescence, ARDS,
Hyperinflammation and mortality
Cytokine storm , Inflammatory storm,
Treatment of COVID-19,
Acalabrunitib, Tocilizumab, Anakinra and Itolizumab,
Roleof itolizumab in suppressing the cytokine storm.
Approval status of Itolizumab.
Treatment with the anti-CD6 MAb Itolizumab.
Current status of itolizumab in the treatment of COVID-19,
Common side effects of itolizumab.
Expert opinion
Neurological Manifestations of COVID-19 InfectionSudhir Kumar
COVID-19 primarily affects respiratory system, however, it can affect other systems too, including nervous system. This presentation offers details about neurological symptoms and disorders seen in patients with COVID-19.
Covid 19 and the cardiovascular system implications for risk assessment dia...Ramachandra Barik
The novel coronavirus disease (COVID-19) outbreak, caused by SARS-CoV-2, represents the greatest medical challenge in decades. We provide a comprehensive review of the clinical course of COVID-19, its comorbidities, and
mechanistic considerations for future therapies. While COVID-19 primarily affects the lungs, causing interstitial
pneumonitis and severe acute respiratory distress syndrome (ARDS), it also affects multiple organs, particularly the
cardiovascular system. Risk of severe infection and mortality increase with advancing age and male sex. Mortality is
increased by comorbidities: cardiovascular disease, hypertension, diabetes, chronic pulmonary disease, and cancer.
The most common complications include arrhythmia (atrial fibrillation, ventricular tachyarrhythmia, and ventricular
fibrillation), cardiac injury [elevated highly sensitive troponin I (hs-cTnI) and creatine kinase (CK) levels], fulminant
myocarditis, heart failure, pulmonary embolism, and disseminated intravascular coagulation (DIC). Mechanistically,
SARS-CoV-2, following proteolytic cleavage of its S protein by a serine protease, binds to the transmembrane
angiotensin-converting enzyme 2 (ACE2) —a homologue of ACE—to enter type 2 pneumocytes, macrophages,
perivascular pericytes, and cardiomyocytes. This may lead to myocardial dysfunction and damage, endothelial dysfunction, microvascular dysfunction, plaque instability, and myocardial infarction (MI). While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis.
Hence, patients should not discontinue their use. Moreover, renin–angiotensin–aldosterone system (RAAS) inhibitors might be beneficial in COVID-19. Initial immune and inflammatory responses induce a severe cytokine storm
[interleukin (IL)-6, IL-7, IL-22, IL-17, etc.] during the rapid progression phase of COVID-19. Early evaluation and
continued monitoring of cardiac damage (cTnI and NT-proBNP) and coagulation (D-dimer) after hospitalization
may identify patients with cardiac injury and predict COVID-19 complications. Preventive measures
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
Dr. Xuebin Qin discusses the development and characterization of new models of SARS-CoV-2 and HIV, and how his lab uses these models to study cardiovascular injury associated with infection.
Despite ongoing research around the world to better understand the pathogenesis of SARS-CoV-2, the ways in which it exacerbates cardiovascular disease (CVD) are not fully understood. While it is well accepted that SARS-CoV-2 infects lung epithelial cells, whether it can also infect endothelial cells is less clear.
In this webinar, Dr. Xuebin Qin discusses his lab’s development and characterization of new rodent models of COVID-19, and how they use these models to study endothelial dysfunction and injury resulting from immune activation. Dr. Qin also discusses why HIV infection is associated with increased risk of CVD. He provides an overview of the cellular and molecular mechanisms underlying HIV-1-associated CVD, and the mouse and NHP models he has worked with to elucidate them.
Key Topics Include:
- Cellular mechanisms by which SARS-CoV-2 and HIV contribute to cardiovascular disease
- Development, characterization and analysis of Mouse and NHP models for the study of COVID-19- or HIV-associated CVD
- Potential targets for therapeutic vaccine testing and pathogenesis studies
A broad perspective on COVID-19: a global pandemic and a focus on preventive ...LucyPi1
Abstract Coronavirus 2019 has become a highly infectious disease caused by severe acute respiratory syndrome coronavirus-2, a strain of novel coronavirus, which challenges millions of global healthcare facilities. Coronavirus are sub-microscopic, single stranded positive sense RNA viruses that leads to multi organ dysfunction syndrome, severe acute and chronic respiratory distress syndrome and pneumonia. The spike glycoprotein structure of the virus causes the viral protein to bind with the receptors on the lung and gut through angiotensin-converting enzyme 2. In some cases, the infected patients become hyper to the immune system because of the uncontrolled production of cytokines resulting in “cytokine storm”, a devastating consequence of coronavirus disease 2019. Due to the rapid mutant strain and infective nature of severe acute respiratory syndrome coronavirus-2, discovering a drug or developing a vaccine remains a global challenge. However, some anti-viral agents, certain protease inhibitor drugs, non-steroidal inflammatory drugs and convalescent plasma treatment were suggested. The containment and social distancing measures only aim at reducing the rate of new infections. In this view, we suggest certain traditional herbs and complementary and alternative medicine as a supporting public healthcare measure to boost the immune system and also may provide some lead to treat and prevent this infection.
TheNeuroSurgeons sponsored the presentation to the Zimbabwe Association of Neurological Surgeons.
we are learning more about the neurological manifestations of the novel coronavirus as we are frantically looking for solution to this formidable pandemic.
Certification and classification (coding) of Covid-19 as cause of death based ICF Education
International guidelines for certification and classification (coding) of Covid-19 as cause of death based on ICD international statistical classification of diseases (16 April 2020)
COVID 19 and The Heart - Lessons Learnt from this Pandemicahvc0858
COVID 19 and The Heart - Lessons Learnt from this Pandemic
Presentation by Dr Jeremy Chow
Cardiologist, Electrophysiologist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Neurological Manifestations of COVID-19 InfectionSudhir Kumar
COVID-19 primarily affects respiratory system, however, it can affect other systems too, including nervous system. This presentation offers details about neurological symptoms and disorders seen in patients with COVID-19.
Covid 19 and the cardiovascular system implications for risk assessment dia...Ramachandra Barik
The novel coronavirus disease (COVID-19) outbreak, caused by SARS-CoV-2, represents the greatest medical challenge in decades. We provide a comprehensive review of the clinical course of COVID-19, its comorbidities, and
mechanistic considerations for future therapies. While COVID-19 primarily affects the lungs, causing interstitial
pneumonitis and severe acute respiratory distress syndrome (ARDS), it also affects multiple organs, particularly the
cardiovascular system. Risk of severe infection and mortality increase with advancing age and male sex. Mortality is
increased by comorbidities: cardiovascular disease, hypertension, diabetes, chronic pulmonary disease, and cancer.
The most common complications include arrhythmia (atrial fibrillation, ventricular tachyarrhythmia, and ventricular
fibrillation), cardiac injury [elevated highly sensitive troponin I (hs-cTnI) and creatine kinase (CK) levels], fulminant
myocarditis, heart failure, pulmonary embolism, and disseminated intravascular coagulation (DIC). Mechanistically,
SARS-CoV-2, following proteolytic cleavage of its S protein by a serine protease, binds to the transmembrane
angiotensin-converting enzyme 2 (ACE2) —a homologue of ACE—to enter type 2 pneumocytes, macrophages,
perivascular pericytes, and cardiomyocytes. This may lead to myocardial dysfunction and damage, endothelial dysfunction, microvascular dysfunction, plaque instability, and myocardial infarction (MI). While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis.
Hence, patients should not discontinue their use. Moreover, renin–angiotensin–aldosterone system (RAAS) inhibitors might be beneficial in COVID-19. Initial immune and inflammatory responses induce a severe cytokine storm
[interleukin (IL)-6, IL-7, IL-22, IL-17, etc.] during the rapid progression phase of COVID-19. Early evaluation and
continued monitoring of cardiac damage (cTnI and NT-proBNP) and coagulation (D-dimer) after hospitalization
may identify patients with cardiac injury and predict COVID-19 complications. Preventive measures
Cardiovascular Disease Associated with SARS-CoV-2 and HIV InfectionsInsideScientific
Dr. Xuebin Qin discusses the development and characterization of new models of SARS-CoV-2 and HIV, and how his lab uses these models to study cardiovascular injury associated with infection.
Despite ongoing research around the world to better understand the pathogenesis of SARS-CoV-2, the ways in which it exacerbates cardiovascular disease (CVD) are not fully understood. While it is well accepted that SARS-CoV-2 infects lung epithelial cells, whether it can also infect endothelial cells is less clear.
In this webinar, Dr. Xuebin Qin discusses his lab’s development and characterization of new rodent models of COVID-19, and how they use these models to study endothelial dysfunction and injury resulting from immune activation. Dr. Qin also discusses why HIV infection is associated with increased risk of CVD. He provides an overview of the cellular and molecular mechanisms underlying HIV-1-associated CVD, and the mouse and NHP models he has worked with to elucidate them.
Key Topics Include:
- Cellular mechanisms by which SARS-CoV-2 and HIV contribute to cardiovascular disease
- Development, characterization and analysis of Mouse and NHP models for the study of COVID-19- or HIV-associated CVD
- Potential targets for therapeutic vaccine testing and pathogenesis studies
A broad perspective on COVID-19: a global pandemic and a focus on preventive ...LucyPi1
Abstract Coronavirus 2019 has become a highly infectious disease caused by severe acute respiratory syndrome coronavirus-2, a strain of novel coronavirus, which challenges millions of global healthcare facilities. Coronavirus are sub-microscopic, single stranded positive sense RNA viruses that leads to multi organ dysfunction syndrome, severe acute and chronic respiratory distress syndrome and pneumonia. The spike glycoprotein structure of the virus causes the viral protein to bind with the receptors on the lung and gut through angiotensin-converting enzyme 2. In some cases, the infected patients become hyper to the immune system because of the uncontrolled production of cytokines resulting in “cytokine storm”, a devastating consequence of coronavirus disease 2019. Due to the rapid mutant strain and infective nature of severe acute respiratory syndrome coronavirus-2, discovering a drug or developing a vaccine remains a global challenge. However, some anti-viral agents, certain protease inhibitor drugs, non-steroidal inflammatory drugs and convalescent plasma treatment were suggested. The containment and social distancing measures only aim at reducing the rate of new infections. In this view, we suggest certain traditional herbs and complementary and alternative medicine as a supporting public healthcare measure to boost the immune system and also may provide some lead to treat and prevent this infection.
TheNeuroSurgeons sponsored the presentation to the Zimbabwe Association of Neurological Surgeons.
we are learning more about the neurological manifestations of the novel coronavirus as we are frantically looking for solution to this formidable pandemic.
Certification and classification (coding) of Covid-19 as cause of death based ICF Education
International guidelines for certification and classification (coding) of Covid-19 as cause of death based on ICD international statistical classification of diseases (16 April 2020)
COVID 19 and The Heart - Lessons Learnt from this Pandemicahvc0858
COVID 19 and The Heart - Lessons Learnt from this Pandemic
Presentation by Dr Jeremy Chow
Cardiologist, Electrophysiologist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Transverse Myelitis in a Patient with COVID-19: A Case Reportkomalicarol
There has been growing evidence of COVID-19
potentially causing a wide range of neurological abnormalities
from as mild as anosmia to as serious as stroke. It is important to
recognize that amid this pandemic, we have been seeing different
manifestations and associations of COVID-19
Review on strategies to counteract sars cov-2 by anti-inflammatory and anti-o...sagapolarajini
Therefore, exploring the repurposing of natural compounds may provide alternatives against COVID19. Several nutraceuticals have a proven ability of immune- boosting, antiviral, antioxidant, anti-inflammatory effects. These include Zn, vitamin D, vitamin C, curcumin, cinnamaldehyde, probiotics,
selenium, lactoferrin, quercetin, etc. Grouping some of these phytonutrients in the right combination
in the form of a food supplement may help to boost the immune system, prevent virus spread, preclude the disease progression to severe stage, and further suppress the hyperinflammation providing both
prophylactic and therapeutic support against COVID-19
Cytokine release syndrome and Cytokine storm in COVID- 19 by Dr. Sonam Agga...Dr. Sonam Aggarwal
Cytokine storm syndrome is one of the most important cause of mortality in severe COVID-19 cases. It can be treated if diagnosed in time and life of a patient can be saved.
The Spartacus Letter – Rev. 2 (2021-09-28) | SpartacusGuy Boulianne
An anonymously posted document by someone calling themselves “Spartacus” of the Institute for Coronavirus Emergence Nonprofit Intelligence (ICENI) has been gaining widespread attention. Zero Hedge called the letter “simply the best document I’ve seen on COVID, vaccines, etc. Whoever Spartacus is, they have a very elaborate knowledge in ‘the field’.”
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportpateldrona
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs
Guillain Barre Syndrome & Covid-19: A Case Reportkomalicarol
Besides respiratory symptoms, coronavirus disease 2019
(COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia,
headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder
that usually follows a viral infection, it is possible that COVID-19
infection and GBS are closely related. In this case report, we try to
elucidate the relation between SARS-CoV-2 and GBS.
Covid 19--EMERGING AND FUTURE CHALLENGES FOR DENTAL SURGEONSOUMENDU KARAK
CORONAVIRUS (COVID-19)-EMERGING AND FUTURE CHALLENGES FOR DENTAL SURGEON.THE SLIDE DESCRIBE BRIEFLY ABOUT VIRUS,ITS CLINICAL MANIFESTATION,FATALITY RATE, MANAGMENT AND HOW WE OVERCOME FROM PRESENT SITUATION.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS
Similar to COVID-19 in Joint Ageing and Osteoarthritis- Manahil khanam Durrani.pptx (20)
Wastewater treatment is a process used to remove contaminants from wastewater and convert it into an effluent that can be returned to the water cycle. Once returned to the water cycle, the effluent creates an acceptable impact on the environment or is reused for various purposes (called water reclamation).
The treatment process takes place in a wastewater treatment plant. There are several kinds of wastewater which are treated at the appropriate type of wastewater treatment plant. For domestic wastewater (also called municipal wastewater or sewage), the treatment plant is called a sewage treatment plant. For industrial wastewater, treatment either takes place in a separate industrial wastewater treatment plant, or in a sewage treatment plant (usually after some form of pre-treatment). Further types of wastewater treatment plants include agricultural wastewater treatment plants and leachate treatment plants.
To minimize the initial generation of waste materials through source reduction, then through reusing and recycling to further reduce the volume of the material being sent to landfills or incineration compared to the conventional approach of simply focusing on disposal of solid waste.
Biowaste is all types of waste that contains or is likely to contain hazardous biological agents (= live infectious or otherwise hazardous micro-organisms).
Biowaste is mainly generated in diagnostic and research laboratories ("biosafety labs"), as well as in hospitals (biowaste thus includes part of the hospital waste).
Lung cancer is the most common cancer in males and second most common in females after breast cancer.
it is the third most commonly diagnosed and leading cause of cancer death in Pakistan, with an estimated 6,800 (4.6%) new cases and 6,013 (5.9%) deaths occurring in 2012
We have compared our data with the international statistics to see where do we stand.
In Pakistan, we do not have a valid central cancer registry at present which can provide a true picture of lung cancer. This calls for an urgent need to formulate a valid central cancer registry in the country in association with the local bodies.
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus.
Most people who fall sick with COVID-19 will experience mild to moderate symptoms and recover without special treatment.
HOW IT SPREADS
The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or exhales. These droplets are too heavy to hang in the air, and quickly fall on floors or surfaces.
You can be infected by breathing in the virus if you are within close proximity of someone who has COVID-19, or by touching a contaminated surface and then your eyes, nose or mouth.
Microbial fuel cells are devices that use bacteria to turn the energy stored in chemical bonds into electrical current that we can use without the need for combustion. Essentially, we are harnessing the power of metabolism for electricity.
“Cytogenetics traditionally refers to the study of chromosomes by microscopy following the application of banding techniques, permitting identification of abnormalities of chromosome number, loss or gain of chromosomal material or positional changes”. Standardized nomenclature is critical for the accurate and consistent description of genomic changes as identified by karyotyping, fluorescence in situ hybridization and microarray. The International System for Human Cytogenomic Nomenclature (ISCN) is the central reference for the description of karyotyping, FISH, and microarray results, and provides rules for describing cytogenetic and molecular cytogenetic findings in laboratory reports. These laboratory reports are documents to the referring clinician, and should be clear, accurate and contain all information relevant for good interpretation of the cytogenetic findings.
This presentation is all about fuels & industrial chemicals.
Important highlights of this presentations are following
*Importance Of Organic Compounds in Fuel Industry
» Introduction of Organic Compounds & Organic Acids
» Why Organic Acids are of interest??
» Role of Organic Chemistry in oil industry
» Organic compound of gasoline
» Alkanes & Importance Of Alkanes
» Bioconversion of Maize Starch
» Starch
» Bioconversion
» Bio products From Starch Waste
» Maize & it’s Products
» Important Products From Maize
» Process OF Bioconversion Of Maize
» Fungal biomass protein production from Starch processing Water
» Ethanol production from various substrates
» Ethanol production from barley β-glucan by yeast displaying Aspergillus
» Ethanol production in solid substrate fermentation using thermo tolerant yeast
» Ethanol production by solid state fermentation of sweet sorghum using thermo tolerant yeast strain
» Ethanol production from agricultural biomass substrates
» Ethanol production From Starch & Molasses
» Industrially Important Amino Acids Production
» l-Lysine production & its uses
» Citric Acid Production & its uses
» Guluconic Acid Production & its uses
» Lactic Acid production & its Uses.
- 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
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.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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.
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.
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
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
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
4. • Since the discovery of the first human coronavirus in 1965, different coronaviruses evolved,
causing mostly respiratory problems that resemble a common cold in infected individuals.
• The most well-known human coronaviruses are SARS-CoV (severe acute respiratory
syndrome coronavirus), MERS-CoV (middle east respiratory syndrome coronavirus),more
recently SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2)
• The latter, which is the virus responsible for COVID-19 (Coronavirus disease ) infections,
spreads quickly over the world.
5. • Up until December 2021, 5.3 million deaths were recorded worldwide by WHO.
• SARS-CoV-2 is a single positive-strand RNA virus consisting of 4 structural proteins:
N(nucleocapsid), S(spike), M(membrane), and E(envelope).
• A SARS-CoV-2 infection is characterized by non-specific respiratory and constitutional
symptoms such as cough, fever, diarrhea, and fatigue. However, a large percentage of the
infected population is asymptomatic
• The most severe cases cumulate into severe pneumonia, respiratory failure, organ damage,
dysfunction, and eventually death
6. Post-Acute and Chronic COVID-19
A SARS-CoV-2 infection is mostly known to be an acute infection
manifesting 4–5 days after exposure and lasting for 7–10 days.
However, 87% of the hospitalized patients and 35% of the out-of-hospital
patients have persistent symptoms continuing for several weeks or
months, irrespective of their viral status.
Depending on the duration of the symptoms, SARS-CoV-2 infections can
cause post-acute COVID when they last longer than 3 weeks but shorter
than 12 weeks.
7. Post-Acute and Chronic
COVID-19
• long term effects of COVID, or long-COVID, last longer
than 12 weeks Most long-COVID patients no longer have a
viral load and are thus microbiologically healthy despite
suffering from persistent symptoms.
• Long-COVID can be classified into different phenotypes
according to the most prominent residual symptoms such
as: cardio-respiratory phenotype, fatigue phenotype, and
neuropsychiatric phenotype .
• Long-COVID is mainly observed in the chronically ill and
patients with more than five symptoms during the acute
phase of the disease.
• Risk of long-COVID will also be higher with increasing
age
8. Musculoskeletal Disorder /
Dysfunction
• Musculoskeletal Disorders or MSDs are injuries and
disorders that affect the human body's movement or
musculoskeletal system
• Common musculoskeletal disorders include: Carpal
Tunnel Syndrome. Tendonitis. Muscle / Tendon strain
• MSDs are common. And your risk of developing them
increases with age.
• The severity of MSDs can vary. In some cases, they cause
pain and discomfort that interferes with everyday activities.
Early diagnosis and treatment may help ease symptoms and
improve long-term outlook.
9. Effects of COVID-19 on the Musculoskeletal
System
• While COVID-19 is primarily a respiratory
disease, numerous studies have documented and
reported the various extra-pulmonary
manifestations and symptoms.
• Clinical manifestations of COVID-19 commonly
include musculoskeletal (MSK) symptoms such as
myalgias, arthralgias, and
neuropathies/myopathies. One study observed
that of 12,046 patients, myalgia and/or
arthralgia were present in 15.5% of patients.
10.
11. Osteoarticular Changes in
COVID-19 Patients
• Although coronaviral infections are mainly linked to
respiratory symptoms, skeletal related risks and
complications are also identified.
• Today, an osteo-metabolic phenotype of COVID-19 has
been characterized, including;
• Hypocalcemia, chronic hypovitaminosis D, and a high
prevalence of bone fragility.
• This phenotype is associated with a more severe form of the
disease and higher mortality.
12. osteo-metabolic
phenotype origin
• A link between COVID-19 and
endocrine organs and tissues was
easily established after observing
higher mortality in patients
suffering metabolic diseases, such
as diabetes or obesity.
• The effect on bone and the mineral
metabolism was later defined, and
subsequently renamed to the
osteo-metabolic phenotype.
14. Inter-related action of Hypocalcemia and
hypovitaminosis D in Osteoarticular Changes
• Hypocalcemia was first observed
in a thyroidectomized patient.
hypocalcemia was reported in
62.6% to 87.2% of COVID-19
patients.
• It corresponds with increased
markers for inflammation and
thrombosis, a higher need for
hospitalization, and increased
mortality.
• The low calcium levels are related
to acute malnutrition, the actions
of the virus, and hypovitaminosis
D.
15. vitamin D deficiency not only influences
hypocalcemia, but also poses a higher risk for
more severe disease and increased
susceptibility to a SARS-CoV-2 infection.
Observed that COVID-19 patients had a high
prevalence of hypovitaminosis D, and that
these patients have a significantly higher
mortality risk
The effecsts of vitamin D are mainly
attributed To the immunomodulatory role of
vitamin D on the immune system.
16. Bone
demineralization
• Immobilization due to the bedrest
associated with SARS-CoV-2
infection or due to lockdown and
quarantine, in combination with
vitamin D deficiency and
hypocalcemia, can lead to bone
demineralization.
17. Musculoskeletal Pain in COVID-19 Patients
• Joint pain and myalgia are also common
characteristics of COVID-19.
• The pain develops during the acute phase
of the disease and is observed in 25 to 50%
of patients.
• Myalgia is associated with a higher
chance of developing post-COVID
syndrome and the presence of post COVID
musculoskeletal symptoms.
18. SARS-CoV-2 related symptoms
Majority of patients (65%), joint pain and myalgia were
widespread throughout the body.
Minority of patients had local joint pain mainly found in
the knee, foot-ankle, and shoulder, while local myalgia was
observed in the lower leg, arm, and shoulder.
Long-COVID pain has been demonstrated to be associated
with fatigue and is more prevalent to occur in women.
An overview of the musculoskeletal
ageing characteristics of long-COVID
20. viral arthritis
• Several cases of viral arthritis after a
SARS-CoV-2 infection have been
reported.
• There is non-immediate role of SARS-
CoV-2 in the onset of musculoskeletal
changes after a SARS-CoV-2 infection.
• In most viral arthritis cases, the virus
was not found in the synovial fluid.
• In contrast, one study of a non-
hospitalized medium ill patient found
traces of nucleic acids of SARS-CoV-2
in the joint.
21. • osteoarticular symptoms and
musculoskeletal pain of patients
with long-COVID closely resemble
early aging characteristics
associated with osteoarthritis (OA).
• These symptoms are probably not
connected to viral arthritis, The
absence of viral RNA in the joint
suggests an indirect effect of SARS-
CoV-2 on the joint.
23. Only sporadically nucleic acids of SARS-CoV-2
could be found in the joint.
SARS-CoV-2 will directly affect the joint tissue.
However, virus could influence the
environment, which can disrupt the normal
function of the osteoarticular system.
SARS-CoV-2 can induce similar changes in
adipose and endothelial tissue as the metabolic
syndrome, which might lead to the early
osteoarthritis-like phenotype.
24. Endothelial Dysfunction
• The aging vascular system is
characterized by endothelial dysfunction.
• Aging endothelial cells demonstrate a
reduced production of nitric oxide (NO),
which is crucial for the control of
vascular tone as well as for the regulation
of vascular and immunological
homeostasis.
26. Mechanism of SARS-CoV-2 induces
endothelial dysfunction
The ACE2(Angiotensin-Converting enzyme 2) is essential for the entry of
SARS-CoV-2 into different types of cells.
this enzyme is mainly responsible for the conversion of angiotensin II to
angiotensin (1–7).
The activation of this peptidase, which is a part of the renin-angiotensin
system (RAS), results in anti-oxidative, anti-inflammatory, and
vasodilative effects.
27. Effect of SARS-CoV-2 on Endothelial cells
• Infection with SARS-CoV-2
leads to a downregulation
of ACE2 expression due to
endocytosis and the
activation of proteolytic
cleavage.
• Endothelial cells are rich in
ACE2, hence, the virus itself
can directly cause
dysfunction by simply
infecting the cells.
28. COVID-19 causes vascular permeability
Endothelial
dysfunction
plays a
pivotal role
in the
development
of COVID-
19.
It will lead
to apoptosis
and the
loosening of
cell-cell
interactions
between the
endothelial
cells, which
will increase
This will reduce
the barrier
function and
allow the
vascular
leakage and
transportation
of the virus to
other organs
with a high
expression of
ACE2 resulting
30. Adipose tissue
dysfunction
an imbalance between pro- and anti-inflammatory
adipokines, causing insulin resistance, systemic
low-grade inflammation, hypercoagulability, and
elevated blood pressure.
The majority of patients with obesity have an
impaired adipose tissue function caused by the
interaction of genetic and environmental factors
which lead to a variety of stresses and
inflammatory processes within adipose tissue.
31. • Adipose tissue dysfunction, characterized by inflammation and
senescence, plays an important role in early aging and obesity.
• Chronic sterile inflammation, a typical phenomenon in aging tissue,
also appears in aging adipose tissue.
• increased secretion of cytokines by adipose tissue, represent the
major causes of chronic inflammation. This phenomenon is known
as “inflamm-aging.”
33. senescence
• During aging, senescence cells also
emerge, which stimulate senescence-
associated secretory phenotype (SASP)
production.
• SASP is responsible for the secretion of
other pro-inflammatory factors, growth
factors, and soluble receptors which
promote inflammation.
• This inflammation and SASP production
will impair adipogenesis, recruit
immune cells, and lead to insulin
resistance.
34.
35. A similar trend is observed in
obese patients. The caloric
overload will create stress in
adipose tissue, leading to the
same cascade of reactions as
observed during aging,
including cellular senescence
and systemic inflammation.
36. Osteoarthritis
• Osteoarthritis is a disease characterized by degeneration
of cartilage and its underlying bone within a joint as
well as bony overgrowth. The breakdown of these tissues
eventually leads to pain and joint stiffness.
37. • Increased expression of adipokines and pro-inflammatory
cytokines contributes to joint damage and the development of OA.
• Adipokines are cell-signaling molecules produced by the adipose
tissue that play functional roles in energy/metabolic status of the
body, inflammation, obesity, etc.
38. SARS-CoV-2
SARS-CoV-2 can induce adipose tissue dysfunction through its
influence on ACE2, adiponectin concentration, and apoptosis.
SARS-CoV-2 can directly affect adipose tissue, as it is one of the
tissues with the highest expression of ACE2.
Via ACE2, SARS-CoV-2 can enter the adipose cells, after which they
potentially act as viral reservoir resulting in longer viral shedding.
39. RAS system
• The renin-angiotensin system (RAS) is present in adipose tissue, and evidence
suggests that it is involved in both diet-induced obesity and the inflammation
associated with obesity.
• Angiotensin II stimulates lipogenesis and decreases lipolysis in white adipose
tissue, leading to adipose hypertrophy and lipid deposition, which is related to
inflammation, insulin resistance, and obesity.
• Moreover, 51% of COVID-19 patients presented with hyperglycemia.
40. The dysregulation of adipokines, a typical marker for the aging adipose
tissue, indicates that SARS-CoV-2 can contribute to adipose tissue
dysfunction and the aging process.
Finally, after viral entry, the adipose cells can undergo apoptosis or
necrosis, which can lead to a meta-inflammation state.
41. Factors responsible for
disease severity and poor
outcome in obese SARS-
COV 2 patients. Obesity-
associate chronic
inflammation, impaired
Immune function and
increased ACE2 expression
results in an increased
disease severity and worse
clinical outcome in obese
subjects with
COVID-19 infection
43. • Articular pain is an important characteristic of OA and is mainly
caused by local pathological changes.
• Pain-sensing afferent neurons and nociceptors are present in
different parts of the joint, including subchondral bone and
synovium, in contrast with cartilage, which is aneural.
• Bone marrow lesions and synovitis will cause pain, while cartilage
damage is not directly linked to pain.
• The nociceptors will be triggered by both mechanical stimuli and
chemical stimuli, including pro-inflammatory factors
44. Acute pain
• acute pain is associated with the
production of cytokines as a response to
the infection.
• The produced cytokines, including IL-1
and IL-6, can interact with nociceptors
and induce pain.
• Acute pain could also originate from the
direct viral invasion of muscle cells.
Muscle cells have ACE2 receptors that act
as an anchoring point for SARS-CoV-2.
45. • It could be postulated that
long-COVID-related pain
is associated with the viral
influence on nociceptors in
the central and peripheric
nervous system.
• SARS-CoV-2 has system,
which it enters through
direct and indirect
pathways.
46. SARS-CoV-2 can
infect the endothelial
cells and epithelial
cells of the blood-
brain barrier, which
increases the
permeability of the
barrier and allows
viral entry.
47. SARS-CoV-2 may enter
the central nervous
system via retrograde
axonal transport using
the peripheral nerve
terminals, for example,
the terminal olfactory
nerve or the enteric
nervous system.
48. • Finally, viral entry could also be
facilitated by infected macrophages
and monocyte, which behave as
carriers.
• It has been demonstrated via
mRNA and protein expression that
ACE2 is present on the dorsal root
ganglia (DRG) in the skin, luminal
organs, and meninges.
• This opens the door for the viral
infection of DRG nociceptors,
which will disrupt the local RAS
and create a disturbance in the
balance between the
neuromodulation systems of
nociception, which can induce
pain.
49. Indirect effect of SARS-CoV-2
• Besides the direct effect of SARS-CoV-2, the virus can also
indirectly induce pain by its excessive immune response, which can
lead to sensory cell injury and systemic damage, further
contributing to the pain manifestation.
• SARS-CoV-2can induce a so-called cytokine storm characterized by
a high number of pro-inflammatory markers, which can induce
tissue damage and lead to pain.
51. Exploring Underlying
Molecular Mechanism
• When evaluating the early aging
alterations and neuronal
sensitization in COVID-19
patients, it is evident that two
molecular systems are crucial to
accommodate the SARS-CoV-2
induced changes:
• RAS
• Immune system
52. Renin Angiotensin system
• The RAS contains several enzymes
• Angiotensin-converting enzyme 1
(ACE1) and ACE2).
• Receptors (AT1R and angiotensin II
type 2 receptor (AT2R))
• Intermediate products (Angiotensin I, II
and angiotensin (1–7)).
• RAS is crucial to maintaining blood
pressure and fluid homeostasis in the
human body, while dysfunction leads
to hypertension.
53. COVID 19 AND ACE RECEPTORS
• ACE2 is an important enzyme of
RAS, is known to be the main
molecular anchoring point for the
viral entry of SARS-CoV-2.
• The binding of SARS-CoV-2 to
ACE2 and the following
disturbance in the RAS system is
involved in the initiation of
endothelial and adipose
dysfunction, and neuronal
sensitization.
• This could potentially induce pain
and Osteoarthritis like changes in
the joint and bones.
55. Role of RAS
system in
Osteoarthritis
Local expression of the RAS
in musculoskeletal tissues is
defined to play a role in
osteoarthritis.
Moreover, AT1R expression
in cartilage is associated with
knee Osteoarthritis and
plays a role in cartilage
degeneration.
It is hypothesized that
Osteoarthritis reflects the
depletion of angiotensin (1–
7) and stimulates the
angiotensin II AT1R pathway.
ACE2 and the RAS
disturbance forms the
molecular machinery
underlying long COVID and
its associated Osteoarthritis
like phenotype.
56. COVID-19 and immune
System
• Systemic inflammation is a typical characteristic of
a viral infection in severe cases of COVID-19,
SARS-CoV-2 can over stimulate the immune
response, leading to cytokine storm and T-cell
lymphopenia.
• SARS-CoV-2 also stimulates a variety of T-cells to
promote the production of IL-1 and IL-6, and
causes more immune cells to produce cytokines,
which can further contribute to the development of
the cytokine dysregulation, all these factors leading
to systemic inflammation.
57.
58. Lab Findings Related to Cytokine storm
• High levels of alanine
aminotransferase
(ALT)
• High Levels aspartate
aminotransferase
(AST)
• High level Lactate
dehydrogenase (LDH)
• High Level Ferritin
• High level CRP
• High Level D Dimer
Suggestive of lymphocyte,
phagocytic , monocyte and
phagocytic macrocyte activation.
61. Therapeutic
approaches in
Treating
Long-COVID
in
Osteoarthritis
• Several RAS modulators are proposed as a therapy
for COVID-19,this comprises all treatments from
stimulating the Angiotensin (1–7)/MAS axis to
inhibiting the ACE2/Angiotensin II/AT1R axis.
• Besides modifying the ACE2 expression and
activity, drugs that prevent viral entry via the ACE2
receptor can also have a beneficial effect. This
includes soluble recombinant ACE2 called
hrsACE2 which competes with the
endogenousACE2 .Chloroquine, which
glycosylates ACE2 to prevent binding and
Camostat mesylate, which is a virus-activating
host cell protease TMPRSS2 inhibitor.
62.
63. The Role of the Nicotinic Cholinergic Receptor
• Nicotine is a naturally produced alkaloid
in the nightshade family of plants and is
widely used as a stimulant and anxiolytic.
• As a pharmaceutical drug, it is used for
smoking cessation to relieve withdrawal
symptoms.
Cholinergic receptors
Are receptors on the surface of cells that get
activated when they bind a type of
neurotransmitter called acetylcholine. These
are of two types
• Nicotinic Receptors
• Muscarinic Receptors
64. • Nicotinic cholinergic system also plays an important role in joint pain
and dysfunction, as observed in the Osteoarthritis pathology.
65. • Nicotine has a direct role
in the upregulation of
ACE2. The higher
enzymatic activity of
ACE2 after nicotine
administration reduces the
amount of angiotensin II in
favor of Angiotensin (1–7),
which will then promote
the anti-inflammatory
pathways.
• Therefore it may be
concluded that nicotine via
alpha 7 nAChR stimulation
might lead to inhibition of
cytokine storm associated
with COVID-19.
67. Conclusions
• Patients suffering from COVID-19 displayed hypocalcemia, vitamin D deficiency, and are often
immobilized due to the disease, which will contribute to bone demineralization.
• Moreover, the patients regularly present with joint and muscle pain. These symptoms resemble
early aging characteristics observed during the development of OA.
• Although no viral presence in the joint could be observed, early aging environmental changes
could contribute to the development of this early OA-like phenotype.
• Drugs that target the renin-angiotensin and immune system were explored as a treatment option
for COVID-related musculoskeletal alterations.
• This includes RAS modulating therapy, circadian clock modulators, immunomodulators, and
chronotherapy
• We believe that SARS-CoV-2 contributes to early aging perturbations, such as endothelial and
adipose tissue dysfunction, the most frequent long-lasting symptoms of SARS-CoV-2 infection as
the result of this accelerated aging process.
Editor's Notes
Adipogenesis Is the process by which fat-laden cells (type of cell that contain cholesterol) that is, adipocytes, develop and accumulate as adipose tissue at various sites in the body, both as subcutaneous fat
The major roles of adipocytes are to store energy as fat
Adipogenesis Is the process by which fat-laden cells (type of cell that contain cholesterol) that is, adipocytes, develop and accumulate as adipose tissue at various sites in the body, both as subcutaneous fat
The major roles of adipocytes are to store energy as fat
Advancing age induces adipose tissue dysfunction, including reduced function of preadipocytes, exacerbated secretion of pro-inflammatory cytokines and chemokines, increased infiltration of immune cells, elevated senescent cell burden, and an increase in the senescence-associated secretory phenotype (SASP)
Adiponectin is the most abundant peptide secreted by adipocytes, whose reduction plays a central role in obesity-related diseases, including insulin resistance/type 2 diabetes and cardiovascular disease.
Angiotensin-converting enzyme (ACE), a dicarboxypeptidase, plays a major role in the regulation of blood pressure by cleaving angiotensin I into angiotensin II (Ang II
Lipolysis is the metabolic process through which triacylglycerols (TAGs) break down via hydrolysis into their constituent molecules: glycerol and free fatty acids (FFAs)
Lipogenesis is defined as the synthesis of fatty acids from nonlipid precursors
Hyperglycemia is the technical term for high blood glucose (blood sugar)
Nociceptors are sensory receptors that detect signals from damaged tissue or the threat of damage and indirectly also respond to chemicals released from the damaged tissue.
Sars cov is found in both peripheral and central nervous system
The olfactory nerve is the first cranial nerve (CN I). It is a sensory nerve that functions for the sense of smell. Olfaction is phylogenetically referred to as the oldest of the senses.
Retrograde axonal transport conveys materials from axon to cell body
Sensory neurons with cell bodies situated in dorsal root ganglia convey information from external or internal sites of the body such as actual or potential harm, temperature or muscle length to the central nervous system
Neuromodulation is "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body". It is carried out to normalize – or modulate – nervous tissue function.