This document describes the creation of a novel cancer and HIV registry in two counties in Kenya. Key points:
1. The registry pilot collected cancer and HIV data from hospitals in Nakuru and Embu counties to provide population-based data on cancer frequencies, trends, and differences between the counties.
2. Preliminary results found the top five cancers were similar to national estimates, though some site-specific differences between counties were seen.
3. Data from the registry will be uploaded to a mobile app platform to provide customized cancer data and statistics to various stakeholders for research, planning, and intervention purposes.
4. Challenges establishing the registry included poor data quality and documentation at healthcare facilities. Completing
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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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.
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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
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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
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Creation of a novel cancer & hiv linked registry by jamilla rajab
1. CREATION OF A NOVEL CANCER
AND HIV LINKED REGISTRY:
A PILOT IN TWO COUNTIES IN
KENYA
By Professionals Against Cancer
2. Professionals Against Cancer
Research Team
• Principal Investigators:
• Dr. Lucy Muchiri1
• Dr. Jamilla Rajab1
• Co-investigators:
• Prof. Christine Kigondu1
• Prof. Peter Waiganjo2
• Dr. Walter Konya3
• Dr Michieka Michieka4
1. Dept. HH.. PPaatthhoollooggyy,, UUOONN
22.. SScchhooooll ooff CCoommppuuttiinngg && IInnffoorrmmaattiiccss,, UUOONN
33.. SStt.. MMaarryy´ss MMiissssiioonn HHoossppiittaall,, NNaaiirroobbii
44.. KKaatthhiiaannii HHoossppiittaall,, MMOOHH
3. Background
• Cancer data in Kenya is disparate, hospital-derived
and not representative of extent of
National cancer burden
• Currently only three PBC registries in place:
Nairobi, Uasin Gishu and Kisumu
• Prevalence of cancer on the rise, recognized
as third commonest cause of death in Kenya
• Long-term survivors of HIV disease at risk of
malignancies
4. Background cont´d
• Quality population-based HIV-linked cancer
registries would provide clear evidence of
differences in disease burden to catalyze
appropriate resource allocation.
• This innovative project is easily scaled up
beyond a one county pilot to regional and
national-based registries
• Cancer data is paramount for planning for
cancer prevention & management
• Long-term implementation of National Cancer
Act 2012
5. Broad Objective
• To Create a Cancer/HIV and AIDS – linked data base on a
unique mobile telephony platform that addresses
knowledge, planning and intervention needs of various
stakeholders
Specific objectives:
• Pilot a HIV linked cancer registry in two counties
• Create a uniquely mobile telephony-accessible
Cancer/HIV/AIDS-linked registry
• Create demand for novel interventions to address IEC
needs based on regional common cancers & HIV linked
data
6. Study Design and methodology
• Study design:
• Descriptive- prospective, retrospective
• Study areas:
• The project piloted in two counties, a rural
and rural/urban setting Nakuru and Embu.
Data collected from all level 3, 4, 5 hospitals,
and private health care facilities in the two
counties.
7. Study population
Study targeted two populations - patients
diagnosed with cancer & those with cancer
and HIV/AIDS:
• Diagnosis of cancer confirmed by a
histology/cytology report for the general
registry.
• All individuals with cancers and HIV positive
for the HIV-cancer linked registry.
8. Methodology…..cont´d
• Cancer data was collected by trained
registrants using the standard CANREG5(1)
data entry software system
• HIV data was obtained from the NASCOP
databanks in the all health facilities in the 2
counties
• Cancer diagnosis based on histology/cytology
& published imaging and clinical guidelines
1. International Agency for Research on Cancer (IARC)
9. Data Management
• Data was validated and entered into the
CANREG 5 software
• Data cleaned & analyzed to obtain specific
cancer incidence, prevalence and trends in the
two counties
• Development of App for a novel, uniquely
designed mobile telephony platform in process
• Minimum cancer registry data set for mobile
App already determined, informed by data
collected & KAP study
10. PRELIMINARY RESULTS
• Frequencies , Trends and early comparative
analysis
• Incidence data still to be analyzed once all
sources are covered in both counties
• KAP studies already done (data analysis not
completed)
• Uploading of data to mobile telephony
platform ongoing
11. Cancer Registry Frequencies 2010 - 2014
Embu County (Pop 516,212)*
– Total cases 1673
– Total complete cases 1646 (98%)
– Female 62%; Male 38%
– Prevalence 64/100,000
Nakuru County (Pop 1,603,325)*
– Total cases 2254
– Total complete cases 2057 (91%)
– Female 58%; 42%
– Prevalence 34.3/100,000
* NCPD - Population census 2009
12. Top 10 Most Frequent Cancers
Embu County Nakuru County
Female
Male
13. Globocan 2012* Kenya
Estimated age-standardized incidence
and mortality rates: males
Estimated age-standardized incidence
and mortality rates: females
* Globocan, 2012: Estimated cancer incidence, Mortality and Prevalence . IARC 2012
18. DISCUSSION
• Preliminary results of population data shows emerging
geographical differences between two counties; but
similar top five as in Globocan estimates
• Although top five cancers are similar in both counties
for males and females, notable colon cancer cases in
Embu in both males & females; not in Nakuru
• Bladder cancer flagged in Nakuru males, not in Embu.
• Both Cervical and Breast cancer most common among
females in both counties, similar to Globocan figures
• Unlikely to be significant differences on analysis of
incidence
19. Conclusions
• Establishment of Population-based regional
cancer registries are possible (to implement
National Cancer Act 2012)
• Provide valuable customized (county) cancer
information of frequencies, incidence, age-specific
data/profiles and trends
• Identifies challenges, gaps for improvements
• Provides valuable cancer data for varied
stakeholders and uses on accessible mobile
telephony platform
20. Challenges
• Stakeholder unwillingness to participate (MOST
unaware of Cancer Act 2012), and MOH letters of
support, ERC approval
• Poor data archiving limiting case tracing, poor
indexing of case files by International disease
classification (ICD)
• Few trained cancer registrars in all health
facilities
• Poor quality cancer documentation by all levels
of health care providers involved in cancer care
• Limited resources to trace all county cancer
cases.
• Incomplete documentation of HIV status
21. Acknowledgement
• Grand Challenges Canada – provided research grant
• Division of NCD, Ministry of Health
• Embu and Nakuru County governments, & County Health
Executives
• Private health facilities in both counties
• Health care providers in all the facilities, especially the Med
Sups.
• Summit Pharmaceuticals – grant manager
• KEMRI – technical & training support, especially Anne Korir
Editor's Notes
Health care facilities in the broadest sense
Denominator – population of the two counties from 2009 national Census
Though data collection and analysis is incomplete, we needed to share with you what we are doing to you potential stakeholders, to create awareness, to get buy-in.
Similar profiles in both counties. Age most affected reflects a 10yr shift from incidence figures as chronic HIV disease is the risk factor for cancer.
Not surprisingly, Cacervix and Kaposi´s sarcoma are the commonest malignancies associated with Chronic HIV disease. Totals Nakuru F 110, M 54 total 164; Embu F 66, M 42, Total 108.
