This document provides information about Cushing's disease/syndrome, which is a hormonal disorder caused by prolonged high levels of the cortisol hormone. It is usually due to a benign tumor in the pituitary gland that causes excessive production of ACTH, stimulating the adrenal glands to overproduce cortisol. Symptoms include weight gain, muscle wasting, high blood pressure, and mental disturbances. The condition is diagnosed through tests measuring cortisol and ACTH levels and imaging to identify tumors. Treatment involves medication to suppress cortisol production, adrenalectomy to remove the glands, or pituitary surgery to remove tumors.
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
A Condition that occurs from exposure to cortisol levels for a long time.the most common cause is the use of steroid drugs,but it can also occur from over production of cortisol by the sdrenal glands.
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
A Condition that occurs from exposure to cortisol levels for a long time.the most common cause is the use of steroid drugs,but it can also occur from over production of cortisol by the sdrenal glands.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
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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.
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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2. Cushing's Disease/ Cushing's Syndrome:
Cushing's is a hormonal disorder caused by prolonged
exposure of the body's tissues to high levels of the
hormone cortisol. Your adrenal glands, which are right
above your kidneys, release cortisol when they receive a
chemical message from your pituitary gland. The message
comes in the form of adrenocorticotrophic hormone
(ACTH), which travels through the bloodstream.
The pituitary gland is known as the “Master gland of the
body”.
Introduction
4. Definition
It is a condition in which the plasma cortisol
level is elevated, causing signs and symptoms
of Hypercortisolism.
5. Causes of Cushing’s
A benign tumor of the adrenal gland
A benign tumor of the pituitary gland
A benign tumor of the lung or other organ
Extensive use of cortisone medication
Administration of ACTH or Corticosteroids.
Primary hyperplasia of both adrenal gland.
Excessive secretion of adrenal androgen.
Exogenous Glucocorticoid administration.
7. Pathophysiology:
Due to etiological factor
Normal feedback mechanisms that control adreno cortical
function are ineffective.
Resulting in excess secretion of adrenal cortical hormones
Inadequate amount of adrenal cortical hormones in
secretion
Hypercortisolism
8. Symptoms of Cushing’s Disease
Excess Glucocorticoids:
Weight gain/obesity
Heavy trunk and thin extremities
Buffalo hump in neck
Thin skin
Rounded face/moon face
Muscles wasted
Osteoporosis
Mental Disturbance
Increased susceptibility to infection.
Excess Mineralo-corticoids:
Hypertension
Hypernatremia
Hypokalemia
Weight gain
Expanded blood volume
Edema
Excess Antrogen:
Women- Hirsutism
- Breast atropy
- Clitoris enlargement
- Voice masculine
• Men- Loss of Libido
Gastro Intestinal:
Peptic Ulcer
Pancreatitis
Gastritis and Duodenitis
Ophthlmic:
Cataracts
Glaucoma
Others
Tachycardia
Fatty Liver
Mild slowing on EEG
Pituitary Adenoma
Migraines
Syncope
Memory and cognitive skills diminished
Superficial skin infections
9. Diagnostic Evaluation
History Collection
Physical Examination
CT Scan and USG
Radio-Immuno Assay of plasma ACTH
Corticotropin releasing factor (CRF) Stimulation Test.
Dexamethasone suppression Test
Blood samples
X-rays of the skull
Reduced eosinophils level
Excessive Plasma cortisol level
10. Medical Management
Mitotane = An agent toxic to the adrenal cortex.
Metropine = To control (steroid hyper secretion) who
do not respond to mitotane therapy.
Amino-glutethimide = Effectively Blocking cortisol
production
Protein anabollic steroids may be given to facilitate is
required (protein and potassium replacement)
11. Surgical Mgt:
i) Trans sphenoidal adenomectomy or Hypophysectomy:
= Removal of pituitary gland
ii) Transfrontal Carinotomy:
= It is necessary when pituitary tumor is enlarge.
iii) Bilateral Adrenalectomy:
= Hyperplasia of adrenals