The document provides details on various dermatology procedures, including:
1. Photochemotherapy treatment for a patient receiving an NB-UVB dose of 350 for 1.3 minutes.
2. Chemodenervation of both axillae for a patient with primary focal hyperhidrosis.
3. Patch testing for an allergic skin condition, applying 40 allergen patches over 5 minutes.
The summary provides an overview of the types of procedures described in the document, while focusing on specific details for three examples.
Acute care of facial burns (7th august 2010)Tauseef Hassan
A brief overview of acute management of facial burns, specific procedures regarding excision and different skin substitutes and dressings used for biological and definitive coverage.
Acute care of facial burns (7th august 2010)Tauseef Hassan
A brief overview of acute management of facial burns, specific procedures regarding excision and different skin substitutes and dressings used for biological and definitive coverage.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
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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.
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.
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
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.
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.
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.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. PROCEDURES
1. 96910: Photochemotherapy; Tar And Ultraviolet B (Goeckerman Treatment) Or Petrolatum And
Ultraviolet B
• Need Approval
Check Diagnosis And Approved Quantity , Authorization Expiry.
Note : Seen And Examined. Explained The Procedure To The Patient, Patient
Understood. Photo Therapy Session For Nb-uvb . Today Patient Received Dose Of
350 For 1.3 Minutes. Skin Intact After Procedure .And The Patient Sent Home With
Appropriate Knowledge Regarding The Procedure Done
4. • 3) 95044:Patch or application test(s) (specify number of tests)
Diagnosis : Allergic skin condition
Z01.82 for Encounter for allergy testing
Procedure note : Seen And Examined. Explained The Procedure To The Patient, Patient Understood .
Consent For Procedure Signed And Secured. Total Of 40 Allergen Patches Applied Comprising Of
Na Standard Series And Cosmetics Series. Procedure Tolerated Well Which Lasted For 5 Minutes.
skin intact after procedure .And The Patient Sent Home With Appropriate Knowledge Regarding The
Procedure Done
QTY must check
5. 95004: Percutaneous Tests (Scratch, Puncture, Prick) With Allergenic Extracts, Immediate Type
Reaction, Including Test Interpretation And Report, Specify Number Of Tests
• Patient came for Prick test History taken: not on medication. Not pregnant.
Informed consent signed. Skin preparation done cleansed with alcohol.
markings done. Prick test done by Dra. Mouza. Procedure well tolerated. Post
care rendered. Post instructions explained. No untoward reactions noted after
the procedure. Total procedure time: 30 mins
• Qty must check
6. DESTRUCTION(method,total time taken,total lesion)
• 1.)17110: Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical
curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14
lesions
•
2.)17111: Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical
curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or
more lesions
• DIAGNOSIS: Thiqa – Warts + Local infection of the skin and subcutaneous tissue
Daman – B08.1Molluscum + Local infection of the skin and subcutaneous tissue
B07.0 : Plantar wart B07.9: VIRAL VART L08. 9 : Local infection of the skin and subcutaneous tissue,
unspecified
Procedure note : Seen And Examined.Explained The Procedure To The Patient, Patient
Understood. Consent For Procedure Signed And Secured.15 Nodules On The (Plantar
Surface Of Right Foot) treated by cryosurgery.Procedure Tolerated Well Which Lasted For
10 Minutes.skin intact and no redness after procedure .And The Patient Sent Home With
Appropriate Knowledge Regarding The Procedure Done
7. Biopsy
• 11100: Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless
otherwise listed; single lesion
• 11101: Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple closure), unless
otherwise listed; each separate/additional lesion (List separately in addition to code for primary procedure)
Diagnosis : From report
Procedure note : Skin Biopsy Done On Left Inner Thigh. Sample Collected. Consent Signed Before The Procedure.
Patient Tolerated The Procedure Well. No Complications Noted. Procedure Lasted At 10 Mints
or
• Consent For Skin Biopsy Obtained.Done With 2% Lidocaine ; Total Of 0.3 Ml Injected 3 Mm Punch Biospy Close
With 3-0 Rapid Viprone Synthetic Absporable Single Inturrupted Suture. Dressing With Fucidin Oitment And Non
Woven/Tagaderm.
8. 11900: Injection, Intralesional; Up To And Including
7 Lesions
• Intralesional Methylprednisolone 20 Mg Per Ml Total Of 0.5 Ml
Injected^consent Obtained. Depo- Medrol 80mg/Cc Injected 0.1cc On
Left Shoulder 1lesion. Fucidin Ointment Applied .Procedure Tolerated
Well, Which Take 10 Minutes.
9. 11306: Shaving Of Epidermal Or Dermal Lesion, Single Lesion, Scalp,
Neck, Hands, Feet, Genitalia; Lesion Diameter 0.6 To 1.0 Cm
• ^Consent Obtained. Left Frontal Scalp 0.6cm Brown Papule Shaved
With Local Anesthesia Injectd 0.5ml. Cauterized The Base. Dressing
With Fucidin Ointment. Procedure Tolerated Well, Which Take 10
Minutes .Biopsy Sample Sent To Lab.
10. 11900: INJECTION, INTRALESIONAL; UP TO
AND INCLUDING 7 LESIONS
• Consent Obtained. Depo- Medrol 80mg/Cc Injected 0.1cc On Left
Shoulder 1lesion. Fucidin Ointment Applied
• DIAGNOSIS : BENIGN LIPOMATOUS NEOPLASM OF SKIN, SUBCU OF
LEFT ARM
11. 10040: Acne Surgery (Eg, Marsupialization, Opening Or Removal Of Multiple Milia, Comedones, Cysts,
Pustules)
• Consent Obtain. Skin Preparation Done. Procedure Done On Acne
Lesion (1) On Forehead. Fucidin Ointment Applied Covered With
Bandage. PROCEDURE TOLERATED WELL,WHICH TOOK 10 MINUTES.
12. 11422 - Excision, benign lesion including margins, except skin tag (unless listed elsewhere),
scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm
• Patient Came For Cyst Removal (3 Cysts On Scalp). Informed Consent
Taken. Skin Preparation Done, Shaved And Cleansed With Bethadine
Solution. Procedure Done By Doctor Mouza Followed All Aseptic
Technique. Injected 2% Lidocaine 1cc For Each Cyst. Used Kiato
Scalpel Size15 For Incision And Closed By Rapid Viprone Absorbable
Surgical Suture 3-0. Fucidin Ointment Applied. No Untoward
Reactions Noted. Excised Diameter 1.5 Cm
13. 87220: Tissue examination by KOH slide of samples from skin, hair,
or nails for fungi or ectoparasite ova or mites (eg, scabies)-
Treatment Notes : : Seen And Examined The Patient In
The Clinic With Presenting Complains Of Distal
Onycholysis Some Toe And Finger Nails . Plan To Tissue
Examination . Explained The Procedure To The Patient,
And Well Understood. Consent For Procedure Signed
And Secured. The Site Is Cleansed Taken From Big Toe
Nail Yellowish Changed , Right Side .Procedure
Tolerated Well, Which Took 10 Minutes ,Post
Treatment Care Done And Post Treatment Instruction
Was Instructed.
14. • Excision (Benign Lesion) - Benign neoplasm (with specific site)
• - Cyst Excision – Cyst (with specified site)
• - Alopacia Treatment (covered only in thiqa)
• For coverage - ICD and CPT codes must be codes to the highest level of specificity
• - Sunburn - not covered
Claim contain Xerosis must code in level 3