Dr. Jaakko Toumilehto, Professor of Public Health at the University of Helsinki, Finland. He is also affiliated with the Diabetes and Genetic Epidemiology Unit of the
National Public Health Institute in Helsinki, Finland, and holds positions as Professor at the Danube-University Krems, Austria. Dr. Jaakko has published over 800 peer-reviewed original articles and an estimated 200 editorials, reviews and book chapters.
Muntada is an innovative platform for sharing new ideas that stimulate creative thinking, learning and active discussions. It is through presenting enriching and locally relevant topics that Muntada aims to inform, update and empower the local community.
Since its inauguration, Muntada has hosted a number of prominent speakers ranging through a variety of topics.
For more info www.shf.ae
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
A Retrospective Study of Clinical and Biochemical Profile in Geriatric Patien...PARUL UNIVERSITY
The aim of the study was to evaluate the clinical and
biochemical characteristics of geriatric patients with type 2
diabetes mellitus (DM) attending tertiary care teaching hospital,
SVIMS, Tirupati. OBJECTIVES: To document clinical
features, biochemical parameters and anti-diabetic medications
received as per records. METHODOLOGY: This
retrospective study was performed in Department of
Endocrinology in SVIMS, Tirupati, over a period of 6 months.
Demograghic details, laboratory parameters and
pharmacotherapy details were collected in the pre-designed
annexure form. RESULTS: A total of 100 diabetic elderly
patients were included in the study. Out of which 57 were men,
43 were women. Most of them were under the age group of
60-64 years followed by other age groups. 28 patients were
having the diabetes duration of 11-15 years. Some of them were
having diabetic complications (such as diabetic retinopathy,
diabetic neuropathy, diabetic nephropathy). Among 100
patients, 32 patients were normal weight, 22 patients were
overweight, 28 patients were obese-I, 18 patients were obese-II.
About 85% of patients were having high lipid levels. Some
patients were on Oral Hypoglycemic Agents (OHAS), some
patients were using both Insulin & OHAS.CONCLUSION:
The present study comprised of 100 elderly type 2 diabetic
patients in which males were higher in number when compared
to females, most of the patients were in the age of group of
60-64 years. Hypertension was the most common co-morbidity
associated with DM followed by Coronary Artery Disease
(CAD). Diabetic neuropathy was the most prevalent
complication followed by Diabetic retinopathy and diabetic
nephropathy. In this study 46% of the patients were obese. Most
of the patients were on OHAS alone, some were on OHAS and
Insulin combination therapy while very few were on insulin
therapy alone. Dyslipidemia was present in 85% of the patients
and the most common form of dyslipidemia was low HDL and
high LD
Fasting and Caloric Restriction Show Promise for Reducing Type 2 Diabetes Bio...Premier Publishers
The global epidemic of type 2 diabetes (T2D) and its co-morbidities threatens to overwhelm public health services and urgent patient intervention is necessary. A review of mainly randomised controlled trials investigating the reduction of biochemical T2D risk markers through fasting or caloric restriction (CR) found that in T2D or where baseline fasting glucose or HbA1c were elevated, there were significant improvements in fasting glucose and HbA1c, while fasting insulin and insulin resistance may show improvement regardless of condition or baseline levels. There may, however, be ethnic differences, with a clear positive correlation found only in Caucasians. Intermittent CR (i.e. non-continuous periods of fasting) is at least as effective as isocaloric continuous CR, while CR of 400-800 kcal/day is possibly more effective than higher levels for reducing fasting glucose and HbA1c. Time restricted feeding also shows promise but there are few human studies. The findings suggest that the optimum regimen to reduce biochemical risk markers for T2D is an intermittent fasting programme employing a very low-calorie diet with the longest possible number of consecutive days of fasting. The addition of liquid meal replacements, low carbohydrate CR and supplementation of vitamin D, ω-3 PUFAs and L-carnitine may also be of benefit.
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
A Retrospective Study of Clinical and Biochemical Profile in Geriatric Patien...PARUL UNIVERSITY
The aim of the study was to evaluate the clinical and
biochemical characteristics of geriatric patients with type 2
diabetes mellitus (DM) attending tertiary care teaching hospital,
SVIMS, Tirupati. OBJECTIVES: To document clinical
features, biochemical parameters and anti-diabetic medications
received as per records. METHODOLOGY: This
retrospective study was performed in Department of
Endocrinology in SVIMS, Tirupati, over a period of 6 months.
Demograghic details, laboratory parameters and
pharmacotherapy details were collected in the pre-designed
annexure form. RESULTS: A total of 100 diabetic elderly
patients were included in the study. Out of which 57 were men,
43 were women. Most of them were under the age group of
60-64 years followed by other age groups. 28 patients were
having the diabetes duration of 11-15 years. Some of them were
having diabetic complications (such as diabetic retinopathy,
diabetic neuropathy, diabetic nephropathy). Among 100
patients, 32 patients were normal weight, 22 patients were
overweight, 28 patients were obese-I, 18 patients were obese-II.
About 85% of patients were having high lipid levels. Some
patients were on Oral Hypoglycemic Agents (OHAS), some
patients were using both Insulin & OHAS.CONCLUSION:
The present study comprised of 100 elderly type 2 diabetic
patients in which males were higher in number when compared
to females, most of the patients were in the age of group of
60-64 years. Hypertension was the most common co-morbidity
associated with DM followed by Coronary Artery Disease
(CAD). Diabetic neuropathy was the most prevalent
complication followed by Diabetic retinopathy and diabetic
nephropathy. In this study 46% of the patients were obese. Most
of the patients were on OHAS alone, some were on OHAS and
Insulin combination therapy while very few were on insulin
therapy alone. Dyslipidemia was present in 85% of the patients
and the most common form of dyslipidemia was low HDL and
high LD
Fasting and Caloric Restriction Show Promise for Reducing Type 2 Diabetes Bio...Premier Publishers
The global epidemic of type 2 diabetes (T2D) and its co-morbidities threatens to overwhelm public health services and urgent patient intervention is necessary. A review of mainly randomised controlled trials investigating the reduction of biochemical T2D risk markers through fasting or caloric restriction (CR) found that in T2D or where baseline fasting glucose or HbA1c were elevated, there were significant improvements in fasting glucose and HbA1c, while fasting insulin and insulin resistance may show improvement regardless of condition or baseline levels. There may, however, be ethnic differences, with a clear positive correlation found only in Caucasians. Intermittent CR (i.e. non-continuous periods of fasting) is at least as effective as isocaloric continuous CR, while CR of 400-800 kcal/day is possibly more effective than higher levels for reducing fasting glucose and HbA1c. Time restricted feeding also shows promise but there are few human studies. The findings suggest that the optimum regimen to reduce biochemical risk markers for T2D is an intermittent fasting programme employing a very low-calorie diet with the longest possible number of consecutive days of fasting. The addition of liquid meal replacements, low carbohydrate CR and supplementation of vitamin D, ω-3 PUFAs and L-carnitine may also be of benefit.
Apelin and Sirtuin 1 Dysregulation induce Endocrine and Metabolic Disorders i...CrimsonPublishersGJEM
Apelin and Sirtuin 1 Dysregulation induce
Endocrine and Metabolic Disorders in Chronic Disease by Ian James Martins in Global Journal of Endocrinological Metabolism
Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood glucose), or when the body cannot effectively use the insulin it produces (1). Raised blood glucose, a common effect of uncontrolled diabetes, may, over time, lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves. More than 400 million people live with diabetes.
Crimson Publishers-Highlighting Significance of Weight Loss and Malnutrition ...CrimsonPublishersGGS
Highlighting Significance of Weight Loss and Malnutrition in Older Adults by Vinod Nikhra in Gerontology & Geriatrics studies
There occurs a variable decrease in appetite in about 15% to 30% of older adults. This decline in desire to eat in older adults was described as the 'anorexia of ageing' by John Morley and Silver in 1988 [1]. The appetite deteriorates with increasing age, being higher in women, Hospitalized Patients, old age home residents and those living alone [2]. The reduced appetite and dietary intake is a harbinger of weight loss and malnutrition (WLM) leading to serious consequences for older adults. The weight loss in older adults may represent more of the tissue loss in skeletal muscle than adipose tissue. When excessive, it results in sarcopenia, often associated with protein-energy malnutrition and various deficiencies of vitamins and essential minerals.
Stem cell therapy first successful in treatment of type 1 diabetesDoriaFang
On October 18, 2021, Vertex Pharmaceuticals Incorporated announced that a patient with severe type 1 diabetes has achieved a "stable recovery" of islet cell function after receiving fully differentiated pancreatic islet cell replacement therapy derived from its stem cell called VX-880. These restored pancreatic islet cells can make patients to regulate insulin and even produce insulin by themselves, reducing their daily insulin consumption by 91% and significantly improving blood sugar control. This is the world's first successful case of stem cell therapy for type 1 diabetes.
Apelin and Sirtuin 1 Dysregulation induce Endocrine and Metabolic Disorders i...CrimsonPublishersGJEM
Apelin and Sirtuin 1 Dysregulation induce
Endocrine and Metabolic Disorders in Chronic Disease by Ian James Martins in Global Journal of Endocrinological Metabolism
Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood glucose), or when the body cannot effectively use the insulin it produces (1). Raised blood glucose, a common effect of uncontrolled diabetes, may, over time, lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves. More than 400 million people live with diabetes.
Crimson Publishers-Highlighting Significance of Weight Loss and Malnutrition ...CrimsonPublishersGGS
Highlighting Significance of Weight Loss and Malnutrition in Older Adults by Vinod Nikhra in Gerontology & Geriatrics studies
There occurs a variable decrease in appetite in about 15% to 30% of older adults. This decline in desire to eat in older adults was described as the 'anorexia of ageing' by John Morley and Silver in 1988 [1]. The appetite deteriorates with increasing age, being higher in women, Hospitalized Patients, old age home residents and those living alone [2]. The reduced appetite and dietary intake is a harbinger of weight loss and malnutrition (WLM) leading to serious consequences for older adults. The weight loss in older adults may represent more of the tissue loss in skeletal muscle than adipose tissue. When excessive, it results in sarcopenia, often associated with protein-energy malnutrition and various deficiencies of vitamins and essential minerals.
Stem cell therapy first successful in treatment of type 1 diabetesDoriaFang
On October 18, 2021, Vertex Pharmaceuticals Incorporated announced that a patient with severe type 1 diabetes has achieved a "stable recovery" of islet cell function after receiving fully differentiated pancreatic islet cell replacement therapy derived from its stem cell called VX-880. These restored pancreatic islet cells can make patients to regulate insulin and even produce insulin by themselves, reducing their daily insulin consumption by 91% and significantly improving blood sugar control. This is the world's first successful case of stem cell therapy for type 1 diabetes.
This presentation was delivered to students at UC San Diego on May 2, 2012 by Dawn DeStefani, BSW, who is the director of programs and services for The Glenner Memory Care Centers in San Diego. Learn more at www.glenner.org.
Watch LIVE 8/13/13 on Google +
http://bit.ly/1aLt5XU
Medical Improv in Healthcare: Exploring Learning Experiences that Promote Safe Care, Patient Satisfaction, & Rewarding Careers
Description
Improv or “Medical Improv”* builds skills that promote the emergent behaviors we need for collaborative practice and cultures. In this 75 min presentation, you’ll learn how the principles of improv can be applied to critical skills, thinking, and relationship-building among healthcare professionals. You’ll meet pioneers in the “Medical Improv” field, explore opportunities for utilizing current strategies, learn about upcoming applications, and participate in Q and A. Join Organizational Development, Consultant Beth Boynton, RN, MS with Co-presenter Stephanie Frederick, RN, M.Ed and and Sponsor, Judy White, SPHR, GPHR in an invitation to learn more about cutting-edge applications of Improv in healthcare settings.
* “Medical Improv”, is a term coined by Professor Katie Watson, JD of Northwestern University Feinberg School of Medicine in her curriculum for medical students.
www.bethboynton.com
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
Diabetes-related Clinical Complications: Novel Approaches for Diagnosis and M...asclepiuspdfs
Metabolic diseases such as hypertension, obesity, diabetes, and vascular diseases have reached epidemic proportions worldwide. In the past four decades, childhood and adolescent obesity has increased four-fold worldwide. During the same period, obesity in adults has doubled and diabetes has increased by four-fold. In China, India, and the USA, the number of prediabetes is more than diabetics. This population is at considerable risk for developing diabetes, its clinical complications, and acute vascular events. The management of modifiable risks for cardiometabolic risks has improved considerably. Several major studies have demonstrated, that robust management of modifiable risks for cardiovascular diseases (CVDs), significantly reduces premature mortality from CVDs. Considering the progress made in the risk assessment, risk management, we feel strongly, that not much progress is made in the areas of primary prevention and early risk assessment, for clinical complications associated with metabolic diseases, in particular, diabetes. The majority of the clinical complications associated with diabetes are due to dysfunction of the vascular system or nervous system. Complications include vasculopathy leading to subclinical atherosclerosis, heart attacks, and stroke.
Objective: Diabetic nephropathy is one of the most serious complications of diabetes mellitus. It develops in approximately one-third of diabetic patients, years after the onset of metabolic abnormalities.
Study Design: The biopsy specimens were evaluated with the focus on light microscopy. The aim of our study was to reveal differences in the details and the frequency of occurrence of individual histomorphological changes in diabetic nephropathy and other glomerulonephritides.
Results: Diabetic nephropathy accounted for 14 out of 82 analyzed biopsies. Isolated thickening of the glomerular basement membrane was not present in any case, but along with some degree of mesangial expansion, hypercellularity or glomerulosclerosis was seen in 12 out of 14 findings of diabetic nephropathy. In other glomerular diseases, mesangial changes, but without glomerular basement membrane thickening, were the most frequent findings. In addition to glomerular lesions, some of the tubular, interstitial, and vascular changes were seen in 13 out of 14 patients with diabetic nephropathy. In other glomerulonephritides the combination of all these changes was a rare finding.
Conclusion: There are cases where immunofluorescence and electron microscopy cannot be performed or their results are not helpful. In such cases we must rely on light microscopic histomorphological changes.
Assessment of the Prevalence of Some Cardiovascular Risk Factors among the O...Scientific Review SR
The prevalence of some cardiovascular risk factors among the Ogonis and Ikwerres in Rivers State,
Nigeria was assessed in two hundred subjects. Well structured questionnaires were used to assess smoking status,
duration of diabetes, age, weight, and height from the participants. Measurement of blood pressure was done to
ascertain the blood pressure of the subjects. Analysis of fasting blood sugar was done to confirm diabetes s tatus of
participants. Body mass index (BMI), was calculated from the height and weight. The mean age of males in the
study was higher than that of the females (P=.05). Mean SBP and DBP values were significantly higher (P=.05)
among the Ikwerres and Ogonis. BMI was significantly higher for Ogonis than Ikwerres ( P=.05). In the various
categories of risk, BMI for males was diabetics (47.89), smokers (44.73) and hypertensives (45.37) for type III
obesity which shows a higher risk for cardiovascular disease.
Sensorineural hearing loss in Type 2 diabetes mellitusiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Chronic kidney disease (CKD) is a global public health problem
worldwide. The worldwide prevalence of CKD has increased in
various countries such as the U.S. (13.1%), Taiwan (9.8-11.9%),
Norway (10.2%), Japan (12.9-15.1%) China (3.2-11.3%), Korea (7.2- 13.7%), Thailand (8.45-16.3%), Singapore (3.2-18.6%), and Australia(11.2%)
this presentation will contains problem of old age, how can they affect the life of geriatric peoples, prevention and control of geriatric problems, national program for better health of old peoples, initiations done by private trusts to improve their health
Similar to Diabetes prevention studies and implications for Alzheimer research | Dr. Jaakko Toumilehto (20)
The digital divide between professors and students is increasing dramatically and so is the challenge of preparing students for jobs that still don't exist.
While Ivy League Universities are already offering free online courseware other international and Pan Arab institutions are resistant to this sharing economy.
Where are the gaps and the possible solutions?
Video available at: http://www.youtube.com/watch?v=lUbgC7rEnqs
Is it possible to prevent Alzheimer’s disease? | Dr. Miia KivipeltoGiorgio Ungania
Dr. Miia Kivipelto, the Deputy Head at the Aging Research Center and Alzheimer Disease Research Center at Karolinska Institute. Dr. Miia has conducted extensive research and is a recipient of numerous awards such as the Academy of Finland Award for Social Impact and the Junior Chamber International Award as Outstanding Young Person.
Muntada is an innovative platform for sharing new ideas that stimulate creative thinking, learning and active discussions. It is through presenting enriching and locally relevant topics that Muntada aims to inform, update and empower the local community.
Since its inauguration, Muntada has hosted a number of prominent speakers ranging through a variety of topics.
For more info www.shf.ae
Information Overload | 24/7 social media connectivity, Digital Distraction an...Giorgio Ungania
My slides for the HPAIR Conference Social Media Panel.
About HPAIRs
Harvard's largest annual student connection in Asia, the Harvard Project for Asian and International Relations creates a forum of exchange and facilitates discussion of the most important economic, political, and social issues relevant to the Asia-Pacific region.
Since 1991, the annual HPAIR conferences have brought together students from the world's foremost universities and leaders in the fields of government, business, culture, and academia.
#COM280 | TEDEd How to turn a How to turn a YouTube into a Lesson, and share ...Giorgio Ungania
What is TEDEd and how everybody can curate and seed educational content via the web.
As assignment students will select YouTube videos and produce unique packaged lessons to share with the world.
Lecture part of the COM280 series at Zayed University, UAE.
#COM280 |Kony2012 the most viewed viral video of all times.Giorgio Ungania
What made Kony 2012 the most viewed viral video of all time and why the shift from online activism to off-line activism did not work quite well.
Lecture part of the COM280 series at Zayed University, UAE.
UNESCO | Touch and Mobile Technologies for the Classroom session 4Giorgio Ungania
The UNESCO/CICT workshop on ‘Touch and Mobile Technologies for the Classroom’ will aim to address issues related to these technologies and beyond and delve into the intricacies of the subject targeting high-level policy makers at the Ministries of Education in the Arab Gulf States.
Beyond policy level discussions the workshop will aim to sensitize the participants to the issues of preparedness for this emerging transformation.
Digital Content, Interactivity, Mobile Applications, Open Educational Content Standards etc. are discussed in details.
Location : Ministry of Education of Kingdom of Bahrain
Speaker : Giorgio Ungania
UNESCO | Touch and Mobile technologies for the Classroom session 3Giorgio Ungania
The UNESCO/CICT workshop on ‘Touch and Mobile Technologies for the Classroom’ will aim to address issues related to these technologies and beyond and delve into the intricacies of the subject targeting high-level policy makers at the Ministries of Education in the Arab Gulf States.
Beyond policy level discussions the workshop will aim to sensitize the participants to the issues of preparedness for this emerging transformation.
Digital Content, Interactivity, Mobile Applications, Open Educational Content Standards etc. are discussed in details.
Location : Ministry of Education of Kingdom of Bahrain
Speaker : Giorgio Ungania
UNESCO | Touch and Mobile Technologies for the Classroom session 1Giorgio Ungania
The UNESCO/CICT workshop on ‘Touch and Mobile Technologies for the Classroom’ will aim to address issues related to these technologies and beyond and delve into the intricacies of the subject targeting high-level policy makers at the Ministries of Education in the Arab Gulf States.
Beyond policy level discussions the workshop will aim to sensitize the participants to the issues of preparedness for this emerging transformation.
Digital Content, Interactivity, Mobile Applications, Open Educational Content Standards etc. are discussed in details.
Location : Ministry of Education of Kingdom of Bahrain
Speaker : Giorgio Ungania
In this lecture we analyze the evolution of broadcasting in the Arab world and we look at the current and future models of digital distribution.
Also, in a world where we can access content for free, which model will be sustainable?
Kevin Kelly shares some insights on how we are inclined to pay for content even if we can access it for free.
The lecture is concluded with Peter Hirshberg TED talk about why the web will improve the TV model.
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
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
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.
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
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.
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!
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
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Diabetes prevention studies and implications for Alzheimer research | Dr. Jaakko Toumilehto
1. Dr. Jaakko Tuomilehto
Professor National Institute for Health and Welfare, Helsinki, Finland;
King Abdulaziz University, Jeddah, Saudi Arabia;
Danube University Krems, Krems, Austria
Monday, September 16, 13
2. Diabetes prevention studies and
implications for
Alzheimer research
Dr. Jaakko Tuomilehto
Monday, September 16, 13
4. Dr. Jaakko Tuomilehto
The International Diabetes Federation Diabetes Atlas 5th Edition
A summary of the
figures and key
findings
Monday, September 16, 13
7. • 366 million people have diabetes in 2011; by 2030 this will have risen to 552 millio
• The number of people with type 2 diabetes is increasing in every country
• 80% of people with diabetes live in low-and middle-income countries
• The greatest number of people with diabetes are between 40 to 59 years of age
• 183 million people (50%) with diabetes are undiagnosed
• Diabetes caused 4.6 million deaths in 2011
• Diabetes caused at least USD 465 billion dollars in healthcare expenditures in 2011; 11% of
total healthcare expenditures in adults (20-79 years)
• 78,000 children develop type 1 diabetes every year
Dr. Jaakko Tuomilehto
Diabetes: the global burden
Monday, September 16, 13
9. Dr. Jaakko Tuomilehto
Diabetes and Alzheimer’s Disease - similarities
• Similar lifestyle risk factors
• Both increase steeply with age
• Diabetes is an independent risk factor for
! Alzheimer Disease and Vascular Dementia
• Long asymptomatic preclinical phase
• Co-morbidities common and similar
• Both reduce life expectancy and quality of life
Monday, September 16, 13
10. Dr. Jaakko Tuomilehto
Common Modifiable Risk Factors for Type 2 Diabetes and Dementia
• Obesity / weight gain
• Central obesity
• Physical inactivity
• Smoking
• Fatty liver
• Depression
• Poor sleep quality
• Hypertension
• Dietary Factors (risk increase/decrease)
- Carbohydrate quality
- Fat quality
- Glycemic index
- Whole grain / cereal fibers
- Alcohol
- Coffee
- Fish
Monday, September 16, 13
11. Dr. Jaakko Tuomilehto
Trends in Body Mass Index and DM in Finland
BMI-Men BMI-Women
0
10
20
30
40
1969 1976 1986 1996 2000 2012
Diabetes
0
10
20
30
40
1969 1976 1986 1996 2000 2012
Diabetes
? ?
Monday, September 16, 13
12. Dr. Jaakko Tuomilehto
Diabetes and Alzheimer disease
Several epidemiological studies have suggested that
diabetes increases the risk of Alzheimer disease
Positive association:
Yoshitake et al., 1995
Leibson et al., 1997
Brayne et al., 1998
Ott et al., 1999
Peila et al., 2002
Yamada et al 2003
Arvanitakis et al., 2004
Luchsinger et al., 2005
Akomolafe et al., 2006
Irie et al., 2008
Xu et al. 2009
Ahtiluoto et al. 2010
No association:
Curb et al., 1999
MacKnight et al,. 2002
Hassing et al., 2002
Xu et al., 2004
Hayden et al., 2006
Monday, September 16, 13
13. Dr. Jaakko Tuomilehto
Cognitive deficits in non-demented people with Diabetes (1)
Compared to age- matched controls elderly (above 70 yrs)
Patients with Diabetes show deficits in :
• global cognitive scores
• perceptual speed
• verbal episodic memory
• semantic memory
• executive functions
Duration of Diabetes is associated with these cognitive deficits
Cognitive deficits are associated with lower functional capability and higher mortality
Monday, September 16, 13
14. Dr. Jaakko Tuomilehto
Cognitive deficits in non-demented people with Diabetes (2)
Whitehall II study
Kumari M, Marmot M, Neurology 2005
N=5600!Follow-up 5 yrs
Diabetes associated with poorer performance on inductive
cognitive reasoning:
! Risk !2.45 fold for males
! ! 1.83 fold for females
Monday, September 16, 13
15. Dr. Jaakko Tuomilehto
Morphologic brain changes in non-demented people with
Diabetes/disturbed glucose tolerance
• den Heijer T et al , Diabetologia 2003: Hippocampal atrophy
• Hassing LB, et al, Age Ageing 2004: General cortical brain
aaatrophy in conjunction with hypertension
• Convit A et al, PrclNatl Acad Sci USA 2003: Reduced glucose
ttttolerance correlates with poor memory perfomance and
hhhippocampal atrophy
Monday, September 16, 13
16. Dr. Jaakko Tuomilehto
Diabetes Mellitus increases the risk of Dementia (1)
Ott A et al. Diabetes Mellitus and the Risk of Dementia. 1999; 53:1937-1942
Rotterdam Study
Prospective population-based cohort study among 6370 elderly subjects.
Non-demented participants were followed up average for 2,1 years
Estimation of RR with proportional hazard regression adjusted for age,
sex and possible confounders.
During FU 126 patients (2%) became demented of whom 89 had AD.
DM almost doubled the risk of dementia RR 1.9 (1.3 - 2.8) and
AD RR 1.9 (1.2 - 3.1)
Monday, September 16, 13
17. Dr. Jaakko Tuomilehto
Diabetes Mellitus increases the risk of Dementia (2)
Luchsinger J A, et al. Diabetes Mellitus and Risk of Alzheimer‘s Disease and Dementia with Stroke in a Multiethnic Cohort. Am J Epidemiol 2001; 154:635-41.
1262 elderly subjects (>~ 65 yrs) without dementia at baseline (1991-1996)
were followed up for an average of 4,3 years (1992-1997).
Outcomes: incident Alzheimer‘ disease (AD) and dementia associated with
stroke. Prevalence of diabetes was 20% at baseline.
RR of AD among subjects with DM ! ! !
RR of AD + cognitive impairment without
dementia in persons with DM (without stroke)
RR of stroke-associated dementia in persons with DM
1.3 (0.8-1.9)
1.6 (1.2-2.1)
3.4 (1.7- 6.9)
Monday, September 16, 13
18. Dr. Jaakko Tuomilehto
Diabetes Mellitus increases the risk of Dementia (4)
Xu W.L. et al. Diabetes mellitus and the risk of dementia in the Kungsholmen project. Neurology 2004; 63: 1181-1186
Kungsholmen project, Sweden
A dementia-free cohort of 1301 community dwellers aged 75 years and older in
Stockholm.
Longitudinally examined twice over 6 years to detect dementia cases. At baseline
114 (8,8%) had Diab
- 350 subjects developed dementia (260 Alzheimer Disease and 49
VascularDementia)
- Diabetes increased the risk of dementia:
-2,6 times for Vascular Dementia, and 1,3 times for Alzheimer Disease
- Diabetes increased the risk of Dementia, in particular in very old people
- The risk of Dementia was especially high when Diabetes occured together !with
severe systolic hypertension or heart disease
Monday, September 16, 13
19. Dr. Jaakko Tuomilehto
Cognitive decline and glycemia
Brayne C, Neurobiol Aging 2005
Association with increased HbA1c and cognitive decline
HbA1c 3.7-5.2 5.3-5.7 5.8-6.9 >7 Self-reported DM
% 3.7 8.6 11.5 37 2.6
Risk for
cognitive
decline
1.0 2.3 3.6 11.2 1.0
Monday, September 16, 13
20. Dr. Jaakko Tuomilehto
Risk of Incident Dementia Associated with
Average Glucose Level over the Preceding 5 Years among People without Diabetes
Crane et al. N Engl J Med 2013
Monday, September 16, 13
21. Dr. Jaakko Tuomilehto
History of Medically Treated Diabetes and Risk of Alzheimer Disease in
a Nationwide Case-Control Study in Finland
Tolppanen et al.Diabetes Care2013; 36:2015–29
Monday, September 16, 13
22. Dr. Jaakko Tuomilehto
Vantaa 85+ study - Finland
To investigate the association of diabetes
with dementia and its main sub-types,
Alzheimer disease and Vascular Dementia
through analyses of
incidence and neuropathological outcomes
in a population-based study.
Monday, September 16, 13
23. Adjusted HR=
2.45 (1.33-4.53)
0.00
0.10
0.20
0.30Cumulativeincidence
0 1 2 3 4 5 6 7 8 9 10
Follow-up time, years
non-DM DM
Alzheimer’s disease
Adjusted HR=
2.15 (1.06-4.36)
0.00
0.10
0.20
0.30
Cumulativeincidence
0 1 2 3 4 5 6 7 8 9 10
Follow-up time, years
non-DM DM
Vascular dementia
Dr. Jaakko Tuomilehto
Vantaa 85+ study: Incidence of Alzheimer Disease and
VascularDementia by Diabetes in the Elderly Finns
Adjusted Risk
with diabetes = 2.45
Adjusted Risk
with diabetes = 2.15
Monday, September 16, 13
24. Dr. Jaakko Tuomilehto
Vantaa 85+ study: Autopsy population characteristics
• n=291
- mean age at death: 92 (range 85-106) years
- 84% female
- 24% with diabetes
- 65% with dementia at death
- 31% with ApoE ε4
• Neuropathology: Same dissection and examination protocol were
used for each brain following the CERAD protocol (Polvikoski et al.,
NEJM 1995, Neurology 2001)
Monday, September 16, 13
25. Dr. Jaakko Tuomilehto
Vantaa 85+ study: Diabetes & cerebral infarcts
0
25
50
75
100
No DM ( N=192) DM ( N=62)
Proportion of subjects with cerebral
infarcts
Diabetes and Risk for cerebral infarcts
44.4 61.3
0
0.5
1
1.5
2
No DM ( N=192) Model1 Model2
1.92 1.79
No Cerebral infarcts
Cerebral infarcts Model 1: adjusted for age at death and gender.
Model 2: Model 1 + education, ApoE ε4, dementia
p=0.028
Monday, September 16, 13
26. Dr. Jaakko Tuomilehto
Vantaa 85+ study: Diabetes & ß-amyloid
0
25
50
75
100
No DM ( N=226) DM ( N=65)
Proportion of subjects with β-amyloid Diabetes and OR (95%CI) for β-amyloid
86.7 72.3
0
0.25
0.5
0.75
1
No DM Model1 Model2
Model 1: adjusted for age at death and gender.
Model 2: Model 1 + education, ApoE ε4, dementia
0.37 0.33
No Amyloid Amyloid
p=0.008
Monday, September 16, 13
27. Dr. Jaakko Tuomilehto
Vantaa 85+ study: Diabetes & tangles
0
37.5
75
112.5
150
No DM ( N=221) DM ( N=62 )
Proportion of subjects with tangles Diabetes and OR (95%CI) for tangles
67 56.5
0
0.25
0.5
0.75
1
No DM Model1 Model2
Model 1: adjusted for age at death and gender.
Model 2: Model 1 + education, ApoE ε4, dementia
0.65 0.6
No Tangles Tangles
p=0.14
Monday, September 16, 13
28. Dr. Jaakko Tuomilehto
Possible etiology of cognitive decline in Diabetes
• Cognitive decline due to cerebrovascular disease
• Insulin resistance
- high peripheral insulin, low cerebral insulin
- Disturbed glucose transport
- Endothelial dysfunction
- Beta-Amyloid accumulation ?
• Hyperglycemia
- Direct neurotoxic effect
- Endothelial dysfunction
• Hypoglycemia (treated patients)
- “Fuel deprivation”
• Inflammation?
Monday, September 16, 13
29. Dr. Jaakko Tuomilehto
Possible mechanisms
Xu WL modified based on Biessels GJ et al. 2006 and Launer LJ. 2005
Brain pathology
• Comorbidity
• Medication
Genetic
predisposition
Diabetes
“Accelerated aging"
Microvascular Disease
•Insidious ischaemia
Glucose toxicity
•Advanced protein glycation
• Oxidative stress
• Inflammation
Alzheimer type
Insulin
↑β-amyloid
↑Phosphorylation
of tau
Insulin
Underlying mechanisms
Dementia
Vascular
Atherosclerosis
•Brain infarcts
Insulin
↑β-amyloid
↑Phosphorylation
of tau
Insulin
Monday, September 16, 13
30. Dr. Jaakko Tuomilehto
Finnish Diabetes Prevention Study (DPS): lifestyle goals
• Weight reduction > 5%
• Fat intake < 30 E%
• Saturated fat intake < 10 E%
• Fibre intake ≥ 15 g/1000 kcal
• Physical activity > 30 min/day
Intervention group
• Individually tailored diet based on 3-day food diary
• 7 dietary counselling sessions during the first year, every 3 months thereafter
• Free-of-charge gym
Tuomilehto et al. NEJM 2001 Lindström et al. Diabetes Care 2003
Control group
• General advice about healthy diet and exercise habits
• No individualized counseling
E, energy
Monday, September 16, 13
31. Dr. Jaakko Tuomilehto
Development of diabetes during the lifestyle intervention in the intervention and control
groups - DPS
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
0 1 2 3 4 5 6
Intervention Group Control Group
Risk reduction: 58%
Monday, September 16, 13
32. Dr. Jaakko Tuomilehto
Prevention of Type 2 Diabetes by Lifestyle Management: The Evidence
DPS - Finland DPP - USA SLIM - Netherlands
0
10
20
30
40
50
0 1 2 3 4 5 6
YEAR
Intervention group Control Group
EDIPS Newcastle - UK Da Qing - China IDPP - India
Risk 58% ↓ Risk 58% ↓ Risk 58% ↓
Risk 58% ↓ Risk 43% ↓ Risk 28.5% ↓
Lifestyle
Control
Metformin
Monday, September 16, 13
33. Dr. Jaakko Tuomilehto
Development of diabetes is inversely related to the
success in achieving multiple intervention targets
during the 1st year of the study - DPS
0
7
13
20
27
33
40
0 1 2 3 4 5
Intervention
Control
%
Monday, September 16, 13
34. Dr. Jaakko Tuomilehto
Unadjusted Adjusted for baseline weight, group and sex
RELATIVE RISK for diabetes according to
weight change from baseline to year 1: DPS
0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
2.0
0 1 2 3 4
Monday, September 16, 13
37. HEALTHY
DIET
MODEL 1 MODEL 2 MODEL 3
Dementia
Low adherence (0-8 points)
High adherence (>8 points)
86% 90% 88%
Alzheimer’s
Low adherence (0-8 points)
High adherence (>8 points)
90% 92% 92%
Dr. Jaakko Tuomilehto
Association between healthy diet and Alzheimer's among participants
Monday, September 16, 13