The document discusses diseases of the external nose and vestibule. It describes the anatomy of the external nose and lists conditions such as cellulitis, nasal deformities including saddle nose and hump deformity, and various tumors that can affect the external nose including congenital tumors like dermoids, benign tumors such as rhinophyma, and malignant tumors such as basal cell carcinoma and squamous cell carcinoma. Treatment options are provided for many of the conditions.
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Dr Junaid Ahmad (MBBS FCPS) is the best plastic surgeon in Lahore. He is a well known, trained and expert in his field. He is MBBS and FCPS in Plastic and Recosntructive Surgery. He is a post graduate of the College of Physicians and Surgeons Pakistan which is oldest and best institute for post graduation in this area of the world. He is doing his practice in Lahore, Pakistan. He is always kind to the patients and listens them carefully as it is part of modern clinical skill and training. He is expert in both cosmetic as well as reconstructive surgery. He is also skin cancer and burn expert. A few of Dr Junaid Ahmad expertise are listed here..... call 03104037071
ENT Nasal septal perforation..... for best rhinoplasty and nose reshape surgery contact
Dr Junaid Ahmad (MBBS FCPS) is the best plastic surgeon in Lahore. He is a well known, trained and expert in his field. He is MBBS and FCPS in Plastic and Recosntructive Surgery. He is a post graduate of the College of Physicians and Surgeons Pakistan which is oldest and best institute for post graduation in this area of the world. He is doing his practice in Lahore, Pakistan. He is always kind to the patients and listens them carefully as it is part of modern clinical skill and training. He is expert in both cosmetic as well as reconstructive surgery. He is also skin cancer and burn expert. A few of Dr Junaid Ahmad expertise are listed here..... call 03104037071
DOES15 - Mike Bland - Pain Is Over, If You Want ItGene Kim
Mike Bland, Practice Director, 18F
Technology is always the easiest part of any problem. This was true of Google in 2005, when Mike Bland joined the Testing Grouplet’s effort to drive adoption of automated testing throughout a highly successful company as its organization and systems increased in complexity at an alarming and unstoppable rate. This was true in late 2013, when the Healthcare.gov crisis led to a stunningly successful recovery after private industry experts were given clearance to fix the technical issues. It is also true of the U.S federal government today, as Mike has joined 18F as part of the effort to modernize how software is developed and procured, and to steer the culture towards maximum transparency, autonomy and collaboration. This talk will outline Mike’s experiences at Google that shaped his outlook and honed his organizational skills, and describe his efforts to capitalize on the opportunity produced by the Healthcare.gov recovery to effect broad cultural change throughout the federal government.
How to Use Oracle RAC in a Cloud? - A Support QuestionMarkus Michalewicz
This presentation, which was first presented during Sangam16, discusses general and specific support rules for the Oracle Database and Oracle RAC with the purpose of enabling you to determine whether a given system is supported, certified or even recommended. This presentation was last updated on August 31st 2017 (minor update).
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Ludwig's Angina is an infective condition of the floar of mouth above and below the mylohyoid muscle. Tongue is raised, mouth remains open and there may be compromised airway and require tracheostomy. Treatment is medical in the form of antibioticsand pain killers and surgical in the form of incision and drainage.
Although diphtheria is not very common but its also not very uncommon. Although there is immunization regarding diphtheria in expanded program of immunization in Pakistan but still we find cases off and on
Both acute and chronic pharyngitis are common diseases and they are important for the students to understand, Moreover acute tonsillitis is also very common and it becomes one of the most important causes of throat pain and fever.
Pharynx is upper part of the aerodigestive tract. It has three parts nasopharynx, oropharynx and laryngopharynx. Pharynx plays an important part in respiration and swallowing. Swallowing is a very complex process. To swallow properly it is important to shut down the openings of nasopharynx, oral cavity and larynx and open the upper sphinctor of esophagus.
Disease of the nasal septum can cause nasal obstruction, excessive nasal discharge, epistaxis, headache and sinusitis. The diseases could be deviated nasal septum, septal haematoma, septal abscess and septal perforation. All these complaints are treatable.
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
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.
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.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
4. The NoseThe Nose
The nose consists ofThe nose consists of
thethe external noseexternal nose
and theand the nasal cavitynasal cavity,,
Both are divided by aBoth are divided by a
septum into right andseptum into right and
left halves.left halves.
5. External NoseExternal Nose
The external noseThe external nose
has two ellipticalhas two elliptical
orifices called theorifices called the
naris (nostrils)naris (nostrils),,
which are separatedwhich are separated
from each other byfrom each other by
thethe nasal septumnasal septum..
The lateral margin,The lateral margin,
thethe ala nasiala nasi, is, is
rounded and mobile.rounded and mobile.
7. External NoseExternal Nose
The framework of theThe framework of the
external nose is madeexternal nose is made
up above by theup above by the
nasal bonesnasal bones, the, the
frontal processes offrontal processes of
the maxillaethe maxillae, and, and thethe
nasal part of thenasal part of the
frontal bonefrontal bone..
Below, the frameworkBelow, the framework
is formed of plates ofis formed of plates of
hyaline cartilagehyaline cartilage
9. Blood Supply of the External NoseBlood Supply of the External Nose
Maxillary arteryMaxillary artery
External NoseExternal Nose
Ophthalmic ArteryOphthalmic Artery
External NoseExternal Nose
Facial ArteryFacial Artery
AlaAla
Lower part of the septumLower part of the septum
10. Nerve Supply - External NoseNerve Supply - External Nose
Ophthalmic nerveOphthalmic nerve
Infratrochlear branchesInfratrochlear branches
External nasal branchesExternal nasal branches
Maxillary nerveMaxillary nerve
Infra Orbital branchInfra Orbital branch
11. Nasal CavityNasal Cavity
The nasal cavity hasThe nasal cavity has
floorfloor
roofroof
lateral walllateral wall
medial or septalmedial or septal
wallwall
12. CellulitisCellulitis
Infection of nasal skin and soft tissueInfection of nasal skin and soft tissue
OrganismsOrganisms
StreptococciStreptococci
StaphylococciStaphylococci
Clinical featuresClinical features
RednessRedness
SwollenSwollen
Tenderness.Tenderness.
TreatmentTreatment
Systemic antibioticsSystemic antibiotics
Hot fomentationHot fomentation
AnalgesicsAnalgesics
18. Hump DeformityHump Deformity
BoneBone
CartilageCartilage
Both - bone and cartilage.Both - bone and cartilage.
TreatmentTreatment
Reduction RhinoplastyReduction Rhinoplasty
Exposure of nasal frameworkExposure of nasal framework
External approachExternal approach
Closed approachClosed approach
Removal of humpRemoval of hump
Narrowing of the lateral wallsNarrowing of the lateral walls
19. Crooked noseCrooked nose
Midline of dorsum from frontonasal angleMidline of dorsum from frontonasal angle
to tip is curved in A C or S shape.to tip is curved in A C or S shape.
Deviated nose-midline is straight butDeviated nose-midline is straight but
deviated to one side.deviated to one side.
EtiologyEtiology -- traumatrauma
BirthBirth
NeonatalNeonatal
childhoodchildhood
Deformities are identified with growthDeformities are identified with growth
TreatmentTreatment
RhinoplastyRhinoplasty
SeptorhinoplastySeptorhinoplasty
24. Meningoencephalocele orMeningoencephalocele or
EncephalocoeleEncephalocoele
TypesTypes
NasofrontalNasofrontal-subcutaneous pulsatile swelling in the-subcutaneous pulsatile swelling in the
midline at the root of nose.midline at the root of nose.
NasoethmoidNasoethmoid - swelling at side of nose.- swelling at side of nose.
Naso-orbitalNaso-orbital-on the antero medial aspect of orbit.-on the antero medial aspect of orbit.
Swellings showSwellings show
cough impulsecough impulse
Reducible.Reducible.
TreatmentTreatment::
• NeurosurgicalNeurosurgical
• Severing the stalk from brainSevering the stalk from brain
• Repairing the bony defect.Repairing the bony defect.
25. GliomaGlioma
• It is a nipped off portion of encephaloceleIt is a nipped off portion of encephalocele
during embryonic developmentduring embryonic development
• Firm subcutaneous swelling on theFirm subcutaneous swelling on the
•
BridgeBridge
•
Side of noseSide of nose
•
Inner canthusInner canthus
• 60%-extranasal60%-extranasal
• 30%-intranasal,30%-intranasal,
• 10%-both10%-both
• Extranasal gliomas are encapsulated andExtranasal gliomas are encapsulated and
can be easily removed by external nasalcan be easily removed by external nasal
27. Dermoid with SinusDermoid with Sinus
seen in infants and childrenseen in infants and children
pit or a sinus in the midlinepit or a sinus in the midline
dorsum of nosedorsum of nose
Hair may be seen protrudingHair may be seen protruding
28. Dermoid with SinusDermoid with Sinus
sinus track may lead to a dermoid cystsinus track may lead to a dermoid cyst
under the nasal bone in front of upperunder the nasal bone in front of upper
part of nasal septumpart of nasal septum
may have an intracranial duralmay have an intracranial dural
connection.connection.
sinus tract passes through thesinus tract passes through the
cribriform plate or foramen caecum andcribriform plate or foramen caecum and
is attached to dura or has otheris attached to dura or has other
intracranial connection.intracranial connection.
29. Dermoid with SinusDermoid with Sinus
ComplicationComplication
MeningitisMeningitis
TreatmentTreatment
Removal of the eermoid with tactRemoval of the eermoid with tact
nasal bones to remove any extension innasal bones to remove any extension in
the upper part of the nasal septum.the upper part of the nasal septum.
Combined approach neurosurgicalCombined approach neurosurgical
otolaryngologicotolaryngologic
Repair of the gapRepair of the gap
32. Rhinophyma (potato tumour)Rhinophyma (potato tumour)
• Slow growing benign tumourSlow growing benign tumour
• Hypertrophy of the sebaceous glandsHypertrophy of the sebaceous glands - tip of nose- tip of nose
•
Seen in long standing cases of acne rosaceaSeen in long standing cases of acne rosacea
•
Unsightly appearance of tumourUnsightly appearance of tumour
•
Obstruction in breathingObstruction in breathing
•
Obstruction of visionObstruction of vision
• Clinical featuresClinical features
•
Pink, lobulated mass over the nose with superficial vascularPink, lobulated mass over the nose with superficial vascular
dilations.dilations.
•
Mostly affect men past middle age.Mostly affect men past middle age.
• TreatmentTreatment
•
Paring the bulk of the tumour with sharp knife orParing the bulk of the tumour with sharp knife or
•
CO2 laser ablasionCO2 laser ablasion
•
Re-epithelialisationRe-epithelialisation
•
Completely excision and skin graftingCompletely excision and skin grafting
36. Basal cell carcinomaBasal cell carcinoma (rodent ulcer)(rodent ulcer)
• Most common malignant tumourMost common malignant tumour -- 87%87%
• Males:females = 1:1Males:females = 1:1
• Age group of 40-60.Age group of 40-60.
• Common sites: tip and the ala.Common sites: tip and the ala.
• Clinical presentationClinical presentation
•
CystCyst
•
Papulo-pearly nodulePapulo-pearly nodule
•
Ulcer with rolled edgesUlcer with rolled edges
37. Basal cell carcinomaBasal cell carcinoma (rodent ulcer)(rodent ulcer)
• CharacteristicsCharacteristics
•
Very slow growingVery slow growing
•
Remains confined to skin for a long timeRemains confined to skin for a long time
•
Underlying bone and cartilage may get invadedUnderlying bone and cartilage may get invaded
•
Nodal metastasis extremely rareNodal metastasis extremely rare
38. Basal cell carcinoma- treatmentBasal cell carcinoma- treatment
Depends onDepends on
SizeSize
LocationLocation
DepthDepth
Early lesionsEarly lesions
CryosurgeryCryosurgery
IrradiationIrradiation
Surgical excision with 3-5mm marginSurgical excision with 3-5mm margin..
Recurrent /extensiveRecurrent /extensive lesionslesions (involvement of bone or(involvement of bone or
cartilage)cartilage)
ExcisionExcision
Defect closed by local or distant flaps or prosthesis.Defect closed by local or distant flaps or prosthesis.
39. Squamous cell carcinomaSquamous cell carcinoma
(epithelioma)(epithelioma)
• 2nd most common malignant tumour -112nd most common malignant tumour -11
%%
• M:F = 1:1M:F = 1:1
• Age group - 40-60Age group - 40-60
• Clinical featuresClinical features
•
Infiltrating noduleInfiltrating nodule
•
Ulcer with rolled out edgesUlcer with rolled out edges
•
Affecting side of nose or collumelaAffecting side of nose or collumela
•
Nodal metastases – 20%Nodal metastases – 20%
40. SSC - treatmentSSC - treatment
• RadiotherapyRadiotherapy
•
Early lesionsEarly lesions
• Advanced lesions - bone or cartilageAdvanced lesions - bone or cartilage
•
Wide surgical excisionWide surgical excision
•
Plastic repair of thePlastic repair of the
• Enlarged regional lymph nodesEnlarged regional lymph nodes
•
Block neck dissection.Block neck dissection.
41. MelanomaMelanoma
Least common variety.Least common variety.
ClinicallyClinically
Superficially-spreading typeSuperficially-spreading type
Slow-growingSlow-growing
Nodular invasive type.Nodular invasive type.
TreatmentTreatment
Surgical excisionSurgical excision
42. MelanomaMelanoma
Least common variety.Least common variety.
ClinicallyClinically
Superficially-spreading typeSuperficially-spreading type
Slow-growingSlow-growing
Nodular invasive type.Nodular invasive type.
TreatmentTreatment
Surgical excisionSurgical excision
43. Furuncle - boilFuruncle - boil
• DefinitonDefiniton
•
Acute infection of hair follicle by staphylococcus aureusAcute infection of hair follicle by staphylococcus aureus
•
EtiologyEtiology
• TraumaTrauma
•
Picking nasal vibrissaePicking nasal vibrissae
•
Plucking nasal vibrissaePlucking nasal vibrissae
•
Clinical featuresClinical features
• Lesion is smallLesion is small
• Extremely painful and tenderExtremely painful and tender
• Inflammation may spread nasal tipInflammation may spread nasal tip
• RednessRedness
• Swollen.Swollen.
• Fever,Fever,
• MalaiseMalaise
• HeadacheHeadache
• Pus discharge _rupture spontaneously in vestibule.Pus discharge _rupture spontaneously in vestibule.
46. VestibulitisVestibulitis
• Diffuse dermatitis of nasal vestibuleDiffuse dermatitis of nasal vestibule
• Causative organism- Staph AureusCausative organism- Staph Aureus
• Predisposing factorPredisposing factor
•
Nose pickingNose picking
•
Plucking of nasal vibrissaePlucking of nasal vibrissae
•
Nasal discharge due to any cause coupled with traumaNasal discharge due to any cause coupled with trauma
due to handkerchiefdue to handkerchief
47. VestibulitisVestibulitis
• Acute formAcute form
•
Vestibular skin is redVestibular skin is red
•
Skin is swollenSkin is swollen
•
TendernessTenderness
•
CrustsCrusts
•
Scales cover over erosionScales cover over erosion
•
Excoriation. Upper lip may also beExcoriation. Upper lip may also be
involved.involved.
• Chronic form-Chronic form-
•
Induration of vestibular skinInduration of vestibular skin
•
Painful fissures and crusting.Painful fissures and crusting.
•
48. VestibulitisVestibulitis
Treatment-Treatment-
Removal of crusts with hydrogenRemoval of crusts with hydrogen
peroxideperoxide
Application of antibiotic steroid creamApplication of antibiotic steroid cream
Chronic fissure cauterized with AgNO3Chronic fissure cauterized with AgNO3
