The document discusses umbilical anatomy, development, and various diseases that can affect the umbilicus. It covers congenital abnormalities like exomphalos major and minor, which are failures of the midgut to return to the abdomen during development. It also discusses acquired conditions like umbilical hernias and infections like omphalitis that can occur. Various umbilical cysts, sinuses, and tumors are also summarized.
A brief anatomical, embryological, patho-physiological and surgical description of the Vermiform Appendix.
Surface Anatomy of Appendix, Appendicectomy, surgical approach, complications, Appendicular lump and abscess, Neoplasia, Carcinoid syndrome, Pseudomyxoma Peritonei, The Alvarado Score
In these slides we will go through the surgical anatomy of the gut,pathophysiology of intestinal obstruction, clinical presentation and management. Also we will discuss specific types of intestinal obstruction.
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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 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
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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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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Are There Any Natural Remedies To Treat Syphilis.pdf
diseases of Umbilicus
1.
2. Umbilicus is a scar
Usually located at the level of L3 – L4
linea alba is well defined above and illdefined
below
line of water shed
supplied by T10 segment
Porto-caval anastomosis
Meeting point of three systems ( vascular ,
GIT , excretory)
8. Three types
1. Exomphalos major and minor
2. Childhood hernias
3. adult hernias
9. it is due to partial or complete failure of
return of the midgut into the peritoneum
during development
2 types
exomphalos minor
exomphalos major
exomphalos minor has a small sac , cord
attached to the summit , easily reducible ,
treated b strapping for 2 weeks
10. Exomphalos major
large defect and a large sac
umblical cord is attached to
the inferior aspect
emergency treatment
primary single staged repair
or 2 staged repair
11. common in Africa , M:F 2:1
neonatal sepsis is a predisposing factor
usually amptomatic
strangulation is a rare complication
spontaneous closure occurs by 2 yrs
surgery is indicated if not closed by 5 yrs
12. Umbilical hernias in adults are mostly acquired
common in women
Predisposing factors are
increased intra-abdominal pressure
pregnancy
obesity
ascites
abdominal distention
single midline aponeurotic decussation
Irreducibility , obstruction , strangulation and
rupture are common complications
13. commonly overweight
thinned and attenuated
midline raphe.
The bulge is typically slightly
to one side of
the umbilical depression,
creating a crescent-shaped
appearance to the umbilicus
Treatment
Small hernias – observation
Large hernias - open or
laparoscopic
repair
primary repair, mayo’s , mesh
, laparoscopy
14.
15.
16.
17. Greek : allanto-sausage,
eidos - shape or similarity
an endodermal evagination of the
developing hindgut
removes nitrogenous waste from the fetal
bladder
allantois is vestigial in humans
18. Urachus – a duct between the bladder and
the yolk sac
- Between the 5th and 7th week
of development, the allantois
will become the urachus
median umblical ligament – obliterated
urachus
19.
20. manifests in new
born
one-third
associated with distal
urinary obstruction
urine from umblicus
giant umblical cord
complete excision
of the tract with a
cuff of bladder
21. commonest urachal anamoly in adults
Due to persistance of the part of the tract
symptoms due to (asymptomatic)
- size ( mass )
- infection( pain, fever,
urinary symptoms ,
umblical discharge )
- rupture ( peritonitis)
22. diagnosis by clinical , usg , cect
treatment
1) single stage – complete excision of
the tract
2) two stage - I & D
followed by
complete excision after
control of sepsis
23. Due to persistance of the distal urachus
asymptomatic unless infected
pain, fever , pus discharge
Usg , sinogram
excision of the sinus tract
24. least common urachal anamoly
asymptomatic
incidental diagnosis cystoscopy , mcu , usg
treatment usually not required
25.
26. Most common abnormality of the omphalo-mesenteric
duct
antimesenteric border of ileum
50 – 200 cms from ICJ
true diverticulum
mostly asymptomatic
lower GI bleed , inflammation , obstruction
heterotropic mucosa
m99Tc scan
Resection and reconstruction
27. asymptomatic
abdominal mass
Umbilical granuloma
umbilical discharge (faeces & air )
GI bleeding
intestinal obstruction
30. Infection of the retained umbilical cord
Poor asepsis and umbilical hygiene during
delivery
Staphylococci, streptococci, Gram-negative
organisms, Clostridium tetani
34. chronic infection of the umbilical cicatrix,
Can occur in any age group, but common in
infants and children.
Presents as umbilical discharge with tender, red,
swelling protruding from the umbilicus which
bleeds on touch.
mimics umbilical adenoma.
Treatment
Antibiotics,
silver nitrate
excision of granuloma
umbilectomy
35. commonly seen in infants.
due to partially obliterated vitello-intestinal
duct towards umbilical end, causing prolapse
of the mucosa
Appears as a moist, red swelling bleeds on
touch.
Secondary infection
Histologically, it consists of columnar
epithelium rich in goblet cells.
36.
37.
38. most common primary benign tumours were,
papillomas,
Congenitalpolyps,
melanotic naevi,
fibromas,
myxomas,
haemangiomas, and
epithelial inclusion cysts.
39. Primary malignancy is
rare (20%)
Skin , soft tissues ,
embryonic tissue rests
adenocarcinoma is the
common primary
tumour
Metastatic tumors are
the commonest (80%)
stomach, ovary, colon
and pancreas
lymphoma, RCC ,
prostate
mean survival is
approximately 10-12
months
Primary Secondary