Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine
Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine
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Hyperparathyroidism is medical condition where overactivity of one or more of the body's four parathyroid glands leads to excess of parathyroid hormone in the bloodstream.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
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For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
Hyperparathyroidism is medical condition where overactivity of one or more of the body's four parathyroid glands leads to excess of parathyroid hormone in the bloodstream.
Pyelonephritis
It is the inflammation of the kidney & upper urinary tract that usually results from the bacterial infection of the bladder.
Pyelonephritis can be classified in several different catagories:
-acute pyelonephritis
-chronic pyelonephritis
-xanthogranulomatous pyelonephritis
This lecture talk about the disturbance of adrenal gland hormones and how it affect health. it also discuss in brief how to manage such condition in your dental clinic
Dental Management of Patient With Adrenal Cortex Disorder Tarek Zaid
a presentation describe the physiology of adrenal gland and focuses on line of treatment and dental management of patient with adrenal cortex problems as over and under production of adrenal secretions
Cushing syndrome occurs when your body has too much of the hormone cortisol over time. This can result from taking oral corticosteroid medication. Or your body might produce too much cortisol.
Too much cortisol can cause some of the hallmark signs of Cushing syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on occasion, type 2 diabetes.
Treatments for Cushing syndrome can return your body's cortisol levels to normal and improve your symptoms. The earlier treatment begins, the better your chances for recovery.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Francesca Gottschalk - How can education support child empowerment.pptxEduSkills OECD
Francesca Gottschalk from the OECD’s Centre for Educational Research and Innovation presents at the Ask an Expert Webinar: How can education support child empowerment?
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
3. INTRODUCTION
The Adrenal Gland also known as suprarenal gland are
endocrine glands that produce a variety of hormones .
They are found above the kidneys. Each gland has an
outer cortex which produce steroids hormones (i.e.
mineralocorticiods, glucocorticoids, and aldosterone ) and
an inner medulla.
A number of endocrine diseases involve dysfunctions of
the adrenal gland.
Like either overproduction or insufficient production of
cortisol leads to disorder.
Also a variety of tumors can arise from adrenal tissue and
leads to a disease.
5. ADDISONS’S DISEASE
Addison’s disease is a rare disorder which develops
when the adrenal glands do not make enough cortisol.
Addison's is an autoimmune disease. Addison’s disease
cause damage to the adrenal glands.
In the long term, this damage can get worse until
eventually the adrenal glands aren't working at all.
6. ETIOLOGY
Primary adrenal insufficiency is caused by hypo
function of the adrenal glands
Auto immune response
Inadequate secretion of the adrenal hormone
Infection of the adrenal hormone
Tuberculosis, AIDS, metastatic cancer etc.
8. RISK FACTORS
A history of other endocrine disorders
Taking glucocorticoids for more than 3 weeks with
sudden cessation
Taking glucocorticoids more than once every
other day
Adrenalectomy
Tuberculosis
14. ASSESSMENT & DIAGNOSTIC FINDINGS
Blood test :This test measure your blood levels of
sodium, potassium, cortisol and adrenocorticotropic
hormone (ACTH), which stimulates the adrenal cortex to
produce its hormones.
ACTH stimulation test : This test measures the level of
cortisol in your blood before and after an injection of
synthetic ACTH.
Other laboratory finding include hypoglycemia and an
increased WBC counts.
16. MEDICAL MANAGEMENT
o Immediate treatment includes restoring blood circulation,
administering fluids and corticosteroids, monitoring vital
signs and placing pt. in a recombant position with legs
elevated.
o Hydrocortisone is administered by IV, following by 5%
dextrose in normal saline.
o Oral medications for the disease are::
• Hydrocortisone pills to replace cortisol.
• If you are also lacking aldosterone, you may receive
fludrocortisones acetate pills.
17. NURSING MANAGEMENT
NURSING DIAGNOSIS -1
Risk for Deficient Fluid Volume related to Increase in sodium
and water excretion with potassium retention
NURSING INTERVENTIONS
• Assess skin turgor and mucous membranes for signs of
dehydration.
• Assess vital signs, especially noting BP and HR for orthostatic
changes.
• Assess color, concentration, and amount of urine.
• Assess trends in weight.
• Encourage oral fluids as the patient tolerates
• Instruct the patient to ingest salt additives in conditions of
excess heat or humidity
18. 2.Risk for imbalance nutrition related to Decreased
gastrointestinal enzymes, causing loss of appetite and
decreased oral intake tolerance
NURSING INTERVENTIONS
• Assess appetite and for the presence of nausea,
vomiting, or diarrhea.
• Monitor trends in weight.
• Assess foods that patient can tolerate
• Monitor serum glucose levels.
• Ask the dietician to provide high-protein, low-
carbohydrate, high-sodium diet.
• Encourage rest periods after eating
19. 3.Risk for Decreased Cardiac Output related to Any
situations requiring increased corticosteroids .
NURSING INTERVENTIONS
• Assess skin warmth and peripheral pulses
• Assess level of consciousness.
• Monitor vital signs with frequent monitoring of BP.
• Monitor urine output.
• Minimize stressful situations and promote a quiet
environment.
20. CUSHING SYNDROME
Cushing’s syndrome is a rare disorder that occurs when
your body makes too much of the hormone cortisol over a
long period of time. Cushing syndrome, may be caused
by the use of oral corticosteroid medication
21. ETIOLOGY
Extensive use of cortisone medication
A benign tumor of adrenal gland
Excessive secretion of adrenal androgen
A benign tumor of the lungs or other organ
Administration of ACTH or corticosteriods
23. CLINICAL MANIFESTATIONS
Weight gain and fatty tissue deposits, particularly around
the midsection and upper back, in the face (moon face),
and between the shoulders (buffalo hump)
Pink or purple stretch marks on the skin of the abdomen,
thighs, breasts and arms
Slow healing of cuts
Acne
Excess sweating
Infertility
Muscle weakness
24. ASSESSMENT & DIAGNOSTIC FINDINGS
Serum cortisol test: Serum cortisol levels are usually
higher in early morning (6-8AM) and lower in the evening
(4-6PM) In Cushing syndrome this variation is lost.
Urinary cortisol test: This tests measure hormone levels
and show whether your body is producing excessive
cortisol(for Cushing syndrome it is generally three times
the upper limit). For the urine test, Pt. is asked to collect
urine over a 24-hour period.
Electrolyte level: A patient with Cushing’s syndrome
include an increase in serum sodium and a decrease
in potassium levels.
25. COMPLICATIONS
• Heart attack and stroke
• Blood clots in the legs and lungs
• Infections
• Bone loss and fractures
• High blood pressure
• Unhealthy cholesterol levels
• Depression or other mood changes
• Memory loss or trouble concentrating
• Insulin resistance and prediabetes
• Type 2 diabetes
26. MEDICAL MANAGEMENT
Most patients are rendered hypoadrenal for months to
years after the procedure.
During this period, they require glucocorticoid
replacement therapy.
Radiation therapy may also be used to treat pituitary or
adrenal tumors.
Medications can be used to control cortisol production
when surgery and radiation don't work.
Ketoconazole, Mitotane ( Lysodren ) and Metyrapone
(Metopirone): to control excessive production of cortisol
at the adrenal gland.
Pasireotide(Signifor): decreasing ACTH production from
a pituitary tumor
27. NURSING MANAGEMENT
NURSING DIAGNOSIS
1.Risk For Excess Fluid Volume related to Retention of water and
sodium caused by an excess of cortisol and mineralocorticoid
levels.
NURSING INTERVENTIONS
• Assess for signs of circulatory overload:
Cyanosis
Dyspnea
Edema
Distended neck veins.
Shortness of breath.
• Assess for cardiac dysrhythmias
• Monitor vital signs, especially BP and HR.
• Instruct the client to elevate feet when sitting down.
• Instruct the client to reduce fluid intake as Indic
28. 2.Risk For Injury related To Generalized fatigue and
weakness and Poor wound healing.
NURSING INTERVENTIONS
• Assess the skin frequently to check for reddened areas,
skin breakdown, tearing, or excoriation.
• Assess the skin for signs of bruising.
• Ask the client about problems with poor wound healing.
• Instruct the client about keeping the skin clean and
moisturized.
• Encourage the client to eat a high-protein diet
29. 3. Risk For Infection related to Altered protein metabolism
or High serum cortisol level.
NURSING INTERVENTIONS
• Assess frequently for subtle signs of infections.
• Avoid unnecessary exposure to people with infections.
• Stress the importance of adequate rest.
• Use strict medical and surgical asepsis when providing
care.
• Emphasized the importance of good nutrition.
• Stress proper hand washing techniques
30. PHEOCHROMOCYTOMA
Pheochromocytomas are a type of tumor of the adrenal
glands that can release high levels of epinephrine and
nor epinephrine. Pheochromocytomas may occur in
persons of any age, (mostly in people with
hypertension). Pheochromocytomas are, fortunately,
quite rare, and most of them are benign.
32. ASSESSMENT & DIAGNOSTIC FINDINGS
• Lab tests: The following tests measure levels of
adrenaline, nor adrenaline or byproducts of those
hormones in your body:
24-hour urine test.
Blood test.
• Genetic testing :Your doctor might recommend
genetic tests to determine whether a
pheochromocytoma is related to an inherited
disorder.
34. MEDICAL MANAGEMENT
• The primary treatment for a pheochromocytoma is
surgery to remove the tumour.
• Before surgery, doctor will likely prescribe specific
blood pressure medications that block the actions of
the high-adrenaline hormones to lower the risk of
developing dangerously high blood pressure during
surgery.
Medications (chemotherapy) designed to kill tumor
cells
Radiotherapy: utilizing radio waves to destroy the
tumors
Medications to control the signs and symptoms of
35. NURSING MANAGEMENT
NURSING DIAGNOSIS
1.Risk for Decreased Cardiac Output related to high blood
pressure.
NURSING INTERVENTIONS
• Review clients at risk as noted in Related Factors as well
as individuals with conditions that stress the heart.
• Monitor and record BP, Use correct cuff size and
accurate technique.
• Observe skin color, moisture, temperature, and capillary
refill time.
• Note dependent and general edema.
36. 2. Activity Intolerance related to Generalized weakness
NURSING INTERVENTIONS
• Note presence of factors contributing to fatigue (age,
frail, acute or chronic illness, heart failure etc)
• Evaluate client’s actual and perceived limitations or
degree of deficit in light of usual status.
• Assess the patient’s response to activity, noting pulse
rate
• Assess emotional and psychological factors affecting the
current situation.
37. 3. Imbalanced Nutrition: More Than Body
Requirements related to Excessive intake in
relation to metabolic need or
Sedentary activity level
NURSING INTERVENTIONS
• Assess risk or presence of conditions
associated with obesity
• Discuss necessity for decreased caloric intake
and limited intake of fats, salt, and sugar as
indicated.
• Review usual daily caloric intake and dietary
choices.
• Refer to dietitian as indicated.
38. PRIMARY ALDOSTERONISM
Primary aldosteronism is a hormonal disorder that leads
to high blood pressure. It occurs when your adrenal
glandsproduce too much of a hormone called
aldosterone. too much of this hormone can cause you to
lose potassium and retain sodium. That imbalance can
cause your body to hold too much water, increasing your
blood volume and blood pressure.
39. CLINICAL MANIFESTATIONS
Sometimes, primary aldosteronism causes low potassium
levels. If this happens, you may have:
• Muscle cramps
• Weakness
• Fatigue
• Headache
• Excessive thirst
• A frequent need to urinate
• high blood pressure
40. ASSESSMENT & DIAGNOSTIC FINDINGS
• Renin test: a test to measure levels of aldosterone
and renin in your blood will be done. Renin is an
enzyme released by your kidneys that helps
control blood pressure. If your renin level is very
low and your aldosterone level is high, you may
have primary aldosteronism.
• Salt-loading test. You may eat a high-sodium diet
for a few days before measuring your aldosterone
levels. You may also be given fludrocortisones ( a
drug that mimics the action of aldosterone) in
addition to the high-sodium diet before the test
41. COMPLICATIONS
• High blood pressure: Persistently elevated blood
pressure can lead to problems with your heart and
kidneys, including:
Heart attack, heart failure and other heart problems
Stroke
Kidney disease or kidney failure
• Hypokalemia: Primary aldosteronism may cause low
potassium levels. Very low levels of potassium can
lead to:
Weakness
Irregular heart rhythm
Muscle cramps
Excess thirst or urination
42. MEDICAL MANAGEMENT
• A combination of medications and can effectively treat
primary aldosteronism caused by over activity of both
adrenal glands.
• Mineralocorticoid receptor antagonists block the action
of aldosterone in your body.
• spironolactone (Aldactone) This medication helps
correct high blood pressure and low potassium.
• Some high blood pressure medicine may also be
prescribed
43. NURSING MANAGEMENT
NURSING DIAGNOSIS
1.Insufficient body fluid related to decreased intake of
water
NURSING INTERVENTIONS
• Urge the patient to drink prescribed amount of fluid.
• Aid the patient if he or she is unable to eat without
assistance, and encourage the family or SO to assist
with feedings, as necessary.
• Emphasize importance of oral hygiene.
• If patient can tolerate oral fluids, give what oral fluids
patient prefers.
44. 2. Fatigue related to low potassium level
NURSING INTERVENTIONS
• Restrict environmental stimuli, especially during planned
times for rest and sleep.
• Aid the patient with developing a schedule for daily activity
and rest. Emphasize the importance of frequent rest
periods.
• Promote sufficient nutritional intake.
• Offer diversional activities that are soothing.
• Encourage an exercise conditioning program as
appropriate
45. RESEARCH
Researchers at NIH’s Eunice Kennedy
Shriver National Institute of Child Health and
Human Development (NICHD), in collaboration
with researchers at other institutions in the
United States, France and Canada, scanned
tumor and cell tissue from 146 children with
pituitary tumors evaluated for Cushing
syndrome at the NIH Clinical Center.
Researchers also scanned the genes of tumors
from some of the children. Investigators in
France scanned the genes of an additional 35
adult patients with Cushing syndrome and
46. The research team found that four of the patients
have mutant forms of CABLES1 that do not
respond to cortisol. This is significant because,
when functioning normally, the CABLES1 protein,
expressed by the CABLES1 gene, slows the
division and growth of pituitary cells that produce
the hormone adrenocorticotropin (ACTH). In turn,
ACTH stimulates the adrenal gland to produce
cortisol, which then acts on the pituitary gland to
halt the growth of ACTH-producing cells,
effectively suppressing any tumor development.
Because cortisol does not affect the four mutant
forms of CABLES1 discovered by the
researchers, these genes leave production of
ACTH-releasing cells unchecked.
47. The study authors noted that
the CABLES1 mutants were found in a small
proportion of patients and that other genes
have been implicated in pituitary tumor
formation. They added that more studies are
needed to fully understand
how CABLES1 suppresses tumor formation in
the pituitary gland.
48. CONCLUSION
Today we all have discussed together about
the topic which is DISORDERS OF ADRENAL
GLANDS. In this we all get to know about the
types of adrenal gland disorder, their sign and
symptoms, their assessment and diagnostic
findings, their medical and nursing
management.