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Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
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.
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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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
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
2 Case Reports of Gastric Ultrasound
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.
2. Personal Data
• Patient’s Name: M.A
• Gender: Female
• Age : 15 Years, 5 Months
• occupation: Student
• Nationality: Jordanian
3. Chief Complaint
“ I have unerupted tooth in my lower jaw
And rotated upper anterior teeth”
4. Medical & Dental History
• Medical History:
Denied Any Medical History.
• Dental History:
• Routine dental
treatment
(filling in UR6&LR6).
• Extraction of LL 1st primary molar, 1 month ago.
5. History
• Trauma: No history of trauma.
• Habits: No Habits.
• Motivation: Internally Motivated.
• Growth status: Non- grower .
6. Jaw & Occlusal Functions
• Mastication: Normal masticatory function.
• Speech: No difficulty.
• TMJ:
No clicking.
No Crepitus or tenderness.
No displacement.
Normal opening.
17. • Teeth present:
76E4321 1234567
7654321 1234567
• Caries in UL6.
• Lower left 1st premolar & Lower
left 2nd molar partially erupted.
• Primary Upper right 2nd molar still
present with no mobility.
19. Upper arch
• U-shaped arch.
• Anterior segment:
Upright anterior teeth.
Rotated Rt&Lt central incisors .
• Posterior segment:
Primary right 2nd molar still
present with no mobility.
Rotated left 2nd premolar.
Caries in UL6.
20. Anterior segment in occlusion
• Incisor relationship: class 1
• Midline: Lower shifted to
the left 2mm.
• Overjet : 2mm.
• Overbite: incomplete 50%.
21. Buccal segment in occlusion
• Molar relationship:
Cl III ¼ unit in the right side.
Cl I in the left side.
• Canine relationship:
Cl I in the right side.
Cl II ½ unit in the left side.
22. Study model analysis in occlusion
Anterioposterior:
• Molar : Cl III1/4 unit.
• Canine : Cl I .
O.J : 2mm
• Molar : Cl I .
• Canine : Cl II ½ unit .
Right Left
29. Radiographical examination
Orthopantomogram “OPT” Analysis :
• No pathology.
• All teeth are present except UR 2nd premolar & all wisdom teeth.
• Primary Upper right 2nd molar still present with good bone level.
• Lower left 1st premolar & Lower left 2nd molar partially erupted.
• Roots of lower left&right 2nd molar not completely formed.
• Fillings in UR6&LR6.
• Other features look normal.
30. Cephalometric
Analysis Measurements Average
SNA 83.6˚ (81)+-3
SNB 81.8˚ (78)+-3
ANB 1.8˚ (3)+-1
SN-MAX 2˚ (8)+-3
Wits
Appraisal
-2mm (0) +-
1.77mm
“f”
MMPA 24˚ (27)+-4
LAFH Ratio 56% 55%+-
2%
UI - MAX 107˚ (109)+-6
LI - MAN 90˚ (93)+-6
IIA 138˚ (135)+-
10Skeletal relationship: cl III
31. Space analysis
Lower Arch:
Space available 62mm
Space required 62mm
0mm ( no crowding)
Upper arch:
Space available 73mm
Space required 70mm
+ 3mm
10.5 6.5 7 7 6.5 8 8 6.5 7 7 6.5 10.5 91 43
6 5 4 3 2 1 1 2 3 4 5 6 over
all
ante
rior
10 7 7 6.5 5.5 5 5 5.5 6.5 7 7 10 82 34
90%=Over all ratio: 82/91
Normal: 91.3% +/- 1.9
Anterior ratio: 34/43 = 79%
Normal: 77.2% +/- 1.7
Normal Bolton Ratio
Note: mesiodistal width of UR primary 2nd molar 9mm.
32. Royal London space planning
LowerUpper
0+3 mmCrowding and spacing
- 2 mm0Leveling of occlusal curve
00Incisors AP position
00Inclination change
-2 mm+3mmTotal
34. Dental Health Component :
• Grade 5
“Extreme /Need Treatment”
5i Impeded eruption of teeth
due to retained deciduous
teeth
35. Diagnostic summary
• M.A 15,5months years old female, denied any medical problem, presented
with concern unerupted tooth in her lower jaw & rotated upper anterior
teeth, good oral hygiene and caries in UL1st molar.
• She has a class I incisors relationship based on class III skeletal pattern,
average lower anterior facial height , straight profile, and asymmetrical soft
tissue face.
• She has missing UR 2nd premolar, over jet 2mm, incomplete overbite 50%,
no crowding in upper and lower arches, rotated lower Rt & Lt 2nd premolars,
distally tilted LL lateral incisor &LL canine, partially erupted LL 1st premolar
&LL 2nd permanent molar, retained upper primary right 2nd molar with no
mobility and good bone level, rotated upper left 2nd premolar& Rt and Lt
central incisors, lower midline shifted to the left side 2mm.
• She has cl III ¼ unit molar relationship in Rt side, cl I in Lt side & cl I canine
relationship in Rt side, cl II1/2 unit in Lt side and increased curve of spee.
36. Problems list
Pathological problems:
Caries in UL 1st molar.
Patient’s concern:
I have unerupted tooth in my
lower jaw and rotated upper
anterior teeth.
Skeletal problems:
Class III skeletal pattern.
Soft tissue problems:
• Asymmetrical face.
Dental problems:
• Missing upper right 2nd premolar and
retained upper primary right 2nd molar.
• Partially erupted LL 1st premolar.
• Rotated lower Rt & Lt 2nd premolars.
• Distally tilted LL lateral incisor &LL
canine.
• Rotated upper left 2nd premolar& Rt and
Lt central incisors.
• Lower midline shifted to the right side
2mm.
• Molars are cl III ¼ unit in Rt side and cl I
in Lt side.
• Canines are cl I in right side and cl II ½
unit in left side.
• Increased curve of spee.
37. Treatment Aims
Restoration of carious tooth.
Correct the patient complaint.
Accept skeletal cl III pattern.
Accept soft tissue problems.
Accept retained upper primary right 2nd molar and consider
future artificial replacement for the missing UR 2nd premolar.
Achieve class I molar and cl I canine relationship in Rt&Lt side.
Correction of rotated and tilted teeth.
Correction of dental midline shift in lower arch.
Correction of curve of spee.
38. Treatment plan: “ Non- Extraction Case”
“ camouflage case ”
1. Refer patient to cons. clinic to treat carious tooth.
2. Oral hygiene instruction.
3. Lower holding arch.
4. Upper & Lower Fixed Appliance: using SWA technique.
“ Pre-adjusted edgewise, Roth prescription, slot 0.022”
5. Interproximal reduction of UR 2nd primary molar.
6. Retention:
( Long term) lower bonded retainer 3-3.
Upper bonded retainer 1-1.
( Short term) Upper and lower Hawley retainer appliance.
39. Justification
1. Camouflage :
Patient passed the peak of growth spurt.
Mild cl III skeletal.
Good vertical facial proportion.
No dental compensation.
Normal overbite and overjet.
2. Non- extraction :
Upper and lower arches with no crowding.
Space can be gained by correction of rotated, tilted teeth and arch
wire expansion .
40. 3. Refer patient to cons. clinic to treat carious tooth.
4. Oral hygiene instruction to maintain stability of the
periodontal tissue.
5. Lower holding arch:
to prevent distal tipping of LL6 during opening space for
LL4 which may interfere with LL7 eruption, and maintain
cl I molar relationship.
As anchorage – to maintain molar relationship – to aid in
traction if the case necessitates .
6. Fixed appliance using Roth prescription:
For 3D tooth movement.
Average torque is needed.
41. 7. Interproximal reduction of UR 2nd primary molar:
Interproximal reduction 2.5mm(M&D sides) of UR 2nd
primary molar to achieve cl I molar relationship in the Rt side and
create accurate space for future artificial replacement of UR 2nd
premolar.
8. Retention:
(Long term )
Lower fixed retainer (3-3) to stabilize the position of anterior teeth and
prevent lower late labial segment crowding .
To maintain aligment of rotated LL3
Upper fixed retainer (1-1) to stabilize the position of central incisors.
(Short term)
Upper and lower Hawley retainer appliance for more settling and
stability.
42. Mechanics
• At direct bonding of U&L fixed appliance:
- Raising bite at lower Rt&Lt 6 –to disarticulate the occlusion in the early
phase of aligment
- lace back in all quadrents except lower left one ( 6 – 3) .
• At working arch wire (19 X 25 S.S):
- Open spring between LL3&LL5 to create space for LL4, achieve cl I
canine in Lt side and correct lower midline.
- Bonding of LL4 and piggyback for traction of partially erupted LL 4.
• At finishing stage:
- Remove lower holding arch.
- TMA wire ( 21 X 25 ) for root parallism.
- CSF .