This document discusses dysphagia and achalasia. It defines dysphagia as difficulty swallowing and distinguishes it from odynophagia, which is painful swallowing. It describes various causes of oropharyngeal and esophageal dysphagia. It then focuses on achalasia, explaining that it is a rare disease caused by loss of ganglion cells that leads to failure of the lower esophageal sphincter to relax during swallowing. The pathophysiology and diagnostic approach for achalasia are outlined, along with current treatment options of surgery or endoscopic myotomy.
Problem oriented approach in pediatric radiologyAhmed Bahnassy
This hand book tries to address the most common clinical problems in pediatrics ,by building a problem based imaging algorithm ,which probes the different differential diagnosis and try to reach a final diagnosis.
Problem oriented approach in pediatric radiologyAhmed Bahnassy
This hand book tries to address the most common clinical problems in pediatrics ,by building a problem based imaging algorithm ,which probes the different differential diagnosis and try to reach a final diagnosis.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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
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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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.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Dysphagia & Odynophagia
A- Oro-
pharyngeal
Esophageal
I- Neuromuscular: Pseudo and true bulbar palsy,
motor neurone disease, Guillain-Barre Syndrome,
myasthenia gravis, polymyositis and some
myopathies and muscular dystrophies.
II- Compression: Zenker’s diverticulum,
cricopharyngeal bar, cervical spondyulosis, thyroid
enlargement and retropharyngeal abscess.
III- Iatrogenic: surgery and radiation
IV- Infectious: pharyngitis.
V- Webs: Plummer-vinson syndrome
VI- Strictures: Peptic, corrosive and post-radiation.
VII- Tumors: Carcinoma, sarcoma and lymphoma.
I- Structural: circumferential lesions like:
Schatzki’s rings.
II- Infectious and inflammatory:
cytomegalovirus esophagitis, monilial
esophagitis, Eosinophilic esophagitis
III- Strictures: Peptic, corrosive strictures and
post-radiation.
IV- Propulsive disorders: abnormality in
peristalsis: diffuse esophageal spasm, achalasia,
and scleroderma.
V- Tumors: Carcinoma. sarcoma, lymphoma and
subepithelial tumours e.g. leiomyoma.
Definition: It is difficulty (i.e. taking more time and effort) in swallowing (It
should be distinguished from Odynophagia which is painful swallowing and
Globus which is sensation of a lump in the throat).
3. Achalasia
• Achalasia originates from the Greek
word a-khalasis, meaning lack of
relaxation = Failure to relax
• It is a rare disease caused by loss of
ganglion cells within the esophageal
myenteric plexus a hypertonic lower
esophageal sphincter which fails to
relax in response to the esophageal
swallowing wave.
4. Pathophysiology of Achalasia
•As the disease progresses, the obstructed lower esophagus
dilates and peristalsis becomes less powerful.
•Longstanding achalasia is characterized by progressive
dilatation and sigmoid deformity of the esophagus with
hypertrophy of the LES.
•This presents in late middle age with episodic chest pain
which may mimic angina, sometimes accompanied by
transient dysphagia.
5. • It can be diagnosed by: barium swallow X-ray and/ or high
resolution manometry (HRM)
Diagnosis
Parrot peak
HRM: absent esophageal peristalsis
pathognomonic for achalasia
6. 1. Previously treated with
pneumatic dilatation
2. But currently the treatment
options are either:
I. Surgery (Heller’s myotomy)
or
II. Endoscopically (Per-oral
esophageal myotomy
(POEM)).
Treatment Options
7. Approach to a pt. with Ach.
• (A) History:
- Age: Cancer in middle and old age, Achalasia in middle and ole age, post-
corrosive in young.
- Type of food: dysphagia only to solids in mechanical causes while to both
solids and liquids in motor dysphagia.
- Duration and Course: transient and of short duration in inflammatory
conditions, progressive in cancer and intermittent in functional disorders.
-Associated symptoms:
• Nasal regurgitation in pharyngeal paralysis.
• Loss of weight in cancer.
• Long preceding heart burn in peptic stricture.
8. Approach to a pt. with Ach.
• (B) Physical Examination:
- Neurological examination: for associated neurological disease.
- Neck: for lymph node and thyroid enlargement.
• (C) Diagnostic Procedures:
- Endoscopy: to exclude mechanical obstruction
- Barium swallow.
- Esophageal manometry studies for functional disorders.