The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
The association of neuropsychiatric disorders with cerebrovascular disease has been recognized by clinicians for over 100 years. Disease of the vascular system contribute greatly to the sum total of psychiatric disability, chiefly in the elderly population, mainly as a result of stroke, cerebrovascular accidents & subarachnoid haemorrhage.
Module: Pharmacotherapy III
Module Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Postgraduate, Master of Pharmacy in Clinical Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This presentation is for Educational purpose. It has no commercial value associated with it.
Module: Pharmacotherapy III
Module Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Postgraduate, Master of Pharmacy in Clinical Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This presentation is for Educational purpose. It has no commercial value associated with it.
DEFINITION :
It is defined as abnormal ,paroxysmal, excessive, involuntary neurological discharge from the brain which may be manifested as –
Loss of Conciousness,
Abnormal- Motor
- Sensory ,
- Behavioral disturbance
- and Autonomic dysfunction.
This uploaded slide is to give simplified information to the needy guy z..I hope it will help you out.Do enjoy and plz do remember me in your duas..You can also mail me at Raashidmumtaz@gmail.com,if you need more or any other help..Thankx.
Neonatal seizures, dr amit vatkar, pediatric neurologistDr Amit Vatkar
In the presentaion i will give you a brief idea to apprach, diagnosis and management of neonatal seizures.
The most prominent feature of neurologic dysfunction in the neonatal period is the occurrence of seizures. Determining the underlying etiology for neonatal seizures is critical. Etiology determines prognosis and outcome and guides therapeutic strategies.
Neonatal seizures, dr amit vatkar, pediatric neurologist
Dr. sarah weckhuysen kcnq2 Cure summit professional track - Lean more at kcn...scottyandjim
Dr. Sarah Weckhuysen speaking at 2014 Denver KCNQ2 Cure summit professionals track at Children's Hospital of Colorado. More information at www.kcnq2summit.org
Dr. john millichap kcnq2 Cure summit professional track learn more at kcnq2cu...scottyandjim
Dr. John Millichap speaking at 2014 Denver KCNQ2 Cure summit professionals track at Children's Hospital of Colorado. More information at www.kcnq2cure.org
SSPE, dr. amit vatkar, pediatric neurologistDr Amit Vatkar
Subacute sclerosing pan encephalitis (SSPE) also known as Dawson Disease, Dawson encephalitis, and measles encephalitis is a rare and chronic form of progressive brain inflammation caused by a persistent infection with measles virus.
In this presentaion i will a case a sspe and give u some information regarding daignosis and treatment
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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
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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
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.
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.
4. Past
• Oldest record SakikKu -babilonian medcal text
1067 B.C
• Aurvedic description as “Apasmara” 400 B.C
• “epilambanein”
to be overwhelmed by surprise
• Falling sickness
• Demonic possession
4
5. Past
• “its cause lies in the brain”
• 1920- Human EEG (Hans Berger)
5
9. Basics
SEIZURE PSEUDO
SEIZURE
SYNCOPE
• Sudden
• Unconscious
• Cyanosis
• Injury
• Sec to mints
• Hand on face
• Post ictal
confusion
• EEG,CPK,
Prolactin
• Gradual
• Conscious
• Thrusting
• Mins to hr
• Eye opening
• Pupil- Normal
• Psycho social
• Suggestive
• Light
headedness
• Standing
• Preventive-
lying
• Brief- lost
consciousness
9
10. Current scenario
• 60 million people worldwide
• 85% people-inadequate/not at all
• Specialist care:
LIC- 56%, HIC-89%
• AEDs: Govt priority, high cost , PB
10
11. Current scenario
• Age: any age (childhood, old age)
• Prevalence:
Single episode - 5%
Repeated- 0.5 to 2.5%
Our country- 2%
Developing country- 5 times higher
11
13. Cause
• Family history
5 to 10% of all epilepsies
Usually- 10 GTCS, Febrile convulsion,
Absence, Juvenile myoclonic epilepsy
• Primary generalized- 75% idiopathic
• Partial & 20 generalized- definite cause
75% adult
13
14. Cause
Neonates
<1 month
Infants
< 12 years
Adolescents
12-18 years
Young adult
18-35 years
Older
>35 years
Perinatal
hypoxia and
ischemia
ICH
Ca++ , Glucose
Bilirubin
Water
intoxication
Inborn error of
metabolism
Trauma
Febrile
seizures
CNS infection
Trauma
Developmental
disorder
Inborn error of
metabolism
Trauma
CNS infection
AVM
Infection
Congenital
defect
Tumors
Trauma
CNS infection
Brain tumor
AVM
Drugs and
alcohol
Drugs and
alcohol
Trauma
Tumor
CVD
Degenerative
CNS infection
14
33. Diagnostic approach
• CLINICAL EXAM
General survey
Vital signs
Cyanosis, Jaundice
Tongue bite mark
Systemic exam
Neurological, CVS, HBS, Resp System
33
34. Diagnostic approach
• LAB INQUIRY
Hematology
Biochemistry
Serology
CSF, Hormone, ECG
Imaging
• Late in onset
• Partial / 2o
generalized
• Refractory to drug
• Focal neuro deficit
• Status epilepticus
• Suspected ICSOL
• EEG shows focal
seizure
MRI/CT brain
Indication
34
35. Diagnostic approach
• LAB ENQUIRY
EEG
Type of epilepsy
Drug choice
Advanced lab test
Sphenoidal intra operative oval and
telemetric EEG
Ambulatory EEG, Videotelemetry
PET, SPET
35
42. Management
• AEDs-
Single drug , Low dose, Compliance
Switching
3rd drug prior combination
Two drugs at a time
Resistant to drug- metabolic/structural
42
43. Type First line Second line Third line
Partial / Secondary
GTCS
Carbamazepine Lamotrigine
Na Valproate
Topiramaate
Tigabine
Gabapentin
Clobazam
Phenytoin
Primidone
Phenobarbital
Oxcarbazepine
Levetiracetam
Vigabatrin
Acetazoalmide
Primary GTCS Na Valproate Lamotrigine
Topiramate
Carbamazepine
Phenytoin
Gabapentin
Primidone
Phenobarbital
Tigabine
Acetazolamide
Absence Ethosuximide Na Valproate Lamotirizine
Clonazepam
Acetazolamide
Myoclonic Na Valproate Clonazepam Piracetam
Lamotrizine
Phenobarbital
43
50. Interphase
• Psychiatric disorders in epilepsy
50% patient with epilepsy.
Ictal, peri-ictal , inter ictal (depression)
• Treatment related psychiatric problem
Depression, psychosis etc
AEDs (PB, Vigabatrin etc)
“Forced normalization”
50
51. Summary
51
History, Exam,
Exclusion D/D
History of
Epilepsy
Adequacy
Sub therapeutic
Level
Increase the dose
Therapeutic
Level
Max dose,
Alternative drug
Lab features
(biochemistry
hematology)
Positive Treat the cause
No History of
epilepsy
Lab features
(Biochemistry,
Hematology)
Positive Further work up Drug
Normal Imaging
Treat cause Drug
Idiopathic Drug
52. References
• Davidson’s principal & practice of Medicine, 21st edition, elsevier publisher,
2012
• Harrison’s Principales of internal medicine, 18th edition.
• Lecture Notes-Prof AKM Anwarullah
• Epilepsia, 44(suppl 6): 12-143. 2003, Blackwell publishing Inc, ILAE
• History of epilepsy 1909-2009: The ILAE century
• Recognition of psychogenic non epileptic seizure: acurable neurophobia, S S
O Sallivan et al, Journal of Neurosurg Psychiatry, 2013, 84: 228-231
• Why do some brain seize? Molecular ,cellular and network mechanism,
Andrew Trevelyan, Jphysiol(editorial)591.4(2013) 751-752
• The treatment gap in epilepsy, A Neliga, J W Sander, Epileptology 1 (2013)
28-30
52
53. “The sadness will last forever”
(Vincent van Gogh)
53
Wheat field with crows (1890)
