1. Esophageal cancer is the 6th most common cause of cancer deaths worldwide and has a poor prognosis, though some patients can be cured.
2. The two main types are squamous cell carcinoma and adenocarcinoma, which have different risk factors and locations in the esophagus.
3. Treatment depends on the stage, and may include surgery, chemotherapy, radiation therapy, stents or other palliative options.
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
esophageal carcinoma is one of the common gastrointestinal malignancy. Its usually present at advanced stage. Its management requires diagnosis as early as possible and staging followed by proper planning of treatment. Its treatment include endoscopic, surgical, adjuvant chemotherapy and palliative management.
Pancreatic Cysts: A Contemporary ApproachJarrod Lee
Pancreatic cysts are increasingly found during abdominal imaging. Although the majority will not cause any problems, a minority may enlarge or become malignant. We present a contemporary approach to managing pancreatic cysts, utilizing the latest evidence, technologies and endoscopic procedures. We identify which cysts need surveillance or even surgery, and which can be safely ignored.
Pancreatic Cysts: A Contemporary ApproachJarrod Lee
Pancreatic cysts are increasingly found during abdominal imaging. Although the majority will not cause any problems, a minority may enlarge or become malignant. We present a contemporary approach to managing pancreatic cysts, utilizing the latest evidence, technologies and endoscopic procedures. We identify which cysts need surveillance or even surgery, and which can be safely ignored.
Esophagus has rich submucosal network of lymphatics which makes longitudinal spread of tumor prevalent.There is propensity for early spread and widespread nodal metastasis.
Adequate proximal (10 cm) and distal resection margin must be achieved.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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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.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
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.
2. ESOPHAGEAL CANCER
• Esophageal cancer is a devastating disease.
• It is the 6th most common cause of cancer deaths worldwide.
• Although some patients can be cured, the treatment for esophageal cancer is protracted,
diminishes quality of life, and is lethal in a significant number of cases.
• The principal histologic types of esophageal cancer are
Squamous Cell Carcinoma (SCC)
Adenocarcinoma.
3. TYPES
• Squamous cells line the entire esophagus, so SCC can occur in any part of the
esophagus, but it often arises in the upper half.
• Adenocarcinoma typically develops in specialized intestinal metaplasia (Barrett
metaplasia) that develops as a result of gastroesophageal reflux disease (GERD); thus,
adenocarcinoma typically arises in the lower half of the distal esophagus and often
involves the esophagogastric junction.
4. RISK FACTORS FOR ESOPHAGEAL SQUAMOUS
CELL CARCINOMA
• The risk factors and etiologic associations for SCC of the esophagus include the
following:
• Smoking and alcohol use
• Diet
• Certain infections
• Tylosis
5. CLINICAL MANIFESTATIONS
• Dysphagia (most common); initially for solids, eventually progressing to include liquids
(usually occurs when esophageal lumen < 13 mm)
• Weight loss (second most common) due to dysphagia and tumor-related anorexia.
• Bleeding (leading to iron deficiency anemia)
• Epigastric or retrosternal pain
• Bone pain with metastatic disease
• Hoarseness (due to the involvement of the recurrent laryngeal nerve)
6. CLINICAL MANIFESTATIONS
• Persistent cough
• Intractable coughing or frequent pneumonia (due to tracheobronchial fistulas caused by
direct invasion of tumor through the esophageal wall and into the mainstem bronchus)
Physical findings include the following:
• Typically, normal examination results unless the cancer has metastasized
• Hepatomegaly (from hepatic metastases)
• Lymphadenopathy in the laterocervical or supraclavicular areas (reflecting metastasis)
7. DIAGNOSTIC EVALUATIONS
• Laboratory studies such as complete blood count (CBC) and comprehensive metabolic
panel (CMP) focus principally on patient factors that may affect treatment (eg, nutritional
status, renal function).
Imaging studies used for diagnosis and staging include the following:
• Esophagogastroduodenoscopy (EGD; allows direct visualization and biopsies of the tumor)
• Endoscopic ultrasonography (EUS; most sensitive test for T and N staging ; used when no
evidence of M1 disease)
• Computed tomography (CT) of the abdomen and chest with contrast (for assessing lung and
liver metastasis and invasion of adjacent structures)
8. DIAGNOSTIC EVALUATIONS
• Pelvic CT scan with contrast if clinically indicated
• Positron emission tomography (PET) scanning (for staging)
• Bronchoscopy (if tumor is at or above the carina, to help exclude invasion of the trachea
or bronchi)
• Laparoscopy and thoracoscopy (for staging regional nodes)
• Barium swallow (very sensitive for detecting strictures and intraluminal masses, but now
rarely used)
9. MANAGEMENT
• Treatment of esophageal cancer varies by disease stage, as follows:
• Stage I-III (locoregional disease) - Available modalities are endoscopic therapies (eg,
mucosal resection or ablation), esophagectomy, preoperative chemoradiation, and
definitive chemoradiation.
• Stage IV – Systemic chemotherapy with palliative/supportive care for patients with
ECOG performance score of 2 or less and palliative/supportive care only for patients
with ECOG performance score of 3 or more.
•
10. SURGICAL MANAGEMENT
• Ivor Lewis esophagogastrectomy (laparotomy plus right thoracotomy)
• McKeown esophagogastrectomy (right thoracotomy plus laparotomy plus cervical
anastomosis)
• Minimally invasive Ivor Lewis esophagogastrectomy (laparoscopic approach)
• Minimally invasive McKeown esophagogastrectomy (laparoscopic approach)
• Robotic minimally invasive esophagogastrectomy
• Transhiatal esophagectomy (THE)
• Transthoracic/transabdominal esophagectomy with anastomosis in chest or neck
15. • Palliative care options for patients who are not candidates for surgery are as follows:
• Chemotherapy
• Radiotherapy
• Laser therapy
• Stents
16. CHEMOTHERAPY & RADIATION
• Chemotherapy and radiotherapy for esophageal cancer are delivered preoperatively.
• The aims of preoperative (neoadjuvant) chemotherapy and radiotherapy are to reduce
the bulk of the primary tumor before surgery to facilitate higher curative resection rates
and to eliminate or delay the appearance of distant metastases.
• Common chemotherapic agents using in the treatment of esophageal cancer are
alkylating, antimetabolite, anthracycline, and antimicrotubular agents,
17. • Stents
• Long-term palliation of dysphagia can be achieved with endoscopic, radiographic-
assisted insertion of expandable metal or plastic stents