This document discusses drugs used in reproductive health, including estrogens, progestins, and oral contraceptives. It provides details on:
1) Estrogens like estradiol that are responsible for female pubertal changes and progesterone that prepares the uterus for pregnancy.
2) Oral contraceptives that contain estrogen and progesterone to prevent ovulation and thickening of cervical mucus to inhibit sperm penetration.
3) Different types of combined oral contraceptives including triphasic pills that mimic the hormonal cycle, and progestin-only mini pills.
These slides contain the information about Estrogen, its basic pharmacology, its synthesis in human body, Functions of estrogen, role in female puberty, Agonists of estrogen and antagonists of estrogen, also contain detail of the receptors associated with the estrogen functioning.
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Introduction.
Causes of Erectile dysfunction
Drugs used for Erectile dysfunction
Mechanism of action .
Structure
Adverse Drug Reactions .
Uses.
Reference
A power point presentation on thyroid hormones and thyroid inhibitors on subject of pharmacology suitable for reading by undergraduate medical students.
These slides contain the information about Estrogen, its basic pharmacology, its synthesis in human body, Functions of estrogen, role in female puberty, Agonists of estrogen and antagonists of estrogen, also contain detail of the receptors associated with the estrogen functioning.
Detailed information of all terms like Thyroid gland, Thyroxine, Triidothyronine, Calcitonine, growth and development , propylthiouracil, Calorigenesis, tadpole to frog, Oligomenorrhoea, snehal chakorkar, pharmacology, Cretinism, Myxoedema coma, Graves disease, Thiocynates, Perchlorate, Nitrates.
Radioactive iodine, I131
Introduction.
Causes of Erectile dysfunction
Drugs used for Erectile dysfunction
Mechanism of action .
Structure
Adverse Drug Reactions .
Uses.
Reference
A power point presentation on thyroid hormones and thyroid inhibitors on subject of pharmacology suitable for reading by undergraduate medical students.
research about female hormones especially progesterone & estrogen , their analogues and antagonists and market products in pharmacy
research talks also about diseases that occurs due to disturbance in hormones
Hormonal control of ovarian &uterine cycles- medical study martinshaji
The ovarian and uterine cycles are controlled by chemical messengers or hormones.
this is a detailed study referred from Textbook of Inderbir Singh’s embryology by v .Subadradevi ..
please comment
thank you
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
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.
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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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
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.
1. DRUGS USED IN REPRODUCTIVE HEALTH
Estrogens & Progestins
Oral Contraceptives
Uterine Stimulants
(Oxytocics)
•Oxytocin
•Methylergotmetrine
•Misoprostol
Uterine Relaxants
(Tocolytics)
•Ritodrine
•Nifedipine
•Isoxsuprine
2.
3. ESTROGEN
•Female sex hormone
• Follicle Stimulating Hormone (FSH) stimulate the
production of Estrogens.
•Natural Estrogens:
•Estradiol (secreted by graafian follicles, corpus
luteum and placenta in females and by
aromatization of testerone in testes and
extraglandular tissues in males; most potent)
•Esterone (oxidised form of estradiol E2, in liver)
•Estriol (formed by hydroxylation of esterone)
6. Estrogen Functions
• Bring about pubertal changes- growth of uterus,
fallopian tubes and vagina
• Responsible for proliferation of endometrium
• Growth of uterine muscles
• Ductal proliferation in breast
• Secondary sexual characters in females
7. MOA: Estrogen binds to specific nuclear
receptors (Estrogen receptors, ER) and undergoes
conformational changes interacting with Estrogen
Response Elements, ERE that regulates protein
synthesis.
9. Actions of Estrogens:
Sex organs:
•Responsible for pubertal changes, growth of uterus,
fallopian tubes and vagina
•Enhances sperm penetration
Secondary Sex Characters:
•Breasts: proliferation of ducts and stroma, accumulation
of fat
•Pubic and axillary hair appears
Metabolic effects:
•Estrogens are anabolic hormone responsible for pubertal
growth in both boys and girls
Maintains bone mass; retards bone resorption; Promotes
fusion of epiphyses
10. • Water and salt retention; Blood pressure may rise on
prolonged use
• Glucose tolerance is impaired especially in diabetes
• Estrogens decrease plasma LDL cholesterol while HDL
and triglyceride levels are raised.
• Blood Coagulability is increased due to induction of
clotting factors
• Fibrinolytic activity increases (lowering of plasminogen-
activator inhibitor-I, PAI-I)
• Nitric oxide synthase and Prostaglandin I2 (PGI2 )
production promotes vasodilatation
• Increases lithogenicity of bile (increased cholesterol
secretion and decresed bile salt secretion)
• Increases Hormone Binding Globulin; Thyroxine Binding
Globulin (TBG), Cortisol Binding Globulin (CBG)
Actions of Estrogens contd…
11. Growth of
Epithelium
rate of bone
skin structure
Liver synthesis of
follilcle
Growth of
endometrium
Lowers
Plasma cholesterol
Behavioral effects
ESTROGENS
Reproductive Tissues
Vaginal Mammary
Gland
Decreases
resorption
Increases blood coagulability
Maintains normal
Reduces
Bowel motility
Sperm
transport
Transport Proteins
Ovarian
Non-reproductive Tissues
Physiology
12. The daily secretion of estrogens in menstruating women
varies from 10–100 μg depending on phase of the cycle.
During pregnancy, placenta secretes large quantities of
estrogens, (mainly estrone and estriol) upto 30 mg/day.
16. Indication & Doses:
•Contraception
•Post menopausal hormone therapy
•Primary hypogonadism
•Dysmenorrhoea & Acne
•Carcinoma of prostate
•Advanced metastatic carcinoma of breast
•Senile vaginitis
•Inhibition of lactation
•Estradiol: 2.5-10mg intramuscular injection
•Ethinylestradiol: 0.02-0.2 mg/day, oral
17. Adverse effects:
•Males; Suppression of libido, gynaecomastia and
feminization
•Children; Fusion of epiphyses and reduction of adult
stature
•Postmenopausal women/ on HRT; Risk of irregular
bleeding and endometrial carcinoma
•Existing Breast cancer; Growth of existing breast cancer
•Long term estrogen therapy; gallstones,hepatoma
•Pregnant Women (esp. first trimester) Vaginal and cervical
carcinoma in female offspring
18. ANTIESTROGENS AND SELECTIVE ESTROGEN
RECEPTOR MODULATORS (SERMs)
Clomiphene citrate
•It binds to both ERα and ERβ and acts as a pure
estrogen antagonist in all human tissues.
•Useful for infertility due to failure of ovulation
and to aid in vitro fertilization.
•The chief use of clomiphene is for infertility due
to failure of ovulation: 50 mg once daily for 5
days starting from 5th day of cycle.
•Also used for male infertility; oligozoospermia.
19. Tamoxifen citrate
•Antagonist action in Breast carcinoma cells, blood
vessels and some peripheral sites (ERα receptors)
•Partial agonist activity on uterus, bone, liver and
pituitary.
•Used in treatment for breast cancer in both pre- and
post-menopausal patients.
•Other use: primary prophylaxis of breast cancer in
high-risk women, as an alternative to clomiphene in
male infertility.
•Dose: 20 mg/day in 1 or 2 doses
21. Progestins
(Progestin = favouring pregnancy)
• Progesterone, the natural progestin is produced in
response to luteinzing hormone(LH) by both females
and males.
• Also synthesized by the adrenal cortex in both sexes.
• Secreted from corpus luteum (10–20 mg/day) in the
later half of menstrual cycle under the influence of LH.
Its production declines a few days before the next
menstrual flow.
• Progestins promote the development of a secretory
endometrium.
22.
23. Progestin actions:
•Uterus: increased secretion
•Cervix: Secretion made viscid favouring sperm penetration
•Vagina: Pregnancy like changes
•Breast: prepares breast for lactation
•CNS: High concentration has sedative effect
•Body Temperature: Slightly rises (0.5o
C)
•Respiration: Stimulates respiration at higher doses
•Metabolism: Prolong use impairs glucose tolerance, raises
LDL and lower HDL, cholesterol levels
•Pituitary: Weak inhibitor of gonadotrophin secretion,
supresses preovulatory LH surge and prevents ovulation if
given during follicular phase
24. MOA: Progesterone binds to Progesterone
Receptor (PR) present in nucleus and undergoes
conformational changes (dimerization) with
Progesterone Response elements (PRE) that
regulates transcription.
Indications:
•As Contraceptive
•Hormone Replacement Therapy (HRT)
•Dysfunctional uterine bleeding
•Endometriosis
•Premenstrual syndrome/tension
•Threatened/habitual abortion
•Endometrial carcinoma
25.
26. Adverse effects:
•General: Breast engorgement, headache, rise in
body temperature, edema, esophageal reflux, acne,
mood swings with higher doses
•Irregular bleeding or amenorrhoea on continuous
administration
•19-nortesterone derivatives: Lowers plasma HDL
levels; promotes atherogenesis
•Impaired glucose tolerance, precipitate diabetes
•Long term administration (HRT): Increase risk of
breast cancer
•Early pregnancy: Masculinization of female foetus
and other congenital abnormality
27. Antiprogestin: Mifepristone
It is 19-norsteroid with potent antiprogestin and significant
antiglucocorticoid, antiandrogenic activity.
MOA: It acts on different phases of mensturation cycle:
•Follicular phase: delay/failure of ovulation
•Secretory/Luteal Phase: blocks progesterone action on
endometrium
•Later stages of cycle: increases Prostaglandin (PG) release
and induces mensturation
•Post implantation: decreases endogenous progesterone,
cervix softens & abortion occurs
28.
29. Mifepristone Indications & Doses:
• Termination of Pregnancy upto 7 weeks, 600mg
single oral dose (+/- 400mg misoprostol after 48
hrs)
• Cervical ripening: Prior to attempting surgical
abortion of induction of labour (600mg oral)
• Post-coital contraception (emergency
contraception) Within 72 hrs of intercourse (600mg
oral)
• Once a month contraceptive
• Induction of Labour: In cases of Intra uterine
foetal death or abnormal foetus
• Cushing Syndrome
30. Adverse effects:
•General: Anorexia, nausea/vomiting, tiredness,
abdominal discomfort, uterine cramps, loose
motions
•When used for termination of pregnancy:
Prolonged bleeding, failed abortion
•When used as postcoital contraceptive:
Subsequent menstrual cycle is disturbed
32. Combined contraceptive pills:Combined contraceptive pills:
•The OCPs with combined estrogen and progesterone are
the most common type of contraceptives.
•MOA: The estrogen provides a negative feedback on the
release of LH and follicle-stimulating hormone (FSH) by the
pituitary gland, thus preventing ovulation. The progestin
also inhibits LH release and thickens the cervical mucus,
thus impeding the transport of sperm.
•These OCPs are started on the 1st day of Menses and
continued for 21 days followed by a 7 days withdrawl
peroid to allow menses.
•Eg: Norgestrel 0. 3 mg + Ethinylestradiol 0.03 mg (21 tab)
and Ferrous fumarate 75 mg (7 tab)
34. Phased Pill
•Phased pills are triphasic regimens that act by mimicking
the normal hormonal pattern in a menstrual cycle.
•The estrogen dose is kept constant while the amount of
progestin is low in the first phase and progressively higher in
the second and third phases.
•Phasic pills are particularly recommended for women over
35 years of age and for those with no withdrawal bleeding.
•Levonorgestrel (50–75 –125 μg) + Ethinylestradiol (30–40 –30 μg)
•Norethindrone (0.5–0.75 –1.0 mg) + Ethinylestradiol (35–35 –35 μg)
35. Progestin only pills ( Mini Pills)
• Contains only progestin and are taken on a
continuous schedule
• Norethindrone 0.35 mg
• Norgestrel 75 ug
• MOA: Progesterone alone can inhibit ovulation
in 40% cycles & thickens cervical mucosa that
impedes sperm penetration.
36. Post coital contraceptive
• Levonorgestrel 0.5 mg + Ethinylestradiol 0.1 mg
• Taken as early as possible but within 72 hrs of
unprotected intercourse and repeated after 12 hrs
• A single dose of Mifepristone 600 mg within 72 hrs of
intercourse
• Levonorgestrel 0.75 mg taken twice with 12 hrs gap
within 72 hrs of intercourse or Levonorgestrel 1.5 mg
37. Implants Contains progestins as:
•Levonorgestrel 216mg (36 mg per rod)
Effective for five years
•Levonorgestrel 150 mg (75 mg per rod)
Effective for three years
•Primarily acts by suppressing GnRH pulse
•Inhibits ovulation
39. • Injectable contraceptives obviate the need for
daily ingestion of pills. They are given i.m. as oily
solution & are highly effective.
• Depot medroxyprogesterone acetate (DMPA)
150 mg at 3-month intervals. After i.m. injection
peak blood levels are reached in 3 weeks and
decline with a t½ of ~ 50 days.
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