This document discusses fluid therapy, including the basics of body fluids, fluid composition, water balance, and fluid regulation. It covers the types of fluids used in therapy including crystalloids like lactated Ringer's solution and normal saline, as well as colloids. The routes of fluid administration and indications for fluid therapy are described. Signs of dehydration and fluid overload are also summarized. Calculations for fluid resuscitation based on weight and dehydration percentage are demonstrated through examples.
Water and Electrolyte balance in surgical patientsDaniroxx
To help understand the need for Iv fluid therapy and electrolyte imbalances and their correction in surgical patients. It aims to keep the patient well hydrated with good urine output and avoid vital sign derangements and to avoid complications of wrongly advised fluids.
Imbalances of fluids occurs when body’s compensatory mechanisms are unable to maintain a homeostatic state.
hypovolemia (fluid volume deficit)
hypervolemia (fluid volume excess)
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
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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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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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 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
3. Body Fluid
• Basics of body fluids and its
composition.
• Water balance in body.
• Regulation of body fluids.
• Fluid therapy &its indication.
• Types of fluids.
• Routes of administration.
• Fluid over load signs.
4. Basics of Body Fluid:
• An adult animal contains about 60% fluid of its body weight.
• Intracellular fluid (ICF) consists of about two-thirds of total body
fluids.
• The extracellular fluid (ECF) which constitutes about one-third of the
total body fluids. It is divided into three sub compartments—
interstitial, intravascular, and trans cellular. The interstitial contains
three-quarters of all the fluid in the extracellular space.
• The intravascular contains the fluid, mostly plasma, that is within the
blood vessels. Total blood volume is roughly 8% of bodyweight and
plasma roughly 5% of bodyweight
5. Continue............
• The fluid in the trans cellular compartment is produced by specialized
cells responsible for cerebrospinal fluid, gastrointestinal fluid, bile,
glandular secretions, respiratory sections, and synovial fluids.
• Daily water intake is about 10% of the body weight (can vary from
animal to animal with respect of their age, environment, feed intake
etc. ).
• Daily water loss equals daily intake and this loss occurs through the
skin, lung, kidney and gastrointestinal tract.
6. Continue............
• Body water contains solutes (substances that dissolve in
solvent; particles).
• Electrolytes are substances that split into ions when placed
in water.
• Primary ions in the body are sodium, potassium, chloride,
phosphate, and bicarbonate.
• Cations are positively charged ions.
• Anions are negatively charged ions.
• Body water is the solvent in biological systems
• To establish equilibrium, body water moves along its
concentration gradient
8. Fluid therapy Types:
• Replacement therapy:
Therapy in which we infuse same type of fluid
which is lost from body .
• Adjunctive Therapy:
One type of fluid is given to remove other type of
fluid e.g. mannitol 25% is given in case of ascites and edema.
• Supportive Therapy:
Fluid is given to animal just to support him to cure
quickly i.e. amino acids, minerals, multivitamins and carbohydrates etc.
9. Indications:
• Fluids are administered to patients not only to replace fluid loss but
also to correct electrolyte abnormalities, promote kidney diuresis,
and maintain the tissue or organ perfusion.
• During shock.
• Dehydration.
• Diuresis (Toxicities , renal diseases).
• After surgical procedure i.e. to prevent hypotension as hypotension
may be due to vasodilation, decreased cardiovascular function etc.
• Acid base abnormalities.
• Electrolyte abnormalities.
10. Dehydration:
• Dehydration or the loss of fluid
from the interstitial space in the
form of increased fluid loss from
vomiting, diarrhea, or polyuria is
one of the main cause of water
reduction in body.
• Signs include decreased skin
tenting, sunken eyes, depressed
mentation, and tacky/dry
mucous membranes, CRT 2-3 sec
in mild cases and >3 sec in severe
cases, Slight depression of eyes
into sockets.
11. Diagnosing Dehydration:
• Physical exam
• Weight loss
• PCV (HCT) increased
• Albumin or total protein increased
• BUN, creatinine
• Prerenal azotemia
12. Clinical examination of Degree of
Dehydration
Degree of Dehydration(%) Clinical signs
<5 Not clinically detectable.
5-6 Subtle-loss of skin elasticity
6-8 Obvious delay in return of tented skin.
Slightly ↑ CRT
Eye possible sunken & dry mucous membrane.
10-12 Skin remain tented.
Very prolonged CRT.
Sunken eyes & dry mucous membranes.
Possibly signs of shock (tachycardia, cool extremities,
rapid & weak pulse)
12-15 Obvious signs of shock.
Death imminent
14. Types of fluid:
(a) Crystalloids.
• Contain sodium as the main osmotically active
particle.
• Useful for volume expansion (mainly interstitial
space).
• For maintenance infusion.
• Correction of electrolyte abnormality.
• Types of crystalloids
• Isotonic crystalloids
Lactated Ringer’s, 0.9%NaCl(Normosol)
• Only 25% remain intravascularly
15. Continue.........
• Hypertonic saline solutions
3% NaCl
0.9% normal saline with 5% dextrose
10% dextrose in water
• Hypotonic solutions
D5W(dextrose 5 % in water)
0.45% NaCl
0.25% NaCl
less than 10% remain intravascularly, inadequate
for fluid resuscitation.
16. Lactated Ringer’s Solution:
• Composition closely resembles ECF
• Contains physiological concentrations of: sodium, chloride,
potassium, and calcium
• Also contains lactate, which is metabolized by the liver alkaline-
forming
• Because small animals that are sick or under anesthesia tend towards
acidosis
17. Ringer’s Solution:
• Same as LRS except no lactate added
• Commonly used in Large animals
• Large animals who are sick tend towards alkalosis instead of acidosis
18. Normal Saline:
• 0.9% Sodium chloride = ISOTONIC
• Lacking in K+, Ca2+
• Used for hyperkalemia, hypercalcemia
• Used as a carrier for some drugs
• Used if don’t want lactate
19. (b) Colloids
• Contain high molecular weight
substancesdo not readily migrate across
capillary walls
• Preparations
- Albumin: 5%, 25%
- Dextran
- Gelifundol
- Haes-steril 10%
21. Synthetic Colloids
• Dextrans, Hetastarch
• Used when quantity of a crystalloid is too great to be able to infuse
quickly
• Stays within the vasculature maintain blood pressure
• Duration of effect is determined by molecular size:
• bigger = longer
• Small volumes produce immediate increases in blood pressure
22. Routes of Fluid administration
Route of administration Advantages Disadvantages
Oral •Safest route
•Easy
•Less rapid absorption
•Possible aspiration
•Cannot use for vomiting animals
Subcutaneous •Relatively easy to administer
•Absorption distributed over time
•Possible infection
•Must use isotonic fluids
•Slower absorption
23. Route of
administration
Advantages Disadvantages
Intravenous •Precise amount given is
available rapidly
•Various tonicities of
fluid can be used
•Possible fluid overload
and vessel damage
•Requires close
monitoring
•Must be sterile
Intraperitoneal •Relatively rapid
absorption
•Can be used when IV
access is not available
•Possible infection
•Cannot use hypertonic
solutions
•Abdominal surgery
hindered after
administration
Intraosseous •Useful for small
animals, birds, and
pocket pets
•Can be used when vein
inaccessible
•Rapid absorption
•Lack of confidence in
administering fluid via this
route
•Possible infection
Rectally •Good absorption •Not frequently used
24. Fluids: How Much to Give?
• Correct dehydration
• Weight in kg times percent dehydration equals the amount
in liters that the animal is dehydrated
• Example: 10 kg animal who is 8% dehydrated
• 10kg X 0.08 = 0.8 liters
• Patient is lacking 0.8 liters, or 800 ml fluids
25. So How Is It Delivered?
• Infusion pump (easy)
• IV drip set: drops per ml written on package
• Regular Drip sets have 10, 15, or 20 drops per ml
• Med – large dogs
• Micro drip sets have 60 drops per ml
• Small dogs - cats
26. Calculate Drops Per Hour
• Calculate ml/hr.
• Calculate drops/hr by: ml/hr X drops/ml (from the package)
• Gives you drops needed in an hour
• Example: 100 ml X 10 drops per ml = 1000 drops in the first hour
27. Calculate Drops Per Minute
• Divide drops per hour by 60 min/hr to get drops per minute
• Ex: 1000 drops/ hr divided by 60 minutes per hour = 16.7 drops per
minute
• 16.7 drops/min divided by 60 sec per min = 0.28 drops/sec
28. Principles of Rehydration:
• Correct dehydration, electrolyte, and acid-base abnormalities prior to
surgery
• . Do not attempt to replace chronic fluid losses all at once
• Severe dilution of plasma proteins, blood cells and electrolytes may
result
• Aim for 80% rehydration within 24 hours
• Monitor pulmonary, renal and cardiac function closely
29.
30. For example.
• An adult 18kg cat with 6% dehydration comes into the clinic. It is
estimated that the cat vomited 150 ml of fluid overnight
• Maintenance fluids can be dosed at 50 ml/kg/day in adults and 110
ml/kg/day in young animals
• Calculate maintenance volume
18kg x 50 ml/kg/day = 900ml per day
• Rehydration fluid is based on the estimated percent of dehydration
% dehydration x weight in kg = deficit in liters
31. Continue........
• Calculate replacement for dehydration
6% = 0.06
0.06 x 18 kg = 1.08 l
1.08 l x 1,000 ml/l = 1080 ml
1080ml x 0.8 (80% of dehydration value
replaced in 24 hours) =840 ml to replace
on first day
• Take estimated volume lost in fluid and add to the other volumes
• Final step: Take all values and add together
900ml + 840 ml + 150 ml = 1890ml
32. Fluid overload:
• Serous nasal discharge
• Increased respiratory rate (Dyspnea)
• Crackles or muffled lung sounds on pulmonary auscultation
• Late stage consequence = pulmonary edema (or pleural effusion in
cats)
• Decreased PCV
• Increased BP