This document discusses glaucoma and how it is characterized by progressive optic neuropathy and loss of retinal ganglion cells, resulting in visual field loss. It can now be detected earlier through evaluation of optic nerve head changes and retinal nerve fiber layer defects, before visual field loss occurs. Specific morphological changes are seen in the optic nerve head in glaucoma, including loss of neuroretinal rim tissue, notching of the rim, hemorrhages across the rim, cupping of the disc, and defects in the retinal nerve fiber layer. Features like cup-to-disc ratio, location of blood vessels, and peripapillary changes can provide clues to detecting glaucomatous damage.
visual field- its assessment, defects, diseases associated. Types of visual field defects. visual field defects in glaucoma in detail. Humphrey's visual field analyser chart.
visual field- its assessment, defects, diseases associated. Types of visual field defects. visual field defects in glaucoma in detail. Humphrey's visual field analyser chart.
It describes about the procedure of Hess charting. it serves as a great tool to understand the concepts involved. Suitable for optometry course. This is not a routine procedure but an important procedure which is used in diagnosis.
Pseudophakic bullous keratopathy (PBK) is a post-operative condition that can occur as a complication of cataract extraction surgery and intraocular lens placement.
May be manifest in the immediate post-operative period or symptoms may not present for many years.
It describes about the procedure of Hess charting. it serves as a great tool to understand the concepts involved. Suitable for optometry course. This is not a routine procedure but an important procedure which is used in diagnosis.
Pseudophakic bullous keratopathy (PBK) is a post-operative condition that can occur as a complication of cataract extraction surgery and intraocular lens placement.
May be manifest in the immediate post-operative period or symptoms may not present for many years.
Gonioscopy and optic nerve head evaluationAhmedfaik
this is a simple presentation copy paste from kanski clinical ophthalmology about gonioscopy and optic nerve head changes in glaucoma... hope you get benefit
Evaluating the optic nerve head in glaucomaRiyad Banayot
The best method readily available to the clinician for performing this examination is high plus lens fundus biomicroscopy. Optimal magnification can be achieved by using a +60D lens which provides 1.5 times the magnification of a 90D lens. During this examination the patient's pupils must be maximally dilated with a combination of mydriatic agents such as 1% Tropicamide and 2.5% Phenylephrine.
Retinal artery occlusion is an ophthalmic emergency which requires urgent management. Its a vision threatening condition which requires prompt diagnosis.
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
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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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.
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.
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
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
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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.
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!
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
2. Glaucoma is defined as heterogeneous group of
disorders which manifests as chronic
progressive optic neuropathy characterized by
specific morphological changes at optic nerve
head and retinal nerve fibre layer with resultant
loss of retinal ganglion cells which results in loss
of visual fields.
3. For many years , the diagnosis of
glaucoma was based on
1. raised intraocular pressure
2. visual field changes
3.optic nerve head evaluation
4. Pre perimetric glaucoma is a new terminology to describe
glaucomatous optic neuropathy before development of visual
field defects.
It is detected by evaluating and documenting the optic nerve
head changes and retinal nerve fibre layer defects.
In one study fifty five percent of patients of ocular
hypertension converted to treatment group based on optic
disc changes without field changes.
Another study showed that sixty percent of ocular
hypertensives have RNFL defects up to 6 years before they
developed visual field defects on standard automated
perimetry.
5. The neuro retinal rim (NRR) is the tissue between the outer
edge of the cup and the optic disc margin. The normal rim
has an orange or pink colour and a characteristic
configuration in most healthy eyes: the inferior rim is the
broadest followed by the superior, nasal and temporal (the
‘ISNT’ rule). The cardinal feature of glaucomatous optic
neuropathy is a loss of NRR from the inner edge of the rim.
6.
7. Features that should raise suspicion that glaucomatous
damage has already occurred include:
1. notching of the rim
2. hemorrhage crossing the rim
3. undercutting of rim
4. asymmetry of rim width between eyes in absence of
asymmetry of disc size
5. an abnormally thin rim in one or two sectors.
8. Cup Disc Ratio
The C/D ratio indicates the diameter of the cup expressed as a
fraction of the diameter of the disc; the vertical rather than the
horizontal ratio is generally used in clinical practice.The NRR
occupies a relatively similar cross-sectional area in different
eyes.
1. Small discs have small cups with a median C/D ratio of
about 0.35
2. Large discs have large cups with a median C/D ratio of about
0.55
3. Only 2% of the population have a C/D ratio greater than 0.7.
4. In any individual, asymmetry of 0.2 or more between the
eyes should also be regarded with suspicion, though it is critical
to exclude a difference in overall disc size.
9. Morphology of glaucomatous optic atrophy
Glaucomatous damage results in characteristic signs
involving (a) the optic nerve head (b) the peripapillary area
(c) the retinal nerve fibre layer
10. Bayoneting
When the local thinning of neural rim tissue reaches the disc
margin , a sharpened rim is produced .
If a retinal vessel crosses the sharpened rim , it will bend
sharply at the edge of the disc creating bayoneting at the disc
edge.
11.
12.
13.
14. Sometimes a thinning of neural rim may be seen as crescentic
shadow adjacent to the disc margin on direct ophthalmoscopy.
It is a sign of early glaucomatous disc damage and it should no
be confused with gray crescent in optic nerve head.
15.
16. Advanced glaucomatous cupping
Eventual loss of all neural rim tissue results in total cupping
which is characterized by white disc with bending of all blood
vessels at disc margin.
This is also known as bean-pot cupping because the cross
section of a histologic section reveals extreme posterior
displacement of lamina cribrosa and undermining of disc
margin.
17.
18. Vascular signs of glaucomatous optic atrophy
Optic disc hemorrhages: Also referred to as splinter
hemorrhages or drance hemorrhages .
They are seen more commonly in patients of normal tension
glaucoma than COAG.
They tend to come and go and reappear at same site or
different site.
They typically cross the disc margin but during resorption, the
papillary portion may disappear first so that an extra papillary
hemorrhage remains.
19.
20. Location of retinal blood vessel in relation to cup
Overpass cupping
Baring of circumlinear vessel
Nasal displacement of blood vessels
Vertical eccentricity of central retinal vessel trunk
Generalized arterial narrowing
21. Overpass cupping is due to deepening of cup where a blood
vessel bridges the cup and then collapse into it.
Baring of circumlinear vessel:
a. In many normal optic discs, one or two blood vessels curve
the outline of a portion of physiologic cup. With glaucomatous
enlargement of the cup, these circumlinear blood vessel may
be bared from the margin of the cup.
b. This sign is not pathognomonic of glaucoma but it’s
presence in glaucoma suspect patients is associated with
visual field loss.
22.
23.
24. Earlier thought to be related to glaucomatous disc changes,
nasal displacement of blood vessels in now no longer
considered diagnostic of glaucoma.
However vertical eccentricity of central retinal vessel trunk may
be related to course of glaucomatous optic atrophy.
Neural rim loss was more likely to occur in the vertical quadrant
further away from the central retinal vessel trunk.
Generalized arterial narrowing outside optic nerve head is seen
in some patients of chronic open angle glaucoma but it is a
nonspecific finding also seen in patients of anterior ischemic
optic neuropathy.
25. Peripapillary changes associated with glaucomatous optic
atrophy
Retinal nerve fibre bundle defects
Peripapillary pigmentary changes
Retinal nerve fibre bundle defects :
• The loss of axonal bundles in glaucoma lead to
loss of neural rim tissue
visible defects in retinal nerve fibre layer.
These defects appear as
a. Dark stripes or wedge shaped defects in peripapillary
region
b. Diffuse loss of retinal striations.
They often follow disc hemorrhages and correlate highly with
visual field defects and lost neural rim tissue.