General anaesthesia involves reversible loss of sensation and consciousness using drugs. Early methods used alcohol, opium and asphyxiants but modern anaesthesia developed in the 1840s using nitrous oxide, ether and chloroform. Ideal anaesthetics provide adequate analgesia and immobility while being safe, easy to administer and fast acting with minimal side effects. Common techniques include inhalational gases like nitrous oxide and intravenous drugs like thiopentone and propofol. Complications can occur during or after anaesthesia and interactions must be considered.
This slide comprise the idea of General anesthesia, The intravenous and Inhalation Anesthetics- their mechanism and uses and effects on the organ system. Also the drug distribution and redistribution, MAC and pre-anesthetic medication with proper pictorial demonstration.
This interesting ppt is the continuation of the Pharmacology of Opioid analgesics I... This impressive ppt highlight the pharmacology, advantages and disadvantages of opioid analgesics other than morphine with illustrations....!!
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
Intravenous Anaesthetics are a group of fast-acting
compounds that are used to induce a state of impaired
awareness of complete sedation.
These are drugs that, when given intravenously in an
appropriate dose, cause a rapid loss of consciousness.
This slide comprise the idea of General anesthesia, The intravenous and Inhalation Anesthetics- their mechanism and uses and effects on the organ system. Also the drug distribution and redistribution, MAC and pre-anesthetic medication with proper pictorial demonstration.
This interesting ppt is the continuation of the Pharmacology of Opioid analgesics I... This impressive ppt highlight the pharmacology, advantages and disadvantages of opioid analgesics other than morphine with illustrations....!!
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
Intravenous Anaesthetics are a group of fast-acting
compounds that are used to induce a state of impaired
awareness of complete sedation.
These are drugs that, when given intravenously in an
appropriate dose, cause a rapid loss of consciousness.
Drugs for prophylaxis of Myocardial InfarctionJervinM
Drugs for prophylaxis of Myocardial Infarction
Myocardial Infarction
Drugs for primary prevention of MI
Drugs for secondary prevention of MI
Recent advances
Cardiac rehabilitation
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.
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
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.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
- 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
2. History
• Before middle 90s: Alcohol, Opium, Cannabis and
Asphyxia: Operations were Horrible.
• Horrace Wells (1844): Nitrous oxide.
• Mortan (1846): Ether
• Simpson (1846): Chloroform
• New Generation Anaesthetics: Halothane (1956)
• First i.v. Anaesthetic: thiopentone (1935)
3. Ques
MAC
Stages of anaesthesia
Second gas effect
Ideal anaesthetic?
Inhalational anaesthetic*
IV anaesthesia
Complications of GA
Consciuos sedation
Pre Aanaesthetic Medication
5. MAC
• MAC: Minimal alveolar concentration of the
anaesthetic in the pulmonary alveoli to produce
immobility to the painful stimulus in 50% of the
individuals.
• Accepted as the valid measure of the potency
because it remains fairly constant for given
species.
6. Guedel (1920) with ether
I. Stage of Analgesia: Administration of GA to loss of
consciousness
II. Stage of Delirium: Loss of consciousness to
onset of regular respiration
III. Stage of Surgical Anaesthesia: Onset of regular
respiration to cessation of spontaneous breathing
IV. Medullary Paralysis: Cessation of respiration to
failure of circulation and death
7. Properties of the Ideal
Anaesthetic
For the patient
Pleasant
Non-irritating
Should not cause nausea or vomiting.
Induction and recovery should be fast.
8. Properties of the Ideal
Anaesthetic
For the Surgeon
Should provide adequate analgesia.
Immobility
Muscle relaxation
Should be noninflammable and
nonexplosive.
9. Properties of the Ideal
Anaesthetic
For the Anaesthetist
Ease of administration, controllable, versatile
Potent at low concentrations
Rapid adjustments in depth of anaesthesia
Wide safety margin
No effect on vital organs
Cheap, Stable
Ease of storage
Should not react with rubber tubing or soda lime
12. MOA
• Ligand gated Ion channels are the major targets of the
anaesthetic action.
• Inhalational Anaesthetics: Potentiate the action of the
Inhibitory Neurotransmitter GABA.
• Also augment the action of the Glycine in the spinal cord.
• Certain fluorinated anaesthetics: Inhibits Cation channel
gated Nicotinic cholinergic receptor.
13. N2O and Ketamine: Selectively inhibits the excitatory
NMDA type of glutamate receptor.
14. Nitrous Oxide
Physical characteristics: Colourless, odourless,
heavier than air, non-inflammable, non-irritating
Uses: + 30% oxygen ± other volatile GAs ± Muscle
relaxant
Advantages:
Fast and smooth induction
Fast recovery (4 mins)
Good analgesia
↓ need for volatile anaesthetics
No AEs on CVS, RS, Kidney, Liver
No arrhythmogenic action
15. Disadvantages:
Low potency
No bronchodilatation
Poor Muscle relaxation
2nd gas effect
Diffusion hypoxia
Megaloblastic anaemia
16. HALOTHANE
Physical characteristics:
Volatile liquid, mild sweetish odour, non-irritant, non-inflammable
Advantages:
High potency
Pleasant induction
Smooth recovery
Bronchodilatation
Inhibits intestinal and uterine contractions
Cheap
17. HALOTHANE
Disadvantages:
Slow Induction and recovery
Poor analgesic
Poor muscle relaxant
Vagomimetic - ↓BP, HR
Sensitises myocardium to arrhythmogenic action of
CAs
Hepatotoxic (repeated use)
19. Thiopentone sodium
Ultra-short acting barbiturate
High lipid solubility and REDISTRIBUTION
Pleasant induction, fast recovery
Poor analgesic, poor muscle relaxant
REFLEXES INTACT
Respiratory centre and VMC ↓, myocardium ↓
BP and respiration ↓ initially, recover
Restlessness, delirium, shivering on prolonged
anaesthesia
20. Propofol
Propofol causes rapid induction/recovery with LESS
HANGOVER
MILK OF AMNESIA
Anti-emetic and anti-convulsant property
Day care surgery
Anaphylaxis
21. Benzodiazepines
Diazepam, lorazepam, midazolam
Induction, maintenance, supplementation of
anaesthesia
Poor analgesic, poor muscle relaxant
NO CV or respiratory ↓↓
NO nausea/vomiting, involuntary movements post-
op
Reversed by FLUMAZENIL
Endoscopy, angiography, cardiac catheterisation
22. Ketamine
Related to Phencyclidine (hallucinogen)
Blocks NMDA subtype of glutamate receptor in cortex (limbic system)
and sub-cortical areas
DISSOCIATIVE ANAESTHESIA
Reflexes INTACT
Respiration unaffected, relieves bronchospasm, CVS ++ (↑HR, CO,
BP)
Cardiac Catheterisation, bronchoscopy, burn dressings, forceps
delivery
SHOCK patients, BRONCHIAL ASTHMA
Emergence delirium, hallucinations
↑ IOP, ICT
26. Nueroleptanalgesia
Characterised by quiescence, psychic
indifference and intense analgesia without loss of
consciousness.
The combination causes significant respiratory
depression, hypotension, bradycardia and EPS
during recovery.
27. Nueroleptanaesthesia
Addition of 65% N2O + 35% O2 to the above
combination
Benzodiazepines
For inducing or supplementing
They cause sedation, amnesia and reduce anxiety
28. IV midazolam is preferred as it is faster and
shorter acting, more potent, does not cause
significant respiratory and cardiovascular
depression and does not cause pain or irritation at
the injection sites.
Also used as preanaesthetic medication.
