GI bleeding, also known as gastrointestinal hemorrhage, occurs when blood vessels in the GI tract rupture. It can occur in any part of the GI tract from the mouth to the anus. The causes of upper GI bleeding include peptic ulcers and esophageal varices. Lower GI bleeding may be caused by inflammatory bowel disease, tumors, or hemorrhoids. Signs and symptoms include acute bleeding presenting as shock or chronic bleeding leading to anemia. Risk factors include liver disease, smoking, and NSAID use. Treatment involves endoscopy, drug therapies, and sometimes surgery. Nursing management focuses on monitoring for signs of bleeding and supporting circulation. Prevention emphasizes lifestyle changes like quitting smoking and limiting alcohol.
Definitions of GI bleeding
GI Bleeding include Upper and Lower of GIB
Causes of GI bleeding
Pathogenesis of GI bleeding
Diagnosis of GI bleeding
Clinical of GI bleeding
Management of GI bleeding
Recommendation of GI bleeding
Clinical guideline of GI bleeding
G I bleeding with radiological interventions(ACR Appropriateness Criteria).Tc-99m RBC scintigraphy,Catheter-directed Angiography,Pharmacological control,Embolization,Arterial interventions,Endoscopy,CT Angiography
Definitions of GI bleeding
GI Bleeding include Upper and Lower of GIB
Causes of GI bleeding
Pathogenesis of GI bleeding
Diagnosis of GI bleeding
Clinical of GI bleeding
Management of GI bleeding
Recommendation of GI bleeding
Clinical guideline of GI bleeding
G I bleeding with radiological interventions(ACR Appropriateness Criteria).Tc-99m RBC scintigraphy,Catheter-directed Angiography,Pharmacological control,Embolization,Arterial interventions,Endoscopy,CT Angiography
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
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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.
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
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
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
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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
3. Definition :
• also known as gastrointestinal hemorrhage , is all forms of bleeding
in the gastrointestinal tract, from the mouth to the rectum.
• Esophagus
• Stomach
• Small intestine, including the duodenum
• Large intestine or colon
• Rectum
• Anus
GI bleeding can occur in any of these organs. If the bleeding occurs in
esophagus, stomach, or initial part of the small intestine
(duodenum), it’s considered upper GI bleeding. Bleeding in the
lower small intestine, large intestine, rectum, or anus is called lower
GI bleeding.
4. Anatomy of GI :
• Individual components of the gastrointestinal system :
• Oral cavity :
The oral cavity or mouth is responsible for the intake of food, and it
is consists of :
- tongue and hard palate
- mucosa : absorption of small molecules such as glucose and
water.
food passes through the pharynx and oesophagus via the action of
swallowing.
5. Anatomy of GI cont. :
• Salivary glands :
Three pairs of salivary glands communicate with the oral cavity.
- Parotids : Immunoglobins are secreted help to fight microorganisms
and a-amylase proteins start to break down complex carbohydrates.
- Submandibular :
secretes 70% of the saliva in the
mouse.
- Sublingual :
provide buffers and lubrication.
6. Anatomy of GIT cont. :
• Stomach :
is a J shaped expanded bag, located just left of the midline
between the oesophagus and small intestine, divided into four
main regions and has two borders called the greater and lesser
curvatures.
• This is where most gastric glands are located and where most
mixing of the food occurs.
• Gastric contents are expelled into the proximal duodenum via
the pyloric sphincter. The inner surface of the stomach is
contracted into numerous longitudinal folds called rugae. These
allow the stomach to stretch and expand when food enters. The
stomach can hold up to 1.5 litres of material.
7. Anatomy of GIT cont.
∗ Small intestine : composed of the duodenum, jejunum, and
ileum.
∗ The duodenum is the proximal C-shaped section that curves
around the head of the pancreas.
∗ The duodenum serves a mixing function as it combines digestive
secretions from the pancreas and liver with the contents
expelled from the stomach.
∗ The start of the jejunum is marked by a sharp bend, the
duodenojejunal flexure.
∗ It is in the jejunum where the majority of digestion and
absorption occurs.
∗ The final portion, the ileum, is the longest segment and empties
into the caecum at the ileocaecal junction.
8. Anatomy of GI cont.
• Large intestine :
consists of the appendix, caecum, ascending, transverse,
descending and sigmoid colon, and the rectum. It has a length of
approximately 1.5m and a width of 7.5cm.
The functions of the large intestine:
- The accumulation of unabsorbed material to form faeces.
- Some digestion by bacteria. The bacteria are responsible for the
formation of intestinal gas.
- Reabsorption of water, salts, sugar and vitamins.
9. Anatomy of GI cont.
∗ Liver : situated in the right upper quadrant of the abdomen. It is
surrounded by a strong capsule and divided into four lobes
namely the right, left, caudate and quadrate lobes.
∗ It acts as a mechanical filter by filtering blood that travels from
the intestinal system.
∗ It detoxifies several metabolites including the breakdown of
bilirubin and oestrogen.
∗ its main roles in digestion are in the production of bile and
metabolism of nutrients.
∗ The bile produced by cells of the liver, enters the intestines at
the duodenum. Here, bile salts break down lipids into smaller
particles so there is a greater surface area for digestive enzymes
to act.
10. Anatomy of GIT cont.
• Gall bladder :
The main functions of the gall bladder are storage and
concentration of bile.
• Bile is a thick fluid that contains enzymes to help dissolve fat in
the intestines.
• Bile is produced by the liver but stored in the gallbladder until it is
needed.
• Pancreas : The pancreas secretes fluid rich in carbohydrates and
inactive enzymes.
• These are secreted in an inactive form to prevent digestion of the
pancreas itself. The enzymes become active once they reach the
duodenum triggered by the hormones released by it
( duodenum).
11. Types :
1. Upper Gastrointestinal Bleeding.
- The upper gastrointestinal tract consists of the mouth, pharynx,
esophagus, stomach, and duodenum.[13] The exact demarcation
between the upper and lower tracts is the suspensory muscle of the
duodenum.
• Can be categorized as either variceal or non-variceal. Variceal is
a complication of end stage liver disease. While non variceal
bleeding associated with peptic ulcer disease or other causes of
UGIB.
• UGIT bleeding is 4 times as common as bleeding from lower GIT,
with a higher incidence in male.
12. Cont.
2. Lower Gastrointestinal Bleeding.
• °Lower gastrointestinal bleeding is defined as abnormal
hemorrhage into the lumen of the bowel from a source distal to
the ligament of Treitz.
• °Originates in the portion of GIT further down the digestive
system :
•-small intestine
•-colon
•-rectum
•-anus
13. Causes :
Upper GI bleeding causes :
•Peptic ulcer. This is the most common cause of upper GI bleeding.
Peptic ulcers are sores that develop on the lining of the stomach and
upper portion of the small intestine.
•Tears in the lining of the tube that connects your throat to your
stomach (esophagus). Known as Mallory-Weiss tears, they can cause
a lot of bleeding. These are most common in people who drink
alcohol to excess.
•Abnormal, enlarged veins in the esophagus (esophageal varices).
This condition occurs most often in people with serious liver disease.
•Esophagitis. This inflammation of the esophagus is most commonly
caused by gastroesophageal reflux disease (GERD).
14. Cont.
Lower GI bleeding causes :
-Inflammatory bowel disease.
-Tumors.
-Colon polyps: Small clumps of cells that form on the lining of your
colon can cause bleeding.
-Hemorrhoids : swollen veins in your anus or lower rectum, similar
to varicose veins.
-Anal fissures: small tears in the lining of the anus.
-Proctitis: Inflammation of the lining of the rectum can cause rectal
bleeding.
-Diverticular disease : If one or more of the pouches become
inflamed or infected, it's called diverticulitis.
15. Signs and symptoms :
• Acute bleeding symptoms
• Patient my develop into shock if have acute bleeding. Acute
bleeding is an emergency condition. Symptoms of shock include :
• a drop in blood pressure
• little or no urination
• a rapid pulse
• unconsciousness
• Chronic bleeding symptoms
• Patient may develop anemia if he have chronic bleeding.
Symptoms of anemia may include feeling tired and shortness of
breath, which can develop over time.
• Some people may have occult bleeding. Occult bleeding may be a
symptom of inflammation or a disease such as colorectal cancer .
A simple lab test can detect occult blood in your stool.
17. Complications :
• A gastrointestinal bleed can cause:
• Shock
• Anemia
• Hypovolemia
• Dehydration and Chest Pain
• Death
• Aspiration from massive upper GI bleed;
18. Diagnosis :
∗ Lab tests : Stool tests - Blood tests.
∗ Gastric lavage :to remove stomach contents to determine the
possible location of GI bleeding.
∗ Endoscopy
∗ Colonoscopy
∗ Flexible sigmoidoscopy
∗ Abdominal CT scan.
∗ Angiogram : is a special kind of x-ray in which a radiologist
threads a catheter through your large arteries.
19. Medical management :
• Endoscopy therapy
• - It is important first to confirm the location of the bleed
before planning endoscopy therapy for a patient with an upper GI
bleed.
• Drug therapies
• Medical therapy for non-variceal bleeding should be examined
separately from that for variceal bleeding.
• Drug therapy for variceal bleeding includes the use of vasoactive
drugs (such as terlipressin), which have little effect on patient
survival but reduce the chance of a bleed recurring.
20. Cont.
• Surgical intervention for non-variceal bleeds :
• Surgery is usually reserved for cases where endoscopic therapy has
been unsuccessful.
• The main reasons for surgical intervention in cases of non-variceal
upper GI bleeding include:
• - Active bleeding - unresponsive to endoscopic therapy;
• - Perfuse bleeding - prevents endoscopic visualization;
• - Continuous re-bleeding - despite technically successful
endoscopic treatment;
• - Patients at low risk of death who have experienced unsuccessful
attempts at endoscopy.
21. Nursing management :
∗ Check for the appearance of vomitus, stool, or drainage.
∗ 2. Monitor vital signs and compare with client’s normal and
previous data; you may take blood pressure in different positions
like when sitting, lying, and standing positions as much as
possible.
∗ 3. Assess client’s physiological response to hemorrhage like
changes in mentation, weakness, apprehension, diaphoresis,
restlessness, and anxiety.
∗ 4. Measure central venous pressure if indicated and available.
∗ 5. Strictly monitor fluid intake and output; measure fluid loss
through emesis, gastric drainage and stools.
22. Cont.
∗ Maintain client on bed rest to prevent vomiting.
∗ Place client in fowler’s position during antacid gavage.
∗ Check for signs of secondary bleeding i.e. nose or gums,
ecchymosis
∗ Resume intake with clear/ bland fluids or as indicated by the
physician; avoid giving dark colored foods.
∗ Administer IV fluids/ volume expanders/ fresh whole
blood/platelet/fresh frozen plasmas indicated.
∗ Insert NGT as indicated by the physician.
∗ Perform gastric lavage with cool saline solution until aspirate is
pinkish in color or if it is clear.
23. Prevention :
To help prevent a GI bleed:
•Limit your use of nonsteroidal anti-inflammatory drugs.
•Limit your use of alcohol.
•Drinking plenty of water
•If patient smoke, must quit.
•If patient have GERD, follow his doctor's instructions for treating it.
•Prevent hemorrhoids by resisting the urge to strain when having a
bowel movement, consuming fiber and using laxatives when
necessary.
•After eating, remain upright for at least an hour to avoid acid reflux.