The document summarizes key points from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines for COPD. It describes GOLD's structure, objectives to increase awareness and improve management of COPD. It provides an overview of COPD definitions, risk factors, burden, and mechanisms. It also summarizes GOLD's approach to diagnosing and assessing COPD through evaluating symptoms, spirometry measurements, exacerbation risk, and comorbidities. Assessment results are combined to classify patients into groups A through D to guide treatment decisions.
Diabetes mellitus (DM) is a chronic metabolic and vascular disorder affecting various organs and systems. Many studies have shown impairment of pulmonary functions in diabetics subjects, whereas some studies did not show any changes in pulmonary functions. Therefore, objective of the present study is to find out alterations in the pulmonary functions. Methods Design, Setting, and Participants: This cross-sectional study was conducted in a tertiary care hospital among patients attending medicine department. The sample size was 200. A total of 100 known cases of DM without any acute or chronic lung disease and 100 healthy controls were included in the age group of 40–50 years. History of smoking was excluded in both groups. The diabetic subjects had at least 1 year of duration of disease. Intervention: Pulmonary function test (spirometry) was performed with NND TrueFlow Easy One™ diagnostic spirometer. Main Outcome Measures: The forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were the primary outcome measures to assess the pulmonary functions. Results: In Phase 1 analysis, diabetic subjects did not show any changes in both FVC and FEV1 when compared with controls. In Pearson correlation test, a significant negative correlation between duration of disease and pulmonary functions, FVC at the level of 0.05 and FEV1 at the level of 0.01 were observed. However, in Phase 2 analysis, a significant reduction in FVC and FEV1 was observed in diabetic subjects with duration of diabetes more than 5 years. Conclusion: The decline in FVC and FEV1 in diabetic subjects is more likely to be the effect of DM. The decline is more pronounced with the duration of the disease.
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Investing in prevention will not only enhance quality of life (and lifespan), but also reduce national healthcare costs, which remove hundreds of euros from each citizen’s pocket every year. In recent years, prevention is increasingly gaining a priority status: with increases in life expectancy and the development of the so-called “diseases of affluence” (including obesity), the costs for national healthcare represent an increasing burden on the population. In Italy, over 40 billion euros are spent each year for the treatment of cardiovascular disease, diabetes and cancer: nearly 700 euros per capita.
Diabetes mellitus (DM) is a chronic metabolic and vascular disorder affecting various organs and systems. Many studies have shown impairment of pulmonary functions in diabetics subjects, whereas some studies did not show any changes in pulmonary functions. Therefore, objective of the present study is to find out alterations in the pulmonary functions. Methods Design, Setting, and Participants: This cross-sectional study was conducted in a tertiary care hospital among patients attending medicine department. The sample size was 200. A total of 100 known cases of DM without any acute or chronic lung disease and 100 healthy controls were included in the age group of 40–50 years. History of smoking was excluded in both groups. The diabetic subjects had at least 1 year of duration of disease. Intervention: Pulmonary function test (spirometry) was performed with NND TrueFlow Easy One™ diagnostic spirometer. Main Outcome Measures: The forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were the primary outcome measures to assess the pulmonary functions. Results: In Phase 1 analysis, diabetic subjects did not show any changes in both FVC and FEV1 when compared with controls. In Pearson correlation test, a significant negative correlation between duration of disease and pulmonary functions, FVC at the level of 0.05 and FEV1 at the level of 0.01 were observed. However, in Phase 2 analysis, a significant reduction in FVC and FEV1 was observed in diabetic subjects with duration of diabetes more than 5 years. Conclusion: The decline in FVC and FEV1 in diabetic subjects is more likely to be the effect of DM. The decline is more pronounced with the duration of the disease.
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Investing in prevention will not only enhance quality of life (and lifespan), but also reduce national healthcare costs, which remove hundreds of euros from each citizen’s pocket every year. In recent years, prevention is increasingly gaining a priority status: with increases in life expectancy and the development of the so-called “diseases of affluence” (including obesity), the costs for national healthcare represent an increasing burden on the population. In Italy, over 40 billion euros are spent each year for the treatment of cardiovascular disease, diabetes and cancer: nearly 700 euros per capita.
My favourite subject is Maths. Maths allow me to play with numbers and improve my problem-solving skills. Maths is an interesting subject as it allows me to exercise my brain. Maths is a subject that can be improved with practice. Solving mathematical problems gives me a lot of confidence. It also boosts my energy and thinking capacity. I love solving maths problems. I also scored good marks in Maths paper in my last exam. My teacher also appreciates me when I solve any problem correctly.
I love numbers. This is one reason why I am good at maths. I love solving problems based on numbers and do not get bored easily. I want to become a Maths teacher when I grow old. I am highly inspired by my maths teacher. She is my favourite teacher. She teaches us how to solve interesting puzzles based on numbers. She also tells us various tips and tricks to solve sums easily in very less time. Because of her, I enjoy the subject even more.
Essay 2
Maths is my favorite subject because I do not have to mug up anything. Like other subjects, there is no need to memorize or retain a lot of information in mind. Mathematics is based on practice. The more you practice, the better you get at the subject. I love calculations and hence enjoy chapters like addition, subtraction, multiplication, and division. My mother also helps me in practicing maths. It is an engaging subject and also a very scoring one. Knowing how to do calculations also helps in our day-to-day lives like while buying any goods, etc. Maths is a very important subject for higher studies, as told by my teacher. That’s why I pay close attention to the subject.
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The latest guidelines on the management of a COPD patient ( Stable COPD, patient with an exacerbation of COPD), latest modalities of treatment of a COPD patient
2018 GOLD POCKET GUIDE
Evidence-based strategy document for COPD diagnosis, management, and prevention, with citations from the scientific literature.
2018 GOLD POCKET GUIDE
http://goldcopd.org/gold-reports/
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.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
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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
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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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.
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
74. Global Strategy for Diagnosis, Management and Prevention of COPD
Manage Stable COPD: Pharmacologic Therapy
(Medications in each box are mentioned in alphabetical order, and
therefore not necessarily in order of preference.)
Patient Recommended
First choice
Alternative choice Other Possible
Treatments
A
SAMA prn
or
SABA prn
LAMA
or
LABA
or
SABA and SAMA
Theophylline
B
LAMA
or
LABA
LAMA and LABA
SABA and/or SAMA
Theophylline
C
ICS + LABA
or
LAMA
LAMA and LABA or
LAMA and PDE4-inh. or
LABA and PDE4-inh.
SABA and/or SAMA
Theophylline
D
ICS + LABA
and/or
LAMA
ICS + LABA and LAMA or
ICS+LABA and PDE4-inh. or
LAMA and LABA or
LAMA and PDE4-inh.
Carbocysteine
SABA and/or SAMA
Theophylline