Gouty arthritis results from deposition of urate crystals in the joints due to chronic hyperuricaemia. It is most common in middle-aged men and is increasing in prevalence worldwide due to aging populations and obesity. Acute gout causes sudden, severe pain in one or few joints like the toe or ankle. Chronic gout leads to frequent attacks and tophus formation, causing permanent joint damage. Treatment involves NSAIDs to relieve pain, colchicine or uricosuric drugs to prevent attacks, and allopurinol long-term to lower urate levels and prevent complications. Lifestyle changes like weight loss, fluid intake and diet modification also help control gout.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
Osteoarthritis is a chronic degenerative disorder of synovial joints in which there is progressive softening and erosion/disintegration of the articular cartilage. In the presentation, I will deal in detail about the condition in every dimension with the most recent evidence.
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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
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.
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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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
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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
2. INTRODUCTION
• Chronic heterogeneous disorder of urate metabolism.
• Results in deposition of monosodium urate crystals in the joints and
soft tissues, with accompanying inflammation and degenerative
consequences.
• Most common form of inflammatory joint disease in men aged ≥40
years.
• Gout has been referred to as the “disease of kings” since it has often
been associated with affluent societies since ancient times.
3. EPIDEMIOLOGY
• Gout is one of the oldest recognized diseases and was identified by Egyptians in
2460BC.
• Due to an ageing population and rising obesity, the burden of gout is increasing
around the world, especially in high income countries.
• The reported prevalence worldwide ranges from 0.1% to approximately 10%.
• In the USA, gout has overtaken rheumatoid arthritis to become the most common
inflammatory arthritis.
• Worldwide, the prevalence of gout is significantly higher in men than women
(about 3:1).
4. RISK FACTORS
• Excessive consumption of red meat
• Obesity
• Excessive consumption of alcohol
• Drugs – Loop diuretics, NSAIDs, cytotoxic therapy,
salicylates
• Trauma
• Other disease –renal failure,etc
5. PATHOPHYSIOLOGY
• Hyperuricaemia results in the crystallization of monosodium urate in the
synovial fluid.
• This triggers an inflammatory cascade.
• Crystal deposits on cartilage surface lead to the cartilage damage.
• Deposition around joints lead to joint destruction
• Long standing gout joint erosions occur.
• Urate deposition occurs in peripheral joints where temperatures are lower
than the core body temperature.
10. CLINICAL FEATURES
• Acute gout is a painful condition that typically affects only
one or a few joints.
• The big toe, knee, or ankle joints are most often affected.
• Throbbing, crushing, or excruciating pain.
• Joint appears warm and red. Fever may be present.
11. CLINICAL FEATURES
• Chronic gout
• Acute episodes occur with increasing
frequency
• Tophus formation
• Permanent joint damage
• Renal damage increases with time
12.
13.
14.
15. LABORATORY INVESTIGATIONS
• Plain radiographs – X-Ray
• Serum Uric acid
• 4.0 to 8.6 mg/dl in men
• 3.0 to 5.9 mg/dl in women.
• Synovial fluid analysis (shows uric acid crystals)
• BUN (blood urea nitrogen), Serum Creatinine
• Synovial biopsy
• Uric acid – urine
16. MANAGEMENT
Aim
• Prompt relief of pain in acute attack
• Eliminate secondary causes
• Prevent recurrence and complications (eg renal stones,
joint damage)
17. DRUGS USED IN TREATMENT
• NSAIDs
• Colchicine
• Uricosuric agents
• Allopurinol/ Febuxstat
19. PHARMACOLOGICAL MANAGEMENT
Colchicine
• Produces its anti-inflammatory effects by binding to the intracellular
protein tubulin, preventing its polymerization leading to the inhibition of
leukocyte migration into affected area.
• Inhibits the synthesis & release of leukotrienes.
• If NSAIDs are contra-indicated use colchicine.
• Initial dose is 1mg, then 0.5 mg every 4 hrs (total of 6mg/course)
• Colchicine is more toxic than NSAIDs
20. PHARMACOLOGICAL MANAGEMENT
Uricosuric agents
• Probenecid & Sulfinpyrazone
• They are weak organic acids .
• Sulfinpyrazone is a metabolite of phenylbutazone.
• Increase the excretion of Uric acid.
21. PHARMACOLOGICAL MANAGEMENT
Allopurinol
• Inhibits synthesis of uric acid by inhibiting xanthine oxidase enzyme.
• It is the prophylactic drug of choice in the management of recurrent gout.
• Initial dose is 100mg daily and could be increased to 900mg daily in patients with
normal renal function.
22.
23. NON-PHARMACOLOGICAL MANAGEMENT
• Acute attack
• Rest the affected joint
• Maintain high fluid intake
• Chronic gout
• Maintain high fluid intake
• Lose weight if obese
• Provide dietary advice
• Avoid alcohol
• Avoid red meat and foods rich in purines (offal, shell fish, spinach)
