1. Tuberculosis of the larynx commonly affects the posterior larynx, causing submucosal tubercles that can ulcerate, forming undermined ulcers. Symptoms include throat pain, hoarseness, and dysphagia. Diagnosis involves chest X-ray, sputum examination, laryngoscopy, and biopsy. Treatment consists of anti-tubercular drugs, vocal rest, and nutrition supplements.
2. Scleroma of the larynx is caused by Klebsiella rhinoscleromatis and commonly involves the subglottic region, presenting as a smooth red swelling. Diagnosis involves biopsy and culture. Treatment includes antibiotics, steroids, and surgery for stenosis
ENT Nasal septal perforation..... for best rhinoplasty and nose reshape surgery contact
Dr Junaid Ahmad (MBBS FCPS) is the best plastic surgeon in Lahore. He is a well known, trained and expert in his field. He is MBBS and FCPS in Plastic and Recosntructive Surgery. He is a post graduate of the College of Physicians and Surgeons Pakistan which is oldest and best institute for post graduation in this area of the world. He is doing his practice in Lahore, Pakistan. He is always kind to the patients and listens them carefully as it is part of modern clinical skill and training. He is expert in both cosmetic as well as reconstructive surgery. He is also skin cancer and burn expert. A few of Dr Junaid Ahmad expertise are listed here..... call 03104037071
Case report - discussion about presentation and managements of laryngoceles.
Published in Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 32, April 20; Page: 5586-5591
Abstract: Laryngoceles are rare, cystic dilatation of saccule of ventricle of larynx. Three types are recognized –internal, external and mixed types. Many of the laryngoceles are asymptomatic; few require surgical excision via internal/endoscopic or external approach. Contrast CT is the investigation of choice. A 40year old male presented to our OPD with a neck Scar, later diagnosed as laryngocele. Here is the case report about presentation, diagnosis and management of a large mixed layngocele.
KEYWORDS: Layngocele, Neck swelling, Saccule, Ventricle of larynx.
Granulomatous conditions in ENT are rare conditions that we come in contact with, we tend to overlook them because they are so rare, however some of the conditions like TB and syphillis and Mucormycosis of the Nose and PNS are seen in our clinics
this is a good summary from scotts brown chapter
ENT Nasal septal perforation..... for best rhinoplasty and nose reshape surgery contact
Dr Junaid Ahmad (MBBS FCPS) is the best plastic surgeon in Lahore. He is a well known, trained and expert in his field. He is MBBS and FCPS in Plastic and Recosntructive Surgery. He is a post graduate of the College of Physicians and Surgeons Pakistan which is oldest and best institute for post graduation in this area of the world. He is doing his practice in Lahore, Pakistan. He is always kind to the patients and listens them carefully as it is part of modern clinical skill and training. He is expert in both cosmetic as well as reconstructive surgery. He is also skin cancer and burn expert. A few of Dr Junaid Ahmad expertise are listed here..... call 03104037071
Case report - discussion about presentation and managements of laryngoceles.
Published in Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 32, April 20; Page: 5586-5591
Abstract: Laryngoceles are rare, cystic dilatation of saccule of ventricle of larynx. Three types are recognized –internal, external and mixed types. Many of the laryngoceles are asymptomatic; few require surgical excision via internal/endoscopic or external approach. Contrast CT is the investigation of choice. A 40year old male presented to our OPD with a neck Scar, later diagnosed as laryngocele. Here is the case report about presentation, diagnosis and management of a large mixed layngocele.
KEYWORDS: Layngocele, Neck swelling, Saccule, Ventricle of larynx.
Granulomatous conditions in ENT are rare conditions that we come in contact with, we tend to overlook them because they are so rare, however some of the conditions like TB and syphillis and Mucormycosis of the Nose and PNS are seen in our clinics
this is a good summary from scotts brown chapter
history of TB,epidemiology, clinical features, lab diagnosis, treatment, MDR TB, XDR TB, TDR TB, and mechanism of drug resistant, methods of identification of resistant drugs
Cellulitis is a spreading infection of subcutaneous &Fascial planes
Oedema gives rise to soft pitting, while if pus is present ,induration can always be felt
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.
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.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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.
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.
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
2. TUBERCULOSIS OF
LARYNX
• Almost always associated with open
pulmonary Tuberculosis
• Due to contamination of sputum
containing acid fast bacilli
• May rarely develop by blood borne
infections which causes extensive
ulceration of mucosa
• Common age group : 20-40 yrs
• Incidence increasing due to emergence
of AIDS
3. TUBERCULOSIS OF LARYNX-
PATHOLOGY
• Posterior part of larynx affected than anterior
• Formation of submucosal tubercles which later
may caseate and ulcerate producing
undermined ulcers
• There may be infiltration of epiglottis and
arytenoids
• Self limiting to some extent –> heals with
fibrosis-> stenosis of larynx
• With reparative process tumor like swellings are
found called Tuberculomas
• there may be diffuse oedematous reaction
consistent to allergic response to AFB
4. TUBERCULOSIS OF LARYNX-
SYMPTOMS
• Throat pain
• Referred otalgia
• Hoarseness with weakness of voice
(earliest symptom)
• Painful speech
• dysphagia
5. TUBERCULOSIS OF LARYNX-
SIGNS
• Mucosal hyperemia and oedema
• Inter-arytenoid mamillations
• Undermined ulcers- mouse nibbled
appearance
• Turban epiglottis
• Ragged ulcerations on arytenoids and inter-
arytenoid region
• Granulation tissue in inter-arytenoid region
• Pale laryngeal mucosa
6.
7. TUBERCULOSIS OF LARYNX-
DIAGNOSIS
• Chest X-ray
• Sputum examination for AFB
• Laryngoscopic examination
• Biopsy of laryngeal lesion
8. TUBERCULOSIS OF LARYNX-
TREATMENT
• Anti tubercular drug regimen
• Vocal rest
• Nutritional supplements
9. SCLEROMA OF LARYNX
• Klebsiella rhinoscleromatis is the
causative organism
• Laryngeal involvement is seen with or
without nasal lesion
• Subglottic region is commonly involved
10. SCLEROMA OF LARYNX-
SYMPTOMS AND SIGNS
• Non specific symptoms as seen in other
chronic laryngeal infections like
hoarseness, wheeze
• Dyspnoea may be presenting symptom
in addition to nasal lesion
• Presents as smooth red swelling in
subglottic region
11. SCLEROMA OF LARYNX-
DIAGNOSIS
• Biopsy of the lesion
• Histopathology -> specimen shows
Mikulicz cells, Russell bodies, gram
negative organism within the Mikulicz
cell
• Culture of organism from biopsy
material
12. SCLEROMA OF LARYNX-
TREATMENT
• Medical combination of an
aminoglycoside such as gentamycin with an
anti-metabolite such as tetracyclin
• Steroids to reduce fibrosis
• Surgical
1. Endoscopic removal of granulomatous
tissue
2. Mild stenosis dilatation
3. Severe subglottic stenosis tracheostomy
13. SYPHILIS OF LARYNX
• Now rarely seen
• All stages can manifest in larynx
• Primary lesion described rarely
• Tertiary stage is most important
gamma are seen
• Peri arterial infiltration and obliterative
endarteritis
• Prediliction for anterior part of larynx
epiglottis and AE folds
14. SYPHILIS OF LARYNX
• Oedematous mucosa with infiltration of
plasma cells, lymphocytes and giant
cells
• Deep ulceration with central sloughing
• Abundant necrotic tissue reaches and
penetrates laryngeal cartilages
• Considerable destruction after healing
leaves deformity of larynx and often
stenosis
15. SYPHILIS OF LARYNX-
CLINICAL FEATURES AND
MANAGEMENT
• Hoarseness, sometimes dysphagia, pain is
rare
• Oedema of mucosa leading to stridor
• Diagnosis only on biopsy and serological
tests
• Treatment Prolonged treatment with high
doses of penicillin
• Local treatment by inhalation
• Endoscopic removal of necrotic tissue to
maintain airway
• tracheostomy
16. LEPROSY OF LARYNX
• Caused by mycobacterium leprae (Hansen's
bacillus)
• Both lepromatous and tuberculoid can arise in
larynx
• Epiglottis and AE fold most commonly
affected
• Granulomatous swelling and often ulceration
and destruction in supraglottic region
• Epiglottis may be curled
• Mucosa may be studded with nodules
• Virchow cells ( foamy histiocytes) and
mucosal thickening seen on HPE
17. LEPROSY OF LARYNX-
TREATMENT
• Medical Dapsone, Clofazimine,
Rifampicin
• Surgical tracheostomy in cases of
stenosis
18. WEGENER’S
GRANULOMATOSIS
• Diffuse systemic disease of unknown cause
• Includes triad of necrotizing granulomatous lesion
in upper and lower respiratory tract (sinusitis,
rhinitis), vasculitis involving pulmonary arteries
and veins and necrotizing glomerulonephritis
• Larynx is rarely source of primary manifestation
• Lesion usually lies in subglottis laryngeal
obstruction
• Edematous mucosa with granular appearance
which bleeds easily and sometimes ulcerates
• If untreated can be rapidly fatal
• Immunosuppressive drugs especially
cyclophosphamide are very active
• Steroids should be started early
19. SARCOIDOSIS OF LARYNX
• Chronic idiopathic granulomatous disease
also called Besnier-Boeck disease
• Head and neck manifestations in 10% of
whom only minor proportion have laryngeal
disease
• Disease is usually self limiting
• Pathology non specific granuloma later
fibrosis and hyalinization
• Main site involved is supraglottis
20. SARCOIDOSIS OF LARYNX- CLINICAL
FEATURES AND MANAGEMENT
• Hoarseness, dysphagia and dyspnoea
• Epiglottis and false vocal cords are swollen
and pale
• True cords and subglottis rarely affected
• Lesion can progress rapidly leading to life
threatening airway obstruction
• Diagnosis biopsy
• Positive Kveim’s test, elevated serum
angiotensin converting enzyme is highly
suggestive
• Treatment high dose corticosteroids,
tracheostomy
21. LUPUS OF LARYNX
• Indolent tubercular infection associated with
lupus of nose and pharynx
• Involves anterior part of larynx.
• Epiglottis is involved first and may be
completely destroyed. disease spreads to AE
fold and ventricular bands.
• Painless asymptomatic condition may be
discovered incidentally
• Prognosis is good
• Treatment is anti tubercular drugs
22. MYCOSIS OF LARYNX
• Following mycosis can occur in the larynx
1. Candidiasis
2. Coccidioidmycosis
3. Paracoccidioidmycosis
4. Histoplasmosis
5. Blastomycosis
6. Cryptococcosis
7. aspergillosis