The guidelines provide recommendations for the secondary prevention of stroke in patients with previous ischemic stroke or transient ischemic attack (TIA). Key recommendations include: aggressively treating hypertension, diabetes, dyslipidemia and other vascular risk factors; initiating antiplatelet therapy; and considering carotid endarterectomy for severe carotid stenosis. Lifestyle modifications such as smoking cessation, weight control, diet and exercise are also encouraged. The guidelines were updated from 1999 based on new clinical trial evidence.
Management of hypertension in acute strokeSudhir Kumar
Hypertension is an important and common risk factor for brain stroke- both ischemia and hemorrhagic subtypes. Appropriate management of blood pressure is crucial for good recovery rom acute stroke, and prevent recurrence of stroke. This presentation looks at the role played by hypertension in causing first ever and recurrent strokes. The current guidelines are also discussed.
Management of hypertension in acute strokeSudhir Kumar
Hypertension is an important and common risk factor for brain stroke- both ischemia and hemorrhagic subtypes. Appropriate management of blood pressure is crucial for good recovery rom acute stroke, and prevent recurrence of stroke. This presentation looks at the role played by hypertension in causing first ever and recurrent strokes. The current guidelines are also discussed.
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Blood Pressure Targets 2017.Still Struggling for the Right Answermagdy elmasry
Blood Pressure Targets 2017.Guidelines For Hypertension 2011-2015.Does SPRINT change our approach to BP targets?
SPRINT vs. ACCORD.Updated Hypertension Guidelines Released by ACP, AAFP
Acute ischemic stroke is an emergency. There are good thrombolytic agents available now. Aspirin or clopidogrel along with statins should be given to all stroke patients. Control of BP and sugar is of paramount importance.
Stroke prevention for nonvalvular AF, summary of evidence-based guidelinesErsifa Fatimah
Ternyata... guideline yang ngebahas prevensi stroke pada nonvalvular AF tu banyak banget! Yang dirilis komunitas Neuro maupun Cardio, yang internasional maupun yang lokal. Dan pertanyaan besarnya tetep: What's the best strategy?
*Bonus special issue: manajemen prevensi stroke infark dengan antikoagulan pasca brain hemorrhage.
SGLT2 inhibitors in Heart failure: A prized addition to HF treatment optionsahvc0858
Early Diabetes and Dyslipidaemia Treatment Optimisation.
Presentation by Dr Chan Wan Xian
Cardiologist, Echocardiologist
Heart Failure Intensivist
Asian Heart & Vascular Centre
www.ahvc.com.sg
Blood Pressure Targets 2017.Still Struggling for the Right Answermagdy elmasry
Blood Pressure Targets 2017.Guidelines For Hypertension 2011-2015.Does SPRINT change our approach to BP targets?
SPRINT vs. ACCORD.Updated Hypertension Guidelines Released by ACP, AAFP
Acute ischemic stroke is an emergency. There are good thrombolytic agents available now. Aspirin or clopidogrel along with statins should be given to all stroke patients. Control of BP and sugar is of paramount importance.
Stroke prevention for nonvalvular AF, summary of evidence-based guidelinesErsifa Fatimah
Ternyata... guideline yang ngebahas prevensi stroke pada nonvalvular AF tu banyak banget! Yang dirilis komunitas Neuro maupun Cardio, yang internasional maupun yang lokal. Dan pertanyaan besarnya tetep: What's the best strategy?
*Bonus special issue: manajemen prevensi stroke infark dengan antikoagulan pasca brain hemorrhage.
JUPITER (Justification for the Use of Statins in Primary Prevention: An Inter...theheart.org
- 4-year, double-blind, placebo-controlled, randomized clinical trial
- Population and treatment:
17 802 patients with normal LDL-C (median 108 mg/dL) and elevated CRP (>2.0 mg/L) randomized to rosuvastatin 20 mg/d or placebo
- Primary outcome:
Composite of nonfatal MI, nonfatal stroke, hospitalization for unstable angina, revascularization, and confirmed death from CV causes
See the article at http://www.theheart.org/article/917181.do
Practical information from a family doctor on what you can do -- without medicines -- to prevent the most common killers in the world, heart attacks and strokes.
ASA/AHA 2014 guidelines for the Primary Prevention of Stroke
Hypertension and dyslipidemia impact on stroke development and prevention
SPRINT and HOPE-3
Secondary Prevention after ACS: Focused on Anticoagulant TherapyPERKI Pekanbaru
Dr. Nathania Marliani Kristanti, SpJP, FIHA. 3rd Pekanbaru Cardiology Update, August 25th 2013. Pangeran Hotel Pekanbaru. Learn more at PerkiPekanbaru.com
Dyslipidemia and CVS by Mohit Soni and Chandan KumarOlgaGoryacheva4
My students Mohit Soni and Chandan Kumar had presented this topic in our 22nd Student Scientific Society Conference in the department of Propaedeutic of Internal Diseases No.2
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.
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New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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.
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.
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
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.
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
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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
How to Give Better Lectures: Some Tips for Doctors
Guidelines for prevention of stroke Guidelines for prevention of stroke
1. Guidelines for Prevention of Stroke in Patients with Ischemic Stroke or Transient Ischemic Attack From the Stroke Council of the AHA Ralph L. Sacco, Chair; Robert Adams, Vice-Chair Greg Albers, Mark J. Alberts, Oscar Benavente, Karen Furie, Larry B. Goldstein, Philip Gorelick, Jonathan Halperin, Robert Harbaugh, S. Claiborne Johnston, Irene Katzan, Margaret Kelly-Hayes, Edgar J. Kenton, Michael Marks, Lee H. Schwamm, Thomas Tomsick Stroke 2006;37:577-617
2. Presentation Compiled by the AHA/ASA Professional Education Committee Susan C. Fagan, Chair Deborah Bergman Glenn D. Graham S. Claiborne Johnston Karen Johnston Edgar J. Kenton Dawn Kleindorfer Creed Pettigrew Kathryn Taubert, Staff Scientist Karen Modesitt, Staff
3. Introduction This slide set was adapted from the AHA/ASA Guidelines for Prevention of Stroke in Patients with Ischemic Stroke or Transient Ischemic Attack. From the American Heart Association/American Stroke Association Council on Stroke Co-Sponsored by the Council on Cardiovascular Radiology and Intervention Affirmed by the American Academy of Neurology The full-text guidelines are available on the Web site of the AHA ( www.americanheart.org )
4. Introduction Since the 1999 AHA Stroke Council guidelines for the secondary prevention of stroke, important evidence from clinical trials has emerged that further supports and broadens the options for aggressive risk reduction therapies. The secondary prevention patient population to be addressed includes those with prior stroke or transient ischemic attack, regardless of etiology.
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7. Secondary Prevention Definition Therapy to reduce recurrent stroke and other cardiovascular events and decrease cardiovascular mortality in patients with previous stroke or TIA. Although prevention of stroke is of primary interest, many grades of recommendations were chosen to reflect the existing evidence on the reduction of all cardiovascular outcomes.
11. Challenges of Dissemination The committee acknowledges that strategies for implementation of the guidelines need to be developed and disparities in health care delivery addressed.
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17. Cholesterol Control ASA 2006 Secondary Stroke Recs Heart Protection Study Collaborative Group. Lancet 2002;360:7-22 Baseline feature SIMVASTATIN (10269) PLACEBO (10267) Rate ratio & 95% CI STATIN better PLACEBO better Prior coronary disease Yes No 1459 1841 (21.8%) (27.5%) 574 744 (16.1%) (20.8%) Prior cerebrovascular disease Yes 406 488 (24.7%) (29.8%) No 1627 2097 (18.9%) (24.3%) Prior diabetes Yes 601 748 (20.2%) (25.1%) No 1432 1837 (19.6%) (25.2%) ALL PATIENTS 2033 2585 (19.8%) (25.2%) 0.4 0.6 0.8 1.0 1.2 1.4 24% SE 3 reduction (2P<0.00001)
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21. Urgent Endarterectomy Surgery within 2 weeks is suggested rather than delaying surgery (Class IIa, Evidence B). Rothwell PM. Lancet 2004;363(9413):915-24
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24. Stroke Prevention: Non-cardioembolic ASA 2006 Recommendations For patients with noncardioembolic ischemic stroke or TIA, antiplatelet agents are recommended rather than oral anticoagulation to reduce the risk of recurrent stroke and other cardiovascular events (Class I, Evidence A).
25. Warfarin-Aspirin for Recurrent Stroke Study (WARSS) 0 90 180 270 360 450 540 630 720 Days After Randomization 0 10 20 30 Probability of Event (%) Warfarin Aspirin 1.13 Hazard Ratio P= 0.25 The primary outcome occurred in 17.8% of patients in the warfarin group and 16.0% in the ASA group. Mohr JP et al. N Engl J Med 2001;345:1444-51 900 932 951 974 984 1004 1032 1057 1103 Aspirin 885 924 939 956 972 998 1013 1047 1103 Warfarin No. at Risk
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28. ESPS 2: Effects on Stroke—Relative Risk Reduction (Pair-wise Comparisons) 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 37.0% P < 0.001 16.3% P = 0.039 18.1% P = 0.013 23.1% P = 0.006 ER-DP = Extended-Release Dipyridamole ASA = Acetylsalicylic Acid RRR = Relative Risk Reduction RRR ASA/ER-DP vs. Placebo ER-DP vs. Placebo ASA vs. Placebo ASA/ER-DP vs. ASA ESPS 2 Group. J Neurol Sci 1997;151(suppl):S1-S77
29. Efficacy of Clopidogrel vs Aspirin in MI, Ischemic Stroke, or Vascular Death (n=19,185) CAPRIE Study Months of Follow-up Cumulative Event Rate (%) 0 4 8 12 16 Clopidogrel Aspirin Overall Relative Risk Reduction 8.7%* 3 6 9 12 15 18 21 24 27 30 33 36 Aspirin 5.83% 5.32% Clopidogrel Event Rate per Year *ITT analysis. CAPRIE Steering Committee. Lancet 1996;348:1329-39
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32. MATCH Trial Primary End Point: MI, IS, Vascular Death, or Rehospitalization for an Acute Ischemic Event Overall Relative Risk Reduction 6.4%* P = 0.244 *ITT Analysis Cumulative Event Rate Clopidogrel + ASA Clopidogrel + Placebo 0.00 0.04 0.08 0.12 0.16 0.20 0 3 6 9 12 15 18 N=7,599 Months of Follow Up Diener H-C et al. Lancet 2004;364:331-7
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36. Adjusted Relative Risk of Stroke According to a Woman’s Status With Respect to Pregnancy* * Relative risks have been adjusted for age and race; † The 6-week period after pregnancy was defined as the 6 weeks after a spontaneous or induced abortion, stillbirth, or live birth; ‡ Subarachnoid hemorrhages (SAHs) have been excluded. During pregnancy or 6 weeks 1.6 (1.0-2.7) 5.6 (3.0-10.5) 2.4 (1.6-3.6) After pregnancy During pregnancy 0.7 (0.3-1.6) 2.5 (1.0-6.4) 1.1 (0.6-2.0) During 6 weeks after pregnancy 5.4 (2.9-10.0) 18.2 (8.7-38.1) 7.9 (5.0-12.7) After delivery 8.7 (4.6-16.7) 28.3 (13.0-61.4) 12.7 (7.8-20.7) After abortion 1.1 (0.2-7.9) 4.5 (0.6-33.1) 1.8 (0.4-7.2) RR of RR of RR of Cerebral Intracerebral Either Type Infarction Hemorrhage of Stroke ‡ Risk Period † (95% CI) (95% CI) (95% CI) Kittner SJ et al. (1996), N Engl J Med 335(11):768-774
37. Postmenopausal Hormones ASA 2006 Secondary Stroke Recs For women with ischemic stroke or TIA, postmenopausal hormone therapy (with estrogen with or without a progestin) is not recommended (Class III, Evidence A).
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39. Estimates of Cumulative Hazards for Strokes in Women’s Health Initiative Study Time (Years) Cumulative Hazard 0.030 0.025 0.020 0 1 2 3 4 5 6 7 0.015 0.010 0.005 0 Estrogen + Progestin Placebo Rossouw et al. JAMA 2002;288(3):321-33