I have listed out the LE cells structure and Microscopical examinaton of LE CELLS, Difference between tart cells and le cells, clinical symptoms and diagnostic procedure.
processing of bone marrow trephine biopsykanwalpreet15
there is no standard method for processing of bone marrow trephine biopsies. there are various fixatives and decalcifying agents . depending upon need of IHC and cytogenetics, we can decide
This presentation in mainly focused of understanding of automation and its utility in cytopathology. It will be very usefull for postgraduate in pathology, cytopathologist and cytotechnicians.
cytology of urine tract - this slide contains the specimen collection method, preparation of specimen, types of fixatives, other preparation techniques, urinary tract histology, normal urinary tract cytology,
I have listed out the LE cells structure and Microscopical examinaton of LE CELLS, Difference between tart cells and le cells, clinical symptoms and diagnostic procedure.
processing of bone marrow trephine biopsykanwalpreet15
there is no standard method for processing of bone marrow trephine biopsies. there are various fixatives and decalcifying agents . depending upon need of IHC and cytogenetics, we can decide
This presentation in mainly focused of understanding of automation and its utility in cytopathology. It will be very usefull for postgraduate in pathology, cytopathologist and cytotechnicians.
cytology of urine tract - this slide contains the specimen collection method, preparation of specimen, types of fixatives, other preparation techniques, urinary tract histology, normal urinary tract cytology,
Anemia can be seen in the emergency department both as a primary pathological process or secondary to both medical and surgical diseases. Moreover, acute anemia can occur in children who have been otherwise healthy, who have systemic disease, or who have known hematologic disorders. Anemia may indicate a disorder with a single hematopoietic cell line (eg, red blood cells) or may be associated with changes in multiple cell lines indicative of bone marrow involvement, immunologic disease, peripheral destruction of erythrocytes, or sequestration of cells. Independent of the etiology, prompt diagnosis is predicated on understanding the classifications of anemia, the associated presenting symptoms, and the proper ordering and interpretation of laboratory studies. This article will discuss the evaluation, proper classification, differential diagnosis, and initial management of acute anemia using cases representative of those that might be seen in the pediatric emergency department.
Anemia is one of the most commonly seen condition predominantly in women due to various causes such as some chronic infection conditions and all. There are different types of anemias are there here we discuss mainly about Iron deficiency and sickle cell anemia.
Anticoagulation in patients with liver cirrhosis copyM Soliman
Presentation on Anticoagulation in patients with liver cirrhosis
including normal physiology of hemostasis, the role of the liver in hemostasis, effect of liver cirrhosis in hemostatic system and indication and use of anticoagulant in portal vein thrombosis & DVT
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.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
2. 2
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Anaemia of chronic disorders (ACD)
Many of the anaemias seen in clinical practice
occur in patents with systemic disorders and are the
result of a number of contributing factors.
It occurs in patients with a variety of chronic
inflammatory (infectious and non-infectious) and
malignant diseases.
Usually, both the erythrocyte sedimentation rate
(ESR) and C-reactive protein (CRP) are raised.
It may be complicated by additional features.
3. 3
+
The pathogenesis
Appears to be related to:
1. The decreased release of iron from macrophages to
plasma and so to erythroblasts.
2. Reduced red cell lifespan
3. Inadequate erythropoietin response to anaemia.
4. Increased levels of various cytokines, especially IL-l, IL-
6 and tumour necrosis factor (TNF-increases apoptosis
of bone marrow erythroid cells.) will reduce
erythropoietin secretion.
4. 4
+
The anaemia is corrected by the successful treatment
of the underlying disease.
It does not respond to iron therapy despite the low serum
iron.
Responses to recombinant erythropoietin therapy may
be obtained (e,g. in rheumatoid arthritis or cancer).
In many conditions the anaemia is complicated by anaemia
from other causes (e.g. iron or folate deficiency, renal
failure, bone marrow infiltration, hypersplenism or
endocrine abnormality).
5. 5
+
Serum iron
The fall in serum iron results from an impaired
flow of iron from cells (including intestinal
mucosal cells, hepatocytes and macrophages) to
plasma.
This is due to increased secretion of hepcidin by
hepatocytes in response to inflammation.
Hepcidin inhibits release of iron from
macrophages and iron absorption
6. 6
+
Ferritin and transferin
A fall in serum transferrin and a rise in serum
ferritin occur as part of the acute-phase response.
Increased lactoferrin, occurring in response to
inflammation and mediated by cytokines,
competes with transferrin for iron and forms a
complex, which is taken up by macrophages in the
liver and spleen.
8. 8
+
Anaemia of malignant diseases
Contributing factors include:
Anaemia of chronic disorders
Blood loss
Iron deficiency
Marrow infiltration (often associated with a leucoerythroblastic
picture)
Folate deficiency
Haemolysis
Marrow suppression from radiotherapy or chemotherapy
9. 9
+
Microangiopathic haemolytic anaemia occurs with
mucin-secreting adenocarcinoma particularly of the
stomach, lung and breast.
Autoimmune haemolytic anaemia with malignant
lymphoma, CLL and rarely with other tumours.
There is also an association of pernicious anaemia with
carcinoma of the stomach
10. 10
+
The anaemia of malignant disease may
respond partly to erythropoietin.
Folic acid should only be given if there is
definite megaloblastic anaemia caused by the
deficiency; it might 'feed' the tumour.
11. 11
Peripheral blood film in metastatic mucin-secreting adenocarcinoma of
the stomach showing red cell polycrmasia and fragmentation and
thrombocytopenia, The patient had disseminated intravascular
coagulation,
13. 13
+
White cell changes
Leukaemoid reactions may occur with tumours
showing widespread necrosis and inflammation.
Hodgkin's disease is associated with a variety
of white cell abnormalities including
eosinophilia, monocytosis and leucopenia.
In non-Hodgkin's lymphoma, malignant cells
may circulate in the blood
14. 14
+
Haemostatic abnormalities
Patients with malignant disease may show either
thrombocytosis or thrombocytopenia.
Disseminated tumours, particularly mucin-secreting
adenocarcinomas, are associated with DIC and
generalized haemostatic failure.
Activation of fibrinolysis occurs in some patients
with carcinoma of the prostate.
Occasional patients with malignant disease have
spontaneous bruising or bleeding caused by an
acquired inhibitor of one or other coagulation factor,
most frequently factor VIII, or to a paraprotein
interfering with platelet function.
15. 15
+
Cancer patients have a high incidence (estimated at 15%) of
venous thromboembolism.
This is increased by surgery and some drugs
It is most common in ovarian, brain, pancreatic and colon
cancers.
It may be difficult to manage with oral anticoagulation because of
bleeding, interruptions with chemotherapy an thrombocytopenia,
anorexia or vomiting.
Liver disease and drug interactions can cause further
complications so daily low molecular weight heparin injections
may be preferable to warfarin.
16. 16
+
Rheumatoid arthritis
In patients with rheumatoid arthritis, the
anaemia of chronic disorders is proportional to
the severity of the disease.
It is complicated in some patients by iron
deficiency caused by gastrointestinal bleeding
related to therapy with salicylates, non-
steroidal anti-inflammatory agents or
corticosteroid.
Bleeding into inflamed joints may also be a
factor.
17. 17
+
Systemic lupus erythromatosus (SLE)
In systemic lupus erythematosus (SLE) there may be
anaemia of chronic disorders
50% of patients are leucopenic with reduced
neutrophil and lymphocyte counts
Renal impairment and drug-induced gastrointestinal
blood loss also contribute to the anaemia.
Autoimmune haemolytic anaemia occurs in 5% of
patients
There may be autoimmune thrombocytopenia also in
5% of patients.
18. 18
+
The lupus anticoagulant interferes with blood
coagulation by altering the binding of coagulation
factors to platelet phospholipid and predisposes to
both arterial and venous thrombosis and
recurrent abortions.
Tests for antinuclear factor (ANF) and anti-DNA
antibodies are usually positive.
19. 19
+
Anaemia of chronic renal failure
A normocytic normochromic anaemia is
present in most patients with chronic
renal failure.
Generally, there is a 2 g/dL fall in
haemoglobin level for every 10 mmol/L
rise in blood urea.
There is impaired red cell production as a
result of defective erythropoietin
secretion.
20. 20
+
Uraemic serum has also been shown to contain
factors that inhibit proliferation of erythroid
progenitors.
Variable shortening of red cell lifespan occurs
In severe uraemia the red cells show
abnormalities including acanthocytosis and burr
cells.
22. 22
+
Increased red cell 2,3-DPG levels in response to the
anaemia result in decreased oxygen affinity and a shift of
the haemoglobin oxygen dissociation curve to the right.
Hyperphosphataemia result in decreased oxygen affinity
and a shift of the haemoglobin oxygen dissociation
curve to the right.
The patient's symptoms are therefore relatively mild for
the degree of anaemia.
Patients with polycystic kidneys usually have retained
erythropoietin production and may have less severe
anaemia for the degree of renal failure.
23. 23
+
Other contributory factors
Bone marrow suppression secondary to
uraemia
↓ RBCs survival
Uraemia cause platelets dysfunction
leading to anaemia secondary to blood
loss
Iron, folate loss during dialysis →
anemia
Aluminum toxicity
24. 24
+
Erythropoietin therapy has been found to
correct the anaemia in patients on dialysis or in
chronic renal failure, providing that iron and folate
deficiency have been corrected.
The dosage of erythropoietin usually required is
50-150 units/kg three times a week intravenously
or by subcutaneous infusion.
A poor response to erythropoietin suggests
iron or folate deficiency, infection, aluminium
toxicity (inhibits erythropoiesis) .
25. 25
Peripheral blood film in chronic renal failure showing red cell acanthocytosis
and numerous burr' cells.
26. 26
+
Platelet and coagulation
abnormalities
Platelets dysfunction occur in CRF secondary to
uraemia
HUS & TTP are associated with thrombocytopenia
Nephrotic syndrome is associated with thrombosis.
27. 27
+
Immune complex-mediated thrombocytopenia
Occurs in some patients with acute nephritis and
also following renal allografts.
Renal allografts may also lead to polycythaemia in
10-15%of patients.
28. 28
+
chronic liver disease is associated with anaemia that is
mildly macrocytic and often accompanied by target cells,
mainly as a result of increased cholesterol in the
membrane.
Contributing factors to the anaemia may include blood
loss (e.g. bleeding varices) with iron deficiency,
dietary folate deficiency and direct suppression of
haemopoiesis by alcohol.
Alcohol may have an inhibiting effect on folate
metabolism and is occasionally associated with (ring)
sideroblastic changes which disappear when alcohol is
withdrawn.
29. 29
+
Haemolytic anaemia may occur in patients with alcohol
intoxication
autoimmune haemolytic anaemia is found in some
patients with chronic immune hepatitis.
Haemolysis may also occur in end-stage liver disease
because of abnormal red cell membranes resulting
from lipid changes.
Viral hepatitis (usually non-A, non-B, non-C) is
associated with aplastic anaemia.
30. 30
+
Coagulation abnormalities
The acquired coagulation abnormalities
associated with liver disease are:
Deficiencies of vitamin K-dependent factors and, in severe
disease of factor V and fibrinogen.
Abnormalities of platelet function may also be present.
Dysfibrinogenaemia with abnormal fibrin polymerization may
occur .
A consumptive coagulopathy may be superimposed.
31. 31
+
Hypothyroidism
T3 and T4 potentiate the action of erythropoietin
A moderate anaemia is usual and may be caused
by lack of thyroxine.
There is also a reduced oxygen need and thus
reduced erythropoietin secretion.
32. 32
+
The anaemia is often macrocytic and the mean
corpuscular volume (MCV) falls with thyroxine
therapy.
Autoimmune thyroid disease, especially
myxoedema or Hashimoto's disease, is
associated with pernicious anaemia.
Iron deficiency may also be present, particularly
in women with menorrhagia.