This document summarizes haemoglobinopathies, genetic blood disorders caused by abnormal hemoglobin. It discusses sickle cell anemia and thalassemias. Sickle cell anemia is caused by a qualitative hemoglobin defect while thalassemias are quantitative defects. The document covers prevalence, pathophysiology, clinical manifestations, treatment including blood transfusions, and preventative measures for these conditions. Electrophoresis is described as a method to separate and identify hemoglobin variants.
My presentation in the "CME on Sickle Cell Disease" at Government Medical College, Akola, Maharashtra, India on 19th December 2012 organized by MMC-CME Committee of GMC, Akola and the Department of Pediatrics, GMC, Akola.
My presentation in the "CME on Sickle Cell Disease" at Government Medical College, Akola, Maharashtra, India on 19th December 2012 organized by MMC-CME Committee of GMC, Akola and the Department of Pediatrics, GMC, Akola.
Sickle cell Anemia: A worldwide popular blood disorder, basically a inheritable disease. This document provides you with basic introduction to blood, Anemia its general considerations, signs and symptoms and lastly about Sickle cell Anemia in detail.
As long as knowledge on inherence, diagnosis and preventive measures are limited to very few people, it is difficult to control the spread of the genetic anomaly in our population. Apart from lack of comprehensive knowledge, The findings in this study showed a high level of general awareness about the existence of SCD but comprehensive knowledge about the cause and prevention was low and associated with vast misconceptions. A large percentage did not see its importance in influencing their marital decisions. Perhaps simple interventions that worked in the western countries can also work in India.
Sickle cell Anemia: A worldwide popular blood disorder, basically a inheritable disease. This document provides you with basic introduction to blood, Anemia its general considerations, signs and symptoms and lastly about Sickle cell Anemia in detail.
As long as knowledge on inherence, diagnosis and preventive measures are limited to very few people, it is difficult to control the spread of the genetic anomaly in our population. Apart from lack of comprehensive knowledge, The findings in this study showed a high level of general awareness about the existence of SCD but comprehensive knowledge about the cause and prevention was low and associated with vast misconceptions. A large percentage did not see its importance in influencing their marital decisions. Perhaps simple interventions that worked in the western countries can also work in India.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
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.
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
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
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
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.
2. TOPICS
Definition and history
Prevalence
Pathophysiology- 1.Sickle Cell Anaemia
2.Thalassemia syndromes
Haemoglobin Electrophoresis
Treatment
3. DEFINITION
Haemoglobinopathies are a group of genetic
disorders caused by production of structurally
abnormal hemoglobin molecule , synthesis of
insufficient quantities of normal hemoglobin , or,
rarely both.
Sickle cell anemia (Hb S )(Qualitative defect)
Thalassemias (Quantitative defect)
9. PATHOPHYSIOLOGY
SS cells may look normal
when fully oxygenated ;
sickling occurs when O
decreased.
Other causes of sickling
include decrease in pH and
dehydration of patient.
Cells become rigid , impeding
blood flow to tissues. Tissue
death , organ infarction and
pain results.
Sickling is reversible upto a
point.
Have both extravascular
hemolysis and intravascular
hemolysis.
17. CLINICAL MANIFESTATIONS
Ø Fever and bacteremia- it is a medical emergency ,
requiring prompt medical evaluation and delivery
of antibiotics– 3rd gen Cephalosporin.
Ø Dactylitis (hand foot syndrome )is first
manifestation of pain in children , ocurring in 50%
of children by 2nd yr. --- pain medications whereas
osteomyelitis requires 4-6weeks of antibiotics.
18. Ø Splenic sequestration---early intervention and
maintainence of hemodynamic stability using
isotonic saline or blood transfusion.
Ø Pain- most commonly in chest, abdomen or
extremities, caused d/t tissue ischemia in
microvasculature .
Ø Lung diseases- 2nd m/c cause of hospital
admission.– acute chest syndrome.
20. There are 3 types of crisis
1. Aplastic crisis- associated with infections which
causes temporary suppression of erythropoises.
2. Hemolytic crisis- results in exaggerated anemia.
3. Vaso-occlusive crisis- associated with severe
pain. Hallmark symptom of sickle cell anemia.
21. CLINICAL MANIFESTATIONS
Infants with sickle cell anemia have abnormal
immune functions and , as early as 6 months of
age, may have functional asplenia.- all by 5 yrs.
Bacterial sepsis is one of the greatest causes for
morbidity and mortality in this patient
population.
22. Regardless of age , all patients with sickle cell
anemia are at increased risk of infection and
death from bacterial infection , particularly
encapsulated such as streptococcus pneumoniae
and hemophilus influenzae type b.
23. TREATMENT
Ø Blood transfusion
Ø Supplemental oxygen
Ø Emperical antibiotics
(cephalosporins and
macrolides)
Ø Bronchodilators and
steroids for patients
with asthma.
Ø Optimum pain control
and fluid management.
24. ELECTROPHORESIS
Electrophoresis is a
comprehensive term that
refers to migration of
charged solutes or
particles of any size in a
liquid medium under the
influence of electric field.
Tiselius was awarded a
nobel prize in 1948 for his
work on protein separation
by electrophoresis.
27. PREVENTIVE CARE
Ø All children require prophylaxis with penicillin or
amoxicillin upto 5 years.
Ø Immunization with pneumococcal ,
meningococcal and hemophilus influenza B
vaccine.
Ø Lifelong folate supplementation
Ø Regularly screening for development of gallstones.
Ø Genetic counselling and testing should be offered
to family.
28.
29.
30. METHEMOGLOBINEMIA
Normal hemoglobin can be oxidised to
methemoglobin.
It occurs because of either increased production
of oxidised hemoglobin because of exposure to
enviromental agents or diminished reduction of
of oxidised hemoglobin because of underlying
germ line mutations.
31. Toxic methhemoglobinemia-sulfonamides, lidocaine
and other aniline derivates, and nitrites. -----
Treatment- 1-2 mg/KgBw of methylene blue I/V , over
a period of 5 mins
Cytochrome b5 reductase deficiency
Hereditary methhemoglobinemia can be treated by
ascorbic acid 300-600mg daily divided into 3-4 doses.
32.
33.
34. TYPES OF THALASSEMIAS
Ø Alpha thalassemia silent alpha
thalassemia trait hemoglobin H
disease alpha thalassemia
Major(Hydrops fetalis)
Ø beta thalassemia minor beta thalassemia
intermedia beta thalassemia major .
35.
36.
37. HEMOGLOBIN BART’S HYDROPS
FETALIS
Ø Most severe form .
Ø Incompatible with life
Ø Having no functioning
alpha gene.(--/--)
Ø Baby born with hydrops
fetalis , is edematous
and shows ascitis
caused by accumulation
serous fluid in fetal
tissues as a result of
severe anemia.
Ø Hepatosplenomegaly
and cardiomegaly.
38.
39. BETA THALASSEMIA MAJOR
Ø Characterized by
microcytic
hypochromic anemia
with extreme
poikilocytosis .
Ø Detected early in
childhood– failure to
thrive, pale, jaundice,
abdominal
enlargement and
hepatospenomegaly.
Ø Hb level- 4-8g/dl
40. Ø Severe anemia causes
marked bone changes
due to expansion of
marrow space for
increased
erythropoieses.
Ø Failure to thrive and
die young are 2
hallmarks.
42. MANAGEMENT
Ø Hematopoietic stem cell transplantation.
Ø Blood transfusion
Ø Chelation therapy
The optimal time to start chelation is 1-2 years
post transfusion (ferritin level- 1000-1500μg/L)---
- deferoxime , deferiprone
Ø Hydroxyurea-
15-20mg/kg/day used to increase HbF production
and reduce the need for transfusion support.