This document provides an overview of common headache types and considerations for their evaluation and diagnosis. It discusses key factors such as duration, location, and aggravating/relieving factors that can help determine the underlying cause. Primary headache types like migraine, tension, and cluster headaches are described. Red flags indicating potential serious conditions are outlined. Secondary headache etiologies like tumors, meningitis, and subarachnoid hemorrhage are also reviewed.
This course classifies the various types of headaches, many of which are mistakenly called migraine. Various types of treatments, specific to a properly diagnosed headache, are listed.
This course classifies the various types of headaches, many of which are mistakenly called migraine. Various types of treatments, specific to a properly diagnosed headache, are listed.
Headache Attributed to Nonvascular, Noninfectious
Intracranial Disorders
Headache Attributed to Trauma or Injury to the Head
and/or Neck
Headache Attributed to Infection
Headache Attributed to Cranial or Cervical Vascular
Disorders
Headache Associated with Disorders of Homeostasis
Headache Caused by Disorders of the Cranium, Neck,
Eyes, Ears, Nose, Sinuses, Teeth, Mouth, or Other
Facial or Cranial Structures
Headaches and the Cervical Spine
Migraine
Chronic Daily Headache
Cluster Headache
Other Trigeminal Autonomic Cephalalgias
Other Primary Headaches
Headache Attributed to Nonvascular, Noninfectious
Intracranial Disorders
Headache Attributed to Trauma or Injury to the Head
and/or Neck
Headache Attributed to Infection
Headache Attributed to Cranial or Cervical Vascular
Disorders
Headache Associated with Disorders of Homeostasis
Headache Caused by Disorders of the Cranium, Neck,
Eyes, Ears, Nose, Sinuses, Teeth, Mouth, or Other
Facial or Cranial Structures
Headaches and the Cervical Spine
Migraine
Chronic Daily Headache
Cluster Headache
Other Trigeminal Autonomic Cephalalgias
Other Primary Headaches
Facial pain is pain felt in any part of the face, including the mouth and eyes.
It’s normally due to an injury or a headache, occasionally facial pain may also be due to neurological or vascular causes, but equally well may be dental in origin.
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.
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.
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.
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.
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
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
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
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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.
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2. General conciderations : _ Headache is one of the most common neurological problems, in which the careful analysis of the details of history is particularly important. _ Duration of the headache may give clear idea of the seriousness of the und- erlying disease . _ sudden headache for the first time may be due to meningitis, intracranial hemorrhage, subarachnoid hemorrhage . _ Headache for years usually is psychogenic . _ Headache for weeks or months may suggest a progressive or an expanding intracranial lesion& require careful investigation. _ Pain sensitive structures both inside and outside the head receive their sensory innervation from the tigeminal, glossopharangeal and vagus nerves or from the upper three cervical nerves
3. General conciderations : cont. _If the headache is due to a lesion above tentorium pain is felt at the distribution of ophthalmic division of trigeminal nerve. _If the lesion is below tentorium the pain is referred to distribution of upper three cervical nerves or ninth or tenth cranial nerves _ the duration and frequency are important when the headache is periodic or recurrent, migraine may occur at regular intervals or confined to certain times, at premenstrual period and may be absent during pregnancy. _ Aggravating factors are important, headache of increased intracra- nial pressure is aggravated by change in posture or sudden movement also in vascular and post-concussional headache
4. General conciderations : cont. _Certain food, cheese , chocolate and hypoglycemia may bring on migraine, while rest will generally relieve vascular headache. _ The quality of pain also helpful, in migraine is throbbing, but in migrainous neuralgia may take the form of severe boring pain, while in tension headache is dull, pressing and band-like.
7. Character of pain Duration Location Comment Ice pick Stabbing Very brief (split-second) Variable, usually temporal or parietal Benign, more common in migraine Ice cream Sharp, severe 30-120 seconds Bitemporal/occipital Obvious trigger by cold stimuli Exertional/coital Bursting, thunderclap Severe for minutes then less severe for hours Generalised Subarachnoid haemorrhage needs exclusion Cough Bursting Seconds to minutes Occipital or generalised Intracranial pathology needs exclusion (especially cranio-cervical junction) Cluster headache (migrainous neuralgia) Severe unilateral, with ptosis, tearing, conjunctival injection, unilateral nasal congestion 30-90 minutes 1-3 times per day Periorbital Usually men, occurring in clusters over weeks/months Chronic paroxysmal hemicrania Severe unilateral with cluster headache-like autonomic features (above) 5-20 minutes, frequently through day Periorbital/temporal Usually women, responds to indometacin SUNCT* Severe, sharp, triggered by touch or neck movements 15-120 seconds, repetitive through day Periorbital May respond to carbamazepine
27. Tension headache _Its common, usually described as severe, continuous as sense of pressure or tightness rather than pain, usually on the vault or less frequently occipito-frontal and usually bilateral
28. Migraine _ migraine is very common and a wide variety of atypical and partial forms are seen. _ usually start at adolescence as recurrent headache lasting 2 hs to 2 days. _ the pain is usually unilateral associated with photophobia, nausea and vomiting. _ Many patients experience an aura before the pain usually visual disturbance as flashing lights, scotomata, or even hemianopia, paraesthesiae may occur around the angle of the mouth or in the hand.
29.
30. Tension type headache: diagnostic criteria A.At least 10 previous headache episodes meeting criteria B to D B.Lasting from 30 minutes to 7 days C. At least 2 of the following pain characteristics 1. Pressing/tightening (nonpulsating) quality 2. Mild or moderate intensity 3. Bilateral location 4. No aggravation by walking stairs D. Absence of both of the following 1. Nausea and vomiting 2. Photophobia and phonophobia
31. Tension type headache: diagnostic criteria Occasional TTH is seldom disabling (unlike chronic TTH) Both TTH and migraine are aggravated by stress (so can be hard to differentiate) Headache more often than once a week may be a mixture of TTH and migraine Successful management is dependent on recognition and management of each separate headache type
32.
33. Cluster headache: diagnostic criteria Formerly known as migrainous neuralgia Generally affects men (ratio 6:1), often smokers, in their 20s or older Typically occurs in bouts for 6-12 weeks every one or two years Attacks typically occur at night, waking the patient 1 to 2 hours after falling asleep, lasting 30 to 60 minutes Pain is intense, probably as severe as renal colic, and strictly unilateral
36. Cluster headache _Its much less common than migraine and more in males, onset usually at third decade. _Characterized by severe periodic unilateral periorbital pain with conjunctival injection, unilateral lacrimation, nasal congestion and partial horner`s syndrome _The pain is brief last 30-90 minutes. _ usually occur at early morning for weeks disappear for months followed by another cluster.
39. Headache of raised intracranial pressure : Cont. _Usually due to space occupying lesions, brain tumor, abscess, or haematoma. _Other causes of raised intracranial pressure, viral encephalitis, lead encephalopathy and malignant hypertension. _Severe headache occurs in meningeal irritation as in meningitis and subarachnoid haemorrhage which are associated with vomiting and neck rigidity.
42. Coital and exercise-induced headache _Usually middle-aged men develop sudden, severe headache at the climax of sexual intercourse last for 10-15 minutes, a milder headache may persist for few hours. _A similar headache may occur after unaccustommed exertion in unfit person.
43. Facial pain _Most patients with persisting facial pain have, trigeminal neuralgia, atypical facial pain or post-herpetic neuralgia. _ Trigeminal neuralgia causes very sharp lancinating pains in one division of trigeminal nerve in middle-aged and elderly patients the pain is severe, brief and repetitive make the patient to flinch. _Atypical facial pain is continuous and unremitting, centered over the maxilla most frequently on left side in middle-aged women. _ Post-herpetic neuralgia is continuous, felt as burning at affected territory which is sensitive to light touch and there is history of Herpes zoster.
44. HEADACHES IN OLD AGE Prevalence : less common in those aged over 60 years than in younger people. Common causes: trigeminal neuralgia, temporal arteritis and post-herpetic neuralgia, which occur rarely in younger patients. Migraine and tension headache: less common than in younger people. Raised intracranial pressure: not always associated with headache, vomiting or papilloedema because intracranial mass lesions can reach larger sizes before presentation, as the involutional process that occurs in ageing brains allows the accommodation of an expanding lesion more easily than in younger patients.