This document provides an overview of hemophilia, including its causes, types, severity, epidemiology, genetics, clinical manifestations, complications, diagnostic evaluation and criteria. Key points include:
- Hemophilia is an inherited bleeding disorder caused by deficiencies in coagulation factors VIII or IX.
- It affects males predominantly and can range from mild to severe based on residual factor activity levels.
- Initial presentations often involve easy bruising, hemarthrosis or bleeding after procedures in infants/children with severe disease.
- Diagnosis involves screening tests like aPTT and factor activity levels, along with family/bleeding history and genetic testing.
- Complications include joint damage, infections and development of factor inhibitors
Understanding of hemophilia increased over years, better understanding now lead us to better comprehensive care for such unfortunate patients. this presentation is derived from the text of world federation of hemophilia and indian academy of pediatrics.
Systemic Diseases and the Eye
Various systemic diseases affect the eye and it's functioning. Here we present those common systemic diseases that are responsible to cause effects in the eye.
What are the diseases that affect eye?
Eye is affected by the following diseases:
Systemic Hypertension (Increased blood pressure of the body)
Diabetes Melitus (Increased blood sugar level)
Systemic Lupus Erythromatosus (SLE)
AIDS and other Venereal Diseases like Syphilis
Sickle Cell Anemia,
Eales Disease and many more.
Look at the slides.
Central Serous Retinopathy is known to be an idiopathic, sporadic, self-limiting collection of fluid at posterior pole which causes mild to moderate visual loss.
Von Willebrand Disease is the most common hereditary bleeding disorder; roughly 1 in every 100 people suffers from the disease. People who suffer from VWD have blood that does not clot properly.
Normally when a person is injured and starts to bleed, the von Willebrand factor in the blood attaches to small blood cells called platelets. This helps the platelets stick together to form a clot at the site of the injury and stop bleeding. When a person has VWD, the clot might take longer to form or not form the way it should and bleeding might take longer to stop. This can lead to heavy, hard-to-stop bleeding. Although rare, the bleeding can be severe enough to damage joints or internal organs, or even be life-threatening.
http://www.nlm.nih.gov/medlineplus/plateletdisorders.html#cat1
http://www.cdc.gov/ncbddd/vwd/facts.html
Ghostdogg productions presents browns syndrome online version 2-1Alistair Hamilton
A general overview and summary of what I think is one of the most intriguing forms of Pediatric Strabismus seen to date. (Note: this presentation was initially made before Alphabet Pattern Strabismus so the transitions are a little off.) Hope you enjoy
Ever wonder what lazy eye means? What is amblyopia? How do you get it? How do you treat it? This presentation will walk you through this functional vision problem so you can understand what lazy eye is and how you can be successfully treated by your developmental optometrist no matter your age.
Understanding of hemophilia increased over years, better understanding now lead us to better comprehensive care for such unfortunate patients. this presentation is derived from the text of world federation of hemophilia and indian academy of pediatrics.
Systemic Diseases and the Eye
Various systemic diseases affect the eye and it's functioning. Here we present those common systemic diseases that are responsible to cause effects in the eye.
What are the diseases that affect eye?
Eye is affected by the following diseases:
Systemic Hypertension (Increased blood pressure of the body)
Diabetes Melitus (Increased blood sugar level)
Systemic Lupus Erythromatosus (SLE)
AIDS and other Venereal Diseases like Syphilis
Sickle Cell Anemia,
Eales Disease and many more.
Look at the slides.
Central Serous Retinopathy is known to be an idiopathic, sporadic, self-limiting collection of fluid at posterior pole which causes mild to moderate visual loss.
Von Willebrand Disease is the most common hereditary bleeding disorder; roughly 1 in every 100 people suffers from the disease. People who suffer from VWD have blood that does not clot properly.
Normally when a person is injured and starts to bleed, the von Willebrand factor in the blood attaches to small blood cells called platelets. This helps the platelets stick together to form a clot at the site of the injury and stop bleeding. When a person has VWD, the clot might take longer to form or not form the way it should and bleeding might take longer to stop. This can lead to heavy, hard-to-stop bleeding. Although rare, the bleeding can be severe enough to damage joints or internal organs, or even be life-threatening.
http://www.nlm.nih.gov/medlineplus/plateletdisorders.html#cat1
http://www.cdc.gov/ncbddd/vwd/facts.html
Ghostdogg productions presents browns syndrome online version 2-1Alistair Hamilton
A general overview and summary of what I think is one of the most intriguing forms of Pediatric Strabismus seen to date. (Note: this presentation was initially made before Alphabet Pattern Strabismus so the transitions are a little off.) Hope you enjoy
Ever wonder what lazy eye means? What is amblyopia? How do you get it? How do you treat it? This presentation will walk you through this functional vision problem so you can understand what lazy eye is and how you can be successfully treated by your developmental optometrist no matter your age.
Factor v deficiency is rare
first described in a Norwegian patient in 1943, Identified by Dr. Paul Owren .
Fewer than 200 cases of congenital factor V deficiency have been reported worldwide since 1943.
inheritance of factor V deficiency is autosomal recessive.
usually only needed for severe bleeds or before surgery.
there is no concentrate containing only factor V.
fresh plasma or (FFP) infusions are used to correct the deficiency temporarily and should be given daily during a bleeding episode.
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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.
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
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.
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!
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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
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.
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.
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2. INTRODUCTION
Hemophilia typically refers to an inherited bleeding disorder caused by deficiency
of coagulation factor
Hemophilia A – Inherited deficiency of factor VIII (factor 8 [F8]); an X-linked
recessive disorder.
Hemophilia B – Inherited deficiency of factor IX (factor 9 [F9]); also called
Christmas disease; an X-linked recessive disorder.
Hemophilia C – Inherited deficiency of factor XI (factor 11); also called
Rosenthal syndrome; an autosomal recessive disorder.
Acquired factor deficiencies – caused by an autoantibody (often to factor VIII)
are sometimes referred to as acquired hemophilia
3. Severity –
based on the residual or baseline factor activity level
this is expressed as a percent of normal or in international units (IU)/Ml.
1) Severe hemophilia – Severe hemophilia is defined as <1 percent factor
activity, which corresponds to <0.01 IU/mL.
2) Moderate hemophilia – Moderate hemophilia is defined as a factor activity
level ≥1 percent of normal and ≤5 percent of normal, corresponding to ≥0.01
and ≤0.05 IU/mL.
3) Mild hemophilia – Mild hemophilia is defined as a factor activity level >5
percent of normal and <40 percent of normal (≥0.05 and <0.40 IU/mL).
4. EPIDEMIOLOGY
Hemophilia affects more than 1.2 million individuals (mostly males)
worldwide .
Hemophilia A – Hemophilia A occurs in approximately 1 in 4000 to 1 in
5000 live male births. Hemophilia A is more common than hemophilia B
and is also more likely to be severe.
Hemophilia B – Hemophilia B occurs in approximately 1 in 15,000 to 1
in 30,000 live male births.
Severe hemophilia is almost exclusively a disease of males, although
females can be affected in some rare cases
Most commonly, hemophilia is inherited ,However, sporadic disease
5. Genetics
The factor VIII gene is located on the X chromosome.
Haemophilia is associated with a range of mutations in the factor VIII gene.
these include major inversions, large deletions and missense, nonsense and
splice site abnormalities.
Sex-linked disorder:-
all daughters of a patient with haemophilia are obligate carriers and they, in turn,
have a 1 in 4 chance of each pregnancy resulting in the birth of an affected male
baby, a normal male baby, a carrier female or a normal female.
Antenatal diagnosis by chorionic villous sampling is possible in families with a
known mutation.
6.
7. CLINICAL MANIFESTATIONS
Disease severity —
Patients with more severe hemophilia are more likely to have
spontaneous bleeding, severe bleeding, and an earlier age of first
bleeding episode begin as early as birth.
Patients with moderate hemophilia often bleed in response to minor
intercurrent injury and invasive procedures. Bleeding is less frequent than
in severe hemophilia and typically occurs four to six times yearly.
Individuals with mild hemophilia generally only have bleeding in response
to injury/trauma or surgery, and bleeding may not become clinically
apparent until later in life.
8. Initial presentation
Age at first bleeding
Most infants with severe hemophilia present within the first year to one
and a half years of life with easy bruising, hemarthrosis, bleeding due
to oral injury, or after an invasive procedure.
Initial site of bleeding
Intracranial bleeding ,
Joints and muscle ,
Epistaxis, oral and gastrointestinal bleeding .
Genitourinary tract Initial site of bleeding
9. Sites of bleeding:-
Infants –central nervous system, extracranial sites such as
cephalohematoma, and sites of medical interventions
including circumcision, heel sticks.
Children –Bruising, joint bleeds, and other sites of
musculoskeletal bleeding become more common once
children begin walking.
Forehead hematomas ("goose-eggs").
Older children and adults – joints, muscles, central
nervous system, and oral or gastrointestinal tract
10.
11. Laboratory findings
Activated partial thromboplastin time (aPTT):-
prolonged, however aPTT may be normal in individuals with
milder factor deficiencies (eg, factor activity level >15 percent).
The platelet count and prothrombin time (PT) are normal in
hemophilia.
Measurement of the factor activity level (factor VIII in hemophilia A;
factor IX in hemophilia B) shows a reduced level compared with
normal controls (generally <40 percent).
The plasma von Willebrand factor antigen (VWF:Ag) is normal in
hemophilia
Urinalysis is not done routinely, but if performed it may sometimes
12. COMPLICATIONS:-
neurologic sequelae of intracranial hemorrhage
joint destruction from repetitive hemarthroses
Rarely pseudotumor
infections transmitted from plasma-derived factor products
(typically viral) and development of antibodies to factor
inhibitors (typically following factor infusions in patients with
severe disease).
13. DIAGNOSTIC EVALUATION
Hemophilia may be suspected in any male with bleeding while a positive
family history is supportive, a negative family history cannot be used as
evidence against the diagnosis, since many cases are sporadic.
Patient and family history
Prior bleeding symptoms should be assessed in patients who are
asymptomatic at the time of the evaluation.
History about all potential hemostatic challenges including menstrual
cycles, dental extractions, trauma, and surgical interventions.
Family history that includes bleeding and prior evaluations of family
members for hemophilia and other bleeding disorders
14. Screening tests
Including the PT, aPTT and platelet count.
PT and platelet count are normal and the aPTT is prolonged in moderate and
severe disease.
Factor activity levels — Factor activity levels should be measured in the
following settings
1. Male patients with a known family history of hemophilia.
2. Patients without a known familial defect who are suspected to have
hemophilia based on clinical history and/or a prolonged aPTT that corrects in
mixing studies.
3. Females identified as carriers by genetic testing, or females who potentially
may be carriers for whom genetic testing is not available.
15. Genetic testing —
predict the risk of inhibitor formation in the patient.
facilitates carrier identification in female family members.
16. Diagnostic criteria
Hemophilia A –
factor VIII activity level below 40 percent of normal (below
0.40 international units [IU]/mL), or,
In some circumstances where the factor VIII activity level is
≥40 percent, a pathogenic factor VIII gene mutation.
A normal VWF antigen (VWF:Ag) should also be documented
to eliminate of the possibility of some forms of VWD
17. Hemophilia B –
factor IX activity level below 40 percent of normal, or
In some circumstances where the factor IX activity level is ≥40 percent, a
pathogenic factor IX gene mutation.
Hemophilia carrier –
requires identification of a hemophilia gene mutation.
Factor levels are important for managing carriers, but are not optimal for
determining or eliminating the diagnosis of a hemophilia