This document discusses hemorrhoids, including their epidemiology, anatomy, pathogenesis, grading system, diagnosis, and management approaches. Hemorrhoids affect 4.4% of people in the US and are cushions in the anal canal that can become enlarged and symptomatic. Risk factors include lack of fiber, straining, and pregnancy. Grades I and II hemorrhoids can often be managed conservatively while grades III and IV may require procedures like rubber band ligation, injections, or surgery.
Cysts of the mesentery are among surgical rarities and of varied aetiology with variable presentations and
this has surgical implications in the pediatric age group. They may be derived from the gastrointestinal
tract, the genitourinary system, previous inflammation (pseudocysts) or malignant cystic tumours, but the
commonest cause is generally considered to be a congenital lymphatic cyst. The clinical presentation is not
characteristic and in addition, the preoperative imaging although suggestive is not diagnostic. In most
cases, the diagnosis is confirmed after surgical exploration and removal of the cyst. A case report of a
baby aged 6 months is being reported. Hope that this information will reinforce the diagnostic and
treatment strategy
Cysts of the mesentery are among surgical rarities and of varied aetiology with variable presentations and
this has surgical implications in the pediatric age group. They may be derived from the gastrointestinal
tract, the genitourinary system, previous inflammation (pseudocysts) or malignant cystic tumours, but the
commonest cause is generally considered to be a congenital lymphatic cyst. The clinical presentation is not
characteristic and in addition, the preoperative imaging although suggestive is not diagnostic. In most
cases, the diagnosis is confirmed after surgical exploration and removal of the cyst. A case report of a
baby aged 6 months is being reported. Hope that this information will reinforce the diagnostic and
treatment strategy
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Varicose veins during pregnancy, diagnosis, and treatmentRustem Celami
Roland Hasa, M.D., Radiology; Rustem Celami, M.D., Ph.D., Ob Gyn; Prof. Dr. Krenar Preza, Radiology; Anton Milo, M.D., Ob Gyn; Myzafer Kaçi, M.D. Ph.D. Surgery
Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Abstract Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Syringoma is a benign eccrine sweat gland tumor affecting mostly
females at puberty projected with multiple soft papules usually 1-2
mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter,
as a benign eccrine sweat gland tumor. The sites of predilection are
lower eyelids, and cheeks. The regions of tendency are cheeks and
lower eyelids. Syringoma of the vulvar is a rare disorder few cases
of which have been reported in literature.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Varicose veins during pregnancy, diagnosis, and treatmentRustem Celami
Roland Hasa, M.D., Radiology; Rustem Celami, M.D., Ph.D., Ob Gyn; Prof. Dr. Krenar Preza, Radiology; Anton Milo, M.D., Ob Gyn; Myzafer Kaçi, M.D. Ph.D. Surgery
Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Abstract Syringoma is a benign eccrine sweat gland tumor affecting mostly females at puberty projected with multiple soft papules usually 1-2 mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter, as a benign eccrine sweat gland tumor. The sites of predilection are lower eyelids, and cheeks. The regions of tendency are cheeks and lower eyelids. Syringoma of the vulvar is a rare disorder few cases of which have been reported in literature.
Syringoma is a benign eccrine sweat gland tumor affecting mostly
females at puberty projected with multiple soft papules usually 1-2
mm in diameter. During puberty, syringoma appears among females; it is presented as multiple soft papules, 1-2 mm in diameter,
as a benign eccrine sweat gland tumor. The sites of predilection are
lower eyelids, and cheeks. The regions of tendency are cheeks and
lower eyelids. Syringoma of the vulvar is a rare disorder few cases
of which have been reported in literature.
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.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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.
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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
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.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
NVBDCP.pptx Nation vector borne disease control program
hemorrhoides.ppt
1. Sunday, May
14, 2023
1
Hemorrhoids
DR. HIWA OMER AHMED
PROFESSOR IN GENERAL AND BARIATRIC SURGERY
UNIVERSITY OF SULAIMANI
COLLEGE OF MEDICINE – SULAIMANI CITY- KURDISTAN
2. Sunday, May
14, 2023
2
Epidemiology
The exact prevalence of symptomatic hemorrhoids is very difficult to
establish, because
1. many sufferers do not seek care for their problems
2. rely on over-the-counter remedies
3. others attribute other anorectal symptoms as being a result of
hemorrhoids.
Thus, epidemiologic data can vary widely. Estimates of the prevalence of
symptomatic hemorrhoid disease in the United States range from 10
million people, a 4.4% prevalence rate.
A recent prospective study of screening colonoscopy patients revealed
the presence of hemorrhoids in 38.9%, with 44.7% of those patients
suffering from hemorrhoidal symptoms.
3. Sunday, May
14, 2023
3
anatomy
The rectum extends from the terminal sigmoid colon to the anus,
lined by columnar epithelial mucosa innervated by the sympathetic and
parasympathetic nervous systems, and consequently is relatively
insensate.
Its vascular and lymphatic supplies originate from the hypogastric
system.
The anal canal, which is approximately 4 cm in length, extends from the
anal verge to its junction with the rectum close to the proximal aspect of
the levator-sphincteric complex.
Unlike the rectum, the anus is lined by anoderm, which is a modified and
sensitive squamous epithelium richly innervated with somatic sensory
nerves, and supplied by the inferior hemorrhoidal system.
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14, 2023
4
The dentate line is the point at which the squamous anoderm
meets the columnar mucosa and typically lies about 3 cm above
the anal verge
The dentate line is the major anatomic reference point when
considering the treatment of hemorrhoids.
Internal hemorrhoids are cushions of fibrovascular tissue located
just proximal to the dentate line,
The external hemorrhoidal cushions lying distal to it.
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14, 2023
6
Hemorrhoid cushions
the submucosa in the area of the anal canal formed a discontinuous
layer of thickened tissue, creating “cushions” typically found in the left
lateral, right anterior, and right posterior positions, although there are
frequent anatomic variations of this arrangement. 3, 7, and 11 oclock.
These cushions receive their blood supply primarily from the superior
hemorrhoidal artery as well as branches of the middle hemorrhoidal
arteries; however, there is some communication with the inferior
hemorrhoidal arteries as well. The venous drainage is provided by the
superior, middle, and inferior hemorrhoidal vessels, allowing for
communication between the portal and systemic circulations.
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14, 2023
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These vessels form direct arteriovenous communications within the
cushions, and for these reasons, hemorrhoidal bleeding is arterial in
nature rather than venous.
The submucosal layer of these cushions contains not only the vessels
mentioned above but is also rich in muscular fibers, which arise from both
the internal sphincter and the conjoined longitudinal muscle.
These muscular fibers (the muscularis submucosae) help to maintain
adherence of these tissues to the underlying internal sphincter.
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14, 2023
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The hemorrhoidal cushions are considered to play an important
role in
1. The maintenance of rectal continence, contributing 15%–20% of
the resting pressure of the anal verge.
2. They also work to protect the sphincter mechanism during
defecation,
3. Providing complete closure of the anal opening, especially while
performing a Valsalva maneuver.
9. Sunday, May
14, 2023
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The pathogenesis
“all etiologic factors work toward stretching and slippage of the
hemorrhoidal tissue.” As the supporting tissue of the anal cushions
weakens, downward displacement of the cushions can occur, causing
venous dilation and prolapse.
1 .Deterioration of the anchoring connective tissue, as described by
Thomson.
2. Downward displacement or prolapse of the hemorrhoidal tissue.
3. Abnormal distention of the arteriovenous anastomoses within the
cushions.
4. Abnormal dilatation of the veins of the internal hemorrhoidal venous
plexus.
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14, 2023
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Risk factors
Any number of possible contributing factors leading to migration of the
hemorrhoidal cushions has been suggested, including
1. lack of dietary fiber
2. chronic straining
3. spending excess time on the commode
4. Constipation
5. Diarrhea
6. Pregnancy
7. sedentary lifestyle
8. family history.
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14, 2023
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Bleeding
1. Hemorrhoids are arteriovenous plexuses, so the bleeding is typically bright
red in color.
Blood that is darker in color suggests other, more proximal sources.
Bleeding can be identified on the toilet paper or in the toilet bowl,
2 Is typically not mixed with stool, can drip or squirt out
3. Can be exacerbated by straining.
4. Hemorrhoids typically do not cause a positive Hemoccult test by
themselves.
12. Sunday, May
14, 2023
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Grades Findings
I Nonprolapsing internal
hemorrhoids
II Internal hemorrhoids prolapse
during defecation, spontaneously
reduce
III Internal hemorrhoids prolapse
during defecation, must be
manually reduced
IV Internal hemorrhoids prolapsed
and incarcerated
15. Sunday, May
14, 2023
15
Dx
Clinical
Anoscopy: It is the most
accurate method for examining
the anal canal and the distal-
most rectum.
Flexible Sigmoidoscopy and
Colonoscopy
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Managements
first degree
Conservative (Medical) Treatment
Dietary and behavioral modifications are typically among
the first-line recommendations made to patients with
most anorectal disorders, including those with
hemorrhoids.
Lubricants
Laxatives
21. Sunday, May
14, 2023
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5. Lord's procedure
Lord recommended manual stretching of the anus to
decrease sphincter pressure
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Surgery
1. Grade III hemorrhoids unresponsive to nonsurgical
approaches
2. Grade IV hemorrhoids
3. Large external hemorrhoids or combined internal and
external components
4. Concomitant anorectal pathology.