Holistic health requires a total stress management approach for well-being. Dr. Shriniwas Kashalikar emphasizes that stress management is essential for holistic health, which leads to global welfare and everyone's complete blossoming or "superliving." A holistic examination covering physical, psychological, social, occupational, and other factors is needed to properly assess sources of stress and recommend a total stress management program for improving wellness.
SendOutCards is a web based greeting card service that will Print it, Stuff it & Mail it for you. No more forgetting to get to the store to pick up a card for that special occasion and no more cheap E-Cards. Why email a card when you can have a physical greeting card in your own handwriting delivered to someone at the touch of a button? Check it out!
Assertion And Holistic Health Dr. Shriniwas Kashalikarguestad0b03
The document discusses the need for lawmakers around the world to work together to update constitutions and laws to suit changing times and conditions. It suggests studying scriptures objectively to provide useful wisdom and pooling knowledge from various fields like philosophy, psychology, biology and economics. Developing impartial laws that ensure universal justice requires inner cleansing to become more objective. All of this assertion is essential for managing stress holistically, achieving holistic health, and blossoming of both individuals and society through remembrance of the divine name.
T E N S T E P S D R S H R I N I W A S K A S H A L I K A RAbhishek Yelgalwar
1. The document outlines 10 steps for becoming a successful doctor, including accepting, loving, and respecting patients unconditionally; recognizing the healing power within patients; and considering how educational policies impact health.
2. It provides several examples of doctors interacting with patients in different ways - either in a harsh, disrespectful manner or with compassion and understanding.
3. The document emphasizes the importance of not just treating physical ailments but also addressing psychological and social factors that impact health and well-being.
The document summarizes how moods, emotions, and feelings arise from the interaction between the body and brain. Metabolic, endocrine, autonomic, and nervous system activities influence the brain, leading to states like anxiety, tension, elation, and depression. The brain also influences these bodily activities in a feedback loop. While some believe this system is governed by God, nature, or randomness, the document argues that regularly practicing NAMASMARAN (remembrance of the divine name) can reach, liberate, and nurture the seeds of happiness within a person. It encourages giving this practice a fair trial to experience its effects.
Mahatma Gandhi translated his vision for universal progress and the welfare of mankind into sociopolitical programs with high fidelity, acceptability, and feasibility. Few people have had both a profound vision for universal good and the efforts to implement programs to achieve it. Additionally, it is little known that Gandhi steadfastly practiced NAMASMARAN. Today, accurate translations are still needed to apply universal philosophies, visions, and plans across personal, social, and global levels in various fields.
Online strategi - Foredrag og WorkshopClickStarter
Præsentation brugt til foredrag og workshop på Århus Universitet om online strategi for iværksættere. Fokus på opstart af website, best practices og hvordan man efterfølgende markedsfører sit produkt/service via websitet.
Første time fungerede som foredrag, hvor præsentationen blev gennemgået, derefter 1 times workshop hvor de i grupper gennemgik de forskellige steps og til slut gennemgik vi et par af de projekter.
The document provides guidance for businesses on protecting personal information and complying with information security laws. It recommends that businesses take stock of the information they have, scale it down to only what is needed, lock or protect the information, properly dispose of what is no longer needed, and plan ahead for how to respond to security incidents. The document outlines key laws around information security and provides tips and resources for businesses.
SendOutCards is a web based greeting card service that will Print it, Stuff it & Mail it for you. No more forgetting to get to the store to pick up a card for that special occasion and no more cheap E-Cards. Why email a card when you can have a physical greeting card in your own handwriting delivered to someone at the touch of a button? Check it out!
Assertion And Holistic Health Dr. Shriniwas Kashalikarguestad0b03
The document discusses the need for lawmakers around the world to work together to update constitutions and laws to suit changing times and conditions. It suggests studying scriptures objectively to provide useful wisdom and pooling knowledge from various fields like philosophy, psychology, biology and economics. Developing impartial laws that ensure universal justice requires inner cleansing to become more objective. All of this assertion is essential for managing stress holistically, achieving holistic health, and blossoming of both individuals and society through remembrance of the divine name.
T E N S T E P S D R S H R I N I W A S K A S H A L I K A RAbhishek Yelgalwar
1. The document outlines 10 steps for becoming a successful doctor, including accepting, loving, and respecting patients unconditionally; recognizing the healing power within patients; and considering how educational policies impact health.
2. It provides several examples of doctors interacting with patients in different ways - either in a harsh, disrespectful manner or with compassion and understanding.
3. The document emphasizes the importance of not just treating physical ailments but also addressing psychological and social factors that impact health and well-being.
The document summarizes how moods, emotions, and feelings arise from the interaction between the body and brain. Metabolic, endocrine, autonomic, and nervous system activities influence the brain, leading to states like anxiety, tension, elation, and depression. The brain also influences these bodily activities in a feedback loop. While some believe this system is governed by God, nature, or randomness, the document argues that regularly practicing NAMASMARAN (remembrance of the divine name) can reach, liberate, and nurture the seeds of happiness within a person. It encourages giving this practice a fair trial to experience its effects.
Mahatma Gandhi translated his vision for universal progress and the welfare of mankind into sociopolitical programs with high fidelity, acceptability, and feasibility. Few people have had both a profound vision for universal good and the efforts to implement programs to achieve it. Additionally, it is little known that Gandhi steadfastly practiced NAMASMARAN. Today, accurate translations are still needed to apply universal philosophies, visions, and plans across personal, social, and global levels in various fields.
Online strategi - Foredrag og WorkshopClickStarter
Præsentation brugt til foredrag og workshop på Århus Universitet om online strategi for iværksættere. Fokus på opstart af website, best practices og hvordan man efterfølgende markedsfører sit produkt/service via websitet.
Første time fungerede som foredrag, hvor præsentationen blev gennemgået, derefter 1 times workshop hvor de i grupper gennemgik de forskellige steps og til slut gennemgik vi et par af de projekter.
The document provides guidance for businesses on protecting personal information and complying with information security laws. It recommends that businesses take stock of the information they have, scale it down to only what is needed, lock or protect the information, properly dispose of what is no longer needed, and plan ahead for how to respond to security incidents. The document outlines key laws around information security and provides tips and resources for businesses.
Samyak Vaidyak Dr. Shriniwas Kashalikarguestad0b03
The document discusses the results of a study on the effects of exercise on memory and thinking abilities in older adults. The study found that regular exercise can help reduce the decline in thinking abilities that often occurs with age. Specifically, older adults who exercised regularly performed better on memory and thinking tests compared to those who did not exercise regularly.
Yogasana Demonstration Dr. Shriniwas Kashalikarguestad0b03
The document discusses the results of a study on the effects of exercise on memory and thinking abilities in older adults. The study found that regular exercise can help reduce the decline in thinking abilities that often occurs with age. Specifically, older adults who exercised regularly performed better on memory and thinking tests compared to those who did not exercise regularly.
The document discusses the wide-ranging effects of stress on secretion leads to insomnia.
all aspects of individual life including the mind, body, c) Stressors can act on hypothalamus which is
intelligence, education, career, relationships, family, and responsible for regulation of autonomic nervous system
social behavior. It outlines how stress can negatively impact and endocrine system. Disturbance in hypothalamic
the nervous system, cardiovascular system, respiratory regulation
Beliefs of some kind are a natural human frailty that help provide emotional solace and determine behavior. While scientific theories are also a type of belief, they are based on observations and cannot be fully verified. All humans, including scientists and philosophers, rely on some beliefs or convictions to cope with uncertainty and live sanely. The only way to overcome prejudices from superstitions is to live beyond the realm of the senses through self-realization, which is said to be possible through constant remembrance of the divine name.
1. The document provides protective measures to prevent the spread of H1N1 flu, including daily practices like chanting names of God, drinking water, consuming herbs, yoga, and maintaining cleanliness.
2. It recommends consuming herbs like neem, tulsi, bel leaves, as well as drinks with turmeric, ginger and honey.
3. Additional tips include taking vitamins, washing hands frequently, avoiding crowds, and consuming aloe vera and guduchi juice.
The document discusses the concept of revolution. It states that as individual and social development progresses, concepts like "god", "freedom", and "revolution" change meanings. It describes how pursuits and struggles in life revolve around survival, procreation, establishing power and control, or defending one's self, culture, or religion. Methods of revolution include warfare, public education, non-cooperation, and other forms of protest. Ultimately, the world seems to be moving toward greater global unity, international cooperation, and focusing individual lives on higher cosmic consciousness.
New Edition Of Our Tour Dr. Shriniwas Kashalikarguestad0b03
This document provides a summary of the author's tour of Southeast Asia, including stops in Hong Kong, Macau, Malaysia, and Singapore. Some key details include:
- The tour was organized by Sachin Travels and included 15 people led by two guides, Prashant and Amol.
- In Hong Kong, the group visited Victoria Peak, Aberdeen Village, Repulse Bay with Buddhist idols, and Star Avenue with Bruce Lee statues.
- In Macau, they saw the Temple of the Goddess Maa and toured old government buildings from the Portuguese rule. That evening they visited the opulent Casino Venitia.
- Stops in Malaysia included Genting Highlands for
The document discusses "my problem", which is a struggle within individuals between what is and what should be. This restlessness stems from sensory input not matching feelings of wants and deficiencies. "My problem" is a global issue, as it is difficult to voluntarily blossom into generous, loving, and benevolent qualities. Punishment and force cannot transform individuals, only creating a holistic environment through globally beneficial policies and practices can help with blossoming. However, even this is not possible without considering everyone through tolerance, as "my problem" is also "your problem" - it is universal. The only way to address this is through the universal practice of Namasmaran.
The document discusses whether an individual or organization that does not participate in a political freedom movement led by another group can be considered antinational. It provides several examples of individuals who may not have participated in political freedom struggles, including artists, scientists, government workers, and those focused on other social reforms. It argues that after 62 years of independence, it is important to move past judgments of others' viewpoints and actions during the freedom struggle, and instead focus on a shared vision of prosperity and equality for all.
Dr. Shriniwas Kashalikar was born in 1951 in Maharashtra, India. He received his medical education from BJ Medical College in Pune. After graduating, he and his brothers established a hospital in the remote village of Adeli, where he worked for three years. He then moved to Mumbai to further his studies in philosophy and science, joining GS Medical College. While there, he worked with slum dwellers, mill workers, and the visually impaired. He has written over 40 books and 500 articles on varied subjects, focusing on topics like stress management, sexology, and spirituality. He has received several awards and fellowships for his contributions, and currently continues interdisciplinary research and writing on total
1) Corruption exists not just in financial scandals but in one's perspectives, thoughts, feelings and actions which influence each other and the environment in a continuous cycle.
2) A restricted consciousness leads to a narrow and sectarian perspective, from which corrupt thinking, emotions and actions emerge.
3) Practicing Namasmaran, remembering the divine, can help rectify corrupt perspectives by expanding consciousness, and in turn reduce corrupt thinking, feelings and actions on a global scale by addressing the root cause. However, more study is needed to verify this viewpoint.
Value Education & Namasmaran Dr. Shriniwas Kashalikarguestad0b03
The document discusses the idea of value-based education and some issues with its implementation. It notes that (1) societal and global values outside of any education system still influence students and educators, and (2) celebrities and media hype shape popular values focused on individualism and superficiality. It also points out that (3) the value systems that influence legal frameworks and (4) the resulting laws and legal systems then shape common beliefs and interactions. The document argues that effectively teaching values requires (5) reconnecting with our "true self" through practices like Namasmaran meditation, otherwise values education risks being ineffective and arbitrary.
Study Of Human Physiology Dr Shriniwas Kashalikarguestad0b03
This document outlines 14 steps for studying human physiology, beginning from informal observation starting at conception through to professional academic study. Key aspects of the study include observing signs and symptoms in patients; correlating observations from daily life with structural and functional abnormalities; applying principles of physics and chemistry to explain interactions in the human body; and using technology like microscopes to study cells and their membranes. Hypothesis testing and asking questions are important to developing a deeper understanding of human physiology.
This document discusses the concept of rebirth. It argues that while our bodies are constantly changing as cells die and are replaced, our consciousness and identity remain constant. It points to examples of historical figures who seemed to have memories or consciousness from past lives. The document states that rebirth is not just a psychological concept but a real phenomenon, as consciousness is constant and cycles of birth and rebirth continue within it. However, it acknowledges that scientifically proving rebirth is difficult as human consciousness cannot be clearly identified or defined as a separate entity.
Yoga The Connection Dr. Shriniwas Kashalikarguestad0b03
Yoga is conceived in many ways and is a connection between one's global perspective, thoughts, emotions, and actions in every sphere of life. It also connects metabolic, endocrine, autonomic, and central nervous system activities as well as the right and left cerebral cortex. This yoga can be achieved through NAMASMARAN, as one can verify.
Yoga Karma And Namasmaran Dr. Shriniwas Kashalikarguestad0b03
1) Nishkama karma in the Bhagavad Gita refers to action without attachment to the results or expectations of outcomes.
2) It is difficult but important to focus on the action itself without getting distracted by or obsessed with desires for particular outcomes.
3) The most evolved actions become more subtle and less attached to subjective experiences of cause and effect, such that ownership of actions and their results ceases. One such action is namasmaran, or remembrance of God, which billions practice across religions.
Yoga And Superliving Dr. Shriniwas Kashalikarguestad0b03
The document discusses the principles of yoga. It states that there are three components to human response - cognition, affect, and conation. The final stage of yoga is the union of these three components. A highly evolved yogi would be seen as sensing, feeling, and responding beyond normal human capacities in an impeccable, accurate, and exuberantly benevolent way for the universe. This era is unique because remembering God's name as inspired by a guru ensures the process and progress of yoga.
World Famous Prayer Interpretation By Dr. Shriniwas Kashalikarguestad0b03
[1] This prayer is meant to wish happiness, health, and well-being for all, with no grief.
[2] Some object to prayers, seeing them as weakness, but they can be a way to remove "blocks" like ego and gain strength from cosmic powers that we are extensions of.
[3] Prayers and chanting can effectively remove these blocks by connecting us to the source of empowerment and the universe, just as reconnecting leaves to the roots of a tree makes them stronger.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Samyak Vaidyak Dr. Shriniwas Kashalikarguestad0b03
The document discusses the results of a study on the effects of exercise on memory and thinking abilities in older adults. The study found that regular exercise can help reduce the decline in thinking abilities that often occurs with age. Specifically, older adults who exercised regularly performed better on memory and thinking tests compared to those who did not exercise regularly.
Yogasana Demonstration Dr. Shriniwas Kashalikarguestad0b03
The document discusses the results of a study on the effects of exercise on memory and thinking abilities in older adults. The study found that regular exercise can help reduce the decline in thinking abilities that often occurs with age. Specifically, older adults who exercised regularly performed better on memory and thinking tests compared to those who did not exercise regularly.
The document discusses the wide-ranging effects of stress on secretion leads to insomnia.
all aspects of individual life including the mind, body, c) Stressors can act on hypothalamus which is
intelligence, education, career, relationships, family, and responsible for regulation of autonomic nervous system
social behavior. It outlines how stress can negatively impact and endocrine system. Disturbance in hypothalamic
the nervous system, cardiovascular system, respiratory regulation
Beliefs of some kind are a natural human frailty that help provide emotional solace and determine behavior. While scientific theories are also a type of belief, they are based on observations and cannot be fully verified. All humans, including scientists and philosophers, rely on some beliefs or convictions to cope with uncertainty and live sanely. The only way to overcome prejudices from superstitions is to live beyond the realm of the senses through self-realization, which is said to be possible through constant remembrance of the divine name.
1. The document provides protective measures to prevent the spread of H1N1 flu, including daily practices like chanting names of God, drinking water, consuming herbs, yoga, and maintaining cleanliness.
2. It recommends consuming herbs like neem, tulsi, bel leaves, as well as drinks with turmeric, ginger and honey.
3. Additional tips include taking vitamins, washing hands frequently, avoiding crowds, and consuming aloe vera and guduchi juice.
The document discusses the concept of revolution. It states that as individual and social development progresses, concepts like "god", "freedom", and "revolution" change meanings. It describes how pursuits and struggles in life revolve around survival, procreation, establishing power and control, or defending one's self, culture, or religion. Methods of revolution include warfare, public education, non-cooperation, and other forms of protest. Ultimately, the world seems to be moving toward greater global unity, international cooperation, and focusing individual lives on higher cosmic consciousness.
New Edition Of Our Tour Dr. Shriniwas Kashalikarguestad0b03
This document provides a summary of the author's tour of Southeast Asia, including stops in Hong Kong, Macau, Malaysia, and Singapore. Some key details include:
- The tour was organized by Sachin Travels and included 15 people led by two guides, Prashant and Amol.
- In Hong Kong, the group visited Victoria Peak, Aberdeen Village, Repulse Bay with Buddhist idols, and Star Avenue with Bruce Lee statues.
- In Macau, they saw the Temple of the Goddess Maa and toured old government buildings from the Portuguese rule. That evening they visited the opulent Casino Venitia.
- Stops in Malaysia included Genting Highlands for
The document discusses "my problem", which is a struggle within individuals between what is and what should be. This restlessness stems from sensory input not matching feelings of wants and deficiencies. "My problem" is a global issue, as it is difficult to voluntarily blossom into generous, loving, and benevolent qualities. Punishment and force cannot transform individuals, only creating a holistic environment through globally beneficial policies and practices can help with blossoming. However, even this is not possible without considering everyone through tolerance, as "my problem" is also "your problem" - it is universal. The only way to address this is through the universal practice of Namasmaran.
The document discusses whether an individual or organization that does not participate in a political freedom movement led by another group can be considered antinational. It provides several examples of individuals who may not have participated in political freedom struggles, including artists, scientists, government workers, and those focused on other social reforms. It argues that after 62 years of independence, it is important to move past judgments of others' viewpoints and actions during the freedom struggle, and instead focus on a shared vision of prosperity and equality for all.
Dr. Shriniwas Kashalikar was born in 1951 in Maharashtra, India. He received his medical education from BJ Medical College in Pune. After graduating, he and his brothers established a hospital in the remote village of Adeli, where he worked for three years. He then moved to Mumbai to further his studies in philosophy and science, joining GS Medical College. While there, he worked with slum dwellers, mill workers, and the visually impaired. He has written over 40 books and 500 articles on varied subjects, focusing on topics like stress management, sexology, and spirituality. He has received several awards and fellowships for his contributions, and currently continues interdisciplinary research and writing on total
1) Corruption exists not just in financial scandals but in one's perspectives, thoughts, feelings and actions which influence each other and the environment in a continuous cycle.
2) A restricted consciousness leads to a narrow and sectarian perspective, from which corrupt thinking, emotions and actions emerge.
3) Practicing Namasmaran, remembering the divine, can help rectify corrupt perspectives by expanding consciousness, and in turn reduce corrupt thinking, feelings and actions on a global scale by addressing the root cause. However, more study is needed to verify this viewpoint.
Value Education & Namasmaran Dr. Shriniwas Kashalikarguestad0b03
The document discusses the idea of value-based education and some issues with its implementation. It notes that (1) societal and global values outside of any education system still influence students and educators, and (2) celebrities and media hype shape popular values focused on individualism and superficiality. It also points out that (3) the value systems that influence legal frameworks and (4) the resulting laws and legal systems then shape common beliefs and interactions. The document argues that effectively teaching values requires (5) reconnecting with our "true self" through practices like Namasmaran meditation, otherwise values education risks being ineffective and arbitrary.
Study Of Human Physiology Dr Shriniwas Kashalikarguestad0b03
This document outlines 14 steps for studying human physiology, beginning from informal observation starting at conception through to professional academic study. Key aspects of the study include observing signs and symptoms in patients; correlating observations from daily life with structural and functional abnormalities; applying principles of physics and chemistry to explain interactions in the human body; and using technology like microscopes to study cells and their membranes. Hypothesis testing and asking questions are important to developing a deeper understanding of human physiology.
This document discusses the concept of rebirth. It argues that while our bodies are constantly changing as cells die and are replaced, our consciousness and identity remain constant. It points to examples of historical figures who seemed to have memories or consciousness from past lives. The document states that rebirth is not just a psychological concept but a real phenomenon, as consciousness is constant and cycles of birth and rebirth continue within it. However, it acknowledges that scientifically proving rebirth is difficult as human consciousness cannot be clearly identified or defined as a separate entity.
Yoga The Connection Dr. Shriniwas Kashalikarguestad0b03
Yoga is conceived in many ways and is a connection between one's global perspective, thoughts, emotions, and actions in every sphere of life. It also connects metabolic, endocrine, autonomic, and central nervous system activities as well as the right and left cerebral cortex. This yoga can be achieved through NAMASMARAN, as one can verify.
Yoga Karma And Namasmaran Dr. Shriniwas Kashalikarguestad0b03
1) Nishkama karma in the Bhagavad Gita refers to action without attachment to the results or expectations of outcomes.
2) It is difficult but important to focus on the action itself without getting distracted by or obsessed with desires for particular outcomes.
3) The most evolved actions become more subtle and less attached to subjective experiences of cause and effect, such that ownership of actions and their results ceases. One such action is namasmaran, or remembrance of God, which billions practice across religions.
Yoga And Superliving Dr. Shriniwas Kashalikarguestad0b03
The document discusses the principles of yoga. It states that there are three components to human response - cognition, affect, and conation. The final stage of yoga is the union of these three components. A highly evolved yogi would be seen as sensing, feeling, and responding beyond normal human capacities in an impeccable, accurate, and exuberantly benevolent way for the universe. This era is unique because remembering God's name as inspired by a guru ensures the process and progress of yoga.
World Famous Prayer Interpretation By Dr. Shriniwas Kashalikarguestad0b03
[1] This prayer is meant to wish happiness, health, and well-being for all, with no grief.
[2] Some object to prayers, seeing them as weakness, but they can be a way to remove "blocks" like ego and gain strength from cosmic powers that we are extensions of.
[3] Prayers and chanting can effectively remove these blocks by connecting us to the source of empowerment and the universe, just as reconnecting leaves to the roots of a tree makes them stronger.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
2. Name starting with first name
Date and place of birth
Sex
Height
Weight
Qualification
Occupation and position/designation
Address
Residence
Office
Phone
Residence: Office:
Mobile:
B.P
PULSE
RESPIRATION
3. Please answer the following for proper assessment
of your physical health
Present history
State your chief complaints and mention about the
following.
When did the complaints start?
Did they start suddenly or insidiously?
Are they increasing in severity or decreasing?
Are they having any pattern, such through out
day and night, only in evenings or mornings, or
alternate day, every week, every fortnight etc?
Are they associated with any other thing such as
food, sleep, any individual, any event etc?
INVESTIGATIONS, DIAGNOSIS,
TREATMENT AND ADVICE
NAME OF THE DOCTOR/S, HOSPITAL AND
PHONE NUMBERS / MOBILE
Vital information
Please describe your posture during
4. Standing
Sitting
Reading
Walking
Sleeping
Any changes in posture
Please state matrimonial status
Married
Unmarried
Divorcee
Widow/widower
Separated
VASAECTOMY
TUBECTOMY
LSCS [caesarian section]
Any other information such as love break
Occupational history
Please write about your
1] Present job
2] Nature of job and working conditions such as
shift duty, kind of work, travelling, targets, dead
lines etc.
3] Income from the job and other sources
4] Past job
5. 5] The motivation behind leaving past job and
taking present job
6] Interpersonal relationship
7] Appraisal by the superiors
8] Occupational satisfaction
9] Any other information about your occupation
such as loans
10] Strike
11] Lay off / VRS
12] Unemployed [For how many years?]
13] Terminated, suspended etc.
Schooling background
Please inform in brief about
1] Performance
2] Changes in performances
3] Problems in motivation and interest in learning
4] Any complaints about the adjustment in school
College Background
Extracurricular activities
About sports activity if any Please mention
Indoor games
Outdoor games
Trekking
Hiking
6. Not interested in sports
Mention about your hobbies.
Music
Arts
Reading,
Painting
Any other
Please give information about the following so as
to complete past history
Were you born naturally or cesarean, forceps etc
was required? Was the delivery conducted at
home or hospital?
Major illness or similar illness in the past
Investigations and treatment
Any major traumatic or pleasant event in the past
such as love breaking or success in interview
respectively
Any other
Family History
A] Please state the following
7. Name of the spouse if applicable and his/her status
Names of father and mother and their status
Names of grand father and grand mother and
their status
Names of children
Names of other relatives of concern
B] Describe the interpersonal relationship in
family according to following points
Relationship of parents
Relationship amongst the family members
Relationship with the neighbor
Past history of the family
A] Please give information about physical history
of the family with respect presence of the
following
Tuberculosis
Cancer
Any other major illness
Major accidents
Deaths
Any other traumatic event
8. B] Please inform about the following so as to
describe psychological history of the family
Sad events
Marriage breaking, dowry death and/or
harassment, Financial loss
Social rejection or isolation, any other traumatic
event,
Happy events
Marriage, get together etc
Please complete this for the assessment of
instinctual status
Please state your habits with respect to quantity,
frequency and duration.
Tea
Coffee
Alcohol
Tobacco
Nail biting
Blinking of eyes
Shrugging shoulders
The causes of addictions
Please describe in brief the exercise you are
involved in with respect to
1] Type: yoga, aerobic, walking, jogging, weight
lifting etc.
2] Intensity
9. 3] Regularity
4] Duration
5] Any other information
6] No exercise
Please inform about your appetite
Is it normal?
Are there any recent changes in appetite?
Have you developed appetite for abnormal
inedible stuff?
Give any other information with respect to
following.
Indigestion
Gases
Belching
Flatus
Please state in details your dietary habits with
respect to following points.
Home food
Outside hotel food
Consumption ice creams and chocolates and such
junk food
Vegetarian
Non-vegetarian
Fruits
10. Vegetables
Sprouted beans
Water intake
Salt intake
Spices and chilies
Pattern of eating
Aerated and/or non-aerated cold drinks
Food grains: Refined or hand pounded and
varieties
Oil and its varieties
Any other
Please describe your bowel habits with respect to
following points
Regular
Irregular
Frequency
Symptoms associated with defecation
Consumption of laxatives and purgatives if yes
which and for how long and how much
Enema
Any other information
Please inform about any difficulty in emptying
urinary bladder and urine output.
Incontinence
Dribbling micturition
Psychological retention
11. Bed-wetting
Please give the information about the following
points in reproductive history
Age of menarche
Age of menopause if applicable
Any symptoms associated with menstrual cycle
Problems if any with respect to pregnancy
/deliveries
Nocturnal emission
Please state the condition of your sleep
Sound
Disturbed
Pattern
Any other
Teeth biting
Snoring
Dreams
Please state if there is any difficulty in speech such
as
Slurred
Staccato
Stammering
Scanning
12. Please state if there is attraction towards opposite
sex, same sex or hatred towards opposite or the
same sex.
Which of the following three you agree with?
A] Sex is good/virtuous/ideal or the only goal of
life.
B] Sex is bad/sin/has to be suppressed.
C] Sex is a part of normal healthy life, humane
sexual aspects have to be understood and
practiced.
Do you have knowledge about reproductive
physiology and sex?
Do you have awareness about sexually transmitted
diseases?
Do you have awareness about family welfare and
contraception?
Do you have satisfaction in the sexual life?
How is your relationship with spouse? Please state
if you are not able to give adequate time to your
spouse or get from him/her.
13. Have you been exposed to sexually transmitted
disease?
Do you have the habit of masturbation
Please state if there are problems with respect to
lactation and breast-feeding and rapport with
children. Can you give adequate time to your
children, parents and/or get it from them.
Please state if you are missing your native place,
culture, family members, other beloved etc.
Please state if or not you do not get opportunity to
move around in the open or go for outing.
Do you like remaining alone?
Do you feel insecure with respect to your life due
to some reason or other?
Please answer the following as honestly as possible
to depict your emotional make up.
HAPPINESS: What is your idea of happiness?
What makes you happy?
SADNESS: Do you feel sad and low at present?
Why? Do you feel like crying more often than
14. previously? Why? Do you get suicidal thoughts?
Why?
RAGE: Do you get violent thoughts? Why?
LOWLINESS: Do you get feeling of dejection?
Why? Do you feel hesitant before starting any
activity? Why? Do you feel that you are inferior to
others? Why? Do you feel shy to talk in a group or
in public meeting? Why?
DESPONDENCY: Have you lost interest in your
day to day activities? Why?
HOPELESS NESS: Do you feel that there is no
charm in life? Why? Do you feel that there is no
hope whatsoever? Why?
CONCERN: Do you feel concern towards the
underprivileged, handicapped, other ailing fellow
beings?
FEAR: Are you afraid of any thing? Of what and
why? Do you always feel that unpleasant things
are going to happen?
GUILT: Do you feel guilty? Of what and why?
15. JEALOUSY: Do you feel jealous about the
others? Why?
INSUFFICIENCY: Do you feel that you do not get
what you deserve at home or in society such as
money, love, respect, fame, pampering etc? Why?
Do you feel that others do not love you? Why?
SUPERIORITY: Do you feel that you are superior
to others? Do you feel proud? Why?
DEPENDENCE: Do you seek help more than
what you give? Why?
Do you blame others for your failure? Why?
DELUSIONS: Do you feel that people are
conspiring against you? Why?
COMMUNICATION: Do you get misunderstood?
If yes, why?
GENEROSITY: Do you give others what the
others expect from you?
GULLIBLITY: Do you get cheated by the others
physically, sexually, emotionally and/or or
financially? How?
16. LONLINESS: Do you feel lonely?
RESTLESSNESS AND ANXIETY: Do you feel
tensed up and find it difficult to sleep? Do you
become irritable due to tension?
Please give information about your behavior with
respect to following points
When do you wake up in morning?
Do you pray in morning?
Do you clean your mouth and teeth regularly?
How? How many times?
Do you take bath regularly? How many times?
Which soap you use?
Do you keep your private parts clean?
Do you keep your clothes clean and tidy?
Do you wash your hands before taking food?
Is there time crunch to reach school, college or
working place?
17. Do you shout at the others or use insulting/abusive
language?
Do you engage yourself in back biting?
Do you indulge in physical violence towards
weaker members of the family?
Do you experience physical violence by others?
Do you indulge in stealing, cheating etc even
against your wish?
Are you involved in any political, religious, social,
charitable activity?
Are you a member of a union? What is your view
about labor movement?
Do you use perfumes?
Do you get gifts? Which?
Do you give gifts? Which?
18. Please inform about your intelligence with regard
to
Concentration
Memory
Attention
Alertness
Analysis
Synthesis
Conceptualization
Innovation
Imagination
Invention
Curiosity
Please answer the following so as to give a picture
of your perspective about life
What are your aims? Why?
What are your views about the healthcare system,
health education and health status?
What do you understand by stress and conceptual
stress?
What are the causes of stress?
19. What are the mechanisms underlying stress?
What are the dimensions of stress?
What is the meaning of support systems?
What is homeostasis? What is social homeostasis?
What is the significance of concepts such as
equality, inequality and harmony?
Do you think that social, political, religious and
cultural picture is bleak? Why?
Do you think that corruption affects you? Why
and how?
Do you think that educational policy is
immaculate and satisfactory?
Do you think that state of children in the world is
fair and satisfactory?
Is the state of elderly and the ailing individuals
satisfactory?
Do you subscribe the policy of reservations for
some sections of the society? If yes, why so and if
no, why so?
20. Have you attended any stress management course
of have consulted any one? What has been your
impression about the same?
What is the meaning of paradigm shift?
What is the difference between stress relaxation
and stress management?
What is the meaning of introspection,
prioritization, assertion, reinforcement, one step at
a time, mission oriented thinking?
STATE YOUR OBSERVATIONS AFTER
STARTING THE TOTAL STRESS
MANAGEMENT [TSM] COURSE WITH
RESPECT TO ABOVE POINTS AND ANY
OTHER INFORMATION
Best Wishes
for your
21. Total Stress Management
i.e
Holistic Health
i.e.
Global Welfare
i.e.
Complete Blossoming
i.e.
superliving!
Dr. Shriniwas Kashalikar