Hypertension frequently occurs with diabetes and amplifies cardiovascular risk. Aggressive blood pressure control below 130/80 mmHg prevents more cardiovascular events in diabetics. Treatment requires multiple drugs like ACE inhibitors, ARBs, thiazide diuretics, and calcium channel blockers to control blood pressure and protect organs. Lifestyle changes like weight loss, exercise, smoking cessation, and moderation of alcohol and sodium also help lower blood pressure.
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.
Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.
Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production.
The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
DIABETES AND CARDIOVASCULAR DISEASE - THE CONTINUUMPraveen Nagula
DIABETES IS ONE OF THE MOST COMMON NONCOMMUNICABLE DISEASES WORLD WIDE.
EVERY 6 SECONDS ONE PERSON IS AFFECTED BY DIABETES..
THEME FOR 2014-2016
LETS UNITE FOR DIABETES
Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia.
Several distinct types of DM are caused by a complex interaction of genetics and environmental factors.
Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production.
The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system.
Nutritional therapy in hypertension and diabetes by SYED SHOAIB HUSSAINPARUL UNIVERSITY
hypertension and diabetes are common problems associated with improper diet habits, so diet therapy is a core management strategy to manage diabetes and hypertension
Management of Hypertension and Diabetes in Aging People 2014Nemencio Jr
This module discusses the issues in the management and treatment goals for hypertension and diabetes in the older population based on the most recent guidelines
A case study on anemia with congestive heart failuremartinshaji
a case dealing with a patient having anemia with congestive heart failure, this gives a clear idea about management, diagnosis, treatment , patient counselling, pharmacist interventions etc
please comment
thank u
Cardiovascular disease in diabetes mellitusYung-Tsai Chu
Reference: 2018 ADA guideline. Topics: hypertension management(drug choice and combination), indications for hyperlipidemia treatment, atherosclerosis disease prevention with antiplatelet agents and issues about coronary artery diseases.
Dyslipidemia-latest guidlines-Review of Guidlines by Dr.Jayasoorya p gjpgkmr
Dyslipidemia newer guidelines
2019 ESC/EAS GUIDLINES FOR MANAGEMENT OF DYSLIPIDEMIA
2019 JUNE UPDATED AMERICAN COLLEGE OF CARDIOLOGY GUIDLINES FOR MANAGEMENT OF DYSLIPIDEMIA
Una de las publicaciones más esperadas en ACC Scientific Sessions 2019 han sido las nuevas guías en prevención primaria. El Dr. Alberto Esteban repasa las claves en #SECenACC19.
Nutritional therapy in hypertension and diabetes by SYED SHOAIB HUSSAINPARUL UNIVERSITY
hypertension and diabetes are common problems associated with improper diet habits, so diet therapy is a core management strategy to manage diabetes and hypertension
Management of Hypertension and Diabetes in Aging People 2014Nemencio Jr
This module discusses the issues in the management and treatment goals for hypertension and diabetes in the older population based on the most recent guidelines
A case study on anemia with congestive heart failuremartinshaji
a case dealing with a patient having anemia with congestive heart failure, this gives a clear idea about management, diagnosis, treatment , patient counselling, pharmacist interventions etc
please comment
thank u
Cardiovascular disease in diabetes mellitusYung-Tsai Chu
Reference: 2018 ADA guideline. Topics: hypertension management(drug choice and combination), indications for hyperlipidemia treatment, atherosclerosis disease prevention with antiplatelet agents and issues about coronary artery diseases.
Dyslipidemia-latest guidlines-Review of Guidlines by Dr.Jayasoorya p gjpgkmr
Dyslipidemia newer guidelines
2019 ESC/EAS GUIDLINES FOR MANAGEMENT OF DYSLIPIDEMIA
2019 JUNE UPDATED AMERICAN COLLEGE OF CARDIOLOGY GUIDLINES FOR MANAGEMENT OF DYSLIPIDEMIA
Una de las publicaciones más esperadas en ACC Scientific Sessions 2019 han sido las nuevas guías en prevención primaria. El Dr. Alberto Esteban repasa las claves en #SECenACC19.
Washington DC Kellogg Conference Hotel, A Washington DC Hoteldckellogghotel
The Kellogg Conference Hotel is located on the historic, gated campus of Gallaudet University, Washington DC. This Capitol Hill hotel and Lodging offers Affordable Hotel Accommodation, a 93 newly renovated guestrooms, a beautiful atrium with vaulted ceilings, and a large ballroom. Listed in the National Register of Historic Places, the campus features architecture dating back to the early 1800's and beautiful grounds perfect for memorable wedding photos.
The unique location of Washington DC Kellogg Conference Hotel on the Gallaudet University campus has distinct advantages. Stroll around the historic grounds or take advantage of our complimentary transportation to and from the nearby Union Station. We’re just two miles from the National Mall, where the Library of Congress, Washington Monument, Lincoln Memorial and Smithsonian museums are located. Experience an evening in Washington by visiting the city’s exciting attractions and nightlife. See our area attractions.
The European (Digital) Library - Overview and OutlookOlaf Janssen
The European Library (www.theeuropeanlibrary.org) is a multilingual portal offering integrated access to the tens of millions of resources (books, magazines, journals...) of 18 national libraries in Europe. It offers free searching and delivers both digital and non-digital objects. It provides a vast virtual collection of mate-rials from all disciplines. The European Library is currently being expanded with the holdings of the national libraries of the 10 EU New Member States. From September 2006 onwards the remaining EU and EFTA na-tional libraries will be connected to TheEuropeanLibrary.org, bringing the total number of participating na-tional libraries to ±35 by the end of 2008.
In the beginning of 2006 the EC expressed support for The European Library to evolve into a much bigger European Digital Library (EDL), including access to the digital collections of other major cultural heritage institutions, such as museums and archives. The EDL is planned to include the holdings of all European na-tional libraries and a minimum of 2M digital works by the end of 2008. By 2010 the EDL needs to have ex-panded to include collections of archives, museums and other libraries, with a minimum of 6M digital works.
The European Library aims to remain a major player in the European cultural heritage field and is already strengthening its cooperation with other relevant key initiatives, such as MACS, DELOS, MICHAEL, BRICKS and MINERVA.
Janssen, O.D. (2006), “The European (Digital) Library - Overview and Outlook”, in: The e-volution of Information Communication Technology in Cultural Heritage, Joint event CIPA/VAST/EG/EuroMed, Project papers, M. Ioannides, D. Arnold, F. Niccolucci, K. Mania (Eds.), EPOCH publication, 2006, pp. 189-193 (and on CD-ROM)
Idéale avant une première utilisation de Subversion (SVN).
Même si certains éléments clés sont laissés de côté, comme la résolution des
conflits ou les branches.
Note de licence/Utilise les jeux d'icônes suivants:
"Crystal Clear" par Everaldo Coelho. – Licensed under the GNU Lesser General
Public License (LGPL).
Nuvola icon theme for KDE 3.x by David Vignoni – Licensed under the GNU Lesser
General Public License (LGPL).
Essential Hypertension By Raheef Alatassi
Definition & classifications
Prevention & detection & importance
Causes
HTN in pregnancy
Management
Goals of treatment
Classes of drugs & side effects
Specific management in e.g. IHD,DM
HTN emergency & urgency with management
Diabetic nephropathy is a clinical syndrome characterized by the following :
Persistent albuminuria (>300 mg/d or >200 μg/min) that is confirmed on at least 2 occasions 3-6 months apart.
Progressive decline in the glomerular filtration rate (GFR).
Elevated arterial blood pressure.
Three major histologic changes occur in the glomeruli of persons with diabetic nephropathy:
First, mesangial expansion is directly induced by hyperglycemia, perhaps via increased matrix production or glycation of matrix proteins.
Second, thickening of the glomerular basement membrane (GBM) occurs.
Third, glomerular sclerosis caused by intraglomerular hypertension (induced by dilatation of the afferent renal artery or from ischemic injury induced by hyaline narrowing of the vessels supplying the glomeruli).
These different histologic patterns appear to have similar prognostic significance.
Several issues are key in the medical care of patients with diabetic nephropathy.
These include glycemic control, management of hypertension, and reducing dietary salt intake and phosphorus and potassium restriction in advanced cases.
A meta-analysis from the Cochrane Database shows a large fall in blood pressure with salt restriction, similar to that of single-drug therapy
International Journal of Diabetology & Vascular Disease Research (IJDVR) is a peer-reviewed and an Open Access journal. This journal mainly focuses on the advancements made in the field of Diabetes Research.
International Journal of Diabetology & Vascular Disease Research (IJDVR) ISSN:2328-353X is an Open Access and a comprehensive journal devoted to Diabetes & Vascular Disease Research. IJDVR, published by SciDoc, includes high quality papers, which cover all major areas of Diabetes, Vascular Diseases and its diagnosis.
Vitamin D is an important prohormone for optimal intestinal calcium absorption for mineralization of bone. Because the vitamin D receptor is present in multiple tissues, there has been interest in evaluating other potential functions of vitamin D, particularly, in cardiovascular diseases (CVD). Cross-sectional studies have reported that vitamin D deficiency is associated with increased risk of CVD, including hypertension, heart failure, and ischemic heart disease. Initial prospective studies have also demonstrated that vitamin D deficiency increases the risk of developing incident hypertension or sudden cardiac death in individuals with preexisting CVD. Very few prospective clinical studies have been conducted to examine the effect of vitamin D supplementation on cardiovascular outcomes. The mechanism for how vitamin D may improve CVD outcomes remains obscure; however, potential hypotheses include the downregulation of the renin-angiotensin-aldosterone system, direct effects on the heart, and vasculature or improvement of glycemic control. This review will examine the epidemiologic and clinical evidence for vitamin D deficiency as a cardiovascular risk factor and explore potential mechanisms for the cardioprotective effect of vitamin D.
How to deal with CALCIFIED CORONARY ARTERY LESIONS .Coronary artery calcification (CAC) is highly prevalent in patients with coronary heart disease (CHD) and is associated with major adverse cardiovascular events. There are two recognized type of CAC—intimal and medial calcification, and each of them have specific risk factors. Several theories about the mechanism of vascular calcification have been put forward, and we currently believe that vascular calcification is an active, regulated process. CAC can usually be found in patients with severe CHD, and this asymptomatic phenomenon make early diagnosis of CAC important. Coronary computed tomographic angiography is the main noninvasive tool to detect calcified lesions. Measurement of coronary artery calcification by scoring is a reasonable metric for cardiovascular risk assessment in asymptomatic adults at intermediate risk. To date, effective medical treatment of CAC has not been identified. Several strategies of percutaneous coronary intervention have been applied to CHD patients with CAC, but with unsatisfactory results. Prognosis of CAC is still a major problem of CHD patients. Thus, more details about the mechanisms of CAC need to be elucidated in order to improve the understanding and treatment of CAC.
Hypertension is a common medical and social problem leading to cardiovascular diseases worldwide. Antihypertensive drugs are clinically applied to decrease the morbidity and mortality induced by hypertension itself and its complications. The 2014 hypertension guideline of the Eighth Joint National Committee (JNC8) for hypertension therapy in the United States has made several significant changes with respect to the clinical management of hypertension and the initiative medications, as compared with the previous guidelines. In addition to the instructions that pharmacologic treatment should be initiated when blood pressure (BP) is 150/90 mmHg or higher in adults over 60 years, 140/90 mmHg in adults younger than 60 years, or 140/90 mmHg or higher (regardless of age) in patients with hypertension and diabetes, a thiazide-type diuretic, calcium (Ca2+) channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB) should be considered to start an initial antihypertensive medication in non-black population. In black population with or without diabetes, initial antihypertensive treatment should include a thiazide-type diuretic or CCB. Thus, CCB has become one of the most important initial agents for antihypertensive monotherapy. Furthermore, since CCBs have been proved not to increase the risk of coronary events and stroke,CCBs appear to be a favorable choice for monotherapy as well as for combination with other agent classes in the treatment of hypertension and may provide specific benefits beyond BP lowering.Nowadays, dihydropyridine (DHP) CCBs are one group of most frequently prescribed antihypertensive medications in China and other Eastern Asian countries.
Among patients with or at high risk of CVD, use of an FDC strategy for blood pressure, cholesterol, and platelet control vs usual care resulted in significantly improved medication adherence.Polypill therapy significantly improved adherence, SBP and LDL-cholesterol in high risk patients compared with usual care, especially among those who were under-treated at baseline.
A transesophageal echocardiogram (TEE) uses echocardiography to assess the structure and function of the heart. During the procedure, a transducer (like a microphone) sends out ultrasonic sound waves. When the transducer is placed at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or "echo" off of the heart structures. The transducer picks up the reflected waves and sends them to a computer. The computer displays the echoes as images of the heart walls and valves.
A traditional echocardiogram is done by putting the transducer on the surface of the chest. This is called a transthoracic echocardiogram. A transesophageal echocardiogram is done by inserting a probe with a transducer down the esophagus. This provides a clearer image of the heart because the sound waves do not have to pass through skin, muscle, or bone tissue. The TEE probe is much closer to the heart since the esophagus and heart are right next to each other.
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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.
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
1. Management of Hypertension in Diabetes Dr. Awadhesh K Sharma ,MD, Senior Resident, Department of Medicine, M.L.B. Medical College, Jhansi, UP
2.
3. Diabetes: The Problem INDIA, the diabetes capital of world in next thirty years can also be the hypertension capital of world. (JAPI 2007)(:55:323-24).
16. Definition, screening and diagnosis According to Joint National Committee – 7 (JNC-7) Staging SBP DBP Normal <120 <80 Prehypertensive 120-139 80-89 Stage 1 hypertension 140-159 90-99 Stage 2 hypertension >160 >100
17. In Prehypertensive------- Life style modification Stage 1 & 2 Should be treated But Prehypertensive + diabetes mellitus /CKD Life style modification,if it fails to redude BP to <130/80 mm Hg then--- Start drug therapy
22. Diabetes ,hypertension and nephropathy--- Increased systolic BP is a significant risk factor for micro albuminuria and rapid progression of nephropathy. Isolated systolic hypertension----- ISH is strongly related to development of micro and macrovascular diseases in patients with DM.
25. Weight loss Loss of weight by 1kg decreases BP by approx 1mm hg. Sodium restriction Decrease in sodium intake from 4.6 gm to 2.3 gm/day results in reduction of 5mm Hg is SBP and 2-3 mm Hg in DBP. Exercise Diabetic patients who are 35 yrs of age or older and are planning to begin a vigorous exercise programme should have exercise stress testing or other appropriate non-invasive testing. At least 150 min of moderate intensity aerobic physical activity is recommended per week. Smoking cessation Moderation of alcohol intake.
26.
27.
28.
29.
30. Health The second part of the equation is nutrition Your body needs the right fuel to help it work well.
31.
32. Encourage people to change habits . Use the pyramid guide to educate people to eat healthy.
35. Pharmacological therapy Thiazide diuretic and Beta Blockers - There have been concerns among physicians as many studies have shown thiazides and beta blockers promote glucose intolerance. Inspite of this both agents have been recommended for treatment of hypertension in DM, lower doses of shorter acting thiazides- hydrochlorthiazide instead of chlorethalidone are generally well tolerated and not associated with adverse metabolic effects. Recommendations for beta blockers are-- combined alpha and beta blocker should be preferable agents. Carvedilol is the potential agent of choice as it effectively control blood pressure and improves insulin sensitivity and decreases HbA1C.
41. How Can You Help Reduce Your Risk of Hypertension in Diabetes ? Eat foods low in fat & calories. If overweight, lose weight. Physical activity Stop smoking! Limit alcohol to 1-2 drinks per day. Take your medications regularly.
42. What are goals to healthy living? Be SMART S pecific M easurable A chievable R elevant T ime
43.
44.
Editor's Notes
The basic idea concerning good health is: ( click ) Physical Activity, such as running ( click ) Plus Sound Nutrition, such as fruits and grains ( click ) Equal Good Health
Now that you know why being healthy is a good idea, lets discuss what you can do to get that way. (click) The first part of our equation, activity, is key. This includes active play and sports. Just get moving with something you enjoy! Ask students What do you like to do? Facilitate responses Do you always make time for activities? (click after all pictures have appeared)
Adopting a healthy lifestyle is essential in helping reduce your overall risk of heart disease. If you currently take medications for preventing heart disease, their effectiveness will be enhanced by making these healthy lifestyle changes.