Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times, while you are resting comfortably for at least five minutes. To make the diagnosis of hypertension, at least three readings that are elevated are usually required
Case history
Definition & incidence of Hypertension
Classification of Hypertension
Diagnosis/ Confirmation of Hypertension
Technique of Hypertension Measurement
White coat Hypertension
Type of Hypertension
Suspicion of secondary hypertension
Management of Hypertension(Stage 1& 2)
Why treatment is necessary
Life style modification
Drug treatment of Hypertension
Rationalae of combination
Hypertension management in special situation/ with complications
Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
One high reading does not mean you have high blood pressure. It is necessary to measure your blood pressure at different times, while you are resting comfortably for at least five minutes. To make the diagnosis of hypertension, at least three readings that are elevated are usually required
Case history
Definition & incidence of Hypertension
Classification of Hypertension
Diagnosis/ Confirmation of Hypertension
Technique of Hypertension Measurement
White coat Hypertension
Type of Hypertension
Suspicion of secondary hypertension
Management of Hypertension(Stage 1& 2)
Why treatment is necessary
Life style modification
Drug treatment of Hypertension
Rationalae of combination
Hypertension management in special situation/ with complications
HYPERTENSION introduction, recommendations for accurate measurements of BP, evaluation of patient with hypertension, management of patient with hypertension, resistant hypertension, hypertensive crisis, hypertensive emergencies
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
This lecture shows the recently updated guidelines for the management of hypertension in primary health care clinics. Moreover, it talks about secondary and resistant hypertension.
Hypertension, its causes, types and managementAbu Bakar
hypertention,it's causes, epidemiology, mechanism,primary and secondary hypertention, preeclampsia and eclampsia, disease related hypertention, classification, dietary plan, diagnosis, clinical presentation, drug related hypertention, treatment,
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
this presentation have various hypertension management guidelines used in the Indian context, hypertension management algorithm, medication used and AYUSH interventions
HYPERTENSION introduction, recommendations for accurate measurements of BP, evaluation of patient with hypertension, management of patient with hypertension, resistant hypertension, hypertensive crisis, hypertensive emergencies
Hypertension is another name for high blood pressure. It can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death. Blood pressure is the force that a person's blood exerts against the walls of their blood vessels.
This lecture shows the recently updated guidelines for the management of hypertension in primary health care clinics. Moreover, it talks about secondary and resistant hypertension.
Hypertension, its causes, types and managementAbu Bakar
hypertention,it's causes, epidemiology, mechanism,primary and secondary hypertention, preeclampsia and eclampsia, disease related hypertention, classification, dietary plan, diagnosis, clinical presentation, drug related hypertention, treatment,
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.
this presentation have various hypertension management guidelines used in the Indian context, hypertension management algorithm, medication used and AYUSH interventions
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
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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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
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
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Problem Magnitude
Hypertension( HTN) is the most common
primary diagnosis in America.
35 million office visits are as the primary
diagnosis of HTN.
50 million or more Americans have high BP.
Worldwide prevalence estimates for HTN may be
as much as 1 billion.
7.1 million deaths per year may be attributable to
hypertension.
3. Definition
A systolic blood pressure ( SBP) >139
mmHg and/or
A diastolic (DBP) >89 mmHg.
Based on the average of two or more
properly measured, seated BP
readings.
On each of two or more office visits.
4. Accurate Blood Pressure Measurement
The equipment should be regularly inspected and
validated.
The operator should be trained and regularly retrained.
The patient must be properly prepared and positioned
and seated quietly for at least 5 minutes in a chair.
The auscultatory method should be used.
Caffeine, exercise, and smoking should be
avoided for at least 30 minutes before BP
measurement.
An appropriately sized cuff should be used.
5. BP Measurement
At least two measurements should be
made and the average recorded.
Clinicians should provide to patients
their specific BP numbers and the BP
goal of their treatment.
6. Follow-up based on initial BP
measurements for adults*
*Without acute end-organ damagewww.nhlbi.nih.gov
8. Prehypertension
SBP >120 mmHg and <139mmHg and/or
DBP >80 mmHg and <89 mmHg.
Prehypertension is not a disease category
rather a designation for individuals at high risk
of developing HTN.
9. Pre-HTN
Individuals who are prehypertensive are not
candidates for drug therapy but
Should be firmly and unambiguously advised to
practice lifestyle modification
Those with pre-HTN, who also have diabetes
or kidney disease, drug therapy is indicated if a
trial of lifestyle modification fails to reduce their
BP to 130/80 mmHg or less.
10. Isolated Systolic Hypertension
Not distinguished as a separate entity as
far as management is concerned.
SBP should be primarily considered
during treatment and not just diastolic BP.
Systolic BP is more important
cardiovascular risk factor after age 50.
Diastolic BP is more important before age
50.
11. Frequency Distribution of Untreated HTN by Age
Isolated Systolic
HTN
Isolated Diastolic
HTN
Systolic Diastolic
HTN
13. Hypertensive Urgencies
Severe elevated BP in the upper
range of stage II hypertension.
Without progressive end-organ
dysfunction.
Examples: Highly elevated BP without
severe headache, shortness of breath or
chest pain.
Usually due to under-controlled HTN.
14. Hypertensive Emergencies
Severely elevated BP (>180/120mmHg).
With progressive target organ dysfunction.
Require emergent lowering of BP.
Examples: Severely elevated BP with:
Hypertensive encephalopathy
Acute left ventricular failure with pulmonary
edema
Acute MI or unstable angina pectoris
Dissecting aortic aneurysm
15. Types of Hypertension
Primary HTN:
also known as
essential HTN.
accounts for 95%
cases of HTN.
no universally
established cause
known.
Secondary HTN:
less common cause
of HTN ( 5%).
secondary to other
potentially rectifiable
causes.
17. Secondary HTN-Clues in Medical
History
Onset: at age < 30 yrs ( Fibromuscular dysplasi)
or > 55 (athelosclerotic renal artery stenosis),
sudden onset (thrombus or cholesterol
embolism).
Severity: Grade II, unresponsive to treatment.
Episodic, headache and chest pain/palpitation
(pheochromocytoma, thyroid dysfunction).
Morbid obesity with history of snoring and
daytime sleepiness (sleep disorders)
18. Secondary HTN-clues on Exam
Pallor, edema, other signs of renal
disease.
Abdominal bruit especially with a diastolic
component (renovascular)
Truncal obesity, purple striae, buffalo
hump (hypercortisolism)
21. Renal Parenchymal Disease
Common cause of secondary HTN (2-5%)
HTN is both cause and consequence of
renal disease
Multifactorial cause for HTN including
disturbances in Na/water balance,
vasodepressors/ prostaglandins
imbalance
Renal disease from multiple etiologies.
22. Renovascular HTN
Atherosclerosis 75-90% ( more common in older
patients)
Fibromuscular dysplasia 10-25% (more
common in young patients, especially females)
Other
• Aortic/renal dissection
• Takayasu’s arteritis
• Thrombotic/cholesterol emboli
• CVD
• Post transplantation stenosis
• Post radiation
23. Complications of Prolonged
Uncontrolled HTN
Changes in the vessel wall leading to
vessel trauma and arteriosclerosis
throughout the vasculature
Complications arise due to the “target
organ” dysfunction and ultimately failure.
Damage to the blood vessels can be seen
on fundoscopy.
24. Target Organs
CVS (Heart and Blood Vessels)
The kidneys
Nervous system
The Eyes
25. Effects On CVS
Ventricular hypertrophy, dysfunction and
failure.
Arrhithymias
Coronary artery disease, Acute MI
Arterial aneurysm, dissection, and
rupture.
26. Effects on The Kidneys
Glomerular sclerosis leading to impaired
kidney function and finally end stage
kidney disease.
Ischemic kidney disease especially when
renal artery stenosis is the cause of HTN
27. Nervous System
Stroke, intracerebral and subaracnoid
hemorrhage.
Cerebral atrophy and dementia
28. The Eyes
Retinopathy, retinal hemorrhages and
impaired vision.
Vitreous hemorrhage, retinal detachment
Neuropathy of the nerves leading to
extraoccular muscle paralysis and
dysfunction
29. Retina Normal and Hypertensive
Retinopathy
Normal Retina Hypertensive Retinopathy A: Hemorrhages
B: Exudates (Fatty Deposits)
C: Cotton Wool Spots (Micro
Strokes)
A B
C
35. Patient Evaluation Objectives
(1) To assess lifestyle and identify other
cardiovascular risk factors or concomitant
disorders that may affect prognosis and guide
treatment
(2) To reveal identifiable causes of high BP
(3) To assess the presence or absence of
target organ damage and CVD
36. (1) Cardiovascular Risk factors
Hypertension
Cigarette smoking
Obesity (body mass index 30 kg/m2)≥
Physical inactivity
Dyslipidemia
Diabetes mellitus
Microalbuminuria or estimated GFR <60 mL/min
Age (older than 55 for men, 65 for women)
Family history of premature cardiovascular disease (men
under age 55 or women under age 65)
37. (2) Identifiable Causes of HTN
Sleep apnea
Drug-induced or related causes
Chronic kidney disease
Primary aldosteronism
Renovascular disease
Chronic steroid therapy and Cushing’s
syndrome
Pheochromocytoma
Coarctation of the aorta
Thyroid or parathyroid disease
38. (3) Target Organ Damage
Heart
Left ventricular hypertrophy
Angina or prior myocardial infarction
Prior coronary revascularization
Heart failure
Brain
Stroke or transient ischemic attack
Chronic kidney disease
Peripheral arterial disease
Retinopathy
39. History
Angina/MI Stroke: Complications of HTN,
Angina may improve with b-blokers
Asthma, COPD: Preclude the use of b-
blockers
Heart failure: ACE inhibitors indication
DM: ACE preferred
Polyuria and nocturia: Suggest renal
impairment
40. History-contd.
Claudication: May be aggravated by b-
blockers, atheromatous RAS may be present
Gout: May be aggravated by diuretics
Use of NSAIDs: May cause or aggravate HTN
Family history of HTN: Important risk factor
Family history of premature death: May
have been due to HTN
41. History-contd.
Family history of DM : Patient may
also be Diabetic
Cigarette smoker: Aggravate HTN,
independently a risk factor for CAD and
stroke
High alcohol: A cause of HTN
High salt intake: Advice low salt intake
42. Examination
Appropriate measurement of BP in both arms
Optic fundi
Calculation of BMI ( waist circumference also
may be useful)
Auscultation for carotid, abdominal, and femoral
bruits
Palpation of the thyroid gland.
43. Examination-contd.
Thorough examination of the heart and
lungs
Abdomen for enlarged kidneys, masses,
and abnormal aortic pulsation
Lower extremities for edema and pulses
Neurological assessment
44. Routine Labs
EKG.
Urinalysis.
Blood glucose and hematocrit; serum
potassium, creatinine ( or estimated GFR),
and calcium.
HDL cholesterol, LDL cholesterol, and
triglycerides.
Optional tests
urinary albumin excretion.
albumin/creatinine ratio.
45. Goals of Treatment
Treating SBP and DBP to targets that are
<140/90 mmHg
Patients with diabetes or renal disease, the BP
goal is <130/80 mmHg
The primary focus should be on attaining the
SBP goal.
To reduce cardiovascular and renal morbidity
and mortality
46. Benefits of Treatment
Reductions in stroke incidence,
averaging 35–40 percent
Reductions in MI, averaging 20–25
percent
Reductions in HF, averaging >50 percent.
48. Lifestyle Changes Beneficial in Reducing Weight
Decrease time in sedentary behaviors
such as watching television, playing video
games, or spending time online.
Increase physical activity such as walking,
biking, aerobic dancing, tennis, soccer,
basketball, etc.
Decrease portion sizes for meals and
snacks.
Reduce portion sizes or frequency of
consumption of calorie containing beverages.
49. DASH Diet
Dietary approaches to Stop Hypertension
As effective as one medication