A 30-year-old man presented with lower limb swelling, shortness of breath, and decreased urine output for 2 weeks. He had a history of drug abuse including heroin, tramadol, and marijuana. Initial labs showed severe kidney dysfunction with a creatinine of 7.5 mg/dl. A renal biopsy was performed which showed acute tubular injury, focal interstitial nephritis with eosinophil infiltrate, and mesangial proliferative glomerulonephritis. He was started on hemodialysis and steroids. After treatment, his kidney function improved and he was discharged with a creatinine of 1.5 mg/dl.
When to dialyse a patient and with what modality of dialysis will be topic of discussion.The recent advances and debates surrounding the topic will be discussed in detail
When to dialyse a patient and with what modality of dialysis will be topic of discussion.The recent advances and debates surrounding the topic will be discussed in detail
Contrast induced nephropathy (CIN) is agenerally reversible form of acute kidney injury (AKI) that occurs soon after the administration of radiocontrast media.
Contrast induced nephropathy (CIN) is agenerally reversible form of acute kidney injury (AKI) that occurs soon after the administration of radiocontrast media.
Case Presentation on Perforated Duodenal Ulcerksaigowtham
a case study in the department of general medicine surgery which was collected in the month of November 2019 and studied analyzed with SOAP format and submitted
Information about Inflammatory bowel disease in history, different investigations and surgery and post op by Dr Dhaval Mangukiya.
Details of Low Anterior Resection(LAR), Arterial Supply, Venous Drainage, Ports, Position, Modified Lithotomy, Vessel Ligation, Lymph Nodes, Nerves Anatomy, Superior Hypogastric Plexus, Lateral Pelvic Nerves, Correct TME, Anastomosis etc.
https://drdhavalmangukiya.com/
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
Clinical cases from infection diseases hospitaldrandreyst-p
Presentation shows some real cases from infection diseases hospital and allow you to challenge your knowledge in medicine. After presentation of each case you will see a slide with a question about diagnosis. Try to answer and if you would have problems go to next slide where you will find a hint. Goodluck! If you would interested in new cases please contact Dr Andrey Dyachkov cd4@inbox.ru
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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
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
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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.
- 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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. A-30 year old patient from Elmahala single ,driver
smoker(2 pack)/day , addict for heroin ,marijuana
and tramadol
Personal History
3. Swollen of both lower limb ,shortness of breath
2 weeks ago
Complaint
4. • 2 weeks before admission, patient developed
lower limb edema associated with decreased
urine output, puffiness of eye lids, dyspnea and
bone aches.
• Also the condition associated with persistent
vomiting about four times per day , nausea ,
epigastric pain and decrease oral intake ,with no
diarrhea or fever
• The condition wasn’t associated with redness or
hotness or any skin lesions on the overlying skin
Present History
5. Patient seeked medical advice
Non-specific TTT: PPI, antiemetic,
However,
No improvement
Lab investigations were ordered
Serum Creatinine 7.5 mg /dl
6. • No history of DM or HTN
• No history of renal disease or liver disease
• No history of immune disease
• No history of radio contrast
• No history of traveling abroad
• No history of previous surgery or blood
transfusion
Past History
7. History of tramadol abuse about 4
tabs per day for 5 years ,Hashish
for 5 years ago and heroin
addiction for 1 year
History for NSAIDS occasionally
,but not in the last 2 weeks before
admition
History of proton pump inhibitors
,anti emetic in the week before the
admition
Drug History
8. • Fully conscious
• BP: 150/100
• Pulse: 84/min sinus
• RR: 22/min
• No fever, rash or arthritis
• neck veins: congested
• Chest: wheeze with bronchial breathing
• Abdomen: lax ,no tenderness
• Edema LL grade 3 with no redness or hotness on
the overlying skin ,
Examination
11. Radiology
1- Abdominal us
• Both kidneys mildly enlarged and swollen with
increased cortical echogenicity
• (RT: 12.9 x 5.5 LT: 12.5x5.2)
• Average parenchymal thickness
• No stones , backpressure ,or mass are seen
• Otherwise , abdominal US completely normal
2-Trans-thorasic ECHO
No vegetation or thrombus with overall cardiac
indices within normal
Radiology
14. • ANA : -ve
• C3: normal
• C4: normal
• pANCA:-ve
• cANCA:-ve
• RF factor 1/8
• LDH:600
• Blood film : no shictocytis . no abnormal cells
• Alb/creat :890 mg/mmol (normal up to 30mg/mmol)
• HCV PCR 1 200.000
Investigations 2
15. A: conservative
B:dialysis
C: CST
D: Renal biopsy
o trial of iv diurtics
o Symptomatic treatment for uremic symptoms and oral
bicarbonate Na supplementation
o Antibiotics for UTI and chest infection
o Liver support with follow up liver function
Management
17. A: conservative
B:dialysis
C: CST
D: Renal biopsy
ManagementProteinuria,
drug history ,
no improvement on
conservative
treatment?
Leukocytosis
,CRP: 96
Diagnosis not confirmed
by renal biopsy yet
18.
19. A: conservative
B:dialysis
C: CST
D: Renal biopsy
Management
Prepare the patient for biopsy as soon as possible:
Control BP
Adjust bleeding profile
Treatment of infection
Management
20. • after 4 days of conservative ttt Patient clinically improved at
the level of liver function and leukocytosis ,but on the
other hand at the level of kidney function patient didn’t
show improvement either at the level of clinical condition ,
uop or. Laboratory investigation :
o S.creatinine 9.5 mg/dl
o PH: 7.3
o H2CO3:14
o PCO2: 23
o K: 6.3mmol/L
Patient kept on conservative measures ,start
steroids 3o mg/day , biopsy done and patient
started hemodialysis
Management
24. Finally
• Patient diagnosed as acute interstitial
nephrites and mesangioproliferative GN and
discharged on serum creat: 1.5mg/dl and on
treatment steroids 30 mg/day,and after 2
weeks on fllow up
s.creat 0.9 mg/dl
And adviced to receive HCV treatment
Finally