INTRACRANIAL HYPERTENSION (ETIOLOGY,PPATHOPHYSIOLOGY,SYMTOMS,COMPLICATIONS,TR...BRINCELET M BIJU
Intracranial hypertension (IH) is a build-up of pressure around the brain. It can happen suddenly, for example, as the result of a severe head injury, stroke or brain abscess. This is known as acute IH. It can also be a persistent, long-lasting problem, known as chronic IH.
Definitions, etiologies and symptoms of intracranial hypertension included. Relevance of intracranial hypertension to ophthalmologist and grading of papilledema discussed. Detailed discussion of Idiopathic Intracranial Hypertension (IIH), including the diagnostic criteria, clinical and radiological diagnosis, management and monitoring of IIH discussed.
INTRACRANIAL HYPERTENSION (ETIOLOGY,PPATHOPHYSIOLOGY,SYMTOMS,COMPLICATIONS,TR...BRINCELET M BIJU
Intracranial hypertension (IH) is a build-up of pressure around the brain. It can happen suddenly, for example, as the result of a severe head injury, stroke or brain abscess. This is known as acute IH. It can also be a persistent, long-lasting problem, known as chronic IH.
Definitions, etiologies and symptoms of intracranial hypertension included. Relevance of intracranial hypertension to ophthalmologist and grading of papilledema discussed. Detailed discussion of Idiopathic Intracranial Hypertension (IIH), including the diagnostic criteria, clinical and radiological diagnosis, management and monitoring of IIH discussed.
Nitric oxide forms the basis for both performance and size.* Nitric oxide dilates the blood channels which may support the delivery of vital training and recovery nutrients to your muscle cells.* In addition, nitric oxide is a molecule known to help "signal" and regulate muscle growth, muscle contraction, and metabolic adaptation to training.* Thanks to MRI's innovative ACTINOS2IR (Instant Release) technology, Black Powder may help to support an increase in nitric oxide levels.
Rectal prolapse: Do we really have a perfect surgical solution? pptx copyDr Amit Dangi
Ventral rectopexy has gained worldwide acceptance for surgical correction of rectal prolapse and high-grade internal rectal intussusception. The technique is based on correcting the descent of the posterior and middle compartments combined with reinforcement of the vaginal septum and elevation of the pelvic floor. anterior mobilization of the distal rectum and mesh suspension performed during VR can correct full-thickness rectal prolapse, rectoceles, and internal rec- tal prolapse and can be combined with vaginal prolapse procedures, such as sacrocolpopexy, in patients with multicompartment pelvic floor defects.
Remote Ischaemic Conditioning: A Paper Review & Uses in Paramedic Practicebgander23
A 2 part presentation. Part 1 reviews a paper on the long-term clinical outcomes of STEMI patients undergoing remote ischaemic perconditioning prior to primary percutaneous coronary intervention. The 2nd part looks at how this technique can be used in Paramedic practice.
Paula Dawson – The Flying Colours ProjectMQ_Library
The Flying Colours Project by Paula Dawson began on 26th of March 2020 in response to the situation caused by the COVID-19 pandemic. The first 60 watercolour works in the series have each been painted with a particular individual or family in mind, imagining what colours would speak to them. The paintings vary in size from 46 x 61 cm and 36 x 51 cm to smaller works measuring 26 x 36 cm. Each painting with its personally chosen pallet has been sent by Australia Post or given in person at the recommended social distancing space. There is a performative element to the series as Paula makes a unique work in her studio each day since the onset of the pandemic.
The extraordinary hologram To Absent Friends, created by Paula Dawson in 1989 was generously donated to Macquarie University by Paula in 2005. At that time To Absent Friends was the largest depth of field hologram in the world, it’s a super dazzling work that is one of a kind on an international scale. Tours on dedicated days and times will be organised for the latter part of this year.
The Flying Colours Project coincides with the 10 year anniversary of launching the landmark exhibition Virtual Encounters: Paula Dawson Holograms at Macquarie University Art Gallery in partnership with Newcastle Region Art Gallery.
Please follow the link to the MUAG website to view Paula’s remarkable series of works in all its variations of pattern, colour and movement.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
1. EBS Presentation
Effectiveness of optic nerve sheath
fenestration in idiopathic intracranial
hypertension
Johnny Wong
14th July, 2011
Advanced Scholar: Prof Marcus Stoodley
3. Clinical Questions:
• Primary Question:
What is the effectiveness of optic nerve sheath fenestration
(ONSF) in patients with idiopathic intracranial hypertension?
• Secondary Question:
How does ONSF compare with other treatments for
idiopathic intracranial hypertension?
4. Search strategy
• P = Idiopathic intracranial hypertension
• I = Optic nerve fenestration
• [C = Other surgical procedures (eg CSF shunting;
sinus stenting) ]
• O = Treatment outcomes
• Cochrane, Ovid Medline, Scopus, Google Scholar
• MeSH terms: “Pseudotumour cerebri” ; “ophthalmologic surgical
procedures”
5. Cochrane
• Methods:
– Searched for RCT only
– 3 categories: Idiopathic patients
with papilloedema; Idiopathic
without papilloedema; IIH with
underlying aetiology
– 7 Interventions types
• Results:
– 85 studies relevant to IIH
– 1 RCT found – poor
randomisation (acetazolamide)
• Recommendations:
– Optic nerve fenestration or LP
shunt for papilloedema
– Further research required
9. Primary Question – Efficacy of ONSF
• No RCT; Case series only;
• 3 review articles found
• Prevent visual deterioration; Improved VA,
not HA (33-50% not relieved)
• Review by Brazis et al(2008), Uretzky et al.
(2009)
– Papilloedema: 86-97% resolved or sig. improved
– VA: 85-91% Improved or stabilised
– VF: 48-95% improved; 25-38% stabilised
10. Primary Question – Efficacy of ONSF
– Bilateral VA improvement from unilateral ONSF
– Better for acute papilloedema
– 10-15% worsening vision
– 4.5-45% complication rates
– Long-term (5 years):
• 36% improvement
• 32% stabilisation
• 33% later deterioration after initial improvement
– Maintenance of vision
• 66% @ 12 months; 55% @ 3y, 38% @ 5y, 16% @ 6y
11. • Retrospective series of 32 patients, 51 eyes
• 41% with PTC; 47% ONSF as primary procedure
• 11/17 had second shunt procedure
12. Case series
• Retrospective case series; 10 patients with
bilateral ONSF
• All 10 patients improved in papilloedema and
VA in short-term
• Long-term: evaluation difficult due to
concomittant treatment
13. Case series: Alsuhaibani et al, 2011
Effect of Optic Nerve Sheath Fenestration on
Papilloedema of the operated and
contralateral non-operated eyes in idiopathic
intracranial hypertension
• Retrospective series; 62 patients unilateral ONSF
• Pre-op papilloedema scores: Ipsi & contral – 3 & 2
• Post-op: 2 & 2 (2 wks); 1 & 1 (3 & 6 months); 0.5 & 1
(12 months)
14. Secondary question: Comparison with
other treatments
• No RCT comparing surgical options or
medical treatment
• Case series and review articles
• LPS – effective in treating symptoms, but high
rates of revisions
• VPS – difficult ventriculostomy with small
ventricles
19. LPS vs VPS
• 115 shunt operations in 42 patients (79 LPS, 36 VPS)
• 95% improvement in headaches
• 19% and 48% recurrent HA despite functioning shunt
at 12 and 36 months respectively
• 2.5 fold increased risk of revisions with LPS
• 3 fold increased risk of distal obstruction with LPS.
21. Conclusion
• ONSF effective in short term for papilloedema
and visual deterioration (85-94%); not HA.
• Unilateral may be adequate;
• Long-term recurrence
• Efficacy similar to LP or VP shunts
• RCTs required for best treatment for IIH
Editor's Notes
• increased intracranial pressure (ICP);• normal/small ventricles on neuro-imaging;• no evidence of intracranial mass;• normal CSF composition (a low CSF protein is acceptable).
Recommended treatment compared with shunting: shorter OT time and lower complications; ? Unilateral ONSF is adequate