Dr. Sandeep B S discusses the imaging findings of sarcoidosis in various organs. On thoracic CT, typical findings include bilateral hilar and right paratracheal lymphadenopathy, as well as peribronchovascular and subpleural lung nodules. Cardiac MRI can detect myocardial inflammation and scarring from sarcoidosis with high sensitivity and specificity. Hepatic and splenic sarcoidosis may appear as nodules or periportal adenopathy on abdominal imaging. Neurosarcoidosis can involve the leptomeninges, cranial nerves, dura, or spine. Bone sarcoidosis may cause lytic lesions, while musculoskeletal sarcoidosis can result
This presenation includes anatomy and pathology of intraconal conal and extraconal orbital pathology. this presenation dealsimaging feature of different pathology. Thanks.
This presenation includes anatomy and pathology of intraconal conal and extraconal orbital pathology. this presenation dealsimaging feature of different pathology. Thanks.
The upper and lower extremity arteries , easy to examine, becoz of good imaging window.
Doppler frequencies are typically more than 3 MHz.
Though real-time gray-scale sonography is useful for evaluating the presence of atherosclerotic plaque or confirming the presence of extravascular masses. Color flow Doppler sonographic imaging allows the clinician to survey the area of interest rapidly, determine if vascular structures are present, and if so, characterize their blood flow patterns
The upper and lower extremity arteries , easy to examine, becoz of good imaging window.
Doppler frequencies are typically more than 3 MHz.
Though real-time gray-scale sonography is useful for evaluating the presence of atherosclerotic plaque or confirming the presence of extravascular masses. Color flow Doppler sonographic imaging allows the clinician to survey the area of interest rapidly, determine if vascular structures are present, and if so, characterize their blood flow patterns
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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.
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
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!
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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.
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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
4. Lymphadenopathy -typical patterns
Most common .
Bilateral symmetric hilar and right paratracheal lymph
node enlargement- in ~ 95%.
Left paratracheal , subcarinal, AP window, prevascular
nodes in ~ 50%.
DD- TB , Lymphoma.
13. Typical lung features
2. Bilateral perihilar opacities
Areas of consolidation with irregular edges.
Radiate from the hilum towards the periphery.
Accompanied by micronodules.
16. Typical features
3.Chronic Fibrotic changes (in 20% of patients)
Follow large airways in perihilar region
Linear opacities
Traction bronchiectasis
Architectural distortion (displacement of fissures
and bronchovascular bundles).
Upper and midzone predominance
4.Pulmonary hypertension in extensive fibrosis.
17.
18. Lung features- Atypical
1.Pulmonary masses
15%–25% of patients
Ill-defined irregular opacities measuring 1–4 cm in
diameter .
Multiple and bilateral.
Small micronodules surrounding them – “Galaxy
sign”.
Multiple cluster of micronodules- “Cluster sign”.
DD- Other granulomatous disease, malignancy
20. Atypical features
2.Patchy GGOs
40% of patients
Confluence of multiple micronodules and fibrotic
interstitial lesions.
Not an isolated finding .
Always on a background of perilymphatic nodules and
other findings.
23. Small Airway Abnormalities
Small airway involvement by granulomas /
fibrosis narrowing of lumen Air trapping
(Multiple small areas of low attenuation).
Expiratory CT- Mosaic attenuation
27. Siltzbach staging
Developed before the introduction of CT.
CT/ HRCT is far more sensitive than chest radiography
in depicting subtle parenchymal abnormalities in early
stages of the disease, even in stage 1.
28. HRCT- Reversible vs irreversible
Reversible / Inflammatory
signs
Nodules
Airspace consolidation
Ground-glass opacities
Irreversible changes
Architectural distortion
Traction bronchiectasis
Honeycombing , cysts, bullae
Volume loss in upper lobes
Mycetoma within a cavity
29.
30. Is it TB or Sarcoidosis ??
Similar clinicoradiological manifestations.
Uncommon manifestations of TB may be commoner
than typical presentation of Sarcoidosis.
Differentiating the two is important as treatments are
different.
CT plays a major role .
33. SARCOIDOSIS TB
Peribronchovascular,
subpleural
Consolidation- less
common
(peribronchovascular/
UZ, MZ)
B/l parahilar mass-like
Non necrotic LNs
Centrilobular,
miliary, random.
Consolidation- more
common(Apico-post
UL, Supr seg of LL)
Less common
Necrotic LNs
34.
35. Asymptomatic throughout life.
Few present with nonspecific features–
Conduction disorders
Congestive heart failure
Ventricular arrhythmias
Sudden cardiac death.
36. Demonstration of non caseating granulomas in
Endomyocardial biopsy is the criterion standard.
Invasive.
Small tissue sample taken from right side
Diagnostic yield is ~30%.
Cannot give data on distribution of disease.
CMR has good sensitivity (75-90%) and specificty (70-
80 %) for diagnosis
37. Important sequences
T2 weighted sequence (water sensitive sequence)-
For detecting edema – bright signal
Late Gad enhancement sequence-
10 min post contrast injection
Gad is an extracellular contrast
Accumulates in areas of increased extracellular space-
inflammation and fibrosis.
For detecting active inflammation and scars .
43. 2.Post inflammatory pattern
Replacement fibrosis / scar.
Loss of myocytes Increase in extracellular space
Late gadolinium enhancement.
Mid myocardial , subepicardial region .
Associated with myocardial thinning.
45. Importance of LGE
Extent of LGE is an important prognostic marker .
Strongest independent risk factor for sudden cardiac
death.
LGE > 20% of LV mass is a strong predictor of life
threatening arrythmias, cardiac failure .
52. Abdominal adenopathy
2 or more nodes with SAD of >1cm
~30% of patients
Periportal, periceliac, mesentric, paraaortic.
Retrocrural and pelvic nodes- less common ( more
common in Lymphoma).
70. Small bone sarcoidosis
Bones of hands and foot.
Lace like lytic appearance
(honeycombing)
Punched out lesions
Pathological # and bone
collapse
71.
72. Sarcoid Arthropathy
Arthralgia due to
cytokines
Lofgren’s syndrome
Polyarticular ( Knee,
ankle, wrist, elbow, PIP)
Self-limiting
X ray- osteopenia, soft
tissue swelling
Granulomatous
arthritis, synovitis
2 or more joints (Knee,
ankle, PIP )
Chronic relapsing course
X ray- Mild joint space
narrowing, subchondral
cysts
73. Role of MRI
Synovitis
Tenosynovitis
Bursitis
Tendonitis
Findings are non- specific .
USG can also pick these lesions
75. Sarcoid Myopathy - Diffuse
Proximal muscle atrophy
with fatty replacement
Post treatment
corticosteroid myopathy-
similar imaging
appearance.
76. Role of PET in Sarcoidosis
PET is a metabolic study which shows areas of
increased metabolism as bright spots (infection,
inflammation, malignancy ).
Not useful for diagnosis of Sarcoidosis.
Used to assess the activity in proven cases of
sarcoidosis / for follow up.
78. TAKE HOME POINTS
B/l hilar and right paratracheal LNs.
Peribronchovascular / subpleural nodules.
Very important to differentiate from TB.
CMRI is powerful tool to assess cardiac sarcoidosis /
risk stratification .
PET – useful to assess the activity and response to
treatment .
79. References
Pulmonary Sarcoidosis: Typical and Atypical Manifestations
at HighResolution CT with Pathologic Correlation .
RadioGraphics 2010; 30:1567–1586 .
Radiologic Manifestations of Sarcoidosis inVarious Organs.
RadioGraphics 2004; 24:87–104.
Dilemma of diagnosing thoracic sarcoidosis in
tuberculosisendemic regions: An imaging-based approach.
Part 1. Indian J Radiol Imaging2017;27:369-79.
Cardiac Sarcoidosis: Spectrum of MRI Features. AJR
2005;184:249–254 0361–803X/05/1841–249