Inhalant abuse involves inhaling chemical vapors from household products like glues and solvents to get high. Common inhalants include volatile solvents, aerosols, gases, and nitrites. Acute effects include euphoria and CNS depression, while chronic use can lead to neurological and cognitive issues like memory problems. Risk factors include peer pressure and socioeconomic adversity. Prevention focuses on limiting access, education, and addressing underlying issues like mental health problems. Management involves treatment of withdrawal, medical complications, and psychosocial support.
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.
Definition, Epidemiology, Etiology, Aspects of anxiety, Classification/types of anxiety, Pathophysiology of anxiety disorders, Management of anxiety disorders along with treatment algorithms
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
Impulse-control disorders (ICDs) are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.
The individual fails to resist performing a potentially harmful act and it is usually accompanied by a sense of tension or arousal before committing the act and a sense of relief or pleasure when it is committed.
The hallmark in describing any of the ICDs is a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others.
A presentation about panic attacks and panic disorder. this presentation composed of the definition, causes, symptoms, diagnosis, treatment, prevention and prognosis of panic disorder.
Continuing Education for mental health and substance abuse counselors and therapists. Reviews types of depressants including inhalants, side effects and effects on sports performance.
Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.
Definition, Epidemiology, Etiology, Aspects of anxiety, Classification/types of anxiety, Pathophysiology of anxiety disorders, Management of anxiety disorders along with treatment algorithms
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
Impulse-control disorders (ICDs) are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.
The individual fails to resist performing a potentially harmful act and it is usually accompanied by a sense of tension or arousal before committing the act and a sense of relief or pleasure when it is committed.
The hallmark in describing any of the ICDs is a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others.
A presentation about panic attacks and panic disorder. this presentation composed of the definition, causes, symptoms, diagnosis, treatment, prevention and prognosis of panic disorder.
Continuing Education for mental health and substance abuse counselors and therapists. Reviews types of depressants including inhalants, side effects and effects on sports performance.
Typical antipsychotics and dopamine in psychosis Ann Sparks
Overview of TYPICAL/Second Generation Antipsychotics (Neuroleptics, Classic, Conventional, D2 Receptor Antagonists). Includes an historical context, Dopaminergic (Reward) Pathways, Symptoms of Psychosis, Side Effedts of Typical Antipsychotics, and animations (if they "translate!").
A comprehensive slide on topic: schizophrenia. Compiled based on Newcastle University and NUMed Stage 5 learning outcomes in Mental Health module. Suitable for medical students and housemen who wish to revisit the topic. (Disclaimer: The diagnostic criteria ae based on ICD-10, so please check the latest version)
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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.
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!
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.
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
7. WHY SOLVENTS ?
A rapid high - much faster than drugs or alcohol.
Relatively cheap, easy to buy.
Not illegal, easily available.
Escape from reality and conflicts.
Novelty seeking and peer influence.
As a replacement for other substances.
(NIDA 2012)
8. NEUROBIOLOGICAL CONSIDERATIONS
• An abuser intakes 20-30 times exposure of substances
than an accidental exposure (>6000 ppm).
• Solvents are highly lipophilic thus cross biological
membranes easily.
• Affect cell membranes in a similar way to anesthetics.
• Not known to have any unique receptors or mimic an
endogenous ligands.
(Lubeman et al, Br J Pharmacol 2008, May 154(2):316-326)
9. ACUTE EFFECTS
• Inhibition of NMDA subunits
• GABA agonistic activity
• Increased DA in VTA & NA (addiction potential)
Dysruption of :
Activity of numerous voltage gated ion channels
Calcium signalling
ATPases
G proteins
(Lubeman et al, Br J Pharmacol 2008, May 154(2):316-326)
10. Stages of inhalant intoxication
Stage 1-Excitatory stage (euphoria ,
excitation )
Stage 2-Stage of early CNS depression
(slurred speech , visual hallucination )
Stage 3-Stage of medium CNS depression
(ataxia, confusion , delirium )
Stage 4-Stage of late CNS depression
(stupor ,seizure ,coma ,death)
(Mathew etal, Addict Sci clin Pract 2011, Jul; 6(1):18-31)
11. SUDDEN SNIFFING DEATH SYNDROMES
• Severe dysarrhythmias (nitrites, toluene, benzene)
• Sudden cold injury to airways (freons)
• Severe burn injury to airway tracts (butane,
propane)
• Suffocation (bagging)
• Aspiration & choking
• Severe brain hypoxemia
• Accidents & falls
(NIDA 2012)
12. Chronic exposure
• ALLOSTASIS :
Semi-chronic (4 days) exposure caused an
increase in NMDA evoked responses with a
decrease in GABA-evoked responses.
• Consistent with a hyper excitability / hyper-
glutamatergic state during withdrawal like in
ADS.
(Lubeman etal, Br J Pharmacol 2008, May 154 (2): 316-326)
13. CHRONIC EXPOSURE (Contd.)
• Most damage to white matter structures
and the lipid component of the myelin
sheath.
• Commonly observed neuropsychological
deficits(impairments in processing speed,
sustained attention, memory retrieval,
executive function and language) are
consistent with white matter pathology.
(Geibprasert etal, Am J Neuroradiol 2010, May,31:803-08)
14. CHRONIC EFFECTS (Contd.)
• Significant improvements in previously
identified impairments(impaired associate
learning and attention deficits)following 2
years abstinence from petrol sniffing.
• MRI abnormalities are however reported to
be irreversible.
15. MRI FINDINGS IN CHRONIC EXPOSURE
• White matter diffuse T2 hyper intensities
• Atrophy
• T2 hypointensities in thalami and basal ganglia
Marked atrophy of brain in inhalant abuser
(Geibprasert etal, Am J Neuroradiol 2010, May,31:803-08)
20. • EMBRYOPATHY: “FETAL SOLVENT SYNDROME”
Children born to mothers using toluene in
pregnancy show growth retardation, craniofacial
dysmorphism, hearing loss, cleft palate,
developmental delay, cerebellar dysfunction.
(Guidelines on Inhalants, National Inhalant Prevention Coalition Website updated 2012)
22. RISK FACTORS
• Adverse socio-
economic
conditions
• H/O child-abuse
• Poor graders
• School dropout
Less formal
education
Peer pressure
Parental abuse
Dysfunctional
families
(Gupta etal, Indian J Med Res 2014, May,139(5): 708-713)
23. CATEGORIES OF USERS
• Transient social user ( 10-16 yr old, short history,
average intelligence, use with friends)
• Chronic social user (20-30 yr old, 5+ yr use, daily use,
with friend,, with friends, brain damage)
• Transient isolate user (10-16 yr old, short history,
average IQ, solo use)
• Chronic isolate user (20-30 yr old, 5+ yrs, daily use,
brain damage, lonely use)
(Guidelines on Inhalants, National Inhalant Prevention Coalition Website updated 2012)
24. DANGER OF EARLY USE
• Increased risk of dependence
• Subsequent shifting to other class of drugs
(gateway hypothesis)
• ASPD & poor IP relations
• Mood disorders
• Poor achiever
• Suicides & DSH
• Early medical complications
25. MANAGEMENT
General Principles:
• Acute medical management (in case of intoxication)
• Detailed history (including products used, other substances,
psychiatric symptoms).
• Physical examination including detailed Neurological (especially
in chronic abusers).
• Lab investigations for Liver & Kidney function, ECG.
• Pharmacological management for withdrawal symptoms and
associated medical / psychiatric conditions.
• Psychosocial interventions
Kumar etal, Indian J Psychiatry 2008, Apr-Jun; 50(2): 117-120
26. MANAGEMENT (contd.)
Pharmacotherapy:
• Some authors recommend BZDs to be used for treatment
of withdrawal symptoms as inhalant act as CNS
depressants.
(Brouette. et al 2001)
• Baclofen (around 50mg/d) has been found useful in
reducing craving and withdrawal symptoms in a case series.
(Muralidharan K. et al 2008)
• Buspirone (40mg/d) was found useful in reducing
frequency of petrol inhalational abuse in a case report.
(Niederhofer et al 2007)
• Lamotrigine (100mg/d) was also found to reduce craving
and maintain abstinence in a case of inhalant dependence.
(Shen Y. et al 2007)
28. PREVENTION
• Tackling supply:
Product elimination/modification
Warning labels
Educating manufacturers/suppliers
Sales controls
• Tackling demand:
Legal control
Information and education with skills-building
29. • A notification was published in Extraordinary
Gazette, 17th July 2012 by Ministry of Health and
Family Welfare, Government of India:
- Banning production/sale of bottled Correction
fluids/Thinners.
- Mandatory warning regarding effects on health.
30. EXTERNALIZING & INTERNALIZING SPECTRUM
Externalizing spectrum
• Less attention spans
• Hyperactivity
• High novelty seeking
• Easy need for gratification
• High impulsivity
• Poor frustration tolerance
• Aggression
• Internalizing spectrum - (phobias, social anxiety,
depressive states , obsessions)
ADHD
Conduct disorder
Oppositional
defiant
disorder
Tacket , Child Development Perspectives, vol 4,3: 161-167
31. OPPOSITIONAL DEFIANT DISORDER
(ICD -10, F 91.3)
• Pattern of persistently negativistic, hostile, defiant,
provocative and disruptive behavior outside normal range of
behavior for child of same age
• Does not include more serious violations of the rights of
others (unlike aggressive and dissocial behavior of socialized
& unsocialized conduct disorder)
• Tend to be angry, resentful, easily annoyed by other people
whom they blame for their own mistakes or difficulties.
• Low frustration tolerance & readily lose temper.
• More evident in interactions with adults or peers whom child
knows well (may not be evident during clinical interview)
32. Biopsychosocial Model
Average
IQ,
ODD traits
Impulsive
Suicide in
mother
Substance
Use in father
Academic
decline,
Punitive
treatment
Death of
mother in early
age,
step mom
Poor socio
economic state,
Dysfunctional
family dynamics
Peer
influence
&
SUBSTANCE
USE
ALTERED
DEVELOPMENTAL
TRAJECTORY
33. PREVENTION at INDIVIDUAL & FAMILY LEVEL
(MOSTLY IGNORED)
REALISTIC APPRAISAL OF
ABILITIES
(NO EXPECTATION Vs
REALITY MISMATCH )
EMOTONALLY
SUPPORTIVE
(EMPATHETIC) &
OPEN COMMUNICATION
STYLE
REDUCING
EXPRESSED
EMOTIONS (EE)
ACTIVITY
SCHEDULING
ENLISTING
SUPPORT SYSTEMS
UNDERSTANDING
NEED
(FOR USE OF
SUBSTANCES)
REALISTIC GOALS
FAMILY ORIENTATION
ASSERTIVENESS
TRAINING
EARLY
ATTETION
34. TAKE HOME POINTS
• Solvent abuse is a significant problem which is
often ignored.
• It has long term neuropsychological and other
medical complications.
• Simple interventions can prove fruitful.