All details about N2O and Halothane volatile anesthetic, their physical properties , their anesthetic effect on human body systems, also the indications and the history, the complications and contraindications, the metabolism.
How supplied ? Types of vaporizers, old and modern.
A powerpoint explaining in detail about all the intravenous induction agents and their clinical uses, pharmacokinetics & pharmacodynamics, adverse effects and complications.
Ropivacaine is a recently launched local anesthetic in Iran. Because of its more safety profile, it would be an appropriate substitution for routinely used LA, Bupivacaine.
A powerpoint explaining in detail about all the intravenous induction agents and their clinical uses, pharmacokinetics & pharmacodynamics, adverse effects and complications.
Ropivacaine is a recently launched local anesthetic in Iran. Because of its more safety profile, it would be an appropriate substitution for routinely used LA, Bupivacaine.
Intro to Hypoxic pulmonary vasoconstriction Arun Shetty
Hypoxic pulmonary vasoconstriction, a seldom heard phenomenon but very effective physiologic property which helps lungs utilise ventilation to the maximum
Intro to Hypoxic pulmonary vasoconstriction Arun Shetty
Hypoxic pulmonary vasoconstriction, a seldom heard phenomenon but very effective physiologic property which helps lungs utilise ventilation to the maximum
Inhalational Anesthetics; Isoflurane and Sevoflurane.pptxMahmood Hasan Taha
Isoflurane (Furane) 1979, Sevoflurane (Ultane) 1990s
general description ,physical properties and anesthetic properties .
Effects on organ system, contraindications, drug interaction.
Two important facets of cardiac disease as it relates to health at work. Agents used in the workplace may produce toxic effects manifested as heart disease or dysfunction. Possibly more important, however, is the effect that heart disease (common in Western society) has on the ability to work.
A case about respiratory acidosis. this case discussed the metabolism of alcohol, the complication of alcohol and the mechanism of respiratory acidosis
Vk gmailcomcom and care Educate the ‘at the hell is not known meaning in 12 hindi meaning of the positive thought ke liye liye mana kiya hai maine us se baat karunga to delay ho gya h kya mere se baat
Desflurane (suprane) 1992
general description , effects on organ system, specific physical properties, inhalational advantages and disadvantages.
desflurane vaporizer (TEC6 PLUS Datex Ohmeda), D-vapor , electrical vaporizer
Zenon (Xe) the Nobel gas , its anesthetic properties.
Discussing many types of anesthesia vaporizer, the old and the new , the modern and advanced vaporizers.
also the mechanism of action of each type.
The properties of different types of vaporizers.
how to select your favorite vaporizer.?
Discussing the history of modern volatile anesthetics, Halothane, Enflurane, Desflurane Isoflurane, and Sevoflurane.
Discussing the general points about volatile anesthetics, the MAC , partition co-efficient.
Factors affecting MAC.
Factors affecting the speed of induction and recovery from volatile anesthesia.
Anesthesia complications range from minor to catastrophic.
complications of general anesthesia might be due to difficulty in airway management or ventilation.
Also the complication might be due to cardiac arrhythmias and poor response to anesthetic effect during induction or maintenance or even the emergence from anesthesia.
So, the the systematic response to the effect of the anesthesia may occur at any time during surgery.
Some of the complications:
Hypoxia, arrhythmia, hypotension , hypertension, regurgitation and aspiration, hypothermia hypoglycemia, coronary ischemia, embolism, persistent apnea delayed recovery , and many others.
also regional anesthesia has its complications like nerve injury, post spinal headache.
Toxicity from local anesthesia is one of the important complication might occur during local infiltration.
When and where the history of volatile anesthesia started and what was the story ?
Whom was the triggering for discovering the effect of volatile anesthesia on human being ?
How the volatile anesthesia developed year by year till reach the best and the most safe volatile anesthetic ?
What were the complications of old volatile anesthetics ?
principles of preoperative evaluation and preparation.pptxMahmood Hasan Taha
The importance of preoperative assessment and evaluation to prepare the patient to surgical procedure is directly proportional with the degree of successful of any surgical procedure.
So, good preoperative assessment and evolution is necessary to avoid the morbidity and mortality that expected to the surgical procedures.
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
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
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.
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Hot Selling Organic intermediates
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.
- 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
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.
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
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.
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.
2. Nitrous Oxide (N2O), Laugh Gas
• Clear, colorless, non explosive , non flammable.
• Supplied by pipeline or pressurized cylinders.
• Boiling point -89ċ.
• Gas at room temperature.
• ≈ 5 times more rapid diffusion than N2.
• Inexpensive.!!
3. • Safe ?, weak anesthetic but good analgesic.
• No toxicity to Heart, Liver, Kidneys.
• Prolong exposure to N2O → bone marrow
depression (megaloblastic anemia) &
peripheral neuropathies.
• Teratogenic after long term uses.
• MAC = 105
5. Cardiovascular:
• Minimal tendency to
sympathetic stimulation.
• Myocardial depression:
caution in IHD & sever hypovolemia.
• B.P, COP & HR unchanged or slightly
increased.
6. Respiratory:
• RR ↑
• Vt ↓
• Vm (-)
• Diffusional hypoxia during recovery d.t
elimination of N2O via alveolus is so rapid, this
hypoxia can be prevented by administration of
100% O2 for 5-10 minute after discontinuing
N2O.
7. Cerebral:
• CBF ↑,CBV↑,ICP↑(mild), CMRO2 ↑.
Renal:
• GFR ↓ ,UOP ↓.
Liver:
• HBF ↓ < other volatile Anesthetics.
Gastrointestinal:
• PONV ↑
Neuromuscular:
• ↑ potency of non depolarizing NMBA.
9. • Metabolism: 0.004%.
• 70% nitrous oxide for >2hours have
been shown to have more postoperative
complications: atelectasis, fever, pneumonia,
and wound infections.
_______________
11. General Description:
• Non flammable.
• Non explosive.
• Potent anesthetic.
• Induction is pleasant.
• Recovery delayed.
• Shivering is common.
12. • Malignant hyperthermia & hepatitis ?
• Rarely used nowadays.
• MAC = 0.75
• Blood/ Gas: 2.3, Oil/ Gas: 224
• Boiling point 50.2℃, SVP 32.5 mmHg.
• Color code: red.
• Clear, colorless liquid in brown glass bottle.
13. • 0.1% Thymol as preservative to protect against
decomposition by light.
• The Thymol preservative does not readily
evaporate, and therefore builds up in the
vaporizer, which requires drainage and
cleaning at regular intervals.
14. • Slightly water soluble.
• Soda lime: compatible.
• Halothane may corrode or tarnish most metals:
with the exception of chromium , nickel and
titanium; Halothane attacks aluminum, tin, lead,
magnesium, brass and solder alloys in the presence
of water; this contact causes rubber and some
plastic materials to deteriorate rapidly.
15.
16. • Suitable vaporizer:
Old design: Goldman vaporizers.
• Designed by an English physician Dr. Victor Goldman
(1903b. – 1994d). tow models: 1956 - 1962.
Modern and New design:
a specifically calibrated plenum vaporizers e.g:
(TEC3,4,5&7, Dräger Vapor, Penlon, Blease).
The term plenum= pressurized chamber in which the
FGF is above atmospheric pressure.
40. Liver:
• HBF↓↓.
• Halothane hepatitis:
Extremely rare (1 : 35000).
Multiple exposure at short interval.
Middle age obese females.
Family history.
Personal history.
Avoidance??
42. Contraindications:
• History of unexplained liver dysfunction,
jaundice following prior administration.
• Risk of triggering malignant hyperthermia.
• With caution in neurosurgical procedure d.t ↑
ICP or ↑ CBF.
• Hypovolemic patient or sever left ventricular
failure.
• With exogenous epinephrine or with pheochrom-
ocytoma.
