This document provides information on examining the integumentary system. It discusses clinical examination of the skin, including distribution and morphology of lesions. Common terms used to describe skin lesions such as macules, papules, and plaques are defined. Hair disorders like alopecia areata and androgenetic alopecia are outlined. Finally, common nail changes and disorders are reviewed, including effects of trauma, nail changes in systemic disease like Beau's lines, and nail findings in conditions like iron deficiency and clubbing.
Fracture & dislocation is well described in Ayurveda. Sushruta Samhita have a separate chapter for bhagna etiology, features, types, prognosis, Management by name of Bhagna-Kandabhagna-Sandhimukta. The basics principles and management of fracture are accurate as per modern orthopedics.
Skin complaints are common in clinical exams and everyday practices.
Skin cancers are increasing in prevalence and if detected early, treatment can be curative.
cutaneous signs can also be a vital in identifying systemic diseases.
With a structured examination technique and a little knowledge of terminology, skin signs can classified systematically.
Rightly diagnosed is half cured so thorough examination of the patient is very much essential for the diagnosis and management of udara roga. Here an attempt made to understand udara roga in parlance with modern science which will be helpful for treating the patient at right time.
Fracture & dislocation is well described in Ayurveda. Sushruta Samhita have a separate chapter for bhagna etiology, features, types, prognosis, Management by name of Bhagna-Kandabhagna-Sandhimukta. The basics principles and management of fracture are accurate as per modern orthopedics.
Skin complaints are common in clinical exams and everyday practices.
Skin cancers are increasing in prevalence and if detected early, treatment can be curative.
cutaneous signs can also be a vital in identifying systemic diseases.
With a structured examination technique and a little knowledge of terminology, skin signs can classified systematically.
Rightly diagnosed is half cured so thorough examination of the patient is very much essential for the diagnosis and management of udara roga. Here an attempt made to understand udara roga in parlance with modern science which will be helpful for treating the patient at right time.
Swasa Roga is a typical respiratory problem mentioned in classical Ayurveda texts. This presentation has tried to include classical as well as modern perspectives of respiratory problems that has difficulty in breathing/dyspnoea as the major symptom.
Sandhigata Vata is the type of pathogenesis involved in various disease conditions affecting the joints, e.g. osteoarthritis, rheumatoid arthritis, etc. and causing pain in affected joints.
this is an ppt presentation by dr.b.arun kumar, who is working as a lecturer in MNR ayurvedic medical college, sangareddy, near hyderabad. in this presentation i given all details of virechana karma.
Gridhrasi is defined as Stambha (stiffness), Ruk (pain), Toda (pricking pain) in a radiating manner along with Spandana (tingling sensation) starting from Kati Pradesha (low back) to Prushtha (back), Janu (knee joints), Jangha (calf muscles) and Pada (dorso lateral aspect of feet) of either one side of the lower limb or may involve both lower limbs. This condition makes raising of the affected leg difficult.
Swasa Roga is a typical respiratory problem mentioned in classical Ayurveda texts. This presentation has tried to include classical as well as modern perspectives of respiratory problems that has difficulty in breathing/dyspnoea as the major symptom.
Sandhigata Vata is the type of pathogenesis involved in various disease conditions affecting the joints, e.g. osteoarthritis, rheumatoid arthritis, etc. and causing pain in affected joints.
this is an ppt presentation by dr.b.arun kumar, who is working as a lecturer in MNR ayurvedic medical college, sangareddy, near hyderabad. in this presentation i given all details of virechana karma.
Gridhrasi is defined as Stambha (stiffness), Ruk (pain), Toda (pricking pain) in a radiating manner along with Spandana (tingling sensation) starting from Kati Pradesha (low back) to Prushtha (back), Janu (knee joints), Jangha (calf muscles) and Pada (dorso lateral aspect of feet) of either one side of the lower limb or may involve both lower limbs. This condition makes raising of the affected leg difficult.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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
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NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
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
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
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
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
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
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2. CONTENTS
1. CLINICAL EXAMINATION IN SKIN DISEASE
2. TERMS USED TO DESCRIBE SKIN LESIONS
3. HAIR DISORDERS
4. COMMON NAIL CHANGES AND DISORDERS
2
3. CLINICAL EXAMINATION IN
SKIN DISEASE
Observation:
The patient must be undressed, with make-up and
dressings removed, and examined in good lighting.
Consider the following:
• Age
• General health
• Distress
• Scratching
3
4. 1. Distribution of rash
Symmetrical vs asymmetrical
Proximal vs distal vs facial
Localised vs widespread
2. If symmetrical
Extensor, e.g. psoriasis
Flexor, e.g. eczema
3. Nail involvement
Psoriatic changes in nails and peri-ungual involvement
4. Involvement of hands:
including nail folds
and finger webs
4
5. 5. Involvement of axillae/groin
e.g. hidradenitis suppurativa
6. Individual lesions
Discrete, grouped, confluent,
reticulate (lace-like), linear
7. Morphology of rash
Monomorphic or polymorphic
8. Morphology of individual lesions
Use a hand lens in good lighting to assist
Use correct terminology
e.g. macules, papules, pustules
Palmoplantar pustulosis
5
6. 9. Examination of scalp
Hair loss
Scalp changes
10. Involvement of face
Central
Hairline
Cheeks and nasal bridge:
‘butterfly’ distribution
Sparing of light-protected sites, e.g. behind ears, under chin
6
7. 11. Eye involvement
e.g. Conjunctivitis/blepharitis in rosacea or eyelash loss in
alopecia areata
12. Oral and genital involvement
Reticulate (lacy) network on buccal mucosa in lichen planus.
May also be genital involvement
13. Joint involvement
e.g. Psoriatic arthritis
14. General medical examination
Including lymph nodes and other systems as indicated
7
8. TERMS USED TO DESCRIBE
SKIN LESIONS
Macule A circumscribed flat area of altered colour, ≤ 1
cm diameter
Patch As for macule, but larger
Papule A discrete elevation of skin
Nodule As for papule, but > 1 cm diameter and involving
dermis
Plaque A raised area of skin with a flat top, > 1 cm
across
Excoriation A linear ulcer or erosion resulting from
scratching
8
9. TERMS USED TO DESCRIBE
SKIN LESIONS
Vesicle/bulla A small (≤ 1 cm)/larger (> 1 cm) blister,
respectively
Pustule A visible accumulation of pus in a blister
Abscess A localised collection of pus in a cavity
Weal An evanescent discrete area of dermal oedema
Scale A flake arising from the stratum corneum
Crust Dried exudate of blood or serous fluid
Ulcer An area from which the epidermis and the upper
dermis have been lost
9
10. TERMS USED TO DESCRIBE
SKIN LESIONS
Petechiae, purpura, ecchymosis
Petechiae are flat, pinhead-sized macules of
extravascular blood in the dermis; larger ones (purpura)
may be palpable; deeper bleeding causes ecchymosis
Burrow A linear or curvilinear papule, caused by a
burrowing
scabies mite
Comedone A plug of keratin and sebum in a dilated
pilosebaceous orifice
Telangiectasia Visible dilatation of small cutaneous blood
vessels
10
11. TERMS USED TO DESCRIBE
SKIN LESIONS
Erosion An area of skin denuded by complete or
partial loss of the epidermis
Fissure A deep, slit-shaped ulcer, e.g. irritant
dermatitis of the hands
Sinus A cavity or channel that permits the escape of
pus or fluid
Scar Permanent fibrous tissue resulting from healing
Atrophy Loss of substance due to diminution of the
epidermis, dermis or subcutaneous fat
Stria A linear, atrophic, pink/purple/white lesion in
the connective tissue
11
12. HAIR DISORDERS
Alopecia
The term means nothing more than loss
of hair and is a sign rather than a
diagnosis.
It is subdivided into localised or diffuse
types and also into scarring or non-
scarring alopecia.
1. Alopecia areata
2. Androgenetic alopecia
12
13. 1. ALOPECIA AREATA
This common, non-scarring autoimmune condition
appears as well-defined, non-inflamed bald patches,
usually on the scalp.
Pathognomonic ‘exclamation mark’ hairs are seen
(brokenoff hairs 3–4 mm long, tapering towards the
scalp) during active hair loss.
The condition may affect the eyebrows, eyelashes and
beard.
The hair usually regrows spontaneously in small bald
patches, but the outlook is less good with larger patches
and when the alopecia appears early in life or is
associated with atopy.
13
14. 2. ANDROGENETIC ALOPECIA
Male-pattern baldness is physiological in men > 20 yrs
old, although rarely it may be extensive and develop at
an alarming pace in the late teens.
It also occurs in females, most obviously after the
menopause.
The distribution is of bitemporal recession and then
crown involvement.
14
16. 1. EFFECTS OF TRAUMA
1. Nail biting/picking:
These are very common.
Repetitive proximal nail-fold trauma results in
transverse ridging and central furrowing of the nail.
2. Chronic trauma:
Trauma from poorly fitting shoes and sport can cause
thickening, disordered nail growth (onychogryphosis)
and subsequent ingrowing toenails.
16
17. 3. Splinter haemorrhages:
Fine, linear, dark brown longitudinal streaks in the plate are
usually caused by trauma, especially if distal.
Uncommonly, they can occur in nail psoriasis and are a hallmark
of infective endocarditis.
4. Subungual haematoma:
Red, purple or grey–brown discoloration of the nail plate, usually
of the big toe, is usually due to trauma, although a history of
trauma may not be clear.
The main differential is subungual melanoma, although rapid
onset, lack of nail-fold involvement and proximal clearing as the
nail grows are clues to the diagnosis of haematoma.
If there is diagnostic doubt, a biopsy may be needed.
17
18. 2. NAIL IN SYSTEMIC DISEASE
1. Beau’s lines:
These transverse grooves appear at the same time on
all nails, a few weeks after an acute illness, moving
out to the free margins as the nails grow.
2. Koilonychia:
This concave or spoon-shaped deformity of the plate is a
sign of iron deficiency.
18
19. 3. Clubbing:
In its most gross form, this is seen as a bulbous swelling
of the tip of the finger or toe.
The normal angle between the proximal part of the nail
and the skin is lost.
Causes include:
● Respiratory: bronchogenic carcinoma, asbestosis,
suppurative lung disease (empyema, bronchiectasis,
cystic fibrosis), idiopathic pulmonary fibrosis.
● Cardiac: cyanotic congenital heart disease, subacute
bacterial endocarditis.
● Other: inflammatory bowel disease, biliary cirrhosis,
thyrotoxicosis, familial causes.
19
20. 4. Discoloration of the nails:
Whitening is a rare sign of hypoalbuminaemia.
‘Half and half’ nails (white proximally and red-brown
distally) occur occasionally in patients with renal failure.
Rarely, drugs (e.g. antimalarials) may discolour nails
20