This document discusses diabetic foot and the importance of hydration. It provides definitions of diabetic foot from health organizations. Diabetes is increasing worldwide and 15% of diabetics develop foot ulcers, with 85% leading to amputations. Maintaining hydration through increased water intake of 1.5-2 liters per day was studied in 11 diabetic foot patients following standard guidelines. All patients showed improved healing times, with complete healing in 2-16 weeks compared to the typical healing time of 6-12 months. Increased hydration through water intake is concluded to dramatically improve healing response for diabetic foot ulcers.
Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy.
The Diabetic Foot: What You Need to KnowOmar Haqqani
Authored by Dr. Jeffrey Stone, DPM. Presented at the First Annual Omar P. Haqqani MD Vascular Symposium, November 10, 2106, Midland Country Club, Midland, MI.
offloading is an important aspect in Diabetic foot ulcer patients.There are two major aspects of offloading. Offloading is immensely useful in helping ulcers heal and secondly in prevention of recurrence of ulcers.
Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy.
The Diabetic Foot: What You Need to KnowOmar Haqqani
Authored by Dr. Jeffrey Stone, DPM. Presented at the First Annual Omar P. Haqqani MD Vascular Symposium, November 10, 2106, Midland Country Club, Midland, MI.
offloading is an important aspect in Diabetic foot ulcer patients.There are two major aspects of offloading. Offloading is immensely useful in helping ulcers heal and secondly in prevention of recurrence of ulcers.
Diabetic Foot Care - DerekJones presenting at Otto Bock ScandinaviaDerek Jones
Presentation at Otto Bock Scandinavia - focusing on the diabetic foot and covering screening, biomechanics and orthotic management for ulcer prevention and treatment
To create a mechanism to allow the patient or the patient’s designated representative to participate in the consideration of ethical issues that arise in the care of the patient; to provide an organization and mechanism for the consideration of ethical issues arising in the care of patients; and to provide education to care givers and patients on ethical issues in health care.
The term Gout is a clinical Spectrum of diseases including elevated serum urate (hyperuricemia), recurrent attacks of acute arthritis associated with monosodium urate crystals in synovial fluid leukocytes, deposits of monosodium urate crystals, in tissues in and around joints, interstitial renal disease, and uric acid nephrolithiasis
chronic kidney failure definition and stages of "CKD" SOAP (subjective,objective,assessment and planing ) example format to easy understand about CKD patients.
Diabetic Retinopathy: Role of Traditional Medicinal Plants in its management ...inventionjournals
The objective of this review is Diabetic Retinopathy (DR) and Role of herbal medicines for the treatment of DR. Eye is unique structure of the body and its anatomical and physiological framework is said to be unique. Every organism has adaptive capacity to lead life on earth. Due to modern life style, the number of diseases increasing day by day. Diabetic Retinopathy is an ocular manifestation of the systemic disease and sight-threatening disease. The treatment of modern system of medicine, focal laser therapy, anti-vascular growth factor drugs. These treatment modalities have side effects. Various medicinal plants have been studied and shown to be effective in the management of DR.based on a various biomarkers present in them.
Chronic renal failure or chronic kidney disease management, pharmacist role, medical management objectives, goals of the therapy .
What are the risk factors of chronic renal failure, clinical manifestations of chronic renal failure, renal failure complications, pathophysiology of chronic renal failure.
Define Chronic Renal Failure.
Mention the main causes of Chronic Renal Failure.
Know the signs and symptoms of renal failure.
Know the treatment options of CRF
Know new definition of CKD
End-stage renal disease (ESRD) can result from a wide variety of different kidney diseases. Currently, 90% of patients reaching CKD have chronic diabetes mellitus, glomerulonephritis or hypertension. With CKD comes a myriad of problems related to the kidney's inability to excrete waste products leads to symptoms of uraemia. The treatments of CKD require dialysis or kidney transplantation. In this review, an attempt has been made to explain the nutritional management of CKD along with various dialysis treatment and the complications related to the dialysis method. It is important to maintain optimal nutritional status so that the patient will be a good candidate to respond to the treatment effectively.Kidney Patients necessitate following a blanced diet plan to retain normal protein stores and to avoid metabolic complications. This article deals with the therapeutic aspects of nutrition in CKD patients and will improve the quality of life Keywords: ESRD, CKD, Dialysis, Nutritional management.
Dyslipidemia in Chronic Kidney Diseases.pdfDr. Nayan Ray
Dyslipidaemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment
Slides Include:
1. Stages of CKD
2. Developments of atherogenesis
3. Lipoprotein in CKD
4. Drug Therapies
5.Summary KDIGO Guideline
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
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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!
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
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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.
Intelligent care for diabetic foot dr,qutaiba abdullah aldori
1. Intelligent care for
diabetic foot
Dr. Qutaiba Abdullah Aldori
Burn & Reconstructive Surgeon at
Azadi –Hospital –Kerkuk/Iraq .
2. Diabetic foot
•According to the World
Health Organization and to
the International Working
Group on the Diabetic Foot
3. • defined as The foot of diabetic pt
with ulceration, infection
and/or destruction of the
deep tissues, associated
with neurological
abnormalities and various
degrees of peripheral
vascular disease in the
lower limb
4. • DM is now thought to be in excess of 200 million
• Pt. is affected .
• This figure is predicted to reach 333 million by 2025
• The current population of the United States of
America is 323,668,578
• 15% of all diabetics with Diabetic foot ulcers
• almost 85% of foot ulcers proceed to amputations.
5. • Submitted by Lorenzo.Piemonte on Wed, 07/01/2015
- 14:00
• Did you know that every 20
seconds an amputation caused by
diabetes occurs somewhere in the
world?
6. objective
• If we keep the diabetic foot
patient in well hydrated state
for two weeks the response
of healing is dramatically
increase in a positive way.
9. • The concept of Many research
• People with high blood
glucose levels have
increased risks of
•increased risks of DM
Complications
10. Predictable Causes of
in diabetics
• 1 / Glycosuria , each glucose molecule surrounded by 6
water molecules taken out of body with urine .
• 2/ Poor water intake
• a A stressful event such as infection, or recent surgery
• bCongestive Heart Failure ,heart attack ,stroke.
• cImpaired thirst sensation .
• d Limited access to water (especially in patients with
dementia or who are bedbound or living lonely)
• e Older age.
12. for 72 kg human weight containing 40 liters
• (2/3 of body water 25 liters is
Intracellular fluid )
• (1/3 of body water) about 15 liters is
Extracellular fluid,
(1/5 of
extracellular fluid)
averages 3 liters
Plasma
(4/5 of
extracellular fluid)
are 12 liters
Interstitial fluid
18. Dr. Ajay Kumar
• Abnormal high blood viscosity in diabetes mellitus
• Conclusion
• The causes of rise of whole blood viscosity are
• 1- Rise in haematocrit: due to increase in capillary permeability
in Diabetes Mellitus.
• 2- Decrease in RBC deformability: it is found that the elevated
glucose level causes stiffness in red cell membrane in Diabetes
Mellitus.
• 3- Increase in Red Cell Aggregation.
• 4- Plasma Fibrinogen Level Rises which is one of the causes for
rise in plasma viscosity.
19. • Red blood cells at rest have an average diameter
• of 7.8 micro meter and must deform markedly to pass
• the smallest capillaries of the microcirculation
• (3–7 micro meter ).
21. Rheological Picture in pt.T1D &T2D
• Maya Mantskava Microcirculation Research Center Georgia
• . Therefore we conclude that blood rheological
disorders are similar in both types of diabetes
mellitus.
• The disturbed blood fluidity related to the
increased RBC aggregability in the
microcirculation promotes, in particular, the
development of the gangrene in both types of
diabetes mellitus.
24. Several studies show
• Water intake inversely independently
associated with Hyperglycemia
• Water intake affect (Copeptin)
vasopressin secretion
•
• Copeptin directly associated with
increase Risk of DM
25. • PLASMA COPEPTIN IS ASSOCIATED
WITH INSULIN RESISTANCE IN A
SWISS POPULATION-BASED STUDY.
• Canivell, S.; Ponte, B.; Pruijm, M.; Ackermann, D.; Guessous, I.; Ehret, G.; Paccaud, F.; Pechere-
Bertschi, A.; Mohaupt, M.; Vogt, B.; Burnier, M.; Devuyst, O.; Martin, P.Y.; Bochud, M.
• Conclusions:
• Insulin resistance was associated with
higher copeptin levels.
26. • Copeptin, a surrogate marker for
vasopressin, is associated with chronic
kidney disease progression in patients with
diabetes mellitus
• W.E. Boertien1, I.J. Riphagen1, I. Drion2, A. Alkhalaf2, S.J.L. Bakker1,
• K.H. Groenier3, J. Struck4, H.J.G. Bilo2,5, N. Kleefstra2,5, R.T. Gansevoort1;
• 1Nephrology, UMCG, Groningen, Netherlands, 2Diabetes Centre, Isala
• Clinics, Zwolle, Netherlands, 3General practice, UMCG, Groningen,
• Netherlands, 4BRAHMS GmbH, Thermo Fisher Scientific, Hennigsdorf,
• Germany, 5Internal Medicine, UMCG, Groningen, Netherlands.
• . Conclusion:
• It would be interesting to study the effect of lowering
vasopressin levels (e.g. by drinking more water) on
the progression of chronic kidney disease in diabetic
patients
27.
28. • Jessica M Sontrop, Nephrology,
• Department of Medicine,
• London Health Sciences
• Centre, London, Ontario,
• Change in water intake and change in plasma
copeptin,
• At the end of 6 weeks we conclude
that ,the increase in water intake
was associated with a significant
decrease in the concentration of
plasma copeptin.
31. Our study
• 11 pt with Diabetic foot submitted for same
guide lines of management (NICE clinical
guideline 119 )
•
• NICE =National Institute for
• Health and Clinical Excellence
32. National Institute for Health and Clinical
Excellence
Admission &
Evaluation
Multidisciplinary Foot care
Team
Management pt.
EDUCATE Pt
33. The only difference is
the additional item
increase of water
intake to 1.5-2 liters per
day.