"The Beauty of BOTOX" presentation by Heidi LaForge, DO, Via Christi Clinic family medicine physician. Dr. LaForge explains how BOTOX is made and how it can help eliminate wrinkles.
Botox Injection is a commercially successful non-surgical cosmetic procedure, to gets rid of the deep wrinkles in the skin between eyebrows, of the forehead, of the corner of eyes. Effective for 3 - 4 months, and the procedure is repetitive in nature.
Cheek Fillers|Facial Aesthetic| Facial Aesthetic by Dr Rajat Sachdeva| Facial...Dr. Rajat Sachdeva
Cheek Fillers rejuvenate the cheeks and to regain last volume.
Autologous Fat Injection, where your own fat harvested from some other area can be used to restore volume of cheeks.
Some other fillers like Hyaluronic acid, Ca Hydroxide and Polymethyl Metacrylate are injected with fine needles in the target area eliminate wrinkles and enhances cheeks volume.
The Art of Liquid Face Lift (Dermal Fillers)Osama Moawad
Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. Perhaps nothing is more gratifying for cosmetic patients than having an immediate correction of rhytides or scars as a result of the injection of a dermal filler The result is a smoother, more youthful appearance with minimal "downtime" and maximum safety. Prof. Moawad uses a variety of soft tissue fillers, including, hyaluronic acid, and autologous fat (one's own fat) among others. Since filler substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever. With the increasing desire for people to achieve a more youthful appearance, the aging baby boomer population, and the increased demand for "lunch-time procedures," the pharmaceutical market has responded by providing the cosmetic surgeon with an increasing number of options to meet the demands of the cosmetic patient.
"The Beauty of BOTOX" presentation by Heidi LaForge, DO, Via Christi Clinic family medicine physician. Dr. LaForge explains how BOTOX is made and how it can help eliminate wrinkles.
Botox Injection is a commercially successful non-surgical cosmetic procedure, to gets rid of the deep wrinkles in the skin between eyebrows, of the forehead, of the corner of eyes. Effective for 3 - 4 months, and the procedure is repetitive in nature.
Cheek Fillers|Facial Aesthetic| Facial Aesthetic by Dr Rajat Sachdeva| Facial...Dr. Rajat Sachdeva
Cheek Fillers rejuvenate the cheeks and to regain last volume.
Autologous Fat Injection, where your own fat harvested from some other area can be used to restore volume of cheeks.
Some other fillers like Hyaluronic acid, Ca Hydroxide and Polymethyl Metacrylate are injected with fine needles in the target area eliminate wrinkles and enhances cheeks volume.
The Art of Liquid Face Lift (Dermal Fillers)Osama Moawad
Soft tissue fillers are flexible substances that can be injected into the skin to improve the appearance of fine lines and wrinkles, plump lips, fill hollow cheeks, repair various facial imperfections, improve scars, and elevate deep folds. Perhaps nothing is more gratifying for cosmetic patients than having an immediate correction of rhytides or scars as a result of the injection of a dermal filler The result is a smoother, more youthful appearance with minimal "downtime" and maximum safety. Prof. Moawad uses a variety of soft tissue fillers, including, hyaluronic acid, and autologous fat (one's own fat) among others. Since filler substances do not involve major surgery and are generally cost-effective, men and women are using these youth-enhancing techniques more than ever. With the increasing desire for people to achieve a more youthful appearance, the aging baby boomer population, and the increased demand for "lunch-time procedures," the pharmaceutical market has responded by providing the cosmetic surgeon with an increasing number of options to meet the demands of the cosmetic patient.
Mesotherapy in Dermatology , by Dr. Amr Ismail MD , Consultant Dermatologist.
Mesotherapy in Depth
Non-prescrition treatment modatlity.
Non Conventional Safe Asethetic Procedure.
Should rely on EBM.
To achieve good results.
Depend on Used Meostherapy Materials.
Classification of Meostherapy Materials
A. Principals :
Ingredients that have been used orally or topically or injectable
for treatment of each indication/condition.
Ingredients with high grade of evidence in treatment of each indication/condition.
Ingredients that have been FDA Approved for treatment of each indication/condition.
B. Complentary :
Ingredients that have been claimed to improve the condition.
Ideal Mesotherapy Materials / Cocktails :
To achieve good results 80- 90 % , your used cocktails should
contain 2 -3 principals.
We are truly in an “era of injectables,” with access to a varied armamentarium of products that yield dramatic aesthetic results with minimal recovery downtime. From its first published mention as an aesthetic treatment for glabellar lines in 1992, the use of commercially available BoNT type A (BoNTA) has captivated healthcare professionals and lay people alike. The availability of newer BoNTA formulations, with more expected in the near future, poses an exciting opportunity for aesthetic practitioners to reach an ever expanding potential patient base and provide increasingly refined treatment
Clinical use of botulinum toxins in oral and maxillofacial surgeryDrKamini Dadsena
Purified botulinum toxin (BTX) was the first bacterial toxin used as a medicine. Since its introduction into clinical use, over 30 years ago, it has become a versatile drug in various fields of medicine.
Its mechanism of inhibiting acetylcholine release at neuromuscular junctions following local injection is unique for the treatment of facial wrinkles.
Other dose-dependent anti-neuroinflammatory effects and vascular modulating properties have extended its spectrum of applications.
Derma fillers are gel like substances that are injected beneath the skin to restore lost volume,smooth lines and soften creases, or enhance facial contours.They can be used as "volumizers" plumping and lifting cheeks,chins,jawlines and temples, filling out thin lips.Mostly Hylarudonic acid fillers like Juvederm are used.The procedure takes around 30-45 minutes and patients can see results in about 10 days-2weeks.
Derma Fillers are done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
As age advances, Connective Tissue becomes thinner, collagen and elastin breakdown and results into wrinkles.
PDO is Thread Lift Therapy, where thread will form an integral support structure for tissue of face due to Collagen Synthesis.
MONO; COG: Crew Threads are three types of PDO thread.
COG Thread are designed to anchor more firmly within the skin as it consist of barbs.
COGS provide immediate face lifting effect, helps in producing brighter skin tone and rejuvenate the skin.
Call us regarding Facial aesthetic :-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Best facial cosmetic surgeons Best facial plastic surgeon Browlift Charlotte endoscopic brow lift Charlotte’s top facial plastic surgeon Facial plastic surgeons Facial plastic surgery Face lifts Facial mini-tuck Lip enhancement Lip augmentation Nose job Nose job cost Nose surgery Rhinoplasty Rhinoplasty Expert Rhinoplasty and teens Revision rhinoplasty Teen Rhinoplasty, Charlotte Teen Rhinoplasty, North Carolina Teen Rhinoplasty Expert Top rhinoplasty surgeons Best Charlotte rhinoplasty surgeons Most experienced rhinoplasty surgeons
Grow your skin with Botox and Dermal fillers. World class treatements by experienced professionals in Fairfax VA which reduces side effects and it is safe as well as effectual in the treatment of wrinkles.
Application of Pstim in Clinical Practice MaxiMedRx
The P-Stim and ANSiStim™ miniaturized device is designed to administer auricular point stimulation treatment over several days. The ear provides numerous points for stimulation within a small area. Stimulation is performed by electrical pulses emitted through strategically positioned needles. The ANSiscope device monitors the pain condition of the patient before, during and after the treatment.
The P-Stim and ANSiStim™ point stimulation therapy is mainly used to treat pain. Use of the device is recommended for pre-operative, intra-operative and post-operative pain therapy as well as for the treatment of chronic pain. DyAnsys is researching the possibilities of using this concept for the treatment of depression, addiction and allergy.
P-Stim and ANSiStim™ therapy allows continuous point stimulation over a period of several days while offering the patient a high degree of comfort and mobility. Use of the P-Stim and ANSiStim™ therapy provides advantages over drug therapy by minimizing possible side-effects caused by pain medications (i.e. opioid). In most cases, the patient continues to lead a normal life without side effects or any loss of quality of life.
Mesotherapy in Dermatology , by Dr. Amr Ismail MD , Consultant Dermatologist.
Mesotherapy in Depth
Non-prescrition treatment modatlity.
Non Conventional Safe Asethetic Procedure.
Should rely on EBM.
To achieve good results.
Depend on Used Meostherapy Materials.
Classification of Meostherapy Materials
A. Principals :
Ingredients that have been used orally or topically or injectable
for treatment of each indication/condition.
Ingredients with high grade of evidence in treatment of each indication/condition.
Ingredients that have been FDA Approved for treatment of each indication/condition.
B. Complentary :
Ingredients that have been claimed to improve the condition.
Ideal Mesotherapy Materials / Cocktails :
To achieve good results 80- 90 % , your used cocktails should
contain 2 -3 principals.
We are truly in an “era of injectables,” with access to a varied armamentarium of products that yield dramatic aesthetic results with minimal recovery downtime. From its first published mention as an aesthetic treatment for glabellar lines in 1992, the use of commercially available BoNT type A (BoNTA) has captivated healthcare professionals and lay people alike. The availability of newer BoNTA formulations, with more expected in the near future, poses an exciting opportunity for aesthetic practitioners to reach an ever expanding potential patient base and provide increasingly refined treatment
Clinical use of botulinum toxins in oral and maxillofacial surgeryDrKamini Dadsena
Purified botulinum toxin (BTX) was the first bacterial toxin used as a medicine. Since its introduction into clinical use, over 30 years ago, it has become a versatile drug in various fields of medicine.
Its mechanism of inhibiting acetylcholine release at neuromuscular junctions following local injection is unique for the treatment of facial wrinkles.
Other dose-dependent anti-neuroinflammatory effects and vascular modulating properties have extended its spectrum of applications.
Derma fillers are gel like substances that are injected beneath the skin to restore lost volume,smooth lines and soften creases, or enhance facial contours.They can be used as "volumizers" plumping and lifting cheeks,chins,jawlines and temples, filling out thin lips.Mostly Hylarudonic acid fillers like Juvederm are used.The procedure takes around 30-45 minutes and patients can see results in about 10 days-2weeks.
Derma Fillers are done at Dr Sachdeva's Dental clinic and Facial aesthetic centre in Delhi. So hurry up and come book an appointment with us at Dr.Sachdeva’s Dental Institute, Ashok Vihar, Delhi which has state of the art clinic and all the latest and advanced equipments.
To book an appointment contact:
Dr. Rajat Sachdeva
Director & Mentor
Dr Sachdeva’s Dental Aesthetic And Implant Institute
I 101, Ashok Vihar Phase 1, Delhi- 110052
Contact us at
Phone : +919818894041,01142464041
Our Websites:
www.sachdevadentalcare.com
www.dentalimplantindia.co.in
www.dentalclinicindelhi.com
www.dentalcoursesdelhi.com
Facebook- dentalcoursesdelhi
Youtube- drrajatsachdeva
Linkedin- drrajatsachdeva
Slideshare- Dr Rajat Sachdeva
Twitter Page- drrajatsachdeva
Instagram page- surgicalmasterrajat
As age advances, Connective Tissue becomes thinner, collagen and elastin breakdown and results into wrinkles.
PDO is Thread Lift Therapy, where thread will form an integral support structure for tissue of face due to Collagen Synthesis.
MONO; COG: Crew Threads are three types of PDO thread.
COG Thread are designed to anchor more firmly within the skin as it consist of barbs.
COGS provide immediate face lifting effect, helps in producing brighter skin tone and rejuvenate the skin.
Call us regarding Facial aesthetic :-
Dr. Rajat Sachdeva
+919818894041,01142464041
drrajatsachdeva@gmail.com
Follow us here:-
• Google+ link: https://goo.gl/vqAmvr
• Facebook link: https://goo.gl/tui98A
• Youtube link: https://goo.gl/mk7jfm
• Linkedin link: https://goo.gl/PrPgpB
• Slideshare link : http://goo.gl/0HY6ep
• Twitter Page : https://goo.gl/tohkcI
• Instagram page : https://goo.gl/OOGVig
Learn more:-
• www.sachdevadentalcare.com
• www.dentalclinicindelhi.com
• www.dentalimplantindia.co.in
• www.dentalcoursesdelhi.com
• www.facialaestheticsdelhi.com
Best facial cosmetic surgeons Best facial plastic surgeon Browlift Charlotte endoscopic brow lift Charlotte’s top facial plastic surgeon Facial plastic surgeons Facial plastic surgery Face lifts Facial mini-tuck Lip enhancement Lip augmentation Nose job Nose job cost Nose surgery Rhinoplasty Rhinoplasty Expert Rhinoplasty and teens Revision rhinoplasty Teen Rhinoplasty, Charlotte Teen Rhinoplasty, North Carolina Teen Rhinoplasty Expert Top rhinoplasty surgeons Best Charlotte rhinoplasty surgeons Most experienced rhinoplasty surgeons
Grow your skin with Botox and Dermal fillers. World class treatements by experienced professionals in Fairfax VA which reduces side effects and it is safe as well as effectual in the treatment of wrinkles.
Application of Pstim in Clinical Practice MaxiMedRx
The P-Stim and ANSiStim™ miniaturized device is designed to administer auricular point stimulation treatment over several days. The ear provides numerous points for stimulation within a small area. Stimulation is performed by electrical pulses emitted through strategically positioned needles. The ANSiscope device monitors the pain condition of the patient before, during and after the treatment.
The P-Stim and ANSiStim™ point stimulation therapy is mainly used to treat pain. Use of the device is recommended for pre-operative, intra-operative and post-operative pain therapy as well as for the treatment of chronic pain. DyAnsys is researching the possibilities of using this concept for the treatment of depression, addiction and allergy.
P-Stim and ANSiStim™ therapy allows continuous point stimulation over a period of several days while offering the patient a high degree of comfort and mobility. Use of the P-Stim and ANSiStim™ therapy provides advantages over drug therapy by minimizing possible side-effects caused by pain medications (i.e. opioid). In most cases, the patient continues to lead a normal life without side effects or any loss of quality of life.
Management of tmd symptoms with photobiomodulation therapyNishu Priya
Conservative approaches, such as soft diets, anti-inflammatory drugs and photobiomodulation therapy (PBMT) or low-level laser therapy (LLLT), have been used to manage TMD.
Lasers have proven to be successful in clinical settings and treatments of soft tissues, musculoskeletal pain, bone regeneration, dentinal hypersensitivity, and provide reduction in symptoms and improved function.
The mechanism of action in PBMT is via absorption of light, with deeply penetrating wavelengths ranging from 630 nm to 1300 nm, to stimulate tissues with direct irradiation to achieve analgesic and anti-inflammatory effects.
The output energy in PBMT does not affect skin temperature and is classified as a soft laser, which increases lymphatic flow, reduces edema and prostaglandin E2 (PGE2) and cyclooxygenase (COX) levels.
A systematic review for pain management reported placebo vs LLLT for practical and clinically relevant parameters using 700nm to 1200nm.
Phisical treatments in Vitiligo - Prof. Lotti Torello, MDVR Foundation
Melanocytes are not completely absent in the depigmented epidermis
Comment:
A subpopulation of “resistant” epidermal melanocytes can persist independent of disease duration
Repigmentation can always occur independent of disease duration and with non-perifollicular pattern
History of biomaterials in dental implantology, various types of implant biomaterials, surface treatments of implants, guidelines for selecting implant biomaterial
This seminar explains about the development, relations, ligaments, various attachments, vascular and nervous supply and various surgical approaches and its modifications to TMJ
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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.
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.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
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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
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!
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.
4. INTRODUCTION
Masseteric muscle hypertrophy (MMH) is a relatively uncommon condition that may present as either a
unilateral or bilateral painless swelling in the region of the angle of the mandible.
Etiology of this anomaly is still unexplained.
Diagnosis is usually established clinically; conventional radiography, CT, MRI and USG may be helpful.
Treatment usually involves resection of a portion of the masseter muscle and/or the removal of exostoses of the
mandibular angle that are frequently associated with this condition.
5. Botulinum toxin type A (BtA) is a potent bacterial neurotoxin produced by anaerobic bacterium
Clostridium botulinum that produces muscle paralysis, atrophy, and weakness.
It has been largely used in medicine in the treatment of alterations characterized by involuntary
spasm of certain muscles, and more recently for cosmetic treatment of hyperfunctional lines.
6. The use of BtA has been reported as a successful method of treatment of MMH that offers some
advantages over conventional surgical treatment.
Report on the treatment of 6 patients with unilateral or bilateral MMH with the use of
intramuscular injections of BtA.
7. PATIENTS AND METHODS
6 patients with unilateral or bilateral MMH were selected by confirming the diagnosis through physical and
radiographic examination-OPG of all patients for hyperostosis diagnosis.
BtA injections were selected as the treatment method, and none of the patients had already received this
form of treatment.
8. The drug used for injections was C. botulinum type A toxin (Dysport; Speywood Pharmaceuticals Ltd,
Berkshire, England, or Botox; Allergan Inc, Irvine,CA).
Composition of Dysport vial-
500 units of BtA dissolved in 2.5 mL of normal saline solution
Final concentration of 200 units/ml.
Composition of Botox vial-
100 units of BtA dissolved in 2.0 Ml of normal saline solution
final concentration of 50 units/ml.
9.
10. Administration-
The point of administration was identified
visually and by palpation with the patient on
clenching.
3.0-mL syringe with 25-gauge needle, the
toxin was administered percutaneously in
varying doses after aspiration, in the thickest
portion of the hypertrophied masseter muscle.
Massaging of the muscle to spread the drug.
11. Recurrence- was considered when the relapse of hypertrophy was noted through clinical and
photographic evaluation of the patient and/or when the patient claimed that muscular discomfort
returned.
12. RESULTS
4
2
Masseter muscle hypertrophy
Bilateral MMH Unilateral MMH
Main complaint of all patients was of an esthetic nature,
5 patients- Mild pain was reported in association with
the hypertrophied muscles.
15. All patients presented with satisfactory regression of MMH, including muscular discomfort and
pain.
Recurrence (relapse of hypertrophy) was observed in 2 cases (patients 1 and 2) but without the
recurrence of symptoms of pain.
Dysport vial Botox vial
2 0
16. DISCUSSION
Complaints of a patient with MMH-
i. Usually esthetic
ii. Mild pain
iii. Heavy sensation in the region of the hypertrophied muscle, and/or
iv. Moderate limitation of mouth opening
5/6 patients had these symptoms, which disappeared after BtA treatment.
17. Although in the majority of MMH cases the etiology is unexplained, it has been attributed to
many causes such as malocclusion, bruxism, clenching, and TMJ disorders.
In 3 of the present patients (patients 4, 5, and 6), the treatment included the control of
parafunctional activities involving the masticatory musculature of patients.
The treatment for parafunctional activity involves the use of an intraoral orthodontic appliance
and neuromuscular re-education exercises to alter the existing muscle function and to help manage
parafunctional habits.
18. BtA is a complex bacterial protein produced by C.botulinum.6 In muscle, it blocks the
neuromuscular transmission through rapid and strong attachment to the presynaptic nerve
membrane, and then it inhibits the release of vesicle-bound acetylcholine at the neuromuscular
junction, producing functional denervation of the muscle and its subsequent atrophy.
Injection of a small amount of this toxin into a muscle produces atrophy and weakness within 1
to 20 days and recovery over 2 to 4 months as new terminal axon sprouts form and restore
transmission. It has been suggested that this new nerve sprout then retracts and the original
junction returns to functionality.
19. Bioequivalence between Botox and Dysport doses of 1:3 for cervical dystonia treatment and 1:4 for
blepharospasm and hemifacial spasm therapy.
Local injections of BtA have been used as a safe and effective method in the treatment of disorders such as
strabismus, nystagmus, spasmodic torticollis, blepharospasm, oromandibular dystonias, tremors, hemifacial
spasms, cricopharyngeal dysphagia, spasmodic dysphonia, rejuvenation, temporomandibular disorders, recurrent
TMJ dislocation, and bruxism and for functional benefit and reduction of disability in cerebral palsy, among other
alterations.
Other applications of Botox-
20. Contraindications-
• History of hypersensitivity to the drug,
• Presence of inflammation at the proposed injection site
• Diseases of neuromuscular transmission and coagulopathy.
• Safety for use during pregnancy or lactation has not been established.
• Coincident administration of agents known to potentiate neuromuscular blockade
(aminoglycosides) should be avoided.
• Single large doses of greater than 500 mouse units of botulinum may produce acute symptoms
and signs of botulism.
21. CONCLUSION
The use of BtA in MMH therapy offers some obvious advantages in relation to conventional
surgical treatment. This approach is non-traumatic and is more cost-effective with few side effects.
22.
23. Frontal view showing mandibular
left angle prominence
Intraoral view showing midline deviation
during occlusion.
25. MRI scan confirming the findings of the
anteroposterior radiograph ,hypertrophy of the
masseter muscle on the left side.
26. Diagnostic technique using ultrasound, the establishment of a normal range by its application to
a control population and its use on patients with clinical masseteric hypertrophy.
Relaxed position- 8.5-13.5mm
Clenched position- 10.5-16.5mm
27. Ultrasound image of normal masseter
Ultrasound image of hypertrophied masseter
28. Botulinum toxin type A (BT) injection into the masseter muscle offers promise as a new and
simple treatment.
29. Facial appearance 4 months after botulinum toxin injection.
Facial appearance of patient at the first visit.
Unilateral left masseteric hypertrophy
30. With a single surgery treatment of bilateral masseteric hypertrophy and mandibular
retrognathism have been carried out which is probably the first of its kind.
34. CRITICAL EVALUATION
Pros-
1. Non- invasive technique and offers better results
2. Treatment is performed on an ambulatory basis
3. Treatment is economical when compared to surgery
4. Comparative study was conducted with the same material in varying concentrations, so that minimally
effective concentration of drug can be studied.
5. Recurrence was less along with regression of muscle discomfort and pain.
Cons-
1. Not reviewed enough articles
2. Comparative studies was not being included which compared surgery Vs botox injections
3. Cases were not being divided properly and time interval between each visit is not mentioned.
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Dysport was used (patients 1, 2, and 3),
Botox was injected (patients 4, 5, and 6).
Reference landmarks for injection. A quadrangular zone is drawn demarcating the area in which the masseter is well-developed and is at a safe distance from vital anatomic structures. Three injection points are selected taking into consideration the diffusion potential of the toxin.
The parafunctional activity of masticatory muscle can be defined as activities involving clenching and/or bruxism (tooth grinding), which frequently contribute to dental, periodontal, or neuromuscular damage. It may occur diurnally or nocturnally or both, and most patients are unaware of its nature, intensity, and frequency.
No significant side effects have been reported after the appropriate use of BtA.
This paper reports a case of masseter muscle hypertrophy diagnosed using imaging modalities such as
conventional radiography, CT and MRI scans. The familiarity with this condition is
important to settle the differential diagnosis with other pathologies such as parotid gland tumors and dental infection.
MRI facilitated the diagnosis at the affected side because muscular structure signals are more intense, making it easier to compare the affected and non-affected sides
62 Subjects were placed in the lateral position, head supported on a pillow, with facial muscles relaxed and teeth just apart (corresponding approximately to the physiological mandibular rest position). Measurements were taken of its maximum transverse dimension (Figure 1) which usually lay just anterior to the ascending ramus of the mandible, directly from the screen. Without repositioning the transducer, the measurement was repeated with the subject clenching
Ultrasound image of normal masseter and anterior margin of parotid gland. +, Measurement end points. (b) Line tracing of a, showing masseter (m), parotid gland (p) and acoustic shadowing caused by ascending ramus (r). Orientation as described in text. ant, anterior; med, medial
P VALUE WAS (P < 0.05)
A 13year-old girl
The patient was asked to clench her jaws, and 5 units of BT were deposited percutaneously within the muscle at each of five sites of greatest muscle bulging. The patient was seen for follow-up examination, and within 4 months masseter muscle atrophy occurred, and the facial asymmetry was no longer visible.
Results was reduction in muscle discomfort and relapse was not noted.
Debulking of the masseter muscle was not performed as the removal of bone alone is sufficient to produce atrophy in the muscle, due to reduction of the area available for attachment. With 8 mm of mandibular advancement fragments are fixed with stainless steel miniplate in both sides.
The patient was under regular follow-up for the next 6 months and there were no associated complications.