This document discusses Kawasaki disease, a medium vessel vasculitis that presents as an acute febrile illness in children. It is a common pediatric disorder characterized by coronary artery anomalies in 15-25% of cases. The document covers the epidemiology, etiology, pathogenesis, clinical features, diagnostic criteria, management, and complications of Kawasaki disease. It provides details on diagnostic testing, treatment including intravenous immunoglobulin and aspirin, long term management of coronary abnormalities, and refractory cases.
What is congenital nephrotic syndrome ,what is the definition of congenital nephrotic syndrome,what is the inheritance,what are the responsible genes ,what are the types of congenital nephrotic syndrome,what is the presentation ,diagnosis ,and treatment of congenital nephrotic syndrome, primary type and secondary type of congenital nephrotic syndrome
What is congenital nephrotic syndrome ,what is the definition of congenital nephrotic syndrome,what is the inheritance,what are the responsible genes ,what are the types of congenital nephrotic syndrome,what is the presentation ,diagnosis ,and treatment of congenital nephrotic syndrome, primary type and secondary type of congenital nephrotic syndrome
Definition, classification, epidemiology, etiology, diagnosis, prognosis of DCM, HOCM, LVNC
Also review of acute myocarditis in children
R/v of heart failure management
simlpe approach to anemia in children , how to diagnose anemia in kids ,types of anemias ,causes of anemia , iron deficeincy anemia, hemolytic anemias , laboratory tests in anemia ,
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
Neuroblastoma is the most common cancer in babies and the third-most common cancer in children after leukemia and brain cancer, proper diagnosis, treatment must be done in appropriate time. As it a fatal condition psychosocial support is most important for patient and family.
Definition, classification, epidemiology, etiology, diagnosis, prognosis of DCM, HOCM, LVNC
Also review of acute myocarditis in children
R/v of heart failure management
simlpe approach to anemia in children , how to diagnose anemia in kids ,types of anemias ,causes of anemia , iron deficeincy anemia, hemolytic anemias , laboratory tests in anemia ,
This presentation was done by Dr. Julius P. Kessy,MD. An intern Doctor at Dodoma Regional Referral Hospital (DRRH) during pediatrics unit clinical meeting and supervised by Dr. Christina K. Galabawa,MD,Mmed2, Pediatrics and Child Health, University of Dodoma (UDOM) in November, 2017.
Neuroblastoma is the most common cancer in babies and the third-most common cancer in children after leukemia and brain cancer, proper diagnosis, treatment must be done in appropriate time. As it a fatal condition psychosocial support is most important for patient and family.
KAWASAKI DISEASE
History of Kawasaki disease
Epidemiology and etiology
Presentation and diagnosis
Treatment
Chronic cardiovascular manifestations
Follow up of patients
Questions in the chronic management
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
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.
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
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
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
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
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 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
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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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.
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Kawasaki disease
1. Dr. Sachin Soni
DNB Pediatrics
Indraprastha Apollo Hospital,
New Delhi
www.dnbpediatrics.com
2. What is it?
Medium vessel vasculitis presents as acute febrile
illness of childhood, characterized by coronary
arteries anomaly in 15-25% of affected
individuals
www.dnbpediatrics.com
3. Epidemiology
Its common pediatric disorder with the annual incidence
range 60-150 per 100,000
Commonest pediatric vasculitis in children below 5
years of age(1-3)
Commonest vasculitic disorder amongst all ages
www.dnbpediatrics.com
5. Pathogenesis
Acute or subacute stages: Inflammatory infiltration of vascular wall, initially
polymorphonuclear cells thereafter by macrophages, lymphocytes
(primarily CD8+ T cells), and plasma cells
Eedema of endothelial and smooth muscle cells
IgA plasma cells are prominent in the inflammatory infiltrate
In most severely affected vessels, inflammation involves all three layers of the vascular wall
Destruction of the internal elastic lamina
Loss of structural integrity weakens the vessel wall
Dilation (ectasia) saccular or fusiform aneurysm formation
Thrombi in lumen and obstruct blood flow
vascular wall can become progressively fibrotic, marked intimal proliferation
Arterial stenosis or occlusion
www.dnbpediatrics.com
6. EPIDEMIOLOGIC CASE DEFINITION
(CLASSIC CLINICAL CRITERIA)
Fever persisting for at least 5 days
Presence of at least 4 principle feature
1- Changes in extremities:A- Acute:- Erythema of palm, soles and edema of hand and feet
B- Sub acute:- Periungul peeling of finger, toes in 2-3
polymorphus exanthema
2- B/L Bulbar conjunctival injection without exudates
3- Changes in lip and oral cavity:- Erythema, lip
cracking, strawberry tongue, diffuse injection of oral and
pharyngeal mucosa
4- Cervical lymphadenopathy (>1.5 cm diameter), usually
unilateral
www.dnbpediatrics.com
7. Other Clinical Findings
Cardiovascular findings
Congestive heart failure, myocarditis,
pericarditis, valvular regurgitation,
Coronary artery abnormalities, Aneurysms
of medium-sized noncoronary arteries
Raynaud phenomenon, Peripheral
gangrene
Musculoskeletal system
Arthritis, arthralgias
Gastrointestinal tract
Diarrhea, vomiting, abdominal pain, Hepatic
dysfunction, Hydrops of gallbladder
Central nervous system
Extreme irritability, Sensoryneural hearing
loss, Aseptic meningitis,
Genitourinary system
Urethritis/meatitis
www.dnbpediatrics.com
15. Coronary Artery Aneurysm
Coronary angiogram demonstrating giant aneurysm of the left anterior
descending coronary artery (LAD) with obstruction and giant aneurysm of
the right coronary artery (RCA) with an area of severe narrowing in 6 yr old
boy
www.dnbpediatrics.com
16. Two-dimensional echocardiography
Most useful test to monitor development of coronary
artery abnormalities
Brightness of the arterial walls and lack of normal
tapering of the vessels
Coronary artery dimensions, adjusted for body surface
area (BSA), are significantly increased in the first 5 wk
after presentation
BSA-adjusted coronary artery dimensions on baseline
echocardiography in the first 10 days of illness to be
good predictors of CAD
www.dnbpediatrics.com
17. Aneurysm defined by Japanese Ministry of Health
classified as: Small (<5 mm internal diameter)
Medium (5-8 mm internal diameter)
Giant (>8 mm internal diameter)
Echocardiography performed at diagnosis and after 2-3 wk
of illness
If the results are normal, repeat study should be performed
6-8 wk after onset of illness
www.dnbpediatrics.com
18. Diagnosis
Classic KD:- Diagnostic criteria
Fever for at least 4 days and at least four of five of
above principal characteristics of the illness
Atypical or incomplete KD:
Patients have persistent fever but fewer than four of
the five characteristics
In these patients, laboratory and echocardiographic
data can assist in the diagnosis
Incomplete cases are most frequent in infants,
who, unfortunately, also have the highest likelihood
of development of coronary artery abnormalities
www.dnbpediatrics.com
23. LONG-TERM THERAPY FOR PATIENTS WITH
CORONARY ABNORMALITIES
Aspirin 3-5 mg/kg once daily orally
Clopidogrel 1 mg/kg/day (max 75 mg/day)
Most experts add warfarin or low-molecular-weight
heparin for those patients at particularly high risk of
thrombosis
www.dnbpediatrics.com
24. ACUTE CORONARY THROMBOSIS
Fibrinolytic therapy with tissue plasminogen activator
Or
Other thrombolytic agent under supervision of a
pediatric cardiologist
www.dnbpediatrics.com
26. • Defined by persistent or recrudescent fever 36 hr
after completion of the initial IVIG infusion
• Another dose of IVIG at 2 g/kg is administered to
patients with IVIG resistance.
• Intravenous methylprednisolone
• If a second dose of IVIG or corticosteroids are
ineffective
• Cyclophosphamide and plasmapheresis.
• Tumor necrosis factor inhibitor infliximab
www.dnbpediatrics.com