Asthma is a chronic inflammatory airway disease characterized by variable and recurring symptoms of wheezing, breathlessness, chest tightness, and coughing. It commonly affects children and is more prevalent in developed countries. The pathophysiology involves inflammation, airway hyperresponsiveness, and reversible airway obstruction. Management focuses on education, reducing triggers, and a stepwise pharmacological approach starting with inhaled corticosteroids and adding other controllers and relievers as needed. Exacerbations are treated by assessing severity and providing short courses of oral corticosteroids and bronchodilators.
Asthma is a chronic inflammatory condition associated with airway hyperresponsiveness (an exaggerated airway-narrowing response to specific triggers such as viruses, allergens and exercise).
Physiotherapy can provide relief from symptoms of uncontrolled asthma, including coughing, wheezing, tightness in the chest, shortness of breath and QOL.
Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms like wheezing, coughing, shortness of breath, and chest tightness. It can be triggered by various factors including allergens, respiratory infections, exercise, smoke, and pollutants. Management involves medication, identifying triggers, creating an action plan, monitoring symptoms, staying active, maintaining a healthy lifestyle, getting vaccinated, and regular check-ups with healthcare providers. Effective management aims to control symptoms, prevent flare-ups, and improve overall quality of life.
Asthma is a chronic inflammatory condition associated with airway hyperresponsiveness (an exaggerated airway-narrowing response to specific triggers such as viruses, allergens and exercise).
Physiotherapy can provide relief from symptoms of uncontrolled asthma, including coughing, wheezing, tightness in the chest, shortness of breath and QOL.
Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to symptoms like wheezing, coughing, shortness of breath, and chest tightness. It can be triggered by various factors including allergens, respiratory infections, exercise, smoke, and pollutants. Management involves medication, identifying triggers, creating an action plan, monitoring symptoms, staying active, maintaining a healthy lifestyle, getting vaccinated, and regular check-ups with healthcare providers. Effective management aims to control symptoms, prevent flare-ups, and improve overall quality of life.
pharmacothrapy of asthma.pptxBronchial asthma is a chronic respiratory diseas...AbhishekKumarGupta86
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pharmacotherpy of asthma M pharm 2nd sem.
Bronchial asthma is a chronic respiratory disease characterized by inflammation and narrowing of airways in the lungs, which cause difficulty in breathing.
Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time.
Although asthma can be a serious condition, it can be managed with the right treatment.
Asthma affected an estimated 262 million people in 2019 (1) and caused 455 000 deaths.
Bronchial Asthma: Definition,Pathophysiology and ManagementMarko Makram
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Definition and Pathophysiology of Asthma in addition to classification and recent updates in the management of asthma based on GINA-2019 Guidelines, by Dr. Marco Makram.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
pharmacothrapy of asthma.pptxBronchial asthma is a chronic respiratory diseas...AbhishekKumarGupta86
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pharmacotherpy of asthma M pharm 2nd sem.
Bronchial asthma is a chronic respiratory disease characterized by inflammation and narrowing of airways in the lungs, which cause difficulty in breathing.
Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time.
Although asthma can be a serious condition, it can be managed with the right treatment.
Asthma affected an estimated 262 million people in 2019 (1) and caused 455 000 deaths.
Bronchial Asthma: Definition,Pathophysiology and ManagementMarko Makram
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Definition and Pathophysiology of Asthma in addition to classification and recent updates in the management of asthma based on GINA-2019 Guidelines, by Dr. Marco Makram.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Â
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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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.
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 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
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
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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!
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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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.
New Drug Discovery and Development .....NEHA GUPTA
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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.
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
2. Definition
• Asthma is a chronic inflammatory disorder of the airways
associated with airway hyperresponsiveness causing variable
airway obstruction, that reversible spontaneously or with
treatment.
• Leading to recurrent episodes of wheezing, breathlessness,
chest tightness and cough.
3. Epidemiology
• Common disease 15%-20% in developed countries, 2%-4% in
developing countries
• One of the most common and important long-term respiratory
conditions in terms of global years lived with disability
• Affects all ages, more common in children
• In childhood asthma M>F, puberty 1:1, adult onset asthma F>M
• Increased over the past decades
4.
5. Pathophysiology
• A complex interaction of cells and mediators that leads to:
1. Inflammation of the airways
2. Airway hyperresponsiveness
3. Airflow limitation (obstruction), which is usually variable and
reversible
8. Hyperresponsiveness
• the tendency for airways to narrow excessively in response to triggers
that have little or no effect in normal individuals
9.
10. Air flow limitation
• Defined as decreased FEV1/FVC ratio< 70% ??????
• In asthma this limitation is usually reversible
• Caused by :
- Bronchoconstriction (smooth muscle contraction)
- wall edema (increased permeability of vessels)
- increased secretions (goblet cells)
11.
12. • With increasing severity and chronicity of the disease, remodelling of
the airway may occur, leading to:
- Fibrosis of the airway wall increasing the thickness of the epithelial
basement membrane
- Hypertrophy and hyperplasia of smooth muscles
- Hyperplasia of goblet cells and loss of cilia on epithelial cells
This will cause fixed narrowing of the airway and a reduced response to
bronchodilator medication
13. • Triggers
- house dust mites
- Cockroaches and other insect debries
- Cat dander
- Seasonal pollens
- Products of combustion
- Tobacco
- Respiratory infections
14. - NSAID’s and aspirin, beta blockers
- Stress including exercise (exercise induced asthma)
- Post nasal drip, GERD, aspiration
15. Risk factors
• Genetic factors
Atopy, high IgE levels
• Environmental factors
Indoor and outdoor air pollution, allergens
• Infections
Viral infections, atypical bacterial infections
• Obesity
• Race and gender
16. Clinical features
• Typical symptoms include recurrent episodes of wheezing, chest
tightness, breathlessness and cough
• These symptoms tend to be provoked by exposure to triggers
• More prominent in the night and early morning
17. • Signs on physical exam
- Normal exam in-between the attacks, but some findings that increase
the probability of asthma: eczema, nasal polyps
- Tachycardia and tachypnea
- Prolonged expiratory phase with or without diffuse wheeze
- Use of accessory muscles
- Pulsus paradoxus
18.
19. Differential diagnosis
• Vocal cord dysfunction
• Cardiac asthma
• COPD
• Upper air way obstruction
• Other conditions: anemia, obesity, LV dysfunction, bronchiectasis
20. Laboratory investigations
• Lung function tests
- Peak expiratory flow
Simple, cheap, can be used at home or work for assessing diurnal
changes or relation to occupational allergens (occupational asthma)
- Spirometry with bronchodilator reversibility
FEV1, FVC, ratio (FEV1/FVC)
- Bronchial challenge test
Used rarely in case of diagnosis uncertainty
21. • Blood tests
- CBC for eosinophil count
- IgE level
- radioallergosorbent testing (RAST)
to identify if the serum has IgE specific certain allergens
- ABG
in acute exacerbations
22. • Chest imaging
- Chest radiograph
Usually normal in mild to moderate asthma
Hyperinflation maybe seen in more severe asthmatic patients
Useful in case of acute exacerbations to exclude pneumothorax,
pneumonia or other diagnoses
- Chest CT
To detect bronchiectasis in allergic bronchopulmonary aspergillosis
(ABPA)
23. • Exhaled nitric oxide (FeNO)
- Not widely available
- Exhaled nitric oxide is high due to eosinophilic inflammation of the
airways
- Can be useful in pediatric patients or for assessment of adherence to
medications
- Still not recommended by the guidelines
27. Management
• Goals of asthma treatment
1. Achieve and maintain control of symptoms.
2. Maintain normal activity levels, including exercise.
3. Maintain pulmonary function as close to normal levels as possible.
4. Prevent asthma exacerbations.
5. Avoid adverse effects from asthma medications.
6. Prevent asthma mortality.
28. Management
1. Patient education.****
2. Identify and reduce exposure to risk factors, including cigarette
smoking. (this includes pneumococcal vaccination (Pneumovax 23) and
annual influenza vaccinations)
3. Pharmacological therapy as a stepwise approach.
32. 1. Inhaled corticosteroids (ICS)
- Beclomethasone, budesonide, mometasone, ciclesonide and
fluticasone are the common ICSs in clinical use .
- Decreases the inflammatory process in the airways with negligible
systemic adverse effects in recommended doses.
- Common side effects oral candidiasis, dysphonia.
- Rarely in high doses, systemic side effects of steroids might be seen
33. 2. Short acting beta2 agonists (SABA)
- Salbutamol, terbutaline
- Cause smooth muscle relaxation, resulting bronchodilation
- Side effects includes tachycardia, arrhythmia, fine tremor, sweating
and agitation
- IV and oral forms
34. 3. Long acting beta2 agonists (LABA)
- As Salmeterol and Formoterol.
- Duration of action is more than 12 hrs.
- In asthma treatment, should be used as add-on therapy to ICS
35. 4. Short acting muscarinic antagonists (SAMA)
- As Ipratropium
- Decreases mucus secretions and causes smooth muscle relaxation
and bronchodilation by blocking the nervous stimuli provided by the
vagal nerve.
- Less effective than SABA in treating asthma, used more in COPD.
- Used in combination with SABA for stronger effect.
36. 5. Long acting muscarinic antagonists (LAMA)
- As tiotropium (the only one approved for asthma), aclidinium,
glycopyrronium, umeclidinium
37. 6. Leukotriene modifiers
- as Montelukast, Zafirlukast.
- Side effects : headache, rashes, and in rare cases eosinophilic
granulomatosis with polyangiitis (Churg-Strauss)
38. 7. Methylxanthines
- As Theophylline, Aminophylline
- Relaxes the smooth muscles and decreases histamine secretion by
mast cells, which leads to bronchodilation.
- Has a narrow therapeutic window
- Side effects: agitation, tachycardia, arrhythmias, GI upset and
vomiting.
39. 8. Systemic steroids
- Used in severe, chronic, poorly controlled cases.
- Also used in exacerbations, so it will take effect after hours i.e. it will
take effect during the late phase.
- Long term use will cause side effects.
- The least dose needed to control the symptoms is used.
40. 9. Mast cell stabilizers (cromones)
- Cromolyn and nedocromil
- Less effective, expensive, not widely used
41. 10. Monoclonal antibodies
- Very expansive, indicated in selected groups of uncontrolled
asthmatics
- Omalizumab : anti IgE
- Mepolizumab : anti IL-5
- Reslizumab: anti IL-5
- Benralizumab: anti IL-5 receptor
- Dupilumab: anti IL-4 & IL-3
42. 11. Immunotherapy
- Greatest benefit seen in patients with single specific allergic trigger
- Allergen specific immunotherapy (ASIT): repeated administration of
allergen products under medical supervision
- Side effects :anaphylaxis
43.
44.
45. Asthma Exacerbation
• Usually triggered by viral respiratory infections, but exposure to other
triggers can precipitate an exacerbation
• Most attacks develop over several hours, but in some attacks
deterioration occurs suddenly (brittle asthma)
• Assessing severity is the cornerstone of managing an asthma
exacerbation
46.
47. • Mild asthma exacerbation:
- Many respond to high dose of inhaled SABA
- If no response start ICS (if not on ICS), or give short course systemic
steroids (7 days) starts in ED
- Early follow up visit to clinic
48. • Moderate asthma exacerbation:
- Correct hypoxemia with oxygen
- Many respond to high dose of inhaled/nebulized (SABA/SAMA)
- Add ICS (if not on ICS)
- Short course systemic steroids (7 days) starts in ED
- If respond, discharge with early clinic visit
- If no response consider admission to floor
49. • Severe (life threatening) asthma exacerbation:
- Oxygen therapy targeting SpO2>90%
- High dose SABA/SAMA
- Systemic steroids (oral or intravenous)
- Magnesium sulfate
- Admission to intensive care unit for close observation
- Antibiotics are not indicated unless high likelihood of bacterial
pneumonia (fever, purulent sputum)
50. • Impending respiratory failure
- Due to worsening obstruction and muscle fatigue
- Endotracheal intubation and mechanical ventilation