This document discusses several types of skin conditions that can occur during pregnancy including Pemphigoid Gestationis, Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP), Polymorphic Eruption of Pregnancy (PEP), and Prurigo of Pregnancy. It provides details on the clinical presentation, pathogenesis, diagnosis, and treatment options for each condition. The document emphasizes that most of these skin conditions do not pose risks to the fetus or mother, but may recur in subsequent pregnancies. Topical corticosteroids and oral antihistamines are usually first-line treatments.
pregnancy induced pruritus,Polymorphic eruption of pregnancy,PEP,pruritic urt...statushigh5
Polymorphic eruption of pregnancy (PEP), pruritic urticarial papules and plaques of pregnancy (PUPPP),Polymorphic eruption of pregnancy (PEP) (syn., pruritic urticarial papules and plaques of pregnancy [PUPPP]) 3. Prurigo of pregnancy (PP) and 4. ... They included three conditions- eczema in pregnancy (EP), prurigo of pregnancy and pruritic folliculitis of pregnancy under AEP due to their overlapping features.
During pregnancy, there are marked changes in sex hormones, the immune system, and the cardiovascular system, and this can lead to changes in the skin......
pruritus/itching of pregnancy , its epidemiology , types and pathogenesis along with management .
References are from fitzpatrick synopsis of dermatology & other sources ( references kept along with slide)
pregnancy induced pruritus,Polymorphic eruption of pregnancy,PEP,pruritic urt...statushigh5
Polymorphic eruption of pregnancy (PEP), pruritic urticarial papules and plaques of pregnancy (PUPPP),Polymorphic eruption of pregnancy (PEP) (syn., pruritic urticarial papules and plaques of pregnancy [PUPPP]) 3. Prurigo of pregnancy (PP) and 4. ... They included three conditions- eczema in pregnancy (EP), prurigo of pregnancy and pruritic folliculitis of pregnancy under AEP due to their overlapping features.
During pregnancy, there are marked changes in sex hormones, the immune system, and the cardiovascular system, and this can lead to changes in the skin......
pruritus/itching of pregnancy , its epidemiology , types and pathogenesis along with management .
References are from fitzpatrick synopsis of dermatology & other sources ( references kept along with slide)
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
Please find the power point on Puerperal sepsis. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Explains the inflammatory process of endometrium,its causes and its two clinical variants as acute and chronic endometritis.
Describes the pathology of its two types with histologic perspective.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
Please find the power point on Puerperal sepsis. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Explains the inflammatory process of endometrium,its causes and its two clinical variants as acute and chronic endometritis.
Describes the pathology of its two types with histologic perspective.
There are several dermatoses that occur during pregnancy or immediately postpartum, in particular polymorphic eruption of pregnancy, pemphigoid gestationis, and atopic eruption of pregnancy. Pruritus due to intrahepatic cholestasis of pregnancy leads to nonspecific skin lesions, including excoriations due to scratching.
Impetigo herpetiformis simply represents pustular psoriasis occurring during pregnancy, and this may be related to the relative hypocalcemia of pregnancy. Lastly, there are physiologic changes that occur during pregnancy.
precocious puberty is one of the grey areas for pediatricians and gyenecologists. this is an attempt to answer some of the questions the content is references taken from authorative textbooks
Hormonal changes in female patients and periodontal diseasesPerio Files
Hormonal fluctuations and gingival changes in female patient occurs during Puberty, Menstruation, Pregnancy, Menopause,
Oral Contraceptives, Osteoporosis.
NEED FOR ASSESSMENT: To identify high-risk stages of female patients in prior so that preventive and treatment procedures can be tailored
During pregnancy, women undergo certain hormonal and physiological changes that can affect their mouths.
EFFECT OF PREGNANCY ON PERIODONTAL TISSUES
PREGNANCY GINGIVITIS
EFFECT OF PERIODONTITIS ON PREGNANCY
PRETERM LOW BIRTH WEIGHT (PLBW) INFANTS
PREECLAMPSIA
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
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
New Drug Discovery and Development .....NEHA GUPTA
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.
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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
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
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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.
4. Predominantly a disease of women in their 1st
pregnancy in the 3rd trimester
Pruritic urticarial papules ; microvesiculation, target
like, annular, polycyclic, no bullae
Begin on the abdomen (in the striae in 2/3 of the cases)
Usually sparing the periumbilical area, palms, soles, and
face
Recurrence in subsequent pregnancies, with menses or
with the use of oral contraceptives; uncommon
5. 10 times more common in women with
twins or triplets
Other : primiparous, male fetus, rapid or
excessive weight gain
Prognosis
unassociated with fetal or maternal morbidity and
mortality
6. Unknown
Sex hormones
Campbell et al; Progesterone has been shown to aggravate the
inflammatory process at the tissue level.
Im et al; increased progesterone receptor immunoreactivity in skin
lesions of PUPPP
Damage to connective tissue within the striae distensae
rapid abdominal wall distension → damage to connective tissue →
conversion of nonantigenic molecules to antigenic ones →
inflammatory process
Fetal cell migration to the maternal skin
Nelson et al ; Increased abdominal stretching → increased vascular
permeability → migration of chimeric cells into the maternal skin
7. Histopathology
Nonspecific perivascular lymphohistiocytic infiltrate
with some edema and eosinophils in the dermis
DIF; negative
Treatment
Conservative therapies
Topical emollients and topical corticosteroids
Oral antihistamines
Oral corticosteroids
8. Prurigo of pregnancy
Pruritic folliculitis of pregnancy
Atopic dermatitis or eczema of pregnancy
9. Prurigo gestationis
Papular dermatitis of pregnancy
Early onset prurigo of pregnancy
10. Clinical feautres
intensely pruritic rashes in the 2nd or 3rd trimester
small, mostly excoriated, nonvesicular erythematous
papules
grouped over the abdomen and the distal extensor
aspects of both upper and lower extremities
propensity to resolve leaving residual PIH
disappearance soon after delivery
Histopathologic examination; nonspecific
DIF; negative
11. No risk to the fetus or to the mother
Recurrences during subsequent pregnancies;
infrequent
Treatment
symptomatic
topical steroids
oral antihistamines
systemic steroids
12. Extremely itchy
erythematous follicular
papules, pustules localized
to the torso
≈ steroid induced acne
Any trimester
(m/c 2nd or 3rd )
May resolve before delivery
13. No morbidity to the mother or fetus
Biopsy; sterile folliculitis
DIF; negative
Treatment
Topical corticosteroid
Benzoyl peroxide
Emollient
UVB
14. Eczema of pregnancy
Eczematous lesion typically appear during the 1st and 2nd
trimester
All parts of the body including the face, palms and soles
Eczematous(50%), papular or prurigo-like features (30%)
15. Etiology: Unknown
20% exacerbation of atopic dermatitis
80% have no past history
Elevated serum IgE in app. 70% of patients
Treatment : topical steroid
16. Clinical features
Markedly pruritic and/or urticarial plaques, papules or
vesicles beginning in the periumbilical region before
spreading across the trunk and body, forming bullae
during the 2nd or 3rd trimester
sparing of the face, mucous membranes, palms, and
soles
17.
18. Pathology
subepidermal vesicles, spongiotic epidermis
some perivascular lymphocyte and histiocyte infiltrates
with a preponderance of eosinophils
DIF; C3 with or without IgG in a linear band along the
BMZ
19. Immunologic response against class II antigens of paternal
haplotype at the placenta, which then cross-reacts with the
skin
Associations with HLA DR3 (61%-80%), DR4 (52%), or
both (43%-50%)
Immunology
HG factor; IgG1 subclass
Epitope mapping; common antigenic site within the
noncollagenous domain (NC16A) of the transmembrane
180-kD HG Ag (BP Ag 2)
20. Clinical course
Remit before delivery or regresses spontaneously over
weeks or months after delivery
Flares
At the time of delivery
During menstruation
Oral contraceptives
Occurrences in subsequent pregnancies
earlier
more severe clinical picture
prolonged postpartum duration
21. No maternal risk
but an increased risk of Graves’ disease, other
autoimmune diseases
Mild increase in fetal morbidity or mortality
small-for-gestational-age infants
- associated with presence of blisters and disease onset
in 2nd trimester but not antibody titer or systemic
corticosteroid treatment
prematurity
22. Treatment
Early urticarial lesions
topical corticosteroids in addition to oral antihistamines
First line; (bullae)
systemic corticosteroids (0.5 mg/kg or 30mg/d of
prednisolone daily)
Chronic HG
plasmapheresis
박 등 (2000); Cyclosporine으로 호전을 보인 임신성 포진 1예
IVIG combined with cyclosporine
Refractory cases; adjuvant medications, especially in the
postpartum period (methotrexate, azothioprine,
gold,pyridoxine, cyclophosphamide)
Alternative ; dapsone, sulfapyridine, pyridoxine, cyclosporine
23. Classification
a rare form of generalized pustular psoriasis in
pregnancy
an entity distinct from psoriasis
Onset; most commonly in the 3rd trimester
Systemic symptoms; malaise, fever, delirium, diarrhea,
vomiting, tetany
Usually no personal or family history of psoriasis
Often associated with hypocalcemia or low serum levels of
vitamin D
24. Erythematous patches with grouped pustules at their
margins starting in the intertriginous or flexural areas and
extend centrifugally
25. Pustular psoriasis occurring during pregnancy tends to
worsen as the pregnancy progresses and resolves rapidly
at delivery or termination.
Obstetric complications
placental insufficiency; increased risk of stillbirths, fetal
abnormalities, neonatal death
fluid and electrolyte imbalance; increased morbidity
and mortality
26. Treatment
systemic corticosteroids; usually effective at a relatively low
dose of 15 to 30 mg/day of prednisone
oral cyclosporin (category C)
parenteral calcium with vitamin D
postpartum administration of oral retinoids
Recurrence in successive pregnancies
earlier onset and increased morbidity
increase in morbidity with each successive pregnancy
27.
28.
29. The safety of topical glucocorticoids (C) varies with the
strength of the agent and the specific vehicle employed.
high potency topical steroids used on large body surface areas
- increased potential for systemic absorption
Not more than 45g/week of potent or 100g /week of weak
or moderately potent topical corticosteroid should be
applied (without occlusion) if systemic absorption is to be
avoided.