Left ventricular failure is a condition where the left ventricle becomes unable to adequately pump blood. It has multiple causes including loss of heart muscle, pressure overload on the heart, and restrictive cardiomyopathies. The condition can be acute, chronic, or acute on chronic. Diagnosis involves history, physical exam, ECG, echocardiogram, and blood tests. Treatment depends on whether the failure is acute or chronic but may include diuretics, vasodilators, inotropes, mechanical circulatory support, medications like ACE inhibitors, beta blockers, ARNIs, aldosterone antagonists, devices like ICDs and CRT, and procedures like revascularization or transplantation. Prognosis
Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Increased intracranial pressure is defined as cerebrospinal fluid pressure greater than 15 mm Hg.
Infections
Tumors
Stroke
Aneurysm
Epilepsy
Seizures
Hydrocephalus
Hypertensive brain injury
Hypoxemia
Meningitis
Due to etiological factors
Components of ICP is disturbed- brain tissue, CSF, blood volume
An increase in the volume of ANY ONE component must be accompanied by a reciprocal decrease in one of the other components.
When this volume-pressure relationship becomes unbalanced, ICP increases.
Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine. Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood.
Definition of heart failure - causes and types of heart failure - pathophysiology and risky factors for heart failure - Diagnosis clinical manifestations and investigations and classification of heart failure- treatment of chronic heart failure
Also Acute heart failure causes - clinical picture and treatment
Cor pulmonale is alteration in the structure and function of the right ventricle (RV) of the heart. The overall five-year survival rate for cor pulmonale complicating COPD is approximately 50%.
CARDIAC TAMPONADE ( Cardiac emergency) • Cardiac Tamponade is a life threatening complication caused by excessive accumulation of fluid in the pericardium. Or • Compression of all cardiac chambers due to excessive accumulation of pericardial fluid leading to compromised cardiac out put.
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Increased intracranial pressure is defined as cerebrospinal fluid pressure greater than 15 mm Hg.
Infections
Tumors
Stroke
Aneurysm
Epilepsy
Seizures
Hydrocephalus
Hypertensive brain injury
Hypoxemia
Meningitis
Due to etiological factors
Components of ICP is disturbed- brain tissue, CSF, blood volume
An increase in the volume of ANY ONE component must be accompanied by a reciprocal decrease in one of the other components.
When this volume-pressure relationship becomes unbalanced, ICP increases.
Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine. Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood.
Definition of heart failure - causes and types of heart failure - pathophysiology and risky factors for heart failure - Diagnosis clinical manifestations and investigations and classification of heart failure- treatment of chronic heart failure
Also Acute heart failure causes - clinical picture and treatment
Cor pulmonale is alteration in the structure and function of the right ventricle (RV) of the heart. The overall five-year survival rate for cor pulmonale complicating COPD is approximately 50%.
CARDIAC TAMPONADE ( Cardiac emergency) • Cardiac Tamponade is a life threatening complication caused by excessive accumulation of fluid in the pericardium. Or • Compression of all cardiac chambers due to excessive accumulation of pericardial fluid leading to compromised cardiac out put.
Myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw.
Pharmacotherapy of congestive heart faliure Rahulvaish13
This PPT covers the pathophysiology, treatment protocol and details of individual drugs used and those drugs failed in clinical trials; taken from standard text books and articles as reference. This will be extremely useful for undergraduates ( MBBS, BDS,) and postgraduates (MD,MDS ,Phd).
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
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
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.
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
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!
7. Ref: Wang TJ, et al. The epidemiology of ‘‘asymptomatic’’ left ventricular
systolic dysfunction: implications for screening. Ann Intern Med 2003;
138:907–916.
Natural
History of HF
Patient:
13. • Activation of the Renin-Angiotensin System:
Renal hypoperfusion and sympathetic stimulation of the kidneys result in
increased production of renin by the juxtaglomerular apparatus.
Renin transform angiotensinogen into the angiotensin I, which is
subsequently cleaved by angiotensin-converting enzyme (ACE) to the biologically
active angiotensin II.
Angiotensin II stimulates aldosterone production by the zona glomerulosa of
the adrenal cortex, which in turn promotes reabsorption of sodium in exchange for
potassium in the distal nephron. Chronically, aldosterone results in the promotion of
hypertrophy and fibrosis in the vasculature and myocardium, endothelial dysfunction,
and inhibition of norepinephrine uptake.
18. The New York Heart Association (NYHA) functional
classification of HF:
19. The Killip classification- Grades the severity of signs of
decompensated heart failure in the post-acute coronary syndrome
setting and is highly predictive of 30-day mortality.
20.
21. Categorization Of Left Ventricular Failure…
Systolic Diastolic Both
Impaired contractility
of the left
ventricle(EF%)
Associated with
chamber dilation
Poor ventricular
filling and high
LVEDP.
left ventricular
hypertrophy-stiff,
noncompliant
ventricle
Often coexist,
particularly in
patients with
coronary artery
disease.
22. Categorization Of Left Ventricular Failure…
Acute Chronic Acute on
chronic LVF
1.Acute MI
2. Acute native valve
failure e.g Chordal
rupture, Endocarditis
3. Acute myocarditis
1.Ischemic cardiomyopathy
2.Dilated cardiomyopathy.
3.Hypertensive and diabetic
cardiomyopathy
4.Valvular disorders
5.Thiamine deficiency
Infection
Viral
Bacterial
25. 12lead ECG Chest X-Ray (P/A) Blood:
It may reveal-
-MI
- left ventricular
hypertrophy(LVH)
- Arrhythmia e.g AF
-IHD
- Enlarged hilar vessels
- Ground glass/Reticular
shadowing of alveolar
edema
-Prominence of upper
lobe vessels
-Septal or Kerley’s B
line
-Pulm. oedema
-NT Pro -BNP
-Complete blood count
-Blood Urea
-Serum Electrolytes
-Serum Creatinine
-Blood sugar
-TSH
26. Class I In patients with dyspnea, measurement of BNP or NT-pro
BNP is useful to support a diagnosis or exclusion of HF.
Class I Measurement of BNP or NT-proBNP is useful for
establishing prognosis or disease severity in chronic HF
Class I Measurement of baseline levels of natriuretic peptide
biomarkers and/or cardiac troponin on admission to the
hospital is useful to establish a prognosis in acutely
decompensated HF.
2017 ACC/AHA/HFSA Heart Failure Focused Update
28. • Most useful diagnostic test in the evaluation of patients with heart
failure.
• Provide information about etiology and prognosis of heart failure.
• Regional wall motion abnormalities, EF, LV dimensions, LV
mass,the myocardial performance index (Tei index), measures of
diastolic dysfunction all can be done by Echo.
36. Sodium Nitroprusside :
-It is a potent vasodilator with venous and arteriolar effects.
- Requires hemodynamic monitoring.
-Dosage of 0.1 to 0.2 μg/kg/min is used and titrated every 5
minutes to achieve response while maintaining MAP > 65 mm Hg.
-Nitroprusside is particularly useful where a rapid and large
reduction in afterload is desired (e.g., cardiogenic shock and acute
severe aortic regurgitation or MR).
41. MCS is beneficial in carefully selected
patients with stage D HF in whom
definitive management (e.g., cardiac
transplantation) or cardiac recovery is
anticipated or Planned.
(Level of Evidence: B)
Class I
Temporary mechanical circulatory
support…
46. 2013 Recommendation+2017 ACC/AHA/HFSA Heart
Failure Focused Update…
Class I
2013
Recommendation
The use of ACE inhibitors is beneficial for
patients with prior or current symptoms of
chronic HFrEF to reduce morbidity and mortality.
2013
Recommendation
The use of ARBs to reduce morbidity and mortality
is recommended in patients with prior or current
symptoms of chronic HFrEF who are intolerant to
ACE inhibitors because of cough or angioedema.
2017 Focused Update
New clinical trial data
In patients with chronic symptomatic HFrEF
NYHA class II or III who tolerate an ACE inhibitor or
ARB, replacement by an ARNI is recommended to
further reduce morbidity and mortality.
48. Ivabradin…
2016 ACC/AHA/HFSA Focused Update on New Pharmacological
Therapy for Heart Failure…
Class II
Ivabradine can be beneficial to reduce HF
hospitalization for patients with symptomatic (NYHA
class II-III) stable chronic HFrEF (LVEF< 35%) who are
receiving a beta blocker at maximum tolerated dose,
and who are in sinus rhythm with a heart rate of 70 bpm
or greater at rest.
51. 2013 ACCF/AHA Heart Failure Guidelines:
Class I
ICD therapy
For primary prevention of sudden cardiac
death to reduce mortality in nonischemic
dilated cardiomyopathy or ischemic heart
disease at least 40 days post-MI with
LVEF of 35% or less and NYHA class II or III
symptoms who have expectation of survival
for more than 1 year.
CRTTherapy
For patients who have LVEF of 35% or less, sinus
rhythm, LBBB with a QRS duration of 150 ms or
greater, and NYHA class II, III, or ambulatory IV
symptoms on GDMT.
52. 2013 ACCF/AHA Heart Failure Guidelines:
Class I
Coronary artery revascularization via CABG or PCI is
indicated for patients with angina and suitable coronary
anatomy, especially for a left main stenosis (>50%) or
left main equivalent disease.
53. CardiacTransplantation…
2013 ACCF/AHA Heart Failure Guidelines:
Class I
Evaluation for cardiac transplantation is indicated
for carefully selected patients with advanced HF
(Stage D) despite GDMT, device, and surgical
management.