This is the talk I gave during ICEM 2010 under the International Experience of Cardiology Track. In this presentation, I highlighted some of the challenges I see within the Malaysian setting, I focus mainly on prehospital and A&E setting. Issues that are conventionally under the care of the cardiologists are not discussed.
NEURAL NETWORKS AND BOOTSTRAP SIMULATION IN PREDICTION OF OUTCOME OF NON-SMALL CELL LUNG CANCER PATIENTS AFTER COMPLETE LOBECTOMIES AND PNEUMONECTOMIES
5-Year Survival of Non-Small Cell Lung Cancer Patients after Radical Surgery Significantly Depended on Phase Transition “Early-Invasive Cancer”, Lymph Node Metastases and Cell Ratio Factors
Kshivets O. Esophageal & Cardioesophageal Cancer SurgeryOleg Kshivets
ADJUVANT CHEMOIMMUNORADIO/CHEMOIMMUNOTHERAPY SIGNIFICANTLY IMPROVED 5-YEAR SURVIVAL OF ESOPHAGEAL/CARDIOESOPHAGEAL CANCER PATIENTS AFTER RADICAL SURGERY
Kshivets O. Cardioesophageal Cancer SurgeryOleg Kshivets
ARTFICIAL INTELLIGENCE, SYSTEM ANALYSIS AND SIMULATION MODELING IN PREDICTION OF 5-YEAR SURVIVAL OF CARDIOESOPHAGEAL CANCER PATIENTS AFTER COMPLETE LEFT THORACOABDOMINAL ESOPHAGOGASTRECTOMIES
Adrenocortical carcinoma (ACC) is a relatively rare malignancy with an estimated incidence of 0.7-2.0 per 1 million population per year showing two distinct age peaks in early childhood and in the 4th-5th decade of life. Most cases of ACCs are sporadic but can also occur in association with several hereditary syndromes, including Li-Fraumeni, Beckwith-Wiedemann, multiple endocrine neoplasia (MEN) 1, congenital adrenal hyperplasia, familial polyposis coli, and germline β-catenin or p53 mutations. Patients with ACC present with either symptoms due to hormone hypersecretion or manifestations of tumor mass effect, although an increasing percentage is discovered as incidentalomas during abdominal imaging.
NEURAL NETWORKS AND BOOTSTRAP SIMULATION IN PREDICTION OF OUTCOME OF NON-SMALL CELL LUNG CANCER PATIENTS AFTER COMPLETE LOBECTOMIES AND PNEUMONECTOMIES
5-Year Survival of Non-Small Cell Lung Cancer Patients after Radical Surgery Significantly Depended on Phase Transition “Early-Invasive Cancer”, Lymph Node Metastases and Cell Ratio Factors
Kshivets O. Esophageal & Cardioesophageal Cancer SurgeryOleg Kshivets
ADJUVANT CHEMOIMMUNORADIO/CHEMOIMMUNOTHERAPY SIGNIFICANTLY IMPROVED 5-YEAR SURVIVAL OF ESOPHAGEAL/CARDIOESOPHAGEAL CANCER PATIENTS AFTER RADICAL SURGERY
Kshivets O. Cardioesophageal Cancer SurgeryOleg Kshivets
ARTFICIAL INTELLIGENCE, SYSTEM ANALYSIS AND SIMULATION MODELING IN PREDICTION OF 5-YEAR SURVIVAL OF CARDIOESOPHAGEAL CANCER PATIENTS AFTER COMPLETE LEFT THORACOABDOMINAL ESOPHAGOGASTRECTOMIES
Adrenocortical carcinoma (ACC) is a relatively rare malignancy with an estimated incidence of 0.7-2.0 per 1 million population per year showing two distinct age peaks in early childhood and in the 4th-5th decade of life. Most cases of ACCs are sporadic but can also occur in association with several hereditary syndromes, including Li-Fraumeni, Beckwith-Wiedemann, multiple endocrine neoplasia (MEN) 1, congenital adrenal hyperplasia, familial polyposis coli, and germline β-catenin or p53 mutations. Patients with ACC present with either symptoms due to hormone hypersecretion or manifestations of tumor mass effect, although an increasing percentage is discovered as incidentalomas during abdominal imaging.
Survival of Esophageal Cancer Patients was Significantly Superior in Comparison with Cardioesophageal Cancer Patients after Surgery
Kshivets Oleg Surgery Department, Roshal Hospital, Moscow, Russia
OBJECTIVE: This study aimed to determine localization influence of tumor for 5-year survival (5YS) of esophageal (EC) or cardioesophageal (CC) cancer patients (ECP, CEP) after complete en block (R0) esophagogastrectomies (EG) through left/right thoracoabdominal incision.
METHODS: We analyzed data of 543 consecutive patients (age=56.4±8.8 years; tumor size=6±3.5 cm) radically operated (R0) and monitored in 1975-2019 (m=405, f=138; ECP=259, CEP=284; esophagogastrectomies (EG) Garlock=280, EG Lewis=263, combined EG with resection of pancreas, liver, diaphragm, aorta, VCS, colon transversum, lung, trachea, pericardium, splenectomy=151; adenocarcinoma=308, squamous=225, mix=10; T1=126, T2=114, T3=178, T4=125; N0=275, N1=69, N2=199; G1=157, G2=139, G3=247; early EC=107, invasive=436; only surgery=420, adjuvant chemoimmunoradiotherapy-AT=123: 5-FU+thymalin/taktivin+radiotherapy 45-50Gy). Multivariate Cox modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence.
RESULTS: Overall life span (LS) was 1892.4±2241 days and cumulative 5-year survival (5YS) reached 51.9%, 10 years – 45.7%, 20 years – 33.5%. 183 ECP lived more than 5 years (LS=4311±2419.7 days), 98 ECP – more than 10 years (LS=5903.4±2299.4 days). 224 died because of EC/CC (LS=629.2±320.1 days). 5YS of ECP (67.3%, LS=2605±2628.9 days) was significantly superior in comparison with CEP (36.4%, LS=1242.6±1558.5 days) (P=0.00000 by log-rank test). AT significantly improved 5YS (68.2% vs. 48.5%) (P=0.00033 by log-rank test). Cox modeling displayed that 5YS of ECP/CEP significantly depended on: phase transition (PT) N0—N12 in terms of synergetics, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), T, G, histology, age, AT, localization, blood cells, prothrombin index, coagulation time, residual nitrogen, blood group, Rh, glucose, protein (P=0.000-0.008). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and healthy cells/CC (rank=1), PT early-invasive EC (rank=2), PT N0—N12 (rank=3), erythrocytes/CC (4), thrombocytes/CC (5), stick neutrophils/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), eosinophils/CC (9), leucocytes/CC (10), monocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
Artificial Intelligence, System Analysis and Simulation Modeling in Precise Prediction of 5-Year Survival of Esophageal Cancer Patients after Complete Esophagogastrectomies
The incidence of cancer is increasing in line with our ageing population, with a greater number of patients requiring ICU admission for support managing complications of their malignancy, it’s therapy, or conditions unrelated to their underlying cancer. Despite these indications, the presence of a cancer diagnosis has been a common reason for refusal of ICU admission, or admission with treatment limitations.
This session will present the current epidemiology, characteristics and outcomes of patients admitted to Australian and New Zealand Intensive Care Units with cancer, and will describe the change in these outcomes across the last 17 years. Results will be reported for the most common malignancies admitted to ANZ intensive care units, common treatments and complications of malignancy will be reviewed and an agenda for further outcomes research in ICU malignancy will be proposed, with demonstration of early work in the analysis of outcomes relating to specific types of malignancy.
5-YEAR SURVIVAL OF UPPER THIRD ESOPHAGEAL CANCER PATIENTS WAS SIGNIFICANTLY SUPERIOR IN COMPARISON WITH MIDDLE AND LOWER THIRD ESOPHAGEAL CANCER PATIENTS AFTER RADICAL SURGERY AND STRONGLY DEPENDED ON PHASE TRANSITION EARLY-INVASIVE CANCER, LYMPH NODE METASTASES, CELL RATIO FACTORS AND ADJUVANT CHEMOIMMUNORADIOTHERAPY
5-Year Survival of Gastric Cancer Patients after Radical Surgery was Significantly Depended on Tumor Characteristics, Blood Cell Circuit, Cell Ratio Factors, Hemostasis System and Adjuvant Treatment
5-Year Survival of Lung Cancer Patients after Radical Surgery was Significantly Depended on Tumor Characteristics, Blood Cell Circuit, Cell Ratio Factors, Hemostasis System, Biochemic Homeostasis, Surgery Type, Adjuvant Treatment and Anthropometric Data
ARTFICIAL INTELLIGENCE, SYSTEM ANALYSIS AND SIMULATION MODELING IN OPTIMIZATION OF TREATMENT FOR ESOPHAGEAL CANCER PATIENTS AFTER COMPLETE ESOPHAGECTOMIES
Survival of Esophageal Cancer Patients was Significantly Superior in Comparison with Cardioesophageal Cancer Patients after Surgery
Kshivets Oleg Surgery Department, Roshal Hospital, Moscow, Russia
OBJECTIVE: This study aimed to determine localization influence of tumor for 5-year survival (5YS) of esophageal (EC) or cardioesophageal (CC) cancer patients (ECP, CEP) after complete en block (R0) esophagogastrectomies (EG) through left/right thoracoabdominal incision.
METHODS: We analyzed data of 543 consecutive patients (age=56.4±8.8 years; tumor size=6±3.5 cm) radically operated (R0) and monitored in 1975-2019 (m=405, f=138; ECP=259, CEP=284; esophagogastrectomies (EG) Garlock=280, EG Lewis=263, combined EG with resection of pancreas, liver, diaphragm, aorta, VCS, colon transversum, lung, trachea, pericardium, splenectomy=151; adenocarcinoma=308, squamous=225, mix=10; T1=126, T2=114, T3=178, T4=125; N0=275, N1=69, N2=199; G1=157, G2=139, G3=247; early EC=107, invasive=436; only surgery=420, adjuvant chemoimmunoradiotherapy-AT=123: 5-FU+thymalin/taktivin+radiotherapy 45-50Gy). Multivariate Cox modeling, clustering, SEPATH, Monte Carlo, bootstrap and neural networks computing were used to determine any significant dependence.
RESULTS: Overall life span (LS) was 1892.4±2241 days and cumulative 5-year survival (5YS) reached 51.9%, 10 years – 45.7%, 20 years – 33.5%. 183 ECP lived more than 5 years (LS=4311±2419.7 days), 98 ECP – more than 10 years (LS=5903.4±2299.4 days). 224 died because of EC/CC (LS=629.2±320.1 days). 5YS of ECP (67.3%, LS=2605±2628.9 days) was significantly superior in comparison with CEP (36.4%, LS=1242.6±1558.5 days) (P=0.00000 by log-rank test). AT significantly improved 5YS (68.2% vs. 48.5%) (P=0.00033 by log-rank test). Cox modeling displayed that 5YS of ECP/CEP significantly depended on: phase transition (PT) N0—N12 in terms of synergetics, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), T, G, histology, age, AT, localization, blood cells, prothrombin index, coagulation time, residual nitrogen, blood group, Rh, glucose, protein (P=0.000-0.008). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and healthy cells/CC (rank=1), PT early-invasive EC (rank=2), PT N0—N12 (rank=3), erythrocytes/CC (4), thrombocytes/CC (5), stick neutrophils/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), eosinophils/CC (9), leucocytes/CC (10), monocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
Artificial Intelligence, System Analysis and Simulation Modeling in Precise Prediction of 5-Year Survival of Esophageal Cancer Patients after Complete Esophagogastrectomies
The incidence of cancer is increasing in line with our ageing population, with a greater number of patients requiring ICU admission for support managing complications of their malignancy, it’s therapy, or conditions unrelated to their underlying cancer. Despite these indications, the presence of a cancer diagnosis has been a common reason for refusal of ICU admission, or admission with treatment limitations.
This session will present the current epidemiology, characteristics and outcomes of patients admitted to Australian and New Zealand Intensive Care Units with cancer, and will describe the change in these outcomes across the last 17 years. Results will be reported for the most common malignancies admitted to ANZ intensive care units, common treatments and complications of malignancy will be reviewed and an agenda for further outcomes research in ICU malignancy will be proposed, with demonstration of early work in the analysis of outcomes relating to specific types of malignancy.
5-YEAR SURVIVAL OF UPPER THIRD ESOPHAGEAL CANCER PATIENTS WAS SIGNIFICANTLY SUPERIOR IN COMPARISON WITH MIDDLE AND LOWER THIRD ESOPHAGEAL CANCER PATIENTS AFTER RADICAL SURGERY AND STRONGLY DEPENDED ON PHASE TRANSITION EARLY-INVASIVE CANCER, LYMPH NODE METASTASES, CELL RATIO FACTORS AND ADJUVANT CHEMOIMMUNORADIOTHERAPY
5-Year Survival of Gastric Cancer Patients after Radical Surgery was Significantly Depended on Tumor Characteristics, Blood Cell Circuit, Cell Ratio Factors, Hemostasis System and Adjuvant Treatment
5-Year Survival of Lung Cancer Patients after Radical Surgery was Significantly Depended on Tumor Characteristics, Blood Cell Circuit, Cell Ratio Factors, Hemostasis System, Biochemic Homeostasis, Surgery Type, Adjuvant Treatment and Anthropometric Data
ARTFICIAL INTELLIGENCE, SYSTEM ANALYSIS AND SIMULATION MODELING IN OPTIMIZATION OF TREATMENT FOR ESOPHAGEAL CANCER PATIENTS AFTER COMPLETE ESOPHAGECTOMIES
My presentation slides during the 1st National Symposium in Emergency and Acute Care (S.E.M.A.C). I presented some of the obstacles and challenges in scientific writing in emergency medicine within the Malaysia context as academic emergency medicine is still progressing in Malaysia,
A Free Paper Presentation in the 16th International Symposium in Critical Care and Emergency Medicine, Grand Hyatt, Bali, Indonesia (30th July - 1st August 2009). Won one of the best paper awards.
An introduction to the rationale and the two types (Write-in and Select-Menu) of Key Feature Questions. This presentation is based on an original article by Page and Bordage (1995).
My talk in April 2015 in Malaysia on Best Practices and Resuscitation Workflow. The new 2015 resuscitation guidelines is expected to be released in Oct 2015.
My talk in April 2015 Malaysia on Best Practices and Resuscitation Workflow. The new 2015 resuscitation guidelines is expected to be released in Oct 2015.
Welcoming message given by Sonia Wallman, of the Organizing Committee, and Lance Hartford, the Executive Director of the Massachusetts Biotechnology Education Foundation.
The 2005 National French Adverse Event Study: ENEIS. Anne Farge – Broyart. Presentation of the National Study of Adverse Events (Madrid, Ministry of Health and Consumer Affairs, 2006)
New Concepts of Newborn Resuscitation – the new national protocolMCH-org-ua
International conference «Actual approaches to the extremely preterm babies: International experience and Ukrainian realities» (Kyiv, Ukraine, March 5-6, 2013)
The presentation briefly describe details regarding different types of cancers prevalance in Pakistan and the opportunity this country offer in Cancer Research Projects by the availability of mostly chemo naive cancer patients
The vital role of oncology nurses in the care of patients with MM necessitates the awareness of the latest treatment advances and best practices for side-effect management. This CE-certified activity will provide updates in first-line, maintenance, and relapsed/refractory settings. Expert faculty will articulate the diagnosis, cytogenetics, and staging of the disease, as well as promising novel agents and evidence-based best practices for the management of side effects. To provide insight to attendees of the impact of evolving data on a personal level, a patient with MM will share personal perspectives on the journey from diagnosis, treatment, and overall patient experience.
Downloadable slide decks are a great tool for self study and teaching purposes. They are non-certified resources available to enhance your knowledge.
Review a downloadable slide deck by Beth Faiman, PhD(c), RN, APRN, BC, AOCN®, covering the most clinically relevant new data reported from Practical Navigation of a Changing Landscape: Keeping Current on Multiple Myeloma Treatments.
Target Audience
This activity has been designed to meet the educational needs of oncology nurses involved in the care of patients with multiple myeloma (MM).
Slide Deck Disclaimer
This slide deck in its original and unaltered format is for educational purposes and is current as of May 2012. All materials contained herein reflect the views of the faculty, and not those of IMER, the CE provider, or the commercial supporter. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. Readers should not rely on this information as a substitute for professional medical advice, diagnosis, or treatment. The use of any information provided is solely at your own risk, and readers should verify the prescribing information and all data before treating patients or employing any therapeutic products described in this educational activity.
For more information click here:
http://imeronline.com/gxpsites/hgxpp001.aspx?11,52,304,O,E,0,,743;561;8612
Download these clinical tools and resources to improve outcomes in care for patients with multiple myeloma:
http://imeronline.com/gxpsites/hgxpp001.aspx?11,52,304,O,E,0,,743;561;8613
Disaster and Mass Casualty Incidents (updated 7th July 2020)Chew Keng Sheng
A new updated slide on an overview of disaster management in Malaysia, including the formation of NADMA as the dedicated agency to coordinate disaster management in Malaysia.
Predatory publishing is a relatively recent phenomenon that seems to be exploiting some key features of the open access publishing model, sustained by collecting APCs that are far less than those found in legitimate open access journals. This CME aims to introduce to the participants on the phenomenon of predatory journals, why they continue to thrive, characteristics that are suggestive of a predatory journal, and how one can take step to minimize the risk of faling into predatory journal publication
A short sharing on doctor-patient communication to First year medical students in Universiti Malaysia Sarawak, to be supplemented with anecdotal accounts.
This slide was first presented during the Malaysian 1st Emergency Medicine Annual Scientific Meeting, in conjunction with the Academy of Medicine Malaysia, Academy of Medicine Singapore and the Academy of Medicine Hong Kong Tripartite Meeting in Aug 2016.
Sensitivity, specificity and likelihood ratiosChew Keng Sheng
A short tutorial on sensitivity, specificity and likelihood ratios. In this presentation, I demonstrate why likelihood ratios are better parameters compared to sensitivity and specificity in real world setting.
ACLS 2015 Updates - The Malaysian PerspectiveChew Keng Sheng
This set of slide was presented during the Kelantan Resuscitation Update 22 Nov 2015 in accordance to the latest ACLS/ILCOR 2015 Guidelines. However, I have emphasized on certain important aspects relevant within the Malaysian context. Nonetheless, in general, there are no major changes for this year 2015
New or Presumed New LBBB To Be Treated As a STEMI Equivalent? A Contra Argume...Chew Keng Sheng
My 6-page notes to go along with the "debate" of whether new or presumed new LBBB per se (without any other qualification) should be treated as STEMI equivalent
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.
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
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
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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!
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
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.
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.
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
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.
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.
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
Ocular injury ppt Upendra pal optometrist upums saifai etawah
Managing Cardiovascular Emergencies In A Malaysian Hospital - Challenges and Issues
1. Handling
Cardiovascular
Emergencies
In
A
Malaysian
Hospital
(A
Personal
Reflec/on
on
Issues
and
Challenges
Ahead)
K
S
Chew
Senior
Lecturer/Emergency
Physician,
Emergency
Medicine
Department
UniversiC
Sains
Malaysia
16150
Kubang
Kerian,
Kelantan,
Malaysia
2. Disclaimer:
The
views
presented
here
are
of
my
own
personal
reflec/on
and
is
not
represen/ng
any
official
statement/opinion
from
the
Ministry
of
Heath
Malaysia
3. Malaysia
mulC-‐ethnic,
mulC-‐religion
country
consisCng
of
13
states
and
three
federal
territories.
Majority
of
the
Malaysian
populaCon
of
about
27
million
people
consists
of
the
Malays
(50.4%),
Chinese
(23.7%),
the
indigenous
groups
(11%)
and
the
Indians
(7.1%)
4. MALAYSIA HEALTH FACTS 2006 2007 2008
Life Expectancy: Male 71.8 years 71.7 years 71.7 years
Life Expectancy: Female 76.3 years 76.5 years 76.5 years
No of MOH Hospitals 128 (30,969) 130 (32,149) 130 (33,004)
(no of beds)
No of Private Hospitals NA 195 (11,291) 209 (11,689)
(no of beds)
No of MOH Clinics 807 806 802
No of MOH Community Clinics 1,919 1,927 1,927
Total no of Public Doctors 13,335 14,298 15,096
Total no of Private Doctors 8,602 9,440 10,006
Doctor : Population Ratio 1:1,214 1 : 1,145 1 : 1,105
Reference:
Health
Facts
2006,
2007
and
2008.
Ministry
of
Health,
Malaysia
Official
Website.
URL:
www.moh.gov.my
5. Top
Ten
Causes
of
HospitalizaCon
in
Malaysian
Ministry
of
Health
Hospitals
2008
1
Normal
Deliveries
13.99%
2
ComplicaCons
of
Pregnancy,
Childbirth
and
the
12.77%
Puerperium
3
Accidents
8.40%
4
Diseases
of
the
Respiratory
System
8.05%
5
Diseases
of
the
Circulatory
System
6.99%
6
CondiCons
OriginaCng
in
the
Perinatal
Period
6.78%
7
Diseases
of
the
DigesCve
System
5.37%
8
Ill-‐defined
CondiCons
3.63%
9
Diseases
of
the
Urinary
System
3.49%
10
Malignant
Neoplasms
3.16%
Reference:
Health
Facts
2008.
Ministry
of
Health,
Malaysia
Official
Website.
URL:
www.moh.gov.my
6. Top
Ten
Causes
of
Deaths
in
Malaysian
Ministry
of
Health
Hospitals
2008
1
Heart
and
Pulmonary
CirculaCon
Diseases
16.54%
2
SepCcaemia
13.18%
3
Malignant
Neoplasms
11.21%
4
Pneumonia
9.28%
5
Cerebrovascular
Diseases
8.65%
6
Diseases
of
the
DigesCve
System
5.18%
7
Accidents
5.00%
8
CondiCons
OriginaCng
in
the
Perinatal
Period
3.97%
9
NephriCs,
NephroCc
Syndrome
and
Nephrosis
3.76%
10
Ill-‐
defined
CondiCons
2.63%
Reference:
Health
Facts
2008.
Ministry
of
Health,
Malaysia
Official
Website.
URL:
www.moh.gov.my
7. Flow
Chart
of
The
Emergency
Management
of
Acute
Coronary
Syndrome
For PCI
Inter-facility transfer
Chest pain Call 999 EMS Response Triage Plan
Fibrinolysis
Patient’s Dispatch EMS EMS Transport Door to Needle time: 30 min
symptoms Arrival
1 min 12-lead ECG Door to Balloon time: 90 min
within 8
5 min after
min ? Pre-hospital thrombolysis Inter-facility transfer
onset
Advice S/L GTN
q5min, max 3
tablets
Cardiopulmonary Resuscitation Automated External Defibrillator
8. Reference:
Clinical
Prac/ce
Guidelines
Management
of
Acute
ST
Eleva/on
Myocardial
Infarc/on
2007.
Ministry
of
Health
Malaysia.
www.moh.gov.my
10. PREVIOUS
EMERGENCY
AMBULANCE
CALL
SYSTEM
PRIOR
TO
2007
(LACK
OF
AN
INTEGRATED
RESPONSE
SYSTEM)
EMERGENCY
CALL
999
HOSPITAL
HEALTH
CLINIC
991
PHONE
NUMBER
PHONE
NUMBER
TELEKOM
OPERATOR
HOSPITAL
JPA
3
OPERATOR
HEALTH
CLINIC
PARAMEDIC
EMERGENCY
JPA
3
TEAM
DEPARTMENT
11. • SCll
plagued
with
the
problem
of
prank
calls.
• In
2007,
97%
of
the
2
million
emergency
calls
are
prank
calls.
• In
2008,
the
percentage
was
64%.
• Prank
callers
can
be
charged
under
SecCon
223
of
the
Malaysian
CommunicaCons
and
MulCmedia
Act
Chew
KS,
Idzwan
ZM,
Hisamuddin
NA,
Kamaruddin
J,
Wan
1998,
which
carries
a
fine
of
up
to
Aasim
WA.
Cardiopulmonary
Resuscita/on:
The
Short
RM50,000
or
up
to
five
years
jail
or
both.
Comings
In
Malaysia.
Malaysian
J
Med
Sciences.
2008;14(2):
23-‐5.
13. Ambulance
Response
Time
Cities Mean Ambulance Response Time (min)
Kota Bharu 15.2
Kuala Lumpur 21.1
United Kingdom 7.0 – 14.0
Australia 7.0 – 11.0
Singapore ± 15.0
Ankara (Turkey) ±9
New York ± 11.4
Chicago ± 11.3
Shah
CH,
Ismail
IM,
Mohsin
SS.
Ambulance
response
/me
and
emergency
medical
dispatcher
program:
a
study
in
Kelantan,
Malaysia.
Southeast
Asian
J
Trop
Med
Public
Health
2008;
39
(6):1150-‐4.
Chew
KS,
Idzwan
ZM,
Hisamuddin
NA,
Kamaruddin
J,
Wan
Aasim
WA.
Cardiopulmonary
Resuscita/on:
The
Short
Comings
In
Malaysia.
Malaysian
J
Med
Sciences.
2008;14(2):23-‐5.
14. Bicycle
and
Motorcycle
Squad
Around
Klang
Valley
Vicinity
As
A
Stop-‐Gap
Measure
Motorcycle
Squad
• Area
covers
100
–150
km
sq
• ‘Response
Time’
less
than
15
min
• Distance
less
than
10km
or
travel
Cme
less
15
min
• The
Advanced
Life
Support
Unit
type
complete
equipments
including:
AED,
Airway
Management
Set,
MedicaCons,
Oxygen
Tank,
CommunicaCon
Set
15. “One
Size
Fit
All”
in
FormulaCng
An
Emergency
Medical
Service
System
In
Malaysia???
21. Cardiopulmonary
ResuscitaCon
• Bystander
CPR
is
performed
in
9%
of
out
of
hospital
cardiac
arrest
in
a
local
study
in
2006.
• Chew
KS,
Mohd
Idzwan
Z,
Nik
Hishamudin
NA,
Wan
Aasim
WA,
Kamaruddin
J.
How
frequent
is
bystander
cardiopulmonary
resuscita/on
performed
in
the
community
of
Kota
Bharu,
Malaysia?
Singapore
Med
J.
2008
Aug;49(8):636-‐9.
22. Willingness
of
Final
Year
Medical
and
Dental
Students
To
Perform
Bystander
CPR
Chew
KS,
Yazid
MNA.
The
willingness
of
final
year
medical
and
dental
students
to
perform
bystander
cardiopulmonary
resuscita/on
in
an
Asian
community
Int
J
Emerg
Med.
2008;1(4):
301-‐09.
23. Willingness
of
Final
Year
Medical
and
Dental
Students
To
Perform
Bystander
CPR
Chew
KS,
Yazid
MNA.
The
willingness
of
final
year
medical
and
dental
students
to
perform
bystander
cardiopulmonary
resuscita/on
in
an
Asian
community
Int
J
Emerg
Med.
2008;1(4):
301-‐09.
24. Unspoken
socio-‐cultural
barriers
to
perform
bystander
CPR
with
mouth-‐to-‐mouth
venClaCon
among
our
mulC-‐
ethnic,
mulC-‐religious
community
Gender
difference
is
probably
one
of
these,
especially
among
the
female
respondents
(performing
bystander
CPR
on
a
male
vicCm)
Chew
KS,
Yazid
MNA.
The
willingness
of
final
year
medical
and
dental
students
to
perform
bystander
cardiopulmonary
resuscita/on
in
an
Asian
community
Int
J
Emerg
Med.
2008;1(4):301-‐09.
30. Malaysian
NaConal
Cardiovascular
Disease
(NCVD)
Database
• In
2006,
there
are
73
coronary
care
units
(CCU)
in
Malaysia
• The
incidence
of
ACS
admission
was
therefore
47.1
per
100,000
populaCon
in
2006
• The
esCmate
of
the
incidence
of
coronary
heart
disease
(CHD)
in
Malaysia
is
141
per
100,000
populaCon
• Over
4000
ACS
being
denied
admission
into
its
CCU
in
2006.
It
has
30%
shoroall
in
CCU
beds
Chin SP, Jeyaindran S, Azhari R, Wan Azman WA, Omar I, Robaayah Z, Sim KH. Acute coronary syndrome
(ACS) registry--leading the charge for National Cardiovascular Disease (NCVD) Database. Med J Malaysia. 2008
Sep;63 Suppl C:29-36.
31. Overall
Outcomes
For
PaCents
With
STEMI
By
FibrinolyCc
Therapy,
Malaysia
2006
In-‐hospital
30-‐day*
Outcome
Fibrinoly=c
therapy
Fibrinoly=c
therapy
Yes
No
Yes
No
No.
%
No.
%
No.
%
No.
%
Discharged
/
Alive
940
92
372
87
686
67
253
59
Died
74
7
55
13
90
9
68
16
Lost
to
follow-‐up
NA
NA
NA
NA
242
24
106
25
Missing
4
0
0
0
0
0
0
0
*Including
pa/ents
who
died
in-‐hospital.
Note:
Percentage
is
to
the
nearest
decimal
point.
Annual
Report
of
the
Acute
Coronary
Syndrome
(ACS)
Registry,
Malaysia
2006
32. Streptokinase
Failure
• In
a
local
study
in
2008,
streptokinase
failure
rate
is
56.8%
• Mean
door-‐to-‐needle
Cme
is
104.9
min
• Other
factors
shown
to
significantly
associated
with
streptokinase
failure
include
– Anterior
locaCon
infarcCon
– History
of
Diabetes
– Hypertension
– High
total
white
cell
counts
– Lee
YY,
Tee
MH,
Zurkurnai
Y
et
al.
Thromboly/c
failure
with
streptokinase
in
acute
myocardial
infarc/on
using
electrocardiogram
criteria.
Singapore
Med
J
2008;
49
(4):304-‐10.
Note:
Streptokinase
failure
in
this
study
is
based
solely
on
ECG
criteria
of
failure
of
STE
of
≥
50%
and
not
on
angiographic
confirma=on
34. Percentage
Of
Stent
Type
By
Total
Number
Of
Stents
Used
(N=13,150)
*‘Other’
refers
to
stent
other
than
listed
in
the
Reference
Stent
List
Na=onal
Cardiovascular
Disease
Database
(NCVD)