This document outlines guidelines for screening, managing, and treating obesity. It discusses screening tools like BMI and waist circumference measurements. Management involves behavioral interventions like diet, exercise, and motivational interviewing. Dietary approaches aim for calorie reduction while increasing physical activity to at least 150 minutes per week. Pharmacotherapy and bariatric surgery are options for patients who do not achieve goals with lifestyle changes alone. The case study examines a patient with obesity, diabetes, hypertension and other comorbidities, highlighting the need for a multidisciplinary treatment plan including medication adjustments and lifestyle modifications.
As a chronic disease it is prevalent in both developed and developing countries, and affecting children(10-20%) as well as adults(20-40%).Excess weight gain invites many associated diseases.
Obesity - Pathophysiology, Etiology and management Aneesh Bhandary
Obesity is a state of excess adipose tissue mass. A massive psychosocial, pathophysiological problem that results in a high rate of mortality as well as morbidity. The basic mechanisms of the illness and its management as of 2017 are described in this presentation
This ppt contains all the details about what is obesity, etiology, & mainly focuses on various methods of assessment of obesity from field tests to lab tests.
Hello ! I am a student of food technology, Delhi university (DU) and this was our group assignment on the topic obesity . We tried our best , hope that it might be helpful for someone and the credits also goes to my teammates (Neha, Saumya, Bhavna , Leena ) and you can see my name on my profile
As a chronic disease it is prevalent in both developed and developing countries, and affecting children(10-20%) as well as adults(20-40%).Excess weight gain invites many associated diseases.
Obesity - Pathophysiology, Etiology and management Aneesh Bhandary
Obesity is a state of excess adipose tissue mass. A massive psychosocial, pathophysiological problem that results in a high rate of mortality as well as morbidity. The basic mechanisms of the illness and its management as of 2017 are described in this presentation
This ppt contains all the details about what is obesity, etiology, & mainly focuses on various methods of assessment of obesity from field tests to lab tests.
Hello ! I am a student of food technology, Delhi university (DU) and this was our group assignment on the topic obesity . We tried our best , hope that it might be helpful for someone and the credits also goes to my teammates (Neha, Saumya, Bhavna , Leena ) and you can see my name on my profile
Delivered for the 25th Annual Convention of the Philippine Association for the Study of Overweight and Obese (PASOO) at the EDSA Shangri-la Hotel in Manila.
اختبار قصير: ماذا تعلم عن التغطية الصحية الشاملة؟
أَجِب على أسئلة هذا الاختبار القصير لتتأكد من صحة إجاباتك.
1 تحتفل منظمة الصحة العالمية (المنظمة) في يوم 7 نيسان/ أبريل من كل عام بذكرى إنشائها، باليوم الذي دخل فيه دستورها حيز النفاذ. فكم ستبلغ المنظمة من العمر هذا العام (2018)؟
30 عاماً
50 عاماً
70 عاماً
90 عاماً
2 ما المقصود بالتغطية الصحية الشاملة؟
يُقصد بالتغطية الصحية الشاملة حصول جميع الأفراد والمجتمعات المحلية على الخدمات الصحية اللازمة لهم متى وحيثما لزمتهم.
التغطية الصحية الشاملة تحمي الناس من الوقوع في دائرة الفقر حينما يُسددون تكاليف الخدمات الصحية اللازمة لهم من أموالهم الخاصة.
التغطية الصحية الشاملة تُمكّن جميع الأشخاص من الحصول على الخدمات التي تعالج أهم أسباب الإصابة بالمرض والوفاة.
التغطية الصحية الشاملة تعني تقديم خدمات صحية للأفراد ومختلف فئات السكان كالقضاء على مواقع تكاثر البعوض.
جميع ما سبق.
3 ما نسبة سكان العالم غير القادرين على الحصول على الخدمات الصحية اللازمة لهم؟
ما لا يقل عن 30% من سكان العالم
ما لا يقل عن 50% من سكان العالم
ما لا يقل عن 70% من سكان العالم
ما لا يقل عن 90% من سكان العالم
4 يُدفع نحو 100 مليون شخص في العالم إلى دائرة ’الفقر المدقع‘ (أي يعيشون بدخل لا يتجاوز 1.90 دولاراً أمريكياً في اليوم) بسبب اضطرارهم إلى سداد تكاليف خدمات الرعاية الصحية اللازمة لهم.
صحيح
خطأ
5 من له دور يؤديه في الدعوة إلى تحقيق التغطية الصحية الشاملة؟
أنت
الجماعات غير الهادفة إلى الربح
العاملون في مجال الصحة
وسائط الإعلام
جميع ما سبق
Session 6 se and complications [repaired]
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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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
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.
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
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
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.
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.
5. Why to stand against obesity ?
NICE: Obesity: identification, assessment and management Clinical guideline (2014).
The greater the waist
circumference and BMI,
the greater the risk of
CVD, type 2 diabetes,
and all-cause mortality.
AHA/ACC/TOS 2013
7. Screening ?
(BMI)
Waist circumference ( mainly if BMI < 35 )
Combined Approach.
Note: BMI is not accurate for muscular pt.
There are different guidelines for the
timing of screening .
8. When to screen ? different guidelines
Nice 2014:
Use Your Clinic Judgment
USPSTF
Screen all ≥ 18 yrs for obesity.
AHA/TOS 2013:
BMI at annual visits or more frequently. ( level E )
11. Patient centered Plan:
State His weight loss goals
Addressing barriers to change
Developing strategies to maintain long-term lifestyle
changes.
13. Management:
Behavioral interventions and Diet should be initiated
in patients who are obese.
Then initiate the exercise plan .
You may think about the Medications and the surgical
interventions later on .
15. Behavioural interventions
Self-monitoring of behaviour and progress
Stimulus control
Goal setting
Slowing rate of eating
Ensuring social support
Problem solving Skills
modifying thoughts
Reinforcement of changes
Relapse prevention Skills
Strategies for dealing with weight regain.
18. Dietary Approaches :
Which Dietary Approaches Have Been Shown to Be Most
Effective for Weight Loss?
Adherence to calorie reduction .
Simple and realistic diet modifications have the highest
likelihood of success
AAFP Recommendation :A deficit of at least 500 kcal per
day from the total daily calorie requirement can be
achieved with intake of 1,200 to 1,500 kcal for women and
1,500 to 1,800 kcal for men.
19. Diet
Aim: Total energy intake ˂ energy expenditure
2013 AHA/ACC/TOS
20.
21.
22. Physical activity
The USPSTF recommends :
150 to 300 min/week of moderate-intensity activity
or
75 to 150 min/week of vigorous activity per week.
Continue even if no weight loss!!
Decrease inactivity.
23. To prevent obesity: 45–60 min/day of moderate-
intensity activity particularly if they do not reduce
their energy intake.
Obese who lost weight: 60–90 min/day of activity to
avoid regaining weight.
24.
25. Activity as part of daily life
Brisk walking
Gardening
Cycling
Swimming
Stair climbing
26. Pharmacotherapeutic options
Only for patients who have not achieved weight loss
goals with diet and lifestyle changes.
Extensive discussion of the risks and benefits with the
patient .
29. AAFP :Bariatric surgery Indications:
After Failure of non surgical intervention
BMI > = 40
BMI 35 – 40 with co-mobidites (e.g. DM, HTN)
Adjustable gastric banding can be consider in also in
case of:
BMI: 30 – 34.9 with recent onset DM – II.
BMI: 30 – 34.9 with obesity-related comorbidities.
31. Case
A 52-year-old woman
Backgound:
Obesity wt 121 kg
DM-II for last 9 years
Depression
HTN
DLS
OA
32. PC:
Fatigue, difficulty losing weight, and no motivation.
Decrease in her energy level
She denies polyuria, polydipsia, polyphagia, blurred
vision, or vaginal infections.
33. Weight gain started 6 years back.
After started on insulin.
Pervious trials:
Tries to cut down on her eating
Hypoglycemia.
Fearful of hypoglycemia that she often eats extra
snacks.
34. Advised in her DM visit to:
High BMI
Advised: Weight loss and exercise
Pain in her knees and ankles makes it difficult to do any
exercise.
35. She is on:
Insulin N: 45 - 35 U
Insulin R: 10 U - 20 U.
HbA1C: 8.9%
36. In the case
1. Multiple Co-morbdites
2. Diet > Hypoglycemia > taking more snakes
3. Arthritis > not able exercise
37.
38. Points to Remember
Use your clinical judgment to investigate co-
morbidities.
Manage Comorbidities.
Assess readiness: if not ready > give information about
obesity and f/u.
39. Adult
Any underlying causes
Eating behaviors
Comorbidities (e.g.: DM-II, HTN, CVD , OA, DLS and
sleep apnea)
Lipid profile, BP and HbA1c.
40.
41.
42. Back to our patient
Agreed to follow a restricted-calorie diet and to
decrease her insulin to 30 U of NPH and 10 U of
regular insulin twice daily.
As she had no contraindications to metformin
(Glucophage), she was also started on 500 mg orally
twice daily.
43. She returned to clinic 3 months later, still on the same
dose of insulin.
She was feeling a little less depressed.
She continued to complain of fear of hypoglycemia in
the middle of the night and was overeating at night.
Despite this she had lost 3 kg.
Her blood glucose values were still elevated in a range
of 7-13 mmol before meals.
44. She was reassured that further insulin reduction would
prevent hypoglycemia.
Her insulin dosage was decreased to 25 U of NPH and
5 U of regular insulin twice daily and metformin was
increased to 500 mg three times daily.
Two months later, she returned to the clinic with an
average blood glucose level of 8.6 mmol.
Her weight was now 111 kg, and her HbA1c was 7.5%.
She was feeling much more energetic, no longer felt
depressed, and was able to start a walking program.
45. Important Points :
Those who loss their weight quickly are using usually
the diet that they can not continue with it for long
time , so they remained weight quickly .
Reduce the weight over period of months .
The main issue not to decrease the weight but how to
maintain the weight after reduction.
Orlistat ??? Still not available
Insluin Victoza for Metabolic syndrome x
46. References :
NICE:
Obesity: identification, assessment and management Clinical
guideline (2014).
Obesity prevention (2006)
AAFP:
Update on office based strategies for the management of obesity.
Diagnosis and management of obesity guideline 2013
2013 AHA/ACC/TOS: ( American College of Cardiology/American Heart Association,
Task Force on Practice Guidelines and The Obesity Society )
Guideline for the Management of Overweight and Obesity in
Adults .
Editor's Notes
AHA/ACC/TOS 2013:AHA/ACC/TOS: ( American College of Cardiology/American Heart Association, Task Force on Practice Guidelines and The Obesity Society )