A presentation on the pathology and current management (with Especial emphasis on surgical management) of Portal Hypertension; a common complication of liver cirrhosis among other liver diseases. Being a copy of seminar presentation I for the HepatoPancreaticoBiliary Unit of the Division of General Surgery, Ahmadu Belllo University Teaching Hospital, Zaria.
Portal hypertension:A disease better controlled than cured.KETAN VAGHOLKAR
Portal hypertension is one of the common causes of upper gastrointestinal bleeding. It is a very lethal condition. Prompt diagnosis and commencement of early medical treatment can help keeping the disease under control. Surgery is a very useful adjunct in uncontrollable bleeding and in long term prevention in certain selected cases.
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A presentation on the pathology and current management (with Especial emphasis on surgical management) of Portal Hypertension; a common complication of liver cirrhosis among other liver diseases. Being a copy of seminar presentation I for the HepatoPancreaticoBiliary Unit of the Division of General Surgery, Ahmadu Belllo University Teaching Hospital, Zaria.
Portal hypertension:A disease better controlled than cured.KETAN VAGHOLKAR
Portal hypertension is one of the common causes of upper gastrointestinal bleeding. It is a very lethal condition. Prompt diagnosis and commencement of early medical treatment can help keeping the disease under control. Surgery is a very useful adjunct in uncontrollable bleeding and in long term prevention in certain selected cases.
This is a flyer design slider. which will help you to create a stunning flyer design for your business. or if you looking for a flyer design you can go the link below to order a creative flyer. https://goo.gl/tGHejV
Querying and Merging Heterogeneous Data by Approximate Joins on Higher-Order ...Simon Price
This paper addresses the important problem of integrating heterogeneous data from sources as diverse as web pages, digital libraries, knowledge bases and databases. The ultimate aim of this work is to be able to query such heterogeneous data sources as if their data were conveniently held in a single relational database. Pursuant of this aim, we propose a generalisation of relational joins from the relational database model to enable joins on arbitrarily complex structured data in a higher-order representation. By incorporating kernels and distances for structured data, we further extend this model to support approximate joins of data originating from heterogeneous sources. We have implemented these higher-order relational operators and their associated kernels in Prolog and applied this framework on the CORA data sets. We demonstrate the flexibility of our approach in the publications domain by evaluating example approximate queries on structured data, joining on types ranging from sets of co-authors through to entire publications.
A Minimum Spanning Tree Approach of Solving a Transportation Probleminventionjournals
: This work centered on the transportation problem in the shipment of cable troughs for an underground cable installation from three supply ends to four locations at a construction site where they are needed; in which case, we sought to minimize the cost of shipment. The problem was modeled into a bipartite network representation and solved using the Kruskal method of minimum spanning tree; after which the solution was confirmed with TORA Optimization software version 2.00. The result showed that the cost obtained in shipping the cable troughs under the application of the method, which was AED 2,022,000 (in the United Arab Emirate Dollar), was more effective than that obtained from mere heuristics when compared.
Oscillation of Solutions to Neutral Delay and Advanced Difference Equations w...inventionjournals
In this article we give infinite-sum conditions for the oscillation of all solutions of the following first order neutral delay and advanced difference equations with positive and negative coefficientsof the forms and where is a sequence of nonnegative real numbers, and are sequences of positive real numbers, and are positive integers. We derived sufficient conditions for oscillation of all solutions of and . AMS Subject Classification 2010: 39A10, 39A12
Portal Vein and portocaval Anastomosis. Anatomy of portal vein, tributaries, branches and course, formations and relations. Anatomy of portal vein and adjacent structures, their relation to liver and intestine, relation to IVC and Aorta, clinical and applied anatomy for both undergraduates and postgraduates. portal hypertension is an increase in blood pressure, however, rather than being systematic, it's localized to the portal system. Portal hypertension is most commonly caused by liver cirrhosis which in itself can be caused by alcoholism or other liver disease. It can also be caused by blood clots in the portal vein and schistosomiasis amongst other things. This increase in blood pressure can affect areas of anastomosis between the portal vasculature which we just discussed and the caval musculature which are classified as the vessels not relating to the portal system resulting in pressure pushing larger blood volumes into these anastomotic areas. This in turn can cause the vessels to dilate and form varicose veins which can result in potentially fatal hemorrhage. Some of these important porto-caval anastomotic areas are listed below – the first vein being the portal vein and the second vein being the caval vein – the superior rectal and inferior rectal veins, the left gastric and esophageal veins, the colonic veins and the retroperitoneal veins and the para-umbilical and epigastric veins.
In severe cases, the last anastomosis mentioned between the para-umbilical veins which are the small veins that run within the round ligament of the liver and the epigastric veins which are found in the anterior abdominal wall can form large dilations. These dilations can form the clinical presentation caput medusa or the head of the medusa as the dilated veins look like the snakes of the head of the medusa or Gorgon from Greek mythology. In this image on the right, we can only see the beginnings of a presentation of the caput medusa as in a true caput medusa, the veins would be raised and enlarged.
Hello everyone! This is Nicole from Kenhub, and today we're going to talk about the hepatic portal vein.
We are going to discuss the hepatic portal vein and to do so we'll be using this image here which is a ventral view of the portal hepatic vein with the central portion of the liver cut out so we can see the portal vein and other portal vessels. You can also see the aorta just here as well as the inferior vena cava just posterior to the portal hepatic vein. The portal venous system is an important system that has its own unique flow and we'll talk about how this works in tandem with the venous system in the coming slides.
The portal vein is one of the most important vessels in the body.
Its main functions are to direct blood to the liver from the gastrointestinal tract and receive nutrient rich blood from the intestines.
The portal hepatic vein also receives blood from the spleen, the pancreas and the gallbladder which are channels within the vessel.
The urinary system's function is to filter blood and create urine as a waste by-product. The organs of the urinary system include the kidneys, renal pelvis, ureters, bladder and urethra.The body takes nutrients from food and converts them to energy. After the body has taken the food components that it needs, waste products are left behind in the bowel and in the blood.
The kidney and urinary systems help the body to eliminate liquid waste called urea, and to keep chemicals, such as potassium and sodium, and water in balance. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys, where it is removed along with water and other wastes in the form of urine. Kidney and urinary system parts and their functions
Two kidneys. This pair of purplish-brown organs is located below the ribs toward the middle of the back. Their function is to:
Remove waste products and drugs from the body
Balance the body's fluids
Release hormones to regulate blood pressure
Control production of red blood cells
The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.
Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.
Bladder. This triangle-shaped, hollow organ is located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.
Upon examination, specific "landmarks" are used to describe the location of any irregularities in the bladder. These are:
Trigone: a triangle-shaped region near the junction of the urethra and the bladder
Right and left lateral walls: walls on either side of the trigone
Posterior wall: back wall
Dome: roof of the bladder
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
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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.
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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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.
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.
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
3. Types of
circulation
Systemic
Aka greater circulation.
RV LV
Provide blood circulation
to organs
Pulmonary
Aka lesser circulation
LVRV
Oxygenation of blood
Portal
4. Portal circulation
part of systemic circulation
passes through two sets of capillaries before draining into a
systemic vein.
Portal vein
Vein draining the first capillary network
Efferent artery
Artery draining the first capillary network
Examples:
Arterial portal system
Hepatic portal circulation
Hypothalamo hypophyseal portal circulation
Venous portal system
Renal portal circulation
8. Drains the deoxygenated blood from lower
esophagus upper anal canal, pancreas, spleen,
gall bladder
Carries nutrient rich blood from intestines to liver
Importance:
First bypass effect
Certain drugs become inactive after being metabolised by
liver, hence route other than oral should be given
eg. Nitroglycerin, midazolam
Activation of prodrug
Requires metabolism by liver to activate
Eg.Dextometrophan, fospropanol
9.
10. Drainage of portal
circulation
Inferior mesentric v splenic v
Splenic v +superior mesentric v portal vein
Direct into portal vein
Left and right gastric v
Posterior superior pancreatoduodenal v
Portal vein banches into left and right portal vein
cystic v drains directly into right portal vein
Passed throught liver sinusoids into hepatic vein
inferior vena cava
20. Increased portal blood flow from
hyperdynamic circulation
Caused by arterial
vasodilation mediated
by NO
Lead to increased
efflux of blood to
portal system
HEPATIC ARTERY
BUFFER RESPONSE
P= F X R
28. Reference
Robbins and Cottran’s Pathological Basis of
Disease, 8th
edition,2010
Guyton and Hall’s Textbook of Medical
Physiology, 12th
edition, 2011
Harrison’s Principle of Internal Medicine, 19th
edition, volume 2 , 2015.
https://www.ncbi.nlm.nih.gov/books/NBK53067/h
epatic Physiology and Pathophysiology
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC30
12579/Regulation of hepatic blood flow,2010
Editor's Notes
current (I) equals the voltage difference (ΔV) divided by resistance (R).
, the voltage difference is the pressure difference (ΔP; sometimes called driving pressure, perfusion pressure, or pressure gradient), the resistance is the resistance to flow (R) offered by the blood vessel and its interactions with the flowing blood, and the current is the blood flow (F).
current (I) equals the voltage difference (ΔV) divided by resistance (R).
, the voltage difference is the pressure difference (ΔP; sometimes called driving pressure, perfusion pressure, or pressure gradient), the resistance is the resistance to flow (R) offered by the blood vessel and its interactions with the flowing blood, and the current is the blood flow (F)
. he velocity of the steady flow of a fluid through a narrow tube (as a blood vessel or a catheter) varies directly as the pressure and the fourth power of the radius of the tube and inversely as the length of the tube and the coefficient of viscosity.