This document provides information on Multiple Sclerosis (MS), including its epidemiology, etiology, clinical presentation, diagnostic tests, disease course, and treatment options. MS is an immune-mediated disease that attacks the central nervous system, destroying myelin and axons. Common symptoms include visual changes, numbness, weakness, and balance issues. Diagnosis involves MRI, lumbar puncture for cerebrospinal fluid analysis, and evoked potentials testing. The disease course varies between relapsing-remitting, primary progressive, and secondary progressive forms. Treatment focuses on reducing inflammation and disability through medications like interferon beta, glatiramer acetate, and natalizumab, as well as managing symptoms with drugs for pain,
Here is very good and amazing presentation on Multiple sclerosis ..its about brain
read this carefully and work on this because the work on brain is very good for future research...
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS , the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body.
Here is very good and amazing presentation on Multiple sclerosis ..its about brain
read this carefully and work on this because the work on brain is very good for future research...
Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS , the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body.
Multiple sclerosis: Introduction, Risk Factors, Diagnosis and TreatmentEnriqueAlvarez93
Introduction about Multiple Sclerosis.
Risk factors affect to Multiple Sclerosis.
When to Suspect Multiple Sclerosis.
Evaluation and Diagnosis of Multiple Sclerosis.
How to treatment of Multiple Sclerosis.
Treatment of Multiple Sclerosis with Monoclonal Antibody.
Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.This damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems
Multiple sclerosis (MS) is a demyelinating disease of central nervous system which includes brain and spinal cord.
it affect the myelin and by damaging the the myelin producing cell -Oligodendrocytes, which leads to sensory, motor and cognitive problems.
multiple sclerosis is an auto immune disease affecting the brain and spinal cord
Multiple sclerosis (MS) or disseminated sclerosis is characterized by chronic inflammation, demyelination, and scaring of the myelin sheath of the CNS. Myelin damage disrupts communication between your brain and the rest of your body. Ultimately, the nerves themselves may deteriorate, a process that's currently irreversible
The cause of multiple sclerosis is unknown. It is believed to be an autoimmune disease, in which the body's immune system attacks its own tissues.
Early Symptoms of MS
• Blurred or double vision
• Thinking problems
• Clumsiness or a lack of coordination
• Loss of balance
• Numbness
• Tingling
• Weakness in an arm or leg
No two people have exactly the same symptoms of MS.
You may have a single symptom, and then go months or years without any others. A problem can also happen just one time, go away, and never return. For some people, the symptoms become worse within weeks or months.
Common Symptoms of MS
These are the most common changes to the mind and body in someone with MS:
Unusual sensations: People with MS often say they feel a "pins and needles" sensation. They may also have numbness, itching, burning, stabbing, or tearing pains. About half of people with MS have these uncomfortable symptoms. Fortunately, they can be managed or treated.
Bladder problems: About 8 in 10 people have bladder problems, which can be treated. You may need to pee often, urgently, need to go at night, or have trouble emptying your bladder fully. Bowel problems, especially constipation, are also common.
Trouble walking: MS can cause muscle weakness or spasms, which make it harder to walk. Balance problems, numb feet, and fatigue can also make walking hard.
Dizziness: It's common to feel dizzy or lightheaded. You usually won't have vertigo, or the feeling that the room is spinning.
Fatigue: About 8 in 10 people feel very tired. It often comes on in the afternoon and causes weak muscles, slowed thinking, or sleepiness. It's usually not related to the amount of work you do. Some people with MS say they can feel tired even after a good night's sleep.
Muscle spasms: They usually affect the leg muscles. For about 40% of people they are an early symptom of MS. In progressive MS, muscle spasms affect about 6 in 10 people. You might feel mild stiffness or strong, painful muscle spasms.
Sexual trouble: These include vaginal dryness in women and erection problems in men. Both men and women may be less responsive to touch, have a lower sex drive, or have trouble reaching orgasm.
Speech problems: Sometimes MS can cause people to pause a long time in between words and have slurred or nasal speech. Some people also develop swallowing problems in more advanced stages of MS.
Creando el mapa de la susceptibilidad genética y un modelo de patogénesis en ...Fundación Ramón Areces
Ciclo de conferencias y debates en Ciencias.
Fundación Ramón Areces-Nature Publishing Group.
Jorge R. Oksenberg. Universidad de California, San Francisco, EE. UU.
Madrid, 2 de febrero de 2012
Multiple sclerosis: Introduction, Risk Factors, Diagnosis and TreatmentEnriqueAlvarez93
Introduction about Multiple Sclerosis.
Risk factors affect to Multiple Sclerosis.
When to Suspect Multiple Sclerosis.
Evaluation and Diagnosis of Multiple Sclerosis.
How to treatment of Multiple Sclerosis.
Treatment of Multiple Sclerosis with Monoclonal Antibody.
Multiple sclerosis (MS) is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.This damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems
Multiple sclerosis (MS) is a demyelinating disease of central nervous system which includes brain and spinal cord.
it affect the myelin and by damaging the the myelin producing cell -Oligodendrocytes, which leads to sensory, motor and cognitive problems.
multiple sclerosis is an auto immune disease affecting the brain and spinal cord
Multiple sclerosis (MS) or disseminated sclerosis is characterized by chronic inflammation, demyelination, and scaring of the myelin sheath of the CNS. Myelin damage disrupts communication between your brain and the rest of your body. Ultimately, the nerves themselves may deteriorate, a process that's currently irreversible
The cause of multiple sclerosis is unknown. It is believed to be an autoimmune disease, in which the body's immune system attacks its own tissues.
Early Symptoms of MS
• Blurred or double vision
• Thinking problems
• Clumsiness or a lack of coordination
• Loss of balance
• Numbness
• Tingling
• Weakness in an arm or leg
No two people have exactly the same symptoms of MS.
You may have a single symptom, and then go months or years without any others. A problem can also happen just one time, go away, and never return. For some people, the symptoms become worse within weeks or months.
Common Symptoms of MS
These are the most common changes to the mind and body in someone with MS:
Unusual sensations: People with MS often say they feel a "pins and needles" sensation. They may also have numbness, itching, burning, stabbing, or tearing pains. About half of people with MS have these uncomfortable symptoms. Fortunately, they can be managed or treated.
Bladder problems: About 8 in 10 people have bladder problems, which can be treated. You may need to pee often, urgently, need to go at night, or have trouble emptying your bladder fully. Bowel problems, especially constipation, are also common.
Trouble walking: MS can cause muscle weakness or spasms, which make it harder to walk. Balance problems, numb feet, and fatigue can also make walking hard.
Dizziness: It's common to feel dizzy or lightheaded. You usually won't have vertigo, or the feeling that the room is spinning.
Fatigue: About 8 in 10 people feel very tired. It often comes on in the afternoon and causes weak muscles, slowed thinking, or sleepiness. It's usually not related to the amount of work you do. Some people with MS say they can feel tired even after a good night's sleep.
Muscle spasms: They usually affect the leg muscles. For about 40% of people they are an early symptom of MS. In progressive MS, muscle spasms affect about 6 in 10 people. You might feel mild stiffness or strong, painful muscle spasms.
Sexual trouble: These include vaginal dryness in women and erection problems in men. Both men and women may be less responsive to touch, have a lower sex drive, or have trouble reaching orgasm.
Speech problems: Sometimes MS can cause people to pause a long time in between words and have slurred or nasal speech. Some people also develop swallowing problems in more advanced stages of MS.
Creando el mapa de la susceptibilidad genética y un modelo de patogénesis en ...Fundación Ramón Areces
Ciclo de conferencias y debates en Ciencias.
Fundación Ramón Areces-Nature Publishing Group.
Jorge R. Oksenberg. Universidad de California, San Francisco, EE. UU.
Madrid, 2 de febrero de 2012
Epstein-Barr virus genetic variants are associated with multiple sclerosis.Mutiple Sclerosis
Rosella Mechelli, Caterina Manzari, Claudia Policano, Anita Annese, Ernesto Picardi, Renato Umeton, Arianna Fornasiero, Anna Maria D’Erchia, Maria Chiara Buscarinu, Cristina Agliardi, Viviana Annibali, Barbara Serafini, Barbara Rosicarelli, Silvia Romano, Daniela F. Angelini, Vito A.G. Ricigliano, Fabio Buttari, Luca Battistini, Diego Centonze, Franca R. Guerini, Sandra D’Alfonso, Graziano Pesole, Marco Salvetti, Giovanni Ristori
OBJECTIVE:
We analyzed the Epstein-Barr nuclear antigen 2 (EBNA2) gene, which contains the most variable region of the viral genome, in persons with multiple sclerosis (MS) and control subjects to verify whether virus genetic variants are involved in disease development.
METHODS:
A seminested PCR approach and Sanger sequencing were used to analyze EBNA2 in 53 patients and 38 matched healthy donors (HDs). High-throughput sequencing by Illumina MiSeq was also applied in a subgroup of donors (17 patients and 17 HDs). Patients underwent gadolinium-enhanced MRI and human leucocyte antigen typing.
RESULTS:
MS risk significantly correlated with an excess of 1.2 allele (odds ratio [OR] = 5.13; 95% confidence interval [CI] 1.84-14.32; p = 0.016) and underrepresentation of 1.3B allele (OR = 0.23; 95% CI 0.08-0.51; p = 0.0006). We identified new genetic variants, mostly 1.2 allele- and MS-associated (especially amino acid variation at position 245; OR = 9.4; 95% CI 1.19-78.72; p = 0.0123). In all cases, the consensus sequence from deep sequencing confirmed Sanger sequencing (including the cosegregation of newly identified variants with known EBNA2 alleles) and showed that the extent of genotype intraindividual variability was higher than expected: rare EBNA2 variants were detected in all HDs and patients with MS (range 1-17 and 3-19, respectively). EBNA2 variants did not seem to correlate with human leucocyte antigen typing or clinical/MRI features.
CONCLUSIONS:
Our study unveils a strong association between Epstein-Barr virus genomic variants and MS, reinforcing the idea that Epstein-Barr virus contributes to disease development.
Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body.
No one knows what causes MS. It may be an autoimmune disease, which happens when your body attacks itself. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people lose the ability to write, speak or walk. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help.
Multiple sclerosis is generally referred to as an autoimmune disease or disorder in which the nerve cells of brain and spinal cord are attacked by patients own immune system.
The patient's bodys immune system perceives myelin sheet as an intruder and attack it resulting in damage due to which this sheet no longer carry the messages properly causing the message transmission process to be slowed, distorted or stopped altogether.
At present there is no cure available for multiple sclerosis, however, using certain drugs such as interferon’s, exercise and physiotherapy it is possible to manage the attacks and symptoms.
Researchers hope that stem cell therapies may provide new approaches that can both prevent damage and enable us to repair it.
Effects of Antioxidants on Age and Multiple Sclerosis-Related Oxidative Stressarsosa
Abstract: Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system (CNS). The pathogenesis of MS involves neurodegeneration which may be due to oxidative stress. Antioxidants such as vitamins have been studied as modifiers and biomarkers of oxidative stress in MS patients. MS progression, specifically that in which relapsing-remitting multiple sclerosis (RRMS) transitions to secondary-progressive multiple sclerosis (SPMS), is independent of disease onset and duration, but correlated with age. Because of the neurodegenerative effects of oxidative stress and the age-dependent course of MS, it is possible that the transition from RRMS to SPMS is caused by levels of oxidative stress that may increase with age. This study investigates the role of antioxidants α-tocopherol, glutathione, and uric acid on oxidative stress and subsequent MS progression. Further, I intend to compare the different effects of antioxidant supplements on RRMS patients, SPMS patients, and relatively healthy individuals based on cerebrospinal fluid and serum samples.
Preliminary report describing a targeted sequencing study in 1500 MS cases and 1500 controls. I presented this at the ASHG 2011 session on large scale resequencing.
Genetic Insights Into Multiple Sclerosis PathogenesisAaron Sparshott
A segment of a group presentation reflecting upon some of the genetic components that may contribute to Multiple Sclerosis pathogenesis.
IL2Rα and IL7Rα were the two genes of focus.
(This presentation was originally done for Semester 2 , 2008)
This project was developed for a competitive intelligence company by mining data from the various information sources e.g. Company (News, Investor Section, SEC filings, Annual Reports, Presentations etc), Universities/Medical Schools/Organizations, Medical Affairs Companies, Non- Profit Medical Agency, Government Agencies, Drug Delivery Companies, Contract Manufacturing Organizations, Contract Research Organizations, Consultancies and Financial Institutions. The complete information available there complied into a single MS word document, listed in MS Excel and then by using MS publisher it was converted into the report which finally converted into PDF.
references:
Phases and Phenotypes of Multiple Sclerosis By Orhun H. Kantarci, MD.
Diagnosis of Multiple Sclerosis By Jiwon Oh, MD, PhD, FRCPC
Nature Reviews | Disease Primers
Multiple sclerosis Massimo Filippi1,2*, Amit Bar- Or3, Fredrik Piehl4,5,6, Paolo Preziosa1,2, Alessandra Solari7, Sandra Vukusic8 and Maria A. Rocca1,2
SLE Systemic lupus erythematosus 2022
Basics, updates Prof. Hanan Ali Taha, professor of Internal Medicine and Head of the immunology unit, Faculty of Medicine, Beni-Suef University University
This presentation on APLA SYNDROME will help you understand the definition, clinical features, risk factors involved, including etiology, physical examination, diagnosis and Management.
It also includes an overview on complications of APLA syndrome and prevention.
SEMINAR PRESENTATION ON CONTRAST INDUCED NEPHROPATHY BY PHARM D STUDENT
IT INCLUDES COMPLETE OVERVIEW OF THE TOPIC CIN.
POST CONTRAST ACUTE KIDNEY INJURY( PC-AKI) WITH TREATMENT AND MANAGEMENT.
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
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.
- 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
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.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of 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
3. • Multiple sclerosis (MS) is an immune-mediated inflammatory
disease that attacks myelinated axons in the central nervous
system (CNS), destroying the myelin and the axon in variable
degrees
• It is characterized by a triad of inflammation, demyelination,
and gliosis (scarring) of the CNS
3
4. EPIDEMIOLOGY:
INDIAN STATISTICS:
• In the 1980s, the prevalence of MS in India was estimated to
be nearly 1/100,000
• A hospital-based study from northwestern India observed that
MS constituted 1.58% of the total neurology admissions from
1968 to 1977.
• These data were compared with more recent data collected
from the same institute in the period 1993-1997, and an
increase was found, to 2.54% of neurology admissions.
• The current World Health Organization (WHO) Multiple
Sclerosis International Federation (MSIF) "Atlas of MS" 2013
quotes prevalence rates of 5-20 per 100,000, which is much
higher than the studies reported previously.
• Previously conducted studies had estimated that MS may be
more common in northern as compared to southern India,
where 3.2 cases were seen yearly, compared to 4.15 cases in
the north
4
8. ETIOLOGY:
• The cause of MS is unknown; however, it is believed to occur
as a result of some combination of genetic and environmental
factors such as infectious agents
Geography
• MS is more common in people who live farther from
the equator, although exceptions exist
• Decreased sunlight exposure resulting in decreased vitamin
D production has also been put forward as an explanation
• Environmental factors may play a role during childhood, with
several studies finding that people who move to a different
region of the world before the age of 15 acquire the new
region's risk to MS. If migration takes place after age 15,
however, the person retains the risk of his home country
8
9. Genetics
• MS is not considered a hereditary disease;
however, a number of genetic
variations have been shown to increase the
risk
• If both parents are affected the risk in their
children is 10 times that of the general
population
• Specific genes that have been linked with MS
include differences in the human leukocyte
antigen (HLA) system—a group of genes
on chromosome 6 that serves as the major
histocompatibility complex (MHC).
• The most consistent finding is the
association between MS and alleles of the
MHC defined as DR15 and DQ6.
• Other loci have shown a protective effect,
such as HLA-C554 and HLA-DRB1
• Overall, it has been estimated that HLA
changes account for between 20 and 60% of
the genetic predisposition.
9
10. 10
Infectious agents
• Viral or bacterial infections may be an important
environmental cause of MS. Although no clear association has
been identified
• Evidence for a virus as a cause include: the presence
of oligoclonal bands in the brain and cerebrospinal fluid of
most people with MS, increased immunoglobulin G (IgG)
synthesis in the CNS and increased antibody titers to viruses
• Many possible agents have been implicated, including
mycoplasma, Chlamydia pneumoniae, spirochetes, rabies
virus, herpes simplex virus, coronavirus, human T-cell
leukemia virus type I (HTLV-I), MS-associated retrovirus,
measles, most recently, human herpes virus type 6 (HHV-
6)10,11 and Epstein-Barr virus.
11. Others
• Smoking cigarettes has been associated with both an
increased risk of acquiring MS and with more severe
progression
• Gout occurs less than would be expected and lower levels
of uric acid have been found in people with MS. This has led to
the theory that uric acid is protective, although its exact
importance remains unknown.
• Stress
• Toxins-mainly solvents
11
12. PATHOPHYSIOLOGY:
• The three main characteristics of MS are the formation of
lesions in the central nervous system, inflammation, and the
destruction of myelin sheaths of neurons.
• The lesions most commonly affect the white matter in
the optic nerve, brain stem, basal ganglia, and spinal cord, or
white matter tracts close to the lateral ventricles
• To be specific, MS involves the loss of oligodendrocytes, the
cells responsible for creating and maintaining a fatty layer—
known as the myelin sheath—which helps the neurons
carry electrical signals (action potentials)
12
15. 15
DISEASE COURSE
Four clinical types of MS have been described
1. Relapsing/remitting MS (RRMS) accounts for 85% of MS
cases at onset and is characterized by discrete attacks that
generally evolve over days to weeks (rarely over hours).
There is complete recovery over the ensuing weeks to
months. Between attacks, patients are neurologically stable.
16. 2. Primary progressive MS (PPMS) accounts for 15% of cases.
These patients do not experience attacks but only a steady
functional decline from disease onset.
Compared to RRMS, the disease begins later in life (mean age,
40 years), and disability develops faster.
16
17. 17
3. Secondary progressive MS (SPMS) always begins as RRMS.
At some point, however, the RRMS clinical course changes so
that the patient experiences a steady deterioration in function
unassociated with acute attacks (which may continue or cease
during the progressive phase).
SPMS produces a greater amount of fixed neurologic disability
than RRMS.
Approximately 50% of patients with RRMS will have developed
SPMS after 15 years.
18. 18
4. Progressive/relapsing MS (PRMS) overlaps PPMS and SPMS
and accounts for 5% of MS patients.
Like patients with PPMS, these patients experience a steady
deterioration in their condition from disease onset
The early stages of RPMS are indistinguishable from those of
PPMS (i.e., until the first clinical attack).
20. DIAGNOSTIC TESTS:
20
MRI:
• Characteristic abnormalities are found in 95% of patients
• An increase in vascular permeability from a breakdown of the
BBB is detected by leakage of intravenous gadolinium (Gd)
into the parenchyma. Such leakage occurs early in the
development of an MS lesion and serves as a useful marker of
inflammation. Gd-enhancement persists for up to 3 months.
• Newer MRI measures such as brain atrophy, magnetization
transfer ratio (MTR) imaging and proton magnetic resonance
spectroscopic imaging (MRSI) may ultimately serve as
surrogate markers of clinical disability.
• For example, MRSI can quantitate molecules such as N-acetyl
aspartate (NAA), which is a marker of axonal integrity, and
MTR may be able to distinguish demyelination from edema.
22. 22
CSF FLUID ANALYSIS:
• CSF abnormalities found in MS include a mononuclear
cell pleocytosis and an increased level of intrathecally
synthesized IgG.
• The total CSF protein is usually normal or slightly
elevated.
• The measurement of oligoclonal banding (OCB) in the
CSF also assesses intrathecal production of IgG.
• OCBs are detected by agarose gel electrophoresis.
23. EVOKED POTENTIALS:
• EP testing assesses function in afferent (visual,
auditory, and somatosensory) or efferent (motor) CNS
pathways.
• EPs use computer averaging to measure CNS electric
potentials evoked by repetitive stimulation of selected
peripheral nerves or of the brain. These tests provide
the most information when the pathways studied are
clinically uninvolved.
• For example, in a patient with a remitting and
relapsing spinal cord syndrome with sensory deficits in
the legs, an abnormal somatosensory EP following
posterior tibial nerve stimulation provides little new
information. By contrast, an abnormal visual EP in this
circumstance would permit a diagnosis of clinically
definite MS.
• Abnormalities on one or more EP modalities occur in
80 to 90% of MS patients.
23
25. TREATMENT:
Current therapy for MS can be divided into several categories:
(1) treatment of acute attacks as they occur;
(2) treatment with disease modifying agents that reduce the
biological activity of MS, and
(3) symptomatic therapy.
Acute Attacks or Initial Demyelinating Episodes:
• Glucocorticoids are used to manage either first attacks or
acute exacerbations.
• IV methylprednisolone, 500 to 1000 mg/day for 3 to 5 days,
either without a taper or followed by a course of oral
prednisone beginning at a dose of 60 to 80 mg/d and
gradually tapered over 2 weeks.
• ADRs: fluid retention, potassium loss, weight gain, gastric
disturbances, acne, and emotional lability.
25
26. Plasma exchange (7 exchanges: 54 mL/kg or 1.1 plasma volumes
per exchange, every other day for 14 days) may benefit patients
with fulminant attacks of demyelination (not only MS) that are
unresponsive to glucocorticoids. However, because the cost is
high, and the evidence of efficacy is preliminary, plasma
exchange should be considered only in selected cases.
Disease-Modifying Therapies for Relapsing Forms of MS (RRMS
SPMS with Exacerbations)
• (1) IFN β-1a (Avonex) : 30 mcg, is administered by
intramuscular injection once every week.
• (Rebif) : 44 mcg, is administered by subcutaneous injection
three times per week.
• (2) IFN β-1b (Betaseron) : 250 mcg, is administered by
subcutaneous injection every other day
• (3) Glatiramer acetate (Copaxone) : 20 mg, is administered by
subcutaneous injection every day.
26
27. IFN- β :
IFN β shows immunomodulatory properties including:
• (1)downregulating expression of MHC molecules on antigen-
presenting cells
• (2) inhibiting proinflammatory and increasing regulatory
cytokine levels
• (3) inhibition of T cell proliferation and
• (4) limiting the trafficking of inflammatory cells in the CNS
• ADRs: flulike symptoms (e.g., fevers, chills, and myalgias) and
mild abnormalities on routine laboratory evaluation (e.g.,
elevated liver function tests or lymphopenia)
27
28. GLATIMER ACETATE:
• It is a synthetic, random polypeptide composed of four amino
acids (L-glutamic acid, L-lysine, L-alanine, and L-tyrosine).
• Its mechanism of action may include:
• (1) induction of antigen-specific suppressor T cells
• (2) binding to MHC molecules, thereby displacing bound MBP;
or
• (3) altering the balance between proinflammatory and
regulatory cytokines.
• Mild pain and pruritus at the injection site are the most
frequent patient complaints.
• Approximately 10% of patients will experience a one-time
transient reaction consisting of chest tightness, flushing, and
dyspnea beginning several minutes after injection and lasting
usually no longer than 20 minutes 28
29. MITOXANTRONE:
• Mitoxantrone (Novantrone), an anthracenedione, exerts its
antineoplastic action by
• (1) intercalating into DNA and producing both strand breaks
and interstrand cross-links,
• (2)interfering with RNA synthesis and
• (3) inhibiting topoisomerase II (involved in DNA repair).
• It is administered as a brief (5- to 15-minute) intravenous
infusion dosed at 12 mg/m2 every 3 months
• The maximum allowable lifetime cumulative dose of
mitoxantrone is 140 mg/m2.
• ADRs: nausea, alopecia, menstrual disorder, amenorrhea,
upper respiratory tract infection, urinary tract infection, and
leukopenia.
29
30. NATALIZUMAB:
• Natalizumab is a partially humanized monoclonal antibody
directed at the cell surface adhesion molecule α4β-integrin
(also known as verylate antigen 1, VLA-1).
• It works by attaching to VLA-1 and blocking its interaction with
its ligand on CNS endothelium vascular cell adhesion molecule
(VCAM)-1.
• Thus, activated lymphocytes are denied entry past the blood-
brain barrier.
• It is indicated as monotherapy, 300 mg every 4 weeks as an
infusion.
• ADRs: headache, fatigue, depression, arthralgia, rash,
abdominal discomfort
30
31. 31
Symptomatic Therapy:
• WEAKNESS: Potassium channel blockers (e.g., 4-
aminopyridine, 10 to 40 mg/d; and 3,4-di-aminopyridine,
40 to 80 mg/d)
• ATAXIA/TREMOR: Clonazepam (1.5 to 20 mg/d),
mysoline (50 to 250 mg/d), propranalol (40 to 200 mg/d)
• SPASTICITY AND SPASMS: lioresal (20 to 120 mg/d),
diazepam (2 to 40 mg/d), tizanidine (8 to 32 mg/d),
dantroline (25 to 400 mg/d), and cyclobenzaprine
hydrochloride (10 to 60 mg/d)
• PAIN: is treated with anti convulsants (carbamazepine,
100 to 1000 mg/d; phenytoin, 300 to 600 mg/d; or
gabapentin, 300 to 3600 mg/d)
32. • BLADDER DYSFUNCTION: propantheline bromide (10 to
15 mg/d), oxybutinin (5 to 15 mg/d), hycosamine sulfate
(0.5 to 0.75 mg/d), or tolteridine tartrate (2 to 4 mg/d)
may help.
• DEPRESSION: Useful drugs include the selective
serotonin reuptake inhibitors (fluoxitine, 20 to 80 mg/d,
or sertraline, 50 to 200 mg/d); the tricyclic
antidepressants, (amitriptyline, 25 to 150 mg/d,
nortryptiline, 25 to 150 mg/d, or desipramine, 100 to 300
mg/d); and the non-tricyclic antidepressants
(venlafaxine, 75 to 225 mg/d).
• FATIGUE: Primary MS fatigue may respond to
amantadine (200 mg/d), pemoline (37.5 to 75 mg/d),
methylphenidate (5 to 25 mg/d), or modafinil (100 to
400 mg/d).
32
33. REFERENCE:
• Pharmacotherapy- A Pathophysiological Approach ; Dipiro 8th
Edition, chapter 57, pgno: 913-926
• Harrison’s Principles of Internal Medicine, chapter 359, pg no: 2461-
2470
• Singhal A, Bhatia R, Srivastava MV, Prasad K, Singh MB. Multiple
sclerosis in India: An institutional study. Mult Scler Relat Disord
2015;4:250-7.
• Dyment DA, Ebers GC, Sadovnick AD (February 2004). "Genetics of
multiple sclerosis". Lancet Neurol 3 (92): 104–10.
• Tramacere I, Del Giovane C, Salanti G, et al. Immunomodulators and
immunosuppressants for relapsing-remitting multiple sclerosis: a
network meta-analysis. Cochrane Database Syst Rev 2015;
9:CD011381.
• Interferon beta-1b is effective in relapsing-remitting multiple
sclerosis. I. Clinical results of a multicenter, randomized, double-
blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study
Group. Neurology 1993; 43:655
• Goodin DS et al Disease modifying therapies in multiple sclerosis:
report of Therapeutics and Technology assessment sub committee
of American Academy of Neurology ,58.169,2002.
33