1. Nasopharyngeal angiofibroma is a rare, benign tumor that occurs mostly in adolescent males and arises from the posterior nasal cavity.
2. It is locally invasive and can extend into surrounding areas like the nasal cavity, paranasal sinuses, and cranial cavity, causing symptoms like nasal obstruction, epistaxis, and cranial nerve palsies.
3. Diagnosis involves imaging like CT and MRI to determine the extent of the tumor. Surgical excision is the primary treatment but carries a risk of heavy bleeding, so preoperative embolization of feeding vessels is often used to reduce bleeding during surgery.
Deviated nasal septum and other septal conditionskrishnakoirala4
Slides prepared by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal , for teaching undergraduate and postgraduate MBBS students in the field of otorhinolaryngology. A clear and concise explanation of the basic concepts in the subject matter concerned.
Oral ca tightly associated with exposure to causative tobacco carcinogens.
HPV-associated with oropharyngeal &nasopharyngeal ca.
EBV-responsible for subset of nasopharyngeal ca.
Male predominance due to more males consume tobacco but in recent years ratio is decreasing because increased incidence of female smokers.
HPV associated head and neck SCC has 4:1 male predominance.
SCC is MC head and neck tumour[88.9%].
Deviated nasal septum and other septal conditionskrishnakoirala4
Slides prepared by highly experienced ENT teacher, Dr. Krishna Koirala from Nepal , for teaching undergraduate and postgraduate MBBS students in the field of otorhinolaryngology. A clear and concise explanation of the basic concepts in the subject matter concerned.
Oral ca tightly associated with exposure to causative tobacco carcinogens.
HPV-associated with oropharyngeal &nasopharyngeal ca.
EBV-responsible for subset of nasopharyngeal ca.
Male predominance due to more males consume tobacco but in recent years ratio is decreasing because increased incidence of female smokers.
HPV associated head and neck SCC has 4:1 male predominance.
SCC is MC head and neck tumour[88.9%].
Tumors of ear including external canal, auricle, middle canal (GLOMUS TUMOR), inner ear ( ACOUSTIC NEUROMA).
Description includes definition, etiological factors, clinical menifestations and management including medical management, surgical management and nursing management.
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 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
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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.
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.
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
3. INTRODUCTION:
• It is a benign but locally aggressive tumor.
• It is a rare tumor, though it is the commonest of all
the benign tumors of nasopharynx.
• The exact cause is unknown but it occurs mostly in
adolescent males. it is thought to be testosterone
dependant.
• These patients have hamartomatous nidus of
vascular tissue which get activated to form
angiofibroma when male sex hormone is released.
5. SITE OF ORIGIN AND GROWTH:
It arises from the posterior part of the nasal
cavity close to the superior margin of
sphenopalatine foramen from here tumor grows
into the nasal cavity, nasopahrynx and into the
pterygopalatine fossa running behind the
posterior wall of maxillary sinus.
Laterally tumor extends into the
pterygomaxillary fossa and thence to
infratemporal fossa and cheek.
6.
7. PATHOLOGY:
The exact aetiology of tumor is unknown but it
tends to develop in males between 10 and 25
years old.
Histologically it is composed of fibrous
connective tissues interspersed with variable
proportion of endothelium lined blood spaces.
The vessels are just endothelium lined spaces
with no muscle coat therefore severe bleeding
may occur on taking biopsy and surgical removal
as these vessels can not contract to stop
bleeding.
8.
9. EXTENSIONS OF THE TUMOUR:
Nasopharyngeal angiofibroma is a benign
tumour but locally invasive and destroys the
adjoining structures. it may extend into:
1. Nasal cavity
2. Paranasal sinuses
3. Pterygomaxillary fossa
4. Orbits
5. Cranial cavity (middle cranial fossa)
10.
11. CLINICAL FEATURES:
Profuse and recurrent epistaxis.
Progressive nasal obstruction and hyponasal
voice.
Conductive hear loss and middle ear effusion.
Extension of tumor in different directions
produces symptoms like facial swelling,
proptosis, diplopia,broadening of nasal bridge,
palatal buldge and cranial nerve palsies.
On examination a pink or purplish lobulated soft
mass is seen. The mass may bleed on touch
12.
13. INVESTIGATION:
• IMAGING STUDIES:
• Plain x-rays of the nasopharynx (lateral view) and
paranasal sinuses (occipito-mental view) will show the
presence of soft tissues mass.
• CT scan is particularly helpful to find the extent of the
tumour. In addition CT scan with contrast will show the
vascularity of the tumour.
• MRI is also helpful especially to see the extension of
the soft tissue tumour into the cranium, orbit and
infra-temporal fossa.
14.
15. • ANGIOGRAPHY:
• Carotid or four vessel angiography (two carotids and two
vertebral) will show the vascular nature of the tumour, its
feeding vessels and extension of the tumour. In addition
during angiography embolization of the feeding vessel with
gelfoam can be done pre-operatively to shrink the tumour
and reduce bleeding during surgery.
• BIOPSY:
• It is contraindicated in suspected cases of angiofibroma
because it will cause profuse bleeding (as the muscular coat
of the vessel is absent).
16.
17. TREATMENT:
Surgical excision is the treatment of choice. various
surgical approaches to angiofibroma depending on
its origin and extension are listed below:
1. Trans-antral
2. Trans-palatal
3. Trans-mandibular
4. Lateral rhinotomy
5. Lateral pharyngeal
6. Mid facial degloving
7. Endoscopic
8. transplatine+sublabial (sardana’s approach)
9. Transmaxillary (le fort I approach)
18. Profuse bleeding during surgery is the main
problem in removal of tumour so different
methods are described to reduce the bleeding:
1. External carotid artery ligation was employed
before surgery to reduce bleeding.
2. Estrogen therapy for three weeks before
surgery is also done to reduce the vascularity.
3. Now super selective embolization is done prior
to surgery in which after angiography
embolization of the feeding vessels is done by
gelfoam. Surgery is performed usually within 24
to 48 hours after embolization.
19. RADIOTHERAPY:
It has been used as a primary mode of
treatment. A dose of 3000 to 3500 cGy in 15-18
fractions is delivered in 3 weeks. Tumour
regresses slowly in about a year sometimes even
upto 3 years.
CHEMOTHERAPY:
Recurrent and residual lesions have been
treated by chemotherapy, doxorubicin,
vincristine, and dacarbazine in combination.
HARMONAL:
Diethylstilboestrol and flutamide have been
used as tumour occurs in males at puberty.