Nephrolithiasis, or kidney stones, are small mineral and salt deposits that form in the kidneys from crystalloid imbalance, infection, diet, and other factors. They are commonly treated using extracorporeal shock wave lithotripsy (ESWL) to dissolve renal calculi or percutaneous nephrolithotomy (PCNL), which uses a nephroscope inserted through a percutaneous tract to directly visualize and remove renal stones. Nursing care focuses on controlling pain, maintaining urine flow to prevent obstruction and infection, and monitoring for complications.
Urolithiasis is a common disease that is estimated to
produce medical costs of $2.1 billion per year in the United States alone.
Renal colic affects approximately 1.2 million people
each year in USA and accounts for approximately 1% of
all hospital admissions.
Most active emergency departments (EDs) manage
patients with acute renal colic every day.
Nephrolithiasis (kidney stones) is a disease affecting the urinary tract. Kidney stones are small deposits that build up in the kidneys, made of calcium, phosphate and other components of foods. They are a common cause of blood in urine.
Kidney stone formation may result when the urine becomes overly concentrated with certain substances. These substances in the urine may complex to form small crystals and subsequently stones.
A number of blood and urine tests will be required to detect the presence of infection and test the function of the kidneys
Urolithiasis Is the process of forming stones in the kidney, bladder or urethra
Kidney stones(calculi) are formed of minerals deposits commonly calcium oxalate and calcium phosphate; however uric acid, struvite and cystine are also calculus formers.
Urolithiasis is a common disease that is estimated to
produce medical costs of $2.1 billion per year in the United States alone.
Renal colic affects approximately 1.2 million people
each year in USA and accounts for approximately 1% of
all hospital admissions.
Most active emergency departments (EDs) manage
patients with acute renal colic every day.
Nephrolithiasis (kidney stones) is a disease affecting the urinary tract. Kidney stones are small deposits that build up in the kidneys, made of calcium, phosphate and other components of foods. They are a common cause of blood in urine.
Kidney stone formation may result when the urine becomes overly concentrated with certain substances. These substances in the urine may complex to form small crystals and subsequently stones.
A number of blood and urine tests will be required to detect the presence of infection and test the function of the kidneys
Urolithiasis Is the process of forming stones in the kidney, bladder or urethra
Kidney stones(calculi) are formed of minerals deposits commonly calcium oxalate and calcium phosphate; however uric acid, struvite and cystine are also calculus formers.
List the signs/symptoms and differential diagnoses of an acute stone episode
Describe the imaging studies available to diagnose ureteral calculi.
List the classes of medications effective for treating the pain of renal colic.
Outline the basic treatment options for ureteral stone
Describe the clinical scenarios requiring urgent decompression of a ureteral stone.
List the basic principles of stone preventi
CHOLELITHIASIS, NEPHROLITHIASIS SECONDARY HYPERTENSION, DM TYPE 2, HYDRONEPH...Jack Frost
CHOLELITHIASIS, NEPHROLITHIASIS
SECONDARY HYPERTENSION, DM TYPE 2, HYDRONEPHROSIS
This presentation contains real names of persons involve of this particular study. This names should not be copied or rewritten. Used the data of this study as basis only. All rights reserved 2009.
Common disorder with an annual incidence of 0.1% to 0.5%.
The peak age at onset is 20 to 30 years
Men > Women ( until 50s )
Wide geographic variations exist, due to differences in diet and water composition, as well as ambient and sunlight exposure. 5-9% in Europe 20% in Saudi Arabia
Kidney stones (also called renal calculi, nephrolithiasis or urolithiasis) are hard deposits made of minerals and salts that form inside your kidneys. Diet, excess body weight, some medical conditions, and certain supplements and medications are among the many causes of kidney stones.
Lifestyle recommendation in patient of kidney stones to reduce the riskSiddesh Dhanaraj
A brief recommendation in patients of kidney stones. Management, complications, Methods to prevent kidney stones (Non-medical & Medical),Do's and Dont's in Kidney stone.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
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
2. Introduction
Nephrolithiasis is a formation of stone in the
kidney. Kidney stones are small deposit that build
up in the kidney made of calcium, phosphate and
other components.
Nephrolithiasis represent one of the 3 common
emergency admissions seen on urology wards (the
other 2 being acute urinary retention and
haematuria).
Approximately 50% of patients present between
the ages of 30 and 50 years.
There is a slight male preponderance.
3. Factors responsible for stone formation
Crystalloid colloid imbalance.
Infection.
Parathyroid tumour.
Diminished excretion citrate in urine.
Prolonged immobilization.
Climate factor.
Dietary factor.
4. Types of urinary stones
According to site
a. Renal stone.
b. Ureteric stone.
c. Bladder stone.
d. Urethral stone.
According to
composition
a. Phosphate stone.
b. Oxalate stone.
c. Uric acid stone.
d. Cysteine stone.
e. Xanthine stone.
5. Typical features of some stones
Phosphate stone
Also known as triple phosphate stones or struvite
stones or staghorn stone.
They tends to grow in alkaline urine especially
with infection caused by urea splitting bacteria
(proteus, pseudomonas, staphylococcus).
They are soft stones with smooth surface. So,
they causes less pain and presentation will be
late.
• Oxalate stone
Irregular sharp projections which cause bleeding.
Presentation will be early with heamaturia and
pain.
Very hard stones.
6. Uric acid stone
Multiple, may be hard or soft. Present in late stage.
They are radiolucent that is they are not seen on
plain xray KUB.
Uric acid, cysteine and xanthine stones are known
as metabolic stones.
8. Investigations
Laboratory
a. Blood: CBC, Na+, K+, Creatinine
b. Urine: urine routine and microscopic
examination
X Ray (KUB)
USG abdomen
Intravenous urography (IVU)
CT scan of abdomen
9. Management of stones
Indication of active removal of stone
1. Size (when stone is of the size 5-8mm or more).
Stones <5mm size should wait for natural
expulsion).
2. Repeated colicky pain.
3. Repeated haematuria.
4. When straight X ray shows stone is increasing in
size.
5. If stone is present in the plviureteric junction or
vesicoureteric junction.
10. Modalities of management
Conservative Surgical
1. Non-invasive
2. Minimally invasive
3. Invasive or open
surgery
11. Conservative
Wait and watch if asymptomatic stones, stones ≤ 5
mm in size and no associated complications.
Drink plenty of water, do exercise and jogging.
On acute presentation give analgesics (diclofenac
100 mg or other higher grade analgesics like
morphine, pethedine), anti-emetics (ondem,
perinorm), antispasmodics (buscopan).
Depending on the type of stone such medication
are given to reduce further stone formation or
dissolve the material forming the stone such as
diuretics, phosphate solution,
allopurinol,antibiotics, sodium bicarbonate or
sodium citrate.
12. Surgical
Non-invasive
1. ESWL (Extracorporeal shock wave lithotripsy)
Minimally invasive
1. Percutaneous nephrolithotomy (PCN)
2. Uretero Renoscopic lithotripsy (URSL)
Invasive or open surgery
1. Open pyelolithotomy
2. Extended pyelolithotomy
3. Nephrolithotomy
13. A: Extracorporeal
shock wave lithotripsy
(ESWL)
for renal calculi
dissolution.
B: A percutaneous
nephrostomy tract
permits access to the
collecting system of the
kidney for removal of
renal calculi under
direct vision via a
nephroscope. (PCNL)
14. Complications of renal stones
Infection (Pyelonephritis, Pyonephrosis).
Obstruction (Hydronephrosis).
Persistent haematuria leading to anemia.
Chronic renal failure.
15. Nursing management
Nursing Assessment
1. Obtain history focusing on family history of calculi,
episodes of dehydration, prolonged immobility, UTI, dietary,
bleeding history, and medication history.
2. Assess pain location and radiation; assess level of pain
using a scale of 1 to 10. Observe for presence of associated
symptoms: nausea, vomiting, diarrhea, abdominal
distention.
3. Monitor for signs and symptoms of UTI, such as chills,
fever, dysuria, frequency. Examine urine for hematuria.
4. Observe for signs and symptoms of obstruction, such as
frequent urination of small amounts, oliguria, anuria.
16. Nursing Diagnosis
1. Acute Pain related to inflammation, obstruction, and
abrasion of urinary tract by migration of stones.
2. Impaired Urinary Elimination related to blockage of
urine flow by stones.
3. Risk for Infection related to obstruction of urine flow
and instrumentation during treatment
17. Nursing Interventions
Controlling Pain
1. Give prescribed NSAID or opioid analgesic (usually I.V. ) until
cause of pain can be removed.
2. Encourage patient to assume position that brings some relief.
3. Administer anti-emetics as indicated for nausea.
Maintaining Urine Flow
1. Administer fluids orally or I.V. (if vomiting) to reduce
concentration of urinary crystalloids and ensure adequate
urine output.
2. Monitor total urine output and patterns of voiding. Report
oliguria or anuria.
3. Help patient to walk, if possible, because ambulation may
help move the stone through the urinary tract.
18. Controlling Infection
1. Administer parenteral or oral antibiotics, as
prescribed
during treatment, and monitor for adverse effects.
2. Assess urine for color, cloudiness, and odor.
3. Obtain vital signs, and monitor for fever and
symptoms of impending sepsis (tachycardia,
hypotension).