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Muscle physiology /certified fixed orthodontic courses by Indian dental acad...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
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
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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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
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.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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2. The Rawalpindi Medical University
FOUNDATION MODULE
SMALL GROUP DISCUSSION
First year MBBS Batch- 50 (2023)_
Dr. Ali Zain
Batch
Date:-16th March2023
2
3. The Rawalpindi Medical University
Neuromuscular
junction and
Neuromuscular
Transmission
3
4. The Rawalpindi Medical University
Motto Vision; The Dream/Tomorrow
• To impart evidence based
research oriented medical
education
• To provide best possible
patient care
• To inculcate the values of
mutual respect and ethical
practice of medicine
4
5. The Rawalpindi Medical University
LEARNING OBJECTIVES
• structure of neuromuscular junction
• series of events occurring at neuromuscular junction
• Myasthenia Gravis
• Lambert Eaton syndrome
5
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WHAT IS NEUROMUSCULAR JUNCTION?
• It is the junction
between terminal
of motor neuron and
muscle fiber.
6
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1. Structures of axon terminal
7
• Presynaptic membrane
• Mitochondria
• Synaptic vesicles
• Sodium choline
co-transporter
• Microfilaments and tubules
• Voltage gated calcium
channels
8. The Rawalpindi Medical University
Reference : Guyton and hall textbook of
medical physiology, 8
• Basal lamina (organized layer
of extracellular matrix inside
the synaptic cleft)
- Acetyl cholinesterase enzyme
2. Structures of synaptic cleft:
9. The Rawalpindi Medical University
3. Structures of postsynaptic membrane:
• Synaptic trough or gutter
- motor endplate
invaginates inside the
muscle fiber and form
depression
• subneural cleft: numerous
folds of post synaptic
membrane
-nicotinic acetylcholine
receptors
- ligand gated ion
channels
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10. The Rawalpindi Medical University
4. Neuromuscular transmission
Transfer of information from motor nerve endings to
the muscle fiber through neuromuscular junction to
initiate muscle contraction
Events in neuromuscular transmission:
1. Propagation of action potential to the axon terminal
2.Opening of voltage gated calcium channels in the
membrane of axon terminal
• Influx of calcium ions from ECF to the axon terminal
• Migration and attachment of acetylcholine vesicles to
the presynaptic membrane
3.Release of acetylcholine via exocytosis
• Acetylcholine diffuses into synaptic cleft
12. The Rawalpindi Medical University
Action of acetylcholine
• binds with nicotinic
Ach receptor in the post
synaptic membrane
• Formation of Ach
receptor complex
• opening ligand gated
sodium channels
• Sodium from ECF
diffuses into muscle fiber
• End plate potential
develops
12
13. 5. Development of end plate potential
• RMP at muscle fiber is -90mv
• Sudden influx of Na+ into the muscle fiber
when the Ach gated ion channels open causes
electrical potential inside the fiber at the local
area of the end plate to increase in the positive
direction as much as 50 to 75mv creating a local
potential called endplate potential.
• EPP is a graded potential(non-propagative,
short distance signal)
• EPP initiates an action potential that spreads
along the muscle membrane and thus causes
muscle contraction.
14. The Rawalpindi Medical University
14
6. Destruction of acetylcholine
• Rapidly removed by two means:
1)destroyed by enzyme acetylcholinesterase
2)small amount of acetylcholine(Ach) diffuses out
of synaptic space
• Ach in synaptic cleft is destroyed very quickly,
within 1millisec by enzyme Ach esterase.
• Ach is so potent that even this short duration is
sufficient to excite the muscle fiber.
• Rapid destruction of acetylcholine prevents the
repeated excitation of muscle fiber and allows
muscles to relax.
15. The Rawalpindi Medical University
7. Reuptake process
-Ach esterase splits Ach into inactive choline and
acetate.
Acetylcholine Ach esterase acetate+ choline
-Choline is taken back into axon terminal from
synaptic cleft by nerve ending via sodium choline
co-transport and reused for synthesis of
acetylcholine
-acetate diffuses into
ECF choline + acetate ATP acetylcholine
16. The Rawalpindi Medical University
8. Miniature end plate potential
• Small quanta of Ach released at resting condition
which in turn generate small potential difference
• about 0.5mv
• When a nerve impulse reaches the ending the
number of quanta released by several order of
magnitude that result in large endplate potential
that exceeds the firing level of muscle fiber .
17. The Rawalpindi Medical University
• Applied physiology
17
i) Myasthenia
gravis
1. Autoantibodies against
acetylcholine receptors.
2. Blockade of acetylcholine
receptors.
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ii) Lambert Eaton Syndrome
Disorder of neuromuscular junction in
which in which autoantibodies are made
against the presynaptic Voltage gated
calcium channels.
19. The Rawalpindi Medical University
ASSESSMENT
Question:
A 35-year-old woman presents with weakness and fatigue in
her upper extremities. On examination, there is a noticeable
decrease in her grip strength, and she has difficulty raising
her arms above her head. She reports no sensory changes or
pain. Further testing reveals abnormalities in her NMJ
transmission.
• What is the neuromuscular junction (NMJ)?
• How does NMJ transmission occur?
• What are some common causes of disturbances
in NMJ transmission?
• What diagnostic tests can be used to assess NMJ
transmission?
• What are the clinical manifestations of NMJ
transmission disorders?
20. The Rawalpindi Medical University
References
• Guyton and Hall Textbook Of Medical
Physiology fourteenth edition
• Ganong’s Review of Medical Physiology
• Google and wikipedia for images for concepts
21. The Rawalpindi Medical University
Suggested research article
https://www.ncbi.nlm.nih.gov/books/NBK470413/
• Physiology, Neuromuscular Junction
Abdillahi Omar; Komal Marwaha; Pradeep C. Bollu.
22. The Rawalpindi Medical University
• Steps to Access HEC Digital Library
1. Go to the website of HEC National Digital Library.
2. On Home Page, click on the INSTITUTES.
3. A page will appear showing the universities from Public and
Private Sector and other Institutes which have access to HEC
National Digital Library HNDL.
4. Select your desired Institute.
5. A page will appear showing the resources of the institution
6. Journals and Researches will appear
7. You can find a Journal by clicking on JOURNALS AND DATABASE
and enter a keyword to search for your desired journal
Link:https://www.topstudyworld.com/2020/05/access-hec-
digital-library.html?m=1
How To Access Digital Library
23. The Rawalpindi Medical University
HOW TO APPLY FOR HEC DIGITAL
LIBRARY IF YOU ARE NOT MEMBER
• If you are not a member of HEC national
digital library then you can fill the application
after downloading it from
http://www.digitallibrary.edu.pk/app_form.html
• Fill the form that will appear like this
• Mail it to mailto: [email protected]