Intra-Fetal Laser Ablation of Umbilical Vessels in Acardiac Twin with Success...Apollo Hospitals
To interrupt blood supply to the acardiac twin in a case of TRAP sequence of monochorionic diamniotic multiple pregnancy to allow for continuation of the normal twin.
EMGuideWire's Radiology Reading Room: Blunt Aortic InjurySean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Blunt Aortic Injury and is brought to you by Rachel Plate, MD and Oriane Longerstaey, MD. It is has special guest editors: Bryant Allen, MD
Intra-Fetal Laser Ablation of Umbilical Vessels in Acardiac Twin with Success...Apollo Hospitals
To interrupt blood supply to the acardiac twin in a case of TRAP sequence of monochorionic diamniotic multiple pregnancy to allow for continuation of the normal twin.
EMGuideWire's Radiology Reading Room: Blunt Aortic InjurySean M. Fox
The Department of Emergency Medicine at Carolinas Medical Center is passionate about education! Dr. Michael Gibbs is a world-renowned clinician and educator and has helped guide numerous young clinicians on the long path of Mastery of Emergency Medical Care. With his oversight, the EMGuideWire team aim to help augment our understanding of emergent imaging. You can follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides or you can also use this section to learn more in-depth about specific conditions and diseases. This Radiology Reading Room pertains to Blunt Aortic Injury and is brought to you by Rachel Plate, MD and Oriane Longerstaey, MD. It is has special guest editors: Bryant Allen, MD
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: December...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Bladder Rupture
- Small Bowel Diverticula
- Type B Aortic Dissection
Here I discuss about the current management guidelines from British Thyroid Association and American Thyroid Association comparing those with the current practice in Sri Lanka
Dr. Kelsey Lena’s CMC Pediatric Orthopedic X-Ray Mastery Project: January CasesSean M. Fox
Dr. Kelsey Lena is Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Clavicle Fractures
Dr. Cravens CMC Implanted Device Imaging Mastery Project: ICD CasesSean M. Fox
Dr. Matthew Cravens is an Emergency Medicine Resident at Carolinas Medical Center and interested in medical education and Critical Care. Along with the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging of implanted devices. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Pacemakers & Internal Cardiac Defibrillators
Drs. Lena, Avery, and Davis’s CMC Abdominal Imaging Mastery Project: December...Sean M. Fox
Dr. Kelsey Lena is an Emergency Medicine Resident and Drs. Michael Avery and Joshua Davis are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s topics include:
- Bladder Rupture
- Small Bowel Diverticula
- Type B Aortic Dissection
Here I discuss about the current management guidelines from British Thyroid Association and American Thyroid Association comparing those with the current practice in Sri Lanka
Dr. Kelsey Lena’s CMC Pediatric Orthopedic X-Ray Mastery Project: January CasesSean M. Fox
Dr. Kelsey Lena is Emergency Medicine Resident and interested in pediatric emergency medicine and medical education. With the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, and supervision of Dr. Danielle Sutton, a Pediatric Emergency Medicine specialist, and Dr. Virginia Casey, a Pediatric Orthopedic Surgeon, they aim to help augment our understanding of emergent imaging. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Clavicle Fractures
Dr. Cravens CMC Implanted Device Imaging Mastery Project: ICD CasesSean M. Fox
Dr. Matthew Cravens is an Emergency Medicine Resident at Carolinas Medical Center and interested in medical education and Critical Care. Along with the guidance of Dr. Michael Gibbs, a notable Professor of Emergency Medicine, they aim to help augment our understanding of emergent imaging of implanted devices. Follow along with the EMGuideWire.com team as they post these educational, self-guided radiology slides. This set will cover:
- Pacemakers & Internal Cardiac Defibrillators
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.
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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.
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.
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.
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.
7. PROCEDURE:
• PREMEDICATION : ATROPINE
SEDATION
• SUPINE WITH ARMS BEHIND HEAD AT
EDGE OF TABLE.
• STERILISATION & LOCAL ANESTHETIC
• SITE:9th OR 10th SPACE-MIDAXILLARY
AREA
• BIOPSY WITH NEEDLE
• LIVER TISSUE TO BE PUT IN FORMALIN
• T.B. SEAL
• VITALS FOR 4 Hrs & NBM TILL 4 Hrs
www.dnbpediatrics.com
8. CONTRAINDICATIONS:
• BLEEDING DIATHESIS
• SEVERE HEPATOCELLULARE JAUNDICE
• INFECTION OF LIVER,PERITONEUM,BILLIARY TRACT
RIGHT LUNG BASE, Rt. SUBHEPATIC ABCESS
• HYDATID CYST OF LIVER
• HEMANGIOMA OF LIVER
• CHRONIC PASSIVE CONGESTION OF LIVER
• GROSS ASCITES
www.dnbpediatrics.com
10. 2.LUMBER PUNCTURE
• NEEDLES: L-P NEEDLE
SHORT 21-23 GAUGE FOR
INFANTS
LONG 21 GAUGE FOR
CHILDREN
• INDICATIONS:DIAGNOSTIC
THERAPEUTIC
CHEMOTHERAPY
• ANTIBIOTICS
www.dnbpediatrics.com
12. PROCEDURE:
• POSITION: KNEE DRAWN UP & HEAD FLEXED
RESTRAIN IN LATERAL RECUMBANT POSITION
• SITE:INTERSPACE BETWEEN L3-L4 OR L4-L5
• SMALL INFANTS:SITTING WITH LEANING FORWARD POSITION
• STERILISATION & LOCAL ANESTHESIA
• ‘GIVE UP’ SENSATION – DURA PIERCED.
• T.B.SEAL
• HEAD LOW POSITION POST PROCEDURE.
• VITAL MONITORING
www.dnbpediatrics.com
15. COMPLICATIONS
• Headache (reduced by keeping head low or
plenty of fluids)
• Backache
• Infection
• Medullary herniation
• Injury to blood vessels,spinal cord or
intervertebral disc
www.dnbpediatrics.com
17. • POSITION ---- sitting with leaning forward
supine in small infants
• SITE----Fifth to sixth intercostal space in posterior axillary line
• PREMEDICATION----atropine and sedation
• Sterlization and local anesthesia
• Large 18-22 G Needle for centesis and mallecot or ICD tube
for drainage
www.dnbpediatrics.com
3.THORACOCENTESIS
23. PROCEDURE
• SUPINE or SEM RECLINED position with back rest
• SITE-midway between umblicus and anterior
superior iliac spine
• Evaluate bladder
• PREMEDICATION – atropine and sedation
• Sterlisation and local anesthetic
• Large bore needle or IV canula using ‘Z’ technique
www.dnbpediatrics.com
24. continue
• Don’t remove large volume or too rapidly-will
precipitate shock
• Tincture Benzoin seal
• Vitals monitoring
www.dnbpediatrics.com
25. complications
• SHOCK-if too rapid removal or large volume is
tapped
• Acute liver cell failure and precipitation of
hepatic coma
• INFECTION –peritonitis
• Perforation of visceral organ
• Protein depletion
www.dnbpediatrics.com
29. PROCEDURE
• SITE
ANTERIOR-fifth ICS outside apex but inside
outer edge of dullness
EPIGASTRIC(PREFERRED) - between
ensiform cartilage and left costal margin
POSTERIOR- near inferior angle of scapula
STERNAL-fourth left ICS lateral to sternum
www.dnbpediatrics.com
30. continue
• SUPINE POSITION
• PREMEDICATION- atropine and sedation
• Sterlisation and local anesthetic
• Epigastric lateral to xiphoid cartilage at 45degree
posteriorly towards MCL with negative suction
• Cardioscope should be attached
• Seal with tincture Benzoin
• Vitals monitoring
www.dnbpediatrics.com
36. SITES
• ILIAC CREST
- 1 cm below iliac crest about 1-2cm posterior
to mid axillary line
-prone or side position
-PREFERRED OVER TWO YEARS
TIBIA
-Upper third of medial shaft
-PREFERRED LESS THAN 2 YRS
STERNUM
LUMBAR SPINOUS PROCESS
www.dnbpediatrics.com
37. PROCEDURE
• Position
• Pre medication
• Local upto periostium
• Nick with screwing motion
• NEEDLES-21G LP needle for infants
18-19G marrow needle for older children
loss of resistance after entering cavity
attach to 10-20cc syringe with negative suction
Immediately make slide
www.dnbpediatrics.com
38. Post procedure
• LOCAL PRESSURE FOR 5 MINS
• Seal
• vitals monitoring
www.dnbpediatrics.com
39. COMPLICATIONS
• DRY TAP Faulty technique
Pathological marrow
- myelofibrosis
-myelosclerosis
-leukemia
-hyper or hypoplasia
Bone pain
Hematoma
Infection(osteomyelitis)
www.dnbpediatrics.com
40. WHAT TO LOOK FOR IN MARROW
• Number and type of
erythropoietic, megakaryocytic and
leucopoietic cell linenage
• Cellularity
• Myeloid erythroid ratio(normal 3:1 to 4:1)
• Tumor and plasma cells
• Parasites,LD bodies,malarial parasites
www.dnbpediatrics.com