The document discusses obesity, including its prevalence, complications, and treatment. Some key points:
- Obesity is defined as having a BMI of over 30 or excess body fat of over 20%. It results from consuming more calories than expended.
- It is common worldwide and in countries like India and China. In the US, over 30% of adults are obese, costing $147 billion annually.
- Obesity increases the risk of conditions like diabetes, high blood pressure, high cholesterol, heart disease, stroke, arthritis, and some cancers.
- Treatment involves lifestyle changes like diet and exercise. For higher-risk patients, treatment may include medication or surgery to help with weight loss and reduce
This ppt contains all the details about what is obesity, etiology, & mainly focuses on various methods of assessment of obesity from field tests to lab tests.
My seminar Obesity by Hani
Obesity is a public health and policy problem because of its increase prevalence, costs and health effect. (WHO, 2012, National heart lung and blood institute. 2012)
. The risk factor for chronic disease are highly prevalence (Zindah, Belbeisi, Walke & Makdad 2008)
The obesity and the overweight are risk for number of chronic disease include diabetes cardio vascular disease and cancer (WHO,2010)
Obesity is a chronic heath problem ,the no.of people having obese rising rapidly world wide and making obesity 1 of the fastest developing peoples health problem
to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/12/obesity.html
obesity, causes, diagnosis, complications, treatment, prevention.
Obesity is that, you have a high amount of fat in your body, and from that definition you can notice that, obesity is not about more weight, it's about more fat .
you will find in his presentation:(Body mass index (BMI),causes,Waist–hip ratio,Childhood obesity,complications and treatment)
Overweight And Obesity : Proven Health Risks, We All Should KnowSanjiv Haribhakti
Overweight and obesity are defined as abnormal or excessive fat accumulation in the body that presents a risk to health. Obesity will have a negative effect on health, leading to reduced life expectancy and/or increased health problems. According to WHO, Obesity is one of the most serious public health problems of the 21st century. For more info visit :- http://gisurgery.info/player_presentation.php?id=133
This ppt contains all the details about what is obesity, etiology, & mainly focuses on various methods of assessment of obesity from field tests to lab tests.
My seminar Obesity by Hani
Obesity is a public health and policy problem because of its increase prevalence, costs and health effect. (WHO, 2012, National heart lung and blood institute. 2012)
. The risk factor for chronic disease are highly prevalence (Zindah, Belbeisi, Walke & Makdad 2008)
The obesity and the overweight are risk for number of chronic disease include diabetes cardio vascular disease and cancer (WHO,2010)
Obesity is a chronic heath problem ,the no.of people having obese rising rapidly world wide and making obesity 1 of the fastest developing peoples health problem
to download this presentation from this link
https://mohmmed-ink.blogspot.com/2020/12/obesity.html
obesity, causes, diagnosis, complications, treatment, prevention.
Obesity is that, you have a high amount of fat in your body, and from that definition you can notice that, obesity is not about more weight, it's about more fat .
you will find in his presentation:(Body mass index (BMI),causes,Waist–hip ratio,Childhood obesity,complications and treatment)
Overweight And Obesity : Proven Health Risks, We All Should KnowSanjiv Haribhakti
Overweight and obesity are defined as abnormal or excessive fat accumulation in the body that presents a risk to health. Obesity will have a negative effect on health, leading to reduced life expectancy and/or increased health problems. According to WHO, Obesity is one of the most serious public health problems of the 21st century. For more info visit :- http://gisurgery.info/player_presentation.php?id=133
53715 Learning OutcomesAfter reading this chapter.docxtarifarmarie
537
15
Learning Outcomes
After reading this chapter, you will be able to:
15.1 Explain why weight management is important
to health and well-being.
15.2 Define the terms appetite, hunger, and satiety,
and describe the physiological factors involved
in regulating food intake.
15.3 Describe the role of hyperplasia and
hypertrophy of adipocytes in the development
of obesity.
15.4 Discuss the role of genetics and the
environment in the development of
underweight, overweight, and obesity.
15.5 Describe the role of diet and exercise in
achieving a reasonable rate of weight loss.
15.6 Design a food and exercise plan to maintain a
healthy weight.
15.7 Describe the role of diet and exercise in
achieving a healthy weight gain.
15.8 Describe the role of weight-loss drugs and
surgery for reducing obesity.
True or False?
1. Healthy weight loss occurs only with at
least 2 hours of daily exercise. T/F
2. The body stops synthesizing fat cells
after adolescence. T/F
3. Grazing throughout the day helps curb
appetite and control body weight. T/F
4. Losing even 10 pounds can improve
health. T/F
5. Genetics and the environment both
affect body weight. T/F
6. Eating more vegetables and fruits can
help an individual lose weight. T/F
7. Obesity is the result of consuming more
energy than is expended. T/F
8. The nutrient that has the most effect on
satiety is fat. T/F
9. You don’t need to diet and exercise if
you are taking a weight-loss drug. T/F
10. Bariatric surgery results in weight loss
without restricting food intake. T/F
See page 572–573 for the answers.
Weight Management
538 Chapter 15 | Weight Management
Why Is Weight Management
Important?
LO 15.1 Explain why weight management is important to health and
well-being.
The term weight management means maintaining body weight within a healthy range.
Achieving a healthy body weight is essential for physical and emotional well-being. It
helps you feel good about yourself, provides the energy you need to enjoy life, and lowers
the risk of chronic disease. In addition, weight management reduces costs to society. The
costs for treating obese individuals are several thousand dollars higher than for their lean
counterparts. It has been estimated that each additional pound of extra body weight above
healthy body weight could add up to $13 a year per pound in added medical costs for men
and up to $45 for women.6
Being Overweight or Obese Increases Health Risks
As you learned in Chapter 14, a healthy weight is a body weight that doesn’t increase
the risk of developing any weight-related health problems or diseases.7 In contrast, over-
weight—and especially obesity—is associated with numerous health problems. In fact, in
2013, the American Medical Association declared obesity a disease in itself—specifically a
multi-metabolic and hormonal disease state.8 This new classification of obesity as a disease helps
focus attention and resources on the problem, .
53715 Learning OutcomesAfter reading this chapter, .docxtarifarmarie
537
15
Learning Outcomes
After reading this chapter, you will be able to:
15.1 Explain why weight management is important
to health and well-being.
15.2 Define the terms appetite, hunger, and satiety,
and describe the physiological factors involved
in regulating food intake.
15.3 Describe the role of hyperplasia and
hypertrophy of adipocytes in the development
of obesity.
15.4 Discuss the role of genetics and the
environment in the development of
underweight, overweight, and obesity.
15.5 Describe the role of diet and exercise in
achieving a reasonable rate of weight loss.
15.6 Design a food and exercise plan to maintain a
healthy weight.
15.7 Describe the role of diet and exercise in
achieving a healthy weight gain.
15.8 Describe the role of weight-loss drugs and
surgery for reducing obesity.
True or False?
1. Healthy weight loss occurs only with at least 2 hours of daily exercise. T/F
2. The body stops synthesizing fat cells after adolescence. T/F
3. Grazing throughout the day helps curb appetite and control body weight. T/F
4. Losing even 10 pounds can improve health. T/F
5. Genetics and the environment both affect body weight. T/F
6. Eating more vegetables and fruits can help an individual lose weight. T/F
7. Obesity is the result of consuming more energy than is expended. T/F
8. The nutrient that has the most effect on satiety is fat. T/F
9. You don’t need to diet and exercise if you are taking a weight-loss drug. T/F
10. Bariatric surgery results in weight loss without restricting food intake. T/F
See page 572–573 for the answers.
Weight Management
538 Chapter 15 | Weight Management
Why Is Weight Management
Important?
LO 15.1 Explain why weight management is important to health and
well-being.
The term weight management means maintaining body weight within a healthy range.
Achieving a healthy body weight is essential for physical and emotional well-being. It
helps you feel good about yourself, provides the energy you need to enjoy life, and lowers
the risk of chronic disease. In addition, weight management reduces costs to society. The
costs for treating obese individuals are several thousand dollars higher than for their lean
counterparts. It has been estimated that each additional pound of extra body weight above
healthy body weight could add up to $13 a year per pound in added medical costs for men
and up to $45 for women.6
Being Overweight or Obese Increases Health Risks
As you learned in Chapter 14, a healthy weight is a body weight that doesn’t increase
the risk of developing any weight-related health problems or diseases.7 In contrast, over-
weight—and especially obesity—is associated with numerous health problems. In fact, in
2013, the American Medical Association declared obesity a disease in itself—specifically a
multi-metabolic and hormonal disease state.8 This new classification of obesity as a disease helps
focus attention and resources on the problem, opening the door for t.
Guide to Creating an Outline Purpose Use this document as.docxwhittemorelucilla
Guide to Creating an Outline
Purpose: Use this document as a resource and guide for creating effective outlines according to APA 6th
edition style guidelines.
Outline Formatting:
1. For first-level headings, use Roman numerals (I, II, III, etc.) and present the information using all
uppercase letters.
2. For secondary headings, begin with a capital letter and present the information using upper and
lowercase letters.
3. For tertiary headings, start with Arabic numerals and present the information using upper and
lowercase letters.
4. Create parallel wording for headings and subheadings (secondary and tertiary headings). For instance,
if the first heading starts with a noun, the second heading must also start with a noun.
5. Include more general information in the first-level headings, while more specific information in the
secondary and tertiary headings.
6. Use double spacing in the outline.
7. Refine the outline by filling in other appropriate details to make it more precise.
Sample Outline:
I. INTERNAL AND EXTERNAL STAKEHOLDERS INVOLVING IN THE DEICSION
A. Internal stakeholders
1. Employees
2. Physicians
B. External stakeholders
II. IMPACTS TO VARIOUS STAKEHOLDERS OF ACQUIRING A CT UNIT
III. INTERNAL AND EXTERNAL FACTORS IMPACTING THE DECISION -MAKING
A. Internal factors
1. Financial stability
2. Leadership and management
B. External factors
Reference
Purdue Online Writing Lab. (2014). Developing an outline. Retrieved from
https://owl.english.purdue.edu/owl/resource/544/1/
Last reviewed: June 2016
Anatomy or system affected: Abdomen, blood vessels, circulatory system, endocrine system, gastrointestinal system, heart, intestines, joints, psychic-emotional system, respiratory system, stomach
Definition: A condition in which the body carries excessive and unhealthy amounts of fat tissue, leading the individual to weigh in excess of 20 percent more than his or her ideal weight
Causes and Symptoms
Obesity is a condition in which the body accumulates an abnormally large amount of adipose tissue, or fat. It is a multifactorial, chronic disease that is rapidly increasing and having devastating effects on health worldwide, especially in high- and middle-income countries. Overweight and obesity are linked to more deaths around the globe than underweight, and obesity is a major risk factor for cardiovascular disease, diabetes, musculoskeletal disorders such as osteoarthritis, and some cancers. The disease has social, cultural, genetic, metabolic, behavioral, and psychological components. People who are obese also face stigma and discrimination in work and social settings. Obesity is preventable. Obesity and overweight are the second leading cause of preventable deaths in the United States.
Silhouettes and waist circumferences representing normal, overweight, and obese. Public domain, via Wikimedia Commons
Because it is not practical to measure body fat content directly but it is easy ...
Nih causes of weight gain and obesity and strategies and help losing weightPrab Tumpati
NIH comprehensive report on causes of weight gain, and strategies to deal with obesity and overweight.
Please feel free to share this free, public domain information
Thank you.
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Clinical Research Challenges and Best Practices in Pediatric Research in Canada - Dr. Al Wahab - 2015
Dr. Zeina AlWahab, M.D.
Prof. Peivand Pirouzi, Ph.D., M.B.A.
5 steps for fast and easy weight loss and wellnessweight-loss-diet
Here are 5 simple and easy steps to lose weight. Understanding why you may be gaining weight is the key to lose weight. For most people, the cause of weight gain is not overeating but metabolic factors such as insulin resistance.
Tharwat's Family
Tharwat's Family
O B E S I T Y A N D T H E D I G E S T I V E S Y S T E M
Diet and exercise in management of obesity and overweight
Kwong Ming Fock* and Joan Khoo†
Departments of *Gastroenterology and †Endocrinology, Changi General Hospital, Singapore
Keywords
BMI, diet, exercise, NAFLD, obesity.
Accepted for publication 30 September 2013.
Correspondence
Professor Kwong Ming Fock, Division of
Gastroenterology, Department of Medicine,
Changi General Hospital, 2 Simei Street 3,
Singapore 529889. Email:
[email protected]
Abstract
According to World Health Organization, in 2010 there were over 1 billion overweight
adults worldwide with 400 million adults who were obese. Obesity is a major risk factor for
diabetes, cardiovascular disease, musculoskeletal disorders, obstructive sleep apnea, and
cancers (prostate, colorectal, endometrial, and breast). Obese people may present to the
gastroenterologists with gastroesophageal reflux, non-alcoholic fatty liver, and gallstones.
It is important, therefore, to recognize and treat obesity.
The main cause of obesity is an imbalance between calories consumed and calories
expended, although in a small number of cases, genetics and diseases such as hypothy-
roidism, Cushing’s disease, depression, and use of medications such as antidepressants and
anticonvulsants are responsible for fat accumulation in the body.
The main treatment for obesity is dieting, augmented by physical exercise and supported
by cognitive behavioral therapy. Calorie-restriction strategies are one of the most common
dietary plans. Low-calorie diet refers to a diet with a total dietary calorie intake of
800–1500, while very low-calorie diet has less than 800 calories daily. These dietary
regimes need to be balanced in macronutrients, vitamins, and minerals. Fifty-five percent
of the dietary calories should come from carbohydrates, 10% from proteins, and 30% from
fats, of which 10% of total fat consist of saturated fats. After reaching the desired body
weight, the amount of dietary calories consumed can be increased gradually to maintain a
balance between calories consumed and calories expended. Regular physical exercise
enhances the efficiency of diet through increase in the satiating efficiency of a fixed meal,
and is useful for maintaining diet-induced weight loss. A meta-analysis by Franz found that
by calorie restriction and exercise, weight loss of 5–8.5 kg was observed 6 months after
intervention. After 48 months, a mean of 3–6 kg was maintained.
In conclusion, there is evidence that obesity is preventable and treatable. Dieting and
physical exercise can produce weight loss that can be maintained.
Introduction
Since 1980, obesity has more than doubled globally and is now
considered as a major health hazard and a global epidemic. This
review aims to evaluate the current management of obesity and
overweight employing a combination of dietary interventions,
exercise, and behavioral modification. For ...
Rivaroxaban with or without aspirin in patients with stable peripheral or car...Bhargav Kiran
Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial
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.
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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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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.
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 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
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
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
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- 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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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
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2 Case Reports of Gastric Ultrasound
2. A good medical quote.
Obesity is not because it runs in the
family!!!!!!!!!
It is because, no one runs in the family!!!!!!
3. What is Obesity ?
It is an abnormal accumulation of body fat, usually 20% or more over
an individuals ideal body weight.
In its simplest terms, obesity can be considered to result from an
imbalance between the amount of energy consumed in the diet and
the amount of energy expended through exercise and bodily
functions.
4. EVALUATION AND
MANAGEMENT OF
OBESITY.
Obesity is associated with an increased risk of
multiple health problems including hypertension, type
2 diabetes, dyslipedemia, obstructive sleep apnea,
nonalcoholic fatty liver disease, degenerative joint
disease and some malignancies.
Thus it is important for physicians to identify, evaluate
and treat patients for obesity and associated comorbid
conditions.
5. Evaluation.
Physicians should screen patients in obesity and offer
intensive counseling and behavioral interventions to
promote sustained weight loss
6. The five main steps in the
evaluation of obesity are:
i. A focused obesity-related history.
ii. A physical examination to determine the degree and
type of obesity.
iii. Assessment of comorbid conditions.
iv. Determination of fitness level.
v. Assessment of the patients readiness to adopt
lifestyle changes.
7. The Obesity-Focused
History.
Information from the history should address the
following seven questions.
I. What factors contribute to the patients obesity?
II. How is the obesity affecting the patients health?
III. What is the patients level of risk from obesity?
IV. What does the patient find difficulty about managing
the weight?
V. What are the patients goal and expectations?
8. VI. Is the patient motivated to begin a weight management
programme?
VII. What kind of a help does the patient need?
9. Body Mass Index (BMI) And
Waist Circumference.
Three anthropometric measurements are important in
evaluating the degree of obesity
Height
Weight
Waist circumference
10. BMI is calculated using the formula
Weight (kg)/Height (m²)
Or
Weight (lbs)/Height (inches)² * 703
BMI provides an estimate of body fat and is related to
disease risk.
Excess abdominal fat, assessed by measurement of waist
circumference or waist-to-hip ratio, is independently
associated with a higher risk for DM and Cardiovascular
disease.
11.
12. Physical Fitness.
Several prospective studies have demonstrated that
physical fitness, reported by questionnaire or
measured by a maximal treadmill exercise test, is an
important predictor of all–cause mortality rate
independent of BMI and body composition.
These observation highlights the importance of taking
a physical activity and exercise history during
examination as well as emphasizing physical activity
as a treatment approach.
13. Obesity Associated
Comorbid Conditions.
The evaluation of comorbid conditions should be
based on presenting symptoms and index of
suspicion.
For all the patient’s a fasting lipid panel should be
performed and a fasting blood glucose level and blood
pressure is to be determined.
Although individuals vary, the severity and number of
organ specific comorbid conditions usually rise with
increasing levels of obesity.
14. Assessing the Patient’s
Readiness to Change.
An attempt to initiate lifestyle changes when the
patient is not ready usually leads to frustration and
may hamper future weight-loss effort.
Assessment includes :
Patient motivation and support,
Stressful life events,
Psychiatric status,
Time availability and constraints
Appropriateness of goals and operations
15. Readiness can be viewed as the balance of two
opposing factors
o Motivation or The patient’s desire to change
&
o Resistance or The patient’s resistance to change.
o Anchoring method of interviewing technique is a
helpful method to begin a readiness assessment.
18. INDIA, with 41 million obese people, ranks third after
the U.S and CHINA in having the highest number of
overweight people in the world say a study.
Together, INDIA and CHINA represent 15% of the
worlds obese population.
19. 1 Out Of 2 Indians Are Obese – India Needs
To Lose Weight.
Indians people typically believe that the Indian diet is
healthier as compare to Western diets. While this may
be true if we compare average the Indian diet with say
eating burgers, but despite this ‘healthier diet’, Indians
are gaining weight, just like people in some of the
developed countries like the US, Australia and others.
20. And this trend is extremely pronounced in urban India,
where over the last 20 years, incomes have risen
significantly, along with spending on food and
entertainment. This, coupled with sedentary lifestyle is
increasing waistlines. And this is not our theory, but
data is showing this.
21. Multiple surveys over the last few years have been pointing
to this.
Fitho recently did a survey, which included over 4000
people – who read the daily newspaper, mostly in urban
India: metros, Tier 1 and Tier 2 towns, and the data was
surprising –
Almost 3 out of 4 participants (i.e. 73%) were overweight.
46% (almost half) of the participants were obese, i.e. a
BMI more than 25 kg/m2.
22. Men and women were both equally obese.
Women have a tendency to become overweight, up to
2 years before men.
The average BMI of a participant was 25.5 kg/m2,
which puts them in the obese category.
23. The problem with increasing waistlines is not one of
aesthetics, but of the multiple health disorders that are
associated with it. And Indians actually have it worse-
Indians are genetically prone to storing fat around the
belly, which is directly related to lifestyle disorders like
diabetes, heart disease, and a lot more.
24. As a result, WHO has predicted India to be the
diabetes capital of the world. Keeping this high risk of
Indians in mind, the Indian Health Ministry in 2012
released lower BMI guidelines for a health weight.
25. The survey data showed some interesting trend
The average person goes from a healthy weight at 26
years to an obese BMI at 38 years.
The average weight loss needed was approximately
11 kg.
26. It takes about 12 years to gain the weight.
To lose the weight through a healthy diet program
requires approximately 3 months.
So, India’s weight and obesity problems are not out of
control, but it’s important for Indians to take control of
their health.
27.
28. According to World Health Organization (WHO),
obesity is one of the most common yet among the
most neglected public health problem in both
developing and developed countries.
According to the WHO World Health Statistics Report
2012, globally one in six adults is obese and nearly
2.8 million individuals die each year due to either over
weight or obesity.
29.
30. Obesity is common,
serious and costly in U.S.
More than one-third (34.9% or 78.6 million) of U.S
adults are obese.
U.S stands the first in the case of obesity
The estimated annual medical cost of obesity in U.S
was $147 billion dollars in 2008.
The medical cost for people who were obese were
$1429 higher than those of normal weight.
31. Obesity affects some
groups more than others.
Non-Hispanic blacks have the highest rates of obesity
(47.8%)
Followed by Hispanics (42.5%).
Then comes the Non-Hispanic whites (32.6%)
And finally the Non-Hispanic Asians (10.8%)
32. Obesity and socio-
economic status.
Men with higher income are more likely to have
obesity than those with low income.
Higher income women are less likely to have obesity
than low income women.
There is no significant relationship with obesity and
education among men.
Among women there is a trend, those with college
degrees are less likely to have obesity compared with
less educated women.
38. 90% of people who develop type 2 diabetes will have
a body mass index (BMI) greater than 23.
The risk of getting type 2 diabetes is highest if the
weight is gained during childhood and there is a family
h/o diabetes caused by obesity.
If a person is obese at the age of 40 then, his life is
shortened by 7 years .
39.
40. If you have obesity, the chance of developing high blood
pressure is up to 5 times greater compared to someone
with a normal weight.
85% of those diagnosed with high blood pressure have a
BMI >25
Increasing cholesterol levels are associated with weight
increase, above a BMI of as little as 21.
High cholesterol, elevated blood pressure and the
presence of diabetes in turn lead to increased heart
disease
41. Even fertility is
decreased by
obesity
• In women, 6% of those who are
obese have trouble to conceiving.
• When a pregnancy occurs, the
chance of a serious event
requiring hospitalization is 4-7
times more in an obese women.
• Gestational DM, Pre-eclampsia,
Difficulties in labor and delivery,
higher c-section rates, and more
death of the mother and/or fetus,
are all associated with obesity.
• Men are also affected, i.e. erectile
dysfunction (impotence) and lower
fertility. They also have low amount
of testosterone because of excess
abdominal fat.
42.
43. • Joints that carry excessive
weight, such as the hips and
knees, arthritis tends to be a
problem and it affects other
joints such as ones in hands.
• Gout is also more common
48. The Goal Of Therapy.
The Primary Goals :
Improve obesity-related comorbid
conditions,
Reduce the risk of developing future
comorbidities.
Information obtained from the history,
physical examination and diagnostic
tests is used to determine risk and
develop a treatment plan
49. this treatment plan depends upon the risk
status, expectation and available
resources.
Patients who present with obesity-related
comorbidities and who would benefit from
weightloss intervention should be
managed proactively.
Therapy begins with lifestyle management
and may include pharmacotherapy or
surgery, depending upon BMI and risk
factors.
53. Behavioural modification to avoid some of
the effects of the ‘obsogenic’ environment
is the cornerstone of long-term control of
weight.
Regular eating patterns and maximising
physical activity are advised, with reference
to the modest extra activity required to
increase physical activity level (PAL) ratios
55. food selection ,
portion size control,
avoidance of
snackling regular
meals to encourage
satiety and
substitution of sugar
with artificial
sweeteners should be
discussed with the
patient.
Regular support from
a dietitian or
attendance at a
weight loss group may
be helpful.
58. Anti-obesity medication or weight loss drugs are all
pharmacological agents that reduce or control weight.
These drugs alter one of the fundamental processes of the
human body, weight regulation, by altering either appetite,
or absorption of calories.
ORLISTAT is the only drug currently licensed for long-term
use.
A no.of other drugs are in development, so the situation
could change rapidly over the next few years.
Sibutramine , is a drug that was recently withdrawn due to
cardiovascular side-effects
59. Mode of action.
Orlistat inhibits pancreatic and gastric lipases and
thereby decreases the hydrolysis of ingested
triglycerides, reducing dietary fat absorption by
approximately 30%
The drug is not absorbed.
60. Side-Effects
Adverse side-effects relate to the effect of the
resultant fat malabsorption on the gut namely:
Loose stools
Oily spotting
Faecal urgency
Flatus
The potential for malabsorption of fat-soluble vitamins
61. Dosage.
It is taken with each of the three meals of the day.
Dose can be adjusted (60-120mg) to minimise side-
effects.
62.
63. Some patients who continue to take anti-obesity drugs
tend to regain weight with time.
This may partly reflect age-related weight gain, but
significant weight gain should prompt reinforcement of
lifestyle advice and, if this is unsucessful, drug therapy
should be discontinued.
66. Bariatric surgery is by far the most effective
long-term treatment for obesity and is the only
anti-obesity intervention that has been
associated with reduced mortality.
it is usually reserved for those with severe
obesity (BMI >40kg/m) or for those with a BMI
>30kg/m and significant complications such
as, type 2 diabetes, hyperlipidemia or
obstructive sleep apnea.
67. A doctor-patient discussion of surgical options should
include the long-term side effects, such as possible
need for reoperation, gallbladder disease, and
malabsorption.
Long-term studies show the procedures cause
significant long-term lose of weight, recovery from
diabetes, improvement in cardiovascular risk factors,
and a reduction in mortality of 23% from 40%.
68. Procedures in
Bariatric surgery.
A : laproscopic adjustable
gastric binding.
B : Laproscopical sleeve
gastrectomy.
C : The Roux-en-Y gastric
bypass.
D : Biliopancreatic
diversion with duodenal
switch.
E : Biliopancreatic
diversion.
69.
70.
71.
72. PUTTING IT ALL
TOGETHER.
Obesity is a disease because it causes problems with
you physical, mental and metabolic health.
If you are unable to loose weight on your own, get
help from your doctor.
Chances are that it is not just the weight, chances are
you do have complications of obesity.
Everyone who has obesity deserves a thorough
medical checkup at least yearly.
73. Clearly, the risk of many medical complications is
increased with obesity
Even Hippocrates wrote so many years ago:
“corpulence is not only a disease itself, but the harbinger
of others”