OCT is a great technology,Many ophthalmologist find very difficult to understand it ,SO I have tired to simplify it as much as possible .Hope everyone can understand now onwards the basic about OCT .
Every feedback s most welcomed sothat i can improve further in coming days
Please email your feedback to me in the following address
yourgyanu@gmail.com
These lectures has prepared for postgraduate student (Ophthalmology) according to the curriculum of Bangladesh College of Physician and Surgeons (BCPS) and Bangabondhu Sheikh Mujib Medical University (BSMMU) Bangladesh
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
OCT is a great technology,Many ophthalmologist find very difficult to understand it ,SO I have tired to simplify it as much as possible .Hope everyone can understand now onwards the basic about OCT .
Every feedback s most welcomed sothat i can improve further in coming days
Please email your feedback to me in the following address
yourgyanu@gmail.com
These lectures has prepared for postgraduate student (Ophthalmology) according to the curriculum of Bangladesh College of Physician and Surgeons (BCPS) and Bangabondhu Sheikh Mujib Medical University (BSMMU) Bangladesh
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
MACULAR FUNCTION TEST PRESENTATION VERY IMPVidhiMadrecha
The macular function test is very important test... To understand the maula dis function and amount of disfunction. It is very useful for Central and colour vision.
Intraocular Lens (IOL) power calculation is a crucial step in cataract surgery and certain refractive surgeries like phakic IOL implantation. The goal is to determine the appropriate power of the IOL to be implanted into the eye, ensuring that the patient achieves their desired postoperative visual outcome. Several formulas and methods are available for IOL power calculation, and the choice of formula depends on various factors, including the patient's eye measurements and the surgeon's preference. Here, we describe the basic principles and some commonly used formulas.
Ocular Biometry:
Ocular biometry is the process of measuring various dimensions of the eye, primarily the axial length, corneal power, and anterior chamber depth. These measurements are essential for accurate IOL power calculation and achieving the desired post-surgical refractive outcome. Here are the key components of ocular biometry:
Axial Length: This measurement determines the overall length of the eye, from the cornea's front surface to the retina's back surface. Axial length is a critical factor in IOL power calculation because it helps determine the eye's focusing power.
Corneal Power: The cornea is the transparent front surface of the eye, and its curvature affects the eye's refractive power. Corneal power is typically measured using techniques like keratometry or corneal topography. It helps account for the eye's astigmatism and assists in selecting the appropriate IOL.
some basic notions on how they are measured is explored here.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
2. Optical coherence tomography, or OCT is a
non- contact, noninvasive imaging technique
used to obtain high resolution 10 cross
sectional images of the retina and anterior
segment.
Reflected light is used instead of sound
waves.
Infrared ray of 830 nm with 78D internal lens.
3. OCT is based on low coherence (white light)
interference of electromagnetic waves, which
was initially used in the measurement of
optoelectronic components. And the first
biological application of low coherence
interferometry was in ophthalmic biometry.
Principle of OCT is based on Michaelson’s
interferometer.
4.
5.
6. TIME DOMAIN
A scan generated
sequentially, one pixel at a
time of 1.6 seconds.
Moving reference mirror
400 scans/sec
Resolution 10 microns
Slower than eye
movement
FOURIER DOMAIN
Entire A scan is generated
at once based on Fourier
transformation of
spectrometer analysis.
Stationary reference mirror
700,00 scans/sec
Resolution 5 microns
Faster than eye movement
7.
8. It is Non-Invasive technique and it gives
resolution level of <10 im which is of the level
of histopathology through light microscopy.
More resolution because of shorter
wavelength because of shorter wavelength
used as compared to ultrasound or light
waves.
OCT provides cross-sectional biopsy of the
tissue in-vivo.
9. It uses infrared radiation that does not get
focused by ocular refracting elements and does
not interfere with patient’s attention or cause
glare during testing or cause any photic retinal
injury.
OCT is the most suitable diagnostic tool to
ophthalmic use, as it not only images anterior
parts of the eye but posterior segment can also
be scanned because the light rays can easily
penetrate the ocular tissues.
10. Despite its varied usage OCT has certain
limitations like:
Clear ocular media is needed for better
performance
Minimum pupillary size of 4mm is required.
It is a costly apparatus.
11. Oct is used for diagnosis, monitoring,
quantitative and qualitative assessment of
macular pathology and is used in most of the
Vitreo-retinal conditions, some of them are
listed.
PosteriorVitreous Detachment (PVD)
Vitreo-MacularTraction Syndrome (VMT)
Asteriod Hyalosis
Intra-retinal Hemorrhage.
12. Macular Edema ( CME, CSME)
Macular Holes and cysts.
Epiretinal Membrane in Diabetic Retinopathy.
Central Serous Retinopathy.
Foveal thining in Retinitis Pigmentosa and in
Myopic Degeneration.
Age Related Macular Degeneration.
Post Retinal Detachment Surgery.
13. Following things need to observed in OCT:
Vitro-retinal interface.
RetinalThickness:
Increases: Edema,Traction.
Decreases: Foveal atrophy.
Reflectivity:
Hyper-reflective lesions: Hard
Exudates, Blood, Scars.
Hypo-reflective lesions: Serous Fluid, Hypo-
pigmented lesions of Retinal Pigment
Epithelium, Media Hazy.
14. Foveal Contour.
Continuity of tissues
Distinction between:
Serous fluid and blood.
Detachment of neurosensory retina & RPE.
15. Highly reflective structures are shown in bright
colures (white and red) .
Those with low reflectivity are represented by
dark colors (black and blue).
Intermediate reflectivity is shown Green.
24. Focal elevation of Retinal Pigment
Epithelium.
Large drusen shows irregular elevation of
Retinal Pigment Epithelium with shadow
from underlying choroid.
Large drusen carry high risk of Choroidal
Neo-Vascular Membrane.
25.
26.
27.
28.
29.
30. There are three type of macular hole we can
see:
Impending Macular Hole.
Lamellar Macular Hole.
FullThickness Macular Hole.
31.
32.
33.
34.
35.
36. OCT can be used to rapidly evaluate the
integrity of the RNFL and the macula for the
purpose of tracking disease progression, and
could also potentially be used to visualize
neuro protection.
37. The clinical indications of RNFL measurement
are:
A sensitive indicator of glaucomatous
damage.
Quantification of RNFL loss which is highly
correlated with visual field loss.
Quantification of diffuse loss of ganglionic
cells.
Identification of early focal defects
