Parkinson's disease is a neurodegenerative disorder caused by the loss of dopamine-producing neurons in the substantia nigra. The main symptoms are motor symptoms like tremors and rigidity, as well as non-motor symptoms like depression and sleep disorders. Diagnosis is based on the presence of cardinal motor features and there are no definitive medical tests. Current treatments aim to replace dopamine or stimulate dopamine receptors through drugs. Emerging treatments include gene therapy, stem cell therapy, deep brain stimulation surgery, and alternative therapies like acupuncture. Researchers are developing new drug formulations and therapies to better treat Parkinson's symptoms like bradykinesia and tremors that remain problematic.
Presentation during IFNR 2016.
Brief description with available evidence on various coma arousal therapy with an illustrative study for each therapy and recommendation for future.
Presentation during IFNR 2016.
Brief description with available evidence on various coma arousal therapy with an illustrative study for each therapy and recommendation for future.
Clinico pathologic case conference 2019, NeurologyPramod Krishnan
This presentation was part of the annual Clinico pathologic case conference of the Bengaluru Neurological Society for the year 2019. The case was provided by the Department of Neurology and pathology, NIMHANS, Bengaluru and i was the discussant. The clinical, radiological and investigation aspects of the case are discussed in detail and the final diagnosis based on histopathology was revealed in the end.
On the occasion of National Epilepsy Day 2014, Dr. V Natarajan gave a talk titled "New Trends in Epilepsy Management" at the Epilepsy Knowledge Forum in Chennai organised by Neurokrish & Trimed and Sponsored Medall.
Autoimmune Encephalitis is a particularly intimidating entity, as recognition of this disease can be delayed because diagnosis can involve ambiguous neurological symptoms, leading to detrimental long-term consequences. Auto-anti-bodies (NMDA,VGKC) can be found through serum lab tests, and magnetic resonance imaging can show inflammation, and spinal tap can reveal auto antibodies and other biomarkers in the cerebrospinal fluid that point to autoimmune encephalitis. Being that autoimmune encephalitis is a recently described diagnosis, there is still a tremendous amount of investigation to be done to discover the root causes of the disease, more anti-body essays need to be developed to discover all of the phenotypes, and the best most effective treatments need to be found to treat this mysterious disease.
Clinico pathologic case conference 2019, NeurologyPramod Krishnan
This presentation was part of the annual Clinico pathologic case conference of the Bengaluru Neurological Society for the year 2019. The case was provided by the Department of Neurology and pathology, NIMHANS, Bengaluru and i was the discussant. The clinical, radiological and investigation aspects of the case are discussed in detail and the final diagnosis based on histopathology was revealed in the end.
On the occasion of National Epilepsy Day 2014, Dr. V Natarajan gave a talk titled "New Trends in Epilepsy Management" at the Epilepsy Knowledge Forum in Chennai organised by Neurokrish & Trimed and Sponsored Medall.
Autoimmune Encephalitis is a particularly intimidating entity, as recognition of this disease can be delayed because diagnosis can involve ambiguous neurological symptoms, leading to detrimental long-term consequences. Auto-anti-bodies (NMDA,VGKC) can be found through serum lab tests, and magnetic resonance imaging can show inflammation, and spinal tap can reveal auto antibodies and other biomarkers in the cerebrospinal fluid that point to autoimmune encephalitis. Being that autoimmune encephalitis is a recently described diagnosis, there is still a tremendous amount of investigation to be done to discover the root causes of the disease, more anti-body essays need to be developed to discover all of the phenotypes, and the best most effective treatments need to be found to treat this mysterious disease.
Title- Parkinson's Disease- Current Breakthroughs and Insights .pptxAnimikhaGhosh
Welcome to today's presentation on "Parkinson's Disease: Current Breakthroughs and Insights." In the next 20 slides, we'll delve into the world of Parkinson's disease, a complex neurodegenerative disorder that impacts millions of lives worldwide. We will explore the latest advancements in understanding its underlying causes, diagnosing the condition, and developing innovative treatments. As we navigate through this presentation, you'll gain valuable insights into the ongoing research and breakthroughs that are shaping the landscape of Parkinson's disease management. Let's embark on this journey to uncover the significant progress being made in the fight against Parkinson's disease.
parkinson's disease by me ..........prakash mahala p.g. medical surgical nursing at himalayan college of nursing dehradun.......prakashjpmmahala@gmail.com
Advances in Management of Parkinson's DiseaseSultana Shaikh
Parkinson's disease [PD] is one of the most common neurodegenerative disorders. There have been significant recent advances in the understanding of the pathogenesis of the disease. There has also been a greater realization that the disorder may be associated with significant non-motor disturbances in addition to the more commonly recognized motor complications. There are many drugs like levodopa and carbidopa, ropinirole, pramipexole, rotigotine etc. and some MAO-B INHIBITOR like selegiline and rasagiline which are used in treatment of Parkinson’s disease. Some COMT INHIBITOR
and others drugs are also available and some herbs like turmeric, ginger, garlic etc. provides temporary relief from Parkinson’s disease. There are two vaccines which are under development for the treatment of Parkinson’s disease.
Parkinson's disease is a brain disorder that progressively affects a person’s ability to control body movements, caused by a disorder of certain nerve cells in a part of the brain that produces dopamine, a chemical messenger the brain uses to help direct and control body movement.
Early diagnosis of Parkinson's disease gives you the best chance of a longer, healthier life. This presentation covers the information about biomarkers for Parkinson Diseases which include biological, physiological and imagine candidate / novel biomarkers.
Module: Pharmacotherapy III
Module Coordinator: Dr. Arwa M. Amin Mostafa
Academic Level: Postgraduate, Master of Pharmacy in Clinical Pharmacy
School: Dubai Pharmacy College
Year of first presented in Class: 2018
This presentation is for Educational purpose. It has no commercial value associated with it.
Parkinson’s disease (PD):It is a progressive disorder of the central nervous system (CNS) with both motor and non-motor symptoms.
PD is a common disease that affects an estimated 1million American and an estimated 7 to 10 million people worldwide.
The prevalence of the disease is expected to increase substantially in the coming years due to the aging of the population.
The average age of onset is 50-60 years.
PATHOPHYSIOLOGY:
Parkinsonism is a generic term used to describe a group of disorders with primary disturbance in the dopamine system of basal ganglia (BG).
BG is a network of sub cortical nuclei consisting of caudate nucleus, putamen ,globus pallidus, and subthalamic nucleus with along with substantia nigra.
The BG engage in number of parallel circuit or loops ,only few of which are motor .
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.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
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.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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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.
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.
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
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
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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.
2. INTRODUCTION
• Parkinson disease is also known from ancient times but their symptoms
were discovered by JAMES Parkinson under the name of the shaking palsy.
In 1879 Charcot found the autonomic dysfunction as an additional feature.
• It is the most slowly progressive, age related , second most common
neurodegenerative disorder found all over the world , after Alzheimer's
disease with unknown a etiology.
• Loss of dopaminergic neuronal cell in the substantia nigra pars compacta in
the mid brain is the pathological hallmark of PD, which causes dopamine
depletion in the striatum , and the presence of intracytoplasmic inclusion
known as Lewy bodies in the remaining cell.
3. Etiology:
• Age : it mostly effects approximately 3% of the population over 66 year of the age.
• Genetic factor : in this factors may include genetic mutations, including alpha synuclein (SNCA),
Parkin, PINK, DJ-1 (PARK6), Leucine- rich repeat kinase 2(LRRK2) ,PARK9 , GBA , DNJC6 ,
SYNJ1, ATXN2, ATXN3, GCHI, DCTNI ect. several monogenic form of the disorder and of
number of genetic factor has been identified as the increasing risk to develop PD. Monogenic
forms, caused by a single mutation in a dominantly or recessively inherited gene, lead to 30% of
familial PD AND 3-5% of sporadic PD.
• Oxidative stress : free radicals have reactive oxygen and nitrogen species. Some of these substance
are normally produced during metabolism like superoxide anion , hydrogen peroxide nitric oxide ,
peroxynitrite, nitroxyl and hydroxy radical. Formation of these product can be responsible for the
damage of protein , DNA and lipid in cell.
4. • Environmental factors: Influence of environmental factor on
PD have shown undetermined results. The focus has been on
the effects of pesticide exposure and water borne risk factors.
Environmental factors plays the major role for the
development of PD. Result indicates that people living in rural
region using well as their water supply have a greater risk of
PD.
5.
6. SYMPTOMS OF PD
• Motor symptoms
• Tremor
• Rigidity
• Bradykinesia
• Non- motor symptoms
• Depression
• Psychosis and hallucination
• Sleep disorders.
7. DIAGNOSIS
• Diagnosis of PD is based on the etiology is difficult because of no single cause of PD. Like both
genetic and environmental factors involved in pathogenesis of PD.
• A study has revealed that earlier PD was diagnosed from pathological confirmation on autopsy of
Lewy body where accuracy was 82% while in neurological diagnosis accuracy rate was higher and
found to be at 91%.
• Parkinson’s disease is also based on the presence of the cardinal features of bradykinesia and
tremor. It is done by taking the careful history and physical examination.
• There are no definitive tests or imaging studies that confirm the diagnosis. Magnetic resonance
imaging of the brain or other tests may be appropriate in some patients, particularly those with
prominent gait abnormalities, to exclude other conditions, but are seldom necessary in a typical
case.
8. CLASSIFICATION
• Drugs affecting brain dopaminergic system:
a) Dopamine precursor : levodopa (1- dopa)
b) Peripheral decarboxylase inhibitors : carbidopa, benserazide.
c) Dopaminergic agonists : bromocriptine, ropinirole, pramipexole
d) MAO-B inhibitor : selegiline, rasagiline
e) COMT inhibitors : Entacapone, Tolcapone.
f) Glutamate antagonist: Amantadine.
• Drug affecting brain cholinergic system
a) central anticholinergics: trihexyphenidyl, Procyclidine, Biperidine.
b) Antihistaminic: Orphenadrine, Promethazine.
9. RECENT ADVANCES
TREATMENT
• The treatment of patients with PD realizes that disease progress slowly and treatment varies with
persons over years.
• Patients with PD require experienced and compassionate healthcare providers for proper
management and effective treatment, care taker should determine the appropriate medications,
regular exercise, a healthy diet, social engagement and cognitive activities, counselling and other
therapies.
• Monoamine oxide inhibitors: Selegiline a monoamine oxidase inhibitor is also used
to treat Parkinson's disease. The mechanism of Selegiline is to prolong the action of dopamine in
the striatum
10. • A study has shown that Selegiline not only improves the symptoms of Parkinson's disease but
also retards disease progression and exert a neuroprotective effect. A report suggest that, when
Selegiline is given in combination with L-DOPA there was 60% increase in mortality
compared with L-DOPA treatment alone.
• Analysis trials of selegiline for selegiline-treated patients didn’t confirm an excess of deaths
and a recent case-controlled study reported higher mortality in Parkinson's disease patients
compared with age-matched controls, but that mortality increment was not occur by taking
selegiline.
• Alternate therapy: Other than L-dopa treatment and MAO-inhibitors, few different
therapies are used to treat PD like catechol-O-methyl transferase (COMT) inhibitors,
dopamine agonists, anticholinergic agents, and amantadine.
• The dopamine agonist provides stimulate the dopamine receptor during the wearing off
period. Another approach is to use catechol-O-methyl transferase (COMT) inhibitors, results
in increase the bioavailability of dopamine by breakdown of its in periphery.
• Anticholinergic drugs such as benzhexol may be useful in early disease to treat tremor and
have limited efficacy and many side-effects.
11. • Surgical therapy: Surgery for PD is becoming increasingly available as new techniques of
electrical stimulation have been developed and the physiology of basal ganglia has been attained.
• The location of the stereotaxic target is the other critical factor that needs to be individualized for
each patient.
• For controlling tremor the thalamus, particularly the ventral intermediate nucleus, considered to be the
most successful target, but bradykinesia is not eliminated by this target; so stereotaxic thalamotomy is
not proven to be a good choice today.
• Expert team of neurosurgeon performed surgery at target specialty centers for patients with PD, to
monitor the target of operating procedure and to program the stimulators of procedure a
neurophysiologist and a neurologist is needed.
12. • Stem cell therapy: Stem cell technologies are therapeutic and current clinical option which
is widely used to investigate and treat neurodegenerative diseases.
• Various stem cell therapies are in pipeline and are develop to treat neurodegenerative diseases, in
which embryonic stem cells (ESCs), mesenchymal stem cells (MSCs), neural stem cells (NSCs)
and induced pluripotent stem cells (iPSCs) are the most common tools for regenerating the brain
cells.
• Dopaminergic (DA) neural cells in the substantia nigra pars compacta are lost in PD. Stem cell-
based therapies can be beneficial by acting through several mechanisms such as cell replacement,
trophic actions, mediating remyelination and modulation of inflammation.
13. • Acupuncture therapy: Acupuncture therapies are also now used as an alternative
treatment for PD and are proven to be effective.
• A report has shown that 63% of patients in Korea and 25% patient in Singapore with PD use
acupuncture as a complimentary therapy which treats well but did not alleviate the symptoms of
PD.
• If the treatment is follows in a manner like applying acupuncture on body or scalp acupoints for 1
hour twice per week in patients with disease improves the sleep and rest but not symptoms.
• Functional magnetic resonance imaging studies shown that if acupuncture is applied to the
Yanglinquan (GB34) acupoints stimulates the portions of putamen and primary motor cortex and
improves motor function. Furthermore, this therapy leads to improves glucose metabolism,
hemispheric regional blood flow in brain. Hence, acupuncture plays a vital role for patients with
PD in reducing the intellectual decline. However research and reports are in pipeline for more
betterment.
14. FUTURE TREATMENTS FOR PARKINSON’S
DISEASE
• Researchers have designed new formulations and drugs for the treatment of PD. Earlier therapies treat
few symptoms and few remains unprotect able results in partial treatment, bradykinesia and tremor are
the factors would not disappear even after treatment. So high effective treatment for bradykinesia and
tremor is required.
• A2a Antagonists (Istradefylline, Preladenant, SYN115).
• Adenosine 2a (A2a) receptor antagonists is a nondopaminergic medications which are under trials to the
effects in improving signs and symptoms of PD.
• They provide potential benefits over dopaminergic therapy and medications and may reduce the
dopaminergic side effects. These medications are used in different models to see the various effects