Asthma in children can usually be diagnosed based on a detailed clinical history and physical examination in over 95% of cases. Spirometry may help diagnose bronchodilator-responsive airway obstruction, though results are not reliable in children under 5 years old. Impulse oscillometry can also measure airway resistance and reversibility. Chest imaging and other tests are not routinely needed but may help evaluate other potential causes of wheezing in difficult cases. An asthma diagnosis is made based on recurrent symptoms, family history of atopy, and response to bronchodilator treatment.
An old presentation that I made when I was an Intern in Pediatric department.
The presentation contains 71 slides. It discusses bronchial asthma in pediatric age group starting from the definition of bronchial asthma and its pathophysiology and ending by the management of acute attacks of asthma and long-term management of bronchial asthma patients.
Asthma in children & Infants: Symptoms and TreatmentEPIC Health
Asthma affects over 7 million children in the U.S, which is about 8.5% of the child population, making it one of the most common pediatric illnesses in the country.
An old presentation that I made when I was an Intern in Pediatric department.
The presentation contains 71 slides. It discusses bronchial asthma in pediatric age group starting from the definition of bronchial asthma and its pathophysiology and ending by the management of acute attacks of asthma and long-term management of bronchial asthma patients.
Asthma in children & Infants: Symptoms and TreatmentEPIC Health
Asthma affects over 7 million children in the U.S, which is about 8.5% of the child population, making it one of the most common pediatric illnesses in the country.
These lecture notes were prepared by Dr. Hamdi Turkey- Pulmonologist- Department of internal medicine - Taiz university
Do Not Forget To Visit Our Pages On Facebook on the following Links:
https://www.facebook.com/groups/569435236444761/
AND
https://www.facebook.com/groups/690331650977113/
This ppt will give you full description about the pulmonary function tests.it includes spirometry with graphs and in easy language so go through it. It also includes indication, contraindications, interpretations. You will find it easy as compare to others
Clinical features and investigations of asthma is explained in very simple wording and style. Easy to remember and present due to interesting pictures. Helpful for medical students, patients with asthma and knowledge seekers.
the scenario given at the start of ppt z nt interstitial lung diseases... its a similar diseases to it.... diagnose it urself to differniate it and hv better command over diffferntial diagnosis.
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.
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
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.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
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
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
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.
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.
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
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.
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
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. By Dr Hisham Alrabty
Pediatric consultant and pulmonologist
Tripoli teaching children hospital
3. There is no global consensus concerned
asthma diagnosis in children.
There is no a single test diagnostic to
asthma in children whatever was blood
,skin or imaging(radiological).
Asthma can be diagnosed in children aged
less than 2 years with exclusion of other
causes of recurrent wheeze like GERD.
Facts:
4. To diagnose asthma in children
you should pass by next steps:
Good history.
Clinical examination.
Some investigational procedures(peak
flow metry).
5. Personal history of asthma or allergy.
Recurrent wheeze and shortness of breath.
Bronchodilator use as nebulizer or syrup.
History of previous admission because of wheeze.
History of chronic cough certainly at night.
History of breathlessness on exercise.
Patient has eczema or AR.
Symptoms relieved by bronchodilators.
Symptoms exacerbated by cold last more than 10 days.
Symptoms got worse by either animal
dander,emotion,dust,smoke,drugs,dust mite.
from gina asthma booklet
History:
7. **By detailed history and clinical
evaluation we could diagnose
asthma in children in more than
95% of cases, the remaining 5% of
cases we could seek help of some
investigation/s .
8. It should not be done on routine basis for
each asthma episode only when we suspect
patient could have complication like
pneumothorax.
Chest x ray:
CBC:
High IgE and eosinophilia indicate the child is
allergic.
10. Results of pulmonary function testing are not reliable
in patients younger than 5 years.
In young children (3-6 y) and older children who are
unable to perform the conventional spirometry
maneuver, newer techniques, such as measurement
of airway resistance using impulse oscillometry
system, are used.
By which measurement of airway resistance before
and after a dose of inhaled bronchodilator may help
to diagnose bronchodilator-responsive airway
obstruction.
Pulmonary Function Tests:
12. In a typical case, an obstructive defect is present in
the form of normal forced vital capacity (FVC),
reduced forced expiratory volume in 1 second (FEV1),
and reduced forced expiratory flow more than 25-75%
of the FVC (FEF 25-75).
Documentation of reversibility of airway obstruction
after bronchodilator therapy is central to the
definition of asthma.
FEF 25-75 is a sensitive indicator of obstruction and
may be the only abnormality in a child with mild
disease.
Spirometry:
13. Patients with chronic persistent asthma
may have hyperinflation, as evidenced by an
increased total lung capacity (TLC) at
Plethysmography.
Increased residual volume (RV) and
functional residual capacity (FRC) with
normal TLC suggests air trapping.
Airway resistance is increased when
significant obstruction is present.
Plethysmography:
15. It could be measured before and after dose
of inhaled bronchodilator and if there were
improvement by 15% , it is asthma.
It can be used as monitor for asthma
control.
Peak expiratory flow merty:
16. In patient has history of exercise induced symptoms this
test could be done to establish diagnosis of asthma.
Done in kids age more than 6 yrs.
Baseline spirometry followed by exercise on treadmill or
bicycle till heart rate reaches 60% of predicted maximum
under monitor of ECG and pulse oxymeter.
Then spirometry done at 3.5,10,15 and 20 min interval.
Then assess reversibility of airway obstruction by
neb.bronchodilator.
Exercise challenge:
17. Either by use of inhaled methacholine or
histamine to induce wheeze in suspected
patient and they should be done by
experienced personnel in specialized labs.
It is neither applicable nor practical
certainly in children.
Positive response is 20% fall in FEV1.
Asthma provocative tests:
18. Either specific igE level in blood or skin
brick test both are done to recognize
the allergen/s patient is sensitized to,
in patients do not respond to
maximum treatment of chromic
asthma, both are not diagnostic.
Allergen detecting tests:
19. Measuring the fraction of exhaled nitric oxide
(FeNO) has proved useful as a noninvasive
marker of airway inflammation, in order to
guide adjustment of the dose of inhaled
corticosteroids.
in some patients, the FeNO rose before
significant exacerbations of the asthma.
Due to the high cost of equipment, FeNO
measurement is used primarily as a research
tool at present.
Fraction of Exhaled Nitric Oxide Testing:
20. Measuring the level of interleukin-5 in
exhaled breath condensate is a possible way
of titrating asthma progress, according to
one study.
In a longitudinal study of 40 asthmatic
children aged 6-16 years, asthma control
score and level of interleukin-5 were
significant predictors of an asthma
exacerbation..
Measuring the level of interleukin-5:
21. It will reveal infiltration with inflammatory cells,
narrowing of airway Lumina, bronchial and
bronchiolar epithelial denudation and mucus plugs.
Thickened basement membrane and airway
remodeling in form of severe subepithelial fibrosis
and smooth muscle hypertrophy or hyperplasia in
severe cases of chronic asthma.
Histological findings:
22. Like chest CT,
MRI, bronchoscopy, gatrograffin
study, sweat test, 24 ph
monitoring… all done to exclude
other causes of recurrent wheeze.
Other investigations:
23. Major criteria:
Parent with asthma.
Physician diagnosed atopic dermatitis.
Minor criteria:
Physician diagnosed allergic rhinitis.
Eosinophilia (>4%).
Wheezing apart from colds.
If the child has more than 4 episodes of wheezing per
year lasting more than 1 day affecting sleep with one
MAJOR or two MINOR criteria.
It is asthma upto this index…
Asthma Predictive Index: