Everything you wanna know about Chagas disease and Trypanosoma cruzi in a nutshell, including the morphology and life-cycle of the parasite ,diagnosis treatment and prophylaxis of Chagas disease.
Everything you wanna know about Chagas disease and Trypanosoma cruzi in a nutshell, including the morphology and life-cycle of the parasite ,diagnosis treatment and prophylaxis of Chagas disease.
LUMEN DWELLING FLAGELLATES - GIARDIA
REFS:
INTERNATIONALLY ACCEPTED BOOK OF MEDICAL PARASITOLOGY BY K. D. CHATTERJEE
TEXT BOOK OF MEDICAL PARASITOLOGY BY PANIKER
IMAGE SOURCES : FROM INTERNET
LUMEN DWELLING FLAGELLATES - GIARDIA
REFS:
INTERNATIONALLY ACCEPTED BOOK OF MEDICAL PARASITOLOGY BY K. D. CHATTERJEE
TEXT BOOK OF MEDICAL PARASITOLOGY BY PANIKER
IMAGE SOURCES : FROM INTERNET
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
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.
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
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
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.
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
- 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
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2. 2
Name of species Areas of Bangladesh Where
the species are found
Type of Malaria
P. vivax Flat lands Benign tertian malaria
P. falciparum Hilly areas like Chittagong,
Sylhet, Mymensingh,
Jamalpur Sherpur etc.
Malignant tertian
malaria
P. ovale Not found in Bangladesh Tertian malaria
P. malariae Not done in Bangladesh Quartan malaria
3. Hosts:
Its life cycle passes through two different hosts :
1. Intermediate host (a vertebrate- man or other animals) –
Asexual multiplication (schizogony) takes place
Sexual multiplication (gametogony) starts and gives rise
to gametocytes (infective to definitive host).
2. Definitive host (an invertebrate - female Anopheles mosquito)
–
Sexual multiplication (sporogony) takes place and gives rise
to Sporozoites (infective to intermediate host).
3
4. Pathogenesis of Malaria:
Agent: Plasmodium.
Host: Human.
Name of clinical illness: Malaria.
Vector – Infected female Anopheles mosquito.
Infective form: Usually sporozoites but trophozoites also can
infect.
Reservoir: Infected children. In Africa , monkeys are reservoir of
P. malariae.
Source of infection: Mainly saliva of infected female anopheles
mosquito containing sporozoites. Also infected blood of man
containing trophozoites.
4
5. Mode of transmission:
By sporozoites: Bite of infected female Anopheles
mosquito containing sporozoites in their salivary glands.
By trophozoites:
Transfusion of blood from a person containing
trophozoites.
Transplacental transmission.
Using infected needles/syringes among IVDU.
5
Sporozoites-induced Malaria Trophozoites-induced
Malaria
Route of entry Mosquito bite Blood transfusion
Pre-erythrocytic schizogony Present Absent
Hepatomegaly Occurs Does not occur
Incubation Period Long Short
Exo-erythrocytic
schizogony
Present Absent
Relapse May occur Do not occur
Schizonticidal drugs No radical cure because of the
presence of E.E. forms.
Can be radically cured; no E.E.
forms
6. Incubation period:
In P. vivax , P. falciparum & P. ovale – 10-14 days
In P. malariae – 18 days – 6 weeks
Evolution of the disease in human 4 stages occur.
Pre-Erythrocytic schizogony (in hepatocytes):
o Consists of only 1 cycle which takes 8 days in P. vivax, 6 days in P.
falciparum and 9 days in P. ovale and P. malariae.
o Parasites pass through trophozoites schizonts and merozoites.
o Liberated merozoites are of 2 types, micromerozoites and
macromerozoites.
o Micromerozoites invades RBC while macromerozoites re enter
into hepatocytes.
o Neither any pathological change nor any clinical features are seen
in this stage.
o Person is not infectious for the mosquitoes.
6
7. Erythrocytic schizogony (in RBCs):
o Micromerozoites enter into RBC and pass through trophozoites,
schizont and merozoite.
o Each cycle lasts for 48 hrs in P. vivax, P. ovale, and P. falciparum
whereas it is 72 hrs in P. malariae.
o This phase is responsible development of clinical features of
malaria.
o The liberated merozoites re enter into new RBC and the cycle
continue for several times.
o After several cycles, the liberated merozoites loose their capacity
to re invade RBC and begin gametogenesis.
7
8. Gametogony (in RBCs inside the capillaries of internal organs
– spleen, bone marrow):
o After several cycles in RBC, parasites develops gametocytes capable
of sexual cycle.
o It takes 4 days to form mature gametocytes .
o 2 types of gametocytes are formed – male gametocyte
(microgametocyte) & female gametocyte (macrogametocyte)
o Gametocytes are not responsible for fever.
o The individual who hourbours gametocytes is known as carrier.
Exo -Erythrocytic schizogony (in hepatocytes):
o Occurs only in P. vivax and P. ovale.
o The parasite in this stage is known as hypnozoite.
o Hypnozoite can be transformed into merozoite at any time.
o Erythrocytic parasite can not transformed into hypnozoite.
o Hypnozoite is responsible for relapse of malaria in P. vivax and P.
ovale.
8
10. Persistence of infection:
1.Recrudescence:
Infection persists inside RBC.
Occurs due to incomplete treatment of falciparum malaria
Low level of parasitaemia continues even after clinical infection is
over.
It may occur up to 1 year.
2.Relapse:
Infection (hypnozoites) persists inside the hepatocyte.
Occurs in P. vivax and P. ovale.
No parasite is found in blood.
May occur up to 2 years.
10
11. Life cycle of Plasmodium in mosquito
To infect a mosquito, human blood must contain at least 12
gametocytes per mm3
of blood.
A female anopheles mosquito bites a carrier for blood meal and
takes up asexual & sexual forms (micro & macrogametocyte) of
the parasite.
In the gut of mosquito, the asexual forms die out but the sexual
forms (micro & macrogametocyte) mature to form male
(microgamete) and female (macrogametocyte) gametes.
In the mid gut of mosquito, one microgametocyte give rise to 5-
8 microgametes and one macrogametocyte to one
macrogamete.
One microgamete fertilizes one macrogamete and zygote is
formed. In the next 24 hours, zygote converts into Öokinete
which migrates outside the mucosa of midgut and becomes
Öocyst .
11
12. Inside Öocyst, nucleus divides and becomes a sporozoite (100 -
1000).
The Öocyst ruptures and sporozoites are released into the body
fluid of mosquito.
The released sporozoites migrate in various organs (except
ovary) specially to the salivary glands & salivary ducts .
This mosquito is now infective to man & spreads the infection.
The incubation period in mosquitoes is about 8- 16 days.
12
13. P. vivax P. falciparum
Form of
plasmodium
All form of plasmodium is
present
Only ring form of trophozoites and
crescent shaped gametocyte is present.
Site of infection Infects only in immature
RBC(Reticulocyte cell)
Infects RBC of all ages.
Rate of infection Usually infection does not exceed
2% (Reticulocyte count is <2%),
sometimes it may become 5%.
Infections of RBC usually exceeds 20-
30% sometimes even 90%.
Relapse May occur up to 2 years Does not occur
Recrudescence Does not occur May occur up to 1 year
RBC size in
peripheral blood
Enlarged almost double than
normal RBC
RBC size is not enlarged
6.Multuple
infection
Never found. One parasite infects
one RBC
Multiple infection is common. Multiple
parasit infects one RBC
Acculi formation Not present Present
13
14. Clinical Features of Malaria
1. Febrile attack: It’s the periodic attacks of fever occurs due to
release of toxic metabolites of the parasite formed during each
erythrocytic schizogony. Each attacks of fever has 3 stages :
o Cold stage – A period of 20 min to 1 hr when a patient feels cold.
o Hot stage – A period of 1 to 4 hrs when a patient complains of
very high fever .
o Sweating stage – Fever spontaneously comes down over several
hours and the patient sweats profusely .
Types of malarial fever:
Malarial fever usually maintains a specific pattern except in falciparum
malaria. These patterns correlates with release of merozoites from
infected RBC. Malarial fevers are of following patterns –
o Benign tertian malaria:
Characterized by fever at every third day.
Caused by P. vivax.
Considered benign due to very low mortality. 14
15. oMalignant tertian malaria:
Caused by P. falciparum.
Fever has no specific pattern.
Considered malignant due to high parasitaemia, very high
mortality.
oOvale tertian:
Caused by P. ovale.
Fever appears in every 3rd
day
oQuartan fever:
Caused by P. malariae.
Fever appears in every 4th
day.
15
16. 2. Anaemia: Microcytic hypochromic anaemia occurs due to –
Massive breakdown of infected RBC.
Splenic removal of both infected and non infected RBC.
Auto immune breakdown of RBC.
Increased fragility of RBC.
Decreased life span of infected RBC.
Inappropriate incorporation of iron in to haem.
Bone marrow suppression.
3. Splenomegaly: Due to hypertrophy and hyperplasia of RES
16
18. 1. Cerebral malaria:
Erythrocytic schizogony occurs within the capillary of internal organs
like brain, kidney, suprarenal gland, spleen etc.
Increased stickiness of the membrane of Infected RBC which adheres to
the capillary of internal organ.
One infected RBC is surrounded by several non infected RBC which
forms rosette pattern
cerebral blood vessel produces anoxia, which stimulates macrophage
and release IL-1, TNF α and other cytokines and produces symptom.
18
19. 2. Black Water Fever:
Characterized by –
o Sudden massive intravascular hemolysis followed by
methaemoglobinaemia haemoglobinurea.
o Previously thought that quinine treatment causes this which is now
been proven wrong.
o Urine becomes coca cola colour.
Imported malaria /Airport Malaria / baggage malaria or taxi rank
malaria:
People who live around airport may be affected by malaria though that
area is non-endemic for malaria. There is not such a strong evidence
but a hypothesis that causing airport malaria. The hypothesis is
malaria spread by the airplane which transmit the vector from
endemic area to the airport area.
19
20. Laboratory diagnosis:
1. Direct evidence:
Microscopic Examination of peripheral blood film after staining by
Leishman stain.
Specimen is peripheral blood.
Blood must be collected during rising temperature or when
temperature has reached the peak.
2 types of peripheral blood films that can be prepared thin film and
thick film.
20
Thick film Thin film
More blood (4 drops) is taken Less blood is taken
Can be diagnosed in low
parasitaemia
Can not be diagnosed
Species can not be diagnosed Can be diagnosed
21. 2. Indirect Evidence :
Detection of antigen.
Detection of antibody.
Detection of nucleic acid sequence
Both the antigen and antibody are detected by Immune
Chromatography Test (ICT).
PCR can be done to detect specie.
Immune chromatographic test (ICT) – Routinely done, high sensitivity &
specificity, cheap, rapid, don’t require sophisticated or expensive
equipments or reagents, available in Bangladesh in some cases its
positive even in patients whose PBF don’t reveal any plasmodium.
21
22. There are a number of genetic factors that protect against malaria:
1. Lack of Duffy blood group antigen: Duffy blood group antigen on
RBC is the receptor for P. vivax. So any person lacking Duffy blood
group antigen is simultaneously resistant to P vivax infection. Found
in West Africans.
2. Protected sickle cell individuals: In sickle cell trait very low oxygen
tension causes parasite to die due to little ATPase activity which
causes low energy production
22
23. Chemoprophylaxix
Chloroquine
• Started at least 1 week before going to endemic area
• Once in every week during the time of staying
• After coming back it will be continued for 4-6 weeks
Doxycycline
• Started at 2-4 days before going to endemic area.
• In endemic area 150 mg daily at same time.
• After coming back it will be continued for 4-6 weeks.
23