This document discusses precancerous lesions and conditions of the oral cavity. It defines precancerous lesions as morphologically altered tissues with a higher risk of developing cancer, and precancerous conditions as generalized states associated with significantly increased cancer risk. Examples of precancerous lesions include leukoplakia, erythroplakia, and speckled leukoplakia. Oral submucous fibrosis and sideropenic dysphagia are examples of precancerous conditions. Risk factors for oral cancer development from these lesions include tobacco, alcohol, infections and nutritional deficiencies. Screening, early identification and treatment can help prevent progression to oral squamous cell carcinoma.
Introduction
Epidemiology
Etiology
Manifestations
TNM staging
Squamous cell carcinoma is defined as malignant epithelial neoplasm exhibiting squamous differentiation as characterised by the formation of keratin and/or the presence of intercellular bridges.
( Pindborg et al, 1997).
Introduction
Epidemiology
Etiology
Manifestations
TNM staging
Squamous cell carcinoma is defined as malignant epithelial neoplasm exhibiting squamous differentiation as characterised by the formation of keratin and/or the presence of intercellular bridges.
( Pindborg et al, 1997).
Includes most common tumors of oral cavity including scc,bcc, melanoma, ameloblastoma, odontoma, fibromas, pindborg tumors etc.
Presented by Dr. Binaya Subedi
AIDS is defined as a condition indicative of a defect in cell-mediated immunity occurring in a person with no known cause for immunodeficiency other than the presence of HIV.
CDC defined AIDS as
“The occurrence of one or more group of life-threatening opportunistic infections, malignancies, neurologic diseases and other specific illness in patients with HIV infection or with CD4 counts less than 200/cu mm”
Erythema multiforme, Steven-Johnson syndrome and Toxic Epidermal NecrolysisBinaya Subedi
Erythema Multiforme is a common Vesiculobullous deramtological condition with mucosal manifestations trigged by Herpes virus infection and certain sulpha containing drugs.
Includes most common tumors of oral cavity including scc,bcc, melanoma, ameloblastoma, odontoma, fibromas, pindborg tumors etc.
Presented by Dr. Binaya Subedi
AIDS is defined as a condition indicative of a defect in cell-mediated immunity occurring in a person with no known cause for immunodeficiency other than the presence of HIV.
CDC defined AIDS as
“The occurrence of one or more group of life-threatening opportunistic infections, malignancies, neurologic diseases and other specific illness in patients with HIV infection or with CD4 counts less than 200/cu mm”
Erythema multiforme, Steven-Johnson syndrome and Toxic Epidermal NecrolysisBinaya Subedi
Erythema Multiforme is a common Vesiculobullous deramtological condition with mucosal manifestations trigged by Herpes virus infection and certain sulpha containing drugs.
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 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
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.
- 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
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
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.
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.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
2. PRECANCEROUS LESION
• It’s a morphologically altered tissue in which cancer is
more likely to occur than in its apparently normal
counterpart
• E.g. erythroplakia
3. PRECANCEROUS CONDITIONS
• Its a generalized state associated with a significantly
increased risk of cancer developing.
• E.g. betel quid chewing
7. CLINICAL FEATURES
• Intrinsic white area
• Homogenous
• Wrinkled
• Verrucous
• Fissured
May vary from transparent and
thin to dense and thick
8. HISTOLOGICAL FEATURES
• Hyperkeratosis with or
without epithelial dysplasia
• Squamous cell carcinoma
• Dysplasia can be categorized
as mild, moderate and severe
9. ERYTHROPLAKIA
• It is relatively uncommon and
appears as a bright red patch
that is well defined from the
surrounding mucosa and has
a velvet-like surface texture
10. ERYTHROPLAKIA
• High incidence of cellular
atypia
• Atrophy of the epithelium
• Candida as primary or
secondary infection
• Biopsy is mandatory
11. SPECKLED LEUKOPLAKIA
• Variant of leukoplakia or
erythroplakia
• White nodular patches on
erythematous background
• Buccal mucosa involvement
16. PRECANCEROUS CONDITIONS
• Most Common Conditions
• Oral Sub mucous Fibrosis (OSF)
• Sidropenic Dysphagia
• Lichen Planus
• Less Common Conditions
• Discoid lupus erythematosus
• Tertiary Syphilis
17. ORAL SUBMUCOUS FIBROSIS
• Oral submucous fibrosis
(OSF) is a condition in
which fibrous tissue is
laid down in the corium
of the oral mucosa
18. ORAL SUBMUCOUS FIBROSIS
• Small vesicle > ulcers>
epithelial atrophy
• Stiffening of oral mucosa
• Difficulty opening the
mouth
• Marbled mucosal
19. ORAL SUBMUCOUS FIBROSIS
• Induced by chewing areca nut
• particularly common in Asian communities.
• Probably a genetic predisposition for OSF
• Have an increased risk of developing oral carcinoma
• There does not seem to be any satisfactory treatment for OSF
although intralesional steroids have been used.
• Primary prevention by reducing the use of areca nut products
would appear to be the best way forward to reduce the
incidence of OSF.
20. SIDEROPENIC DYSPHAGIA
• Also called Paterson Kelley syndrome
• Affects middle aged females having
iron deficiency
• Mucosa appear shiny red and atrophic
• Oral leukoplakia and oral carcinoma
can develop
26. TOBACCO USE
• Nicotine, ethanol and caffeine (frequently used)
• Betel quid
• Areca nut
• Betel leaf
• Lime
• Tobacco
• Catechu
27. ALCOHOL CONSUMPTION
• Independent risk factor for oral carcinoma
• Combined effect of alcohol and tobacco is greater
than individual effect of both
28. DIET & NUTRITIONAL STATUS
• Deficiency of vitamin A, E and C
• Lack of dietary iron
• Increased intake of red meat
30. MANAGEMENT OF ORAL CA
• Surgery
• Chemotherapy
• Combination of both
• Depends on
• Patient preference
• Biological age
• General health
• Site & staging of cancer
36. PREVENTION & MANAGEMENT
(OSTEORADIONECROSIS)
• Avoid trauma to the oral mucosa
• Arrange extractions before radiotherapy
• Conserve teeth if possible
• Extractions must be under antibiotic cover
• Rinse with chlorhexidine 0.2 %
• Consider the use of hyperbaric oxygen
37. PREVENTION OF ORAL CARCINOMA
•Primary
•Advice on stop smoking and chewing
tobacco
•Advise moderation of alcohol intake
•Dietary advice
38. PREVENTION OF ORAL CARCINOMA
•Secondary
• Screen entire oral mucosa
• Recognize abnormalities
• Identify candida infection
• Refer any suspicious lesion to hospital
39. PREVENTION OF ORAL CARCINOMA
•Tertiary
• Importance of routine intra oral & extra oral
examination
• Regular review
• Dietary advice
• Low threshold for referral
• Chemoprevention
