Anatomy of Brain by MRI
In this presentation we will discuss the cross sectional anatomy of brain. Then we will discuss the Most common diseases to be evaluated by brain imaging.
In my opinion this presentation is a road map for beginars.
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
Anatomy of Brain by MRI
In this presentation we will discuss the cross sectional anatomy of brain. Then we will discuss the Most common diseases to be evaluated by brain imaging.
In my opinion this presentation is a road map for beginars.
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
TUBEROUS SCLEROSIS
Cutaneous Features
Neurological Features
Retinal Features
Systemic Features
NEUROFIBROMATOSIS
Cutaneous Features of Neurofibromatosis Type 1
Systemic Features of Neurofibromatosis Type 1
Neurological Features in Neurofibromatosis Type 1
Clinical Features of Neurofibromatosis Type 2
STURGE-WEBER SYNDROME
Cutaneous Features
Ocular Features
Neurological Features
Diagnostic Studies
Treatment
VON HIPPEL-LINDAU SYNDROME
Neurological Features
Ocular Features
Systemic Features
Molecular Genetics
Treatment
HEREDITARY HEMORRHAGIC TELANGIECTASIA
Neurological Features
Treatment
HYPOMELANOSIS OF ITO
Cutaneous Features
Neurological Features
Systemic Features
INCONTINENTIA PIGMENTI
Cutaneous Features
Neurological Features
Genetics
ATAXIA-TELANGIECTASIA
Cutaneous Features
Neurological Features
Immunodeficiency and Cancer Risk
Laboratory Diagnosis
EPIDERMAL NEVUS SYNDROME
Cutaneous Features
Neurological Features
Other Features
Neuroimaging
NEUROCUTANEOUS MELANOSIS
Cutaneous Features
Neurological Features
Laboratory Findings
Neuroimaging
EHLERS-DANLOS SYNDROME
Neurovascular Features
CEREBROTENDINOUS XANTHOMATOSIS
Neurological Features
Xanthomas
Other Clinical Features
Treatment
PROGRESSIVE FACIAL HEMIATROPHY
Clinical Features
KINKY HAIR SYNDROME (MENKES DISEASE)
Cutaneous Features
Other Clinical Features
Neurological Features
Neuroimaging
Genetic Studies
Diagnosis and Treatment
XERODERMA PIGMENTOSUM
Complementation Groups
Related Syndromes
Cutaneous and Ocular Features
Treatment
OTHER NEUROLOGICAL CONDITIONS WITH CUTANEOUS
MANIFESTATIONS
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.
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.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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
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.
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
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.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
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.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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
- 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
2. Epilepsyis a chronic neurological disorder characterized by
spontaneous and recurrent seizures due to excessive and
abnormal electrical activity of cortical neurons. It affects about
1% of population.
Epilepsy diagnosis is purely clinical but neuroimaging,
especially structural magnetic resonance (MR), plays a key role
to rule out (and characterize) anatomic abnormalities and for
treatment planning.
Seizures are divided into generalized and partial. Generalized
seizures usually originate in both cerebral hemispheres and
most of them have a good response to antiepileptic drugs.
Partial seizures (focal) most likely originate in one anatomical
region and are classified as simple (when there is no loss of
consciousness) and complex (when loss of consciousness is
associated).
3.
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10. The role of CT in the assessment of epilepsy has considerably
diminished and is viewed as supplementary or supportive.
CT can be used as an initial screening method for excluding a brain
neoplasm as a cause for seizure activity, but usually MRI is more
appropriate in addition to avoiding irradiation.
CT is ideal for identifying the presence and extent of intracranial
calcification, but this has a limited impact on patient management.
CT is not as sensitive as MRI at identifying small lesions and more
subtle structural changes such as those involving the temporal
lobe and focal cerebral dysplasia.
There is also a role in the acute phase of status epilepticus, when
cerebral edema secondary to hypoxia or anoxia is suspected.
C.T
11. Hippocampal sclerosis (mesial temporal sclerosis).
Mesial temporal sclerosis is the most common epileptogenic
abnormality found after surgery in several series of epilepsy (65%)
and the most important cause of refractory epilepsy.
The most important MRI findings in hippocampal sclerosis are
atrophy and increased signal intensity in long TR sequences . There
are also other findings that we should look for because, although
they are less important, they can help us to support the diagnosis.
These findings are: the loss of the internal hippocampus
architecture (which is best viewed with 3T machines), fornix and
ipsilateral mammillary body atrophy (usually long-standing cases),
ipsilateral temporal horn dilation, decreased of para-hippocampal
white matter and reduced temporal lobe volume. In 8-20% cases of
hippocampal sclerosis, dual pathology will be found, i.e.
hippocampal sclerosis associated to other epileptogenic lesion,
which is usually located outside the hippocampus.
12. Lesions most commonly associated are cortical
development abnormalities, but tumours, post-
traumatic gliosis or infectious residual lesions can
be found. In up to 65% of cases of hippocampal
sclerosis, white matter of the temporal pole has a
subtle signal alteration (hyperintensity signal on
FLAIR images) sometimes with gray-white matter
junction blurred. It is important to identify these
structural alterations that may be associated with
hippocampal sclerosis because lesionectomy and
hipocampectomía (when possible) have a greater
benefit in seizure control.
18. Malformations of cortical development (MCD)
Second cause of anatomic abnormality found in surgical series of
patients with chronic epilepsy. MCD are particularly common
when the beginning of the crisis occurs in childhood. They occur as
a result of defects in the different phases of cortical development:
1. Proliferation / Apoptosis of neuroblasts from the germinal
matrix.
2. Migration (radial, tangential).
3. Organization of the cortex in sheets with neural network and
synapses formation.
About 15% of patients with MCD have seizures refractory to
medical treatment and surgery may be the definitive treatment. In
the case of diffuse alterations, surgical treatment is ineffective,
contrary to focal lesions. In general, the degree of damage is
related to the extension of the malformation.
Barcovich classification of MCD provides four groups depending on
the stage of development predominantly affected:
21. GROUP I (malformations due to abnormal proliferation or apoptosis).
- MICROCEPHALY.
It may be primary (genetic) or secondary.
- HEMIMEGALOENCEPHALY (HE).
FOCAL CORTICAL DYSPLASIA (FCD) TYPE II. It associated with
subtle focal changes which sometimes apparent microscopically. Seizures
with type 11 FCD is high. Type1 FCD may or not present with epilepsy.
- TUBEROUS SCLEROSIS.
AD inherited disorder with classic clinical triad: facial
angiofibromas, mental retardation
and refractory seizures. Underlying pathogenetic: cortical tubers,
subependymal nodules and subependymal giant cell astrocytomas.
- TUMORS.
Ganglioglioma. Desmoplastic infantile ganglioglioma.
Gangliocytoma.
Disembrioplastic neuroepithelial tumour.
22. Extreme Microcephaly, Diffuse Agyria, Agenesis of Corpus Callosum,
Cerebellar Hypoplasia with Dandy-Walker Malformation:
23. Hemimegalencephaly with enlarged, dysmorphic LT. hemisphere, enlarged l
left lateral ventricle with heterotopia and abnormal white matter.
28. GROUP II (malformations due to abnormal neuronal
migration).
- LISSENCEPHALY.
MCD caused by the arrest of neuronal migration
developing cerebral cortical thickening
and smooth surface. Important overlap with band
heterotopy. In image, particularly MRI,
the cerebral hemispheres appear as "eight" or "hourglass"
Number of cortical sulci separated by broad gyres,
enlarged ventricles, truncated arborisation of the white
matter. In infants, on T2 weighted-images can
distinguish three layers:
31. HETEROTOPYS (HT).
Alteration / arrest migration of groups of neurons from the
periventricular germinal zone to the cortex, appearing as gray
substance anywhere outside the cortex, from the ventricles to the
meningeal coating, with size, morphology and location variable:
1. Periventricular / subependymal nodular HT (the most common). Uni
or multifocal asymmetric indentation.
2. Band HT ("double cortex"). Symmetric thick band of subcortical gray
matter.
3. Subcortical nodular HT.
• Isolated nodules. Thin surface cortex often.
• "Mass" of white matter that continues the cortex and the ventricular
surface.
4. Periventricular and subcortical HT associated.
CT and MRI show heterotopys similar to the cortex in density and signal
intensity respectively . The ipsilateral hemisphere is small and the
lateral ventricle is usually large due to underdevelopment of white
matter.
32. GROUP III (malformations due to abnormal cortical
organization)
- POLYMICROGYRIA.
MDC due to an anomaly in the late stages of neuronal
migration and cortical organization.
Convolutions formed are numerous, small, prominent and
irregular. T2-weighted MRI
has two patterns:
• <12 months: cortex with fine and small ripples, normal
thickness.
•> 18 months: thick and irregular cortex, increase of
Virchow-Robin spaces and variable cortical invagination.
41. - SCHIZENCEPHALY (E).
Alteration in cortical organization characterized by the presence of
clefts in the cerebral parenchyma, which extend from the cortical
surface to the ventricular system coating
with dysplastic gray matter. Often associated with polymicrogyria,
heterotopy and microcephaly. There are two types:
• E. "Closed lip": walls oppose one another, obliterating the
subarachnoid space. Irregular
gray matter cord extending from the cortical surface to the
ventricle.
• E. "Open-lip": CSF fills the cleft from the lateral ventricle to the
subarachnoid space.
At MRI gray matter coating can be more difficult to distinguish
from that in the "closed Lip”
The most common location is close to the pre and post-central
gyrus. More often is unilateral than bilateral. Venous
developmental anomalies are common in the cleft.
44. FOCAL CORTICAL DYSPLASIA (FCD) TYPE I.
It is characterized by greater extension than the type II,
affects more than one lobe and associates loss of white
matter volume, without thickening or distortion the
cortical pattern. Juxtacortical white matter shows
discrete increase signal intensity especially in FLAIR and
effacement of the SG / SB union differentiation. These
findings are more difficult to detect than in type II FCD.
It is most commonly located in the temporal lobe and
may be associated with mesial sclerosis (dual
pathology). The surgical outcome is worse due to its
greatest extent and worse definition.
50. Neoplasms.
The neoplasms may also cause drug-resistant epilepsy. About 90% of
neoplasms that produce seizures will be located next to the cerebral cortex
and of these, 70% are located in the temporal lobes. They tend to be low-
grade neoplasm and slow growth usually without edema or mass effect
associated. They can produce thinning or remodeling adjacent calvarium.
Enhancement after intravenous contrast is common but may not be present.
Oligodendroglioma, ganglioglioma (neoplasm associated with
chronic epilepsy in children and young adults and that may be
associated with focal cortical dysplasia), DNET or pleomorphic
xanthoastrocytoma.
Hypothalamic hamartoma is another neoplasm that is typically
associated with gelastic epilepsy in childhood. It usually has similar
signal intensity to gray matter on all pulse sequences and typically
does not enhance after administration of intravenous contrast.
Epileptogenic hypothalamic hamartoma always affects the
mammillary bodies and also often the tuber cinereum .
56. Vascular malformations (VM).
VM represent 5% of lesions found in series of patients
with chronic epilepsy. Mainly arteriovenous
malformations (AVMs) and cavernous malformations .
To explain the seizures that occur in patients with
AVMs two phenomena have been postulated:
1. Focal cerebral ischemia due to a steal phenomenon
due to arteriovenous shunt.
2. Gliosis and hemosiderin deposits in the parenchyma
due to subclinical bleeding.
The sensitivity of MRI in detection is nearly 100%.
59. Gliosis / Miscellaneous.
Gliosis is the end state of several injuries that can affect the central
nervous system, mainly: trauma, infection and stroke. The findings
are nonspecific at MRI although usually hyper-signal areas often are
present in long TR sequences, associated with loss of volume sings
(such as grooves widening and ventricular retraction) and
encephalomaly areas. Emphasize the stroke as most common cause
of epilepsy in the elderly.
There are many other diseases that can cause seizures.
-Parenchymal infectious processes (encephalitis, abscesses) with
or without meningeal involvement: may present with seizures.
- The Sturge-Weber syndrome or pial angiomatosis.
Rasmussen's encephalitis: Childhood typical chronic encephalitis
characterized by partial motor seizures and progressive cognitive and
neurological deterioration; in image is characterized by a progressive
unilateral cerebral cortical atrophy.