Vitreous hemorrhage is the extravasation, or leakage, of blood into the areas in and around the vitreous humor of the eye.[1] The vitreous humor is the clear gel that fills the space between the lens and the retina of the eye. A variety of conditions can result in blood leaking into the vitreous humor, which can cause impaired vision, floaters, and photopsia.
It's an indepth presentation by Dr. Shah-Noor Hassan.
Vitreous hemorrhage is the extravasation, or leakage, of blood into the areas in and around the vitreous humor of the eye.[1] The vitreous humor is the clear gel that fills the space between the lens and the retina of the eye. A variety of conditions can result in blood leaking into the vitreous humor, which can cause impaired vision, floaters, and photopsia.
It's an indepth presentation by Dr. Shah-Noor Hassan.
This presentation describes the background of the cornea and the corneal diseases in general, also it describes in detailed manner how to manage the corneal ulcer with its different causes
This presentation describes the background of the cornea and the corneal diseases in general, also it describes in detailed manner how to manage the corneal ulcer with its different causes
Pterygium Excision with Free Conjunctival Limbal Autograftiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Pathogenesis and management of macular holes with video demonstration.pptxAvuru James
management of macular holes surgeries, Nigeria, traumatic macular hole, atrophic.macular hole, primary macular hole macular hole surgery in nigeria, Vitreos an retinal, atrophic holes, traumatic macular holes, myopic Schisis, retinoscisis, parsplana vitrectomy, internal limiting membrane peeling, epiretinal membrane peeling, air fluid exchange, internal limiting membrane staining dye, west african college of surgeons, vitreoretinal surgery, national post graduate medical college of Nogeria, residency training.
A DISSERTATION ON
“COMPARISION OF RESIDUAL ASTIGMATISM
FOLLOWING CONJUNCTIVAL AUTOGRAFT AFTER PTERYGIUM EXCISION, SUTURE VERSUS FIBRIN GLUE”
by Optom. Ankit Varshney.
Background: Nowadays, ICRS are a step in the treatment of keratoconus. The purpose of this study was to evaluate the refractive effect and the tomographic and biomechanical parameters in keratoconus patients implanted with Ferrara ICRS, and their stability after 18 months.
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
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
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.
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.
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
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.
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
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
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3. Aetiology
1) Growth disorder characterised by conjunctivalisation
of the cornea due to
localised ultraviolet induced damage to the
limbal stem cells.
2 ) Aggressive pterygial fibroblasts are also
responsible for corneal invasiveness.
4. Grading/staging
Grade 1-- midway between
limbus and pupil border
Grade2-- extends up to pupil
border
Grade 3-- crosses pupil
Indian J Ophthalmol. 2007:Pterygium-induced
corneal refractive changes; Sejal Maheshwari,
11. Literature
Clinical study- Fernandes et al
Analysis of pterygium outcomes over 14 years
CAG – an effective modality for primary and
recurrent pterygia
Bare sclera technique- unacceptably high recurrence
rates
Comparison among CAG/CLAG/AMG requires more
prospective studies
12.
13. Why CAU ?
Excellent cosmesis and
low recurrence .
Risks of MMC:
Scleral necrosis,
Cataract, perforation,
glaucoma
Need long term studies
to justify the routine use
in pterygium surgery
14. Recurrence
Conjunctival autograft (CAU)– 12.2%
AMG -26.7%
CLAU ( Conjunctivolimbal autograft)-17.3%
Bare Sclera- 19.4%
M.Fernandes : Outcome of pterygium surgery: analysis over 14 years.
Eye(2005)1182-1190
Bare sclera +MMC- 0 to 38%
Bare sclera -24% to 89 %
CAU- 2 to 39 %
Donald T H Tan: Conjunctival autograft. Ocular Surface Disease and Management. 175-
193
15. Risk factors for recurrence
Young males ( age below 40)
Recurrent ones
Morphology ( fleshiness of pterygium)
.
Tan DT et al .Effect of pterygium morphology on pterygium recurrence in a
controlled trial comparing conjunctival autografting with bare sclera excision.
Arch Ophthalmol. 1997 Oct;115(10):1235-40
16. Surgical technique
Steps and principles
1) Complete removal of pterygium at Bowmans plane
and scleral surfaces
2) Harvesting and suturing in place a thin, Tenon
free conj graft of adequate size
18. Surgical technique
Anaesthesia- Peribulbar block
GA –recurrent pterygium with marked muscle
restriction and scarring
Exposure- SR bridle / corneal traction suture at 12 o
clock
Excision- initiate at neck /body not too far from
limbus
19. Surgical technique
Using the beaver microblade pterygium can be peeled
from the sclera and limbus
Detach all pterygium in one piece, no remnant tissue
tags on the cornea
Where it is deeply adherent in the stroma, avoid deep
dissection and tissue loss near head of pterygium
20. Recurrent pterygium
Isolation of recti muscles
More difficult surgery
Dissection of scar tissue around the muscle is
necessary
Release of symblepharon
Best performed by an experienced ocular surface
surgeon
21. Graft harvesting
Conjuctival autograft harvested from the superior site
, ensuring a superficial ,tenon free dissection and
adequate size to account for retraction
Cautery should be avoided on the graft
Maintain graft orientation
22. SECURING GRAFT
10-0 Nylon sutures
8-0 Vicryl sutures
Fibrin glue
superior to sutures and has almost replaced sutures
in pterygium surgery
Pan HW, Zhong JX, Jing CX. Comparison of fibrin glue versus
suture for conjunctival autografting in pterygium surgery: a
meta-analysis. Ophthalmology. 2011 Jun;118(6):1049-54
23. FIBRIN GLUE
Significantly lesser operating time
Lesser post operative discomfort
Less recurrence
No increased risk of complications
.
Uy HS, Reyes JM, Flores JD, Lim-Bon-Siong R. Comparison of fibrin glue
and sutures for attaching conjunctival autografts after pterygium
excision. Ophthalmology. 2005 Apr;112(4):667-71
.
Ratnalingam V Fibrin adhesive is better than sutures in pterygium
surgery. Cornea. 2010 May;29(5):485-9.
24. Post op regime
Topical steroids( Prednisolone eye drops) qid tapered
over 4 weeks
Topical antibiotics for one week
Tear substitutes
Review on POD 1, 7 and one month
28. Late post op complications
Conjunctival scarring at
the donor site
Steroid induced ocular
hypertension
Astigmatism and
scarring
SINS- very rare
Jain V et al .Surgically induced
necrotizing scleritis after pterygium
surgery with conjunctival autograft.
Cornea 2008. Jul 27(6): 720-1