DYSPNOEA IS DEFINED AS THE UNDUE AWARENESS OF UNPLEASANT BREATHING.WHEN THERE IS AMIS MATCH BETWEEN THE AFFERENT VENTILATORY SIGNALS AND THE EFFERENT RESPIRATORY SIGNALS IN THE BRAIN WE MAY GET AN UNIGNORABLE FEELING FOR NEED OF MORE AND MORE OXYGEN.
DYSPNOEA IS DEFINED AS THE UNDUE AWARENESS OF UNPLEASANT BREATHING.WHEN THERE IS AMIS MATCH BETWEEN THE AFFERENT VENTILATORY SIGNALS AND THE EFFERENT RESPIRATORY SIGNALS IN THE BRAIN WE MAY GET AN UNIGNORABLE FEELING FOR NEED OF MORE AND MORE OXYGEN.
The health hazards associated with obesity. Mortality morbidity
Complications related to obesity
type 2 diabetes.
high blood pressure.
heart disease and strokes.
certain types of cancer.
sleep apnea.
osteoarthritis.
fatty liver disease.
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
- 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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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.
Follow us on: Pinterest
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
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.
2. Pulmonary vascular diseases
Pulmonary vascular diseases are a
heterogeneous group of disorders with
multiple causes. Pulmonary vascular
disorders are caused by conditions that
directly affect the pulmonary vessels, as in
idiopathic pulmonary arterial hypertension
(IPAH), or by disorders outside of the lung, as
in pulmonary hypertension associated with
lung disease and hypoxemia.
3. Review of Respiratory CirculationReview of Respiratory Circulation
The pulmonary circulation consists of arteries, capillariesThe pulmonary circulation consists of arteries, capillaries
and veins.and veins.
The major role of the pulmonary circulation is to bring bloodThe major role of the pulmonary circulation is to bring blood
in to close proximity to air, so that gas exchange can occur.in to close proximity to air, so that gas exchange can occur.
The pulmonary vascular bed receives the entire cardiac output.The pulmonary vascular bed receives the entire cardiac output.
-high volume/low pressure system.-high volume/low pressure system.
Pulmonary Circulation:Pulmonary Circulation:
Bronchial Circulation:Bronchial Circulation:
• The bronchial arteries typically originate off aorta and supplyThe bronchial arteries typically originate off aorta and supply
airways (2% of cardiac output).airways (2% of cardiac output).
-low volume/high pressure.-low volume/high pressure.
• 1/3 of blood flow through the bronchial circulation empties into1/3 of blood flow through the bronchial circulation empties into
azygous vein.azygous vein.
• 2/3 of blood flow empties into pulmonary capillaries (broncho-2/3 of blood flow empties into pulmonary capillaries (broncho-
–pulmonary anastamoses).pulmonary anastamoses).
4. Pulmonary Hypertension
Which is defined as mean pulmonary artery
pressure over 25 mm Hg at rest or over 30
mm Hg with exercise.
In Pulmonary Hypertension there is:
1. Enlarged proximal pulmonary arteries,
2. Right ventricular hypertrophy
3. Right atrial dilation
5. Chamber Pressures in PAH
55
>30>30
Mean >24 at rest, >30 with exercise
PCWP <15 mmHg
6. Pathophysiology of PHTN
Hypoxemia causes vasoconstriction
Decreased perfusion worsens hypoxemia
Hypoxic alveoli cause arterioles to
vasocontrict further to preserve VQ matching
Pulmonary pressures increase and become
sustained
Right ventricle works harder, develops
hypertrophy and overload
16. Primary pulmonary hypertension
Defined as Pulmonary htn in the absence of
other disease of lungs or heart.
Develops: Young and middle aged women
Characterized by right heart failure, leading to
death in 2-8 yrs.
B/c of low cardiac output:
1. Weakness, fatigue, edema, ascites. Syncope
17. On Examination
Inspection:
1. Prominent JVP
2. Cyanosis
Palpation:
1. Left parasternal heave due to RVH
2. Systolic pulsation in 2nd
ICS due to dilated
pulmonary artery
18. Auscultation:
1. Loud pulmonary component of 2nd
heart sound
2. Systolic ejection click and flow murmur in
pulmonary area
3. Right ventricular S4
4. Advanced cases, tricuspid and pulmonary
regurgitation and signs of cor pulmonale are
found
19. Studies in Pulmonary HypertensionStudies in Pulmonary Hypertension
ECG: Right Ventricular Hypertrophy.
CXR: Dilated main pulmonary arteries/pruning of
peripheral vascular markings.
ABG: Hypoxemia with exertion.
PFT’s: Findings c/w underlying disease;
Decreased DLCO.
Echocardiogram:
Right heart catheterization:
Pulmonary Pressure MeasurementPulmonary Pressure Measurement
27. Risk Factors for Poor Prognosis
Age at presentation > 45 years
Functional class III or IV
Pericardial effusion
Large right atrial size
Elevated right atrial pressure
Septal shift during diastole
Increased BNP level
Failure to improve to a lower functional
class during treatment
28. Diagnostic Approach to Pulmonary HypertensionDiagnostic Approach to Pulmonary Hypertension
History and Physical Exam often suggestive.
ECG and echocardiogram: elevated pulmonary
pressures.
Right heart catheterization ± pulmonary angiography.
Identify treatable causes of secondary pulmonary
hypertension.
Hypoxemia (at rest or at night, with sleep apnea).
Chronic Thromboembolic Disease.
29. Routine Medical Treatments
Continuous oxygen
Pulmonary artery vasodilator
Anticoagulants
Treat and prevent thrombosis
Diuretics / Low Salt Diet
Decrease RA pressures
Treat right heart failure
Digoxin
Increases cardiac output
30. Routine Medical Treatments
Calcium channel blockers
Lowers pulmonary artery pressure
May improve right heart cardiac output
Exercise
Immunization
Prevent pulmonary infections
Opportunistic Infection Prophylaxis
Patients on immunosuppression (ILD)
31. Surgical Therapies
Pulmonary thromboendarterectomy
Correct mitral stenosis
Repair left to right shunt (ASD, VSD)
Atrial septosotomy to relieve RHF
when PA pressure exceeds systemic pressure
Lung transplantation
for advanced PHTN not responsive to medical therapy
~1,000 lung transplants/year in US
Heart / lung transplantation
32. Who Should Receive Advanced Medical
Therapy?
Group 1 (PAH) rarely respond to primary
therapies
Group 2 (cardiac abnormalities) usually
worsen with advanced therapies
Group 3 (COPD) respond to oxygen
therapy
Group 4 (thromboembolic) respond to
thrombectomy and anticoagulation
Group 5 unknown effects of advanced
therapies, primary therapy indicated
33. Treatment of Pulmonary HypertensionTreatment of Pulmonary Hypertension
Treat underlying disease.Treat underlying disease.
Oxygen supplementation- minimize hypoxicOxygen supplementation- minimize hypoxic
vasoconstriction.vasoconstriction.
Long term anticoagulation (even when not due to chronic PE).Long term anticoagulation (even when not due to chronic PE).
Vasodilators especially for primary pulmonary hypertension:Vasodilators especially for primary pulmonary hypertension:
Calcium channel blockers.Calcium channel blockers.
Prostacyclin.Prostacyclin.
Endothelin receptor blockers (Bosentan).Endothelin receptor blockers (Bosentan).
TransplantationTransplantation
34. Secondary pulmonary HTN
Hypoxia of any cause is the most important
stimulus of Pulmonary arterial vasoconstriction
leading to pulmonary HTN
Chronic lung disease
Chronic bronchitis/ Emphysema /Lung fibrosis
Increased pulmonary blood flow:
Left or right shunt: ASD, VSD, PDA
Increased pulmonary venous pressure:
Mitral stenosis/ Left ventricular failure/ Mitral
regurgitation/ Pulmonary thromboembolic disease
35. Treat the cause
Supplemental Oxygen for atleast 15hrs/ day
in patients with COPD
Inhaled NO
Anticoagulation: To dissolve small pulmonary
emboli
37. Clinical features
Dyspnea/ Cyanosis/ Clubbing/ Weakness
Features of Right heart failure:
1. Raised JVP
2. Right ventricular heave
3. Murmurs of pulmonary and tricuspid
regurgitation maybe present
38. Investigations:
CXR: Right ventricular enlargement and right
atrial dilation. Prominent pulmonary artery
ECG: Right ventricular hypertrophy
demonstrates right ventricular hypertrophy (right
axis deviation, possibly a dominant R wave in
lead V1, and inverted T waves in right
precordial leads) and a right atrial abnormality
(tall peaked P waves in lead II)
ECHOCARDIOGRAPHY:
Right ventricular dilation
39. Chest radiography
Signs of pulmonary hypertension:
Enlarged right descending pulmonary artery with diameter
≥15mm
The ratio of the diameter of right descending pulmonary
artery to trachea≥1.07
Bulge of pulmonary artery/with the height≥3mm
dilation of the main pulmonary artery and its branches
with concurrent underperfusion of the peripheral branches
Signs of right ventricular enlargement
Signs of underlying diseases and infection
In PAH, the pulmonary artery becomes stiff and narrow. The right ventricle has to work harder and harder to push blood through the narrow artery. When this happens, less and less blood is able to flow out into the body, and more and more symptoms of PAH begin to appear
Due to diseases that localize to small pulmonary arterioles
Slide 14 Summary---BM minhas if this helps!!
RVH, tall R in V1, tall S waves in V5-6, inverted T V1-3, peaked T in II
Uses sound waves to show the function of the right ventricle, to measure blood flow through the heart valves, and then calculate the systolic pulmonary artery pressure.