This document outlines a 3-point plan to reduce the burden of prostate cancer: 1) Integrate available information to calculate individual risk; 2) Use modern diagnostic imaging and biopsy techniques; 3) Treatment for early prostate cancer in the right patient reduces mortality. It discusses using risk calculators and family history to determine risk, multiparametric MRI and PCA3 testing to accurately diagnose cancer, and robotic surgery for high-grade tumors to improve cancer control, continence and potency outcomes. The goal is to precisely diagnose and treat those who will benefit from intervention to reduce death rates.
Mills-Peninsula Health Services 2013 Cancer Symposium presentation - Brad Ekstrand, MD/PhD, California Cancer Care Mills-Peninsula Health Services San Mateo, CA
Treatment for Prostate Cancer | Robotic Surgery | Robotic Prostatectomy | Pla...Mark Allen
Dr. Mark Allen is a Plano Texas urologist who offers the da Vinci robotic prostatectomy surgery for the removal of prostate cancer. This treatment for prostate cancer has proven to be effective in reducing the side effects following surgery including less scarring, less pain, and faster overall recovery.
Role of Prostate Health Index in the changing landscape of prostate cancer di...Lincoln Tan
The prostate health index is superior to PSA and %fPSA, and can be integrated with MRI in predicting who needs prostate biopsies, and sparing men from unnecessary biopsies.
Kidney Cancer Treatment in Chennai | Cancer Specialist in Tamil NaduDr. Balamurugan
Check our website : www.cancer-treatment-madurai.com
Guru Multispecialty Hospital, Madurai is a comprehensive cancer center with state-of-the-art technologies. It is one of the largest cancer centers in Tamil Nadu – with a unique commitment to provide world-class cancer care to everyone in need.
Know more @ : https://www.cancer-treatment-madurai.com/types-of-cancer-kidney-cancer.html
Dr. Samadi performs robotic prostate cancer surgery using the da Vinci robotic system. This minimally invasive procedure employs the latest advancements in robotics and computer technology to completely remove the cancerous prostate.
Mills-Peninsula Health Services 2013 Cancer Symposium presentation - Brad Ekstrand, MD/PhD, California Cancer Care Mills-Peninsula Health Services San Mateo, CA
Treatment for Prostate Cancer | Robotic Surgery | Robotic Prostatectomy | Pla...Mark Allen
Dr. Mark Allen is a Plano Texas urologist who offers the da Vinci robotic prostatectomy surgery for the removal of prostate cancer. This treatment for prostate cancer has proven to be effective in reducing the side effects following surgery including less scarring, less pain, and faster overall recovery.
Role of Prostate Health Index in the changing landscape of prostate cancer di...Lincoln Tan
The prostate health index is superior to PSA and %fPSA, and can be integrated with MRI in predicting who needs prostate biopsies, and sparing men from unnecessary biopsies.
Kidney Cancer Treatment in Chennai | Cancer Specialist in Tamil NaduDr. Balamurugan
Check our website : www.cancer-treatment-madurai.com
Guru Multispecialty Hospital, Madurai is a comprehensive cancer center with state-of-the-art technologies. It is one of the largest cancer centers in Tamil Nadu – with a unique commitment to provide world-class cancer care to everyone in need.
Know more @ : https://www.cancer-treatment-madurai.com/types-of-cancer-kidney-cancer.html
Dr. Samadi performs robotic prostate cancer surgery using the da Vinci robotic system. This minimally invasive procedure employs the latest advancements in robotics and computer technology to completely remove the cancerous prostate.
Prostate cancer - diagnosis using prostate cancer risk calculators, multiparametric MRI, MRI-targeted transperineal prostate biopsies using software registration
EAU - Guidelines on Prostate Cancer dr. ali mujtabaDr Ali MUJTABA
EAU - Guidelines on Prostate Cancer Organ Confined by Dr. Ali Mujtaba, Sindh Institute of Urology and Transplantation (SIUT)
https://www.youtube.com/watch?v=kXX9ItF4as4
https://www.youtube.com/watch?v=0m4YUI6Rr5w
Acute and chronic prostatitis presentation IDF Malaga Marc Laniado
A 10 minute talk I did on the chronic prostatitis, which is also known as the chronic pelvic pain syndrome to doctors at the Independent Doctors Federation meeting.
Prolaris to help make treatment decisions in localised prostate cancerMarc Laniado
Prolaris is a biomarker that predicts the behaviour of prostate cancer better than conventional variables (e.g. PSA, Gleason score, stage). It can be used to help select patients for conservative or radical prostatectomy or radiotherapy
BPH treatments that safer, preserve ejaculation and help urinary symptoms due...Marc Laniado
Presentation at Independent Doctors Forum (IDF) meeting in Verbier on treatments to improve urinary symptoms that have developed in last few years and reduce side-effects including UroLift, laser prostatectomy, Rezum and Cialis
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
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
6. Follow this 3 point plan to reduce the burden of prostate cancer Integrate available information to calculate risk Use modern diagnostic imaging and biopsy reliable minimally invasive technique
18. What are these men’s risk of disease? 55 years old white male, No family history Prostate feels abnormal PSA 0.3 no prior bx, recommendation? – Biopsy, right? 68 years old African American Man, Positive family of Pca Normal feeling prostate PSA 2.4 no prior biopsy Recommendation?- Biopsy, No?
19. Calculator is more accurate predictor Any prostate cancer=13% High grade cancer=1% Any prostate cancer=31% High grade cancer=11%
26. PCA3 is the best single test for prostate cancer Digital Rectal Examination Prostate cancer cells shed in urine Ca Norm BPH PCA3 RNA PSA RNA Quantitative Northern Blot for PCA3
27. PCA3 is not affected by inflammation or prostate size, so can use in big prostates and UTIs
39. Follow this 3 point plan to reduce the burden of prostate cancer Integrate available information to calculate risk Use modern diagnostic imaging and biopsy reliable minimally invasive technique
Editor's Notes
In men aged <65 years, death rate after 10 years Watchful waiting ~20% Radical Prostatectomy ~10%NNT=10Absolute risk reduction 0.59 (CI 0.41 to 0.84, P=0.004)…Over 65 years, no difference in death rates…1989 to 1999: Recruitment periodRandomised 695 men (Scandinavia)Mean age 65 yearsNon-screen detectedIntermediate Risk Group regarding PC: Palpable tumours: ie clinical stage T2 (75%), PSA 9 (median)Gleason score 6 (median, biopsy) Excluded high grade prostate cancerLymph node positive 10%Mean follow up 8 yearsCause of death evaluated blind Holmberg, Bill-Axelson, NEJM 2002, 2005; JNCI 2008
If we look at the US, where PCa diagnosis and treatment is more aggressive, there has been a signifcantly faster fall in the rate of diagnosis of prostate cancer.Age-specific and age-adjusted prostate-cancer mortality peaked in the early 1990s at almost identical rates in both countries, but age-adjusted mortality in the USA subsequently declined after 1994 by –4·17% (95% CI –4·34 to –3·99) each year, four-times the rate of decline in the UK after 1992 (–1·14% [–1·44 to –0·84]). The mortality decline in the USA was greatest and most sustained in patients aged 75 years or older (–5·32% [–8·23 to –2·32]), whereas death rates had plateaued in this age group in the UK by 2000. The mean ratio of USA to UK age-adjusted prostate-cancer incidence rates in 1975–2003 was 2·5, with a pronounced peak around the time that PSA testing was introduced in the USA. Numbers needed to treat to prevent one death from prostate cancer were 33 000 in the 55–64-year age group.Interpretation The striking decline in prostate-cancer mortality in the USA compared with the UK in 1994–2004 coincided with much higher uptake of PSA screening in the USA. Explanations for the diff erent trends in mortality include the possibility of an early effect of initial screening rounds on men with more aggressive asymptomaticdisease in the USA, diff erent approaches to treatment in the two countries, and bias related to the misattribution of cause of death. Speculation over the role of screening will continue until evidence from randomised controlled trials is published.Age Adjust PC Mortality rates: USA v UKAge-specific and age-adjusted prostate-cancer mortality peaked 1990s identical rates in UK & USAAge-adjusted mortality declined after 1992-1994By –4% each year US By -1% each year UKCollin 2008 Lancet Oncology
Using PSA alone, 1410 men need to be screened to save one life at 9 yearsCompares Favorably With Other Cancer ScreeningAt 14 years of follow-up, the number who needed to be invited to screening (NNS) to prevent 1 prostate cancer death was 293, whereas the number needed to be diagnosed (corresponding to number needed to treat, NNT) was 12, the Swedish researchers report.These outcomes compare favourably with the well-established screening programs for breast and colorectal cancer."These outcomes compare favourably with the well-established screening programs for breast and colorectal cancer," Dr. Neal comments in the editorial.In their article, the Swedish researchers cite several papers for comparable figures.Mammography for breast cancer screening has reported a NNS of 377 and an RR of 0.68 for women aged 60 to 69 years, and an NNS of 1339 and RR of 0.86 for women aged 50 to 59 years at 11 to 20 years of follow-up. A separate review reported an NNT for mammography of 10 over 10 years.Colorectal cancer screening by fecal occult blood test has reported an RR of 0.84 in 2 separate reviews (after 11.7 - 18.4 years and 7.8 - 13 years, respectively), and an NNS of 1173 after 10 years.Colorectal cancer screening by flexible sigmoidoscopy has reported an RR of 0.69 and an NNS of 489 at median follow-up of 11.2 years. However, as sigmoidoscopy removes any polyps that are found, it is associated with a reduced colorectal cancer incidence, and so an NNT cannot be calculated.
reater number of biopsy cores increased the risk of cancer (odds ratio for >6- versus 6-core biopsy, 1.35; 95% confidence interval, 1.18-1.54; P < 0.0005); recent screening led to a smaller increase in risk per unit change in PSA (P = 0.001 for interaction term) and U.S. cohorts had higher risk than the European cohorts (2.14; 95% confidence interval, 1.99-2.30; P < 0.0005).CONCLUSIONS: Our results suggest that the relationship between PSA and risk of a positive prostate biopsy varies, both in terms of the probability of prostate cancer at a given PSA value and the shape of the risk curvClin Cancer Res. 2010 Sep 1;16(17):4374-81. Epub 2010 Aug 24.The relationship between prostate-specific antigen and prostate cancer risk: the Prostate Biopsy Collaborative Group.Vickers AJ, Cronin AM, Roobol MJ, Hugosson J, Jones JS, Kattan MW, Klein E, Hamdy F, Neal D, Donovan J, Parekh DJ, Ankerst D, Bartsch G, Klocker H, Horninger W, Benchikh A, Salama G, Villers A, Freedland SJ, Moreira DM, SchröderFH,Lilja H.
The PCPT riskcalculator seems to be more suitable forpatients in whom previous DRE and PSAresults are available, and the ERSPC riskcalculator seems to be more suitable for newpatients in whom no information has beencollected before use, except for not havingprostate cancer.Refer urgently patients:l with a hard, irregular prostate typical of a prostate carcinoma. Prostate-specific antigen(PSA) should be measured and the result should accompany the referral. (An urgentreferral is not needed if the prostate is simply enlarged and the PSA is in the age-specificreference range6.) lCl with a normal prostate, but rising/raised age-specific PSA, with or without lower urinarytract symptoms. (In patients compromised by other comorbidities, a discussion with thepatient or carers and/or a specialist may be more appropriate.) lCl with symptoms and high PSA levelsThe age-specific cut-off PSA measurements recommended by the Prostate Cancer Risk Management Programme are asfollows: aged 50–59 >–3.0 ng/ml; aged 60–69 >–4.0 ng/ml; aged 70 and over >–5.0 ng/ml. (Note that there are no age-specificreference ranges for men over 80 years. Nearly all men of this age have at least a focus of cancer in the prostate. Prostatecancer only needs to be diagnosed in this age group if it is likely to need palliative treatment.)
ON conventional T1 and T2 MRI20-40% of significant tumours are missedmany false positives (with inflammation, hemorrhage and scarring mimicking tumour)post-biopsy hemorrhage can last for up to 3 monthsAdding contrast and diffusion sequences takes the sensitivity of MRI to over 90% for significant tumour, including in the transition zone, and without the need for an endorectal coil4Contrast and diffusion also enable us to reliably exclude disease in a third to a half of patients who do not have a significant tumourAhmed Nature Reviews Clinical Oncology