Dr. Anitha and Dr. Santhosh presented on types and pathophysiology of respiratory failure. They discussed oxygen diffusion from alveoli to tissues and factors affecting it like diffusion distance and membrane thickness. They described four zones in the lung based on relative pressures and types of ventilation/perfusion mismatch including physiological, anatomical and pathological shunts. Equations for calculating shunt fraction were provided. Dead space and its types were also mentioned.
The Mousetrap is an immersive bar experience that utilizes three distinct environments that each pull from the events of the three main climaxes of Shakespeare’s Hamlet.
This was a project completed as part of a group. My contribution included the logo design and mock-ups, an exterior facade mock-up, and a complete physical mock-up of the drink menu, which is found within a weathered book of shakespeare's poems.
The Mousetrap is an immersive bar experience that utilizes three distinct environments that each pull from the events of the three main climaxes of Shakespeare’s Hamlet.
This was a project completed as part of a group. My contribution included the logo design and mock-ups, an exterior facade mock-up, and a complete physical mock-up of the drink menu, which is found within a weathered book of shakespeare's poems.
Anestesia multimodal, una vista hacia la Ginecología.pptxJazminDiazSoria1
una vista de el manejo de el dolor desde el punto de vista anestésico, mejoría en tratamiento y prevención de dolor en pacientes obstétricas, anestesia multimodal.
Walif Chbeir: Medical Imaging of PneumoThorax (PNO)–3Walif Chbeir
Dr. Walif Chbeir outlines in detail the medical imaging practice and diagnostic approach of pneumothorax (also known as PNO). This is the third in a four-part piece on PNO by Chbeir.
Capnography is a simple non-invasive monitoring technique that provides prompt and valuable information about patient’s ventilation, perfusion and metabolism. We are presenting a case of a 10 year-old boy
with a history of repaired Tetralogy of Fallot (TOF) undergoing a cardiac catheterization for recurrent left pulmonary artery (LPA) stenosis. A variable plateau capnogram waverform was detected and attributed
to ventilation-perfusion abnormalities from differential lung perfusion secondary to critical LPA stenosis. Capnogram can prove vital monitoring tool in detecting critical perfusion abnormalities.
Dr. Amit kumar Suresh Rathi*, Dr. Vinod Gite, Dr. Kanchan Rahul Tadke
ABSTRACT- INTRODUCTION: Hoarseness of voice is a very common symptom seen in the ENT outpatient department. Vocal cord palsy due to cardiac diseases and conditions are very less reported .Ortners syndrome or cardiovocal syndrome is one of it, which constitutes hoarseness of voice due to left recurrent laryngeal nerve involvement in cardiovascular disease.
CASE REPORT : A 40 year old lady was referred to ENT outpatient department by the physicians for hoarseness of voice. Patient had hoarseness since 10months; there was no history of smoking, alcohol abuse, voice abuse or upper respiratory tract infection. On complete ENT examination including the indirect laryngoscopy left vocal cord was found to be immobile. Other ENT examination was normal.
DISCUSSION: Hoarseness of voice due to paralysis of the left recurrent laryngeal nerve caused by a dilated left atrium in mitral stenosis was first discussed by Nobert Ortner, a Viennese physician, in1897. He explained that hoarseness was caused by compression of the left recurrent laryngeal nerve by the enlarged left atrium. Later it was described with other identifiable cardiovascular diseases associated either with left atrial enlargement including mitral regurgitation and atrial myxoma or severe pulmonary hypertension including congenital heart diseases. For this reason it is also known as cardiovocal syndrome.
CONCLUSION: For an ENT surgeon, in a case of clinical fix, when all possible causes of the vocal cord palsy are ruled out, a complete cardiovascular examination should be sought.
Key-words: Ortners syndrome, Left recurrent laryngeal nerve palsy, Mitral stenosis, Cardiovocal syndrome
Anestesia multimodal, una vista hacia la Ginecología.pptxJazminDiazSoria1
una vista de el manejo de el dolor desde el punto de vista anestésico, mejoría en tratamiento y prevención de dolor en pacientes obstétricas, anestesia multimodal.
Walif Chbeir: Medical Imaging of PneumoThorax (PNO)–3Walif Chbeir
Dr. Walif Chbeir outlines in detail the medical imaging practice and diagnostic approach of pneumothorax (also known as PNO). This is the third in a four-part piece on PNO by Chbeir.
Capnography is a simple non-invasive monitoring technique that provides prompt and valuable information about patient’s ventilation, perfusion and metabolism. We are presenting a case of a 10 year-old boy
with a history of repaired Tetralogy of Fallot (TOF) undergoing a cardiac catheterization for recurrent left pulmonary artery (LPA) stenosis. A variable plateau capnogram waverform was detected and attributed
to ventilation-perfusion abnormalities from differential lung perfusion secondary to critical LPA stenosis. Capnogram can prove vital monitoring tool in detecting critical perfusion abnormalities.
Dr. Amit kumar Suresh Rathi*, Dr. Vinod Gite, Dr. Kanchan Rahul Tadke
ABSTRACT- INTRODUCTION: Hoarseness of voice is a very common symptom seen in the ENT outpatient department. Vocal cord palsy due to cardiac diseases and conditions are very less reported .Ortners syndrome or cardiovocal syndrome is one of it, which constitutes hoarseness of voice due to left recurrent laryngeal nerve involvement in cardiovascular disease.
CASE REPORT : A 40 year old lady was referred to ENT outpatient department by the physicians for hoarseness of voice. Patient had hoarseness since 10months; there was no history of smoking, alcohol abuse, voice abuse or upper respiratory tract infection. On complete ENT examination including the indirect laryngoscopy left vocal cord was found to be immobile. Other ENT examination was normal.
DISCUSSION: Hoarseness of voice due to paralysis of the left recurrent laryngeal nerve caused by a dilated left atrium in mitral stenosis was first discussed by Nobert Ortner, a Viennese physician, in1897. He explained that hoarseness was caused by compression of the left recurrent laryngeal nerve by the enlarged left atrium. Later it was described with other identifiable cardiovascular diseases associated either with left atrial enlargement including mitral regurgitation and atrial myxoma or severe pulmonary hypertension including congenital heart diseases. For this reason it is also known as cardiovocal syndrome.
CONCLUSION: For an ENT surgeon, in a case of clinical fix, when all possible causes of the vocal cord palsy are ruled out, a complete cardiovascular examination should be sought.
Key-words: Ortners syndrome, Left recurrent laryngeal nerve palsy, Mitral stenosis, Cardiovocal syndrome
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
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
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
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
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
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.
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
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
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.
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10. Endcapillary blood
Essentially the same as alveolar gas, in health
Arterial blood
Diluted by venous admixture= PaO2 of 92 mmHg
The difference between alveolar and arterial gas is the A-a gradient
Normal A-a gradient is 7mmHg in the young, and 14mmHg in the
old
Tissue oxygen tension
Drops due to diffusion distance
Varies from tissue to tissue, but is usually around 10-30 mmHg
Mitochondrial oxygen tension
Drops due to diffusion distance
Usually between 1-10 mmHg
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15. Increase in the diffusion distance between the alveolar space
and the capillary lumen,
-Reduction in the total alveolar surface area
-Reduction in the capillary transit time
Increased membrane thickness
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18. The lung can be divided into discrete regions according to the
interplay between alveolar pressure, arterial pressure and venous
pressure.
These regions are:
Zone 1, where alveolar pressure is higher than arterial or venous
pressure;
Zone 2, where the alveolar pressure is lower than the arterial but
higher than the venous pressure
Zone 3, where both arterial and venous pressure is higher than
alveolar
Zone 4, where the interstitial pressure is higher than alveolar and
pulmonary venous pressure (but not pulmonary arterial pressure)
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22. Physiological shunt:
Anatomical shunt
Bronchial veins
Thebesian veins
Functional shunt
V/Q scatter
Pathological shunt:
Intracardiac shunt
Pulmonary AVM
Intrapulmonary shunt (true shunt)
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23. Shunt fraction is the calculated ratio of venous admixture to total
cardiac output
The shunt equation, otherwise known as the Berggren equation,
is used to calculate the shunt fraction:
Qs/Qt = (CcO2 - CaO2) / (CcO2 - CvO2)
where
Qs/Qt = shunt fraction (shunt flow divided by total cardiac
output)
CcO2 = pulmonary end-capillary O2 content, same as alveolar
O2 content
CaO2 = arterial O2 content
CvO2 = mixed venous O2 content
CaO2 = (Hgb * 1.34 * SaO2/100) + ( 0.0031* PaO2)
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Editor's Notes
The primary abnormality is located in one of three sites: 1) inadequately oxygenated alveoli (due to low FiO2 and/or alveolar collapse and/or the presence of alveoli filled with fluid, cells, debris, or blood); 2) compromised transition of oxygen from the alveoli to the blood (due to interstitial processes or pulmonary vascular disease); or 3) compromised ability of the blood to become oxygenated (due to obstructed blood flow, shunting, low Hgb concentration, or the presence of dysfunctional Hgb)
