Urinary retention is defined as the inability to completely or partially empty the bladder. It can be caused by obstructions in the urinary tract like kidney stones or enlarged prostate, or by problems with the nerves that control urination. Symptoms include difficulty starting or fully emptying urine, abdominal pressure, and incontinence. Treatment depends on the cause but may involve catheterization to drain the bladder or surgery to remove obstructions. Chronic retention is when incomplete obstruction leads to large residual urine volumes and overflow incontinence.
here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control.
In this presentation I have shown the etiology, clinical features and treatment for both Phimosis & Paraphimosis. I have also showed various methods of circumcision for both infants and adults.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Urolithiasis is a common disease that is estimated to
produce medical costs of $2.1 billion per year in the United States alone.
Renal colic affects approximately 1.2 million people
each year in USA and accounts for approximately 1% of
all hospital admissions.
Most active emergency departments (EDs) manage
patients with acute renal colic every day.
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control.
In this presentation I have shown the etiology, clinical features and treatment for both Phimosis & Paraphimosis. I have also showed various methods of circumcision for both infants and adults.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Urolithiasis is a common disease that is estimated to
produce medical costs of $2.1 billion per year in the United States alone.
Renal colic affects approximately 1.2 million people
each year in USA and accounts for approximately 1% of
all hospital admissions.
Most active emergency departments (EDs) manage
patients with acute renal colic every day.
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
A benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hyperplasia and BPH.
Renal System - History Taking
By Dr. Usama Ragab Youssif
Lecturer of Medicine, Zagazig University
Email: usamaragab@medicine.zu.edu.eg, usama.ragab.zu@gmail.com
SlideShare: https://www.slideshare.net/dr4spring/
Facebook: https://www.facebook.com/doc.usama
Facebook Clinic: https://www.facebook.com/usamaclinic
Mobile: 00201000035863
- 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
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.
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.
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!
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
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.
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
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.
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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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Retention of urine
1. Retention of Urine
Dr Prabha Om
Professor Surgery
SMS Medical College, JAIPUR
2.
3. Definition
Urinary retention is defined as the inability to completely
or partially empty the bladder.
It is a sudden painful inability to urinate inspite of a full
bladder
Urinary retention, also known as ischuria, is a lack of ability to
urinate
Suffering from urinary retention means
you may be unable to start urination
, or if you are able to start, you can’t fully empty your
bladder.
4.
5. Normal micturition cycle:
A. Filling: Impulses from the CNS to
sympathetic and pudendal nerves
relax the bladder and close the outlet.
B. Voiding: Inhibition of sympathetic
and pudendal impulses.
Stimulation of parasympathetic (S2-4)
leads to detrusor contraction →
voiding in the absence of obstruction
6. Urinary retention is characterised by poor urinary stream
with intermittent flow, straining, a sense of incomplete
voiding and hesitancy (a delay between trying to urinate
and the flow actually beginning)
. As the bladder remains full causes incontinence,
nocturia (need to urinate at night) and high frequency.
Acute retention is a medical emergency, as the bladder may distend
(stretch) to enormous sizes and possibly tear if not dealt with quickly.
If the bladder distends enough it will begin to become painful.
The increase in pressure in the bladder can also
prevent urine entering from the ureters or
even cause urine to pass back up the ureters and
get into the kidneys, causing hydronephrosis
, and possibly pyonephrosis, kidney failure and sepsis.
A person should go straight to an emergency department as soon as
possible if unable to urinate when having a painfully full bladder.
7. Anuria means nonpassage of urine,
in practice is defined as passage of less than
50 milliliters of urine in a day
Anuria is complete absence of urine production by the kidney
for 12 hours or more.
Oliguria is decreased urine volume to less than 400 ml in a day.
. Anuria is often caused by failure in the function of kidneys.
It may also occur because of some severe obstruction
like kidney stones or tumours.
It may occur with end stage renal disease.
It is a more extreme reduction than oliguria,
sometimes called anuresis.
8. Causes
There are two general types of urinary retention:
obstructive and non-obstructive.
If there is an obstruction (for example,
kidney stone urine cannot flow freely through
the urinary tract
. Non-obstructive causes include a weak bladder
muscle and nerve problems that interfere with
signals between the brain and the bladder.
If the nerves aren’t working properly,
the brain may not get the message
that the bladder is full.
9. Causes of non-obstructive urinary retention are:
•Stroke
•Vaginal childbirth
•Pelvic injury or trauma
•Impaired muscle or nerve function due to
medication or anesthesia
•Accidents that injure the brain or spinal cord
10. Obstructive retention may result from:
•Cancer
•Kidney or bladder stones
•Enlarged prostate (BPH) in men
11. Causes:
A. Mechanical or obstructive:
1- Bladder:
- Stone, bladder neck obstruction,
cancer.
2- Prostate:
- BPH is the most common cause in
men over 50 years.
- Acute prostatitis and abscess.
- Prostate cancer.
12. 3- Urethra:
-Stone, stricture, urethritis,
rupture, phimosis,
- posterior urethral valves.
4- Clot retention in severe
hematuria e.g. cancer, trauma.
5- Women: pelvic masses,
urethral stenosis and diverticulum,
pelvic prolapse, hysterical.
13. C. Functional and neurogenic:
1. Postoperative AUR is common:
Pain, limited mobility, drugs, bladder nerve
injury e.g. hysterectomy & abdominal resection
Prevention is important by catheterization after
surgery to bladder, prostate, urethra.
•vaginal childbirth
•infections of the brain or spinal cord
•diabetes
•stroke
•accidents that injure the brain or spinal cord
•multiple sclerosis
•heavy metal poisoning
•pelvic injury or trauma ,
• some children are born with nerve problems that can
keep the bladder from releasing urine
15. Symptoms of urinary retention may include:
•Difficulty in starting to urinate
•Difficulty in fully emptying the bladder
•Weak dribble or stream of urine
•Loss of small amounts of urine during the day
•Inability to feel when bladder is full
•Increased abdominal pressure
•Lack of urge to urinate
•Strained efforts to push urine out of the bladder
•Frequent urination
•Nocturia (waking up more than two times
at night to urinate)
16. History:
- Cause- related:
A complication of BPH
Drugs:
Urethral trauma
Stone disease
- Suprapubic bursting pain, no urine, strong desire to
urinate.
- Acute urine retention should be differentiated from
obstructive anuria.
18. Differential diagnosis of acute
retention and obstructive / anuria
• Acute retention obstuctive Anuria
Desire to urinate + - -
Suprapubic pain + - -
Renal pain - - +
General exam. Good May be uremic
Abdominal exam. Tender Full bladder Empty
Loin bladder
19. Treatment:
A) Conservative measures in non-obstructive causes:
Patient is asked to go out of bed.
Take hot bath.
Parasympathomimetics.
Failure → catheterization.
20. Urethral catheterization: Nelaton or
Foley's:
It is absolutely contraindicated in
urethral injury.
Proper Sterilization of parts.
Adequate lubrication of urethra.
Proper catheter size
Children 6-12 F
Adults 16 F
21. Clot retention:
- Triway 22F urethral catheter with irrigation.
- Evacuation of clots.
-Cystoscopy - diagnostic and therapeutic
Suprapubic cystocath: done in
Urethral trauma
Urethral stricture
Failure of urethral catheterization
22. Treatment of the cause e.g.
- TURP for BPH
urethroplasty for urethral stricture
.
- Endoscopic crushing of vesical stone.
23. Chronic Retention of Urine
Causes: Long standing incomplete obstruction
A) Mechanical : BPH, prostate cancer
B) Functional: Neuropathic flaccid bladder.
- Large amounts of residual urine exist.
- When the vesical pressure exceeds the urethral
resistance, the patient can pass some urine or
dribble continuously. This is called false or
overflow incontinence.
24. Differentiation between acute and
chronic urine retention
Acute retention Chronic retention
Urination No urine Overflow
incontinence
Pain Severe, suprapubic, Painless
bursting
Obstruction Complete Partial
Suprapubic + +/-
tenderness
25. Emergency measures –
Urethral catheter
or
Suprapubic catheter
if urethral trauma or injury are expected
- Ureteric catheter
Or DJ stent
if Failure - PCN
26. Causes according to site
In the bladder
⇒ Detrusor sphincter dyssynergia
⇒ Neurogenic bladder (commonly pelvic splanchic nerve damage,
cauda equina syndrome, descending cortical fibers lesion
, pontine micturation or storage center lesions,
demyelinating diseases or Parkinson's disease)
⇒ Iatrogenic scarring of the bladder neck
(commonly from removal of indwelling catheters
or cystoscopy operations)
⇒ Damage to the bladder
In the prostate
⇒ Benign prostatic hyperplasia
⇒ Prostate cancer and other pelvic malignancies
⇒ Prostatitis
.
27. Penile urethra
⇒ Congenital urethral valves
⇒ Phimosis or pinhole meatus
⇒ Circumcision
⇒ Obstruction in the urethra, for example a metastasis or
a precipitated pseudogout crystal in the urine
⇒ STD lesions (gonorrhoea causes numerous strictures,
leading to a rosary bead appearance,
whereas chlamydia usually causes a single stricture)
Other
⇒ Paruresis ( shy bladder syndrome )-, urinary retention can result
⇒ Consumption of some psychoactive substances, mainly stimulants,
such as MDMA and amphetamine.
⇒ Use of NSAIDs or drugs with anticholinergic properties.
⇒ Stones or metastases can theoretically appear anywhere along
the urinary tract, but vary in frequency depending on anatomy
Paruresis, inability to urinate in the presence of others (such as in a public restroom)
, may also be classified as a type of urinary retention, although it is psychological
rather than biological.
28. Investigations
History of complaints and physical examination
Ultrasonography for any calculi, growth,
post voiding residual urine, condition of Kidney
any injury
Xray KUB for calculi
Blood Urea , Creatinine levels
CT Scan for any pathology
Urine examination for infection
PSA for Prostate Cancer
Urodynamic Test for Cystocele
Cystoscopy for status of bladder
MRI Lumber spine for spinal pathology
29. Dysuria refers to painful urination.
It is one of a constellation of irritative bladder symptoms,
which includes urinary frequency and haematuria.
Differential diagnosis
This is typically described to be a burning or stinging sensation.
It is most often a result of a urinary tract infection
It may also be due to an STD, bladder stones,
bladder tumours, and virtually any condition of the prostate.
It can also occur as a side effect of anticholinergic
medication used for Parkinson's disease.
30. Polyuria is a condition usually defined as excessive or
abnormally large production and/or passage of urine .
Polyuria often appears in conjunction with polydipsia
(increased thirst), though it is possible to have one
without the other, and the latter may be a cause or an
effect. Psychogenic polydipsia may lead to polyuria.
Polyuria is physiologically normal in some
circumstances, such as cold diuresis, altitude diuresis,
and after drinking large amounts of fluids
31. The most common cause of polyuria in both adults and
children is uncontrolled diabetes mellitus, causing an
osmotic diuresis.
Primary polydipsia (excessive fluid drinking),
diabetes insipidus
hypercalcemia) or
various chemical substances (diuretics, caffeine, alcohol).
after supraventricular tachycardias, during an onset of
atrial fibrillation, childbirth, and the removal of an
obstruction within the urinary tract.
Cold diuresis is the occurrence of increased urine
production on exposure to cold, which also partially
explains immersion diuresis.
Substances that increase diuresis are called diuretics.