This document provides an overview of retinopathy of prematurity (ROP), including:
1) ROP is a proliferative retinopathy affecting premature infants that can cause lifelong visual impairment.
2) The development of the retinal vasculature is disrupted in premature infants due to their early exposure to a hyperoxic extra-uterine environment.
3) Laser photocoagulation treatment is recommended for high-risk pre-threshold and threshold ROP to ablate the peripheral avascular retina and prevent retinal detachment and blindness.
Age-Related Macular Degeneration by\ Eman Salman
It was used for student presentation in ophthalmology course rotation
I Hope you find what is helpful for your knowledge ♥
Retinopathy of prematurity (ROP), initially described as retrolental fibroplasia one of the leading cause of blindness in children.
Despite advances in diagnosis and treatment, as medicine and technology advances and premature infants are surviving at earlier gestational ages, ROP continues to be a significant problem.
ROP results in disorganized growth of retinal blood vessels, which may lead to scarring and retinal detachment.
Age-Related Macular Degeneration by\ Eman Salman
It was used for student presentation in ophthalmology course rotation
I Hope you find what is helpful for your knowledge ♥
Retinopathy of prematurity (ROP), initially described as retrolental fibroplasia one of the leading cause of blindness in children.
Despite advances in diagnosis and treatment, as medicine and technology advances and premature infants are surviving at earlier gestational ages, ROP continues to be a significant problem.
ROP results in disorganized growth of retinal blood vessels, which may lead to scarring and retinal detachment.
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
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
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.
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!
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.
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
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- 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
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
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2. Introduction & Definition
• Retinopathy of prematurity (ROP) is a proliferative retinopathy affecting
premature infants of low birth weight and young gestational age.
• ROP remains a leading cause of life long visual impairment among children
• Earlier this disease was known as Retrolental fibroplasia.
3. Development of retinal vasculature
• During normal retinal development , vasculogenesis transforms precursor
mesenchymal cells into capillary networks beginning at about 16 weeks of
gestation.
• Mature vessels differentiate from these networks and reach-
– Nasal ora serrata at about 36 weeks
– Temporal ora serrata at about 39 to 41 weeks
4. • Full retinal vascular development is mostly accomplished in utero, where
the fetus is:
1. In a relatively hypoxic environment ( average PaO2 is 25-35)
2. Exposed to the placental and maternal cytokines and growth factors
5. Risk factors for ROP
• Primary risk factors:
– Low gestation age, especially <32 weeks
– Low birth weight (<1500g, especially <1250g)
– Supplemental oxygen therapy
6. Other risk factors
• Light
• Vitamin E deficiency
• Respiratory distress syndrome
• Asphyxia
• Shock and acidosis
7. Pathogenesis
• Pathogenesis of ROP is multifactorial – influenced by developmental,
genetic and environmental factors
• Premature birth exposes the fetus to ex-utero hyperoxic environment and
disrupts several pivotal cell-signalling pathways and growth factors
involved in retinal vasculogenesis.
• High oxygen administration at birth was among the first factors to be
found critical to the pathogenesis of ROP.
8. Two phase hypothesis for ROP
• FIRST PHASE
– There is a delay or halting in physiological retinal vascular
development due to:
• Prematurity
• Hyperoxia induced endothelial cell damage
• Subsequent vasoattenuation
9. Second phase
• Peripheral avascular retina continues to develop in the
absence of a developing vascular bed
• Becomes relatively hypoxic and secretes pro-angiogenic
factors
• Promote retinal neovascularization and abnormal
vasoproliferation in the vitreous
10. Clinical features and classification
• The international classification of retinopathy of prematurity
(ICROP) was instrumental in establishing the standards and
nomenclature for the clinical assessment of ROP based on:
– Anatomical location (zone) and
– Severity (stage) of disease
17. Stage 2- ridge
• Demarcation line develops into a pink or white elevation
(ridge) of thickened tissue
• Small tufts of vessels may be seen posterior to the ridge
18.
19.
20. Stage 3 – Extraretinal fibrovascular
proliferation
• Vessel growth into and above the ridge (extraretinal
fibrovascular proliferation)
• This fibrovascular proliferation may extend into the overlying
vitreous and cause prereinal or vitreous hemorrhage
21.
22.
23. Stage 4- Partial detachment
• Contraction of fibrovascular proliferation exerts traction on
the retina, leading to partial retinal detachment
– Stage 4A: without foveal involvement
– Stage 4B: with foveal involvement
24.
25.
26.
27. Stage 5- Total retinal detachment
• Detachments are funnel shaped and described as open or closed
anteriorly and open or closed posteriorly
• Retrolental fibroplasia: refers to what we know today as stage 5
30. Differential diagnosis
• Active ROP needs to be differentiated from:
– Familial exudative vitreoretinopathy (FEVR)
– Incontinentia pigmenti in girls
– Persistent fetal vasculture
• Advanced retrolental fibroplasia: the presenting fiding in this may be leukocoria and
hence needs to be differentiated from other causes of leukocoria like:
– Retinoblastoma
– Exudative Retinal detachment- commonly from Coat’s disease
– Coloboma optic disc or choroid
– Toxoplasmosis/ Toxocariasis
– Cataract
– Genetic syndromes like trisomy 13, Norrie’s disease etc
31. Diagnosis and screening
• Early diagnosis and treatment is essential to prevent blindness in high risk
cases.
• Therefore, a regular screening and timely intervention is recommended.
• Screening of ROP should be performed in all premature infants born :
– Less than or equal to 32 weeks of gestational age ( for Indian scenario < 35
weeks)
– Those weighing 1500g or less ( for Indian scenario <2800gm )
32. Screening procedure
• Initial examination of the anterior segment is performed with specific
attention to the iris vessels, lens, and tunica vasculosa lentis
• After pupillary dilation, fundus examination is performed with an indirect
ophthalmoscope and a 20 D lens
• The posterior pole is examined without depression for plus disease
• Scleral depression is then used to examine the temporal retina, followed
by thenasal retina, to establish the proximity of retinal vessels to the ora
serrata
33. First examination
• Should be performed between 4 and 6 weeks of chronological (postnatal) age
or between 31 & 33 weeks of postmenstrual age, whichever is later.
• Further line of action will depend upon the status of retina
• Immature retina is labelled when the vessels are short of one disc diameter of
the nasal or temporal ora serrata but ROP is not developed yet.
• ROP, when present should be classified as its stage, zone, and extent of
involvement.
34. Subsequent follow-ups
• Examination at 2 week intervals - Infants with immature
retinas (no ROP) vascularized into zone II or III
• Examination weekly or twice a week may be required in
infants with type 2 pre-threshold disease (low risk)
• Peripheral laser ablation - is required for infants with type1
prethreshold disease (high risk).
35. Retcam
• Delivers objective, interpretable detail
• Allows image comparison over time
• Enables remote consultations and facilitates
a convenient method for second opinions
• Serves as an effective educational
tool for staff and parents which may help with
compliance
• Provides reliable, defensible medico-legal
documentation
36.
37.
38. Management
• Treatment of well-established disease is unsatisfactory
• Thus prophylaxis is very important
• To reduce high-risk ROP:- premature newborns should not be placed in
incubator with an 02 concentration of more than 30%.
• Efforts should be made to avoid infections or attacks of apnoea.
39. Ablation of peripheral avascular retina
• Can be done by:
– Cryotherapy (or)
– Laser photocoagulation
• ETROP group has recommended use of laser over the cryotherapy
• Advantages of laser photocoagulation over cryotherapy include ease of
treatment, portability, and fewer systemic complications.
40. • Laser photocoagulation is done usingLIO
(Laser indirect ophthalmoscope)with
– Diode laser 810 nm (or)
– Frequency doubled Nd: YAG (532nm)
• Laser photocoagulation should be carried
out in all patients with high-risk pre-
threshold, threshold, and aggressive
posterior ROP
41. Post laser follow-ups
• Post-laser treatment follow-up should be done weekly for 3
weeks
• Persistent plus disease or fibrovascular proliferation are
indications for additional re-treatment
• Subsequent follow-up examination should be continued at 3,
6 and12 weeks after treatment.
42. • Complications of laser photocoagulation
– Anterior segment ischemia
– Cataract
– High myopia
– Burns of the cornea, iris, or tunica vasculosa lentis.
43. Pharmacological blockade of VEGF
• Intravitreal Bevacizumab & Ranibizumab (Anti-VEGF) has been
used for the treatment of ROP, but an optimal regimen is yet
to be established
– Zone I disease is more likely to respond than zone II
– Potential advantage is it allows retinal development to proceed
normally without destruction, which is integral to laser treatment
– However, systemic complications an long-term effects in this age
group are undetermined.
44. Surgery in ROP
• Although retinal ablation is effective in a majority of cases of ROP, some eyes will
progress to retinal detachment (RD)- Stages 4A, 4B and 5
• RD in ROP is most commonly tractional type originating at the ridge.
• The surgical goal is interrupting the traction resulting from fibrous proliferation
and several tractional vectors
• Patients with stage 4A, 4B and 5 require surgery
– Lens sparing vitrectomy
– Endolaser photocoagulation
– Retinal reattachment measures