1. Rheumatoid arthritis does not affect fertility or the chances of getting pregnant. It also does not affect the unborn baby.
2. During pregnancy, RA symptoms often improve in the first and second trimesters due to changing hormone levels. Symptoms may worsen in the third trimester or after delivery.
3. Medications like methotrexate and leflunomide must be stopped before pregnancy due to risks. Hydroxychloroquine, sulfasalazine, low-dose steroids are considered safe options during pregnancy and breastfeeding.
Living with rheumatoid arthritis is challenging. Besides the benefit of getting shortly on medication after diagnosis, lifestyle modifications play an important role in rheumatoid arthritis management. Diet, exercise, sleep, medication can be very helpful.
Living with rheumatoid arthritis is challenging. Besides the benefit of getting shortly on medication after diagnosis, lifestyle modifications play an important role in rheumatoid arthritis management. Diet, exercise, sleep, medication can be very helpful.
Treatment of recurrent and resistant dermatomyositis and polymyositis in adults. prof. Adel Abdel-Salam (Rheumatology & Immunology - Mansoura School of Medicine: 2017)
ANA testing is confusion and many times getting a positive ANA complicates the clinical picture. A few tips to know what to do when you have a positive ANA.
Trends in management of rheumatoid arthritis Dr.Neena Mehan
Rheumatoid Arthritis (RA) is an auto-immune disease in which body mistakenly considers some parts of its own system as pathogens and attacks them.
Myasthenia gravis (MG) is a chronic autoimmune disorder of the postsynaptic membrane at the neuromuscular junction (NMJ) in skeletal muscle. Circulating antibodies against the nicotinic acetylcholine receptor (achr) and associated proteins impair neuromuscular transmission
Treatment of recurrent and resistant dermatomyositis and polymyositis in adults. prof. Adel Abdel-Salam (Rheumatology & Immunology - Mansoura School of Medicine: 2017)
ANA testing is confusion and many times getting a positive ANA complicates the clinical picture. A few tips to know what to do when you have a positive ANA.
Trends in management of rheumatoid arthritis Dr.Neena Mehan
Rheumatoid Arthritis (RA) is an auto-immune disease in which body mistakenly considers some parts of its own system as pathogens and attacks them.
Myasthenia gravis (MG) is a chronic autoimmune disorder of the postsynaptic membrane at the neuromuscular junction (NMJ) in skeletal muscle. Circulating antibodies against the nicotinic acetylcholine receptor (achr) and associated proteins impair neuromuscular transmission
RHEUMATOID ARTHRITIS BY DR BASHIR AHMED DAR ASSOCIATE PROFESSOR MEDICINE SOPO...Prof Dr Bashir Ahmed Dar
Dr Bashir ahmed dar associate professor medicine chinkipora sopore kashmir presently working in medical college malaysia describes rheumatoid arthritis which is a autoimmune disorder in which Immune system identifies the synovial membrane as "foreign" and begins attacking it.
A Power Point Presentation on the Disease Rheumatoid Arthritis covering everything from explanation and history to causes, effects, treatments, diagnosis, and prognosis.
(MS) is an analytical technique that produces spectra (singular spectrum) of the masses of the atoms or molecules comprising a sample of material. The spectra are used to determine the elemental or isotopic signature of a sample, the masses of particles and of molecules, and to elucidate the chemical structures of molecules, such as peptides and other chemical compounds,so it is considered one f the very important diagnostic analytical techniques .
Managing DM and thyroid disease in shift workersNemencio Jr
This slide deck discusses the effects of shift work on physiology and behavior of thyroid axis and beta cell function and risk of diabetes, including glucose control among those with diabetes. Management strategies are also discussed
Recurrent pregnancy loss (RPL), also referred to as recurrent miscarriage or habitual abortion, is historically defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period.
This Presentation is made by Dr.Laxmi Shrikhande
Healthy Choices are the key!
Healthy diet including raw foods & avoiding processed food or high fat diet is the best way to eliminate toxins from your body. Toxins damage your egg follicles.
Similar to Rheumatoid Arthritis patient wants to get Pregnant ( Clinical Scenario ) (20)
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
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
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
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.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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5. Present History
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for
the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315---24.
14. Does RA affect the chances RA affect the
Does
Am I ready for pregnancy?
Does RA affect the Baby ?
of getting pregnant ?
pregnancy outcome ?
15.
16. Does RA affect the pregnancy outcome?
There is no increase in the rate of miscarriage or
stillbirth in patients with RA
Ostenson M et al Pregnancy and reproduction in autoimmune rheumatic diseases Rheumatology. 2011;50(4):657-664
17. Does RA affect the chances of getting
pregnant?
No, RA does not affect fertility .. Unlike lupus it
does not affect the chances of getting or staying
pregnant.
Ostenson M et al Pregnancy and reproduction in autoimmune rheumatic diseases Rheumatology. 2011;50(4):657-664
18. Does RA affect the Baby?
• No , RA does not affect the unborn baby. R.A
need not to be inherited by the baby from the
mother even if it is active during pregnancy.
• Our concern is all about the medications which
will need to be changed.
Ostenson M et al Pregnancy and reproduction in autoimmune rheumatic diseases Rheumatology. 2011;50(4):657-664
19. Am I ready for pregnancy ?
1. Your RA has to be fairly controlled for 3-4
months before getting pregnant.
2. New laboratory investigations.
3. Reviewing your current medications.
21. Remission criteria
Felson, D.T., et al., American College of Rheumatology/European League Against Rheumatism provisional definition of remission in rheumatoid
arthritis for clinical trials. Arthritis Rheum, 2011. 63(3): p. 573-86.
22. • Yes, your RA is considered
clinically controlled for the
past 3 month.
26. • Your Lab results are all
considered
normal range.
within
the
27. I will stop all medications
during pregnancy ?
28. Medication during Pregnancy
• Sources for the pregnancy data presented come
from the FDA classification of drugs and experts
reporting.
FDA category
Classification
A
B
C
D
X
N
Controlled studies showed no risk
No evidence of risk in humans
Risk cannot be ruled out
Positive evidence of risk
Contraindicated in pregnancy
Not rated
Temprano KK, Bandlamudi R, Moore TL. Antirheumatic drugs in pregnancy and lactation. Semin Arthritis Rheum. Oct
2005;35(2):112-21
29. Medications used by the patient
Drug
Steroids
NSAIDs
Methotrexate
Leflunomide
FDA category
C
B or C
X
X
Temprano KK, Bandlamudi R, Moore TL. Antirheumatic drugs in pregnancy and lactation. Semin Arthritis Rheum. Oct
2005;35(2):112-21
30. Anti TNF α
Orozco C, Dao K, Cush JJ, Kavanaugh A: Safety of TNF- inhibitors during pregnancy in patients with inflammatory arthritis.
Arthritis Rheum 2005, Suppl:22-23
31. Anti TNF α
Orozco C, Dao K, Cush JJ, Kavanaugh A: Safety of TNF- inhibitors during pregnancy in patients with inflammatory arthritis.
Arthritis Rheum 2005, Suppl:22-23
32. Anti TNF α
Drug
FDA
Category
TNF α blockers B
Concerns
Minimal data but not
documented increased
rate of malformation
to date
Clinical practice
Use until plan
or confirm
pregnancy
then
discontinue
42. • S u l p h a s a l a z i n e 500m g
t a b s
•
d a i l y
3
o r a l l y
H y d r o x y c h l o r o q u i n e 200m g 2
t a b s
d a i l y
o r a l l y
5m g
1 t a b
• C a l c i u mc a r b o n a t e
1200m g +400I U
• Pr e d n i s o l o n e
d a i l y
o r a l l y
43. o NSAI Ds
f o r
a n a l g e s i a
wh e n n e e d e d .
o o n l y
i n t h e f i r s t
s e c o n d t r i me s t e r
i n t e r mi t t e n t
a n d
,
u s e , s h o r t
a c t i n g .
o c o n t r a i n d i c a t e d i n t h e
44. o C h o l e s t r y r a mi n e
t i me s d a i l y f o r
•
8g
3
11 d a y s
Sa c h e t s
d i s s o l v e d
g l a s s o f
wa t e r
i n
a
45. Follow up is important by the
Rheumatologist and Obstetrician
during the pregnancy
47. Pathogenesis of RA
-Forger F, Marcoli N, Gadola S, et al. Pregnancy induces numerical and functional changes of CD4+CD25 high regulatory T cells in
patients with rheumatoid arthritis. Ann Rheum Dis 2008;67:984–90.
-Munoz-Valle JF, Vazquez-Del Mercado M, Garcia-Iglesias T, et al. T(H)1/T(H)2 cytokine profile,metalloprotease-9 activity and
hormonal status in pregnant rheumatoid arthritis and systemic lupus erythematosus patients. Clin Exp Immunol 2003;131:377–84.
-Alavi A, Arden N, Spector TD, et al. Immunoglobulin G glycosylation and clinical outcome in rheumatoid arthritis during
pregnancy. J Rheumatol 2000;27:1379–85.
48. Straub RH. The complex role of estrogens in inflammation. Endocr Rev 2007;28:521–74.
49. Straub RH. The complex role of estrogens in inflammation. Endocr Rev 2007;28:521–74.
50. Straub RH. The complex role of estrogens in inflammation. Endocr Rev 2007;28:521–74.
51. What to expect during
pregnancy
First
trimester
&
second
trimester:
RA tends to improve and
patients
more
who
likely
improve
to
are
stay
remission during pregnancy.
in
52. What to expect during
pregnancy
Third trimester:
• You may experience fatigue
due to weight gain.
• Swelling of feet / ankles
• Hand numbness / tingling.
They need not always mean a
flare, Consult Rheumatologist.
55. What to expect after pregnancy
•
Hygiene and wound care after delivery
is extremely important. You may be on
steroids or other DMARDs which may
impair immunity & make you prone to
infections if appropriate care is not
taken.
56. What to expect after pregnancy
•
Caring for the baby requires a great
deal of energy, feeding multiple times
in the night can add up to the fatigue &
exhaustion.
•
Carrying the baby around can be
difficult if the hand joints are inflamed.
57. What to expect after pregnancy
•
Sleep deprivation happens to every
Mom; however can add to your joint
pain & fatigue
•
You will not be able to take MTX /
Leflunomide to control RA activity
when you are breast feeding.
58. - Orbach H, Shoenfeld Y. Hyperprolactinemia and autoimmune diseases. Autoimmun Rev 2007;6:537–42.
- Barrett JH, Brennan P, Fiddler M, et al. Breastfeeding and postpartum relapse in women with rheumatoid and inflammatory
arthritis. Arthritis Rheum 2000;43:1010–15
59. - Orbach H, Shoenfeld Y. Hyperprolactinemia and autoimmune diseases. Autoimmun Rev 2007;6:537–42.
- Barrett JH, Brennan P, Fiddler M, et al. Breastfeeding and postpartum relapse in women with rheumatoid and inflammatory
arthritis. Arthritis Rheum 2000;43:1010–15
60. What to expect after pregnancy
• RA tends to flare up in most of
the patients during the lactation
phase..
62. • No
• There are Drugs considered
safe during Lactation.
63. Breast Feeding
Drug
Official recommendation
Clinical practice
recommendation
NSAIDs
Considered safe; small
Safe except acetyl
amounts in breast milk ;
salicylic acid.
avoid acetyl salicylic acid
due to bleeding risk in infant
Steroids
Excreted in milk but still
Safe (consider
safe; wait 4 hr if on
delaying feed by 4 hr)
prednisolone >20mg