Sarcoidosis
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1. Sarcoidosis is an idiopathic multisystem disorder characterized by non-caseating granulomata that most commonly affects the lungs (95%), thoracic lymph nodes (50%), skin (30%), and eyes (30%). 2. Ocular involvement in sarcoidosis includes anterior segment granulomas, uveitis, and retinal lesions like choroidal granulomas and sheathing of the retinal veins. 3. Investigations for sarcoidosis include chest X-ray to detect hilar lymphadenopathy and lung infiltrates, serum ACE levels, and gallium scans to detect organ involvement.
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Systemic Diseases and the Eye
Systemic Diseases and the Eye
Various systemic diseases affect the eye and it's functioning. Here we present those common systemic diseases that are responsible to cause effects in the eye.
What are the diseases that affect eye?
Eye is affected by the following diseases:
Systemic Hypertension (Increased blood pressure of the body)
Diabetes Melitus (Increased blood sugar level)
Systemic Lupus Erythromatosus (SLE)
AIDS and other Venereal Diseases like Syphilis
Sickle Cell Anemia,
Eales Disease and many more.
Look at the slides.
Metabolic disorders of eye ro
This document discusses various metabolic disorders that can affect the eye, including diabetic retinopathy, galactosemic cataract, thyroid eye disease, Marfan syndrome, homocystinuria, and Wilson disease. Diabetic retinopathy is the leading cause of blindness and is caused by retinal changes in patients with diabetes mellitus. Risk factors include duration of diabetes, age of diabetes onset, poor metabolic control, and hypertension. Proliferative diabetic retinopathy can lead to neovascularization and vitreous hemorrhage if left untreated. Management involves controlling blood sugar and other factors as well as treatments like laser therapy and anti-VEGF injections.
Sarcoidosis
Sarcoidosis is a multisystem granulomatous disease of unknown etiology that commonly involves the lungs and lymphatic system. It presents most often in young adults and females with bilateral hilar lymphadenopathy on chest imaging. Ocular involvement occurs in 20-50% of cases and can include anterior or posterior uveitis, choroidal nodules, and retinal periphlebitis. Diagnosis involves ruling out other causes like tuberculosis with tests such as chest imaging, serum ACE levels, and biopsy when possible. Treatment involves systemic steroids, with immunosuppressants for more severe disease.
Salivary gland pathology 2
This document discusses various pathologies of the salivary glands including mucoceles, ranulas, salivary duct cysts, sialolithiasis, xerostomia, myoepithelial sialadenitis, Sjogren's syndrome, necrotizing sialometaplasia, and salivary gland infections. It provides details on the etiology, clinical presentation, histopathology, diagnosis and management of each condition. The document is intended as an educational reference for oral pathology residents and dental professionals.
Salivary Gland Diseases - A Summary.pptx
Diseases, infections, cysts, benign and malignant tumors of the salivary glands. All categorised and summarised with most important points: location, description, signs and symptoms, causative agents, risk factors, metastasis potential and recurrence potential.
Leg ulcer
The document discusses the approach and classification of leg ulcers. It begins by defining a leg ulcer and classifying them as non-specific, specific, or malignant. The main causes of leg ulcers are then discussed, including venous insufficiency (80-85% of cases), arterial disease, neuropathy, infection, trauma, and malignancy. Diagnostic evaluation of a leg ulcer involves obtaining a thorough history and physically examining the ulcer, surrounding skin, and vascular and neurological systems. Key distinguishing features of venous versus arterial ulcers are also provided.
Sarcoidosis
This document provides an overview of sarcoidosis, with a focus on its ocular manifestations and diagnosis. Some key points:
- Sarcoidosis is a chronic inflammatory disease characterized by non-caseating granulomas that commonly affect the lungs, lymph nodes, eyes, and skin.
- Ocular involvement occurs in 40% of sarcoidosis patients, usually presenting as chronic, bilateral granulomatous uveitis. This can manifest as anterior uveitis, intermediate uveitis, posterior uveitis, or a combination.
- Complications of ocular sarcoidosis include glaucoma, cataracts, cystoid macular edema, choroidal granulo
FlashPath - Sarcoidosis
This document provides information on sarcoidosis, including its clinical presentation, pathogenesis, gross and microscopic pathology, differential diagnosis, and special studies. Some key points:
- Sarcoidosis is a chronic granulomatous disease that commonly involves the lungs and lymph nodes. It presents with non-caseating granulomas and is diagnosed after ruling out infections.
- Clinically, it can involve multiple organs and cause symptoms like cough, eye inflammation, skin lesions. Lung involvement is seen in 90% by chest imaging.
- Pathogenesis involves an abnormal immune response with excessive CD4+ T cells and macrophage activation leading to granuloma formation.
- Microscopically, well
Cutaneous vasculitis by dr maria
1. Cutaneous vasculitis is inflammation of blood vessel walls usually resulting in palpable purpura.
2. It can be classified based on the size of vessels involved, and may be primary or secondary to other conditions like infections, drugs, or rheumatological diseases.
3. Clinical features include painful palpable purpura, ulcers, and haemorrhagic or necrotic lesions, with involvement typically in lower limbs. Investigations aim to identify underlying causes or systemic involvement while management focuses on treating triggers, complications, and symptoms.
01 salivary gland tumors
This document provides information on benign and malignant diseases of the salivary glands, including:
1. It discusses the embryology, surgical anatomy, non-neoplastic conditions, benign tumors, and malignant tumors of the major and minor salivary glands.
2. It describes common benign tumors like pleomorphic adenoma and Warthin's tumor, as well as malignant tumors such as mucoepidermoid carcinoma.
3. It provides details on the classification, clinical features, histology, treatment and prognosis of various salivary gland neoplasms.
Systemic disease SR
This document discusses common systemic diseases that can affect the eye, including infectious diseases like toxoplasmosis and tuberculosis, and non-infectious diseases like diabetes, connective tissue diseases, and vasculitides. It provides details on diabetic retinopathy, including risk factors, stages of progression from background retinopathy to proliferative retinopathy, and treatment with laser panretinal photocoagulation. It also summarizes ocular features and systemic signs of sarcoidosis, phakomatoses including neurofibromatosis, tuberous sclerosis, von Hippel-Lindau syndrome, and Sturge-Weber syndrome. Giant cell arteritis is also briefly discussed.
Bacterial eyelid infections and blepharitis.
This document discusses bacterial infections and blepharitis that can affect the eyelids. It begins by covering the anatomy of the eyelid and then describes several specific bacterial infections including external hordeolum, impetigo, erysipelas, necrotizing fasciitis, anthrax, and syphilis. It then discusses blepharitis in detail, describing the different types (staphylococcal, seborrheic, posterior), associated conditions like meibomian gland dysfunction, symptoms, signs, treatment, and complications.
Uveitis classification & clinical features 1
Uveitis is inflammation of the uvea, which includes the iris, ciliary body, and choroid. It is classified based on anatomy, clinical course, etiology, and histology. The Standardization of Uveitis Nomenclature (SUN) Working Group developed standardized classifications including anatomical (anterior, intermediate, posterior, panuveitis), descriptors (onset, duration, course), and grading systems. Clinical features depend on the involved area and can include symptoms like pain, photophobia, blurred vision, and floaters. Signs on examination may reveal cells and flare in the anterior chamber, keratic precipitates, hypopyon, synechiae, and lesions of the iris, retina, or
uveitisclassificationclinicalfeatures1-160818172529 (1).pdf
Uveitis is classified based on the primary site of inflammation in the eye: anterior, intermediate, posterior, or panuveitis. It is also described based on clinical features like onset, duration, and course. A thorough evaluation is needed to categorize uveitis and identify any underlying etiology, as it can be associated with systemic diseases. A standardized system of nomenclature exists to describe uveitis uniformly based on anatomy, activity, and other characteristics. Symptoms depend on the location and severity of inflammation, and may include pain, photophobia, blurred vision, or floaters.
Ca penis [edmond]
Here are the key organ-preserving treatment options for penile cancer:
- Circumcision for very small, prepuce-confined tumors
- Local wedge excision or partial penectomy for small T1 tumors
- Glansectomy for selected T1 tumors not involving corpora cavernosa
All local options have significant recurrence risks of 40-50%. Close follow-up is required.
THROMBOTIC MICROANGIOPATHY
This document provides an overview of systemic vasculitis for medical residents. It defines vasculitis as inflammation of blood vessels and explains how different types of vasculitis can affect different vessel sizes and organ systems. The document outlines the clinical approach to diagnosing vasculitis through history, physical exam, lab tests, imaging studies and tissue biopsies. It then discusses several specific types of vasculitis in more detail, including giant cell arteritis, granulomatous polyangiitis (Wegener's), and microscopic polyangiitis. The presentation provides information on clinical manifestations, diagnostic criteria, pathology findings, and treatments for these forms of vasculitis.
Pars Planitis
Pars Planitis is a disease of the eye that is characterized by inflammation of the narrowed area (pars plana) between the colored part of the eye (iris) and the choroid. This may lead to blurred vision; dark, floating spots in the vision; and progressive vision loss.
Episcleritis & scleritis
Episcleritis and scleritis involve inflammation of the outer layers of the eye. Episcleritis affects just the episclera, while scleritis penetrates deeper into the sclera. Scleritis is more severe and can cause vision loss. It is often associated with autoimmune diseases. Treatment involves anti-inflammatory drugs like NSAIDs or corticosteroids. Necrotizing scleritis is the most severe form and requires prompt high-dose immunosuppressive therapy to prevent complications like scleral thinning and perforation that can cause permanent vision loss.
Inflammatory & non Inflammatory Salivary Gland Disease.pptx
This document discusses inflammatory and non-inflammatory salivary gland diseases. It begins with objectives and introductions. It then covers topics like salivary gland development, surgical anatomy, approaches to patients, and specific diseases. Salivary gland diseases discussed include developmental issues, cysts like mucoceles and ranulas, obstructive disorders like sialolithiasis, and inflammatory conditions. Treatment options are provided for various diseases. The document is intended to discuss presentation and management of non-neoplastic salivary gland diseases.
Carcinoma VULVA
This document discusses pre-malignant and malignant conditions of the vulva. It begins by describing vulvar intraepithelial neoplasia (VIN), the pre-malignant condition where cellular changes are limited to the epithelium. VIN is graded based on the depth of atypical cells. Vulvar cancer most commonly presents as squamous cell carcinoma in older women. Risk factors include HPV infection, smoking, and immunosuppression. Examination may reveal irregular growths or ulcers. Biopsy is needed for diagnosis. Treatment options depend on the grade of the lesion and include local excision, laser ablation, or topical therapies. Follow up is important due to the risk of recurrence.
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uveitisclassificationclinicalfeatures1-160818172529 (1).pdf
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Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
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The Nervous and Chemical Regulation of Respiration
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
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PGx Analysis in VarSeq: A User’s Perspective
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
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Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Sarcoidosis
- 1. 1 SARCOIDOSISSARCOIDOSIS • Idiopathic multisystem disorder • Characterised by non-caseating granulomata • More common in women 20-50 yrs • More common in blacks and Asians • ? Related to mycobacteria
- 2. 2 SARCOIDOSISSARCOIDOSIS Systemic InvolvementSystemic Involvement • Lung lesions – 95% • Thoracic lymph nodes – 50% • Skin lesions – 30% → • Eyes – 30%
- 3. 3 SARCOIDOSIS Ocular Involvement • Anterior segment lesions (30%) – Conjunctival granuloma – Lacrimal gland involvement/dry eye – Acute or chronic uveitis → – KPs described as ‘mutton fat’ because they are large and greasy
- 4. 4 SARCOIDOSIS Ocular Involvement • Posterior segment lesions (20%) – Patchy venous sheathing – Cellular infiltrate around vessels – Chorioretinal granulonmas – Vasculitis including occlusive causing:- – Neovascularisation – Infiltrate in vitreous (vitritis) including cell clumps (snowballs)
- 5. 5 SARCOIDOSIS Ocular Involvement • Sheathing of the retinal veins • Fluorescein angiography showing leakage and staining at sites of sheathing
- 6. 6 SARCOIDOSIS Granuloma in Fundus • Retinal and pre-retinal • Choroidal
- 7. 7 SARCOIDOSIS Granuloma in Fundus • Optic nerve head granuloma • Normal optic nerve head
- 8. 8 SARCOIDOSISSARCOIDOSIS Systemic SignsSystemic Signs Lupus pernio affecting the nose – a chronic progressive cutaneous sarcoid that most commonly affects face and ears
- 9. 9 SARCOIDOSIS Systemic signs • Facial palsy • Salivary gland enlargement
- 10. 10 SARCOIDOSIS Systemic signs • Hilar adenopathy on chest x-ray • Lung infiltrate • Erythema nodosum • Arthritis
- 11. 11 SARCOIDOSIS Investigations (1) CXR – to detect pulmonary signs • Bilateral hilar lymph- adenopathy • Pulmonary mottling
- 12. 12 SARCOIDOSIS Investigations (2) • Serum angiotensin-converting enzyme (ACE) – elevated in active sarcoidosis • Mantoux test – caution in patients who have had BCG vaccination. Test may be negative • Lung function tests
- 13. 13 SARCOIDOSIS Investigations (3) Gallium scan showing increased uptake in the lacrimal and parotid glands and pulmonary regions in a patient with active sarcoidosis
- 14. 14 SARCOIDOSIS Treatment Systemic steroids may be necessary in patients with posterior segment disease where vision is threatened, especially if optic nerve is involved