Any deviation in the normal nasal septum is called DNS (Deviated Nasal Septum).
Deviated Nasal Septum may be caused by mechanical trauma and may be
associated with some developmental defects.
Any deviation in the normal nasal septum is called DNS (Deviated Nasal Septum).
Deviated Nasal Septum may be caused by mechanical trauma and may be
associated with some developmental defects.
An oroantral communication is an unnatural perforation between oral cavity and maxillary sinus.
Oroantral fistula is an epithelized, pathological, communication between these two cavities. A fistulous tract present more than 14 days should be considered as chronic fistula.
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
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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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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
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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
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
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
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2 Case Reports of Gastric Ultrasound
2. INDICATIONS
1. Deviated nasal septum (DNS) causing symptoms
of nasal obstruction and recurrent headaches.
2. DNS causing obstruction to ventilation of
paranasal sinuses and middle ear, resulting in
recurrent sinusitis and otitis media.
3. Recurrent epistaxis from septal spur.
4. As a part of septorhinoplasty for cosmetic
correction
5. As a preliminary step in hypophysectomy (trans-
septal
trans-sphenoidal approach) or vidian neurectomy
(transseptal approach)
3. 1. Patients below 17 years of age. In such
cases, a conservative surgery (septoplasty)
should be done.
2. Acute respiratory infection.
3. Bleeding diathesis.
4. Untreated diabetes or hypertension.
4. Local anaesthesia is preferred.
General anaesthesia is used in children and
apprehensive adults.
6. 1. The incision
The incision is made
on one side of the
septum about 5mm
from the anterior
edge of the septum.
Its carried through
the mucosa and
perichondrium.
The incision should be
made on the side of
maximum deviation
7. 2. The Dissection
A plane of cleavage
is found between
the cartilage and
perichondrium and
this is opened by
dissection
8. 3.
The cartilage is
incised in the same
line as the original
incision and a cut is
taken through the
cartilage to open
another plane on
the other side again
between the
cartilage and
perichondrium
9. 4.
The cartilage is removed by punch forcep
or by a ballenger swivel knife as far as the
dissection has proceeded and then further
separation of flaps is continued back onto
the perpendicular plate of ethmoid and
vomer
10. There is no set amount of cartilage or
bone to remove, as much is removed as is
necessary to straighten the septum.
A strip of cartilage should be left
anteriorly ,in front of incision ,about 5mm
wide and another similar strip along the
dorsum of nose. these are to maintain
shape of the nose and preent collpase of
the nasal tip or retraction the collumella
11. 5.
Stitching. One or two catgut or silk stitches
are applied in the initial mucoperichondrial
incision.
12. 8. Packing.
Ribbon gauze, smeared with an antibiotic
ointment or liquid paraffin, is packed in each
nasal cavity to prevent collection of blood
between the flaps.
Nasal dressing is applied.
13. Septoplasty is a conservative approach to
septal surgery;
As much of the septal framework as possible
is retained.
Mucoperichondrial/periosteal flap is
generally raised only on one side. This
operation has almost replaced the SMR
operation
14. 1. Deviated septum causing nasal obstruction on one or both
sides.
2. As a part of septorhinoplasty for cosmetic reasons.
3. Recurrent epistaxis usually from the spur.
4. Sinusitis due to septal deviation.
5. Septal deviation making contact with lateral nasal wall
and causing headaches.
6. For approach to middle meatus or frontal recess in
endoscopic sinus surgery when deviated septum obstructs
the view and access to these areas.
7. Access to endoscopic dacryocystorhinostomy operation in
some cases.
8. As an approach to pituitary fossa (trans-septal trans-
sphenoidal approach).
9. Septal deviation causing sleep apnoea or hypopnoea
syndrome.
18. 1. Infiltrate the septum with 1% lignocaine with adrenaline, 1:100,000.
2. In cases of deviated septum, make a slightly curvilinear incision, 2–3
mm above the caudal end of septal cartilage on the concave side
(Killian’s incision). In case of caudal dislocation, a transfixion or
hemitransfixion (Freer’s) incision is made. The latter is
septocolumellar incision between caudal end of septal cartilage and
columella.
3. Raise mucoperichondrial/mucoperiosteal flap on one side only.
4. Separate septal cartilage from the vomer and ethmoid plate and
raise mucoperiosteal flap on the opposite side of septum.
5. Remove maxillary crest to realign the septal cartilage.
19. 6. Correct the bony septum by removing the deformed
parts. Deformed septal cartilage is corrected by
various
methods, such as:
(a) Scoring on the concave side.
(b) Cross-hatching or morselizing.
(c) Shaving.
(d) Wedge excision.
Further manipulations like realignment of nasal spine,
separation of septal cartilage from upper lateral
cartilages, implantation of cartilage strip in the
columella or the dorsum of nose may be required.
7. Trans-septal sutures are placed to coapt
mucoperichondrial flaps.
8. Nasal pack.
20. POSTOPERATIVE CARE
1. Patient is placed in semi-sitting position to prevent
oozing of blood. Outer nasal dressing is changed if
soaked in blood.
2. A soft diet should be taken in the first two
postoperative days to minimize active mastication
which causes bleeding.
3. Pain, if any, should be controlled with analgesics.
4. Antibiotic cover is given for 5–6 days.
5. Nasal packs are gently removed after 48 h -72hand
thereafter, decongestant nasal drops started..
6. Patient should avoid trauma to the nose for several
days.
21. 1. Bleeding. It may require repacking, if severe.
2. Septal haematoma. Evacuate the haematoma
and give intranasal packing on both sides of
septum for equal pressure.
3.Septal abscess. This can follow infection of
septal haematoma.
4. Perforation. When tears occur on opposing side
of mucous membrane.
5. Depression of bridge. Usually occurs in supratip
area due to too much removal of cartilage along
the dorsal border.
6. Retraction of columella. Often seen when
caudal strip of
cartilage is not preserved
22. 7.Persistence of deviation. It usually occurs due to
inadequate surgery and may require revision
operation.
8. Flapping of nasal septum. Rarely seen, when too
much of septal framework has been removed.
Septum, which now consists of two
mucoperichondrial flaps, moves to the right or left
with respiration.
9. Toxic shock syndrome. It is rare after septal
surgery. It can follow staphylococcal (sometimes
streptococcal) infection and is characterized by
nausea, vomiting, purulent secretions, hypotension
and rash. It should be diagnosed early. It is treated by
removal of packing, hydrating the patient,
maintaining blood pressure and administering proper
antibiotic