JNC 8 guideline to Management of HypertensionPranav Sopory
JNC - 8 guidelines to management of Hypertension.
Rencent developments in CKD (Chronic Kidney Disease) and DM (Daibetes Mellitus) management.
Drugs discussed along with doses and side effects.
Compelling indiactions.
2017 AHA/ACC criteria for Hypertension management in brief.
>> Contains animation. Download and view.
A technique used to measure air flow in and out of the lungs.
A recording of lung volumes and capacities defined by the respiratory process. These recordings may be static (untimed) or dynamic (timed).
Assesses the integrated mechanical functions of lungs, chest wall and respiratory muscles.
The gold standard for diagnosis, assessment and monitoring of COPD.
Better than PEFR (which is effort dependent) for demonstrating airway obstruction in BA.
The most commonly used PFT
Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
Definition of heart failure - causes and types of heart failure - pathophysiology and risky factors for heart failure - Diagnosis clinical manifestations and investigations and classification of heart failure- treatment of chronic heart failure
Also Acute heart failure causes - clinical picture and treatment
Intensive insulin therapy is best defined as a comprehensive system of diabetes management with the patient and management team as partners. The system is directed at improvement of glycemia and patient well-being.
JNC 8 guideline to Management of HypertensionPranav Sopory
JNC - 8 guidelines to management of Hypertension.
Rencent developments in CKD (Chronic Kidney Disease) and DM (Daibetes Mellitus) management.
Drugs discussed along with doses and side effects.
Compelling indiactions.
2017 AHA/ACC criteria for Hypertension management in brief.
>> Contains animation. Download and view.
A technique used to measure air flow in and out of the lungs.
A recording of lung volumes and capacities defined by the respiratory process. These recordings may be static (untimed) or dynamic (timed).
Assesses the integrated mechanical functions of lungs, chest wall and respiratory muscles.
The gold standard for diagnosis, assessment and monitoring of COPD.
Better than PEFR (which is effort dependent) for demonstrating airway obstruction in BA.
The most commonly used PFT
Definition of hypertension - prevalence- classification and varieties of hypertension - risk factors - clinical manifestation of hypertension -complication -diagnosis - management - treatment of hypertension and special cases
Definition of heart failure - causes and types of heart failure - pathophysiology and risky factors for heart failure - Diagnosis clinical manifestations and investigations and classification of heart failure- treatment of chronic heart failure
Also Acute heart failure causes - clinical picture and treatment
Intensive insulin therapy is best defined as a comprehensive system of diabetes management with the patient and management team as partners. The system is directed at improvement of glycemia and patient well-being.
this is a detailed study on blood pressure measurement on clinical watching , methods , equipment's , common problems ,and all major aspects of blood pressure measurement is mentioned in detail .
please comment
thank you
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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.
Follow us on: Pinterest
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
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
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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!
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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.
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
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.
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
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Mercury -desk type
Aneroid palm type
Non-mercury Digital
column type with LCD
display
Non mercury
Digital fully auto
with LCD display-
desk type
Types of
sphygmomanometers
Aneroid desk type Aneroid gauge type
Aneroid stand
type
Mercury-stand type
3. Maintenance of mercury
sphygmomanometer—Phase it out…..
Mercury apparatuses are still considered as the best to
record most accurate BP.
It should be calibrated/ standardized, at least once in
every 2 months or SOS. Any error displayed on the
apparatus itself.
Check if the mercury liquid is clean; black discoloration
due to mercuric oxide may require cleaning of the
column & the reservoir.
Check the angle of the column.
Check that the reading is at zero mark, when the cuff is
completely deflated.
4. Maintenance contd.
Test the cuff and tubing for air leaks or blockage;
Test the column and reservoir for mercury leaks.
Any spillage/leaks-follow the guidelines of BMWM.
Check that during inflation of the cuff, the mercury
rises smoothly.
Check that when inflation is stopped, mercury rise
stops immediately.
Clean and disinfect the device, every 6 months
according to the manufacturer’s specifications.
5.
6. Some do’s!
1.Ask the patient to empty bladder, before recording BP.
2.Let the patient relax for 30 minutes, before recording, if
patient comes on foot from a distance.
3.Let the patient warm up, if it is cold outside.
4.Counsel the patient, make him comfortable & ask him to
remain calm, during the procedure.
5. Make the patient sit, with straight back (affects DP-
high), like sitting on a dinning chair with arm supported
on the table, with both feet resting on the ground (affects
SP-high).
6.Support the arm on table, on which the apparatus has
been placed.
7. Some do’s!
7. Best position, for the procedure, is the sitting
position. If it is being recorded in the lying down
position, then rest the arm on a pillow to bring it
to the level of heart.
8.Recording should be at the same time, on the
same limb & in the same posture every time, to get
correct reading.
9.Cuff should be of proper size. The bladder of the
cuff should cover 40% of the circumference of the
arm and 2/3 of the length of the arm.
10.Ensure there is no zero error in the apparatus.
8. Some don’ts
For monitoring BP, patient should not suffer from
any illness at that time.
Patient should not take alcohol/caffeine, at least
30 minutes before recording the BP.
Patient should not talk, laugh, sneeze, cry, weep
and should breath smoothly, during the procedure.
Patient should not eat/take anything orally, at
least 30 minutes, before recording the BP.
Patient should not sit with legs crossed.
9. Some don’ts
There should be no medical problem in that
arm.
Patient should not smoke, within 30 minutes of
the procedure.
Patient should not do any exercise, within 30
minutes of the procedure.
The cuff should not be applied over the clothes.
The clothes should not be folded up to expose
the arm, if unavoidable then ensure that these
should not be constricting on the arm.
10.
11. Procedure to record blood pressure
• Ask the patient to loosen any tight clothing or
remove long-sleeved garments, so that it is
possible to access the upper arm.
• Switch the apparatus on.
• Place the cuff around the upper arm, directly
over the skin, 1"-2" above the elbow and secure it
tight to the extent to allow two fingers between
the arm & cuff.
• The position of the arm should be such that the
cuff and the heart are at the same level.
12.
13.
14.
15. Procedure contd.
• The tubes of the cuff should be on the inner side
of the upper arm, along the course of brachial
artery.
• Connect the cuff tubing to sphygmomanometer
tubing and secure it tight.
• Rest the patient's arm on a surface of the table if
patient is sitting and on a pillow if s/he is lying
on the bed.
• The cuff, heart and the apparatus should be at
the same level.
16. Procedure contd.
• The column of mercury should be at the level of
doctor’s eyes. The horizontal & vertical parts of
the apparatus should be at right angle to each
other . The BP apparatus should be kept on the
even surface to avoid any tilt.
• Place the stethoscope in the cubital fossa, over
the brachial artery and listen for the pulse beat.
• Inflate the cuff slowly and listen for the pulse,
when it disappears. This is an indication to stop
inflating the cuff.
17. Procedure contd.
• Wait for a moment, to ensure that the pulse is not
audible & start to deflate the cuff slowly, while watching
the mercury level in the sphygmomanometer.
• Note the sphygmomanometer reading, when the pulse
reappears: record this as the systolic pressure.
• Deflate the cuff further, until the pulse disappears:
record this reading as the diastolic pressure.
• Record these two measurements, first the systolic and
then the diastolic ,in the patient's notes.
• Deflate the cuff completely. Take at least two readings at
1-2 minutes interval
18. Procedure contd.
• Best position, for the procedure, is the sitting
position. If it is being recorded in the lying down
position, then rest the arm on a pillow to bring it
to the level of heart.
• Tell the patient, the blood pressure reading.
• Decontaminate chest piece and ear pieces of the
stethoscope with the alcohol wipe.
• Wash/sanitize and dry your hands.
• If there is extremely low or high reading of BP,
then ask the patient to consult medical specialist.