د فيصل الناصر - Faisal Alnasir is a Professor and Chairman at Dept Of Family & Community Medicine at Arabian Gulf University.
http://www.faisalalnasir.com
Epidemiology of Chronic Non- communicable diseases and ConditionsSheetal Singh
This presentation focuses on the most prevailing Non- Communicable diseases of the world. It includes the problem, causes, risk factors, prevention and worldwide statistics of each disease.
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
Epidemiology of Chronic Non- communicable diseases and ConditionsSheetal Singh
This presentation focuses on the most prevailing Non- Communicable diseases of the world. It includes the problem, causes, risk factors, prevention and worldwide statistics of each disease.
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
Non-communicalbe diseases and its preventionShoaib Kashem
Non communicable disease account for a large and increasing burden of disease worldwide. It is currently estimated that non communicable disease accounts for approximately 60% of global deaths and 43% of global disease burden. This is projected to increase to 73% of deaths and 60% of disease burden by 2020.
Risk Assessment and Management of Cardiovascular Diseases - an English Approach. Lynam E. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
This presentation is a keynote address delivered by me in regional level conference of indian association of preventive and social medicine(IAPSM) in oct.2013 at goverment medical college haldwani,uttrakhand
Non-communicalbe diseases and its preventionShoaib Kashem
Non communicable disease account for a large and increasing burden of disease worldwide. It is currently estimated that non communicable disease accounts for approximately 60% of global deaths and 43% of global disease burden. This is projected to increase to 73% of deaths and 60% of disease burden by 2020.
Risk Assessment and Management of Cardiovascular Diseases - an English Approach. Lynam E. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
This presentation is a keynote address delivered by me in regional level conference of indian association of preventive and social medicine(IAPSM) in oct.2013 at goverment medical college haldwani,uttrakhand
Prof. DR. Dr. Rochmad Romdoni, SpJP(K), FINASIM, FIHA, FAsCC. 3rd Pekanbaru Cardiology Update, August 24th 2013. Pangeran Hotel Pekanbaru. Learn more at PerkiPekanbaru.com
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
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
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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.
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
د فيصل الناصر
1. Hypertension the Silent Killer
Epidemiology
Prof Faisal A Alnasir FRCGP, MICGP, FFPH, PhD
President, Family & Community Medicine Council Arab Board
Chairman, Department of Family & Community Medicine
Arabian Gulf University
3. 3
WHO estimated that high blood pressure
causes one in every eight deaths, making
hypertension the third leading killer in the world.
Globally, there are one billion hypertensives and
four million people die annually as a direct result
of it.
Hussein A. Gezairy
Regional Director for the Eastern Mediterranean
5. 5
Size of the problem
1-World wide
• In 2010, 1.2 billion people were expected to be suffering from
hypertension worldwide
Sixth report of the Joint National Committee on prevention,1997
• Expected to increase to 1.56 billion by 2025
International Society of Hypertension
• Its prevalence from 20% to 30% of the adult population.
Alwan A 1993
• Incidence In USA between 14% to 40% in 35 to 64 years.
WHO 2002
• Prevalence in Canada 17.3%. Most patients had untreated
hypertension (68.6%), and only 15.8% had blood pressure
treated and controlled.
6. 6
Size of the problem
2-In the Eastern Mediterranean Region
• The average prevalence of hypertension 26% and it affects
approximately 125 million individuals.
• Each year, there are several million new cases of
hypertension and more of pre-hypertension
Report on the regional consultation on hypertension
UAE, 2003
7. 7
Size of the problem
In Bahrain
National Non-communicable Diseases Risk Factors Survey 2007
8. 8
Size of the problem
In Bahrain
National Non-communicable Diseases Risk Factors Survey 2007
9. In Lebanon
•23.1% are hypertensive
•Prevalence increases with age
•Occurs more in the less educated and unemployed
•Prevalence increases significantly with an increase in
body mass index particularly in female patients
•Only14.7% exercised daily
R A Tohme, A R Jurjus, A Estephan 2005
10. 10
Size of the problem
In Saudi Arabia:
The prevalence range from 4% to 15%.
Abolfotouh MA et al.
It may reach as high as 20.4% for systolic hypertension and
25.9% for diastolic hypertension.
Al-Nozha MM et al.
In south-western 11.1%.
Abolfotouh MA et al.
In Jeddah, the hypertensive were 22.6%.
Elkalifa Am et al.2011
In the UAE:
Hypertension has become one of the leading public health
problems
11. In Sudan
of 6-12y children:
4.9% were pre-hypertensive and
4.9% were hypertensive
Salman Z, et al 2010
12. 12
Size of the problem
It has been estimated that individuals who are
normotensive at the age 55 years have a 90%
lifetime risk for developing hypertension.
EMR0 Technical Publications
Blood pressure is under control in less than 20% of
patients with hypertension in many countries
A joint CINDI/EuroPharm Forum project WHO
13. 13
Awareness of Hypertension
Although the prevalence of high blood pressure is high,
there is a low awareness rate (Up To 70% are unaware)
Alwan A1993
15. 15
Awareness of Hypertension
In Egypt only 37.5% of hypertensives were aware of
Having it.
In United States, Chile, and Cub, 32%, 37%, and 39%
of the people were not aware.
Pan American Health
16. 16
Advantage of Controlling Hypertension
•A 5-6 mmHg reduction in diastolic BP reduces stroke by 40%.
Joint National Committee on Detection, 1992
•lowering by 5-6mmHg can reduce mortality from cerebrovascular
disease by 35%-40%, from ischemic heart disease by 15% 20%
and reduction in all deaths from cardiovascular causes by 23%.
Psaty, et al 1997
• 3 mmHg decrease in systolic BP reduces annual mortality
from stroke, coronary heart diseases and all other causes by 8%,
5% and 4%.
Whelton PK, 1994
•The chances of mortality from CVD in old hypertensive people
when taking anti hypertensive medications is decreased by 34%.
MacMahon, 1993
17. 17
Economic Impact
The economic burden of chronic NCDs can
be analyzed on two levels.
•First, the effects of macroeconomic policies on
opportunities for prevention in different
population groups
•Second, the cost and overall efficiency of
interventions must be evaluated in terms of
effectiveness and health gains for the
population at large.
18. 18
Economic Impact
Direct Cost:
Including prescribing medicines, inpatient visits,
outpatient visits, emergency room visits, office-
based medical provider visits, home health
visits, and other medical expenses
Sanjeev Balu, 2001
Indirect Cost:
Productivity loss ($300 per eligible employee per year)
absence & short term disability
Goetzel (2004), the only study in the U.S.
19. 19
Economic Impact
•Poor are disproportionately affected
•more vulnerable
•Prevalence 6 time more in uneducated
•Medication cost up to US$ 100 per month
•further poverty
•Cost to Health Services
•USA total cost of CVD is 2% of the gross
domestic product
• direct medical costs estimated at nearly $55.0
billion for the year 2001
Sanjeev Balu, 2001
•Canada 21% of all diseases costs are due to
CVD (US$12 billion/Year) direct cost is $3,072
per person per year, and indirect cost is $854
Guijing Wang,2008
20. 20
Economic Impact
In Alkhobar the total direct cost of hypertension
care for patients registered in the primary health
care represented 6.32% of the estimated cost of
treating the expected number of patients.
Al-Shahri 1998
21. 21
Prevention
Primary prevention is the most cost-effective
approach to containing the emerging
hypertension epidemic.
Hussein AlGezairy
Regional Director for WHO
22. 22
Prevention
Incidence of hypertension was reduced by 20% to
50% if primary prevention were implemented
Stamler 1991
For the developing countries prevention of
hypertension should be the goal.
24. 24
Modification Recommendation Approximate systolic BP
reduction
Weight reduction Maintenance of normal body weight 5–20 mmHg/10 kg
healthy eating plan Consumption a diet rich in
vegetables, fruits, and
low-fat dairy products with a
reduced content of saturated and
total fat
8–14 mm Hg
Dietary sodium Reduction dietary sodium intake to
no more than
2.4 g sodium
2–8 mmHg
Physical activity Engagement in regular aerobic
physical activity at least 30
minutes daily, most days of the
week
4–9mmHg
Recommended lifestyle modifications
25. 25
Life style Modification
• Weight reduction
Every 1 kilogram of weight loss lower blood pressure by
1.6/1.1 mmHg
Khatib et al. EMR0 Technical Publications
26. 26
Prevalence of overweight and obesity among
some countries of the Eastern Mediterranean
Region (WHO.2004)
Country Overweight/obesity (%)
Males Females
Saudi Arabia 64.0 70.0
Lebanon 60.0 53.0
Islamic Republic of Iran 57.0 67.7
Bahrain 56.4 79.0
Jordan 46.0 43.7
Egypt 43.8 41.0
Libyan Arab Jamahiriya 42.5 74.9
Oman 40.5 43.5
Morocco 37.2 21.7
United Arab Emirates 25.5 39.9
Tunisia 13.1 41.9
Kuwait 79 56
34. 34
Life style Modification
• Sodium moderation
Reducing dietary sodium intake to no more than 100 mEq/L
)2.4g sodium or 6 g sodium chloride), reduces the blood
pressure by an average of 4–6 mmHg.
Khatib et al. EMR0 Technical Publications
40. 40
Life style Modification
• Cocoa ingestion
100g/day of chocolate
drink reduces the systolic BP and
diastolic BP
Taubert et al 2007
41. 41
Blood Pressure Pooled Change (mm Hg) P
Cocoa
Systolic -4.7 .002
Diastolic -2.8 .006
Tea
Systolic 0.4 .63
Diastolic -0.6 .38
Change in Blood Pressure reduction
between cocoa & Tea
Taubert et al 2007
42. 42
Change in Blood Pressure reduction
between cocoa & Tea
Taubert et al 2007
“The magnitude of the hypotensive effects of cocoa
is in the range that is usually achieved with
monotherapy of β-blockers or angiotensin-
converting enzyme inhibitors”
43. Chocolate and Coronary Heart Disease: A Systematic Review
This article reviews current evidence on the effects of cocoa/chocolate on
clinical and subclinical coronary heart disease (CHD), CHD risk factors,
and potential biologic mechanisms.
The high content of polyphenols and flavonoids present in cocoa has
been reported to play an important protective role in the development of
CHD.
Although studies have demonstrated beneficial effects of chocolate on
endothelial function, blood pressure, serum lipids, insulin resistance, and
platelet function, it is unclear whether chocolate consumption influences
the risk of CHD.
Khawaja O et al Current Atherosclerosis Reports, Volume 13 / September 2011
44. 44
Measurement of Blood Pressure
The "white-coat" effect
Prevalence of white coat hypertension
was 3.6% overall and 12.8% in
hypertensive patients.
Marquez Contreras et al. 2006
45. 45
Measurement of Blood Pressure
The "white-coat" effect
Prevalence of white coat hypertension
was 3.6% overall and 12.8% in
hypertensive patients.
Marquez Contreras et al. 2006
46. 46
Measurement of Blood Pressure
The "white-coat" effect
Prevalence of white coat hypertension
was 3.6% overall and 12.8% in
hypertensive patients.
Marquez Contreras et al. 2006
47. 47
Hypertension Control
Very poor control of hypertension world wide
•In Egypt 23.9% were receiving treatment & 8%
controlled
Ibrahim et al.
•In Canada 15.8% had blood pressure treated and
controlled
Petrella et al, 2007
•In Saudi Arabia, 76 % were receiving treatment, but only
20% were found controlled
Abolfotouh et al,
48. 48
Measurement of Blood Pressure
•Seated in a quiet room
•Arm muscles relaxed
•Cubital fossa at heart level
•Avoid tight sleeves
•Suitable size Cuff to be used
•Repeat if BP > 140/90
•Measurement on both arms
•Mercury sphygmomanometers are most reliable
Goodman and Gilman's1993
49. 49
Management
Good management of hypertension is central to any
strategy formulated to control hypertension at the
community level. Randomized trials of drugs that
lower and control blood pressure clearly show a
reduction in mortality and morbidity.
Hussein A. Gezairy
Regional Director for the Eastern Mediterranean
50. 50
Management
2 mmHg reduction in systolic blood pressure
is likely to reduce the annual mortality from
stroke, coronary heart disease and all other
causes by 6%, 4% and 3%, respectively
51. 51
Conclusion
Hypertension is a serious problem that could
be called "the silent killer". Its prevalence is
very high especially in the GCC countries.
Effective efforts ought to be taken in order to
prevent, prevent, prevent, prevent
then diagnose and treat it.
52. 52
Conclusion
Hypertension is a serious problem that could
be called "the silent killer". Its prevalence is
very high especially in the GCC countries.
Effective efforts ought to be taken in order to
prevent, prevent, prevent, prevent
then diagnose and treat it.
53. 53
Conclusion
Hypertension is a serious problem that could
be called "the silent killer". Its prevalence is
very high especially in the GCC countries.
Effective efforts ought to be taken in order to
prevent, prevent, prevent, prevent
then diagnose and treat it.