Ocular synechiae are abnormal adhesions of the iris to other ocular structures that can be caused by inflammation or trauma. Anterior synechiae involve the iris adhering to the cornea, while posterior synechiae involve the iris adhering to the lens or vitreous. This can block the normal flow of aqueous humor and cause glaucoma. Synechiae are generally treated by breaking up adhesions with mydriatic drugs or surgery like laser iridotomy. Managing any underlying conditions like uveitis is also important to prevent future synechiae formation.
Leukocoria ( or white pupillary reflex) is an abnormal white reflection from the eye.
Leukocoria is a medical sign for a number of several conditions.
- this presentation at annual conference of the Ophthalmic department, faculty of medicine - Al-Azhar University in association with DOS & EOS Cairo, Egypt January 2017
Aphakia and its causes. Correction of Aphakia. Advantages and disadvantages of different corrections. Surgeries and related signs and symptoms of aphakia. Complications related to Aphakia.
Maddox Rod
Use of Maddox Rod
Method of Assessment MR
Double MR Test procedure
Recording procedure of MR Test
Heterophoria, Cyclophoria, Esophoria,Exophoria,Hyperphoria,Hypophoria
Leukocoria ( or white pupillary reflex) is an abnormal white reflection from the eye.
Leukocoria is a medical sign for a number of several conditions.
- this presentation at annual conference of the Ophthalmic department, faculty of medicine - Al-Azhar University in association with DOS & EOS Cairo, Egypt January 2017
Aphakia and its causes. Correction of Aphakia. Advantages and disadvantages of different corrections. Surgeries and related signs and symptoms of aphakia. Complications related to Aphakia.
Maddox Rod
Use of Maddox Rod
Method of Assessment MR
Double MR Test procedure
Recording procedure of MR Test
Heterophoria, Cyclophoria, Esophoria,Exophoria,Hyperphoria,Hypophoria
www.ophthalclass.blogspot.com has the complete class on uveitis for undergraduate medical students. This presentation is the third in the series and deals with the sequelae and complications of uveitis.
www.ophthalclass.blogspot.com has the complete class on uveitis for undergraduate medical students. This presentation is the second part of the introductory class in the series and deals with the clinical features of uveitis.
Uveitis is an interesting disease of the with such a varied and diverse pathogenesis, various systemic causes and Dangerous complications in relation to the eye which makes it difficult and challenging to treat in a proper way. I hope this share will help.
ePortfolio@LaGuardia Community College:What, Why and Howpstadlerctl
Developing an ePortfolio helps LaGuardia Community College students collect their work, select sample course work , reflect on their learning, and connect between their academic and professional lives.
The OpenStack Havana release had more than 910 contributors and delivers nearly 400 new features, including two new services: Orchestration and Metering.
glaucoma and cataract.pdf, After the class the students will be able :
Explain the structures and function of eye.
Explain the age affect on vision.
Describe the definition , etiology, risk factors, pathophysiology, medical management, surgical management and Nursing management of Glaucoma.
Describe the definition , etiology, risk factors, pathophysiology, medical management, surgical management and Nursing management of cataract.
List down the health education for Glaucoma and cataract.
INTRODUCTION
ETIOLOGY
RISK FACTORS
PATHOPHYSIOLOGY
CLASSIFICATION
CLINICAL FEATURES
DIAGNOSTIC MEASURES
MANAGEMENT
Medical
Surgical
Nursing
CONCLUSION
BIBLIOGRAPHY
POST TEST
magnification, It's definition, types, clinical uses, Uses in Optical instruments like microscopes, telescopes, Uses in Optical instruments like direct Ophthalmoscopes, indirect ophthalmoscopes and slit lamps, In low vision
Polarization and it's application in OphthalmologyRaju Kaiti
Polarization, types of polarization, mechanisms to produce polarization, Applications of polarization, precautions with polarizing sunglasses, ophthalmic uses of polarization
Color vision physiology, defects and different testing ProceduresRaju Kaiti
Color vision Physiology, Different types of Color vision defects, different testing procedures, trichromatic theory, color opponent theory, inheritance of color vision defect, management of color vision defect
Pediatric Ophthalmic dispensing in different visual problemsRaju Kaiti
Pediatric dispensing, introduction, different from adult dispensing, frame selection, lens selection, special case fitting, Do's and Dont's, Measurements, Down's syndrome, albinism, aphakia, strabismus, syndromes
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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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
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Synechia
1. SYNECHIAE
Raju Kaiti
Optometrist
Dhulikhel Hospital, Kathmandu University Hospital
Ocular synechiae are abnormal adhesions of the iris to other ocular structures. It is sometimes
visible on careful examination but usually more easily through an ophthalmoscope or slit-lamp.
Anterior synechiae is an adhesion of the iris to the posterior cornea due to abnormal fibro
vascular tissue formation. Posterior synechiae and is an adhesion of the iris to the anterior lens
capsule and/or vitreous due to abnormal fibrovascular tissue formation or due to organization of
the fibrin rich exudates. There can also be concurrent anterior and posterior synechiae.
Associated lesions include staphyloma (partial protrusion of the iris into the corneal stroma),
entropion uveae (posterior inversion of the pupillary margin of the iris), and occlusion of the
pupil by an abnormal fibrovascular membrane, and inflammation, among others.
Morphologically, posterior synechiae may be segmental, annular or total.
Segmental posterior synechiae refers to adhesions of iris to lens at some points.
Annular posterior synechiae is adhesion of the whole rim of the iris to the anterior capsule of
the lens (ring synechiae).These prevent the circulation of aqueous humor from posterior chamber
to anterior chamber (seclusion pupillae). Thus the aqueous collects behind the iris and pushes it
anteriorly leading to “iris-bombe” formation.
Total posterior synechiae is the adhesion of the total posterior surface of the iris to the anterior
of lens. It is rarely formed in acute plastic type of Uveitis and result in deepening of anterior
chamber.
2. Anterior synechiae causes closed angle glaucoma, which means that the iris closes the drainage
way of aqueous humor which in turn raises the intraocular pressure. Posterior synechiae also
cause glaucoma, but with a different mechanism. In posterior synechiae, the iris adheres to the
lens, blocking the flow of aqueous humor from the posterior chamber to the anterior chamber.
This blocked drainage raises the intraocular pressure.
Etiology:
Infective uveitis : such as herpes simplex, herpes zoster, tuberculosis and syphilis
Allergic (hypersensitivity) uveitis
Toxic uveitis
Traumatic uveitis
Uveitis associated with non-infective systemic diseases
Posterior synechiae are the most common ocular complications in chronic or recurrent
anterior uveitis, such as HLA B27-associated uveitis, idiopathic anterior uveitis, and
iridocyclitis in juvenile idiopathic arthritis, sarcoidosis, intermediate uveitis, lens-induced
uveitis and uveitis-glaucoma-hyphema (UGH) syndrome.
Intraocular inflammation, especially of the iris and ciliary body.
Synechiae can also be squeal of many ocular diseases, such as cataract, increased
intraocular pressure, compressive or invasive intraocular neoplasms, and inflammation
resulting from various causes.
Idiopathic uveitis
Signs:
Central iridocorneal synechiae are frequently associated with rubeotic iris vessels
Annular Posterior synechiae Total posterior synechiae FestoonedPupil
3. Pupil is irregular/ festooned pupil
Synechiae associated with uveitis have signs like Keratic precipitates, anterior chamber
cells and flares, irregular pupils, ciliary injections, vitreous cells, iris abnormalities,
fundal changes as well. These signs depend on type of uveitis anterior, intermediate
uveitis, posterior uveitis and pan uveitis.
Peripheral anterior synechiae are a well-recognized consequence of altered anterior chamber
(AC) anatomy and anterior chamber inflammation. Peripheral anterior synechiae can
subsequently result in significant morbidity as a precipitant to secondary angle-closure
glaucoma.
Symptoms
Peripheral anterior synechiae are usually asymptomatic unless large areas of at least 270°
are involved.
Peripheral anterior synechiae can present in the following manners:
Acute angle closure with the classic constellation of symptoms, including ocular pain,
headaches, blurred vision, photophobia, watering and halos..
Reduced vision due to corneal edema or end-stage glaucomatous optic neuropathy
If associated with systemic diseases may have recurrent attacks
Differential Diagnosis:
Cataract, Traumatic
Filtering Bleb Complications
Uveitis, Anterior, Granulomatous/Nongranulomatous
Uveitis, Intermediate, Juvenile Idiopathic Arthritis
Sarcoidosis
Glaucoma, Angle Closure, Acute/ Chronic
Glaucoma, Aphakic and Pseudophakic
Glaucoma, Phacolytic/ Phacomorphic
Herpes Simplex/Herpes Zoster
HLA-B27 Syndromes
Melanoma: Choroidal/ Ciliary Body/ Iris
Neurofibromatosis-1
Retinopathy of Prematurity
Management:
Mydriatic/cycloplegic agents, such as topical homatropine, which is similar in action to atropine,
are useful in breaking and preventing the formation of posterior synechiae by keeping the iris
dilated and away from the crystalline lens. Dilation of the pupil in an eye with synechiae can
cause the pupil to take an irregular (non-circular) shape. If the pupil can be fully dilated during
4. the treatment of iritis, the prognosis for recovery from synechiae is good. Inflammation from
synechiae or synechia may be treated with topical corticosteroids.
In some cases, surgical interventions might be required. In annular posterior synechiae, a
complete iridectomy or laser irodotomy might be required. In cases with total posterior synechiae
with complicated cataract, removal of the lens is after rupturing the posterior synechiae with iris
repository.
No specific medical management exists pertaining to the treatment of peripheral anterior
synechiae (PAS). In general, the treatment of the underlying etiology prevents the formation of
peripheral anterior synechiae.
The appropriate management of peripheral anterior synechiae depends on the disease process
that leads to peripheral anterior synechiae formation. The following drug categories may be
considered depending on the primary diagnosis: topical beta-blockers, topical alpha-agonists,
topical carbonic anhydrase inhibitors, oral carbonic anhydrase inhibitors, topical prostaglandin
analogs, miotics, cycloplegic, and topical corticosteroids.
Treat intraocular pressure (IOP) as necessary.
o Topical alpha-agonists, beta-blockers, CAIs, and prostaglandin analogs may be useful in
lowering intraocular pressure in eyes with peripheral anterior synechiae.
o Miotics are useful in pupil block due to primary angle closure but may accentuate angle
closure in posterior pushing mechanisms.
o Miotics or prostaglandin analogs likely will not be useful in cases where 360° peripheral
anterior synechiae exist.
Inflammatory states
o Topical steroids minimize inflammation and therefore, PAS formation.
o Cycloplegics should be used to prevent posterior synechiae.
o Mitotic and epinephrine should be avoided because they can increase inflammation.
Surgical care:
Nd:YAG/argon laser irodotomy
Surgical iridectomy
Argon laser peripheral iridoplasty
Argon laser pupilloplasty is used to expand/enlarge pupil, which may break acute angle-
closure attack and/or posterior synechiae.
Nd: YAG peripheral synechialysis can be attempted in early synechial closure but may
not be effective if the synechiae are firm.
Surgical goniosynechialysis
Glaucoma filtering procedures
Optometric management:
5. Mydriatic/cycloplegic agents can be prescribed and are useful in breaking and preventing the
formation of posterior synechiae. Prescribing protective sunglasses will help the patients with
photophobia. Inflammatory conditions can be treated with topical steroids. Measuring intraocular
pressure is important and if raised should be treated with anti- glaucoma medications. Apart from
these the causative conditions should be ruled out and treated. Proper counseling should be
provided and in cases of recurrent attacks systemic evaluations should be advised.