Systemic fluoride was used as early as 1874 to prevent dental caries. Fluoride ions are absorbed in the gut and nearly all retained fluoride is incorporated into developing bones and teeth, making enamel crystals larger and more stable. This affects crown morphology by making pits and fissures shallower, less likely to cause decay. Systemic fluoride intake can cause dental fluorosis if intake is too high during tooth development between ages 1-4. Topical fluoride is now recognized as more important for caries prevention than systemic fluoride.
Fluoride is often called as sword as an expression for anything that can simultaneously help & hinder .
Accumulated evidence from numerous studies show that the prolonged use of fluoride at recommended levels doesn't produce harmful physiological effects in human.
Inadequate ingestion of fluoride is associated with dental caries & an extensive intake of fluoride can lead to dental & skeletal fluorosis
Acute ingestion of fluoride in large quantities may be followed by rapidly developing signs and symptoms which may result in death
Fluoride is often called as sword as an expression for anything that can simultaneously help & hinder .
Accumulated evidence from numerous studies show that the prolonged use of fluoride at recommended levels doesn't produce harmful physiological effects in human.
Inadequate ingestion of fluoride is associated with dental caries & an extensive intake of fluoride can lead to dental & skeletal fluorosis
Acute ingestion of fluoride in large quantities may be followed by rapidly developing signs and symptoms which may result in death
A comprehensive presentation about role of fluorides in caries prevention. Their sources, metabolism, history of fluorides, how to administer fluorides, advantages and disadvantages of different kinds of systemic fluorides.
A comprehensive presentation about role of fluorides in caries prevention. Their sources, metabolism, history of fluorides, how to administer fluorides, advantages and disadvantages of different kinds of systemic fluorides.
overview of flouride with detailed information on their pharmacological action, mechanism, uses and adverse effect for both medical and dental students.
learning objectives
Introduction
History Of Water Fluoridation
How Does Fluoride Act In Dental Caries Prevention?
Goals Of F Administration
Fluoride Administration
Appropriate Levels Of Fluoride in Drinking Water
Methods of water fluoridation
--------------------------------------------------------------------
Efficacy Of topical fluorides
Range Of therapeutic fluoride concentrations used to prevent caries
Recommended doses
HISTORY & MECHANISM OF ACTION SYSTEMIC FLUORIDES.pptxRUCHIKA BAGARIA
EVERYTHING YOU NEED TO KNOW ABOUT SYSTEMIC FLUORIDES.
HISTORY, MECHANISM OF ACTION, METABOLISM, DIETARY SUPPLEMENTS AND RECENT ADVANCES.
LETS STUDY SYSTEMIC FLUORIDE TOGETHER.
LETS LEARN AND SHARE OUR KNOWLEDGE.
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
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!
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
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
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
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.
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
1. Systemic Fluoride
In prevention of dental caries
Systemic fluoride was used to prevent dental caries back to
as early as 1874. Fluoride ions convert to [hydrofluoric acid]
(HF) at pH 1.0-2.0 in the gut and are rapidly absorbed. Nearly
all (99%) of retained Fluoride is incorporated into developing
bones and teeth in the mineral, making the enamel crystals
larger and more stable&affecting the crown morphology
making the pits and fissures shallower and hence less likely
to create stagnation areas
BY
Dr.Marwa Laith Faris
2/20/2011
2. Systemic Fluorides
I ntroduction
The use of fluorides date back to as early as 1874 when the German
Erharde suggested the use of potassium fluoridetablets for expectant
mothers and children in order to strengthen teeth. This recommendation
was without any scientific evidence. What we now know to be dental
fluorosis (mottling) was noted by dentists long ago, who reported on
„Colorado Stain‟ without the etiology of the tooth defect being
established.
M etabolism and absorption
Fluoride ions convert to [hydrofluoric acid] (HF) at pH 1.0-2.0 in the
gut and are rapidly absorbed. Approximately 50% of ingested Fluoride
is excreted in the urine. A small amount is excreted in the feces, saliva
and sweat. Serum Fluoride levels peak within 1 hour of ingestion and
return to normal after approximately 3 to 5 hours. Fluoride accumulates
in patients with impaired kidney function and its retention is affected by
the acid-base balance: a diet rich in meat protein will producean acidic
renal filtrate and cause more Fluoride to be retained. Nearly all (99%)
1
3. of retained Fluoride is incorporated into developing bones and teeth in
the mineral.
Fluoride exchanges with the hydroxyl groups of existing hydroxyapatite
crystals in bone to form fluorapatite (FA), which is less soluble in acid.
Tooth enamel with more FA is more resistant to acid erosion from
dietary acids and the weak acids produced by oral bacteria that cause
dental decay. Similarly, FA in bone makes it more resistant to
osteoclasts, which use protons to dissolve the mineral.
M echanisms of Action of Fluoride
The action of fluoride can give the following results:
*It has an effect during tooth formation making the enamel crystals
larger and more stable;
*It inhibits plaque bacteria by blocking the enzyme enolase during
glycolysis;
*It inhibits demineralization when in solution;
*It enhances remineralization by forming fluorapatite when in solution;
*It affects the crown morphology making the pits and fissures shallower
and hence less likely to create stagnation areas.
2
4. The most important of these mechanisms is that, when fluoride is
present in the oral environment at the time of the acid attack, it inhibits
demineralization and promotes remineralization.The critical pH for
apatite is 5.5 and below this the calcium and phosphate ions pass out of
the enamel (demineralization). At pH = 7.0, apatite remineralizes and if
fluoride is present at this time fluorapatite forms (remineralization).
Fluorapatite is resistant to acid attack until the pH drops to 3.5.
Therefore, it is most important to have an intra-oral source of fluoride
when remineralization is taking place.In the past it was thought that the
systemic action of fluoride was important for caries prevention. This
view has completelychanged and it is now known that it is the topical
action of fluoride that is essential for caries prevention.
It is the presence of fluoridein the liquid phase at the plaque-
enamelinterface that is of most importance.Studieshave shown that even
lowlevels of fluoride (0.01 ppm) wereeffective in preventing the
dissolutionof enamel. It has been stated that it isthe activity of the
fluoride ion in the oralfluid that is important in reducing thesolubility of
the enamel rather than ahigh content of fluoride in the enamel.
Saliva, the fluid that bathes the teeth,has been extensively studied. The
levelof fluoride in saliva is thought to beimportant for caries prevention
and ithas been shown that subjectssusceptible to caries had salivary fluoride
3
5. levels of <0.02 ppm, whereascaries resistant subjects had levels of>0.04
ppm.
There are a vast number of fluorideproducts that are available for
systemicand topical use. Systemic fluoride can be described as follows:
A -Water Fluoridation
This is a systemic method of providingfluoride on a community basis. Over
300million people worldwide receivenaturally or artificially
fluoridatedwater. In 1942, Dean et al.showed 1.0ppm fluoride to be the
optimum level.This was in a pre-fluoride era andperhaps the optimum level
needs to bereviewed. There have been 113 studies in 23 countries over the
last 50 years13showing that dental caries is reduced by50%. It is cheap and
cost-effective but there are opponents to its use. In some countries school
water has been fluoridated, but a concentration of 5ppm is required to offset
the less frequent intake.
B - Fluoride Supplements
These are in the form of:
I-Tablets anddrops.Caries reductions vary from 20 - 80%.There is
usually very poor patientcompliance, especially for high caries-risk
groups. A „Catch 22‟ situation is thecase in which those patients that
4
6. arecompliant do not need supplements,whereas those that will benefit
will nottake them.
The doses vary worldwide and are being increasingly heldresponsible
for the rise in fluorosis. Thefluoride supplement doses depend on the
age of the patient and the level offluoride in the drinking water.
Nosupplements should be prescribed if the water fluoride level is
greater than 0.7 ppm.
The tablets should be allowed todissolve slowly in the mouth,
thusproviding a topical application offluoride to the teeth. There are of
course other systemic methods for providingfluoride to the community.
These are:
II-Salt;50% reductions in Switzerland and Hungary;
III-Milk;15–65% reductions;
IV-Mineral Water;46% reductions in Bulgaria.The fluoride levels of
bottled waters vary considerably, from 0.0-2.0 ppm mainly, but can be
as high as 10.0-13.0 ppm in some countries.
V- Sugar;Luoma showed decreased caries levels in animals and
humans when fluoride was added to sugar.
5
7. There are, therefore, a number of sources of fluoride that we and our
patients may be exposed to:
*Water1.0 mg/day
*Supplements1.0 mg/day
*Diet0.5 mg/day
*Toothpaste0.25 mg/day (in children)
A dverse effect and toxicity
C hronic Toxicity
Before prescribing fluoride supplements we must first determine the
fluoride level of the patient‟s drinking water, the infant may be at
increased risk of developing dental fluorosis. The maxillary permanent
central incisors are most susceptible to fluorosis at about 2 years of age.
Dental fluorosis is a health condition caused by a child receiving too
much fluoride during tooth development. The critical period of
exposure is between 1 and 4 years old; children over age 8 are not at
risk. In its mild form, which is the most common, fluorosis appears as
tiny white streaks or specks that are often unnoticeable. In its severest
6
8. form, which is also called mottling of dental enamel; it is characterized
by black and brown stains, as well as cracking and pitting of the teeth.
Fig. 1; A mild case of dental fluorosis (the white streaks on the
subject's upper right central incisor) observed in dental practice
Fig 2; A severe case of dental fluorosis, or "mottled dental
enamel."
7
9. The „Halo Effect‟ is the term used to describe the ingestion of fluoride
from hidden sources. For example, fizzy drinks like Pepsi or Coca- cola
may contain fluoride if the bottling plant is in a fluoridated area and
therefore uses fluoridated water.
Other than dental fluorosis there are no known adverse effects of
ingesting fluoride on chronic basis at levels that are associated with
drinking water of concentrations of 4 ppm or less. These levels of intake
include fluoride not only in water but also in diet and in fluoride-
containg dental products.
Studies have shown that fluoride causes various histologicalstructure
changes of the kidney, including extensive induction of cell apoptosis,
resulting in impairment of renal function and metabolism, Fluoride
interferes with the formation of normal collagen, the protein cement
which holds body structures together.
Total collagen is increased, as much as 50% in one study, but the
collagen is imperfect. Structures heavily dependent upon collagen
include tooth enamel and dentin, bone, cartilage, and muscle and skin.
Finally signs of skeletal fluorosis may appear with high levels with
fluoride intake (8-10 ppm or higher in drinking water) for
approximately 10 years or more.
8
10. A cute Toxicity
The Probably Toxic Dose (PTD) was defined by Whitford as the
minimum amount of fluoride ingestion that requires action, and is
5mg/Kg body
PTD for 1-2 year old child, ~ 10 kg (22 lb) = 50 mg F
PTD for 5-6 year old child, ~ 20 kg (44 lb) = 100 mg F
PTD for adult, ~ 60 kg (130 lb) = 3000 mg F (3 g)
The most popular unit: ppm = part per million
(wt/wt ; vol/vol)
Water with 1 ppm F = 1 mg/L
9
11. At higher concentration, usually use
%(F-containing products)
1 % = 10,000 ppm
0.1 % = 1,000 ppm
0.05 % = 500 ppm
A mounts of dental products required to constitute the
PTD for a 5-year-old child
100 ml of an adult toothpaste (1000 ppm F)
440 ml of a daily F rinse (225 ppm F)
110 ml of a weekly F rinse (900 ppm F)
8 ml APF gel (12,300 ppm F)
4.4 ml F varnish (22,600 ppm F)
10
12. S igns and symptoms of acute fluoride toxicity
Nausea
Vomiting
Hypersalivation
Abdominal pain
Diarrhoea
Convulsions (due to fall in plasma calcium)
Respiratory failure
Cardiac failure
Death
T reatment of acute fluoride toxicity
*Induce vomiting (to remove F)
*Give milk or 1% calcium gluconate orally toslow F absorption
*Advise hospital of acute F poisoning
R EFERENCES
11
13. 1. K. Jack Toumba, Jinous F. Tahmassebi, RichardBalmer. Paediatric Dentistry in the New Millennium:
5. Clinical Prevention: The Role of the General Dental Practitioner
2. Zhan X-A, Wang M, Xu Z-R, Li J-X. Toxic effects of F on kidney function and histology in young
pigs. Research report Fluoride 39(1)22–26 January-March 2006
3.Yiamouyiannis, John, “Water Fluoridation and Tooth Decay: Results from the 1986-1987 National
Survey of U.S. Schoolchildren,” Fluoride, Journal of the International Society for Fluoride Research,
vol. 23, No. 2; April 1990; p. 55, pp. 28 33.
4. Murray JJ. Efficacy of preventive agents for dental caries. Systemic fluorides: water fluoridation.
Caries Res 1993; 27(Suppl. 1): 2–8.
5. Leverett D, Adair S, Shields C. Relationship between salivary and plaque fluoride levels and dental
caries experience in fluoridated and non-fluoridated communities. Caries Res 1987; 21: 179 (abstr. 57).
6. Fejerskov O, Thylstrup A, Larsen MJ. Rational use of fluorides in caries
prevention.ActaOdontolScand1981; 39: 241–249.
7. Martin J. Wagner. Absorption of Fluoride by the Gastric Mucosa in the Rat. J DENT RES 1962 41:
667
8. Dean HT, Arnold FA, Elvove E. Domestic water and dental caries. Public Health Report (US) 1942;
57: 1155–1179.
9. Angus C Cameron, Richard P Widmer. Handbook Of Pediatric Dentistry, first edition, 1997, chapter
3; Fluoride modalities.
Thank You
12