Clinical study of fundal changes in high myopiaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Case Series of Thyrotoxicosis in the Age Group of 11-20 Yearsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Clinical study of fundal changes in high myopiaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Case Series of Thyrotoxicosis in the Age Group of 11-20 Yearsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The relative increase in the incidence of diabetic complications in Nigeria and Increase in the number of diabetic foot ulcer cases leading to increase in amputation of lower extremities. Depression and cognition problems are rarely assessed in patients with diabetic foot ulcer .
Study of Barthel Score among CKD Patients Belonging from Tribal Areas in Tert...ijtsrd
Chronic Kidney Disease CKD is one of the independent diseases which can lead to sever disability and it is a major emerging public health concern worldwide because it often leads to poor patient outcome 1 . Some of the associated factor with impaired functional status with CKD patients has not been fully elucidated, but some traditional such as cardiovascular diseases hypertension, myocardial ischemia , cerebrovascular diseases, and diabetes mellitus as well as non-traditional factors such as malnutrition-inflammation syndrome and depression may involve. A cross-sectional and longitudinal study has shown that risk of low functional status is directly proportional to kidney impairment 2, 3 . Thus, individuals with chronic kidney disease CKD have 40-70 higher risk of functional limitation than those without CKD 4 . In one study to assess the functional status of the CKD patients by using Barthel index found that 50 patients were dependent for the basic activities of daily life 5 In the current study, we hypothesize that there is a close relationship between the presence of CKD and the functional status of renal patients. We conducted this study with objective to assess the functional status of patients with Chronic Kidney Disease by using Barthel Index as a assessment tool on patients who were admitted under Nephrology Unite of Dr. B.R.A.M Hospital Raipur, CG. Dr. Dolly Ajwani Ratre | Rashmi Nande | Navin Kumar Ratre "Study of Barthel Score among CKD Patients Belonging from Tribal Areas in Tertiary Care Hospital, Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20266.pdf
Paper URL: https://www.ijtsrd.com/medicine/other/20266/study-of-barthel-score-among-ckd-patients-belonging-from-tribal-areas-in-tertiary-care-hospital-chhattisgarh/dr-dolly-ajwani-ratre
Aim: To compare one Field Of View (1 - FOV) and two Field Of View (2 - FOV) photography for diabetic retinopathy detection by assessing and comparing disease level and outcome.
Methods: A retrospective audit of a random sample of 500 patients with known proliferative diabetic retinopathy (PDR or R3), and 500 non-proliferative diabetic retinopathy (NPDR or R2). Images were re-assessed according to the English program criteria for DR levels using 1-FOV.
Clinical trials established in 2005 the efficacy of Ranibizumab (Lucentis, Genentech) for the treatment of neovascular age-related macular degeneration (wetAMD), the leading cause of legal blindness in the United States.This disease is affecting people over the age of 65 with a prevalence of 1.6 million and 200000 new cases per year in the USA .While awaiting approval for ranibizumab from the Food and Drug Administration, ophthalmologists began treating neovascular AMD with off-label use of bevacizumab (Avastin, Genentech), since the drug had a target specificity similar to that of ranibizumab and was available at low cost for about 50$ per monthly injection Vs 1950$ for Lucentis monthly injection.
Ranibizumab received the FDA approuval in 2006 to treat specifically the wetAMD,there was a huge debate about the cost effectiveness and the reimbursement of Lucentis in comparaison with Avastin for treating the eye disease.
This paper explores the dilemma from different angles.First,it make the emphasize on the need of realizing a head to head comparative study between the two drugs and the means to finance and to launch this study since many roadblocks have been identified.
Then, it explores and analyzes the Genentech reaction facing this problem and their strategy to emphasize on the higher risk of death with Avastin, as compared to Lucentis in one hand and in the other hand their strategy to extend the ophthalmologic indications for Lucentis, including diabetic macula edema (DME).
Finally it explores what value should be put on safety in health technology assessments HTAs by developing that we can’t just consider the dollar value of medicine alone but we need to consider the cost of adverse events caused by the treatment and the cost of living with these adverse events
Reducing Uveitic Glaucoma: therapeutic judgement is the keyiosrphr_editor
Abstract: Background: Uveitic glaucoma (UG) due to disease and /or therapeutics is an important reason for reduced vision. Different therapeutic regimen employed in uveitis can alter the course of UG. Purpose: Evaluation of prevalence of UG with different commonly used therapy. Study design: Randomised prospective hospital based study Study Period: 2007-2012 Methods: Baseline IOP; Field and optic nerve head photographs were recorded. Three groups were randomised: 1.topical steroid 2.Systemic steroid +gr 1, 3.Topical synthetic steroids, cycloplegic and periorbital triamcinolone injection. Outcome measure: IOP more than 22 mm/4 mm increase from baseline is marker.
The relative increase in the incidence of diabetic complications in Nigeria and Increase in the number of diabetic foot ulcer cases leading to increase in amputation of lower extremities. Depression and cognition problems are rarely assessed in patients with diabetic foot ulcer .
Study of Barthel Score among CKD Patients Belonging from Tribal Areas in Tert...ijtsrd
Chronic Kidney Disease CKD is one of the independent diseases which can lead to sever disability and it is a major emerging public health concern worldwide because it often leads to poor patient outcome 1 . Some of the associated factor with impaired functional status with CKD patients has not been fully elucidated, but some traditional such as cardiovascular diseases hypertension, myocardial ischemia , cerebrovascular diseases, and diabetes mellitus as well as non-traditional factors such as malnutrition-inflammation syndrome and depression may involve. A cross-sectional and longitudinal study has shown that risk of low functional status is directly proportional to kidney impairment 2, 3 . Thus, individuals with chronic kidney disease CKD have 40-70 higher risk of functional limitation than those without CKD 4 . In one study to assess the functional status of the CKD patients by using Barthel index found that 50 patients were dependent for the basic activities of daily life 5 In the current study, we hypothesize that there is a close relationship between the presence of CKD and the functional status of renal patients. We conducted this study with objective to assess the functional status of patients with Chronic Kidney Disease by using Barthel Index as a assessment tool on patients who were admitted under Nephrology Unite of Dr. B.R.A.M Hospital Raipur, CG. Dr. Dolly Ajwani Ratre | Rashmi Nande | Navin Kumar Ratre "Study of Barthel Score among CKD Patients Belonging from Tribal Areas in Tertiary Care Hospital, Chhattisgarh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-2 , February 2019, URL: https://www.ijtsrd.com/papers/ijtsrd20266.pdf
Paper URL: https://www.ijtsrd.com/medicine/other/20266/study-of-barthel-score-among-ckd-patients-belonging-from-tribal-areas-in-tertiary-care-hospital-chhattisgarh/dr-dolly-ajwani-ratre
Aim: To compare one Field Of View (1 - FOV) and two Field Of View (2 - FOV) photography for diabetic retinopathy detection by assessing and comparing disease level and outcome.
Methods: A retrospective audit of a random sample of 500 patients with known proliferative diabetic retinopathy (PDR or R3), and 500 non-proliferative diabetic retinopathy (NPDR or R2). Images were re-assessed according to the English program criteria for DR levels using 1-FOV.
Clinical trials established in 2005 the efficacy of Ranibizumab (Lucentis, Genentech) for the treatment of neovascular age-related macular degeneration (wetAMD), the leading cause of legal blindness in the United States.This disease is affecting people over the age of 65 with a prevalence of 1.6 million and 200000 new cases per year in the USA .While awaiting approval for ranibizumab from the Food and Drug Administration, ophthalmologists began treating neovascular AMD with off-label use of bevacizumab (Avastin, Genentech), since the drug had a target specificity similar to that of ranibizumab and was available at low cost for about 50$ per monthly injection Vs 1950$ for Lucentis monthly injection.
Ranibizumab received the FDA approuval in 2006 to treat specifically the wetAMD,there was a huge debate about the cost effectiveness and the reimbursement of Lucentis in comparaison with Avastin for treating the eye disease.
This paper explores the dilemma from different angles.First,it make the emphasize on the need of realizing a head to head comparative study between the two drugs and the means to finance and to launch this study since many roadblocks have been identified.
Then, it explores and analyzes the Genentech reaction facing this problem and their strategy to emphasize on the higher risk of death with Avastin, as compared to Lucentis in one hand and in the other hand their strategy to extend the ophthalmologic indications for Lucentis, including diabetic macula edema (DME).
Finally it explores what value should be put on safety in health technology assessments HTAs by developing that we can’t just consider the dollar value of medicine alone but we need to consider the cost of adverse events caused by the treatment and the cost of living with these adverse events
Reducing Uveitic Glaucoma: therapeutic judgement is the keyiosrphr_editor
Abstract: Background: Uveitic glaucoma (UG) due to disease and /or therapeutics is an important reason for reduced vision. Different therapeutic regimen employed in uveitis can alter the course of UG. Purpose: Evaluation of prevalence of UG with different commonly used therapy. Study design: Randomised prospective hospital based study Study Period: 2007-2012 Methods: Baseline IOP; Field and optic nerve head photographs were recorded. Three groups were randomised: 1.topical steroid 2.Systemic steroid +gr 1, 3.Topical synthetic steroids, cycloplegic and periorbital triamcinolone injection. Outcome measure: IOP more than 22 mm/4 mm increase from baseline is marker.
open-globe injuries in palestinePalestine: epidemiology and factors associate...Riyad Banayot
Background: The purpose was to describe the epidemiology of open-globe injury (OGI) in Palestine and identify
the prognostic factors associated with profound visual loss.
Materia l and methods: The current study is a retrospective review of hospital files for 83 consecutive patients
with OGI who presented to St. John Eye Hospital, Jerusalem, within 5 years, between 2009 and 2013. Demographic
details included age, gender, wound characteristics, and visual acuity (VA). The Ocular Trauma Classification Group
was used for wound location, classification, and scoring for each case.
Results: We identified 83 OGI that presented to St. John eye hospital. The study group included 62 males and
21 females. The mean age was 16.66 years ± 3.216. The most frequent injuries were playground injuries (59%),
followed by workplace injuries (26.5%). Penetrating injuries represented 45.8% of injuries, and rupture globes
occurred in 39.8% of cases. The most frequent objects causing injury were metal (31.3%) and stone (20.5%). Kinetic
impact projectiles were a statistically significant poor prognostic factor for the visual outcome. Variables that
were statistically significant poor prognostic factors for visual outcome included: retinal detachment, macular scar,
vitreous hemorrhage.
Conclusi on: This study showed that the act of demonstration, street injuries, kinetic impact projectiles, zone III
injuries, globe disruption, retinal detachment, vitreous hemorrhage, and a poor VA at the first visit are poor prognostic
factors for OGI. Recognition of these prognostic factors will help the ophthalmologist evaluate the injury
and its prognosis.
Inter grader agreement in the diabetic retinopathy screening program in pales...Riyad Banayot
This audit aims to assess the quality and accuracy of primary graders in the diabetic retinopathy screening program in the occupied Palestinian territories
Benign orofacial lesions in Libyan population a 17 years retrospective studyZiad Abdul Majid
Abstract: Objectives: To analyze the frequency and type of benign orofacial lesions submitted for diagnosis at Tripoli Medical Centre over 17 years period (1997-2013). Materials and Methods: Entries for specimens from patients were retrieved and compiled into 9 diagnostic categories and 82 diagnoses. Results: During the 17 years period, a total of 975 specimens were evaluated, it comprised a male-female ratio of 0.76:1. The mean age of biopsied patients was 36.3±18.32 years. The diagnostic category with the highest number of specimens was skin and mucosal pathology (22.87%); and the most frequent diagnosis was pyogenic granuloma (14.05%). Conclusion: Pyogenic granuloma, lichen planus, radicular cyst and fibroepithelial polyp were found to be the most predominant diagnoses. Frequencies of most benign orofacial diseases were comparable to similar studies in the literature and to those reported from the eastern region of Libya. Further surveys are needed to define the epidemiology of orofacial diseases in Libyan population.
Incidence of Glaucoma & Diabetic Retinopathy in Patients with Diabetes Mellit...QUESTJOURNAL
Background: Vision is a means of communication of man with the external world. The impact of visual loss due to various ocular morbidities has profound implications for the person affected and the society as a whole. Diabetes has become one of the world’s most important public health problems & WHO indicate that 19% of world’s diabetic population lives in India. Diabetes related microvascular complications cause visual disability even in younger age group individuals. Aim: To estimate the magnitude of Glaucoma and diabetic retinopathy in diabetic patients in our institution. To create awareness about avoidable blindness in diabetic patients.To enlighten and thereby motivate the patient for further evaluation and follow up. Materials and methods: The study is a hospital- based , non- interventional, cross-sectional study. The ocular disorders are evaluated in 500 consecutive diabetic patients attending ophthalmology out patient department of Kanyakumari medical college hospital. Estimation of visual acuity, slit lamp examination, intraocular pressure, retinoscopy & fundus examination, visual field analysis , gonioscopy are done to detail the defective vision. Result analysis Data is analysed using SPSS. The common manifestations are cataract- 346 (69%), diabetic retinopathy- 94 patients (18.8%), glaucoma– 34 (6.8%). Patients with cataract are well managed by cataract extraction techniques. Prime importance is to create awareness and also diagnose the early changes of retinopathy and glaucoma.Treatment of glaucoma if instituted early will go a long way in preventing avoidable blindness Therefore periodic visual screening along with control of hyperglycemia and associated risk factors is needed to ensure good quality of vision.
Ocular Manifestations In Sickle Cell Disease – A Preventable Cause Of Blindness?iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
:Extraocular foreign bodies (EOFBs) are a common presentation to the emergency
department (ED). Given that inadequate management can result in severe complications including visual
impairment, ED clinicians may be overly cautious and often schedule patient reviews in the ED even
where it is unnecessary, placing a burden on hospital resources.
Clinical and dermographics profile of glaucoma patients in Hebron - Palestin...Riyad Banayot
ABSTRACT
BACKGROUND: The purpose of the study was to describe the clinical profile of glaucoma types, treatment modalities, visual outcomes, and intraocular pressure (IOP) control for patients in Palestine.MATERIAL AND METHODS: Data collection was done through the hospital record review, which included basic demographics including file number, age, sex, family history of glaucoma, history of anti-glaucoma and steroid medication, history of ocular trauma or surgery, etiology of secondary glaucoma and history of systemic illness. All the patients had a comprehensive eye examination, including visual acuity, intraocular pressure, vertical cup-disc ratio, and gonioscopy. Data were obtained, tabulated, and organized using Microsoft Excel, and statistical analyses were done using Wizard Version 1.9.49 by Evan Miller.RESULTS: There were 100 females with a mean age of 53 and 101 males with a mean age of 67. Primary open-angle glaucoma and its variants represented 45.3% of all patients, while secondary glaucoma represented 40.3% and primary angle closure glaucoma represented 10.4%. The prevalence of glaucoma increased with age, and the last visual acuity (VA) showed that 39.2% of eyes had Normal/near normal VA. The highest average IOP of 25 mm Hg was recorded among secondary glaucoma patients. Of all glaucoma eyes studied, 64% were on one or two medications, and the most common surgical procedures performed were peripheral iridectomy 18.2% followed by trabeculectomy 15.5%. CONCLUSION: Primary open-angle glaucoma (POAG) was the predominant glaucoma. Glaucoma increased significantly with advancing age. Pseudoexfoliation and neovascular glaucoma comprised the majority of secondary glaucoma.
Acute ocular chemical injury: a descriptive assessment and management review ...Riyad Banayot
Background: The purpose of the study was to assess caregivers’ compliance with the management protocol for
chemical injury at St. John Eye Hospital, Jerusalem.
Materia l and methods: Charts of all new chemical injury patients who presented to St. John Eye Hospital,
Jerusalem, between January and December 2019 were retrospectively reviewed. Data categories collected included:
Presentation, age, sex, injury, irrigation, lids, visual acuity, slit-lamp examination (SLE), management plan, and
medications given. Data were stored and analysed using Excel.
Results: Patients’ presentation date and time, sex, and age were recorded in over 90% of cases. The mechanism of
injury and type of offending chemical were recorded in 65% of cases. The irrigating solution was identified in 50%
of cases. Corrected visual acuity was recorded in both eyes in almost 50% of cases. Limbal ischemia was documented
in 45% of cases, and intraocular pressure (IOP) was recorded in 25%. The management plan and explanation of the
condition to patients were documented in less than 50% of cases. Antibiotics and steroids (drops/ointment) were
prescribed in 92.5% of cases.
Conclusi ons: The results of this study reveal that our documentation needs improvement for several parameters.
Several recommendations were formulated:
1. Emphasize to caregivers that irrigation must be done first.
2. Corrected visual acuity should be attempted for both eyes in all cases, and reasons for not recording it should be
documented.
3. It is important to document and record limbus details, iris details, and IOP in all cases.
Use of digital retinal camera to detect prevalence and severity of diabetic ...Riyad Banayot
ABStrAct
BAckGround: The purpose of this study was to determine the prevalence of diabetic retinopathy among Palestinian
refugees serviced by the Diabetic Retinopathy Screening Program in the Occupied Palestinian Territories (DRS-
-OPT).
MAterIAl And MethodS: This is a retrospective study of retinal images of 1891 diabetic patients in 15 urban
UNRWA clinics participating in the DRS-OPT program in Palestine over 12 months. A nonmydriatic Canon CR-2
fundus retinal camera was used to capture two 450 non-stereo fundus images for each eye. Qualified graders (nurses)
performed the grading based on the DRS-OPT grading system.
reSultS: Out of the 1891 diabetic patients screened, 1694 had at least one gradable eye. 16% of patients had
diabetic retinopathy (5.7% had mild nonproliferative diabetic retinopathy, 4.3% had moderate nonproliferative
diabetic retinopathy, 1.1% had severe, moderate nonproliferative diabetic retinopathy, and 1.7% had proliferative
diabetic retinopathy. Maculopathy without retinopathy amounted to 3%. Other findings included the identification
of blinding diseases such as age-related macular degeneration and optic disc glaucomatous cupping.
concluSIonS: The retinopathy screening program using a nonmydriatic fundus camera identified diabetic retino-
pathy in 16% of diabetic Palestinian refugees. A total of 72% of these patients were diabetics with nonproliferative
retinopathy. This program can be used to prevent progression by facilitating the education of patients and early
intervention.
Bilateral lens capsule rupture in a patient with previously undiagnosed alpor...Riyad Banayot
Ophthalmologists may be the first to consider the diagnosis of Alport’s Syndrome based on lens changes. Uncontrolled Blood pressure can delay surgery during which time IOP should be monitored closely. Results of lensectomies with foldable IOL implantation are successful. To our knowledge, this is the second report of a case of bilateral lens capsule rupture in a patient with previously undiagnosed Alport’s Syndrome.
Evaluating the optic nerve head in glaucomaRiyad Banayot
The best method readily available to the clinician for performing this examination is high plus lens fundus biomicroscopy. Optimal magnification can be achieved by using a +60D lens which provides 1.5 times the magnification of a 90D lens. During this examination the patient's pupils must be maximally dilated with a combination of mydriatic agents such as 1% Tropicamide and 2.5% Phenylephrine.
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.
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
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.
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.
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
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
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.
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
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.
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
2. Banayot: Eye conditions in Palestine
Ibnosina Journal of Medicine and Biomedical Sciences ¦ Volume 10 ¦ Issue 4 ¦ July-August 2018 131
Design
Charts of all new patients who presented to St. John Eye
Hospital, Hebron, Palestine, between 2006 and 2013 were
retrospectively reviewed. Ethical approval of the study was
obtained from St. John Eye Hospital Ethics Committee.
Confidentiality of the study was maintained by concealing
the names of patients.
Dataset synthesis
Age at presentation, sex, and clinical diagnosis were extracted
from medical records. One principal diagnosis representing
the main complaint about the outpatient services sought. The
clinical diagnoses were grouped as appropriate into anatomical
categories [Table 1]. Patients were classified by age. Patients
who presented for a medical checkup and had no eye disorders
were excluded from the study.
Data analysis
Data were stored and analyzed using Wizard Data Analysis
version 1.8.5 (Evan Miller, Chicago, Illinois, USA). Results
were summarized using descriptive statistics as absolute or
relative frequencies. Relations were explored and Chi‑square
test was used to compare variables, and P < 0.05 was
considered statistically significant.
Results
Patients’ profiles
We evaluated charts of all the new patients who were seen
during the study periods 2006–2013 (n: 4986, 4847, 5473,
5238, 4528, 3974, 3615, and 3436). Patients who had no eye
disorders ranged 7%–10% and they were excluded.The highest
frequency of consultation was recorded among the age group
of 10–19 years. The highest frequency (25.2%) was in 2009
and lowest (18%) in 2013 [Figure 1a]. The review was done
on 33,183 patients. A minimal female excess (50.3%) was
seen [Figure 1b].
General patterns of eyes diseases
Refractive errors were the most common disorders seen
(22.0%–32%), followed by conjunctival diseases (21%–24%)
and cataract (8%–13%). The relative frequency of various
conditions expressed as the mean percentages is presented
in Figure 2. The frequency and pattern of eye diseases varied
across age groups [Table 2]. The difference in the presentation
by age group was particularly evident in refractive errors
among the age groups of 5–9 and 10–19 years (P < 0.001).
Conjunctival diseases were frequent among the age groups of
5–9 years up to 40–49 years (P < 0.001). Cataract was common
among patients in the age groups of 50–59 and 60–69 years.
Table 1: Anatomical and clinical categories and subcategories used to classify conditions included in the study
Conjunctiva: Conjunctivitis
(bacterial, viral, allergic), vernal
keratoconjunctivitis, dry eye,
pterygium, others
Lens: Cataract, dislocated/subluxated
lens, others
Diabetes mellitus: Proliferative
DR, Nonproliferative DR, no DR
Refractive errors: Any
Lids: Ptosis, chalazion/
stye, trichiasis/distichiasis,
blepharitis, entropion, ectropion,
others (including tumors)
Orbit: Orbital/preseptal cellulitis
inflammatory disease, vascular
lesions, thyroid eye disease, others
(including tumors)
Cornea/sclera: Keratitis (bacterial,
viral, fungal), keratoconus, bullous
keratopathy/dystrophy, scleritis,
episcleritis, others
Iris/CB/choroid: Anterior U,
posterior U, others (including
tumors, malignant melanoma,
metastasis, choroidal disease)
Glaucoma: Ocular
hypertension, normal tension
G, open‑angle G, angle‑closure
G, PXF G, secondary G,
neovascular G, others
Retina/vitreous: Retinal
detachment and breaks, RVO,
RAO, endophthalmitis, macular
disorders (ARMD, myopia, toxic),
hereditary fundus dystrophies (Best’s,
Stargardt’s, albinism cherry red, RP),
others (including retinoblastoma)
Neuro‑ophthalmology:
Papilledema, optic neuritis,
anterior ischemic optic neuropathy,
abnormal papillary reaction/
strabismus, nystagmus, migraine/
myopathy/neurofibromatosis, others
Ocular trauma:
Nonpenetrating, penetrating,
eyelid laceration, hyphema,
chemical, blunt trauma,
corneal foreign body, others
(including subconjunctival
hemorrhage)
Strabismus and amblyopia:
Convergent S, divergent S,
vertical S, amblyopia, Duane
syndrome
Congenital disorders: Congenital
G, congenital cataract, retinopathy of
prematurity, others (including tumors)
Lacrimal apparatus: Nasolacrimal
duct obstruction, dacryocystitis
(acute/chronic), others
Miscellaneous: Unclassified
elsewhere
DR: Diabetic retinopathy, G: Glaucoma, S: Strabismus, U: Uveitis, ARMD: Age‑related macular disease. RP: Retinitis pigmentosa, RVO: Retinal vein
occlusion, RAO: Retinal artery occlusion, PXF: Pseudoexfoliation, CB: Ciliary body
Figure 1: Distribution of the study population by age (a) and gender (b)
percentages over 9 years of the study
b
a
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3. Banayot: Eye conditions in Palestine
Ibnosina Journal of Medicine and Biomedical Sciences ¦ Volume 10 ¦ Issue 4 ¦ July-August 2018132
disorders and retina/vitreous morbidities were more
prominent in males than females [Table 2].
Ocular trauma and conjunctival disease
Ocular trauma represented the fifth most common disorder
seen (mean 7%) and was statistically significant (Chi‑square,
P < 0.001) among adults in the age group of 20–39 years.
Non‑penetrating injuries and corneal foreign bodies were
the most frequent presentations recorded [Figure 4a].
Conjunctival diseases were more frequent among all four age
groups (5–49 years) (Chi‑square, P < 0.001). It represented
the second most common disorder seen (mean 22%).
Conjunctivitis (bacteria, viral, and allergic) was the most
common diagnosis recorded. Figure 4b shows frequency and
distribution of conjunctival diseases. Lid diseases were the
fourth most common presentation in our study (mean 8%)
and were statistically significant among the age group of
10–29 years (Chi‑square, P < 0.001). Chalazion/stye and
Table 2: Relative frequency of common five presentations by year and gender
Year Sex Conjunctival diseases (%) Cataract (%) Diabetic eye disease (%) Strabismus (%) Refractive errors (%)
2006 Female/male 5.2/5.8 7.8/5.5 3.2/2.6 4.2/3.3 13.0/10.3
2007 Female/male 8.0/6.6 6.4/5.1 2.7/2.2 2.9/2.7 15.5/10.1
2008 Female/male 6.3/6.6 4.6/4.5 2.7/2.2 2.3/1.8 15.4/10.4
2009 Female/male 6.3/6.6 4.6/4.5 2.7/2.2 2.3/1.8 15.4/10.4
2010 Female/male 5.6/6.1 4.9/4.3 4.0/3.8 2.1/2.2 15.3/12.6
2011 Female/male 5.2/6.0 3.9/3.9 3.4/3.3 1.9/1.6 17.9/14.3
2012 Female/male 6.5/7.4 6.0/4.8 4.1/4.8 2.0/2.4 15.4/9.6
2013 Female/male 6.0/4.4 6.3/6.1 6.1/6.3 2.3/1.9 11.7/10.3
Ocular trauma was statistically significant among adults in the
age groups of 20–29 and 30–39 years (P < 0.001). Diabetes
frequency increased among older patients in the age groups
of 40–49, 60–69, and 70–79 years (P < 0.001).
Refractive errors, cataract, diabetic retinopathy, and
strabismus
Refractive errors were recorded more frequently and
statistically significant (Chi‑square, P < 0.001) among
the age groups of 5–9 and 10–19 years and represented
the most common disorders seen (mean 26%). Figure 3a
shows the frequency of refractive errors across study
periods. Cataract was more frequent among the age groups
of 50–59 and 60–69 years (Chi‑square, P < 0.001) and
represented the third most common disorder seen (mean
10%). Figure 3b shows the frequency of cataract. Diabetic
patients represented 7% of cases seen and were more
frequent among patients in the three age groups, i.e., 40–
49, 60–69, and 70–79 years (Chi‑square, P < 0.001). All
three categories (proliferative, nonproliferative, and no
diabetic retinopathy) showed a steady increase over the
study periods [Figure 3c]. Strabismus and amblyopia
cases represented 6% of cases and were more particularly
common among young children in the age group of
5–9 years (Chi‑square, P < 0.001). Convergent strabismus
was the most frequent type. Refractive errors, cataract, and
lid and lacrimal diseases were seen more in females than
males. Diabetes was more frequent among women in the
first 6 years of the study. Ocular trauma and conjunctival
Figure 2: The relative frequencies of various eye conditions seen during
the study period
Figure 3: The trends of the major primary eye conditions over the
study years, namely, refractive errors (a), cataract (b) and diabetic
retinopathy (c)
c
b
a
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4. Banayot: Eye conditions in Palestine
Ibnosina Journal of Medicine and Biomedical Sciences ¦ Volume 10 ¦ Issue 4 ¦ July-August 2018 133
blepharitis were the most common presentations recorded in
this category.
Discussion
To the best of our knowledge, this is the first study on the
spectrum of eye diseases in Palestinians. Convenience
sampling (proximity and availability) prevents this study
from assuming to be a representative of the population. Our
results show that refractive errors and cataract were the first
and third most common morbidities seen for all age groups
in this study, which is consistent with other reports, in which
uncorrected refractive errors were first[1,2]
and cataract was
second.[1,2]
Refractive errors were the most common disorders seen
(22%–32%) in the whole sample and they were the most
common morbidity seen in the 5–19‑year‑old children, in
agreement with reports from China, Bengal, Brazil,Australia,
and Kathmandu.[8‑12]
Refractive errors affect childhood
development, and in the absence of regular preschool or
school eye screening for refractive errors, many children with
refractive errors may go unnoticed and will not benefit from
such simple solution (a pair of glasses!). Refractive errors in
children aged 5–19 years increased up to 2011 but later on
showed a steady decrease. This could be partly attributed to
a “vision screening program” that was conducted in 2008 by
St. John Eye Hospital in Hebron and targeted members of the
School Health Program (Ministry of Health, Hebron) who were
conducting vision screening. The objectives of the program
were to raise the screener’s awareness and capacity in terms
of better detection of refractive errors and proper referral to
optometric services for glasses.
Conjunctival diseases (56% of which were conjunctivitis) were
the second most common disease seen for all age groups in this
study (20%–24%) and were increased among the age groups
of 5–9, 10–19, 20–29, 30–39, and 40–49 years. Our findings
concur with previous reports that allergic conjunctivitis is the
most common disorder in children.[13‑17]
Although conjunctivitis
does not result in blindness, it is one of the leading causes of
absence from school in children and from work in the adult
population with potentially serious implications on education
and productivity.
Cataract was more common in the age groups of 50–59 and
60–69 years. Cataract represented the third most common
disorder seen in this study affecting one in ten on average in
agreement with several previous studies.[1,2]
Cataract was the
leading cause of blindness (55.0%) in the Occupied Palestinian
Territories[18]
and the leading cause of visual impairment
in older Americans.[19]
Globally, cataract represents the
second most common cause of moderate and severe vision
impairment in North Africa and Middle East (18.0%).[1]
Cataract is also the second most common cause of avoidable
visual impairment (33%)[2]
worldwide and the third most
frequent cause of incidence of bilateral visual impairment in
Australia.[11]
Diabetes mellitus represents the fifth common cause of
presentation in this study (around 7%). It is noteworthy that
percentages of diabetic patients with no signs of retinopathy
were increasing from 1% to 4% over the study period, while
the percentages of diabetics diagnosed with proliferative
retinopathy also showed an increase from 2% to 5% over
the study period. Diabetic retinopathy represented the
fifth cause of moderate and severe vision impairment in
North Africa and Middle East (2.4%) and the fifth cause of
blindness (3.5%).[1]
There are limited data on the prevalence
of diabetes mellitus and diabetic retinopathy in Palestine.
One study suggested that the prevalence of diabetes in men
and women aged 30–65 years was 11.3% and 13.9% in rural
and urban populations, respectively,[20]
and another study
reported self‑reported diabetes mellitus at 26.4% in the
over 50‑year‑old people.[18]
In 2012, St. John of Jerusalem
Eye Hospital, in partnership with the United Nations Relief
and Works Agency for Palestine Refugees, initiated a 3‑year
screening, treatment, and management program for diabetic
retinopathy among diabetic patients in East Jerusalem and the
West Bank, including the refugee population of the southern
districts of the West Bank (Bethlehem and Hebron). The
program aimed to reduce the proliferation of preventable
diabetic retinopathy in the occupied Palestinian territory. An
estimated 40,000 patients were screened over 3 years of the
project. The primary objective of the screening component
of the project was to detect the maximum number of cases
of sight‑threatening retinopathy and refer them for further
examination and management by an ophthalmologist
Figure 4: Trends in the relative frequencies of types of ocular trauma (a)
and conjunctival conditions (b) over the study period
b
a
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5. Banayot: Eye conditions in Palestine
Ibnosina Journal of Medicine and Biomedical Sciences ¦ Volume 10 ¦ Issue 4 ¦ July-August 2018134
while retaining those with nonsight‑threatening disease
under periodic review. The final outcomes of the program
are eagerly awaited. In the older age groups, the present
study demonstrated that diabetes mellitus and cataract are
significantly increased. This association may explain the
earlier report of posterior segment disease being found in
proportionally more patients presenting with “borderline”
and “poor” outcomes postphacoemulsification and that the
majority of these patients had diabetic retinopathy.[21]
Trauma and injury affected 7% of all cases seen in this study
and were significantly increased in young adults in the age
groups of 20–29 and 30–39 years. Nonpenetrating injury and
corneal foreign bodies represented 59.5% of cases in this
category. The high frequency of injuries in these age groups
can be attributed to work in construction by this age group and
the common neglect of protective goggles at work. Our results
are at variance from different previous reports where trauma
injury in children ranked as the first, second, third, or fourth
most common disorder.[14‑16,22]
Strabismus and amblyopia represented 6% of all cases seen
in our study and were particularly seen in the age groups of
0–4 and 5–9 years. Other studies showed that for children
aged 0–15 years, trauma was the most common morbidity
in Nigeria,[22]
allergic conjunctivitis was the most common
in Ethiopia,[13]
and refractive errors were the most common
form in China,[8]
Bengal,[16]
and Iraq.[17]
Furthermore, refractive
errors were the most common morbidity seen in patients
between 5 and 19 years’ age group, and strabismus was
most commonly seen among the 0–9‑year‑old children. The
study also lends support to the reported association between
refractive error and specific forms of strabismus.
The study is limited by its retrospective design, hospital chart
rather than whole community as the basis, and potential for
selection bias introduced by self or professions referrals.
These limitations could have increased the number of more
severe cases and consequently overestimated the frequency
and morbidity of eye diseases in our sample compared to the
background population. However, the study remains the first
study of its nature in Palestine, and being from a large referral
hospital, it must reflect the spectrum of ocular morbidity in
our community.
Conclusions
The most common causes of ocular morbidity in decreasing
frequency were refractive errors, conjunctivitis, cataract,
chalazion/stye and blepharitis, diabetic retinopathy,
nonpenetrating trauma and foreign body, and convergent
strabismus. Most of these morbidities are either treatable or
preventable and require attention of all health professionals for
complete management because they lead to visual impairment
and probably blindness. Programs that raise the capacity of
health providers and screening programs should be conducted
regularly and preferably conducted in partnership with all
health service providers.
Authors’ contributions
The author is responsible for conception of the study, data
collection and analysis and for drafting, revising and approving
the final version of the manuscript.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Compliance with ethical principles
Ethical approval was granted by the St John’s Hospital Ethical
Committee. All data were de‑identified before analysis. No
consent was possible in such a retrospective study.
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Reviewers:
Essam Osman (Riyadh, Saudi Arabia)
Nehal Elgendy (Cairo, Egypt)
Editors:
Salem A Beshyah (Abu Dhabi, UAE)
Elmahdi Elkhammas (Columbus, Ohio, USA)
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