The document discusses thyroid ultrasound techniques, anatomy, pathologies, and diseases. It provides details on:
1. Indications for thyroid ultrasound including evaluating nodules, diffuse changes, and post-operative evaluation.
2. Techniques including using a high-frequency linear probe in transverse and longitudinal planes with color Doppler.
3. Common pathologies include multinodular goiter, Hashimoto's thyroiditis, Graves' disease, and thyroid cancers. Features helpful for characterizing benign versus malignant nodules are described.
Description of various ultrasound features of benign and suspicious thyroid nodules with multiple ultrasound systems for risk stratification of malignancy.
Description of various ultrasound features of benign and suspicious thyroid nodules with multiple ultrasound systems for risk stratification of malignancy.
Sonographic evaluation of breast Dr. Muhammad Bin Zulfiqar
In this we will discuss role of high resolution Ultrasound in breast pathologies.
We will further discuss the role of Elastography in characterization of BIRADS.
In this presentation we will discuss role of high resolution in characterizing normal variant and pathologies of spinal pathologies.
This is a pictoral review.
Sonographic evaluation of breast Dr. Muhammad Bin Zulfiqar
In this we will discuss role of high resolution Ultrasound in breast pathologies.
We will further discuss the role of Elastography in characterization of BIRADS.
In this presentation we will discuss role of high resolution in characterizing normal variant and pathologies of spinal pathologies.
This is a pictoral review.
Scrotal Masses
98-100% accuracy in distinguishing intra and extra-testicular masses.
*** Most extratesticular masses are benign & most intratesticular masses are malignant
Malignant lesions are msotly hypoechoic.
Malignant neoplasia pts usually presents as
painless , unlateral testicular mass .
Clinically it is important to differentiate between Seminomas and Non Seminomatous germ cell tumors.
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
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.
- 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
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
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
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!
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
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
21. Congenital and Developmental Anomalies of Thyroid Gland
Thethyroidglandprimordiumdevelopsfrommedianeminenceinthefloorofprimitivepharynx(apointlaterknownasforamencecumatthebaseoftongue)during4thweekofgestation.Fromforamencecum,theprimitiveprimordiumdescendsthroughanteriormidlineportionofthenecktoreachitsfinalpositionbelowthyroidcartilageby7thweekofgestation.
29. Diseases of Thyroid Gland
Theincidenceofallthyroiddiseasesishigherinfemalesthaninmales.Nodularthyroiddiseaseisthemostcommoncauseofthyroidenlargement.Majorityofpatientswiththyroiddiseasepresentwithmidlineneckswelling, occasionallycausingdysphagiaandhoarsenessofvoice.
30. Broadly the thyroid diseases are classified into three categories:
•(i) benign thyroid masses,
•(ii) malignant tumors of thyroid gland, and
•(iii) diffuse thyroid enlargement
33. Other features to characterize nodule
•size<1 cm, width > length. Size of the nodule is also helpful. The size of the nodule increase with age, so follow up is helpful. Although 90 percent of the benign nodules can also increase in volume by 50% in 5 years.
34. Other features to characterize nodule
•Texture: thyroid nodules may either be hypo echoic, Isoechoicor hyperechoic. It may be solid, cystic or mixed.
•Hyperechoic nodules with internal cystic areas are benign in nature. But hyper echoic nodule with thick external hollow is a sign of malignant nodule. But hyper echogenicity without thick peripheral hallow is a strong feature of benign nodule.
•Malignant nodules are mostly hypoechoic but it is not necessary for all hypoechoic nodules to be malignant. Because most of the thyroid nodules are benign in nature that’s why most of the hypoechoic nodules are benign
42. Other features to characterize nodule
•Calcification: calcification is common in benign as well as in malignant nodules but it is more probably malignant if found in solitary nodules.
•Micro calcination <2mm is most commonly found in malignant nodule.
47. Other features to characterize nodule
•Margins
•Margins may be smooth, speculated, micro-labulated, or Ill defined. Spiculatedmargins are strongly suggestive of malignancy.
48. Other features to characterize nodule
•presence of hypoechoic halo
•It is caused either by nodular capsule or by the compression of the thyroid tissue.
•It may either be thin or thick and regular or irregular
•Thin and regular is suggestive of benign
•While thick and irregular more probability of malignancy.
49.
50. Other features to characterize nodule
•Vascularity
•There are three paternof vascular distribution in the tumer.
•Type one: absence of flow
•Type two: peripheral vascularity
•Type three: internal flow. ( associated with malignancy)
99. Advanced Ultrasound Techniques in Thyroid Imaging
Ultrasoundelastographyisadynamictechniquethatestimatesstiffnessoftissuesbymeasuringthedegreeofdistortionunderexternalpressure.Thyroidglandelastographyisusedtostudyhardness/elasticityofthethyroidnoduletodifferentiatemalignantfrombenignlesions.Abenignnoduleissofteranddeformsmoreeasily,whereasthemalignantnoduleisharderanddeformslesswhencompressedbyultrasoundprobe.
100. Advanced Ultrasound Techniques in Thyroid Imaging
Theelastographytechniqueutilizesexternalcompressiontodifferentiatemalignantthyroidnodulesfrombenignlesions.Itdeterminestheamountoftissuedisplacementatvariousdepths,byassessingtheultrasoundsignalsreflectedfromthetissuesbeforeandaftercompression.Dedicatedsoftwarethenprovidesanaccuratemeasurementoftissuedistortionanddisplaysitvisuallyasanelastographicimage.
101. Advanced Ultrasound Techniques in Thyroid Imaging
Theelastographicimage(elastogram)displayedovertheB-modeimageinacolorscale,indicateslocaltissueelasticityas(i)verysoftinbluecolorfortissuewithgreatestelasticstrainand(ii)veryhardinredcolorfortissuewithnostrain.Real-timeshearelastographyisalatesttechnique;thatcharacterizesandquantifiestissuestiffnessbetterthanconventionalelastography.
102. Advanced Ultrasound Techniques in Thyroid Imaging
CysticlesionsandcalcifiednodulesareexcludedfromUSelastographicevaluation.USelastographyhelpsincharacterizingacytologicallyindeterminatenoduleasmalignantorbenignwithhighaccuracythatisalmostcomparabletoFNACandobviatestheneedofunnecessaryFNAexamination.ThemajorlimitationofUSelastographyisthatitcannotassessthelesionswhicharenotsurroundedbyadequatenormaltissue.
103. Advanced Ultrasound Techniques in Thyroid Imaging
Contrast-enhancedultrasound(CE-US)isanewlydevelopedtechniquethathelpsincharacterizingathyroidnodule.OnCE-US,enhancementpatternsaredifferentinbenignandmalignantlesions.Ringenhancementispredictiveofbenignlesions,whereasheterogeneousenhancementishelpfulfordetectingmalignantlesions. However,overlappingfindingsseemtolimitthepotentialofthistechniqueinthecharacterizationofthyroidnodules.Useofspecificcontrast(e.g.SonoVue)andpulseinversionharmonicimagingfurtherimprovestheefficacyofultrasoundindiagnosingamalignantthyroidnodule.
104. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Severalstudieshavebeenconductedtoevaluatetheroleofultrasoundusingelastographyandcontrastagentinthecharacterisationofthyroidnodules.
105. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Astudy(doneon23thyroidnodules)wasconductedbyFSFerrarietal.in2008,todifferentiatebenignfrommalignantthyroidnodule,usingbothelastographyandCE-US.Elastographyyieldedasensitivityof88%, specificityof78%,positivepredictivevalue(PPV)of71%,negativepredictivevalue(NPV)of91%anddiagnosticaccuracy(DA)of82%;andCE-USyieldedasensitivityof100%,specificityof71%,PPVof69%, NPV100%andDAof83%
106. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Anotherstudy(samplesize90)wasdonebyYHongetal.in2009toevaluatethediagnosticutilityofreal- timeultrasoundelastographyindifferentiatingbenignfrommalignantthyroidnodules.Accordingtothisstudy,elastographyyieldedasensitivityof88%, specificityof90%,PPVof81%andNPV93%
107. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Arecentstudy(doneon703thyroidnodules)publishedbyMoonetal.in2012evaluatedthediagnosticperformanceofgray-scaleUSandelastographyindifferentiatingsolidthyroidnodules.Accordingtothestudy,thesensitivityandNPVfordifferentiatingbenignfrommalignantthyroidnodulesongrayscaleUSare91%and94.7%respectively,andonUSelastographyare65.4%and79.1%respectively.TheyconcludedthatelastographyaloneorincombinationwithgrayscaleUSisnotausefultoolindifferentiatingbenignfrommalignantthyroidnodules.
108. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Anotherstudy(samplesize72)hasbeendonerecentlybyMGiustietal.in2012,inwhichtheyhaveevaluatedtheroleofultrasound,elastographyandCE-USinscreeningofthyroidnodules.TheyfoundthattheultrasoundscoreshowedhighspecificityandPPVwhencomparedwithelastographyandCE-US.BothelastographyandCE-USwereexpensive,timeconsumingandoflimitedutilityinselectingpatientsforthyroidectomy
109. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Inshort,somestudiesshowveryhighsensitivityandspecificityofUSelastography;intherangeof85-90%. Onthecontrary,therearestudieswhichshowitssensitivityaslowas65%andless(comparefromthesensitivityofgray-scaleUSwhichisintherangeof90to95%).
110. Current Status of US Elastographyand CE-USG in Characterisationof Thyroid Nodules
Thus,althoughelastographyandCE-USappearpromisingimagingtechniques,theyneedtobestandardized.Atpresent, theyseemtobeexpensive,timeconsumingandoflimitedutilityinselectingpatientsforsurgery.LargerprospectivestudiesareneededtoestablishthediagnosticaccuracyandcosteffectivenessofthesetechniquesoverconventionalgrayscaleandcolorDopplerimaging
112. Conclusion
It is the imaging modality of choice for evaluating thyroid masses in children and pregnant females. Real time USG also helps to guide the diagnostic and therapeutic interventional procedures in various thyroid diseases.